2020 - Sept/Oct TFDA

2019 Dentists’ on theCrown Hill - March 11-12, 2019 - Page FDC2021 Speaker Day Preview: Lengthening — See Page248

VOL. 32, NO. 6 • SEPTEMBER/OCTOBER • AESTHETICS ISSUE

The Cosmetic Challenge of Cleft Palate Repair

A New Face in Dentistry

Is it Esthetic or Aesthetic?

Cosmetic Dentistry as a Business Model

FDAPAC-SUPPORTED CANDIDATES

A PUBLICATION OF THE FLORIDA DENTAL ASSOCIATION

We work for you.

Dr. Noel Rodriguez

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Thanks Mike, for the rapid response, service and great job when I needed health insurance!

Mike Trout, Your North Florida Agent 904.254.8927 | mike.trout@fdaservices.com

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HELPING MEMBERS SUCCEED VOL. 32, NO. 6 • September/October 2020

A PUBLICATION OF THE FLORIDA DENTAL ASSOCIATION

CAUTION

in every issue 3 Staff Roster 5 President's Message 10 Did You Know?

12 Info Bytes

28

Florida Board of Dentistry Discusses Lasers

32

The Cosmetic Challenge of Cleft Palate Repair

74 Career Center 75 Advertising Index

38

Cosmetic Dentistry as a Business Model

76 Off the Cusp

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42

Is it Esthetic or Aesthetic?

Job Reference Requests

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58

So, What Exactly is a Security Risk Analysis?

18 news@fda 71 Diagnostic Discussion

52

Data Management for Digital Prescriptions Between the Lab and Dental Office

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62

12 Tips to Engage with Your Patients and Respond to Reviews Online

66

Moving to the Cloud vs.

Built for the Cloud

A New Face in Dentistry

FDAPAC-supported Candidates

17

DIY Dentistry Poses Risks for Floridians

48

FDC2021 Speaker Preview: Crown Lengthening

TODAY'S FDA ONLINE: floridadental.org

American Sensor Tech

FLORIDA DENTAL ASSOCIATION SEPTEMBER/OCTOBER 2020 VOL. 32, NO. 6

EDITOR Dr. John Paul, Lakeland, editor

STAFF Jill Runyan, director of publications Jessica Lauria, communications and media coordinator Andrew Gillis, graphic design coordinator

BOARD OF TRUSTEES Dr. Andy Brown, Orange Park, president Dr. Dave Boden, Port St. Lucie, president-elect Dr. Gerald Bird, Cocoa, first vice president Dr. Beatriz Terry, Miami, second vice president Dr. Jeffrey Ottley, Milton, secretary Dr. Rudy Liddell, Brandon, immediate past president Drew Eason, CAE, Tallahassee, executive director Dr. Dan Gesek, Jacksonville • Dr. Karen Glerum, Boynton Beach Dr. Reese Harrison, Lynn Haven • Dr. Bernard Kahn, Maitland Dr. Gina Marcus, Coral Gables • Dr. Irene Marron-Tarrazzi, Miami Dr. Eddie Martin, Pensacola • Dr. Rick Mullens, Jacksonville Dr. Paul Palo, Winter Haven • Dr. Howard Pranikoff, Ormond Beach Dr. Mike Starr, Wellington • Dr. Stephen Zuknick, Brandon Dr. Don Ilkka, Leesburg, speaker of the house Dr. Rodrigo Romano, Miami, treasurer • Dr. John Paul, Lakeland, editor

PUBLISHING INFORMATION

Aftco

Today’s FDA (ISSN 1048-5317/USPS 004-666) is published bimonthly, plus one special issue, by the Florida Dental Association, 545 John Knox Road, Ste. 200, Tallahassee, Fla. 32303 .

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

Periodical postage paid at Tallahassee, Fla. and additional entry offices. Copyright 2020 Florida Dental Association.

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

POSTMASTER: Please send form 3579 for returns and changes of address to Today’s FDA, 545 John Knox Road, Ste. 200, Tallahassee, Fla. 32303.

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

EDITORIAL CONTACT INFORMATION All Today’s FDA editorial correspondence should be sent to Dr. John Paul, Today’s FDA Editor, Florida Dental Association, 545 John Knox Road, Ste. 200, Tallahassee, Fla. 32303.

FDA office numbers: 800.877.9922, 850.681.3629; fax 850.561.0504; email address, fda@floridadental.org; website address, floridadental.org.

ADVERTISING INFORMATION For display advertising information, contact: Deirdre Rhodes at rhodes@floridadental.org or 800.877.9922, Ext. 7108.

For career center advertising information, contact: Jessica Lauria at jlauria@floridadental.org or 800.877.9922, Ext. 7115.

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

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TODAY'S FDA SEPTEMBER/OCTOBER 2020

FLORIDADENTAL.ORG

CONTACT THE FDA OFFICE 800.877.9922 OR 850.681.3629 545 John Knox Road, Ste. 200 • Tallahassee, FL 32303

EXECUTIVE OFFICE DREW EASON, Executive Director deason@floridadental.org 850.350.7109

FLORIDA DENTAL CONVENTION (FDC)

GREG GRUBER, Chief Operating Officer/ Chief Financial Officer ggruber@floridadental.org 850.350.7111

CRISSY TALLMAN Director of Conventions and Continuing Education ctallman@floridadental.org 850.350.7105

CASEY STOUTAMIRE, Director of Third Party Payer and Professional Affairs cstoutamire@floridadental.org 850.350.7202

BROOKE MARTIN, FDC Marketing Coordinator bmartin@floridadental.org 850.350.7103

JUDY STONE, Leadership Affairs Manager jstone@floridadental.org 850.350.7123 LIANNE BELL, Leadership Concierge lbell@floridadental.org 850.350.7114

ACCOUNTING BREANA GIBLIN, Director of Accounting bgiblin@floridadental.org 850.350.7137 LEONA BOUTWELL, Finance Services Coordinator Accounts Receivable & Foundation lboutwell@floridadental.org 850.350.7138 DEANNE FOY, Finance Services Coordinator Dues, PAC & Special Projects dfoy@floridadental.org 850.350.7165 APRELL GRIFFIN, FDAS Commission Coordinator aprell.griffin@fdaservices.com 850.350.7142 MITZI RYE, Fiscal Services Coordinator mrye@floridadental.org 850.350.7139

DEIRDRE RHODES, FDC Exhibits Coordinator drhodes@floridadental.org 850.350.7108 EMILY SHIRLEY, FDC Program Coordinator eshirley@floridadental.org 850.350.7106 EMILY SOMERSET, FDC Meeting Assistant esomerset@floridadental.org 850.350.7162

GOVERNMENTAL AFFAIRS JOE ANNE HART Chief Legislative Officer jahart@floridadental.org 850.350.7205 ALEXANDRA ABBOUD Governmental Affairs Liaison aabboud@floridadental.org 850.350.7204 TATIANA AHLBUM Governmental Affairs Legislative Assistant tahlbum@floridadental.org 850.350.7203

INFORMATION SYSTEMS

FDA SERVICES 800.877.7597 or 850.681.2996 545 John Knox Road, Ste. 201 Tallahassee, FL 32303 Group & Individual Health • Medicare Supplement • Life Insurance Disability Income • Long-term Care • Annuities • Professional Liability Office Package • Workers’ Compensation • Auto • Boat

SCOTT RUTHSTROM Chief Operating Officer scott.ruthstrom@fdaservices.com 850.350.7146 CAROL GASKINS Commercial Accounts Manager carol.gaskins@fdaservices.com 850.350.7159 MARCIA DUTTON Membership Services Assistant marcia.dutton@fdaservices.com 850.350.7145 PORSCHIE BIGGINS Central Florida Membership Commercial Account Advisor pbiggins@fdaservices.com 850.350.7149 MARIA BROOKS South Florida Membership Commercial Account Advisor maria.brooks@fdaservices.com 850.350.7144 KELLY DEE Atlantic Coast Membership Commercial Account Advisor kelly.dee@fdaservices.com 850.350.7157 MARRISA LEE North Florida Membership Commercial Account Advisor marrisa.lee@fdaservices.com 850.350.7122

STEPHANIE TAYLOR, Membership Dues Coordinator staylor@floridadental.org 850.350.7119

LARRY DARNELL Director of Information Systems ldarnell@floridadental.org 850.350.7102

COMMUNICATIONS AND PUBLICATIONS

RACHEL STYS, Systems Administrator rstys@floridadental.org 850.350.7153

RENEE THOMPSON Director of Communications and Marketing rthompson@floridadental.org 850.350.7118

MEMBER RELATIONS

MELISSA STAGGERS West Coast Membership Commercial Account Advisor melissa.staggers@fdaservices.com 850.350.7154

KERRY GÓMEZ-RÍOS Director of Member Relations krios@floridadental.org 850.350.7121

TESSA DANIELS Commercial Account Advisor tessa.daniels@fdaservices.com 850.350.7158

MEGAN BAKAN Member Access Coordinator mbakan@floridadental.org 850.350.7100

LIZ RICH Commercial Account Advisor liz.rich@fdaservices.com 850.350.7171

JOSHUA BRASWELL Membership Coordinator jbraswell@floridadental.org 850.350.7110

ARIEL WORD Commercial Account Advisor a.word@fdaservices.com 850.350.7151

JILL RUNYAN, Director of Publications jrunyan@floridadental.org 850.350.7113 AJ GILLIS, Graphic Design Coordinator agillis@floridadental.org 850.350.7112 JESSICA LAURIA Communications and Media Coordinator jlauria@floridadental.org 850.350.7115

FLORIDA DENTAL ASSOCIATION FOUNDATION (FDAF) R. JAI GILLUM, Director of Foundation Affairs rjaigillum@floridadental.org 850.350.7117 KRISTIN BADEAU, Foundation Coordinator kbadeau@floridadental.org 850.350.7161

FLORIDADENTAL.ORG

CARRIE MILLAR Director of Insurance Operations carrie.millar@fdaservices.com 850.350.7155

YOUR RISK EXPERTS DAN ZOTTOLI, SBCS, DIF, LTCP Director of Sales — Atlantic Coast 561.791.7744 Cell: 561.601.5363 dan.zottoli@fdaservices.com DENNIS HEAD, CIC Director of Sales — Central Florida 877.843.0921 (toll free) Cell: 407.927.5472 dennis.head@fdaservices.com MIKE TROUT Director of Sales — North Florida Cell: 904.254.8927 mike.trout@fdaservices.com

JOSEPH PERRETTI, SBCS Director of Sales — South Florida 305.665.0455 Cell: 305.721.9196 joe.perretti@fdaservices.com RICK D’ANGELO, CIC Director of Sales — West Coast 813.475.6948 Cell: 813.267.2572 rick.dangelo@fdaservices.com

CHRISTINE TROTTO Membership Concierge ctrotto@floridadental.org 850.350.7136

The last four digits of the telephone number are the extension for that staff member.

To contact an FDA Board member, use the first letter of their first name, then their last name, followed by @bot.floridadental.org.

For example, Dr. John Paul: jpaul@bot.floridadental.org.

TODAY'S FDA SEPTEMBER/OCTOBER 2020

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6

leadership

OUT OF THE ASHES I had the pleasure of going to the American Dental Association (ADA) State PresidentsElect Conference in Chicago last year and was involved with a presentation of the new “consumerism” becoming prevalent in many aspects of dentistry. Dr. Marko Vujicic, chief economist and vice president of the ADA, discussed patients’ changing attitudes and acceptance regarding many aspects of the dental experience. He also described the attributes of many dental systems that are now almost fully digitally integrated in the front offices we own, as well as the changes to many clinical components of the methods we use to practice.

So, out of the flames of this pandemic, what changes have you brought out of the ashes and implemented within your office and/ or systems? With an emphasis on the front office, how many have embraced and implemented more communication opportunities with your staff, patients and prospective patients? How many are using the full aspects of your proprietary software with text and email options that you had plenty of time to research and learn while we were idled? In that same vein, is your social media presence adequate?

In the face of touchless systems and minimizing potential extraneous contamination in my orthodontic practice — and with my clienteles’ ages for the most part — how many have video conferencing with parents elsewhere (in the car, for instance?) during the patient’s visit, from the meet and greet to FLORIDADENTAL.ORG

the care given to the subsequent scheduling “live and in-person” throughout? How many offices are using any downtime, hygiene or otherwise, to virtually reinforce education and prevention to those families and patients we all know need support?

Are your financial controls in place to work with your patients for financing and payment options? Whether they are third-party accounting issues or contract payment schedules, are they easily automated? Likewise, are we streamlining receiving payments, from third parties and patients’ checks and electronic-funds transfers, as well as the ubiquitous credit card payments all consumers are using? As consumers, the patients expect to pay for their health care in the same manner as other services. The digital efficiency of payments processing can impact revenue significantly.

PRESIDENT’S MESSAGE ANDY BROWN, DDS, MS FDA PRESIDENT

Dr. Brown can be reached at abrown@bot.floridadental.org.

Regarding third-party payers, there are now options for dental providers to help eliminate barriers to care and access patient benefits for those without insurance options as well.

For instance, one of the Florida Dental Association’s (FDA) partnerships is with Bento, which directly connects patients and dentists.

It has a web-based platform that has revolutionized transparency and works in real time for patients to see options for and costs of care. It helps pave the way to increase your practice revenue with less work and more transactions.

SEE PAGE 7 TODAY'S FDA SEPTEMBER/OCTOBER 2020

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leadership

FROM PAGE 5

And finally, we get to the dentistry itself. This issue of Today’s FDA presents many thoughts on aspects of the aesthetics we deal with in dentistry. Digitally, there’s so much moving forward at such a rapid pace, it’s hard to keep up. One good measure, however, is that outside of the potential steep costs of the initial purchase of some of the digital platforms, the subsequent time savings, reproducibility and predictability of the materials and restorations produced can be excellent! It’s incredibly consumer-driven in that respect!

Consumers have found, especially during the ongoing COVID-19 timelines, that a practice’s technology, software and methods can help facilitate their own time management, outcomes and certainly safety in a predictable manner. Given all the time we had on our hands from March to May this year, what other great transitions will come out of the ashes of the pandemic in the way of new technology and efficiencies? I look forward to that chapter!

Join us in Jacksonville for the 2021 Florida Mission of Mercy.

With a goal of treating 2,000 patients, FLA-MOM seeks to have a positive impact on Northeast Florida.

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FLORIDADENTAL.ORG

JACKSONVILLE 2021 FLA-MOM TODAY'S FDA SEPTEMBER/OCTOBER 2020

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human relations

JOB REFERENCE REQUESTS How should I respond to a request for a job reference by a prospective employer about a former employee? How do I answer, “Is this person eligible for rehire?”

DEBORAH S. MINNIS

Ms. Minnis practices labor and employment law at Ausley McMullen, and she also represents various local government bodies. She can be reached at dminnis@ausley.com.

This article is for informational purposes only and is not intended to be a substitute for professional legal advice.

If you have a specific concern or need legal advice regarding your dental practice, you should contact a qualified attorney.

1.

If you are asking these questions, chances are that the information you have about the former employee is not favorable or perhaps they were just not a stellar employee. The question most former employers dread — “Is this person eligible for rehire?” — is inevitable. Using caution in responding to reference requests is understandable given today’s litigious society.

The types of claims filed against former employers relating to responding to references include claims of tortious interference with a business relationship, defamation and retaliation claims (practices with 15 or more employees).

Tortious Interference Claims For tortious interference claims, the former employee must first prove that they had a business relationship in the form of a job offer, which does not have to be in writing or even be a definite offer. Next, the employer must prove that the former employer knew about the business relationship and unjustifiably interfered with that relationship. Finally, the employee must prove that based on the reference given by the former employer, the prospective employer refused to hire the former employee or withdrew the job offer.

One of the defenses the former employer can make is to establish that the refusal to hire or the withdrawal of the offer was not connected to the reference provided.

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TODAY'S FDA SEPTEMBER/OCTOBER 2020

Defamation Claims For defamation claims, the former employee must prove that the former employer made a false statement about the employee to a third party, and that the falsity of the statement caused injury and damages to the former employee. Like tortious interference claims, the injury in the context of giving a job reference could be a potential employer refusing to hire or withdrawing an offer of employment. A defense to a defamation claim, of course, is that the information provided was a true statement. As another defense, Florida law requires that publication of the alleged defamatory statement be made to a third party, so the former employer must have told a third party. If the former employee selfdiscloses out of fear that the former employer will do so, a claim for defamation cannot be sustained.

Defenses As mentioned above, one way to defend against tortious interference and defamation claims is to show that the failure to get the job or the withdrawal of an offer was not related to or caused by the information provided in the reference. Presenting and proving this defense is reliant upon information obtained from the prospective employer about the hiring process.

Because prospective employers must make a good faith evaluation of not only the technical skills of the person that they intend to hire, but also of the individual’s personality or behavioral traits, a reference check is just one piece of information they collect. In addition to reference checks, the prospective FLORIDADENTAL.ORG

employer also may conduct criminal and investigative background and credit checks, and review public social media posts, among other things. The ultimate employment decision could have been based on a myriad of reasons unrelated to the information provided during the reference check.

In addition to the general defenses above, Florida has enacted a law that gives former employers protection from lawsuits for providing information to prospective employers about a former employee’s job performance. The former employee can only defeat the protection by showing that the information given to the prospective employer was knowingly false or was done as retaliation for the employee filing a claim against the former employer under either state or federal civil rights laws.

FLORIDADENTAL.ORG

To invoke the protection, the former employer must show that it acted in good faith in disclosing the information.

The former employer also must show that it had an interest in the subject matter or had a duty to speak on the subject matter, and a corresponding interest or duty by the listener. Finally, the former employer must demonstrate that there was a proper occasion to discuss the information and that publication of the information was done in a proper manner.

Retaliation Claims Finally, some employees sue their former employers under the retaliation provisions of the Florida and federal civil rights laws. Like the discrimination laws, these suits apply to employers with 15 or more employees. The general

allegation by the former employee is that he/she was given an unfavorable job reference because he/she filed a discrimination claim against the former employer. One defense to such an allegation is to show that the withdrawal of the job offer had no connection to the reference provided.

Conclusion Because of the litigious nature of the society we live in, there is an increasing need to conduct significant pre-hire investigations. To establish that a good faith investigation was made, prospective employers have become more insistent upon conducting thorough reference checks. An employer’s best practice in responding to employment reference checks should be to respond in good faith, be truthful and only state the facts.

TODAY'S FDA SEPTEMBER/OCTOBER 2020

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BOD

RULES FOR PATIENT RECORDS Did you know there is a Florida Board of Dentistry rule that explains when you must release, what must be included and how much you can charge for the release of patient records? Any dentist who examines or administers treatment to any person must provide copies of all reports or records, including X-rays, made during the examination or treatment to the person or his/her legal representative. You may charge a fee for copying the records. However, the cost cannot be DR. JOE CALDERONE FDA LIAISON TO THE FLORIDA BOARD OF DENTISTRY

greater than the cost per page charged by the clerk of the county court where you practice and the fee for copying X-rays cannot exceed your actual cost of duplication. Finally, you must comply with a patient’s written request for copies of the records in a timely manner, which means less than 30 days, taking into account the patient’s health needs.

CASEY STOUTAMIRE FDA DIRECTOR OF THIRD PARTY PAYER & PROFESSIONAL AFFAIRS

If you have any questions, please contact Director of Third Party Payer and Professional Affairs Casey Stoutamire, Esq. at cstoutamire@floridadental.org or 850.350.7202, or FDA Liaison to the Florida Board of Dentistry Dr. Joe Calderon at drcalderone@gmail. com or 407.509.1493.

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TODAY'S FDA SEPTEMBER/OCTOBER 2020

FLORIDADENTAL.ORG

FDA Online Radiography Training Program

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info bytes

SO, YOU WANT TO BUY A NEW COMPUTER?

LARRY DARNELL, MBA, CAE FDA DIRECTOR OF INFORMATION SYSTEMS

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

Lately, there has been a greater need to have better computers. Perhaps it’s because so many more people are working from home or more students are doing virtual education.

In fact, I get asked this question at least once a week within my network of influence. In response, I have some questions to ask them: What do you want to do with it? What is the purpose? Do you want it to be portable or will it stay at the house? These are critical questions to answer for yourself. Other questions arise, too. Do you want a laptop or a desktop? Would a tablet or a Chromebook meet your needs? How much do you want to spend? Usually, the answer becomes clear just from this initial questioning.

If you are looking to work from home or you have students doing virtual school, the answer will generally be a laptop. Why? Because it’s portable, flexible and most laptops can do what you need. I’m sure you’ve seen advertisements for Chromebooks, and they’re economically priced. A Chromebook is essentially an internet-only computer where the browser is the operating systems (as opposed to a Windows or a Mac operating system).

Chromebooks have their uses, primarily in educational settings, where the subset of applications are solely internet-based. If you want to install other applications that aren’t browser-based, you’re going to want a laptop.

What about a tablet? Tablets are more powerful, but they’re restricted to applications that run on the tablet (either Android or Apple IOS). You can use a tablet like a laptop, but there are obviously things a tablet cannot do.

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TODAY'S FDA SEPTEMBER/OCTOBER 2020

If you can accept those limitations, then a tablet might work.

Why not a desktop? Well, if you plan on seldom moving your computer and have no plans to pop down to the coffee shop with your desktop in tow, then that could work.

However, most people want the flexibility to have their computer be mobile, thus, a laptop is a better choice. You also can buy accessories like dual monitors and external keyboards and mice to make your laptop have that desktop feel.

Now that I have sold you on a laptop (chaching!), what more do you need to know?

Size matters. An 11-inch laptop and a 17inch laptop are just that different. An 11-inch screen may be too small to see, and a 17-inch laptop may be too heavy to easily lug around.

You must do what is right for you based on how you plan to use it. Go to a store where you can see them and pick them up. You don’t have to buy from there, but you can try out the look and feel.

Should you choose Windows or Mac? That question often is a matter of personal preference and money these days because Macs and PCs mostly can do the same things. A Mac is more expensive but quite honestly, requires less maintenance by the user. I bought a Mac for my wife years ago because I was tired of spending all my free time fixing her Windows PC. A PC is significantly less expensive and for some, that alone is the deciding factor.

FLORIDADENTAL.ORG

What about all those letters and numbers and two and three letter abbreviations? Those things matter, since you’ll want a better processor. If it’s an Intel processor, they go from I3 to I7 and generally, the higher the number, the better. Same is true with RAM — 4 GB will never be enough. You need at least 8 GB of RAM, and preferably more. Your hard drive size isn’t as important as it used to be, and there’s now solid state drives (SSD) that are fast but have limited capacity. You always can add an external drive to store files, but you need to get enough hard drive space to store applications, so 256 GB is a minimum for a hard drive.

Video capabilities also matter. Laptop video cards are underwhelming, so look for one with a better video card, also measured in gigabytes of RAM. Another factor to consider is the number and type of ports the laptop has on it. You need at least three USB ports and an HDMI port for video output capabilities. All laptops have wireless capability built in and some have a standard network jack as well. If you are concerned, look at the battery life as well.

One of my recent tricks of the trade is to buy gaming laptops for everyday use. They come with more than enough processor, RAM and video capabilities to play high-end games, but that also means they can do all that you want, too.

If you have time to make a purchase, I also recommend you get it from a reputable seller. The cheapest one on Amazon Marketplace may not be the best option for you. Google the make and model number you are interested in and see what people are saying about it. There are manufacturers I won’t buy from just because of the reported problems. You can look at back-to-school or holiday specials but often, they’re selling a lower-class PC with limitations. Caveat emptor.

I admit the options and information can be overwhelming, but remember, you will use this computer every day. We all know a computer can be the greatest source of frustration imaginable, so do your research, get what you need and revel in the joy of how much easier this purchase has made your life.

FLORIDADENTAL.ORG

“

One of my recent tricks of the trade is to buy gaming laptops for everyday use — they come with more than enough processor, RAM and video capabilities.

”

TODAY'S FDA SEPTEMBER/OCTOBER 2020

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FDAPAC-SUPPORTED CANDIDATES GENERAL ELECTION: TUESDAY, NOV. 3 Thanks to your Florida Dental Association Political Action Committee (FDAPAC) membership and support, the FDAPAC has already contributed to many candidates’ campaigns for the 2020 General Election. Without the membership of FDAPAC, FDAPAC Century Club and FDAPAC Capital Hill Club, organized dentistry would not be as effective during the legislative session. Below is a list of FDAPAC-supported House and Senate candidates for the 2020 General Election. For those candidates supported in the 2020 Primary Election, please refer to page 12 of the July/August Today’s FDA.

For additional information on FDAPAC-supported candidates, contact the FDA Governmental Affairs Office at 850.224.1089 or gao@floridadental.org.

ATLANTIC COAST DISTRICT

CENTRAL FLORIDA DISTRICT Paul Renner, R-Palm Coast

H-24

Tom Leek, R-Daytona Beach

H-25

David Smith, R-Winter Springs

H-28

Joy Goff-Marcil, D-Maitland

H-30

Erin Grall, R-Vero Beach

H-54

Geraldine Thompson, D-Orlando

H-44

Kelly Skidmore, D-Boca Raton

H-81

Carlos Guillermo Smith, D-Orlando

H-49

John Snyder, R-Palm City

H-82

Tyler Sirois, R-Merritt Island

H-51

Toby Overdorf, R-Stuart

H-83

Randy Fine, R-Palm Bay

H-53

Delores Hogan Johnson, D-Fort Pierce

H-84

Travis Hutson, R-Palm Coast

S-7

David Silvers, D-West Palm Beach

H-87

Jason Brodeur, R-Sanford

S-9

Michael Caruso, R-Boca Raton

H-89

Emily Slosberg, D-Delray Beach

H-91

Randolph Bracy, D-Orlando Victor Torres, D-Kissimmee

S-11 S-15

Patricia Williams, D-Fort Lauderdale

H-92

Christine Hunschofsky, D-Parkland

H-96

Debbie Mayfield, R-Melbourne

S-17

Gayle Harrell, R-Stuart

S-25

Tina Polsky, D-Boca Raton

S-29

Lori Berman, D-Boynton Beach

S-31

FLORIDADENTAL.ORG

NORTHEAST DISTRICT Clay Yarborough, R-Jacksonville

H-12

Wyman Duggan, R-Jacksonville

H-15

Cyndi Stevenson, R-St. Augustine

H-17

Sam Garrison, R-Orange Park

H-18

Bobby Payne, R-Palatka

H-19

Jennifer Bradley, R-Orange Park

S-5

TODAY'S FDA SEPTEMBER/OCTOBER 2020

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SOUTH FLORIDA DISTRICT NORTHWEST DISTRICT

Cindy Polo, D-Hialeah

H-103

Pat Maney, R-Shalimar

H-4

Bryan Avila, R-Hialeah

H-111

Allison Tant, D-Tallahassee

H-9

Nick Duran, D-Miami

H-112

Doug Broxson, R-Pensacola

S-1

Demi Busatta-Cabrera, R-Coral Gables

H-114

Loranne Ausley, D-Tallahassee

S-3

Vance Aloupis, R-Miami

H-115

Jose Javier Rodriguez, D-Miami

S-37

WEST COAST DISTRICT Ralph Massullo, R-Beverly Hills

H-34

Chris Latvala, R-Clearwater

H-67

Blaise Ingoglia, R-Spring Hill

H-35

Ben Diamond, D-St. Petersburg

H-68

Randy Maggard, R-Zephyrhills

H-38

Will Robinson, R-Bradenton

H-71

Josie Tomkow, R-Auburndale

H-39

Tommy Gregory, R-Bradenton

H-73

Colleen Burton, R-Lakeland

H-40

Michael Grant, R-Port Charlotte

H-75

Melony Bell, R-Fort Meade

H-56

Spencer Roach, R-North Fort Myers

H-79

Mike Beltran, R-Valrico

H-57

Bob Rommel, R-Naples

H-106

Jackie Toledo, R-Tampa

H-60

Darryl Rouson, D-St. Petersburg

S-19

Susan Valdes, D-Tampa

H-62

Jim Boyd, R-Bradenton

S-21

Chris Sprowls, R-Clearwater

H-65

Joe Gruters, R-Sarasota

S-23

Nick DiCeglie, R-Largo

H-66

Ray Rodrigues, R-Estero

S-27

Your

BACKSTAGE

ALL ACCESS

18

TODAY'S FDA SEPTEMBER/OCTOBER 2020

FLORIDADENTAL.ORG

DIY Dentistry Poses Risks DIY Dentistry Poses Risks for Floridians for Floridians From YouTube videos to ads on do-it-yourself (DIY) at-home teeth straightening and whitening, DIY dentistry is a growing trend. However, YouTube videos to ads do-it-yourself (DIY) damage. at-home teeth DIYFrom dentistry can cause serious andon sometimes irreparable straightening and whitening, DIY dentistry is a growing trend. However, DIY dentistry can cause Dentists Are Educated for aserious Reasonand sometimes irreparable damage.

Dentists have the extensive education and training to understand how your teeth Areimpacted Educated a Reason andDentists mouth are byfor dental treatments. Orthodontists undergo even Dentists have the extensive education and bones, trainingteeth to understand your teeth more training to know the mechanics of how and gumshow move and and mouthtoare impacted by dental treatments. grow in order safely and effectively straighten teeth.Orthodontists undergo even more training to know the mechanics of how bones, teeth and gums move and Patients undergo dental first teeth. seeing a dentist won’t know growwho in order to safely andtreatment effectivelywithout straighten if they have underlying problems, such as tooth decay or gum disease, that can Patients whoby undergo dental treatment be made worse unsupervised treatment.without first seeing a dentist won’t know if they have underlying problems, such as tooth decay or gum disease, that can As Florida’s oral health, treatment. the Florida Dental Association (FDA), along be madeadvocate worse byfor unsupervised with the American Dental Association (ADA), works to educate Floridians on Florida’s advocate dental for oraltreatment health, thewithout Florida the Dental Association along the As risks of undergoing expert care of (FDA), a dentist with the American Dental Association works of to direct-to-consumer educate Floridians on or specialist.

The ADA strongly discourages(ADA), the practice the risks of undergoing dental treatment without the expert care harm of a dentist dental laboratory services because of the potential for irreversible to or specialist.

The ADA strongly discourages the practice of direct-to-consumer patients. This includes services where patients take their own impressions and dental laboratory because products, of the potential for irreversible order products such asservices teeth bleaching partial dentures, veneersharm and to patients. This includes services where patients take their own impressions and aligners. order products such as teeth bleaching products, partial dentures, veneers and aligners.

HOW PATIENTS CAN REPORT A PROBLEM

DIY dental treatments have the potential dental treatments toDIY cause damage have the potential and irreversible to cause damage complications for and irreversible patients. complications for patients.

• Tooth loss • Jaw problems • Tooth loss • Bite problems • Jaw problems • Gum disease • Bite problems • Infection • Gum disease • Infection

HOW PATIENTS CAN REPORT A PROBLEM If a patient experiences any problems with direct-to-consumer (DTC) dental laboratory products, such as aligners or partial dentures, they can report them to the U.S. Food and Drug Administration at If a patientfda.gov/safety/medical-product-safety-information/forms-reporting-fda. experiences any problems with direct-to-consumer (DTC) dental laboratory products, such as aligners or partial dentures, they can report them to the U.S. Food and Drug Administration at Specifically, Formfda.gov/safety/medical-product-safety-information/forms-reporting-fda.

FDA 3500B – Voluntary Reporting for Consumers (a consumer-friendly reporting form).

Specifically, Form FDA 3500B – Voluntary Reporting for Consumers (a consumer-friendly reporting form).

For more information on DIY dentistry, please contact: Joe Anne Hart

For more information on DIY dentistry, please contact: CHIEF LEGISLATIVE OFFICER jahart@floridadental.org or 850.224.1089 Joe Anne Hart CHIEF LEGISLATIVE OFFICER

jahart@floridadental.org or 850.224.1089 Alexandra Abboud GOVERNMENTAL AFFAIRS LIAISON

Alexandra Abboud aabboud@floridadental.org or 850.224.1089 GOVERNMENTAL AFFAIRS LIAISON

aabboud@floridadental.org or 850.224.1089 FLORIDADENTAL.ORG

TODAY'S FDA SEPTEMBER/OCTOBER 2020

19

updates for members

*PLEASE NOTE THAT FDA MEMBERS HAVE THEIR NAMES LISTED IN BOLD.

2021 Dentists’ Day on the Hill: Dental Care is Essential Care!

All dentists agree that good oral health is essential to having good overall health. It is for that reason that “Dental Care is Essential Care” will be an important message and theme we need to impress upon legislators in Tallahassee during the 25th Dentists’ Day on the Hill (DDOH)! The 2021 DDOH will take place on Tuesday, March 16 with a legislative briefing on Monday, March 15 at 6 p.m. at Hotel Duval. To register for DDOH, please visit floridadental. org/ddoh.

The Florida Dental Association (FDA) needs dentists, dental students and spouses to travel to Tallahassee to advocate and educate how an individuals’ oral health is directly connected to their overall health. In the wake of the COVID-19 pandemic, it’s important to remind the Legislature that when discussing important health care policies, dental care should not be left out of the conversation.

The FDA will host a complimentary buffet dinner with entertainment at Hotel Duval after the legislative briefing on March 15. If you plan on attending the briefing and dinner, please add both

20

items during your registration. The FDA has a room block at Hotel Duval of $219 a night plus tax. To book your room, please call 850.224.6000 and reference the “Florida Dentists’ Day on the Hill,” or visit bit.ly/3mq7DiI and select March 15-16 as the dates of your stay. Rooms are almost booked up — so reserve your room today!

Please note: Room reservations should only be made for yourself/parties staying in the same room. Multiple rooms reserved under one name for any affiliate or district may be subject to cancellation by the FDA. Thank you for your cooperation.

Information regarding DDOH will be sent periodically to registrants throughout the year and up until the event.

Register as soon as possible to receive timely information. If you have any questions, please contact Governmental Affairs Liaison Alexandra Abboud at 850.224.1089 or aabboud@floridadental. org.

Component Challenge: Join Century Club Today The FDA Political Action Committee (FDAPAC) is working to identify and support legislators and candidates who are friends of organized dentistry during this 2020 election cycle. The FDA is able to support dental-friendly candidates because of the funding that comes

TODAY'S FDA SEPTEMBER/OCTOBER 2020

from members who join the FDAPAC Century Club. The $150 membership is a small investment in political advocacy that allows dentistry to have a strong voice in the legislative process. The FDAPAC Century Club has made it possible for dentistry to actively participate in the campaign process that has elected House and Senate leaders who have helped move the FDA’s legislative agenda forward.

Even though we are living in unusual and challenging times, there will still be an election in November. The pandemic hasn’t slowed down campaigning for elected office, it’s just altered the platforms that are being used to garner support. If we want to continue to have a seat at the table, we need to be sure that we have adequate resources to remain on the front lines.

We are challenging each component to a friendly competition. That’s right — a competition between the six dental districts to see who can get the most new members to join FDAPAC Century Club. This challenge began on Tuesday, Sept. 1 and will continue until Friday, Dec. 18. For a list of current FDAPAC Century Club members by component, please visit bit.ly/3kqQpQB. If you wish to become a Century Club member, please visit bit.ly/3htnWaM. The district with the most new sign-ups at the end of the period will receive a special recognition from the FDA.

FLORIDADENTAL.ORG

Are you a Century Club member? Who’s next? Visit bit.ly/32D5okp for a short video.

Alert: Open Enrollment Began Oct. 1 The FDA Services Health Solution Center Open Enrollment Period for individual/family plans is Oct. 1 through Dec. 11. Visit fdaservices.com/health learn more or request a quote today.

2017-2018 Workforce Survey Reports Now Available The Florida Department of Health Public Health Dental Program (PHDP) has announced that the 2017-2018 Workforce Survey of Dentists and Dental Hygienists Reports are now available.

Please visit floridahealth.gov/oral-data to view the reports.

Since 2009, the PHDP has developed a biennial workforce survey for Florida’s dentists and dental hygienists to obtain information concerning the dental workforce and its changing landscape, which better informs health care policymakers and shapes oral health care policy development.

The 2017-2018 Workforce Survey of Dentists and Dental Hygienists Reports will guide the Workforce Advisory Committee, composed of representatives from the PHDP, the FDA and the

Florida Dental Hygiene Association, in its efforts to provide evidence-based recommendations to the state surgeon general and the department on matters concerning dental workforce needs. To better assist the Workforce Advisory Committee and those in oral health professions, the 2017-2018 Workforce Survey Reports present data from the 2017-2018 workforce surveys and compare the current findings with findings from previous surveys. This can help identify trends within the changing workforce over a 10-year period.

If you have any questions about the reports, please contact Louiza SaintHillien at Louiza.sainthillien@flhealth. gov or 850.558.9640.

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

Dr. Maya Bartels, St. Petersburg Dr. Omeed Behmardi, Parkland Dr. Katherine Brattebo, Jupiter Dr. Daniel Camacho, Fort Lauderdale Dr. Yania Carralero, Homestead Dr. Victor Celis, Davie Dr. Leeann Chu, Pleasant Hill Dr. Mavi Cruz, Port St. Lucie Dr. Atenas De Taboada Da Silva, Fort Lauderdale Dr. Carlo Decandia, Plantation Dr. Joseph Depalo, Jupiter Dr. Matthew Dillon, Jupiter Dr. Raymond Fan, Irvine Dr. Lauren Gerkowicz, Boca Raton Dr. Carole Gleich, Fort Lauderdale Dr. Michelle Gonzales, Boca Raton Dr. Adam Gorfinkel, Weston Dr. Alberto Graupera, Miami Dr. Vanesa Grullon, Lake Worth Dr. James Hanna, Fort Lauderdale Dr. Emily Hardin, Lighthouse Point Dr. Jennifer Knowlton, Lauderhill Dr. Trupti Lofholm, Atlantis

Atlantic Coast District Dental Association

Dr. Michael London, Boynton Beach

Dr. Rodolfo Acosta-Ortiz, Pompano Beach

Dr. Daniel Marquez Menendez, Jacksonville

Dr. Ryan Alman, Boca Raton

Dr. Sara Moghul, Plantation

Dr. Mohammed Alrubaie, Davie

Dr. Forrest Newman, Plantation

Dr. Jose Arcay, Jensen Beach

SEE PAGE 20 FLORIDADENTAL.ORG

TODAY'S FDA SEPTEMBER/OCTOBER 2020

21

updates for members FROM PAGE 19

Dr. Anja Erwin, Daytona Beach

Dr. Gregory Norton, Boynton Beach

Central Florida District Dental Association

Dr. Javier Ochoa, Tamarac

Dr. Syed Abdul-Rahman, Orlando

Dr. Sarah Funaro, Orlando

Dr. Federico Perez, Fort Lauderdale

Dr. Roz Aghaaliandastjerdi, Gainesville

Dr. Krystal Gage, Gainesville

Dr. Mykhue Nguyen-Tran, Gainesville

Dr. Ninoska Perez, Coconut Creek Dr. Gretel Perez Lopez, Jacksonville

Dr. Amir Akhavan, Newberry

Dr. Jacob Foshee, St. Cloud

Dr. Kavan Gandhi, Gainesville Dr. Amanda Ghaffari, Gainesville

Dr. Vu Pham, Coral Springs

Dr. Sarah Al Moussally, Reunion

Dr. Gregory Quattlebaum, West Palm Beach

Dr. Kenda Albaree, Orlando

Dr. Carol Gilbert-Orrego, St. Augustine

Dr. Shanice Algarin, Orlando

Dr. Miral Gomaa, Tampa

Dr. Johanna Ramos, Fort Lauderdale

Dr. Yasel Almeida, Orlando

Dr. Marcela Guzman, Orlando

Dr. Christina Rizk, Palm Beach Gardens

Dr. Malik Altoos, Orlando

Dr. Hilury Ha, Ocala

Dr. Daniela Alvarez, Orlando

Dr. Adam Hadsell, Gainesville

Dr. Christian Arcolin Lo Monaco, Winter Garden

Dr. David Hall, Orlando

Dr. Daniel Robbin, Boca Raton Dr. Christopher Rodriguez, Jensen Beach

Dr. Natalie Atyeo, Gainesville

Dr. Kaitlin Rodriguez, Jensen Beach

Dr. Melissa Batres, Davie

Dr. Viviana Rojas, Plantation

Dr. Hayden Bell, Gainesville

Dr. Samantha Sauers, Boynton Beach

Dr. William Bell IV, Indian Harbour Beach

Dr. Gerry Schwartz, North Miami Beach

Dr. Karoline Biami, Orlando

Dr. Hayoung Shin, Davie

Dr. Mina Bishara, Orlando

Dr. Iva Sinamati, Fort Lauderdale

Dr. Alyssa Brown, Clermont

Dr. Jessica Singer, North Palm Beach

Dr. Joseph Calderone, Debary

Dr. Kristina Springer, Delray Beach

Dr. Anabel Casado, Orlando

Dr. Macdalie St. Preux, Stuart

Dr. Malek Chahada, Orlando

Dr. Lorena Valenti, Royal Palm Beach

Dr. Abinaya Chari, Port Richey

Dr. Lena Varone, Fort Lauderdale

Dr. Li-Yin Chiang, Winter Park

Dr. Josefina Vazquez Garcia, West Palm Beach Dr. Zachary Viens, Okeechobee Dr. Daniel Wetcher, Tamarac Dr. Maximilian Zhang, Boca Raton

Dr. Ryan Clance, Gainesville Dr. Ruben Daboin, Kissimmee Dr. Alexandra Davila, Gainesville Dr. Carlos De Bruzos, Gainesville Dr. Ana Diaz, Orlando Dr. Nour Elkhatib, Orlando

22

TODAY'S FDA SEPTEMBER/OCTOBER 2020

Dr. Kai Ta Huang, Orlando Dr. Quentin Hudson, Bell Dr. Thomas Huntley-Loehr, Gainesville Dr. Joshua Insco, Ocala Dr. Carline Isme, Hollywood Dr. Brian Jardina, Gainesville Dr. Allen Khai, Gainesville Dr. Muhammad Khan, Orlando Dr. Long Khuu, Gainesville Dr. Morgan Kubis, Ocala Dr. James Lee, Orlando Dr. Kyulim Lee, Gainesville Dr. Laura Londono, Gainesville Dr. Amber Medellin, Orlando Dr. Megan Menashe, Boca Raton Dr. Adam Miller, Orlando Dr. Sumayya Mujeeb, Merritt Island Dr. Daniel Nguyen, Orlando Dr. Abeire Nirh, Orlando Dr. Justin Norell, Gainesville

FLORIDADENTAL.ORG

Dr. Ricardo Obando, Miami

Dr. Joshua Lovelace, Jacksonville

Dr. Lauren Soekirman, Gainesville

Dr. Jimmy Orphee, Windermere

Dr. Aya Mansour, Jacksonville

Dr. Gregory Stanley, Pensacola

Dr. Mariya Pecheny, Melbourne

Dr. Cynthia Martinez, Jacksonville

Dr. Alton Stone, Marianna

Dr. Evelyn Pereda, Gainesville

Dr. Shane Mc Tiernan, Jacksonville

Dr. Edmund Whitson, Pensacola

Dr. Priscila Quito Calderon, Kissimmee

Dr. Megan Reckley, Neptune Beach

Dr. Jacob Woods, Tallahassee

Dr. Eric Ress, Jacksonville

South Florida District Dental Association

Dr. Eric Rabinowitz, Gainesville Dr. Irada Rahman, Naples Dr. Sherley Rivera, Bradenton Dr. Allan Rodrigues, Ocoee Dr. Thayssa Rodrigues, Ocoee Dr. Emily Roig, Melbourne Dr. Ariosto Rosado, Altamonte Springs Dr. Jaime Ruiz, Viera

Dr. Suset Romano, Jacksonville Dr. Michael James Toledo, Jacksonville Dr. Michael Vracar Jr., St. Johns Dr. Camille Wright, Jacksonville Dr. Frank Zimmerman, Jacksonville

Northwest District Dental Association

Dr. Marice Acevedo Jimenez, Hialeah Dr. Marines Alvarado, Medley Dr. Jose Arcia Rosales, Miramar Dr. Lauren Arguelles, Hialeah Dr. Jennifer Bosch, Miami Dr. Jessica Bouzo, Hialeah

Dr. Nikola Skakavac, Gainesville

Dr. Sydney Brown, Freeport

Dr. Nicole Buzzi, Miami

Dr. Wellington Tejeda Feliz, Kissimmee

Dr. Julie Davis, Panama City

Dr. Kelly Calderon, Southwest Ranches

Dr. Adam Tow, Ormond Beach

Dr. Rachel Duckworth, Spring Hill

Dr. Joseph Cannon, Gainesville

Dr. Sergio Trevino de Lascurian, Kissimmee

Dr. Michael Fabian, Tallahassee

Dr. Gaetano Capozza, North Miami Beach

Dr. Nelly Unger, Lake Mary Dr. Ruby Wagimin, Orlando

Dr. Wendy Hernandez, Defuniak Springs

Dr. William Washburn, Orange Park

Dr. Tuan Le, Fort Walton Beach

Dr. Silvia Corbelle Batista, Davie

Dr. Shayla Wilson, Orlando

Dr. John Lisonbee, Pace

Dr. Jenny Cortes, Hialeah

Dr. Summer Young, Brooker

Dr. Ernesto Llerena, Tallahassee

Dr. Kenton Covington, Fort Lauderdale

Dr. Mark Zavala, Windermere

Dr. Daniel May, Port St. Joe

Dr. Carlos Da Silva, Plantation

Dr. Elizabeth Zogaib, Winter Park

Dr. Tyler Merritt, Pensacola

Dr. Laura Davila, Miami

Dr. Marshall Myrick, Freeport

Dr. Aylen de la Cruz, Miami Springs

Dr. Alexandra Ortega-Arguello,

Dr. Liana De La Torre, Hialeah

Santa Rosa Beach

Dr. Lorena Delgado, Miami

Dr. Kyle Penland, Pensacola

Dr. Shantall Di Loreto-Parra, Sunny Isles Beach

Northeast District Dental Association Dr. Shelby Denman, Ponte Vedra Beach Dr. Alexa Fritz, Fleming Island Dr. Rami Habib, St. Augustine Dr. Garrett Karow, Melbourne Dr. Zhimin Li, Jacksonville

Dr. Natalia Hauber, Pensacola

Dr. Jake Perry, Niceville Dr. Oscar Sanchez, Boca Raton Dr. Laurence Sitchon, Panama City Beach

Dr. Greyddy Carvajal Borges, Miami Dr. Yanet Cejas Dominguez, Miami

Dr. Janelle Diaz, Miami Dr. Jeimy Diaz Abreu, Miami

SEE PAGE 22 FLORIDADENTAL.ORG

TODAY'S FDA SEPTEMBER/OCTOBER 2020

23

updates for members Dr. Oriana Pacheco, Miami

Dr. Yousof Sinjab, Davie

Dr. Marcela Patterson, Davie

Dr. Robert Size, Davie

Dr. Daniel Pazos, Miami Springs

Dr. Marissa Solares, Miami Lakes

Dr. Carlos Perez, Hollywood

Dr. Iliana Suarez, Davie

Dr. Nicole Perez, Davie

Dr. Oscar Tarano Jr., Miami Lakes

Dr. Rachel Perez, Miami

Dr. Jacob Teichner, Miami Beach

Dr. Sean Perez, Miami

Dr. Beatriz Tejera, Davie

Dr. Linards Galvez Neimane, Miami

Dr. Jeff Phan, Davie

Dr. Joanna Theodorou, Miami Beach

Dr. Nathalie Garcia Diez, Doral

Dr. Kevin Phanord, Davie

Dr. Joshua Tillinger, Weston

Dr. Jheiny Garcia Gonzalez, Miami Gardens

Dr. Kyle Phanord, Davie

Dr. Maria Toirac, Miami

Dr. Tatiana Reino Agosto, Miramar

Dr. Loc Tong, Miramar

Dr. Kiren George, Cooper City

Dr. Leandro Reyes Valdes, Miami

Dr. Francesca Verratti, Weston

Dr. Serena Ghodasra, Davie

Dr. Emil Ricart, Miami

Dr. Rafael Vorona, Hollywood

Dr. David Gonzalez, Hialeah

Dr. Christina Rios, Davie

Dr. Audrey Wang, Davie

Dr. Katia Gonzalez Farinas, Miramar

Dr. Arianna Rodriguez, Miami

Dr. Jaclyn Willis, Pembroke Pines

Dr. Steven Gross, Miami

Dr. Christian Rodriguez, Miami Lakes

Dr. Jonathan Wirth, Pinecrest

Dr. Lizvette Hernandez, Hialeah

Dr. Pablo Rodriguez, Coral Gables

Dr. Shari Witkoff, Coral Gables

Dr. Amy Iglesias, Hialeah

Dr. Yaniris Rodriguez, Miami

Dr. Alex Yee, Weston

Dr. Fanchon James, Miami

Dr. Kevin Rodriguez Santos, Miami

Dr. Michael Zinn, Pinecrest

Dr. Eleine Laffita Aguilera, Hialeah

Dr. Thais Rosales, Deerfield Beach

Dr. Hanna Lee, Davie

Dr. Melissa Ruiz, Miami

Dr. Rafael Llanes, Hialeah

Dr. Sepideh Sajadi, Miami

Dr. Laura Lugo, Miami

Dr. Saymar Salas, Miami

Dr. Liannette Marquez, Miami Dr. Ignacio Martinez, Miami

Dr. Mariannina Savoca Astudillo, Hialeah

Dr. Roshni Amin, Lakeland

Dr. Rafael Martinez, Davie

Dr. Javier Scarton, Doral

Dr. Jeannely Arias, Ruskin

Dr. Vanessa Matamoros, Davie

Dr. Stephen Scoglio, Davie

Dr. Valentina Aristizabal, Bradenton

Dr. Nitish Mathew, Coral Springs

Dr. Jose Seota, Doral

Dr. Etan Austein, Boca Raton

Dr. Tamara McCallum, Coral Springs

Dr. Denys Severchenko,

Dr. Emad Barakat, Lithia

Dr. Daymis Montalvo, Hialeah

Hallandale Beach

Dr. Samir Barsoum, Lutz

Dr. Daisy Montoyo Rosario, Wellington

Dr. Haneen Shehadeh, Coconut Creek

Dr. Hanan Beck, Tampa

Dr. Frank Murias, Miami Lakes

Dr. Diana Shima, Miami Lakes

Dr. Cody Bertoch, Tampa

Dr. Karen Nachum, Davie

Dr. Mordechai Shur, Hollywood

Dr. Brandon Bohrer, Clearwater

FROM PAGE 21

Dr. Yeni Fernandez, Hialeah Dr. Ana Fernandez-Cordero, Miramar Dr. Katrina Fins, Pembroke Pines Dr. Mason Fortuno, Pembroke Pines Dr. Flavio Fuentes Falcon, Miami Gardens

24

TODAY'S FDA SEPTEMBER/OCTOBER 2020

West Coast Dental Association Dr. Hussein Abdulameer, Fort Myers Dr. Baha Abuaita, Lutz Dr. Beatriz Alpizar, Miami

FLORIDADENTAL.ORG

Dr. Jordan Brown, St. Petersburg

Dr. Jimmy Huynh, Palm Harbor

Dr. Rebecca Pikos, St. Petersburg

Dr. Sachell Calderon, Wesley Chapel

Dr. Anna Ichoa, Tampa

Dr. Jackson Reddick, Lake Wales

Dr. Matthew Chan, Plant City

Dr. Charles James, Fort Myers

Dr. Roberto Reyes, Winter Haven

Dr. Michael Chanthalangsy, Riverview

Dr. Cameron Johnson, Sarasota

Dr. Carolina Rodriguez Colon, Lithia

Dr. Elizabeth Chavez, Cape Coral

Dr. Young Kim, Bradenton

Dr. Leidy Santos, St. Petersburg

Dr. Jason Cho, Lakeland

Dr. Linda Kornienko, Cape Coral

Dr. Karin Schey, Gainesville

Dr. Anthony Coello, Davie

Dr. Ruben Krebs, Naples

Dr. Grady Scott, Bonita Springs

Dr. Jonathan Colucci, Tampa

Dr. Linda Lavadia, Clearwater

Dr. Francesco Sebastiani, Naples

Dr. Zaneta Corral, Bradenton

Dr. Lynn Le, Largo

Dr. Rita Seddeik, Largo

Dr. Vinh Dang, Tampa

Dr. Alexander Levine, Fort Myers

Dr. Parth Shah, Port Charlotte

Dr. Bao Tran Dao, Clearwater

Dr. Paul Lewis, Largo

Dr. Masroor Shariff, Temple Terrace

Dr. Anya de Frias, Miami

Dr. Tiara Lewis, Winter Haven

Dr. Mitchell Shoemaker, Lehigh Acres

Dr. Yash Desai, Plant City

Dr. David Long, Bonita Springs

Dr. Aaron Sipos, Fort Myers

Dr. Matthew DeVivo, Tampa

Dr. Mary Mabry, Lakeland

Dr. Robert Sparks, Lakeland

Dr. Bhumi Dharia, St. Petersburg

Dr. Ashima Madan, Safety Harbor

Dr. Mitchell Stumpf, Tampa

Dr. Amit Doshi, Tampa

Dr. Armita Mashkouri, Orlando

Dr. Anastasia Talalenko, Bonita Springs

Dr. Nicole Dunlap, North Port

Dr. Vilson Merkaj, Largo

Dr. Jean Paul Taveras Santos, Tampa

Dr. Lucas Eliopoulos, Fort Myers

Dr. Ashley Millstein, Wesley Chapel

Dr. Lang Thach, Riverview

Dr. Omar Estevez Delgado, Bradenton

Dr. Macy Moore, Seminole

Dr. Jean Valdez, Wesley Chapel

Dr. Juan Fajardo, Miami

Dr. Paul Mosad, Wesley Chapel

Dr. Norlis Felix Ventura Garcia, Miami

Dr. Lauren Feininger, St. Petersburg

Dr. Mohamed Moustafa, Tampa

Dr. Jay Wickersham, Zephyrhills

Dr. Kara Ford, Temple Terrace

Dr. Kenninthon Munoz, Miramar

Dr. Shanele Williams, Sarasota

Dr. Marcel Fundora, Winter Haven

Dr. Nikhila Nemmarugommula, Spring Hill

Dr. Andrea Wise, Fort Myers

Dr. Benjamin Ghaly, Brandon Dr. Daniela Ghobrial, Tampa Dr. Katherine Gouveia, Tampa Dr. Ericka Gray, Tampa Dr. Lori Gruskin, Bradenton Dr. Zena Gutmann, Sarasota Dr. Marina Hanna, Palm Harbor Dr. Fasih Haq, Fort Myers Dr. Yismae Hernandez, Lehigh Acres

FLORIDADENTAL.ORG

Dr. John Obeck, Tampa Dr. Johnathan Parks, Sarasota

Dr. Petros Zacharopoulos, Dunedin Dr. Annie Zhang, Tampa

Dr. Hollie Paschke, Sarasota Dr. Puja Patel, Wesley Chapel Dr. Sneha Patel, Tampa Dr. Steven Pavlushkin, Tampa Dr. Tyler Perimenis, Naples Dr. Anthony Pikos, Clearwater

TODAY'S FDA SEPTEMBER/OCTOBER 2020

25

now you know INFORMATION FROM THE FDA

all you need to know about hot topics Opioids  Dental Therapists  Student Debt  Board of Dentistry  Medicare/Medicaid

all in one place floridadental.org/nyk The latest news from the Florida Dental Association about major topics that affect dentistry in Florida. A members-only benefit!

For more reading, you can view the latest Today’s FDA, email blasts or Beyond the Bite blog.

26

TODAY'S FDA SEPTEMBER/OCTOBER 2020

FLORIDADENTAL.ORG

Remembering Dr. Bert Dannheisser “Dentistry lost a great champion; I lost my mentor, friend and father of 38 years.”

— Dr. Kim Jernigan

Florida Dental Association (FDA) Past President (1976-1977), Dr. Bertram “Bert” Dannheisser, of Pensacola, passed away Sept. 5. He was 93.

Bert was a trailblazer in local, state and national dentistry. He was a member and past president of the Pensacola Dental Association and also a past editor of Today’s FDA for 19 years.

Bert will be remembered for his positive and uplifting attitude and his famous saying: “Onward and upward. ”

If —

BY RUDYARD KIPLING (’Brother Square-Toes’ — Rewards and Fairies) If you can keep your head when all about you Are losing theirs and blaming it on you, If you can trust yourself when all men doubt you, But make allowance for their doubting too; If you can wait and not be tired by waiting, Or being lied about, don’t deal in lies, Or being hated, don’t give way to hating, And yet don’t look too good, nor talk too wise: If you can dream — and not make dreams your master; If you can think — and not make thoughts your aim; If you can meet with Triumph and Disaster And treat those two impostors just the same; If you can bear to hear the truth you’ve spoken Twisted by knaves to make a trap for fools, Or watch the things you gave your life to, broken, And stoop and build ’em up with worn-out tools:

FLORIDADENTAL.ORG

If you can make one heap of all your winnings And risk it on one turn of pitch-and-toss, And lose, and start again at your beginnings And never breathe a word about your loss; If you can force your heart and nerve and sinew To serve your turn long after they are gone, And so hold on when there is nothing in you Except the Will which says to them: ‘Hold on!’

If you can talk with crowds and keep your virtue, Or walk with Kings — nor lose the common touch, If neither foes nor loving friends can hurt you, If all men count with you, but none too much; If you can fill the unforgiving minute With sixty seconds’ worth of distance run, Yours is the Earth and everything that’s in it, And — which is more — you’ll be a Man, my son!

TODAY'S FDA SEPTEMBER/OCTOBER 2020

27

FDAS: Workers' Cmp

SAVE ON WORKERS’ COMP FOR YOUR PRACTICE Florida Dentist Dividend Offer Practices with an annual workers’ compensation premium of $500 or more are now eligible (down from $1,000)!

Available for dental offices that meet the following requirements: 1. Annual workers’ compensation premium of $500 or more 2. Claims-free the past three years (current year plus two prior years) The carrier will immediately apply a 25% dividend of your earned annual premium to all new and existing policies that meet the program guidelines starting July 1, 2018.

25%

DIVIDEND

28

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“Getting your workers’ comp coverage through the FDA is a no-brainer. I switched and was able to take advantage of the dividend savings and the great coverage and extras provided by The Zenith! FDAS just makes the process so simple.”

— Dr. Michael Stratton, FDAS vice president

29

BOD meeting

FLORIDA BOARD OF DENTISTRY DISCUSSES LASERS

CASEY STOUTAMIRE FDA DIRECTOR OF THIRD PARTY PAYER & PROFESSIONAL AFFAIRS

If you have any questions, please contact Director of Third Party Payer and Professional Affairs Casey Stoutamire, Esq. at cstoutamire@floridadental.org or 850.350.7202.

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The Florida Board of Dentistry (BOD) met via conference call on Friday, Aug. 21, at 8 a.m. The BOD had to cancel its in-person meeting due to the COVID-19 pandemic, but still met to conduct the necessary business of the board. The Florida Dental Association (FDA) was represented by FDA BOD Liaison Dr. Joe Calderone and Director of Third Party Payer and Professional Affairs Casey Stoutamire. Other FDA members, Drs. Jim Antoon, Dave Boden, Andy Brown, Jolene Paramore and Jessica Stilley also were on the call.

All of the BOD members were present, which included: Dr. Naved Fatmi, chair; Dr. Nick White, vice chair; Drs. Matt Freedman, Nick Kavouklis, Claudio Miro and T.J. Tejera; hygiene members, Ms. Cathy Cabanzon and Ms. Karyn Hill; and, consumer member, Mr. Fabio Andrade. One dentist position and one consumer member position are open on the board that has not been filled yet by the governor.

Ms. Cabanzon proposed several rule changes approved by the Council on Dental Hygiene.

The BOD approved the proposed rule change to Rule 64B5-16.006, Remediable Tasks Delegated to a Dental Hygienist, which requires that all certified registered dental hygienists must follow procedures for reporting adverse incidents while administering local anesthesia as outlined in Rule 64B5-14.006(4). This is just a cross-reference to the anesthesia rules with no substantive changes.

TODAY'S FDA SEPTEMBER/OCTOBER 2020

The Council on Dental Hygiene also put forth a proposal to allow hygienists to use a laser while performing their remediable tasks. The proposed language is as follows: n 64B5-16.001 Definitions of Remediable Tasks and Supervision Levels. n Remediable tasks, also referred to as expanded functions of dental hygienists and dental assistants, which are enumerated in Rules 64B5-16.006, 64B5-16.0061, 64B5-16.005, 64B516.0051, F.A.C., are those intra-oral tasks which do not create unalterable changes in the oral cavity or contiguous structures, are reversible and do not expose a patient to increased risks. The use of a laser or laser device of any type is not a remediable task, unless utilized to accomplish the existing remediable tasks outlined in 64B5-16.006, F.A.C. as an assessment device. n 64B5-16.002 Required Training. n

(5) A dental hygienist who is a laser user, unless only using the device for caries detection, must first successfully complete training that covers at a minimum fundamentals of laser physics, safety, and appropriate use prior to utilizing the laser. The course must be a minimum of twelve (12) hours in length, contain a hands-on opportunity, and a learning assessment

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The next BOD meeting is scheduled for Friday, Nov. 13 at 7:30 a.m. EDT in Orlando.

CAUTION

instrument. At least three (3) of the twelve (12) hours must include clinical simulation laser training in the procedures that the hygienist will perform by instructors that have equal to or higher training.

The dentist authorizing laser procedures must also have equivalent training. n (a) Training must be obtained through a course provided or recognized by any of the following organizations (or a successor organization): i. A Commission on Dental Accreditation (CODA) accredited institution.

n

n

ii. The American Dental Association (ADA) Continuing Education Recognition Program (CERP); or

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n

iii. The Academy of General Dentistry (AGD) Program Approval for Continuing Education (PACE).

The FDA opposed this rule language because it is, among other things, overly broad and the training requirements do not go far enough to adequately train a hygienist in the use of a laser. The use of a laser by any health care professional has risks and the FDA wants to ensure the public is adequately protected.

After much discussion, the BOD sent the proposal back to the Council on Dental Hygiene for more work based on its questions and comments, which included: n

Should the use of a laser be done under direct supervision?

n

What are the wavelength and power restrictions on the types of lasers being used?

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Will the hygienist be required to report adverse occurrences?

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What about limiting the ownership of the laser to only dentists?

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Should the education requirements be increased to match the medical field?

One board member stated that in the medical field, a physician or nurse must have a master’s level education to use any type of laser.

The BOD also approved numerous rule changes proposed by the Rules Committee that was done as part of the review required by the governor. However, they were not substantive, and most were updates to bring the language current.

For example, the rules still used a previous acronym for the American Board of Dental Examiners (ADEX), which is no longer applicable. The rule change will update the outdated reference of ADLEX to ADEX for accurate reflection of Florida’s dental licensure exam requirements.

Mr. David Flynn, board counsel, also updated members on the status of several rule changes moving through the regulatory process. As a reminder, the recently updated anesthesia rules are now effective. To read a summary of those changes as well as the rules in their entirety, please visit bit. ly/3fF0CqZ. There were six disciplinary cases, two determinations of waivers, and four voluntary relinquishments dealing with failing to meet the minimum standard of care and failing to keep adequate records. Please note, there was much discussion on record-keeping during the discipline cases. Many of the cases might have been avoided if adequate records were kept by the dentist. It is much better to be a spectator than a participant in BOD disciplinary cases.

TODAY'S FDA SEPTEMBER/OCTOBER 2020

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PEOPLE.

PURPOSE.

PASSION.

PATHWAYS TO SUCCESS THE OFFICIAL MEETING OF THE FDA

GAYLORD PALMS RESORT & CONVENTION CENTER 32 ORLANDO, FL

SAVE THE DATE!

JUNE 24-26, 2021

FLORIDADENTALCONVENTION.COM

now you know INFORMATION FROM THE FDA GO TO SUMMARY All health care providers must include non-opioid alternatives for pain and pain management in their discussions with patients before providing anesthesia, or prescribing, ordering, dispensing or administering a schedule II controlled substance for the treatment of pain.

Effective July 1, 2019.

 OPIOIDS

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HEALTH CARE PROVIDER CHECKLIST INFORM

 Non-opioid alternatives for pain treatment, which may include non-opioid medicinal drugs or drug products are available.

 Non-opioid interventional procedures or

treatments, which may include: acupuncture, chiropractic treatments, massage, physical or occupational therapy, or other appropriate therapy are available.

DISCUSS

 Advantages and disadvantages of non-opioid alternatives.

 Patient’s risk or history of controlled

substance abuse or misuse, and patient’s personal preferences.

DOCUMENT IN PATIENT’S RECORD

 Non-opioid alternatives considered.

Your

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cleft palate repair

THE COSMETIC CHALLENGE OF CLEFT PALATE REPAIR Achieving the best treatment outcome for cleft palate patients takes an entire team of caregivers — nurses, plastic surgeons, otolaryngologists, pediatricians, pediatric and general dentists, oral surgeons, orthodontists, speech therapists, audiologists, social workers and supportive families.

We’ve both been members of the Lakeland-based Central Florida Cleft Palate Team for more than 30 years. Treating the cleft patient is challenging, but also extremely rewarding. It’s not a financial reward — it is an emotional, self-serving exercise.

DR. CHARLES D. LLANO

Dr. Llano is a general dentist in Lakeland and can be reached at cdllano@gmail.com.

How does the anomaly we refer to as a cleft palate influence a patient’s oral function, care and outcome? Dentists can identify the maxillary segments; the premaxilla, the left and right posterior dental arches, and a soft palate. These segments connect with sutures forming the palatal vault. The bones of the palate form the floor of the nasal cavity. Palatal bones approximate and fuse by the end of the first trimester. The posterior soft palate is supported by the hard palate where muscles allow the soft palate to control airflow for proper speech and prevent posterior food and fluid entry.

A cleft forms when developing segments of soft tissue and bone fail to fuse. Clefts vary in their severity and extent. Seventy percent of unilateral clefts are left-sided, but clefts can occur on both sides. Bilateral clefts are those that involve a non-union of the premaxillary segment on both sides. Unilateral clefts are less extensive than bilateral clefts because they only involve one side of the alveolar ridge and lip. The lip and nose on the unaffected side in a unilateral cleft are supported by intact skin and muscle to a stable alveolar ridge. Logically, there is less facial distortion in a unilateral cleft. What connection exists provides some balance of force to limit displacement of the ridge by the tongue.

DR. GREGORY P. SCOTT

Dr. Scott is an orthodontist and dentofacial orthopedist in Lakeland and can be reached at gps@scottsmiles.com.

When a cleft is present, the base of the nose is not closed and the lip and supporting muscle is not present. This resultant lack of support creates a nose that is wider and flatter. The stretching of tissues from surgical correction results in a thinner and flatter upper lip due to this lack of premaxillary prominence and loss of associated filler from muscle and soft tissue. Stretching the lip muscle across the cleft alveolar ridge also can cause collapse and distortion of the maxillary arch when the arch is not supported. Restorative surgery that can gain premaxillary form and preserve the limited oral tissues for the nose and upper lip is a difficult achievement and is dependent on the talent of the surgeon.

The amount of cosmetic correction that is achieved depends on the initial condition. The location and orientation of independent maxillary segments may be orthopedically and surgically improved. Some surgeons prefer to have the palatal segments orthopedically aligned during infancy prior to surgery with a variety of methods including the Latham appliance and the

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nasoalveolar molding appliance. The use of infant orthopedic appliances and the decision to perform early surgery on the alveolar ridge called a gingivoperiosteoplasty is controversial.

However, it is generally agreed that early lip correction is appropriate, and that the soft palate should be surgically corrected by 18 months to benefit the development of speech.

Bone grafting of the cleft alveolar ridge usually is completed around age 8 to provide bone for eruption of the adult cuspids. This normally involves an early phase of orthodontics, often with maxillary expansion, to create appropriate space for placement of the bone graft. A second phase of orthodontics is necessary to finish the occlusion and improve cosmetics. Cleft patients often are missing lateral incisors and it’s not unusual to find other missing, supernumerary and malformed teeth.

Orthodontics also helps to sort out these anomalies in preparation for the restorative dentist to do their job.

As the child gets older, dental restoration demands patience for the best outcome. It’s important that a pediatric dentist or a team dentist follow and provide preventive and restorative care. One of the great challenges in treating cleft patients is oral hygiene. Craniofacial patients have ear and developmental auditory concerns. It’s normal for these young patients to need ear tubes to help regulate the pressures on the ear drums.

Ear infections are common. Speech therapy is needed to assist with altered air flow resulting from a palatal fistula or impaired soft palate movement. Obturators may be requested to close a palatal fistula for improvement of speech or eating.

By the early teens, development of bone and teeth is established. Orthodontic evaluation has been continual. Panoramic films and cone beam computed tomography images (CBCT) are taken during development for planning and treatment.

CBCT imaging is a vital tool for the orthodontist, surgeon and restoring dentist. A temporary removable prosthesis to replace missing teeth may be employed but many times the efficient placement of a prosthetic tooth bracketed to the existing braces is a temporary cosmetic success. During the late teens, results are being realized as significant orthodontic, plastic and ENT care is being provided. Post-operatively, the lip and nose will be the slowest to mature. Nasal surgery is delayed until the late teens for the best cosmetic results and there often is a need for revision of the lip surgery.

Because of scar tissue from the lip and palate repair, the maxillary growth is stunted compared to the normally growing mandible. This becomes more obvious in the later teenage years and into the 20’s as the occlusion tends to become more FLORIDADENTAL.ORG

1 month old with pre-lip closure

3 months old with Lantham appliance

5 months old

Class 3 and the anterior teeth more edge to edge due to this growth discrepancy between the maxilla and mandible. This becomes a challenge for the orthodontist and the restorative dentist who must contend with proper anterior occlusion and lack of incisal guidance. It’s not at all unusual for growth to necessitate either another phase of orthodontics or often a Le Fort surgery to advance the maxilla. Restored clefts with adequate bone and soft tissue are the result of orthopedic planning and a credit to proactive orthodontic and surgical input.

Results vary and are dependent on many factors.

The achievement of facial balance is the result of the care a multidisciplinary team provides. There are limitations and

SEE PAGE 35 TODAY'S FDA SEPTEMBER/OCTOBER 2020

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PNC Bank

cleft palate repair

FROM PAGE 33

options in surgery and dental restoration. Primary evaluation with articulated models and photos is needed. Implants may not be an option when placement will proximate low-density bone, scar tissue or vascular insufficiency. Prosthetic designs when planning anterior aesthetic appearance can stretch the golden proportions rule. Midlines often are displaced as most clefts are unilateral. There is a tendency for teeth to displace into the cleft. Canted anterior occlusal planes present another cosmetic challenge. Premaxillary segments are flatter and prosthetic designs will look wider. Occluding contacts may be irregular and will influence lateral function. This is where preplanning with articulated models in the office and on the laboratory bench helps.

Pre-ortho

Removable prosthetics remains a common therapy because the gingival base on a prosthesis can mimic the contralateral gingival fullness and allow more anterior tooth arrangement and emergence from the partial dentures base. Abutment teeth proximal to clefts may not always be able to provide the support needed for a fixed prosthetic. Consider guide planes to equalize forces of these less stable abutment teeth that approximate a removable prosthesis.

Young adults can benefit from a single-tooth fixed bridge placement. A bonded fixed prosthesis retained with palatal wings is effective. There is usually little to no overbite, so abutment teeth may be minimally prepared. Conservative design allows for future options in later adulthood. Newer nonmetal materials are aesthetic when there is root exposure associated with deficient tissue sites. Deep shoulder preparation is not indicated on this dentin.

Post-ortho

Know your patient, and when it is a willing child, involve them and the parents in the treatment. These are normal children — they just have a cleft. You will be in a relationship with the child and the caregivers for many years. Listen to concerns, give reasonable answers, and provide support and reassurance.

With bridge FLORIDADENTAL.ORG

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y r t s i t n e l e D d c i o t e M m s s s o e n Cs a Busi a cosmetic dentistry

“

So, you want to be a “cosmetic” dentist?

What does that really mean?

Will you specialize in treating only the six upper anterior teeth?

Not likely!

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As we know, there is no recognized specialty of cosmetic dentistry, nor is that “specialty” likely to be approved by organized dentistry. Every dentist needs to be well-versed in making all teeth and smiles healthy, functional and beautiful.

Cosmetic dentistry has been defined as “dentistry that focuses on improving appearance and facial KAREN GLERUM, DDS, FICD self-image by correcting the align ment, shape and color of teeth.

Dr. Glerum is a general dentist in Boynton Beach and can be Dental professionals who offer reached at drglerum@smilesbycosmetic options can improve the glerum.com. appearance of stained, chipped and misshapen teeth, and correct uneven gums and replace old fillings with nearly invisible filling materials. Cosmetic dentistry procedures are elective and, therefore, often not covered by insurance.”1

The best days in my office occur when we finish a case, hand the patient a mirror, and they have tears of joy in their eyes.

We make sure the patients know that the photos will be used only for internal communication between our lab and our team and have them sign a photo release. However, if I wish to use a patient’s full face, I personally ask them and require they sign an additional release to use their photos.

Fig. 1: Before — many carious teeth, uneven smile line, and curves of Spee and Wilson; from “piecemeal” dentistry over many years.

When you emphasize cosmetic dentistry in your practice, how does this change your business model, your patients’ perceptions of your practice, and most importantly, your bottom line?

My practice has focused on cosmetic dentistry for many years.

It’s interesting that we receive many differing responses by patients to this emphasis. Some patients hardly notice; some tell me they were “specifically looking for a cosmetic dentist.” Others even tell us, “I don’t need fancy cosmetic work; I just need a ‘regular’ dentist!” We point out that we perform “regular” dentistry all the time; we just make it look better!

One of the best ways to show that your practice is indeed “cosmetic” is to take photos of your own dentistry. Even posterior teeth can be made more beautiful as well as functional. Many dentists still have a “canned” or pre-prepared website, with stock photos, or even no photos at all! When I took the Esthetic Advantage courses with Dr. Larry Rosenthal, he said, “You need to have the sizzle as well as the steak.” In other words, it’s not enough to do great dentistry, you must show people what you can do!

Once you (and your team) become adept at clinical photography (and there are many courses in which you can learn this skill), use these photos to promote the type of dentistry you really enjoy and find gratifying to both you and your patients.

FLORIDADENTAL.ORG

Fig. 2: After — full-mouth reconstruction with proper occlusion, vertical dimension, aesthetics and health!

Use your photos everywhere: social media, print advertising, on your website, on business cards, flyers; and in any community or organization that offers advertising. You never know who is looking for a great dental office — you can be that office.

Another great tool for cosmetic dentists is the intra-oral camera. We use Mouthwatch cameras in my office. They are easy to install in most computer systems, integrate easily with dental software, and give patients a bird’s-eye view into their own mouths. We recently added 40-inch HD, 1080P TV monitors in each operatory. When patients view their broken and decayed teeth on the “big screen,” it’s a significant motivator to sign up for treatment.

SEE PAGE 41 TODAY'S FDA SEPTEMBER/OCTOBER 2020

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The Doctors Company

cosmetic dentistry

Fig. 3: One of our new 40-inch HD screens

FROM PAGE 39

Another business/treatment aspect of being cosmetically oriented is that you must slow down and really take your time to get the results you and the patient desire. When we schedule six or more teeth to be restored, we schedule these cases on a day in which that patient is our only focus. Give yourself the time to be fabulous! Some cosmetic patients can be “pickier” with the results they demand and are paying for. You must have the patience and perseverance to deal with these personalities. If this is not your personality, recognize this and evaluate whether these types of patients are a good fit for your practice.

Cosmetic treatments also entail more planning, diagnosing and time to execute. We use a case plan form that delineates all the items that must be checked. This is useful for the entire team, including the doctor. You don’t want to be in the middle of sending a case to the lab and discover that you forgot the prep (stump) shade or the impression of the patient’s temporaries.

FLORIDADENTAL.ORG

May I add that becoming a fabulous cosmetic dentist means much less (or zero) dependence on dental insurance? My practice is entirely fee for service. I have never signed a contract with any insurance company, and I don’t plan to ever do so!

When you have services that people want and desire, they will find ways to pay for what they value. We explain that we will file insurance if the patient has a plan, and they can expect to be reimbursed by their insurance company directly. We further explain that “insurance” is merely a “discount coupon” for their treatment, and we are happy to help them get their discount.

A recent innovation we made in our practice is the addition of a dental membership plan. For non-insured patients, they love that they can join our plan and have all their cleanings, exams and X-rays covered for an entire year. They also receive a significant discount on any dentistry they need or want. Most of our uninsured patients have been appreciative of this added service.

After many years as a cosmetic dentist, creating fabulous smiles and healthy teeth still give me a thrill. I love coming to the office on a day when I only have one patient, and I know they will leave with a great new look. If I have inspired any of my colleagues to follow this path, I am truly grateful for the opportunity.

Reference: 1. Encyclopedia.com, accessed on Aug. 4, 2020.

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esthetic or aesthetic

1.6

1.0

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1.0 .75

Is itEsthetic orAesthetic 44

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?

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I want to show you that “Beauty is in the eye of the beholder” is not a true statement. Aesthetics is the philosophy of the nature of beauty and is a subjective, sensory value with links to emotions. The concept of beautiful human form has no effect from social influences or changes over time. Many animals have mating rituals that are dependent on the good looks DR. PAUL MILLER of the opposite sex. Models that Dr. Miller is a general dentist in made it to the top in their cultures New Port Richey and can be reached at molar01@msn.com. also look attractive to the rest of the world. Babies have been shown to fixate on beautiful faces, leading scientists to believe there may be a gene for that. This saying took hold in the last part of the 19th century to give all people hope of finding a mate. So, what is the common factor in all these situations?

It’s symmetry and the golden rule. The need for aesthetics may be socially driven, but aesthetic principles are not. Facial and body symmetry combined with the golden rule of proportions is what makes something or someone beautiful to the eye. The Egyptians called this pleasing proportion the sacred ratio, and they used it to build the pyramids. They were the first culture to be obsessed with human beauty based on this principle.

Greek sculptors in 400 B.C. used it in their statues and called it the Greek letter phi. Leonardo Da Vinci, most famous for his human form drawings, called it the Divine Proportion and is credited with finding it in all of nature. It took until 1564 for a mathematician, Simon Jacob, who called it the golden ratio, to pin the number at 1.618. In modern times, we call it the golden rule, or the rule of thirds, and it’s found all around us.

This philosophy of beauty has crossed all social and cultural barriers in all of time.

Cosmetics is the science of technics and materials used to achieve the aesthetics of symmetry and proportion. Body tattoos and piercings are not aesthetic, but rather a fad or statement. They’re rarely symmetrical or proportional. While a tattoo or jewelry may be beautiful in its own right, no one ever

FLORIDADENTAL.ORG

says that tattoos or piercings make you more beautiful. The cosmetic techniques used in plastic surgery and dentistry do improve aesthetics. Hopefully, all dentists consider themselves cosmetic dentists, i.e., not wanting to make people ugly.

Why is this important when practicing dentistry? Proportions established by lines and shapes are the basis for aesthetics and not color. Yes, I said not color! (I remember a time when A3.5 was the only shade I used. Now it’s rare to use anything darker than A2.) Patients usually think the color of their teeth is the problem because they don’t understand the golden rule. Often, I will have a patient say they hate their teeth and want them whiter. When I show them they are already shade B1, they are confused. The whitest periodontally involved teeth are still ugly. How many times have you had patients show you a small, fuzzy Polaroid picture of them and exclaim they want their teeth to be like that again? You would have to be a mind reader to tell what they are seeing and remembering. So, I educate the patient about making teeth aesthetic by showing them an ideal picture with normal A2 shades. Then it is up to me to use cosmetic techniques to make teeth taller not wider and having decreasing widths from the facial aspect (centrals being 1.6, laterals 1.0, canines 0.6), make sure the distal vertical emersion profile lines are parallel as they fade off to the corners of the mouth. Frame the teeth by altering the gingival zenith with a little diode laser troughing.

Finally, you can make a feminine or masculine age-specific shape by the amount of rounding done to the corners. Rounder is feminine and younger; flatter or square is masculine and older. The eye perceives the width as the flat section of the tooth, so you can trick the eye into seeing a narrower or wider tooth than exists by making a longer or shorter curve to achieve the golden rule. It’s that simple — it works every time.

I make them whiter just to enhance the effect. Even diastemas can be pleasing to the eye if the rule is followed for the adjacent teeth. I’ve been known to even get out the boley gauge for tough situations. Even those patients with purple hair, more piercings than teeth and tattoos all over their body desire this aesthetic.

So, what is it: Esthetic or aesthetic? I think aesthetic looks more beautiful.

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facial aesthetics

A NEW FACE IN DENTISTRY Dentists have a long history in facial aesthetics, beginning with the work of Dr. Varaztad Kazanjian, a dentist who volunteered during World War I to rehabilitate wounded soldiers to current day maxillofacial prosthetics.

Throughout the world, general dentists are becoming more involved in facial aesthetics than ever before.

DR. DAVID KIMMEL

Dr. Kimmel is a general dentist in Hudson, Fla. and is faculty at the American Academy of Facial Aesthetics. He can be reached at dskimmel@me.com.

I’ve been teaching facial aesthetics for more than a decade and am always asked these three questions: “Is it really worth adding this service to dental practices?” “How hard is it to bring these services into the practice?” “How can I make this profitable when products cost so much?” These procedures have grown to be 35% of my practice. Facial aesthetic procedures can be profitable and rewarding for you and your patients. I wish I could say it happens overnight, but it doesn’t.

Like any other new procedure brought into your office, it takes commitment to pull this off. You need to train, get your staff on board, work out your systems and get patients to accept treatment.

Training is more readily available than ever before. To succeed in implementing facial aesthetics, find a program that has a continuum that builds upon your skill levels and knowledge, and teaches the needed skills to start basic procedures on Monday morning. From the ability to give comfortable injections, in-depth understanding of facial

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anatomy and handling of complications, these aspects give us a unique understanding of aesthetics that makes it a perfect addition to our armamentarium. Often, getting the staff on board can be a challenge. However, you’ll be pleasantly surprised that it’s not the case with facial aesthetics — you’ll find that your staff will volunteer to be your patient for training courses. And just like patients, they will push you to learn more. It’s vital to involve staff in the learning process — they’ll interact with the patients not just about the procedures, but also what to expect after treatment. More importantly, just as with dental procedures, they are invaluable in helping to evaluate your work. Have you ever worked on a central incisor and something just didn’t quite look right? Then your assistant points the suction at the line angle that is the problem. This same principle applies to facial aesthetics. When you make your staff look good and feel good about themselves, it’s easy to build a great team for facial aesthetics.

Systems are the heart of integrating aesthetics into a dental practice, and many are the same we use in dentistry. However, there are some that are different. Inventory and pricing can make or break you. In dentistry, there are formulas to determine what to charge for services. For instance, a crown fee should be four times the lab fee. Facial aesthetic procedures have a different formula to follow. Neuromodulators (NMs) like Botox, for example, FLORIDADENTAL.ORG

“

From the ability to give comfortable injections, in-depth understanding of facial anatomy and handling of complications, these aspects give us a unique understanding of aesthetics that makes it a perfect addition to our armamentarium.

can have varying price points dependent on many factors.

Companies that make NMs have different pricing structures that are volume dependent. Some providers even use NMs as a loss leader, pricing far below what you can afford. A common way to price NMs are by finding the high and low price in your market. You do not want to be the most expensive nor the cheapest. You often end up with 50% of your fee being the cost of your product. With such a low profit margin, you must be efficient in providing this service. Fortunately, this is easily done by combining appointments. I routinely combine my hygiene and NM recall. In this way, there isn’t a separate room breakdown and setup. At the end of the hygiene appointment I take less than 10 minutes to do a NM recall case. This adds an easy $150-200 profit to a routine hygiene appointment. Yes, your hygienists are going to be on board with you by keeping them looking good.

Another factor you need to consider with NMs is that they’re only good for 24 hours once reconstituted per manufacturers’ recommendations and how much to keep in stock. When first getting started, it can be tough to have enough patients to use a full bottle of NM in one day. It’s common practice to reconstitute NM off-label with preserved saline, which gives you four weeks to use the NM. No need to tie up your profit in inventory either. The good news is the NM companies have 24-hour express shipping. When first starting, it works well to

Fig. 1: Lip enhancement with dermal filler.

FLORIDADENTAL.ORG

”

always have two bottles of NM. When you open one bottle, order one. This way you always have enough. The same principal works with dermal fillers. Although the profit margin is more in line with crown and bridge dentistry, it’s still possible to tie profit up in inventory. Again, with these companies having 24-hour express shipping, it’s more profitable to only keep a working inventory.

Putting this all together won’t work if you don’t have patients.

This is the easy part. Your practice is full of them. Just ask on your medical history if your patients are currently using dermal fillers or NM, and you’ll be surprised how many are.

Another pleasant surprise is how quick your staff will be willing to promote this new service. An easy thing to do is have them carry a copy of their before and after pictures to show to patients or have the front desk display their pictures. Facial aesthetic companies supply marketing materials you can place around the office. Lastly, Instagram is an active place to market your practice for aesthetic procedures.

Integrating facial aesthetic procedures into your practice can be financially and emotionally rewarding as a practitioner.

Patients will look forward to their appointments. It’s also rewarding to our patients as these procedures can be done comfortably in their dental office with a high degree of excellence.

Fig. 2: Gummy smile treated with Botox.

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FDC2021 Speaker Preview

YES, Crown Lengthening Will Enhance Your Restorative Results It’s common for dentists to become frustrated when recently placed crowns or bridges develop red and/or sore tissues at the margins. Or, in some situations, a tooth may look so badly broken down that a dental implant seems obvious, dissuading the clinician from even considering treatments that not only might save the tooth, but also render it predictably restorable.

Dr. Jim Kohner Dr. Kohner is a periodontist in Denver, Colo. and is an instructor at the Perio Institute.

He can be reached at JamesKohnerDDS@gmail.com or 602.390.2229.

Dr. Kohner will be presenting his courses, “Crown Lengthening: Can it REALLY Enhance Restorative Results?” and “Crown Lengthening Workshop” at the 2021 Florida Dental Convention.

Visit floridadentalconvention. com to learn more about these courses.

There often are solutions to those types of everyday restorative challenges, so that every brokendown tooth does not have to be extracted and potentially become an implant. Many of those problematic teeth can be restored predictably, and the above types of challenges solved. Giannobile and Lang stated in a 2016 editorial in the Journal of Dental Research1 that “… the erroneous belief of implants yielding a better long-term prognosis has now clearly been rejected in several studies and reviews.” They go on to say that “teeth even compromised because of periodontal disease or endodontic problems may have a longevity that surpasses by far that of the average implant,” and they offer 16 bibliographic entries to support their statement.

It’s worth noting their premise and keeping the idea in mind that all compromised teeth do not have to become implants. Fortunately, there is a basic procedure that might help avoid restorative frustrations with badly broken-down teeth and allow saving and predictably restoring these teeth that seem hopeless at first glance.

The procedure, and one that many clinicians overlook, is crown lengthening. While this is a “periodontal” procedure, the goal of crown lengthening is clearly intentioned as a “restorative” procedure. Crown lengthening has essentially remained unchanged throughout the past 30+ years and remains as useful now as it was then. It has applications in all parts of the mouth.

Often, there isn’t enough clinically visible tooth structure for retention on posterior teeth, with preps going subgingivally far enough that obtaining a predictable hassle-free impression is a challenge (Figs. 1-2). The clinical situation in Fig. 2 is an illustration where clinicians will be tempted to prep subgingivally for more retention, only to end up with marginal impingement on soft tissues, causing inflamed and sore soft tissues, or compromised impression results that can produce

SEE PAGE 50

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Fig. 1: Excessive tissue around second molar due to thick bone on palate, which forces tissues more coronally than would be desired for ideal crown preps.

Fig. 2: Same tooth as Fig. 1 with crown off, illustrating lack of tooth structure for sound restoration and potential to have open margins or impingement when reaching subgingivally for retention.

Fig. 3: Provisionals in place. Note distal of provisional is subgingival (arrow).

Fig. 4: Same area following osseous reduction and shortening of soft tissue to expose previously hidden, but sound, tooth structure.

Fig. 5: After three months healing with provisionals still in place. Note more tooth structure is now available for preps and the margin location can avoid any soft-tissue impingement, and even can be located supragingivally, if desired. Also note the distal of the provisional (arrow) is no longer buried under tissue, an indication of how much more tooth structure is available.

Fig. 6: Final restorations showing that adequate tooth structure has allowed for supragingival margins despite very short teeth to start with. Also, the restorations are done with less stress and higher predictability for taking impressions.

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FDC2021 Speaker Preview FROM PAGE 48

sions, the need for subgingival margins or potential soft-tissue impingement,6 such as in Fig. 7. Final restoration with healthy tissue and enough tooth to allow for good retention and avoiding deep subgingival margins is seen in Fig. 6.

In the aesthetic zone, errors of margin placement can be even more noticeable when inflammation results from crown margins impinging on the soft tissues (Fig. 7). Learning the concepts of crown lengthening and proper margin location can help avoid those inflammatory complications.

Fig. 7: Soft-tissue reaction following laser soft-tissue removal with no bone reduction. The placement of crowns within the space for biologic width attachment leads to impingement and subsequent inflammation.

open margins as an example. This can occur because of excessive gingiva as in this situation, or deep caries or fractures.

While these teeth display too much soft tissue, the problem typically is too much bone underneath the soft tissue, resulting in soft tissues moving coronally over and around thick bone.2, 3 When clinical crowns are short, the finish lines often end up subgingivally as illustrated, with a deep distal margin on the provisionals in Fig. 3. This deep finish line location can lead to inadequate impressions, which in turn can lead to open margins.

To shorten the soft tissues, with the goal of exposing more tooth structure, bone reduction is crucial for predictable clinical results, since soft tissues will grow back to establish the normal dimension of soft tissues, called biologic width4, 5 if bone is not moved. The dimension of biologic width is typically 3 mm coronal to osseous crest. That is the normal development of soft-tissue dimensions whether bone is or isn’t removed.5 After removal of bone and soft tissues, the two allegedly compromised teeth in Figs. 1-2 can have adequate tooth structure exposed (Figs. 4-5), thus avoiding difficultly with taking impres-

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The stated goals of crown lengthening in a restorative application, as listed in the American Dental Association’s CDT Codes, is below and it offers an explanation of just how that inflammation seen in Fig. 7 can occur, or what the goal is for restoring teeth with limited clinical crown available: To expose enough sound tooth structure to allow placement of a restorative margin onto that sound tooth structure, to have adequate mechanical retention, and at the same time avoid disrupting or impinging on any of the gingival fiber attachments to the tooth.

In the rush to use the latest new materials and greatest techniques such as implants or lasers, the benefits and applications of crown lengthening often are ignored. But instead of being pushed aside and forgotten, this “old standard” should make its way into every contemporary clinician’s armamentarium.

Of course, each tooth with restorative/soft-tissue problems is not automatically an indication for crown lengthening! Extraction leading to an implant or a fixed or removable appliance always needs to be in the differential diagnosis. Orthodontic extrusion could be considered as well, as it is sometimes a viable option, but that is a topic for another paper and has been covered by others.

Not every indication could be covered in this short article.

Some indications for crown lengthening, or what some clinicians call gum shortening, are: FLORIDADENTAL.ORG

Excessive gingival display in the anterior, often associated with thick bone Short posterior teeth usually associated with excess gingiva and thick bone Uneven gingival levels Subgingival fractures Subgingival caries Previous crowns and finish lines too close to the softtissue attachment and the bone As an adjunct to implant treatment, where super-eruption had occurred Using some of these ideas could help clinicians accomplish more predictable impressions and more predictable restorative results, not to mention happier patients when complications are avoided.

References: 1. Giannobile, W.V., Lang, N.P. Are Dental Implants a Panacea or Should We Better Strive to Save Teeth? J. Dental Research 2016, vol.95 (1) 5-6 2. Deas DE, Moritz AJ, McDonnell HT, Powell CA, Mealey BL. Osseous surgery for crown lengthening: A 6-month clinical study. J Periodontology 2004;75(9):1288-1294.

3. Arora R, Narula SC, Sharma RK, Tewari S. Evaluation of supracrestal gingival tissue after surgical crown lengthening: a 6-month clinical study.

J Periodontology.

4. Coslet J, Ingber J, Rose L. The “Biologic Width” – A Concept in Periodontics and Restorative Dentistry. Alpha Omegan 1977; 70:24-28 5. Gargiulo A, Wentz F, Orban B. Dimensions and Relations of the Dentogingival Junction in Humans. J Periodontology 1961;32, 261.

6. Newcomb, GM. Relationship between the location of subgingival crown margins and inflammation. J. Periodontology 1974; 45:151-154

FLORIDADENTAL.ORG

“

Fortunately, there is a basic procedure that might help avoid restorative frustrations with badly broken-down teeth and allow saving and predictably restoring these teeth that seem hopeless at first glance.

”

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data management

DATA MANAGEMENT

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FOR DIGITAL PRESCRIPTIONS BETWEEN THE LAB AND DENTAL OFFICE

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data management

MARY A. BARTLETT

Mary A. Bartlett is president and co-founder of Safelink Consulting Inc., an internationally recognized regulatory compliance consulting firm specializing in the dental industry.

Digitizing your restorative workflow is becoming a norm for dental practices. Intraoral scanners now are becoming a common item in a dental practice due to claims by scanner manufacturers that it’s more comfortable for the patient and provides a more accurate measurement. The dental laboratory owners also are being required to digitize to meet the needs of their dental clients who are using digital technology.

the Act as it applies to this subject and follow the requirements of their state board to meet those requirements.

As with any new equipment and processes, however, there are learning curves. In addition to more comfort for the patient, it benefits the dental staff by not having to mix impression material. For the dental lab, the use of digital impressions eliminates the process of disinfecting impressions and reduces the time to disinfect incoming impressions.

n Name, address and license number of the registered dental lab

Digital workflow also can include transmitting the work authorization or prescription electronically. This now requires the dentist and the dental laboratory who will be manufacturing the appliance to comply with their state Dental Practice Act (“Act”). This typically means that the dentist must provide a signature on the work authorization and the dental laboratory must retain that work authorization for a designated period in the Act. If the dental laboratory does not meet the requirements of the state board, then sanctions can be imposed on the dental laboratory owner.

n Date sent to lab

Unfortunately, the Dental Practice Acts in most states haven’t kept up to date with technology. The Florida Board of Dentistry is an exception, since they do recognize that electronic signatures can be acceptable. The dentist and the dental laboratory must read

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Here are some excerpts from three state board requirements:

Florida Must use approved work order forms and contain:

n Name, address and license number of the Florida-licensed dentist who owns the work order form and is authorizing the procedure n Name of patient(s)

n Signature of the licensed dentist, which may be an electronic signature Copies of work order forms must be maintained, either on paper or stored electronically in an encrypted database, by the dentist for a period of four years.

Georgia Dentist must furnish a written prescription that must be written in duplicate with original delivered to the lab technician and duplicate retained by dentist; both must retain this record for 10 years from date of delivery of the prescription. The board also states that the prescription must contain specific information including the signature and address of the licensed dentist.

FLORIDADENTAL.ORG

Illinois Dentist must furnish a written prescription in duplicate with specific information including the number of the dentist’s license to practice dentistry. Also, it states that if the dentist or the lab doesn’t abide by their requirements that it could result in a Class A misdemeanor, plus the dentist’s license can be revoked or suspended. The Illinois State Board also requires the dental laboratory to notify the dentist if a subcontractor is going to be used along with specific information about the subcontractor.

The dentist’s signature can be provided in various ways. n Hard copy: It can be handwritten on a paper prescription that is delivered to the dental laboratory along with the case components. There are some states that go to the extent of stating that it must be handwritten in “blue.” n Electronic signatures: The U.S. Federal ESIGN Act defines an “electronic signature” as an electronic sound, symbol or process, attached to or logically associated with a contract or other record and executed or adopted by a person with the intent to sign the record. Unless otherwise indicated by a state board, an electronic signature should be acceptable on a prescription or work authorization.

“

The current issue in dentistry is that some of the electronic prescriptions do not contain the dentist’s signature.

The lack of a signature places the dentist and the dental laboratory in a difficult situation.

”

The current issue in dentistry is that some of the electronic prescriptions do not contain the dentist’s signature. The resolution to this would be for the dentist to also provide a hard copy prescription containing the information specified by the state board. The lack of a signature places the dentist and the dental laboratory in a difficult situation.

This is another aspect of dentistry where the dentist and the dental laboratory owner need to collaborate to avoid sanctions by the state board.

FLORIDADENTAL.ORG

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Henry Schein

HIPAA

So, What Exactly is a Security Risk Analysis?

MATT DIBLASI PRESIDENT, ABYDE

Contact Abyde for a complimentary HIPAA educational webinar as an FDA member at abyde.com/webinar/fda.

You might be aware that all dental practices need to complete a security risk analysis (SRA) as a part of their HIPAA-compliance program, but do you know exactly what this analysis covers? While this is the first step and among the most important aspects of a complete HIPAA program, it’s often missed or not properly completed. In fact, during the latest round of Office for Civil Rights’ (OCR) audits, 83% of covered entities could not show a properly documented SRA for their practice.

The HIPAA Security Rule defines an SRA as an “accurate and thorough assessment of the potential risks and vulnerabilities to the confidentiality, integrity and availability of electronically protected health information held by the covered entity or business associate.” In layman’s terms, the risk analysis is a systematic review of your processes and policies that is ultimately designed to shed light on any aspects of your practice that could be considered weaknesses in protecting the privacy and security of your practice and the protected health information (PHI) it holds. Not having a properly documented analysis leaves potential risks unidentified and is a huge red flag for your overall compliance efforts.

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“

Completing a risk analysis for your organization is not just a one-time thing. Assessments should be reviewed periodically — especially as new work processes are implemented or technologies are updated.

”

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HIPAA

FROM PAGE 58

What questions does an SRA need to include? There is no specific checklist to follow when it comes to performing a risk analysis for your practice. However, the OCR does provide specific elements that should be included. Your assessment should: assess current security measures used to safeguard PHI. n identify where PHI is stored, and how it’s received or transn mitted for the full scope of your practice. This includes accounting for all areas from your electronic medical records system to your patient billing systems. assess whether the current security measures are used n properly. determine the potential impact of a breach of PHI. n assign risk levels for vulnerability and impact combinations. n identify and document potential threats and vulnerabilities. n document the assessment and take action where necessary. n

ing more information electronically rather than in a physical exchange are all things that will need to be addressed for any additional vulnerabilities or threats they bring on.

What’s the best way to tackle an SRA? If your organization hasn’t completed an SRA before or has done so in a more basic or incomplete manner, using an outside organization will help to ensure all areas of the SRA are fully completed and documented accordingly. A third party also can help add new areas and questions to the SRA that reflect changing regulations as well as technology enhancements that present new threats or vulnerabilities to your organization.

Abyde is an FDA Crown Savings endorsed partner and the Abyde software solution is the easiest way for any sized dental practice to implement and sustain comprehensive HIPAA-compliance programs. FDA members save 20% on Abyde services that help their practices meet government-mandated HIPAA standards that protect patient health information by identifying and correcting key security safeguards. Visit fdaservices.com/ abyde or call 800.594.0883.

Completing a risk analysis for your organization is not just a one-time thing. Assessments should be reviewed periodically — especially as new work processes are implemented or technologies are updated. After events such as COVID-19, addressing any changes your practice made regarding remote operations, using telehealth services, or receiving/provid-

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12

online community management

Tips

to Engage with Your Patients and Respond to Reviews Online

From your social media platforms to your online reviews, it’s important to keep a pulse on what your patients are saying and engage in positive dialogue.

Proactively engaging with patients on your online platforms helps you keep your practice top of mind, highlight services and products, and get feedback from your patients.

The following are best practices for engaging on your online platforms:

2 “Like” and respond to positive comments — even a simple “Thank you!” or “You’re welcome!” The commenter will appreciate it, and it keeps positive comments at the top of the thread.

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1 Check your social media platforms at least once a day and aim to respond to messages and questions within 12 hours. This shows your audiences that they are valued and ensures you are handling any issues quickly.

3

4

Ensure that all posts and responses are on-brand, professional and respectful.

Hide or remove comments with inappropriate language, threats, HIPAA compromises (such as photos where individuals’ faces are shared without consent) or negative mentions of a specific doctor. Consider including these community guidelines in your “About” section.

FLORIDADENTAL.ORG

5 Identify sensitive questions or comments and determine the best course of response. This could include patient complaints and questions on cost, billing or office policies. A good practice is to take the conversation in private via direct message.

7

Now, you might be wondering what to do when a patient or follower shares a negative review, comment or complaint. You may be tempted to delete the post, respond tersely or even fire back. But remember that the rest of the online community is “watching” your actions. It’s critical to show professionalism and respect and to take the time to think through the question and best response. While you can’t control every comment or review, your response may help prevent further negative feedback. The following are tips to keep in mind for negative reviews:

8

6 Decide whether it is worth it to respond on a case-by-case basis. In some cases, it may be best not to respond, depending on the content of the review, the volume of reviews for your practice, etc.

9

If you respond, do so in broad “all patient” terms and office policies versus getting into a direct dispute.

Do not get into an online debate over the incident that prompted the negative review. Doing so can look defensive or confrontational.

10

11

12

Consider this example response: “Our office strives to provide the best service to all patients. We would like to learn more about what happened and hope you will contact us as soon as possible.”

Negative reviews should not be removed, unless they include profanities or statements of hate, reference a specific provider or violate any privacy policies.

Make sure that any response represents you as a compassionate, concerned and understanding professional.

Invite the negative reviewer to contact you directly to discuss the issue further.

Consumers don’t expect businesses to have 100%, five-star reviews. Engaging with positive online comments and reviews, while thoughtfully handling any negative feedback, will help your practice strengthen your relationships, reputation and service to your patients.

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FDAS: Bank of America practice solutions

Financing promotions practice solutions

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• Available minimum loansare of expansions, $250,000 with flexible repayment options • Loanfor types that qualify practice remodels, relocations, and additional locations • You’ll also get for a competitive rateofthrough maturity, and you’ll know the rate up front • Available minimum loans $250,000 with flexible repayment options • Established loan applications must be received byknow December • You’ll alsoproject get a competitive rate through maturity, and you’ll the rate1, up2020 front and interim

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Bank of America account. Sponsorship of endorser’s products and services is not an expressed opinion or approval by the Bank. All promotional and marketing materials are Bank of America Practice Solutions property and, as such, cannot be changed, altered or modified, orally or of Americaregarding and the Bank America logo are registered of America Corporation. of America Solutions is a division of Bank of America, N.A. ©2020 Bank of America Corporation | MAP3208743 | 08/2020 in writing.Bank All questions theseofmaterials should be directedtrademarks or referredoftoBank a Bank of America PracticeBank Solutions Sales Practice Associate.

Bank of America and the Bank of America logo are registered trademarks of Bank of America Corporation. Bank of America Practice Solutions is a division of Bank of America, N.A. ©2020 Bank of America Corporation | MAP3208743 | 08/2020 1

PSC Group, Inc.

built for the cloud

Are you still relying on a server-based system for your practice management?

Risks and costs are high if you plan to maintain the status quo and stick to your server. The cloud is the modern way to efficiently reduce cost and increase efficiency in your practice.

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FLORIDADENTAL.ORG

Moving to the Cloud vs.

Built for the Cloud: Choosing the Right Cloud-based Practice Management System If you’re on a legacy, server-based software and you want to begin reaping the many benefits of cloud-based practice management, there are a couple of ways to approach this move. You can transition to your current provider’s cloud version of their practice management software. Even though it’s the same company, ROBERT MCDERMOTT your system will look and function PRESIDENT AND CEO, differently than how you’re used to ICORECONNECT operating. Understandably, this is due to substantial technical challenges when trying to translate old technology (server-based software) to a completely different technology (cloud platform).

The other option is to evaluate a cloud-based software service actually “born” in the cloud. That means the software doesn’t face the same burden of translating old software because it’s developed in the cloud from the beginning. This can offer you more robust capabilities at a competitive cost, along with rapid customer support.

Let’s look at the differences in a designed-from-scratch, exemplary cloud-based system.

Eliminate Software Upgrade Fees A cloud-based practice management system offers agility. An efficiently designed cloud-based practice management system includes updates and upgrades every four to eight weeks due to new HIPAA laws, to improve system functionality and en-

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hance the user experience based on direct customer feedback.

These improvements should be included at no additional cost.

Eliminate Hardware Fees If you’re using a server-based system (the server sits somewhere in your office), then you’re well aware of multi-thousand-dollar expenses incurred every time you need new hardware. Replacing a server can easily cost $5,000 every few years and often more. With the cloud, you say “Goodbye” to those in-office servers and “Hello!” to saving money.

Access Responsive, Real-time Support at No Cost Have questions? Get them answered promptly by real people.

Look for a cloud-based provider who delivers real-time support, an attitude to solve problems and customer care at no additional cost. That’s right — support doesn’t have to cost extra cash and you don’t have to wait on hold for long periods of time.

Protect All Your Records When all your practice data lives on one server (and possibly a backup hard drive kept in your car, briefcase or spare bedroom), a natural disaster, broken water pipe or stolen computer can result in total data loss. That could prove catastrophic to your business, requiring several weeks — or much longer — to remedy. With exceptional cloud-based practice management, your data is protected at multiple secure, off-site data centers and continually backed up in real time. That offers SEE PAGE 69

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Books iCoreDental

SHELF

NOW AVAILABLE ONLINE! FDA: Books on the An FDA-members Shelf only benefit!

Read reviews of the latest scientific and clinical information, or choose a book from the shelf and write a review. And, keep the book at no charge!

floridadental.org/member-center/publications/books-on-the-shelf

DON’T MISS THE DEADLINE!

MANDATORY CE COURSE DUE BY JAN. 1, 2021

All Florida-licensed dentists and hygienists are required to complete a one-hour course on human trafficking by Jan. 1, 2021.

The FDA offers this course at the discounted rate of $35 for FDA members and $55 for team members.

Go to floridadental.org/online-ce to access the course.

built for the cloud

FROM PAGE 67

you multiple levels of secure, HIPAA-compliant backups. Your records won’t be lost or destroyed because of a disaster at your practice. In the case of a total computer loss, run down the street to buy a new computer or tablet, and get back up and running fast.

Work from Anywhere When a patient ends up needing care while you are out of the office, you can log in from anywhere, check records, write prescriptions, and send or receive images. Cloud-based systems are accessible anywhere you have an internet connection. You can even use your phone as a hotspot.

Not VPN By the way, a virtual private network (VPN) is not the widely accepted definition of cloud-computing. If anyone proposes using a VPN to access your practice management system, many of the advantages and conveniences discussed above will not apply.

If you haven’t moved to the cloud, it’s time. You’ll improve your practice workflow and protect your data. Choosing a practice management system natively built for the cloud will equip you with the functionality and support to move your practice forward.

iCoreConnect is an FDA Services Crown Savings merchant with expertise in cloud-based technologies to improve and protect your practice. FDA members receive special discount pricing on iCoreConnect’s services, including iCoreDental cloud-based practice management software. Visit iCoreConnect.com/FDA or call 888.810.7706.

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Cloud-based systems are accessible anywhere you have an internet connection. You can even use your phone as a hotspot.

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2020 STATEMENT OF OWNERSHIP

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DRS. AUSTIN BELKNAP*, DONALD M. COHEN, NEEL BHATTACHARYYA AND NADIM M. ISLAM

A 70-year-old female presented to Dr. John Mazzuoccolo at North Florida Oral and Facial Surgery in Orange Park, Fla. for the evaluation of a painless swelling of the right posterior maxilla. The patient’s past and present medical history was noncontributory. The patient reported the swelling to be present for the last few months. Clinically, both hard- and soft-tissue expansion was noted extending from tooth No. 2, which was mobile, to the tuberosity.

The panoramic radiograph (Fig. 1) showed an ill-defined radiolucency involving the upper right maxilla. The CBCT revealed a multilocular, expansile lesion of soft-tissue density associated with the right posterior maxilla (Figs. 2-3).

The lesion extends beyond the superior aspect of the scan, incorporating most of the right maxillary sinus, and extends inferiorly to the displaced alveolar crest (Fig. 2). The lesion extends anteriorly from the displaced facial cortex, to the first molar region and posteriorly to the displaced left pterygoid process of the sphenoid bone (Fig. 3). Dr. Mazzuoccolo performed an incisional biopsy and the tissue was submitted to the Oral Pathology Biopsy Service at the University of Florida (UF).

Question: Based on the given history, panoramic radiograph and CBCT images, what is the most likely diagnosis?

Fig. 1: Panoramic radiograph reveals an ill-defined radiolucency lesion of the right posterior maxilla.

Fig. 2: CBCT imaging: Coronal view shows an expansile and destructive multilocular lesion encroaching to the right maxillary sinus.

Fig. 3: CBCT imaging: Axial view showing a destructive and expansile multilocular radiolucent lesion of the posterior right maxilla.

A. Metastatic Carcinoma B. Odontogenic Myxoma C. Odontogenic Keratocyst D. Large Periapical Cyst E. Ameloblastoma SEE PAGE 72 FLORIDADENTAL.ORG

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diagnostics FROM PAGE 71

Diagnostic Discussion A. Metastatic Carcinoma Incorrect, but due to the destructive radiographic presentation, this is probably located at the top of your differential diagnoses list. Metastatic carcinoma is the most common form of cancer involving bone. Nevertheless, metastases to the oral cavity are rare and account for only about 1.5% of all malignant tumors in this region. Reported primary sites, which have metastasized to the oral cavity include breast, lung, thyroid, kidney, prostate and colorectal, with approximately 70% being of epithelial origin. The patient did not report any history of a malignancy. Clinically, metastatic disease to the oral cavity has a wide variety of signs and symptoms. The most common symptoms include paresthesia, pain and swelling, mass formation and loosening of teeth in the absence of periodontal disease. The massive destruction seen in the radiograph is similar to that seen in a metastatic lesion, which presents as a radiolucent defect that frequently localizes in areas of preexisting inflammation. Metastases to the mandible are four times more common than to the maxilla, and this is due to the increased marrow vascularity. Our lesion appears ill-defined on the panoramic radiograph, but the CBCT images better demonstrate a destructive lesion similar to metastatic malignancy. If this diagnosis is included in your list of differentials, we emphasize the importance of submitting a tissue sample for microscopic examination to rule out this fatal entity.

B. Odontogenic Myxoma Incorrect. Odontogenic myxomas are benign, rare and somewhat aggressive intraosseous tumors that arise from the odontogenic ectomesenchyme. These lesions usually are found among younger adults, with an average age range of 25 to 30 years. Odontogenic myxomas may be found in any area of the jaws, but the mandible is involved more commonly than the maxilla. The posterior maxilla is involved in about 16% of cases. The clinical presentation varies from smaller lesions that are asymptomatic to large, rapidly progressive and expansile lesions. Radiographically myxomas appear as a uni- or multilocular radiolucency that can displace or cause resorption of

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teeth. Not seen with our lesion, myxoma’s radiolucent margins often are irregular or scalloped and contain wispy, thin trabeculae of residual bone. Large myxomas, found in the mandible have shown a “soap bubble” radiolucent pattern, which are radiographically indistuishable from ameloblastomas.

C. Odontogenic Keratocyst Incorrect, but should be included in your list of differentials.

Odontogenic keratocysts (OKCs) are considered developmental odontogenic cysts that arise from cell rests of the dental lamina. A broad age range is associated with these cysts, but about 60% of all cases are diagnosed in people between 10 to 40 years of age. The mandible is involved in 60-80% of cases, and the posterior maxilla is involved in 20% of cases.

These cysts are known to cause boney expansion and can radiographically appear as large, multilocular “soap bubble” radiolucencies that can be destructive, similar to this case.

Also comparable with our case, as OKCs enlarge, they characteristically grow anterior-posteriorly and often cause clinical expansion. However, the degree of expansion seen in OKCs is considerably less than seen in large ameloblastomas. Also, one-third of the cases are associated with an unerupted/impacted tooth. The diagnosis of OKC is based on the histopathologic features since the radiographic features may resemble other entities, including dentigerous cysts and ameloblastoma.

D. Large Periapical Cyst Incorrect. When the epithelium at the apex of a tooth is stimulated by inflammation, a periapical cyst is formed.

Remember that these periapical lesions are almost always associated with non-vital teeth. Patients usually provide a history of dental pain and/or drainage. At the very least, decay should be apparent or a history of trauma, neither of which are seen for this case. These lesions can grow to a very large size if left untreated and are usually noted on routine radiograph.

Periapical cysts most commonly are situated at the apex of the involved tooth. An important point pertaining to this case is that periapical inflammatory disease almost never presents as a multilocular radiolucency. Root resorption and occasional boney expansion can be seen, but never as extensive as in our case.

E. Ameloblastoma Correct — great job! This diagnosis should always be on your list of differential diagnoses whenever the patient presents with a multilocular expansile radiolucency. Ameloblastomas FLORIDADENTAL.ORG

are the most common clinically significant tumors of odontogenic origin and are considered benign but locally aggressive.

Ameloblastomas involve all age groups, with a peak incidence within the third and fourth decade. These lesions most often are found in the posterior angle of the mandible and ascending ramus but have occurred anywhere in the mandible or maxilla.

Overall, 80% of all ameloblastomas occur in the mandible and 20% in the maxilla. As with our case, clinically, painless buccal and/or lingual expansion is characteristic. Ameloblastomas tend to be destructive and unlike this case, root resorption commonly is seen. Radiographically, ameloblastomas can be unilocular, but most often are multilocular radiolucencies. The characteristic radiographic appearance is that of a “soap bubble” appearance and erosion through the cortex with extension to the soft tissue is common. CBCT findings have reported cystic areas of low attenuation with scattered isoattenuating regions, representative of soft-tissue components.

Ameloblastomas are known for local destruction and do have the propensity for recurrence if not completely excised. CBCT imaging is extremely useful in the assessment of these tumors and assists in the mapping of the cortical destruction. The current accepted management of ameloblastoma is resection with wide margins and aesthetically acceptable reconstruction of the residual defect. This case poses some major treatment issues due to the amount of destruction and patient’s age.

Therefore, Dr. Mazzuoccolo referred to the oral surgery team at the UF Jacksonville for her definitive treatment.

References: Adeel M, Rajput MSA, Arain AA, Baloch M, Khan M. Ameloblastoma: Management and Outcome. Cureus. 2018;10(10):3437.

Dunfee BL, Sakai O, Pistey R, Gohel A. Radiologic and pathologic characteristics of benign and malignant lesions of the mandible. Radiographics.

2006;26(6):1751-1768.

Effiom OA, Ogundana OM, Akinshipo AO, Akintoye SO. Ameloblastoma: current etiopathological concepts and management. Oral Dis. 2018;24(3):307-316

Diagnostic Discussion is contributed by UFCD professors, Drs. Don Cohen, Indraneel Bhattacharyya and Nadim Islam who provide insight and feedback on common, important, new and challenging oral diseases.

The dental professors operate a large, multi-state biopsy service. The column’s case studies originate from the more than 12,000 specimens the service receives every year from all over the United States.

DR. COHEN

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

Drs. Bhattacharyya, Cohen and Islam, can be reached at oralpath@dental.ufl.edu.

Conflict of Interest Disclosure: None reported for Drs. Bhattacharyya, Cohen and Islam.

DR. BHATTACHARYYA The Florida Dental Association is an

ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association 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 CE proDR. ISLAM vider may be directed to the provider or to ADA CERP at ada.org/goto/cerp. *Third-year resident in Oral and Maxillofacial Pathology University of Florida College of Dentistry.

Francisco AL, Chulam TC, Silva FO, et al. Clinicopathologic analysis of 14 cases of odontogenic myxoma and review of the literature. J Clin Exp Dent. 2017;9(4):e560-e563.

Kaplan I, Raiser V, Shuster A, et al. Metastatic tumors in oral mucosa and jawbones: Unusual primary origins and unusual oral locations. Acta Histochem. 2019;121(8):151448.

Neville, BW, Damm DD, Allen CM, and Chi AC. (2016) Oral and Maxillofacial Pathology. 4th edition, WB Sanders, Elsevier.

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

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 10th of every other month (e.g., Jan. 10 for the Jan/Feb issue, March 10 for the March/April issue, etc). Please note: Ads for the Nov/Dec issue must be received no later than Nov. 1.

Please visit the FDA’s Career Center at careers.floridadental.org.

Oral Surgeon — Aventura. Established multi-specialty group is looking for a part time Oral Surgeon for our Aventura and North Miami locations.

Great opportunity to work with an outstanding group of professionals and dedicated staff. Well-equipped facilities, CBCT on premises, fully digitalized office. Large practices with a robust patient base, in house and external referrals provided. Potential for a substantial amount of production from day one. Please contact us via email at dk1013d@outlook.com or call us at 786213-5706. Current Active Florida License. Board Certified.

Naples, FL General Practice for Sale. If you’ve been looking for the idea practice in southwest Florida, look no further! New to the market is a busy general practice in Naples, FL. Located in a retail center with great visibility this practice is in a desirable part of town. With thirty new patients per month, it certainly isn’t slowing down any time soon. The current doctor is interested in staying on for a smooth transition or open to an affiliation with the right group. For an overview of this practice on the Paradise Coast, read below: 6 operatories; Collections over $1.8 million; Adjusted EBTIDA $530,000; SDE $890,000; Over 1,500 active patients. Ready to learn more about this exquisite practice? Contact Kaile Vierstra with Professional Transition Strategies via email: kaile@professionaltransition.com or give us a call: 719.694.8320. We look forward to hearing from you!

Dental Director (Insurance). This position oversees clinical aspects of multiple departments at Argus Dental & Vision, Inc. This is a Full-Time role.

Summary of Essential Job Functions: Acts as the central point of contact for clinical insight on all dental operations decision-making needs or client escalation concerns, including tasks such as, but not limited to, utilization management medical necessity review of prior authorizations, review of denial recommendations on prior authorization, CDT code cost analysis, chart reviews, and quality reviews. Oversees the Dental Provider Manual and Dental Clinical Guidelines construction and revisions. Stays abreast of all industry policy and regulatory updates, writing executive summaries as needed to share with the executive team. Participates/supports any internal dental client audits as needed. Conducts peer to peer discussions and education with dental providers as necessary. Reviews grievance and appeal cases as requested, including Quality of Care cases. Participates in the grievance process, including Maximus or ALJ hearings as needed to ensure a fair member outcome. Reviews over and underutilization and upcoding or improper coding. Ensures provider fee schedules are constructed properly from the clinical perspective. Chairs the Dental Peer Review Committee.

Works with the Credentialing department to oversee the credentialing of all dental providers. Conducts provider outreach and education based off feedback from the provider and member surveys. Writes “From the Desk of

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the Dental Director” columns for the provider newsletter. Participates as a member of the Utilization Management Committee, the Health Education and Wellness Committee, Grievance and Appeals Committee, and the Quality Improvement Committee. Assists with the investigation and write up of risk management cases. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed. Required Knowledge, Skills and Abilities: DDS/DMD degree and current state license (Florida required).

Ability to thrive in a fast-paced organizational structure. Experience working on projects in a team-based environment. Takes initiative and responsibility: a self-starter with a strong focus to meet deadlines and deliver results with a high attention to detail. Proficient in MS Office software, including Outlook, Word, PowerPoint, and Excel. Capable of identify processing deficiencies and initiate recommendations for process improvement. Exhibits a professional demeanor. Excellent communication, interpersonal, organizational, project management and planning skills required. NOTES: Telecommuting is allowed. Visit careers.floridadental.org/jobs/13883821.

Associate Dentist — Brandon. Let us allow you to do what you do best by doing the dentistry that you diagnose while exploring future partnership opportunities. We follow through on our promise to clinicians with our culture of patient centric care, our ability to deliver comprehensive integrated care, and our ability to support modern dentistry. PDS supported owner dentists know that being backed by the country's leading dental support organization allows them to focus on providing patient centric and clinically excellent care. Benefits: Competitive Compensation and Benefit Package; Modern offices equipped with the latest dental technology; Malpractice Insurance; Healthcare Benefits (Medical, Prescription Drugs, Dental and Vision); 401(k) Savings Plan; The average full-time PDS-supported Dentist earns $160,000 - $390,000. Testimonial from Dr. Callaway-Nelson: “Partnering with PDS has given me the opportunity to realize my dream of practice ownership. I am able to do the dentistry that I love.” Pacific Dental Services is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military status. Apply Here: bit.ly/3hwLhs8.

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General Dentist — Lakeland. Let us allow you to do what you do best by doing the dentistry that you diagnose while exploring future partnership opportunities. We follow through on our promise to clinicians with our culture of patient centric care, our ability to deliver comprehensive integrated care, and our ability to support modern dentistry. PDS supported owner dentists know that being backed by the country's leading dental support organization allows them to focus on providing patient centric and clinically excellent care. Benefits: Competitive Compensation and Benefit Package; Modern offices equipped with the latest dental technology; Malpractice Insurance; Healthcare Benefits (Medical, Prescription Drugs, Dental and Vision); 401(k) Savings Plan. The average full-time PDS-supported Dentist earns $160,000 - $390,000. Testimonial from Dr. Callaway-Nelson: “Partnering with PDS has given me the opportunity to realize my dream of practice ownership.

I am able to do the dentistry that I love.” Pacific Dental Services is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military status. Apply Here: bit.ly/3iDP8F0.

Dental Assistant — Orlando. Overview: Responsibilities: Perform functions in accordance with the applicable state’s Dental Auxiliaries Table of Permitted Duties; Actively participate in the Perfect Patient Experience by striving to keep your patients focused on optimal treatment while attending to their individual needs and concerns; Escort patients to/from the front desk and introduce them to other team members as appropriate. Maintain a clean, sterile, and cheerful environment; Record patient charting and all of the dentist’s notes in the digital patient chart as directed by the dentist; Maintain strict compliance with State, Federal, and other regulations, (e.g., OSHA, WC, Dental Board, HIPAA, ADA, DOL, HR policies and practices). Qualifications: Necessary industry certifications and education; Possess outstanding time management, communication, and technical skills; Can-do attitude, a proactive nature, a strong sense of ownership and integrity and a desire to continue to learn and grow; Demonstrate knowledge of dental terminology, instruments and equipment. Benefits: Medical, dental and vision insurance; Continuing Education (CE Units); Paid time off; Tuition Reimbursement; Child care assistance; 401K; Paid time to volunteer in your local community.

Pacific Dental Services is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military status. Apply here: bit.ly/2FDYZN1.

Endodontist Position OPEN! ENDODONTIST WANTED: We are a growing Endo office in Tampa Florida and we are looking for a new Associate Doctor.

We have all the latest in technology including CBCT in each office, Digital Xrays, Zeiss Microscopes, etc. We are looking for a motivated People-Person to join our team. We have the patients and need someone ASAP. Full time or Part-Time. Dental Degree, Endo Certificate, Florida State Dental License. Visit careers.floridadental.org/jobs/13694313.

The Villages/Ocala Area General Dental Practice For Sale with Real Estate.

10 year old Fee For Service/No Insurance Quality General Dental Practice For Sale. Centrally located among several 55+ communities including The Villages. 950 sq. ft. Free standing building built in 2008 with additional vacant lot. 2 operatories fully equipped, 1 more plumbed, and plenty of room for expansion. Almost an acre of land on busy US 301. $205 gross, $102 net on three days, referring out all endo and extractions. Incredible potential in a beautiful area full of outdoor activities. Could stay on part-time for the right buyer. $500k for practice and real estate. Visit careers.floridadental.org/ jobs/13686503.

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Oral Surgeon & Prosthodontist — Broward County. Oral Surgeon and Prosthodontist wanted to join a multispecialty practice in Broward County.

Equity position available. Please contact us at 954-4749660. NOTES: 2 openings. Visit careers.floridadental.org/jobs/13676179.

Associate Dentist — Fort Myers. At our affiliated practice Towncare Dental of Ft. Myers, we’ve been transforming smiles and changing lives for more than 22 years. Trained in the latest techniques and the newest technology, our Fort Myers dentists and dental specialists are superbly equipped to handle all of your family’s dental care needs. We offer a comprehensive suite of preventive, cosmetic, restorative and reconstructive services for all ages. Outstanding Associate Opportunity for an experienced General Dentist to join one of our highly successful affiliated practices in the Fort Myers, FL area. Strong commitment to long-term dental care for the whole family. Be chair side and make money from day one. Highly trained and dedicated staff to support you. No Day-to-Day headaches of Managing a Practice. Excellent compensation pkg. with performance based incentives. Well-established and growing patient base. Full Time Dentist Benefits Package: Company paid professional liability insurance; DCA sponsored continuing education; Medical Insurance; Dental Plan; Life Insurance; Vision Insurance; Long Term Disability; Section 125 - Flexible Spending Account; 401K; EAP Program; DCA Voluntary Supplemental Insurance Products. Licensed to practice in state of Florida. NOTES: Additional Salary Information: Excellent Comp & Benefits.

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off the cusp

WHY I LOVE DENTISTS

JOHN PAUL, DMD FDA EDITOR

Dr. Paul can be reached at jpaul@bot.floridadental.org

Right now would be a great time to tell “Woe is Me” stories. The Rona has made sure everyone has one. Things just aren’t right, and it’s hard to find any good news.

the stump for the Tooth Party. He’d remind every one of us that it’s our duty to give back to the profession that provides us our lifestyles and to improve the situation for every dental patient.

This is why I love dentists. Not dentistry — that’s another story — but dentists.

I’m painting with a pretty broad brush, but I think it’s deserved. Our story starts out with a tragedy that happened to one of our friends, prominent oral surgeon and avid cyclist Dr. Jerry Bird, known to many as the voice of dental political action. He took a tumble from his bike, leading the fall with his head and a couple of ribs. As I write, he’s not doing too well, but he’s much improved from over a couple of weeks ago and we feel better that this life’s little side trip will turn out OK after a while. The first thing that made me proud was my staff. They wanted to know if I had heard about the dentist in Orlando who had a bike accident. The second question they asked was what days they needed to book me out of my office so I could help cover his. This is what we are known for, helping each other when times are tough.

Several people realized Jerry’s full-time job right now is recovery and felt that they should step up and carry the flag for Jerry. The fact that so many people had the same thought, “I can’t cover his office, but I can take this thing off his todo pile,” should make us all proud. You might work alone, but there are plenty of other dentists who are concerned about your well-being and willing to help without being asked. A lot of folks took the “Maize and Blue Challenge”* initially issued by Dr. Paul Palo, as maize and blue are the school colors of Jerry’s beloved Michigan Wolverines.

Most are pretty funny, check them out on Facebook. The number of people who accepted the challenge is amazing because I can imagine most folks are like me and a bit hesitant to video themselves making a plea for a political donation.

Normally at this time of year, Jerry would be waving the flag and pounding

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It’s not too late to be part of the fun.

When we put on the Tooth Party pin and talk about politics as dentists, we

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only talk about things that effect dentistry and our patients. We believe that dentists know a lot about what is best for the profession and how best to provide care for citizens of Florida and the U.S. It’s our job to educate those who make our laws and support those who help us out. It doesn’t matter who is a Democrat, Republican, Libertarian or Independent if you will give us a chance to spread the Tooth Party message.

JOHN PAUL, DMD, EDITOR, TODAY'S FDA

*The Facebook “Maize and Blue Challenge” was started by Florida Dental Association (FDA) member Dr. Palo to honor his friend and colleague (and University of Michigan fan), Dr. Bird. The challenge is to post a short video on Facebook where the dentist wears the maize and blue colors, announces their donation to the FDA Political Action Committee, encourages others to donate and finishes by challenging three other dental colleagues to do the same.

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