2016 - Jan/Feb TFDA

Licensure Exams A Week in the Life Big Cases, Little Patients

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VOL. 28, NO. 1 • JANUARY/FEBRUARY 2016

AV E D YO YO EN U R UR T D AL FL E EA L O N F E D IC RI EW B . L I N EN DA E D 2 8 E SE : ?

FLA-MOM

TRY MY AGENT

contents Turning the tables: Brogan and Harper Paul give their dad, Dr. John Paul, his six-month check up.

Cover photo by Sharon Paul

Insurance for your Dental Career

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news

literary

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news@fda

Letter to the Editor

20 Board of Dentistry

Rick, thank you so much for taking the time to explain and clarify some of the complexities of health insurance coverage. You were very helpful in explaining to me what are the most appropriate options for our particular situation. My husband and I feel more confident to make the right decisions for us and our working team.

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- Lynette Salheiser

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New Innovations in Dental Licensure Examinations

37

Digital & Social Media Advertising Campaigns

f e at u r e s 27

Who is the Alliance of the FDA?

28

Fluoridation

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A Week in the Life of an Old Pediatric Dentist

3

Staff Roster

5

President’s Message: #GivingBack

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Legal Notes

11

Information Bytes

45 Diagnostic Discussion 92

Off the Cusp

40 Big Cases, Little Patients

classifieds

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FLA-MOM

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Creating a Kid-friendly Waiting Room

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Give Kids a Smile

Practice Administrator

60 Dental Lifeline Network

Hans R. Salheiser, DMD, PA Endodontic Specialist, Sarasota, FL

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Exhibit Marketplace

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FDC2016 Speaker Profile — Dr. Fred S. Margolis

74

FDC2016 Speaker Profile — Drs. Richard H. Madow and David M. Madow

75 FDC2016 Speaker Profile — Dr. John P. Kenney

and David M. Madow

Read this issue on our website at:

www.floridadental.org.

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

columns

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82 Listings

RENEWING YOUR LICENSE? WE HAVE INFORMATION! Online CE: page 38 CE Broker FAQs: page 48 Five Ways We Protect Your License: page 77

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

January/February 2016

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FLORIDA DENTAL ASSOCIATION

CONTACT THE FDA OFFICE 800.877.9922 or 850.681.3629

JANUARY/FEBRUARY 2016 VOL. 28, NO. 1 The last four digits of the telephone number are the extension for that staff member.

EDITOR Dr. John Paul, Lakeland, editor

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

BOARD OF TRUSTEES

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ONLINE CREDIT CARD PAYMENT Visit floridadental.org/dues to pay your dues in full or set up a dues installment plan with a credit card.

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1111 E. Tennessee St. • Tallahassee, FL 32308

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

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

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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.

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January/February 2016

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@Ralph RALPH C. ATTANASI JR., DDS, MS

#GivingBack

DOCTOR’S ORDERS

The dental profession and health care industry are heavily regulated. Issues debated at the state level impact Florida dentists every day, and cavities will continue to take over the mouth of dentistry if we don’t use our voice.

The FDAPAC is our tool to ensure a positive outcome on critical issues such as: 1.

2.

3.

4.

5.

6.

7.

Dental student loan repayment program Funding for Donated Dental Services Funding for Community Water Fluoridation Maintaining educational standards for graduates of non-accredited dental schools Increasing funding in the Medicaid program for dental services Maintaining direct dentist involvement in ownership of dental practices Opposing scope of practice changes for dental hygienists (outside of their training/patient protection) 8. Opposing the creation of dental health aide therapists (DHATs)/mid-level providers 9. Opposing dental hygienists receiving a Medicaid number to bill for services directly 10. Opposing the arbitrary rating of dentists by insurance companies

As a state PAC, funds raised will go to local candidates who share our vision and will stand with us on these issues. They don’t have to pull our teeth for support; instead they must only follow the doctor’s orders to have: • Support of local dentists • Legislative potential • Accessibility to organized dentistry • A favorable health care philosophy • Support of other organizations and individuals Together, we have a unied voice to make an impact in the public policy arena on behalf of Florida dentists and our practices, patients and profession.

Questions?

Joe Anne Hart, Director of Governmental Affairs: jahart@floridadental.org • 850.224.1089

FDAPAC is a state-registered political committee that makes contributions to state candidates and committees. Contributions to FDAPAC and ADPAC are voluntary and any member has the right to refuse to contribute without reprisal. The contribution guidelines are merely suggestions and a member may contribute more or less or not at all without concern of favor or disadvantage by the association. Corporate donations to ADPAC will be used exclusively to pay for the administrative and operating expenses of ADPAC. Contributions are not deductible as charitable contributions for federal tax purposes.

Growing up, I learned the importance of participating in charitable organizations from my father. As many of you may know, my dad was a pediatrician. What you may not know is that he volunteered at a children’s clinic run by the Catholic Charities of New York City every Thursday throughout his career. Oftentimes, we would go as a family and help those in need in whatever way we could. This construct has stayed with me and guides my actions each and every day.

When Dr. Ethan Pansick and I first opened our prosthodontic office, we made ourselves available to the local community and offered to provide volunteer services to those in need.

One day, a fifteen-year-old Salvadoran boy with a partially restored cleft palate was brought into my office from a local clinic. He was having difficulty eating and was being bullied by the other children because of his speech impediment. I knew we could assemble a team and help this young man, so that’s what we did. It was dental volunteerism at its best.

Today, he is a proud American citizen who owns his own business and recently got married.

He also gives back doing volunteer work in the community. He even wants one of his future children to become a dentist, thus fulfilling the “American Dream.”

signed up for these. If you have, I would like to thank you! If you would like more information regarding any of these programs or have a personal charity that you feel we should learn about, please contact us.

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

Please folow us on Facebook and Twitter.

The Florida Dental Association has many volunteer opportunities you can participate in: Give Kids A Smile, Donated Dental Services, Project: Dentists Care, and our Florida Mission of Mercy event this year in Jacksonville are just a few that we offer. Many of you have already

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Your participation makes us the leaders in our community and brings smiles to all those involved — after all, that’s what we do best!

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January/February 2016

” Today's FDA

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Legal Notes

Legal Notes

What about the Children?! Won’t Somebody Please Think of the Children!?

An Advanced Discussion on Florida Informed Consent Law, HIPAA Privacy Rights and Dentistry (Part One) Graham Nicol, Esq., HEALTH CARE RISK MANAGER, BOARD CERTIFIED SPECIALIST (HEALTH LAW)

According to Wikipedia — everyone’s favorite reference — Helen Lovejoy is a fictional character from “The Simpsons” — everyone’s favorite television show. Her catchphrase is “What about the children?! Won’t somebody please think of the children!?”

While she meant it satirically, it is an effective reminder for dentists that Florida law treats children and many others differently when it comes to informed consent and records privacy. So, next time you are faced with determining who is the decisionmaker for purposes of federal HIPAA and Florida informed consent law, remember Helen Lovejoy and “think about the children!” and those other patients who are treated differently under Florida law.

For purposes of our discussion, the informed consent and records privacy

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“decision-maker” is the individual(s) legally empowered to: v consent to treatment. v refuse treatment (even if it is lifesaving). v pay for treatment. v authorize insurance or managed-care claims. v pursue or settle medical malpractice litigation. v access the Florida Dental Association’s peer review program. v control the use and disclosure of personally identifiable health information (PHI). v decide about records access, amendments, accounting of disclosures, etc.

Usually, the decision-maker is the patient.

But when you “think about the children!” it often is the patient’s legal representative(s) — rather than the minor patient — who is responsible for informed consent and HIPAA privacy decisions. For example, HIPAA says, “a Covered Entity must … treat a personal representative as the individual” for purposes of privacy decisions.1 But who has authority to act as the representative on behalf of an individual patient is not determined by HIPAA. Rather, it is determined under Florida’s informed consent law.2 Consent under HIPAA to use and disclose PHI is related to, but different than,

informed consent under Florida law. The former relates to records privacy decisions; the latter relates to permission to provide or refuse clinical care. However, Florida’s informed consent law controls who the decision-maker is for both treatment and HIPAA privacy issues.

Overview of Informed Consent and Privacy Decision-Makers Under HIPAA,3 it is clearly the patient or the patient’s legal representative(s) — not the treating doctor or the Covered Entity’s privacy official — who is the decision-maker. Doctors can no longer presume to decide about treatment or informational privacy without being aware of their patients’ rights under Florida informed consent law and HIPAA. HIPAA therefore calls into question the traditional notion that the doctor is the “owner” of the medical records and the records are his or her personal property.

At least one court has concluded that “although patients have rights to access their records concerning medical treatment … it is well settled that these records … become property belonging to the doctor.”4 And, the Florida Board of Dentistry states that the records are the “property of the owner dentist.”5 But does the doctor really “own” the records?

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Under HIPAA, it is more precise to think about records ownership as comprising “sticks in a bundle.” If each stick represents a property right (e.g., the right to dispose of the property, the right to prevent others from taking it without permission, the right to charge others a fee to use it, etc.), then it becomes apparent that the doctor owns some, but not all, sticks in the bundle.

Who is the Decision-maker for Informed Consent and Privacy Issues?

The rule to determine who — between the patient and the doctor/Covered Entity — is the treatment and privacy decision-maker is simple. It’s almost always the patient. In fact, Florida’s Constitution, Article I, Section 23 says: “Every natural person has the right to be let alone and free from governmental intrusion into the person’s private life except as otherwise provided herein.”

Florida courts have construed this language to mean that patients have almost absolute authority to control what is done to their bodies.

But the rules to determine who — between the patient and the patient’s legal representative(s) — is the informed consent and privacy decision-maker are more complicated. Under HIPAA, the privacy official must follow the instructions of the patient’s legal representative even if they explicitly contradict the patient’s instructions. Often, the representative — not the patient — is the sole or exclusive decision-maker, having all the HIPAA privacy rights associated with the individual patient’s PHI. To like effect is Florida law regarding informed consent.

But HIPAA does not specify which representatives have legal authority. It forces privacy officials to understand state law.6 Nor does HIPAA specify who the decision-

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maker is when there are two or more representatives and they disagree (e.g., divorced parents of a minor child). Only Florida law answers these questions. The answer varies depending on the type of patient and the type of PHI at issue. The Florida rules are outlined immediately below.

privacy decisions on their behalf. These representatives are specified under Florida law and include:11

Pediatric Patients

When the child is a juvenile delinquent or a foster child, there is a “custodian” (see Part Two in the next issue). When the child is in the care of someone else pursuant to a health care power of attorney, there is a “guardian” (see Part Two). In Part One, we’ll discuss natural and adoptive parents, and divorced parents who disagree on treatment and records decisions — especially who has to pay! These are the most common situations encountered in private practice.

The typical situation in private practice involves pediatric patients.7 In Florida, a “minor” is anyone under the age of 18.8 In general, minors are not recognized as health care decision-makers because they have not attained “legal age.” They cannot give informed consent for medical care.9 Similarly, they cannot make decisions regarding use or disclosure of their own PHI under HIPAA. A 16-year-old in Florida can lawfully operate a Chevy Suburban that weighs 7,300 pounds and may constitute a “deadly weapon” for purposes of criminal violations10 (especially if you drive a heavily abused 1972 Ford Torino like I did when I was 16!). But a 16-year-old in Florida with a toothache has to have mom or dad authorize dental care. Initially written in 1973, the statute seems anachronistic 43 years later, but it nevertheless remains Florida law. And maybe that’s okay. I honestly don’t know if 18-year-olds in 1973 were any more or less mature than 18-year-olds in 2016. It probably depends on the individual more than chronological age, but regardless, 18 years or older is the dividing line between children and adults marked by Florida law when it comes to medical care.

In Florida, “minors,” or those under 18, suffer from the “disability of nonage” meaning they cannot enter into contracts, have their contracts enforced against them, sue, be sued, consent to or refuse medical care, or authorize use and disclosure of their own PHI. Representatives must make records

v a natural or adoptive parent. v a legal custodian. v a legal guardian.

Natural or Adoptive Parents Florida dentists should recognize the parents of minor patients as the primary privacy decision-makers under HIPAA. Normally, they also have lawful authority to consent to their minor children’s treatment under Florida law.12 But there are exceptions depending on the type of patient, the type of procedure and the type of PHI at issue.

Five exceptions depend on the type of patient at issue: v If the child has been legally adopted, the adoptive parents — not the natural (or birth) parents — are the privacy and treatment decision-makers. v Parents have no informed consent rights over general medical treatment provided to foster children or juvenile delinquents. In these circumstances, the custodian (discussed in Part Two), not the parents, gives informed consent.

Thus, the custodian, not the parents, is the privacy decision-maker regarding use and disclosure of PHI pertaining to treatment authorized by the custodian.

Please see LEGAL, 8

January/February 2016

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Legal Notes

Legal Notes

LEGAL from 7

v Florida law allows a parent to agree that the minor and the doctor may have a confidential relationship. Under HIPAA, the privacy official also may withhold PHI from the parent but only to the extent of the confidentiality agreement. The agreement must be in writing to be enforceable. Such confidentiality agreements are rare in dentistry compared to other medical services like abortion, pregnancy tests, treatment of sexually transmissible diseases, etc. v When a doctor’s professional judgment is that the child has been (or will be) subjected to abuse or neglect — or that recognizing the representative as the informed consent and privacy decision-maker could endanger the child — the dentist may disregard the representative’s authority. Under HIPAA, domestic violence and endangerment circumstances require independent review by a “licensed health care professional.” If the privacy official is not licensed (e.g., the office manager), then a doctor should be consulted. v When the minor patient has been emancipated under Florida law. Emancipation means that patients under 18 have nevertheless attained legal age and have had the disability of nonage removed from them. Therefore, the privacy official must recognize them, not their parents, as the sole decision-makers with respect to informed consent and records privacy issues. Emancipated minors include those who:13

v are currently married. v have been married in the past (e.g., divorced or widowed). v have been adjudicated as adults in civil14 or criminal proceedings. v are in custody or under supervision by the Florida Department of Corrections.15

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Other exceptions depend on the type of treatment at issue. These exceptions apply to a number of medical — but no dental — treatment decisions, as follows: v Minors may obtain treatment for sexually transmissible diseases without the consent of parents or guardians.16 v Unwed pregnant minors may consent to medical treatment regarding their pregnancy.17 v Minor mothers (but not fathers) may consent to medical treatment regarding their children but only if the services are performed by a hospital, clinic, physician or osteopathic physician.18 v Minors 17 or older may consent to donate blood.19 v Minors 13 or older may access outpatient crisis intervention services and treatment without parental consent.20

The “Both Parents” Rule Under Florida law, both parents have equal authority (i.e., independent of the other parent’s position) to make (or withhold) informed consent to treatment. Therefore, both parents share authority to exercise the unemancipated minor’s privacy rights under HIPAA.21 HIPAA allows the privacy official to disclose (or allow access to) an unemancipated minor’s PHI to either parent if such disclosure is permitted by or authorized under Florida informed consent law. But if disclosure to one parent is prohibited by Florida informed consent law, the privacy official violates HIPAA by making disclosure or allowing that parent to access or copy the PHI. Where state law is silent or unclear, HIPAA allows the privacy official to follow the instructions of a licensed health care professional.

In practical effect, the “both parents” rule means that either parent has lawful authority regarding the use or disclosure of PHI

and consent to dental treatment. This is true even if the other parent refuses to sign the acknowledgment or authorization form.

Similarly, either parent has lawful authority to access PHI, to request an accounting of disclosures, to request restrictions on disclosure, etc. But, with regard to informed consent, we will see that if the parents disagree, then the dentist is placed in an awkward position and needs to do a little more “due diligence.”

Divorced Parents Florida’s “both parents” rule creates a potential problem for records privacy and informed consent when, as is common, divorced parents take opposite positions (e.g., the custodial parent requests restrictions on PHI disclosures to the non-custodial parent while the non-custodial parent demands access). Before agreeing to any such restrictions or denying access under HIPAA, the privacy official must determine which parent has “parental responsibility” under Florida law.22 Similarly, if there is a dispute between the divorced parents over informed consent, the dentist must proceed carefully.

Parental responsibility is different from “physical custody.” Primary physical custody normally is given to one divorced parent (with the other having visitation rights). In contrast, parental responsibility over health care decisions usually is shared equally by both parents.

For example, the mother may consistently bring the child to your office and be the only one to pay for services. The mother has physical custody. That does not necessarily mean the father has lost parental responsibility over his child. Even though he has divorced his wife and no longer lives with the child, he is still the child’s parent. Only if a court determines that it is in the child’s best interests will sole parental

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responsibility be given to one parent (e.g., other parent in jail, has a record of domestic violence, is a sex offender or is a substance abuser).

parents who disagree regarding treatment or records privacy of their minor children, and the legal difference between parental responsibility and physical custody.

If a divorced parent asserts that the other parent has no parental responsibility rights under Florida informed consent law, and is therefore not the privacy decision-maker under HIPAA, the dentist should get a copy of the dissolution of marriage order from the court. That does not mean that your staff needs to travel to the courthouse; rather, ask the parent asserting sole parental responsibility to provide you with a copy of the court order. You’ll find that most divorced parents who have sole parental responsibility are more than familiar with this drill and will have a copy readily at hand.

You are entitled to rely on what the court order says unless it appears to a reasonable person that it is fake. In bitter divorces, I’ve seen that happen as well.

Part Two of this article will be published in the next issue of Today’s FDA and will discuss other exceptions to informed consent and records privacy law. It will discuss health care powers of attorney, what to do when the dental practice cannot locate the adoptive or natural parents of the minor patient, records privacy rights when the patient has deceased, and informed consent and privacy decision involving unemancipated minors in custodial settings.

Other Patients In addition to minor children, there are several other types of patients who are treated differently under Florida informed consent and federal records privacy laws.

This article discusses pediatric patients, natural or adoptive parents, emancipated minors, the “both parents” rule, divorced

(Endnotes) 1. 45 C.F.R. §164.502(g)(1).

2. §766.103, Fla. Stats., is Florida’s informed consent law.

3. 45 C.F.R. §§164.501 and 164.502(g).

4. Walden v. Ball Corp., 619 N.Y.S.2d 841 (A.D. 3d Dept., 1994).

5. 64B5-17.002(5), Fla. Admin. Code.

6. 45 C.F.R. §164.502(g).

7. Of course, the parents of the child may give a healthcare power of attorney to someone else (e.g., to the grandparents while the parents go on vacation).

8. §§1.01(13) (defines “minors”); 382.002(11) (defines “legal age”); and 743.07(1), Fla. Stats.

9. Under Florida law, exceptions apply where the minor has been emancipated (e.g., the minor has been adjudicated as an adult in a criminal proceeding, has been or is currently married, etc.).

10. See, e.g., V.A. v State, 819 So2d 847 (Fla. 4d DCA

2002).

11. §743.0645(1)(c), Fla. Stats.

12. §743.0645(1)(c), Fla. Stats., defines “person who has the power to consent as otherwise provided by law” to include a “natural or adoptive parent, legal custodian, or legal guardian.” §743.0645(1)(b) defines “medical care and treatment” to include “ordinary and necessary medical and dental examination and treatment, … but does not include surgery (and) general anesthesia….”

13. §743.01, Fla. Stats.

14. §743.015, Fla. Stats. This is unusual because a circuit court must find emancipation is in the minor’s best interests based on the minor’s character, habits, education, income, mental capacity for business, and ability to provide his or her own food, shelter, clothing, medical care, and other necessities.

Doctors should obtain a copy of the judgment on record in the county where the minor resides.

15. §743.066, Fla. Stats. This exception is different than the one applicable to juvenile delinquents.

Here, the child is adjudicated as an adult and is under the jurisdiction of DOC, not DJJ. Note also that the disability is not removed for medical services relating to abortion or sterilization.

16. §384.30, Fla. Stats.

17. §743.065(1), Fla. Stats.

18. §743.065(2), Fla. Stats.

19. §743.06, Fla. Stats.

20. §394.4784(1), Fla. Stats.

21. Typically, natural or adoptive parents are joint, co-equal guardians of their minor children. Section 744.301(1), Fla. Stats., states: “The mother and father jointly are natural guardians of their own children and of their adopted children, during minority.” The mother of a child born out of wedlock is the natural guardian of the child.

22. §744.301(1), Fla. Stats. See also, In re Dubreuil, Case No. 80,311 (Fla. Supreme Court, November 4, 1993) which states: “Under Florida law,… a child with two living natural parents has two natural guardians who share equally the responsibilities of parenting… in the absence of any contravening legal agreement or order.”

What Florida Dentists Need to Know about Prescription, Controlled Substance and Pain Management Laws (LC01) Patient Abandonment (LC02) Take these courses online to earn free CE credit. For links, go to floridadental.org/members. FDA Members Only! www.floridadental.org

January/February 2016

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Work With the Best ®

Information Bytes

Children and Technology

Nationally Respected. Locally Made.

By Larry Darnell DIRECTOR OF INFORMATION SYSTEMS

Can you remember the technology you had when you were a child? I can, because that’s what got me interested in computers. There was a video game where a white blip went across the screen and hit a white paddle over and over again … that’s right, it’s “Pong” by Coleco. When I was 12, I had a Telestar system and I remember thinking what an impressive piece of technology it was. It’s right up there with the Mattel classic handheld football game, where little red blips go across a tiny screen to score touchdowns — I remember how fascinated I was by that.

Today, children start out with way much more impressive technology than I ever could have

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imagined when I was 12. I remember watching the old “Star Trek” TV show and thinking how cool that technology was — and now we have a lot of that in use today.

Technology is advancing at such a fast pace; I would not want to speculate what we might have in 2025. I’m still amazed that when I bought my children high-tech toys, they would rather play with the box than that toy. Technology is now woven into every facet of life. We

One team.

Every case. Every time.

have even more ways to communicate with each other and, yet, we seem to communicate less.

So, what’s my point? Don’t let technology take the place of a relationship. Children, whether

“

Children, whether they are your patients or your children/ grandchildren, still need and desire human interaction, no matter how much technology we provide for them.

”

they are your patients or your children/grandchildren, still need and desire human interaction, no matter how much technology we provide for them. Technology is a tool and should

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

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January/February 2016

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Members‘ Opinion

Letter to the Editor The Florida Dental Association (FDA) welcomes letters from readers on articles that have recently appeared in Today’s FDA (TFDA) and matters of general concern to Florida dentists. The FDA reserves the right to edit all communications and requires that all letters be signed. Letters must be no more than 550 words and may cite no more than five references. Brevity is appreciated. No illustrations will be accepted. You may submit your letter via email to fda@floridadental.org, by fax to 850.561.0504 or by mail to Florida Dental Association, Attn: TFDA Editor, 1111. E Tennessee St., Tallahassee, FL 323086914. By sending a “Letter to the Editor,” the author acknowledges and agrees that the letter and all rights of the author in the letter become the property of the FDA. Letter writers are asked to disclose any personal or professional affiliations or conflicts of interest that readers may wish to take into consideration in assessing their stated opinions. The views expressed are those of the letter writer and do not necessarily reflect the opinion or official policy of the editor, staff, officials, Board of Trustees or members of the FDA.

Letter to the Editor

By Diane Ede-Nichols, DMD, MHL, MPH

Dear Dr. Paul, I want to congratulate you and the Florida Dental Association (FDA) for highlighting a special population of dental patients — those with disabilities! The articles in the September/October issue of Today’s FDA outlined the need for oral health care, the nuances of treatment and the tremendous satisfaction achieved when working with “special” patients.

Seven days after taking my first born, a healthy 8 lbs. 14 oz. beautiful baby boy, home from the hospital, the first sign something was not quite right occurred — he had a seizure. As a new dental school graduate and a first-time mother, the future for my child and my career appeared frighteningly bleak. What was subsequently diagnosed as a grade III bilateral intraventricular hemorrhage of unknown origin, soon changed the future course of many lives — most especially mine.

www.floridadental.org

has been diligently working to provide excellence in oral health care to people with disabilities since 2003. A wonderful clinic filled with excellent and committed faculty, staff, residents and students was established through the combined efforts of Drs. Robert Uchin and John Tabak, myself and others. We welcome young adults through seniors with developmental or acquired disabilities, the medically or psychiatrically complex, and the frail elderly.

For several years while seeking medical care for my own child, I was exposed to many other children with a broad range of disabilities. What I didn’t know at the time was that this event would be the catalyst for an incredibly gratifying career of providing special care dentistry to many individuals who — through no fault of their own — would never enjoy what most of us would consider a “normal” life! Although I was uncertain how, I knew that given the chance to help these individuals in any way, I would be grateful for the opportunity.

Our main goal is to provide quality care while educating residents and students to do the same once they become communitybased practitioners. We also serve as one of Florida’s safety net dental homes for patients who are unable to be seen in the private sector and may require additional modalities of behavior management.

Fast forward 28 years — my son is a tall, intelligent, funny and kind young man who holds both bachelor’s and master’s degrees from Florida State University and I have been privileged to provide special needs dental care to many people. Over the last 26 years, I’ve had the incredible opportunity to work with people with special health care needs through my residency training and subsequently as a faculty member in two dental schools.

As a proud member of both the FDA and Nova faculty, I encourage you to continue to bring this important subject to light until every Florida-licensed dentist and every person with a disability can share in a mutually beneficial oral health relationship.

Below are two links for video segments on our clinic as a snapshot of what we do there: http://bit.ly/1OizKa6 http://bit.ly/1IF8eXC

Dr. Ede-Nichols is an associate professor and chair of Community and Public Health Sciences at Nova Southeastern University School of Dental Medicine.

I am pleased to share that Nova Southeastern University College of Dental Medicine

January/February 2016

Today's FDA

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

Put Renewing Your Membership at the Top of Your To-do List!

Happy New Year! A big thank you to our members who already have renewed their Florida Dental Association (FDA) membership by taking advantage of the various forms of payment options we offer. We love how our members promptly respond to take care of business! If renewing for 2016 is still on your to-do list, remember these are some of the options available to you: m Online payment in full or monthly credit card payment plan enrollment: If you opt for a payment plan before Jan. 20, 2016, your Total Investment Amount will be divided into nine equal payments beginning in January 2016.

Your last installment will be processed in September 2016. To pay your dues online, please visit www.floridadental. org/dues. m Mail: Payment in full via check or credit card, or credit card payment plan. m By phone: Call the member relations team (800.877.9922), and make a payment in full with your credit card by phone. Please note: monthly payment plan enrollment cannot be accepted over the phone.

Questions or concerns? Contact your member relations team at 800.877.9922 or membership@floridadental.org. We are always happy to help!

14

Today's FDA

January/February 2015

Volunteer at the 2016 FLA-MOM! In 2014, in response to the deficit in Florida’s access to care — and the consequential decline in the quality of public oral health — the Florida Dental Association (FDA) Foundation launched a new philanthropic program called the Florida Mission of Mercy (FLA-MOM). The FLA-MOM is a massive, two-day dental clinic that provides free dental care to the underserved and uninsured in Florida — those who would otherwise go without dental care. This is a first-come, first-served event, and seeks to have a positive impact on our region by relieving pain and infection, restoring dignity and creating smiles. Our next FLA-MOM event will be held at the Prime Osborn Convention Center in Jacksonville and on April 22-23, 2016, with setup beginning on April 20.

Sign up to volunteer with these 10 easy steps: 1. Go to http://www.rsvpbook.com/FLAMOM2016.

2. Are you volunteering as part of a group, or independently? Choose accordingly.

3. Enter your email address and click Continue.

4. Fill in your information.

5. Under volunteer type, choose your specialty.

6. Enter your license number.

7. Please register for all the days you will be onsite so we have enough food.

8. Choose the date and shift you want to work: a. Wednesday — setup only b. Thursday — setup, triage 250

patients, volunteer party c. Friday — first full clinic day d. Saturday — second full clinic day, breakdown 9. Click the round radio button under

the volunteer agreement.

10. Click the green button at the bottom to finish.

FDAF Welcomes New Board Members The FDA Foundation (FDAF) is pleased to welcome Drs. Isabel Garcia and Linda Niessen, the deans of the University of Florida College of Dentistry and Nova Southeastern University College of Dental Medicine, respectively, to the FDAF Board of Directors. The FDAF is confident that the energy, experience and vision of these two outstanding professionals will allow them to further develop effective relationships with the students and faculty at their respective universities.

FDA Member Creates Mobile Unit to Fill Gap in Elderly Dental Care Dr. Don Ilkka’s father-in-law had stopped eating, so the family called Dr. Ilkka to see if he could find out why. The cause: three broken teeth. But because of the advanced stage of his dementia, he couldn’t communicate why he couldn’t eat. “And that really stuck in my mind. I wondered who’s taking care of these people’s teeth?” said Dr. Ilkka, who has a practice in Leesburg.

His solution was a mobile dental unit, taking a dental office inside the facilities, rather than having patients travel — something that could be disorienting and

www.floridadental.org

difficult for people with memory loss. He founded Thrive Dentistry OnSite three years ago, purchasing a mobile dental power unit from the military, a mobile X-ray unit, a transportable dental chair — and with a van, his mobile unit was ready to go. Along with two other dentists, one in Tavares and the other in Winter Garden, Thrive takes dental services to residents of eight assisted living and memory care facilities in Central Florida and is hoping to add four more sites by early next year.

Thrive doesn’t have a financial arrangement with the sites, rather, it charges patients on a fee-for-service basis. Patients can also use their insurance.

Thrive provides dental exams, cleaning and treatments that don’t require surgery, and is available in case of dental emergencies. Patients receive a comprehensive dental exam, are given an assessment and are asked how they want to proceed with their care.

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

Atlantic Coast District Dental Association Anthony Adkins, Plantation Jeffrey Cohen, Boca Raton Robert Davis, Wellington Aparna Durve, Royal Palm Beach Yanice Gonzalez, Wellington Jodi Kodish, Fort Lauderdale Maria Magurno, Weston Curt Sonchaiwanich, Jupiter Jason Witonsky, Fort Lauderdale

www.floridadental.org

Central Florida District Dental Association Jia Chang, Gainesville Ann Delman, Orlando Stephanie Ferreira, Orlando Kathleen Knisley, Gainesville Mario Ku-Torres, Gainesville Gustavo Lopes De Oliveira, Orlando Tejumade Matthew-Daniel, Winter Garden Mani Mirpourian, Gainesville Amy Sagatys, Gainesville Rafael Seminario, Jupiter Terrence Soule, Longwood Molly Stanford, Gainesville

Northeast District Dental Association Heather Gabler, Jacksonville Beach Ekaterina Hamidzadeh, Yulee Daniella Peinado, Jacksonville Charles Poblenz, Ponte Vedra Beach

Northwest District Dental Association Tracy Eckles, Tallahassee Codie LeBlanc, Navarre Ashok Manocha, Tallahassee

South Florida District Dental Association Ronia Baker, Plantation Christopher Bob, Miami Sandra Castillo, Sunny Isles Beach Raymond Del Castillo, Miami Farah Diaz, Miami Arnaldo Lopez, Miami Laura Marin Jimenez, Miami Orffa Masso, Weston Veronica Narvaez, Miramar Zara Nensey, Miami Katherine Roman, Miramar Felipe Salles, Pembroke Pines

West Coast District Dental Association Anthony Adams, Clearwater Juan Alvarez, Valrico Tanya Bejarano, Port Orange Sarina Bhole, Tampa Joseph Castor, Naples Christopher Chiaramonte, Valrico

Catherine De La Torre, Tampa Jan Delassen, Largo Angela Homoky, Venice Mi Ae Kwon, Tampa Francis Lugo, Tampa Ramy Mousa, Sarasota Luyen Nguyen, Naples Rebecca Orsini, Redington Beach Gustavo Pardo, Labelle Brina Patel, Tampa Christina Pepper, Punta Gorda Robert Reaves, Saint Petersburg Ryan Ricafort, Tampa Hector Rodriguez, Tampa Michael Sampson, New Port Richey Omar Shuayb, Spring Hill Melissa Smiley, Saint Petersburg Eric Stevens, Bonita Springs Alexandra Zabala, Cape Coral

In Memoriam The FDA honors the memory and passing of the following members: Angelo Amato Orange Park Died: 5/29/14 Age: 81

Clarence E. Gingras Palm Beach Gardens Died: 11/3/15 Age: 99

V. Paul Bruno Pensacola Died: 4/27/14 Age: 88

Hubert H. Hughston Fruitland Park Died: 11/11/15 Age: 84

James C. Yeargin Port Orange Died: 8/7/2014 Age: 77

William J. Thompson Bradenton Died: 11/24/15 Age: 83

Enwood Ashmore Tallahassee Died: 9/08/14 Age: 89

Lawrence J. Jones Palatka Died: 11/28/15 Age: 93

Ernest Visco Deerfield Beach Died: 9/19/14 Age: 86

Donald W. Legler Gainesville Died: 12/9/15 Age: 84

Peter Ramko Fort McCoy Died: 10/12/14 Age: 80

Collis P. McGeachy Jacksonville Died: 10/11/16 Age: 90

January/February 2016

Today's FDA

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Board of Dentistry

Board of Dentistry

Board of Dentistry Meets in Lake Mary

By Casey Stoutamire FDA LOBBYIST

“

The BOD unanimously approved a motion to support SB 234/ HB 139, which is the FDA’s dental care access account initiative.

”

20

Today's FDA

January/February 2015

The Florida Board of Dentistry (BOD) met in Lake Mary on Friday, Nov. 20. The FDA was represented by FDA BOD Liaison Dr. Don Ilkka and FDA Lobbyist Casey Stoutamire. Other FDA members in attendance included Drs. Andy Brown, Chris Cowell, Bill D’Aiuto, Rudy Liddell, Charles Llano, Mark Romer and Wade Winker. Also in attendance were several pre-dental students from the University of Central Florida.

Nine out of 11 BOD members were present, which included Dr. Bill Kochenour, chair; Drs. Joe Calderone, Naved Fatmi, Claudio Miro, Robert Perdomo, T.J. Tejera and Joe Thomas; hygienists, Ms. Catherine Cabazon and Ms. Angie Sissine. Consumer member, Mr. Tim Pyle, was absent. Mr. Anthony Martini resigned from the BOD and his position still is vacant. This was the first meeting for Drs. Calderone, Fatmi and Miro.

Ms. Sue Foster introduced her replacement Jennifer Wenhold, MSW, who will become the BOD’s new executive director in February. Ms. Jessica Sapp, CPM, also was introduced as the new program operations administrator replacing Ms. Cindy Ritter, who retired at the end of the year. The FDA would like to thank Ms. Foster and Ms. Ritter for all their hard work and assistance to the BOD and the FDA, and we look forward to working with Ms. Wenhold and Ms. Sapp.

Dr. Kochenour asked Dr. Winker to give a report on the American Board of Dental Examiners (ADEX) meeting. He reported that Florida has representation on the ADEX House of Representatives and the dental and hygiene exam committees. Ms. Cabazon is Florida’s representative on the Hygiene Exam Committee and Dr. Calderone is Florida’s representative on the Dental Exam Committee, and both are representatives in the House of Representatives.

Dr. Winker continues to be a member of the ADEX Board of Directors. Dr. Winker also reported that the Curriculum Integrated Format (CIF) of the ADEX exam now is being called the Patient Centered Curriculum Integrated Format. Also, in 2017, the ADEX exam will convert to a pass/fail exam. Currently, a score of 75 or more is required to pass each examination. Lastly, Dr. Winker reported that the ADEX exam is

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being administered by the Commission on Dental Competency Assessments (CDCA) and the Council of Interstate Testing Agencies (CITA). Currently, Florida accepts the ADEX exam administered by the CDCA, but Dr. Winker suggested the BOD consider how it would handle an applicant who has taken the ADEX exam administered by a CITA state. This also led to a discussion on the requirement that an applicant taking the ADEX exam in Florida must be examined by a Florida-licensed dentist. There seemed to be support to do away with this requirement and allow any licensed dentist to be an examiner in Florida. In order for this requirement to be changed, the BOD would need to seek a statute change.

Mr. Flynn gave a report on Rule 64B517.002, Written Dental Records: Minimum Content, Retention, which now is effective. Mr. Flynn stated Nova Southeastern University College of Dental Medicine has challenged this rule, specifically the removal of subsection (9) pro bono dental events.

Mr. Flynn will work with Nova to see if they can come to a compromise. With the removal of subsection (9), records for treatment is provided at a pro bono event will need to be kept for at least four years. Mr. Flynn gave an update on the North Carolina case that was decided by the U.S. Supreme Court. As board counsel, he now will be looking closely at the impact of any rules and actions by the BOD to see if they are in jeopardy of violating anti-trust laws. The Office of the Attorney General also will look at every rule promulgated by any board to see if there are anti-trust issues.

Dr. Tejera gave a report on the Anesthesia Committee conference call held on Aug. 25,

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2015. The BOD unanimously approved the committee’s motion to: s revise the anesthesia rules to include mild, moderate, general and deep sedation. s require end-tidal CO2 monitoring for all conscious sedation permit holders. s add sevoflurane and isoflurane to the prohibitions listed in Rule 64B514.002(8). s modify Rule 64B5-14.003(1)(a); the residency program requirement now will be two years. This makes the rule current, since all programs are now two years. s modify Rule 64B5-14.003(2)(d) and 14.003(a)(1); affiliated programs for conscious sedation permits and pediatric conscious sedation permits now must be affiliated with an accredited dental school, program or teaching hospital.

Ms. Cabazon gave a report for the Hygiene Council’s conference call held on Nov. 2, 2015. The BOD approved the council’s recommendation to strike section 10 of Rule 64B5-2.0144. This change means hygiene applicants from unaccredited dental schools who fail the hygiene exam will not have required remediation until they fail the exam three times.

The Florida Academy of Pediatric Dentistry requested that the six hours of continuing education (CE) for the Advanced Cardiac Life Support/Pediatric Advanced Life Support (ACLS/PALS) course be approved as part of the required 30 hours of CE required per biennium. Currently, the ACLS/PALS hours are in addition to the 30 required hours. The BOD did not approve this request. Furthermore, the BOD unanimously

The next BOD meeting is scheduled for Friday, Feb. 19, 2016 at 7:30 a.m.

The location has yet to be announced.

approved a motion to support SB 234/HB 139, which is the FDA’s dental care access account initiative. The BOD also approved a motion to support the theory of health access settings to be reimbursed for services performed by a hygienist in a health access setting, but did not support the current bill language of SB 580/HB595.

There were six disciplinary cases related to failure to meet the standard of care and performing “sleep dentistry” without a valid general anesthesia permit. If you have not yet attended a BOD meeting, it is suggested that you take the opportunity to attend and see the work of the BOD. It is much better to be a spectator than a participant in BOD disciplinary cases.

Lastly, the BOD held elections for the 2016 term. Dr. Perdomo was unanimously elected BOD chair and Dr. Thomas was elected vice chair. The FDA thanks Dr. Kochenour for all his hard work this past year and looks forward to working with Drs. Perdomo and Thomas in 2016.

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

January/February 2016

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21

Licensure Exams

Licensure Exams

New Innovations in Dental Licensure Examinations: Patient Centered CIF

By David Perkins, DMD and Ellis Hall, DDS

In 2016, the Commission on Dental Competency Assessments (CDCA) — formerly the North East Regional Board of Dental Examiners (NERB) — will administer a new dental licensing exam format in Florida. This new model, the Patient Centered Curriculum Integrated Format — also known as the “Buffalo Model” — modifies the traditional Curriculum Integrated Format (CIF) exam to provide additional focus on patient care while still meeting the American Board of Dental Examiners’ (ADEX) standards and criterion.

This new exam format marks the next step in a 10-year successful relationship between the CDCA and Florida. The CDCA first partnered with Florida in March 2005 when (then) NERB contracted with the Florida Department of Health to administer the Florida-developed dental licensing examination. In 2008, a jointly developed Florida/NERB format was used until Florida joined the ADEX in October 2011, when the nationally recognized ADEX licensing examination was adopted. Florida became a full member of the CDCA in January 2014.

Now, Florida will be one of the first states with licensure candidates participating in the Patient Centered CIF examination at the Fort Lauderdale-based Nova Southeastern University exam on Feb. 19, 2016.

22

Today's FDA

January/February 2015

A History of Innovation The CDCA has been at the center of dental testing innovations since its founding in 1969.

The CDCA offered the first regional dental licensing examination, allowing dentists to take one examination and be eligible for licensure in all of its regional member states. In 2008, it introduced the CIF, which integrates the dental licensing process into the final year of dental education, and allows candidates to be eligible for licensure by graduation with time to remediate should they need to retake any portion of the examination. Then in 2015, after two years of discussions between the CDCA, ADEX and the New York State Dental Association (NYSDA), the Patient Centered CIF was introduced as part of a successful and collaborative pilot effort at the University at Buffalo.

The University at Buffalo Pilot Exams

Curriculum Integrated Format vs. Buffalo Pilot — ASDA Comparison Table Previous ADEX

University of Buffalo Pilot

Times given per year

1–2

5

Patients are approved

Day of Exam

Prior to exam date

Content, scoring and criteria

No difference

No difference

Referral for treatment

Provided the day of

Shut down

Simultaneously open

No

Yes

3

3

Definitive follow-up care Clinic status Simultaneous competency Number of examiners

This new exam format included the same content, scoring and criteria as all other ADEX examinations. However, the CDCA’s “Buffalo Model” pilot exams had several key exam administration modifications. First, the CDCA collaborated with the University at Buffalo (UB) School of Dental Medicine’s faculty, allowing them to identify and pre-approve correct and appropriate patient lesions prior to the exams. Second, on exam days all treatment occurred on patients of record as part of an appropriately sequenced treatment plan. Therefore, candidates did not have to search for patients for their exams. Also, if the candidate treatment was incomplete, all patients received treatment to completion after the exam and under faculty supervision. Third, the new Patient Centered CIF “Buffalo Model” was offered five times at UB between January and May 2015. Having multiple exam dates (compared to the normal one to two annual CIF examinations) prevented delay of appropriate and timely treatment on patients, and gave candidates who did not initially pass the examination the ability to take the exam at a later date at this same site for a retake fee. Also, candidates with no-show patients had additional opportunities to take the exam without an additional cost.

Finally, the exam was integrated into a normal clinic day so there was minimal disruption to the candidates’ academic schedule. As explained by Drs. Paul Leary and Joel Friedman of the NYSDA after observing the pilot exam at UB in April, “If you didn’t know an exam was happening, you’d think that this was just a regular day in a dental school clinic.”

Author, Dr. Kristopher Mendoza (2015) reported, “A small group of people who took the exam said this exam was much better than the previous model. Students ideally treated patients in an appropriately sequenced treatment plan. The five exam dates mitigated the bottleneck usually created when students search for the same perfect lesion at the same time … Many of the students finished the exam in two to three sessions, helping to mitigate the increased pressure of a high-stakes, single exam,” (p.

8). The association also published a comparison table between ADEX’s CIF exam (also offered by the CDCA) and the UB pilot examinations (see above). The table highlights improvements in exam administration while noting that ADEX regulations and guidelines were maintained.

Student Feedback

A Future for Dental Licensure

The American Student Dental Association (ASDA) offered feedback on the candidate experience during the CDCA’s Buffalo Model pilot exam in their September 2015 ASDA News.

Overall, the new CDCA administered Patient Centered CIF model provides a

www.floridadental.org

www.floridadental.org

practical solution to the dental community’s concerns regarding patient involvement in dental licensure examinations. In addition to having more exam dates per school to prevent delay of appropriate and timely treatment on patients, the new format also guarantees treatment to completion and minimizes the search process between candidates and patients by using patients of record at the candidates’ school. As described

by UB Assistant Dean Joseph Gambacorta, “This model is the curriculum integrated format in action. It enables the focus of the exam to shift from the candidate to the patient.”

The CDCA also offers schools participating in the new Patient Centered CIF the option to include simultaneous competencies with the exam and flexibility in the frequency and timing of exam dates. Moving forward, the CDCA will continue to provide innovations for the dental licensure process in Florida as well as its other 24 member jurisdictions. These advances help the CDCA further its mission to provide excellence, integrity and fairness in candidate testing.

For more information on the CDCA and our latest news, we encourage you to visit our website at www.cdcaexams.org.

References These benefits and administrative modifications will be applied at Nova Southeastern University (and six other U.S. dental schools) for their 2016 graduating class, with several more dental schools expected to adopt this new model in 2017.

Gambacorta, Joesph. “The Buffalo Model” (presentation, AADB Business Session, Washington, DC, November 3, 2015).

Mendoza, K. (2015, September). ADEX pilots new licensure exam at Buffalo. ASDA News, 45(7), 8.

January/February 2016

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Alliance of the FDA

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Who is the Alliance of the FDA?

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By Ms. Jerilyn Bird

Who is the Alliance of the Florida Dental Association (FDA)? We are your partners in life and dentistry who are committed to you and the success of your practice. Alliance members come from many different backgrounds with a wide array of careers, hobbies and personalities; yet, we all share a common bond — we are FDA member dentists’ spouses and significant others. The Alliance is where the dental family belongs.

To find out more about the Alliance of the FDA, opportunities to volunteer and support the FDA and your dental partner or spouse, contact Mrs. Jerilyn Bird at JRBird23@aol.com.

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MEMBER IN GOOD STANDING

FLORIDA DENTAL ASSOCIATION

Ralph C. Attanasi Jr., DDS 2016 Florida’s Advocate for Oral Health ATLANTIC COAST D I S T R I C T D E N TA L A S S O C I AT I O N A COMPONENT OF THE AMERICAN & FLORIDA DENTAL ASSOCIATIONS

In the fall of 1988, I was 33, a new mom of a baby boy and working in a dental office as the practice manager — my third (and hopefully) final career. Our local “auxiliary” recreated themselves as the “Alliance” and launched our first project, Senior Smiles, in 1991. We purchased a video on senior dental health and took the program to nursing homes in our community. Our purpose: Educate the nursing staff on how to improve the oral health care of the patients, place identifying marks on dentures and interact with the patients. We took Polaroid photographs of each patient and led a parade of patients through the halls as a spirited patient nicknamed “Singing Gloria” accompanied us in song.

In 1992, we received an award for Senior Smiles by our national organization, the Alliance of the American Dental Association (AADA). I arrived in Williamsburg, Va.

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“

Our goal is to make you and the dental profession SHINE!

to accept the award knowing no one. I left with friends from everywhere who would last a lifetime! These people had knowledge about practice management, dental health education, buying/selling a practice and were willing to share — free of charge! Later, our local Alliance orchestrated our first 5K race, the Tooth Trot, to benefit Brevard Dentist’s Care adult dental care clinic. This year, we held the 18th Annual Tooth Trot 5K on Jan. 30 at Wickham Park in Brevard County. The Brevard County Dental Society presented the race, who the Alliance works hand-in-hand with to make this successful and well-known 5K a Space Coast Runners’ Runner of the Year Series race. Proceeds benefit Give Kids a Smile (GKAS) in Brevard County and helps purchase oral health care items, as well as educational booklets for children and parents.

In 2014, the AADA, along with the ADA and Henry Schein Cares, launched Healthy Smiles from the Start, a prenatal/postnatal dental health care education program for mothers and caregivers of newborns. It

”

was created to address the nation’s growing dental health issues during pregnancy and throughout early childhood. Healthy Smiles from the Start is a free kit that is engaging and filled with helpful information, and is available in both English and Spanish. For more information on the kit or to sign up to receive the toolkit, email AADA@AllianceADA.org.

The Alliance is an organization of men and woman who are spouses and/or significant others of dentists, dental students or are contributing members (dentists, family and friends). The Alliance of the FDA sponsors Dentist’s Day on the Hill, supports the FLAMOM event, mentors new dental spouses/ significant others and promotes community oral health education. We encourage you and your spouse or significant other to become a member of the Alliance. Our goal is to make you and the dental profession SHINE! Mrs. Bird can be reached at JRBird23@aol. com.

January/February 2016

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Fluoridation

Fluoridation

Exploration of a Failed Attempt to Reinstitute CWF in a Small Mid-Florida Town

By Eric Jump, DO, MPH

Children in small towns and rural communities are in desperate need of dental health care services, but sometimes they don’t get the consideration they need. A case could be made for dental health care as a crucial necessity. Community water fluoridation’s (CWF) importance — particularly in disadvantaged communities — cannot be overstated.

We are faced with an epidemic of dental caries, especially in poor communities across the country. In this busy, complex and demanding world, if we allow the proven safe, effective and cost-saving measures of CWF to be ignored, patients will suffer.

However, success requires a community-wide group effort. Our endeavors to reinstate CWF in Palatka — the small north central Florida town where the research for this material was centered — were not only a failure, but the city commissioners unanimously voted against restoring it.

My concern about reinstating CWF began about three years ago, when I recognized an alarming, progressive increase in the number and severity of dental caries in our pediatric patients. As a pediatrician for many years in the poorest communities in Florida, I am a daily witness to this scourge of dental caries as I go from patient to patient. The sickest patients require hospitalization, with extensive head and neck surgeries. While caries were not previously uncommon, they have not been seen at this alarming, unprecedented number and severity.

I began to question why the incidence and severity of dental problems increased.

To my dismay, I discovered that in 2011, our city commission had rescinded the CWF ordinance that had been in place for many years. I read the minutes from that city commission meeting and noted that not one public health official and not one dentist or physician was present during this important decision that would adversely affect the community’s health. To my knowledge, no one in the health community was informed that CWF had been eliminated, but it clearly was in the minutes of the commission meeting. This was a wake-up call for me.

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Though sticky carbs and inadequate brushing are culprits in dental caries, the worst culprit is when CWF is taken away from a community. We know that CWF reduces cavities in children by 25 percent or more, and when it is eliminated from the equation, the results can be catastrophic — especially for children from low-income families.

The town has had the same water manager for many years. When I spoke to him, he confirmed the ordinance for CWF had been rescinded. When I asked his opinion about the value of CWF, he responded with unsubstantiated anti-fluoridation reasoning about toxicity and the difficulty of maintaining equipment. He admitted to opposing it, but would follow the city commission’s direction. He further stated it is not required by the state to add it.

Though I attempted to seek support from our local and state health departments, it was not forthcoming. In legislating against CWF, our city commissioners presented the perfect picture of typically unfounded anti-fluoridation assertions that have been in existence over many decades.

I was invited by our local health department administrator to a community health council meeting, and I requested CWF to be a topic on the agenda. When I asked about CWF at the meeting, the administrator in charge waived off the request, saying this would be a topic to discuss only in the distant future. It was interesting that this same administrator previously had presented me a certificate of achievement as a public health hero, commemorating the 10 Great Public Health Achievements of the 20th Century. One of those achievements was, ironically, CWF. The mayor responded by saying he fell on the side of allowing individual choice for fluoride intake. The fact is, CWF helps equalize the risk of cavities across all socioeconomic groups.

Fluoride taken on an individual basis does not. CWF helps prevent cavities in citizens of all ages.

The vice mayor responded by saying CWF didn’t work, alluding to the water manager’s distaste for his job of putting fluoride in the water and his concerns about toxicity. The fact is that optimal ranges of fluoride are safe and effective in reducing cavities, and water plant managers execute safe procedures for adding fluoride to the water.

A commissioner — one of the two still on the board who voted to rescind CWF in 2011 — cited the fear of CWF as toxic and said he would not let his own children drink tap water.

Obviously, any common micronutrient we ingest daily can be toxic if ingested in too large an amount. But, no established evidence in the research indicates a link between properly administered CWF and disease.

A vocal citizen from the audience (who had been advocating against CWF for many years) cited personal family stories of chronic illness caused by CWF — again, without any valida-

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tion. Our hearts go out to her family, but to blame CWF for all sorts of diseases is another unfounded, persistent claim.

CWF is neither a conspiracy nor a form of mass medication. It is not intended to treat disease, but rather used to prevent it.

Prescriptions for fluoride are dispensed, but at a much higher cost than CWF, and with poor compliance on the patient’s part.

The proven safe and effective benefits of CWF reach the entire community without a conscious need for behavioral change on anyone’s part. Simply drink the water, and reap the benefits of cavity reductions.

Cost also was cited as a reason not to fluoridate. It should be noted, however, that if just one of our patients is hospitalized for illness secondary to dental cavities, head and neck surgery results in costs that are higher than a year of CWF for our community. In addition, startup costs and grant money for the first year were offered, but declined by the city commissioners.

Our local dentists, dental assistants and hygienists came to support our efforts for CWF. Many spoke of the dramatic differences seen in oral health between communities with and without CWF. Our local newspaper allowed us to write guest editorials and covered our efforts at the commission meetings and the CWF workshop.

Many national and state organizations, including the National Parent Teacher Association, the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics, the American Dental Association (ADA), the Florida Surgeon General, the American Water Works Association and others issued supportive documents.

Please see FLUORIDATION, 31

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benefit

Fluoridation

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In searching out other institutions for support, it was difficult to find prominent minority group organizations that encourage the use of CWF. Within the African-American and Latino communities, conspiracy theories abound. Citizens within these communities need to hear from their leaders to gain a fair perspective.

A poor rural community is confronted with amazingly difficult and complex problems, including single-parent homes, teen pregnancy, high infant mortality, poverty, psychiatric issues, drug addiction and transportation problems. CWF particularly is important in a community where basic dental care is limited. This was quite a learning experience for me — it taught me that science is important, but it is not enough on its own. Now, the collection of anti-fluoridation documents is growing, and the reasons against it never change.

Unfortunately, I had a negative experience attending an open meeting of elected city officials, some of whom voted to rescind CWF in 2011. None of the city commissioners showed any inclination toward reinstating CWF, nor offered one encouraging word. Pediatricians are good at accessing all sorts of specialty care, but our biggest downfall is in the realm of dentistry. Even high-risk groups with dental Medicaid most often do not receive dental care for all sorts of reasons, including lack of funds and lack of insurance. To have CWF in place is vitally important for them. If we are to practice holistically — treating the whole person — dental care must become more readily available.

In spite of my best efforts and those of the advocates for CWF, the commission voted down a motion to reinstate it. Accordingly, I have created a wish list for future programs, which includes CWF: n Provide proper dental for pregnant women with decaying teeth to prevent passing infectious diseases to their babies. n Incorporate cultural diversity within our health organizations for effective collaboration.

The poverty rate for African-American children continues to grow and contributes to an even higher risk of cavities. n Organize a national forum in the African-American community to discuss CWF and counter conspiracy theories. n Create a state notification policy to inform communities when there are changes in CWF. n Achieve a consensus in a strategic dental health care plan. Imagine an oral health pyramid — similar to the food pyramid on nutrition— with the large base representing CWF. It is the foundation and the most comprehensive and economical tool at our disposal. n Recruit water works associations that understand the science and the benefit of CWF to help. Presently, the Florida Department of Environmental Protection employs a Rural Water Works Association with employees who do not favor CWF and don’t recognize that it is unethical not to use fluoridation when indicated. However, the American Water Works Association advocates for CWF. We need their expertise and training in our

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poor, rural communities. n Use social media to fight against misinformation, as most of what is seen online is information to support anti-fluoridation. We need better media attention to reach the public at large, especially in allowing our health departments to access the new technology that now is mostly forbidden. Let’s move into the 21st century and use social media! n Hire trained employees with a Master of Public Health to educate and advocate for CWF — they could be central in fighting disease. n Create university mobile dental outreach programs for our poor communities. n Talk to your local pediatricians to find out what efforts are being made for CWF advocacy to begin, continue or be reinstated in your community. We only can succeed by joining together in a team effort to uphold scientific health standards that promote health.

Let’s tackle this serious health threat together. Let’s continue to promote one of the top 10 Great Public Health Achievements of the 20th Century in our country to fight against the most common chronic disease in children. Interact and educate for community water fluoridation.

Dr. Eric Jump is a pediatrician in Palatka, Fla. and can be reached at ejump@kidscarepediatricspa.com.

January/February 2016

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A Week in the Life

A Week in the Life

A Week in the Life ... of an Old Pediatric Dentist

By Dr. Barry Setzer

“

Children in need of care are typically referred to our office, but sometimes we see in-hospital patients from very poor or war-torn countries with no possible dental care for their children.

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After 39 years of practice, nothing is more rewarding than treating the children of my former patients. It confirms two things: First, my staff and I have made “visiting the dentist” a positive, fun and truly enjoyable experience for thousands of children throughout the years; and, second, I absolutely love what I do.

And, oh yeah — it also reminds me that I’m getting old!

When I moved home to Jacksonville, FL. in 1977 to start my practice, I never imagined I’d have such a fulfilling career and that, one day, I’d be treating second- and third-generation patients. Today, we have three pediatric dental partners, an orthodontist every Thursday and a pediatric dental associate, Dr. Karen Hubbard, who conducts most of our hospital cases and works in the office on Fridays or when one of us is on vacation. My partner, Dr. Steve Cochran, has owned half the practice since 1995, and Dr. Flavio Soares bought a quarter of it two years ago. This has allowed me to continue treating patients at my pace, participate in numerous charities and organizations such as the Florida Dental Association (FDA) and take long vacations with my wife of 35 years.

While my weekly routine has evolved throughout the years, some things remain a constant.

On the days that I work, I still wake up at 5:30 a.m., eat my bowl of Cheerios and a banana, skim two newspapers and start seeing patients by 7:30 a.m. Now it just so happens that I take a lot more medication each morning than I used to!

Mondays are non-sedation days in our office. I typically run five chairs until

noon, and then resume seeing patients from 1-4 p.m. I have one column of operative, four columns of hygiene and sealants, and typically see four to five new patients. I try to take an hour for myself to eat the lunch my wife packs for me and squeeze in a 30-minute nap. This happens only on a good day, as I’m oftentimes interrupted by FDA phone conferences or office meetings. I always like to end my Mondays at the gym with my trainer. I really need these workouts, especially when I’ve spent the day dealing with disagreeable parents who prevent me from giving their children X-rays, fluoride, sealants and nitrous oxide — even when these things are so desperately needed.

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Tuesdays are IV days. Years ago, I’d dread having to sedate a child because I’d

have to restrain them when medications didn’t work — and nothing is worse than having to forcefully restrain a scared child. But, in those days, anesthesiologists could treat patients only in the hospital, and the hospital fees for OR dentistry were unaffordable for most parents since their medical insurance wouldn’t cover the OR and anesthesia bills. I spent a lot of time discussing this dilemma with my good friend and colleague, Dr. Dennis Stone, a wonderful pediatric anesthesiologist I met at our children’s hospital in the 1980s. Fortunately, a lot has changed in the past 20 years. We now have more effective sedation medications, and more importantly, the Florida Dental Practice Act Rules were amended to allow anesthesiologists like Dr. Stone to treat patients in dental offices such as mine. Now Pediatric Dental Anesthesiology Associates covers the state and treats its most difficult pediatric patients. I’m proud to say I played a part in bringing this great service to the children of Florida.

Now my Tuesdays are wonderful. My partner sees IV patients in the morning, and I have the afternoon to treat our very young patients, as well as autistic children and those with Down syndrome, learning disabilities and so on. It’s a kind and humane approach to pediatric sedation dentistry, and I feel as if it’s given me an extra 10 years of practice … and life!

Wednesdays are Versed days. Versed is a great drug for light-conscious seda-

tion of an anxious child. Children treated with Versed typically are good 95 percent of the time, or wiggly 5 percent of the time. We never use a restraint, however. The uncooperative child is simply rescheduled for IV Tuesdays or hospital OR care. I see my Versed patients in the morning, and then the rest of my Wednesday is just like a Monday, followed by the gym!

Thursdays are hospital days or Cleft Palate Clinic days. I’ve been on the staff

of Wolfson’s Children’s Hospital since 1977, and I’ve been its chief of pediatric dentistry for many years. The hospital has provided us with two mobile dental beds, two portable A-dec dental units, portable X-ray equipment and so much more. Today, we have six to seven pediatric dentists on staff who not only give our children fantastic OR dental care, but also allow us to cover the Pediatric ED. Children in need of care are typically referred to our office, but sometimes we see in-hospital patients from very poor or war-torn countries with no possible dental care for their children. We’ve been called upon to dentally rehabilitate these children before they have other surgeries.

There is financial help for our medically compromised children. For years, the Grottoes of North America, a mystic group similar to the Shriners, has helped cover dental care for children with cerebral palsy, mentally delayed children, and those with Down syndrome and other debilitating medical syndromes. The Grottoes pay for the children’s hospital bills, anesthesia and for the actual dental care itself.

examine 14-15 children at the clinic. We then decide what type of care is needed and when to complete it. We also try to educate these children and their parents about the importance of good home care to prevent dental decay. This can be challenging, but I feel that if we can positively impact even just a few of these families for the long term, we’ve done a good job. Thursdays are definitely my rewarding, “feel good” days.

Friday is either my day or the FDA’s

day. When it’s my day, I work out with my wife and enjoy the rest of the weekend with her. We try to travel as much as possible and visit my daughter and son-in-law in NYC, where they live. I’ve been very active with the FDA since the early 1980s, but the past few years have actually been my busiest with the organization. I’ve been a trustee, American Dental Association alternate delegate, served on many committees, and I’m currently the April 2016 Fundraising Lead for the Florida Mission of Mercy to be held in Jacksonville. Needless to say, Friday can very well run into Saturday and even Sunday thanks to my FDA duties.

In June 2017, I’ll be retiring from all my FDA functions to devote my free time to my wife (and hopefully future grandchildren). We still have a lot to complete on our “bucket list.” But, there’s no telling when I’ll finally stop practicing pediatric dentistry. I may get old, but treating my patients — and their children — never will.

Dr. Setzer can be reached at bsetzer@bot. florida.org.

The Jacksonville Cleft Palate and Craniofacial Clinic helps take care of hundreds of children in northeast Florida and southern Georgia. I’ve been a part of this clinic since the late 1970s. Once a month — sometimes even twice a month — all of the specialists on the team

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Digital and Social

FDA Launches Digital and Social Media Advertising Campaign The Florida Dental Association (FDA) is excited to share that we are adding a new chapter to our marketing efforts with the launch of our first digital and social media advertising campaign. This campaign will support our members and our membership through the following objectives: m Increase brand recognition among consumers and Florida dentists. m Educate and engage consumers to visit an FDA dentist. m Educate and engage Florida dentists on the value provided by the FDA to its members.

The FDA has chosen to advertise on digital and social media platforms based on their ability to reach and engage specific consumer audiences and optimize engagement and cost-effectiveness. Digital and social media advertising provides the opportunity to target audiences based on their demographics, geographic locations, and online interests and behaviors, such as the websites they visit and online search keywords.

Through these platforms, the FDA can reach and engage target audiences who are most likely to take action, which maximizes the ad campaign’s relevance, efficiency and cost-effectiveness. Additionally, these advertising platforms provide insights on what messaging is most effective with different target audiences, allowing the FDA to tailor messaging to each individual audience segment to build increased engagement.

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Digital vs. Traditional Advertising Advertising on traditional media platforms, such as television, radio and billboards, brings high costs and offers limited opportunity to tailor content to target audiences and gauge the effectiveness of the campaign.

In reviewing opportunities to increase engagement in advertising and raise awareness of the FDA, digital and social media platforms offer the most cost-effective opportunities to tailor content to our target audiences and to gauge and maximize engagement with them. Other state dental associations, such as Virginia and Wisconsin, have already shifted to or are strongly considering digital and social media advertising in place of traditional advertising platforms to maximize return on investment.

Looking Ahead Over the next six months, you may begin to see FDA advertisements on Facebook or your favorite websites, that share information on the importance of oral health and regular visits with FDA dentists, information on key FDA programs and member benefits, and other engaging content to promote the FDA and its members as the premier dental advocates and professionals in Florida. We encourage you to share these messages and resources on your own social media pages as we seek to grow and strengthen our organization and brand!

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The FDA has chosen to advertise on digital and social media platforms based on their ability to reach and engage specific consumer audiences and optimize engagement and cost-effectiveness.

�

January/February 2016

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Compleat Dentistry

Compleat Dentistry

Big Cases, Little Patients

Compleat dentistry is a slower-paced, deliberate style of dentistry, espoused by Pankey, Dawson and so many others, in which the dentist knows the patient well, knows the work, knows their own abilities and limitations, and uses this knowledge to take care of the patients who trust them with their care. The world will change, but the principles of compleat dentistry will remain the foundation of an exceptional practice. The spelling is an homage to Isaak Walton, whose book, “The Compleat Angler,” was about so much more than fishing.

By Dr. Edward Hopwood

The idea of doing “big cases” is exciting to most dentists. We travel all over and spend a lot of money trying to develop the skills and technical knowledge to do the big cases. Somehow, the thought of prepping six or 12 or 28 teeth in one day, and then seating them three weeks later seems appealing to most dentists.

If only we could have one of those cases every other month, then all of our overhead and production worries would disappear.

When we have trouble with a big case, we look for another course that will help solve the occlusal or aesthetic problems we had with our last big case.

“

On the other hand, we typically are schooled in the philosophy that it is best to do as little dentistry as possible, preserving intact enamel and only working on our patients when it is necessary to preserve the teeth. This philosophy is (quite correctly) instilled in every dentist — although some are too quick to shrug it off.

In my opinion, everyone should reap the benefits of compleat dentistry — even children.

The conflict of these desires often creates angst when we sit in continuing education courses in which presenters show big cases with a lot of restorative work — which is what we want to learn — but may border on overtreatment of teeth that may have been preserved with simpler restorations —which is the philosophy we were taught in school. The most extreme example of this would be the TV ads that offer to help correct yellow teeth with dental implants (“Completed in an hour!”).

Dr. Gary DeWood resolved this conflict for me during his class at the Pankey Institute. He explained that you don’t have to look for big cases — they are all big cases. This is a valuable

lesson for all of us: We can treat all cases as big cases and we can try to do as little dentistry as necessary for our patients.

Once we begin to treat every patient as a big case, our perspective switches. We do not look to present and “sell” as much dentistry as possible to every patient that walks through our doors. Instead, we look to present a plan to help that patient preserve their teeth for the rest of their life. When viewed in the context of a lifetime, every patient is a “big case.” A compleat dentist welcomes each new patient as a member of his or her practice. They do not worry about how much dentistry they will do this week or this year on that patient, they simply present a plan to help them preserve their teeth for the rest of their life.

Unfortunately, it is difficult to maintain this lifetime perspective when we are pressured to meet daily or monthly production goals.

A true professional practice is financially prudent enough so that daily or monthly production goals do not interfere with treatment planning. This is in direct contrast with corporations who typically maintain much shorter time horizons.

For me, the minimum I can give to my new patients is a comprehensive exam with a careful evaluation of the occlusion, periodontal situation and the dental structure.

Please see LITTLE, 43

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Compleat Dentistry

2016 P R E S E N T I N G

T H E

LITTLE from 41

SAPPHIRE SYMPOSIUM AND AWARDS

Health Transformation: The Power of Engagement PARTIAL LIST OF SPEAKERS AND TOPICS Joseph R. Betancourt, M.D., M.P.H. Associate Professor of Medicine and Director of the Disparities Solution Center, Harvard Medical School

Improving Quality and Achieving Equity: Engaging Diverse Populations in Health Care

Cara V. James, Ph.D. (Invited) Director, Office of Minority Health, Centers for Medicare and Medicaid Services (CMS)

I then review the exam and make the appropriate diagnoses. Next, I present a review of the findings from the exam and we work out a treatment plan for that patient. The treatment plan always involves infection control, occlusal control and definitive restoration of the teeth. I am happy to keep a patient in my office as long as they complete infection control.

They can proceed with occlusal control and definitive restoration at their own pace.

Often, definitive restoration will take several years. Some of my best work has taken more than five years to complete. Now, if I showed you the slides at a lecture, it would look like a “big case” — but the reality is that it was completed a little bit at a time. Even patients who want full mouth restorations as fast as possible often take 18 months or more to complete.

the same appointment times and prophy times. When compared to adults, during the one-hour prophy for a child, less time is spent scaling and more time is spent on home care. And I don’t do stainless steel crowns or sedation — I refer those to a specialist — but I only need to refer a child every three to four years. In my opinion, everyone should reap the benefits of compleat dentistry — even children.

What are the biggest cases that come into our offices? Those are the subject of this issue of Today’s FDA: children. When viewed in the context of a lifetime treatment plan, there are no bigger cases that walk through our doors. Children in my office are treated as adults, given

Dr. Hopwood is a restorative dentist in Clearwater and can be reached at edwardhopwood@gmail.com.

The CMS Equity Plan for Improving Quality in Medicine

Rena Coughlin Chief Executive Officer, Nonprofit Center of Northeast Florida

Grant Writing

Henrie M. Treadwell, Ph.D. Founding Director and Senior Advisor, Community Voices, Healthcare for the Underserved, Research Professor, Community Health and Preventive Medicine, Morehouse School of Medicine

Workforce, Public Policy and Oral Health Equity

Oscar Arevalo, D.D.S., Sc.D., M.B.A., M.S. Attending and Assistant Director, Pediatric Dentistry Residency Program, Nicklaus Children’s Hospital

Workforce, Public Policy and Oral Health Equity

Rebecca Koenig

April 20-21, 2016 Rosen Plaza Hotel 9700 International Drive Orlando, Florida

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Tackling Childhood Obesity: An Evidence-based and Sustainable Model And many more speakers on topics related to health, health care and philanthropy.

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Diagnostic

INSURANCE CHECKLIST FO R D E NTAL PRACTI C E S Professional Liability Insurance Malpractice Coverage for individuals, corporations, or employees.

Diagnostic Discussion

Workers Compensation Insurance Mandatory for all offices with four or more employees, but strongly recommended as protection for all dental offices.

By Drs. Indraneel Bhattacharyya, B.J. Schlott and Nadim M. Islam

Dental Office Policy Covers general liability, office furnishings, equipment, building, improvements to leased space and build-outs. Can include business income, accounts receivable and wind/hail coverage.

Commercial Umbrella/Excess Liability Provides coverage in the event of a catastrophic liability loss in excess of underlying policy limits. Can cover general liability, employer’s liability, and commercial auto insurance liability.

Employment Practices Liability Responds to allegations of wrongful termination, failure to promote, harassment, or discrimination.

Data Breach/Privacy Insurance Responds to risk involving personal health information.

Directors & Officers Liability Coverage for allegations against the dental practice’s officers or board members.

Health Insurance PPO, POS, HMO and HSA plans for your practice. Also offer individual health insurance that can be set up via payroll deduct.

Office Overhead Protection to continue business operations should you become disabled.

Life Insurance To facilitate buy-sell agreements should a partner die, protect the practice, protect the family, or replace the income derived from a key employee.

Disability Insurance Coverage to protect your loss of income due to a disability.

Long Term Care Insurance This voluntary benefit for you and your employees covers costs of home care, assisted living, nursing home.

Bonds ERISA compliance for pension and profit-sharing plans

Personal Auto Insurance & Umbrella Personal Auto protection and excess liability protection.

A 7-year-old female presented to the Oral and Maxillofacial Surgery Clinic at the University of Florida College of Dentistry (UFCD) for evaluation of non-eruption of the right maxillary second primary molar and first primary molar. This was the main concern expressed by the parents to their dentist who then referred the patient to the oral surgery clinic. All other teeth had followed the normal eruption cycle. Slight expansion of the right posterior maxilla was seen and the patient reported some discomfort in the region only upon palpation. The overall lying tissue was minimally affected and the lesion found in that area felt firm on touch. No ulceration was noted. Careful dental examination was within normal limits. The patient’s medical history was otherwise unremarkable and her parents reported normal growth landmarks. Radiographic examination of the lesional area revealed a radiolucent lesion with ill-defined borders and multiple discrete “popcorn” radiopacities (Figs. 1 and 2). The primary second molar appeared to be impacted. An excisional biopsy was planned and the lesion was completely removed under sedation in the oral surgery clinic. During removal, numerous “gritty” small calcified masses were obtained along with somewhat gelatinous soft tissue. Microscopic examination was performed at the UF Oral Pathology Biopsy Service.

Fig. 2

Q. Which of the following is the most likely diagnosis?

A. Odontogenic keratocyst B. Follicular cyst C. Ameloblastoma D. Odontoma E. Ameloblastic fibro-odontoma

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Fig. 1

Please see DIAGNOSTIC, 46

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Diagnostic

Diagnostic

DIAGNOSTIC from 45

Diagnostic Discussion A. Odontogenic keratocyst Incorrect. Odontogenic keratocysts (OKC) recently have been renamed by the World Health Organization (WHO) as keratocystic odontogenic tumor (KOT), mainly to account for the aggressive clinical behavior and high recurrence rate of these lesions.

Unlike the radiographic presentation noted here, KOTs never show calcifications and are uncommon in this age group. Lesions may occur over a wide age range with the majority occurring between 10-40 years of age. In addition, KOT often is seen in the posterior body and ramus of the mandible, and usually causes expansion in anteroposterior direction and not as much in the bucco-lingual aspect. It is a common developmental odontogenic cystic lesion arising from cell rests of the dental lamina. Unlike other developmental cysts, the growth of this cyst is related to genetic factors inherent in the epithelium itself or enzymatic activity in the fibrous wall. OKCs are significant because of their growth potential, higher recurrence rate and association with the nevoid basal cell carcinoma syndrome.

Males are slightly favored. Typically, a lesion is clinically silent and discovered during routine examinations. However, large lesions may be associated with pain, swelling or drainage. Radiographic features show a well-defined radiolucency with corticated margins. Approximately 25-40 percent of lesions contain an unerupted tooth. Histopathologically, the cyst shows a thin, friable epithelial wall six to eight cells thick, with a hyperchromatic and palisaded basal cell layer, which often is difficult

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to enucleate, resulting in a tendency for recurrence. Treatment of choice is enucleation and curettage along with long term follow-up. If inadequately curetted, a brisk recurrence rate estimated at higher than 30 percent has been reported. Patients under 18 years of age with this lesion should be evaluated for the Gorlin-Goltz or basal cell nevoid carcinoma syndrome.

B. Follicular cyst Incorrect. Very similar to KOT above.

Follicular or dentigerous cysts almost never exhibit calcifications within the lumen of the cyst. Some cases with prominent dystrophic calcification rarely have been reported. Dentigerous cysts are the most common type of developmental odontogenic cyst associated with the crown of an impacted tooth. It originates by the separation of follicle from around the crown of an unerupted tooth; hence, it encloses the crown of an unerupted tooth and is attached to the tooth at the cementoenamel junction. Most involve the mandibular third molars, with maxillary canines, maxillary third molars and mandibular second premolars also frequently being involved.

These cysts are unusual in children younger than 10. Most patients are between their teens to 30 years of age, with a slight male predilection. Small cysts are asymptomatic and discovered on routine radiographs.

In rare occasions, larger cysts may cause a painless expansion and resorption of roots of adjacent/involved teeth. Radiographs show a unilocular radiolucency associated with the crown of an unerupted tooth.

Histopathologically, the cyst shows a thin nonkeratinized epithelial lining. Enucleation is the treatment of choice.

C. Ameloblastoma Incorrect — a good choice, but some important clinical differences are seen with the actual diagnosis. Ameloblastomas are rare in children and almost never exhibit calcifications within the lesion. This is the most common clinically significant odontogenic tumor. These tend to be aggressive and frequently cause expansion of bone and resorption of the roots of teeth. Ameloblastomas originate from rests of dental lamina, developing enamel organ, epithelial lining of an odontogenic cyst, or very rarely, surface epithelium. These slow-growing tumors are locally invasive and if untreated, can grow to massive proportions. Most patients are in the third to seventh decades of life. Vast majority of cases occur in the posterior mandibular region. Small lesions are asymptomatic and radiographically detected. Larger lesions cause a painless expansion. Radiographically, it presents as a unilocular or multilocular scalloped radiolucency when large, buccal and lingual cortical expansion is evident. Histopathologically, a follicular pattern is the most common and presents with multiple islands of odontogenic epithelium demonstrating peripheral columnar differentiation with reverse polarity. The central zone of these islands resembles stellate reticulum and exhibit foci of cystic degeneration.

D. Odontoma Incorrect, but excellent choice! It’s usually hard to distinguish between an odontoma and the actual diagnosis. Odontomas can exhibit multiple variably sized tooth-like calcifications as seen in this case; however, minimal associated radiolucency is noted. Odontomas are the most common type of odontogenic tumor seen in the U.S. They primarily consist of a mixture

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of dental hard tissue comprised of varying proportions of enamel and dentin with variable amounts of pulpal tissue. Based on the morphology, they are subdivided into compound and complex odontoma.

A compound odontoma is composed of tooth-like structures and more commonly seen in the anterior parts of the jaws. Complex odontomas are a conglomerate mass of enamel and dentin and bear no resemblance to a tooth. These are more common in the posterior parts of the jaws. Most lesions are detected in the first two decades of life.

Typically, they are small and seldom exceed tooth size; hence, they are discovered on routine radiographs to determine cause of an unerupted tooth. Large lesions are rare and when present, most often have not been associated with some expansion of jaws. The mandible is the site of predilection. Soft tissue odontomas are encountered occasionally. Radiographically, a compound odontoma appears to resemble a tooth and a complex odontoma appears as a mass with radiodensity comparable to that of a tooth.

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Histologically, variable amounts of dentin, enamel and pulp-like structures are seen.

Simple local excision is the treatment of choice.

E. Ameloblastic fibro-odontoma Correct! Ameloblastic fibro-odontoma (AFO) is a benign, mixed odontogenic tumor. In 98 percent of the cases, the lesion is diagnosed in the first two decades of life, mostly before the age of 10. It has been designated as a “mixed tumor” because it is composed of both epithelial (ameloblastic) and mesenchymal (fibroma/odontoma) components in varying proportions. The soft tissue component is composed of strands and islands of odontogenic epithelium associated with myxoid connective tissue resembling dental papilla. The hard tissue component is composed of enamel and dentin. The WHO has described AFO as a neoplasm similar to ameloblastic fibroma, with varying degrees of inductive change and dental hard tissue formation.

Some authorities have considered the three

lesions — namely, ameloblastic fibroma, AFO and odontoma — as part of the same spectrum of mixed odontogenic lesions.

Clinically, it presents as an asymptomatic slow-growing expansile tumor often associated with an unerupted or a displaced tooth, as seen here. Teeth in the area are vital. There is a slight male predilection and majority of cases are found in the posterior mandible followed by the posterior maxilla.

This tumor remains an exclusively central or intraosseous lesion. In some cases, these lesions show progressive growth, causing significant bone destruction and deformity.

Radiographic features include a welldefined unilocular or rarely multilocular lesion radiolucency with multiple foci of radiopacities of various shapes and size.

Histogenesis of this lesion is controversial.

The tumor is composed of islands, strands and cords of odontogenic epithelium distributed in a cell-rich, dental papilla-like ectomesenchymal stroma. Variable amounts Please see DIAGNOSTIC, 48

EARN FREE CE CREDIT TO RENEW YOUR LICENSE!

“DIAGNOSTIC DISCUSSION”

Visit the FDC & CE page on the FDA website and click the “Online CE” button for this free, members-only benefit. You will be given the opportunity to review this column and its accompanying photos, and will be asked to answer five additional questions.

Questions? Contact FDC Meeting Coordinator, Brooke Martin at bmartin@floridadental.org or 800.877.9922. * These courses expire on 2/28/2017.

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Diagnostic

Barnes L, Eveson J, Reichart P, Sidransky D. World Health Organization classification of tumors. Pathology and genetics head and neck tumors. Lyon: IARC press: 2005; pp309-310.

DIAGNOSTIC from 47

of dentin-like material and occasionally enamel matrix can be identified. Conservative surgical enucleation is the treatment of choice for AFO since most lesions are welldefined, non-aggressive and non-invasive.

Larger lesions warranting extensive surgical procedures have been reported. Involved teeth should be preserved in cases where they do not interfere with enucleation, with the possibility of spontaneous eruption occurring. In this case, the lesion was completely curetted and no recurrence was noted after one year.

Buchner A, Kaffe I, Vered M. Clinical and radiological profile of ameloblastic fibro-odontoma: an update on an uncommon odontogenic tumor based on critical analysis of 114 cases. Head & Neck Pathol: 2013; 75:54-63.

Dr. Bhattacharyya

Cohen DM, Bhattacharyya I. Ameloblastic fibroma, Ameloblastic fibro-odontoma and odontoma. Oral Maxillofac Surg Clin North Am 2004; 16:375-384.

Zouhary KJ, Said-Al-Naief N, Waite P. Ameloblastic fibro-odontoma: expansile mixed radiolucent lesion in the posterior maxilla: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106:e15e321.

AFO always should be considered in the differential diagnosis of any jaw lesions where radiographic presentation of a mixed radiolucent/opaque lesion is noted in a patient less than 15 years of age. These are far less common in adults.

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

Useful References Kramer IRH, Pindborg JJ, Shear M. Histologic typing of odontogenic tumors 2nd ed.

Berlin: Springer-Verlag; 1992.

Dr. Islam

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

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

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

1. HOW DO I RENEW FOR THE 2014-2016 BIENNIUM?

FAQs Do you have questions about the biennium, the renewal process, CE Broker or your FDA-earned CE credits?

Contact Brooke Martin at the Florida Dental Association: bmartin@floridadental.org or 850.350.7103.

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Today's FDA

You must renew at www.cebroker.com. You must create an account and report any CE credit that has not been automatically reported for you. YOU WILL BE ABLE TO RENEW ONLY WHEN YOU HAVE ALL THE NECESSARY REQUIREMENTS.

2. HOW MANY CREDITS DO I NEED TO RENEW? You must have 30 CE hours to renew your license.

• 28 general hours (including two hours of domestic violence and up to 3 hours of practice management) • 2 hours of medical errors • An uploaded up-to-date CPR certificate • If this is your first year renewing your license, you also must have 2 hours of HIV/AIDS

3. HOW DO I REPORT PRO BONO OR VOLUNTEER CE CREDIT? Once logged into CE Broker, look under the “Submission Options” tab and select the option “Volunteer Health Care Provider Program.” Only 7 hours of pro bono or volunteer work is eligible to go toward license renewal and the services must be to indigents residing in Florida.

January/February 2015

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LAST CALL FOR VOLUNTEERS!

FLA-MOM is a massive, free, two-day dental clinic with a goal of treating up to 3,000 patients who, for many reasons, lack access to dental care. This is a first-come, first-served event that seeks a positive impact on our state by relieving pain and infection, restoring dignity and creating smiles. Our next FLA-MOM event is scheduled for April 20-23, 2016 at the Prime Osborn Convention Center in Jacksonville.

For more information, or to volunteer: www.flamom.org 800.877.9922 ď Ž flamom@floridadental.org

FLA-MOM volunteer registration closes March 1.

BEFORE

AFTER

FLA-MOM

FLA-MOM

Dentists and Others Volunteer for the Florida Mission of Mercy

Bone grafts, braces, crowns, extraction of unerupted wisdom teeth, gum surgery, implants, root canals and teeth whitening services will not be provided. Additionally, no narcotics will be provided to any patients.

Free Dental Services for 3,000 of Jacksonville’s Neediest

“

We don’t have people here demanding treatment, Dr. Cullinan said.

They don’t expect it. They’re just grateful, grateful people.

”

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By Megg Murphy FDA FOUNDATION PROGRAM COORDINATOR

In April, volunteers from around the state will gather in Jacksonville to provide free dental care to some of the area’s neediest residents at the Florida Mission of Mercy (FLA-MOM).

The FLA-MOM is organized by the Florida Dental Association Foundation (FDAF) and will be held April 22-23, from 6 a.m. until 5 p.m. each day, at the Prime Osborn Convention Center in Jacksonville.

About 1,100 dentists, along with their staff and other volunteers, will provide services ranging from basic cleanings and fillings to extractions, root canals, X-rays, oral health education and — in some cases — even partial acrylic dentures.

“As highly trained dental professionals, we have a rare gift to share with people in need,” said FDA Past President Dr. Terry Buckenheimer. “Most of us do so in many small and often unseen ways. But there also is an occasion for showing compassion on a large scale, for attempting to do something together that could never be done alone.”

The FLA-MOM is a two-day clinic held annually to provide much-needed dental care and raise awareness of the epidemic of untreated dental disease occurring locally and nationally. By raising awareness of the problem, the FDA hopes to create local public and private partnerships that will increase access to oral health care for Florida’s neediest residents.

The first-come, first-served event, held in a different location in the state each year, has a goal of treating 3,000 patients in two days. An estimated 15,000 dental procedures will be performed, providing about $2 million in free dental care, thanks to funding from corporate and private donors, and labor provided by dental, medical and community volunteers. In addition to volunteering out of simple good will, many of the dentists who participate bring their staff to work with them as a team-building exercise.

“At the end of the day, we’re seeing the population of patients who absolutely need our help,” said Dr. Leo Cullinan, who was a co-chair of the first FLA-MOM event held in Tampa in

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www.FLAMOM.org 2014. “These are patients who have difficulty with access to care. They’re not asking for a handout — they’re asking for a leg up.”

Patients seen at MOM events frequently have dental concerns that cause debilitating pain and prevent them from working and fully participating in life. Dental care simply is not something they can afford. MOM events have been held all over the United States since 2000, treating nearly 200,000 patients and providing approximately $120 million in free oral health care. Patients usually are aware of the first-come, first-served nature of the clinic and often camp out the night before.

“We don’t have people here demanding treatment,” Dr. Cullinan said. “They don’t expect it.

They’re just grateful, grateful people.”

According to data collected by the National Institute of Health (NIH), 60 percent of American adults have not been to the dentist in the past year, and nearly half of all Americans who meet federal poverty definitions have not visited a dentist in at least five years. According to the Centers for Disease Control and Prevention (CDC), more than 40 percent of poor adults have at least one untreated, decayed tooth. Toothaches are the most common pain in the mouth or face reported by adults. This pain can interfere with vital functions such as eating, swallowing and talking. Almost one out of every four adults reports having some form of facial pain in the past six months.

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The high volume of patients seeking help at a FLA-MOM event highlights a clear gap between those with and without good dental health. Considering that oral health is connected to total health, financial barriers to care should be a major concern to the leaders of our state.

“That’s the beauty of the FLA-MOM,” Dr. Buckenheimer said. “That powerful philosophy is the essence and backbone of membership in the Florida Dental Association.”

For more information, or to donate or volunteer, contact FDAF Director of Foundation Affairs Heather Gioia at 850.350.7117 or hgioia@floridadental.org, or visit www. floridadental.org/foundation/programs/ mission-of-mercy to read about the FLAMOM and the Foundation’s other efforts.

Ms. Murphy can be contacted at 850.350.7161 or mmurphy@floridadental. org.

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The Florida Mission of Mercy (FLA-MOM) provides dental care to those in need. You can make a difference by volunteering and helping us reach our goals!

92,000 square foot venue 40,000 square foot venue

2 days

Our FLA-MOM Committee members are comprised of the following specialties:

190 dental chairs 500+ dentists/ hygienists

103 dental chairs

Services offered ...

13 General Practice 3 Orthodontics & Dentofacial Orthopedics

350+ dentists/ hygienists

2 days

The expertise of our volunteers makes it possible to offer an array of state of the art dental services!

1,100+ support volunteers

1,660 patients treated

2014

Accomplishments

Evolution of the FLA-MOM

Oral Surgery

Prosthodontics

Oral hygiene & cleanings

1 Medical Doctor 6 Hygienists 2 Staff

15,000 treatment procedures

13 Community Volunteers

To volunteer or to donate, visit flamom.org, email flamom@floridadental.org or call 850.350.7117.

2000

2000

Restorative dentistry

1 Prosthodontics

3,000 patients treated

$2,000,000 worth of treatment

The MOM event was founded by Dr. Terry Dickinson in Virginia.

Endodontics

2 Endodontics

8,017 treatment procedures $1,141,648 worth of treatment

Pediatric dentistry

4 Pediatric Dentistry 1 Oral and Maxillofacial Surgery

Goals

Diagnosis

4 Periodontics

1,100+ support volunteers

2016

Radiology

2014

2008 America’s Dentists Care Foundation (ADCF) was founded to loan and provide equipment to MOM events around the country.

2005

2016

The MOM event came to Tampa, Fla. in the first ever FLA-MOM.

2010

The FLA-MOM will be hosted in Jacksonville, Fla. on April 22-23.

2015

2020

Waiting Rooms

Waiting Rooms

“

With careful consideration and planning, you can have a kid-friendly waiting room that enhances the parent/patient experience, and doesn’t break the bank.

”

Creating a Kid-friendly Waiting Room

By Dr. Troy King

The waiting room is a dilemma for most dental practitioners. On one hand, we want the reception area to be as comfortable as possible for our patients. On the other hand, we want them to “enjoy” the area for as little time as possible. Below, I’ve outlined a stepwise approach to achieving a kid-friendly waiting room that will not only function well for your patients and staff, but also may be a catalyst for future referrals.

Whether you are in the process of building a dental office, or in an existing space, it is a good idea to give the waiting area some thought.

Step 1: The first decision you should make is the size of the space. This will differ with your practice style. If you are a pediatric dentist who likes to have parents remain in the waiting room during their child’s treatment, then you may need more square footage and adult amenities in the reception area. If you prefer to have the parents accompany the child throughout the office during the visit, the square footage may be better used by increasing the size of each treatment area. Either way, the goal is to have the patients and parents comfortable during the entire visit. A guideline you may find helpful is roughly 25 percent of the total office space should be reserved for the reception area. Adjust accordingly for personal preferences and anticipated use patterns. Another guideline would be two to three reception room seats per operatory.

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Step 2: Next, we must consider our patient population. We treat children, so we have to cater to that patient population. The things that make a reception area appealing to a 3-year-old don’t necessarily appeal to a 13-year-old. It is difficult to appeal to all age groups at once, but not impossible. In general, parents will be pleased if their kids are entertained, and the space is clean and safe.

This means taking routine child protection steps, such as placing outlet protectors and securing items that could fall onto children.

One tip I learned from a mentor was to have clear glass on the door leading from the clinic area to the reception room. That way we don’t inadvertently knock kids over when entering the waiting room to welcome our patients.

Step 3: The next step in getting your reception room to be kid-friendly is design.

Aside from being kid-friendly, it also should be practice-friendly. Entertaining kids can be loud, so we have to anticipate the impact our waiting room has on answering phones, etc. Perimeter seating will help the receptionist keep an eye on the room and give toddlers room to roam. One way we were able to overcome the noise factor was to create separate areas or pockets of entertaining space and position these areas as far away from the central reception desk as possible. This allows the front desk staff a reasonably quiet area to conduct business and have conversations with parents. We discovered one enormous benefit of this design concept that we did not anticipate: the reception room chairs in this immediate

area are great for parents who choose to stay in the reception room during treatment, but don’t have a child remaining in the reception room.

Step 4: The fourth and final step in creating a kid-friendly waiting room is selection of entertainment equipment and décor.

My first office was about 1,000 square feet, so our waiting room was necessarily small.

We had one video game box and a Lego table. Inexpensive, entertaining and easy is how I remember it. A homework nook or library corner is an appealing way to use space that might otherwise be used for a table holding magazines. Funny mirrors or wall games also can be placed with limited space requirements.

You can choose décor and entertainment equipment to fit any budget. Taken to the extreme, the possibilities are unlimited. It is not unusual for the reception room budget to approach 10 percent of the overall cost of an interior build-out.

No matter the scope of your project, you will benefit tremendously from visiting as many offices as possible. There is no substitute for seeing a design concept or decoration style in person. Seeing different waiting rooms function during a workday will give you a tremendous amount of information that can make your project much easier to manage.

Dr. King has a practice in Oviedo and can be reached at troyking@aol.com.

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Give Kids A Smile

Give Kids A Smile

phylaxis and sealants through informed consent, Kelly and I felt more could be done. With the help of Dr. Ana Maria Ospina, predoctoral director of oral and maxillofacial surgery, we were able to contact both the medical and optometry schools at Nova. Through her interprofessional resources, we confirmed their participation. Medical students would provide interactive nutritional counseling and optometry students would perform free eye exams.

As the student consultant to the ADA Council on Access, Prevention and Interprofessional Relations, I felt empowered by Nova’s truly collaborative network. We were destined to give kids total health.

1.

2.

Total Body Dentistry: The GKAS Revolution

By Adam Saltz 2016-2017 ASDA EDITOR-IN CHIEF

In August 2015, the American Dental Association (ADA) Foundation announced that the national 2016 Give Kids A Smile (GKAS) kickoff would be held at my school — Nova Southeastern University. The GKAS national kickoff is celebrated on the first Friday in February to coincide with National Children’s Dental Health Month, and more than 1,500 GKAS events are held throughout the year around the country — providing dental services to about 350,000 underserved children. For the past 11 years, Nova has held our GKAS event on a Saturday, which accommodated our participants whose parents worked multiple jobs and long hours on weekdays. However, this year the kickoff was scheduled for Friday, Feb. 5, which meant that this time, we faced new

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legal hurdles that forced us to completely restructure our recruitment strategies. But, in spite of this date change, we had a continued responsibility to serve our community.

Previously, children ages 2-18 mainly came from the Boys & Girls Clubs throughout Broward County. Kelly Cundy and I, Nova’s GKAS coordinators, felt that these children would benefit most from our care. All 30 members of Nova’s GKAS team set out to recruit children and special needs patients. Last year alone, we were able to provide dental care to 320 participants with more than $100,000 in donated services!

But this recruitment model would not work for a Friday — we had to go to the children directly. With the help of Dr. Laurie Gordon-Brown, Nova’s director of practice management, we were able to contact two Title 1 schools: Pompano Beach and Park Ridge Elementary Schools. She was instrumental in connecting us to these schools, which had a combined enrollment of around 1,000 students. Kelly, Dr. Brown and I met with their respective principals to discuss our goals with this year’s program. We were pleased to hear that our GKAS event aligned with some of the schools’ own health care initiatives.

With recruitment behind us, the upward climb to the Big Day truly had just begun. However, without a parent attending, we were now limited as to what services we legally could provide. Though a parent could allow their child to receive preventive treatment, like pro-

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Nova’s GKAS event has long been one of a few programs to offer comprehensive care to participants, including restorative and surgical services. Our pediatric dental program was even awarded the Patriot Grant, which allows these children to continue dental treatment with Nova’s residents. More than 194 children have been referred for the Patriot Grant, which provides a maximum of $200,000 in dental services. Dean Linda Niessen and the rest of Nova’s faculty, administration and student body have made this growth possible. We are privileged to have this sincere sense of commitment and dedication to community outreach at all levels.

Our program serves as a platform to advocate on the lack of access to care. Throughout the year, Nova students continue to visit schools in the surrounding areas to educate them on the value of good oral hygiene. They reinforce what was taught at the GKAS event, and even offer a toothbrush and toothpaste starter kit to take home. We are proud to have received the 2014 ADA Foundation Dental School Student Community Leadership Award for these ongoing efforts.

“

I felt empowered

by Nova’s truly collaborative network. We were destined to give kids total health.

”

The Big Day arrived, and as you would imagine, the GKAS kickoff event was not your usual office visit — we threw a party! With a clown, face painter, balloon artist, DJ, Miami Dolphins players and cheerleaders, and a cast of characters that included Elsa and Anna from “Frozen” to the Transformers, we wanted to totally immerse the children in their dental experience and develop a positive rapport with their student dentist. Nova was incredibly excited to celebrate another year of service to our community — and even more so as the national kickoff site!

Adam Saltz is a member of Nova Southeastern University School of Dental Medicine, class of 2017, as well as the 2016-2017 ASDA Editor-In Chief. Adam can be reached at as1676@nova. edu.

Photos: 1. Adam Saltz, left, and Kelly Cundy, right, Nova’s GKAS coordinators.

2. GKAS volunteers pose with a robot.

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Dental Lifeline

Dental Lifeline Network Florida 2014-2015 Annual Report

Thanks to Our Volunteers!

FDA Members

“Excellent doctor and excellent staff — I give them 5 stars. I’m so grateful for how they worked with me. I feel more confident, eat better and keep smiling.”

— Cesar, a DDS patient “Our experience with Cesar — seeing how we affected him in a positive way and seeing him smile again — really made my staff and I appreciate the difference we make every day.”

— Dr. Luz Guerra,

a DDS volunteer Dr. Luz Guerra with Cesar, a DDS patient

Cesar, 67, of Orlando, is a retired construction worker who provides care for his wife of 45 years, a cancer survivor. The couple’s income is limited to social security benefits and food stamps. Cesar could not afford the dental care he desperately needed. Referred to the Donated Dental Services (DDS) program, he had only one upper tooth and four lower teeth when DDS volunteer Dr. Luz Guerra, a general dentist, first examined him. She extracted two teeth, and provided Cesar with full upper and partial lower dentures fabricated by DC Dental Lab, one of 216 labs that volunteer for Florida DDS. Now able to chew, Cesar enjoys walking, spending time with his family — ­ and smiling.

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www.floridadental.org

Volunteer Since

Dr. Jose R. Abadin 1997 Dr. Mark Abdoney 2008 Dr. Suzanne Abergel Nahon 1997 Dr. Jim Abramowitz 2015 Dr. Frank Addabbo 2008 Dr. Amy Addington 2015 Dr. Jennifer Adelson 2008 Dr. Alan Adkins 2008 Dr. Sudhir Agarwal 2008 Dr. Rodger S. Aidman 1997 Dr. John O. Akers 2006 Dr. Darrell Alford 2015 Dr. Sandra Aljure-Estrada 2004 2002 Dr. Joseph A. Allen Dr. Gilda Alonzo 2002 Dr. Richard S. Altman 2003 2006 Dr. Gloria Alvarez Torre Dr. Gary Alvo 1997 1997 Dr. Rosie Angelakis Dr. James W. Antoon 2003 Dr. William Aughton 2006 Dr. Anthony Auletta Jr. 2013 Dr. Richard L. Balick 1997 Dr. William Barkins 2001 Dr. Scott Barr 2002 Dr. Jose Barros 1999 Dr. William Bassett 2002 Dr. William Baxter 2008 Dr. Jeffery Beattie 2010 Dr. Glenn Beck 2015 Dr. Laurent Belanger 2010 2008 Dr. Aldo Bendana Dr. Bryan Bergens 2012 Dr. Paul Berger 2007 Dr. Juliana Bermudez 2015 Dr. Bruce A. Bernstein 2006 Dr. Wayne L. Berry 1997 2004 Dr. Mark Bills Dr. John M. Bindeman 2004 1997 Dr. Robert Blank Dr. Eric Bludau 2009 Dr. Jeffrey D. Blum 1997 Dr. Barton Blumberg 2015 1997 Dr. Barry A. Bluth Dr. Patricia Bobadilla 2013 Dr. Carey Bonham 2015 Dr. Christopher J. Bonham 2002 Dr. Patricia Botero 2015 Dr. Brent Bracco 2014 Dr. Mark Braxton 2015 Dr. Alan Bresalier 2001 Dr. Robert L. Brockett 2007 Dr. John J. Brodner 2004 Dr. Michael Brody 2003

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Dr. Susan R. Brooks Dr. Craig Broome Dr. Solomon G. Brotman Dr. Lawrence Brown Dr. Terry Buckenheimer Dr. Robert R. Burks Dr. Robert Burns Jr. Dr. Andrew Byrnes Dr. Donald I. Cadle Jr. Dr. Fernando Campos Dr. Manuel Capiro Dr. Donald S. Carmona Dr. Axel Castro Dr. Erika Caviedes Dr. Rene Cedeno Dr. Jorge R. Centurion Dr. Jeffrey Chait Dr. Joseph Chiafair Dr. Dolcie Chin Dr. Robert Churney Dr. Reinaldo Claudio Dr. Eric Claussen Dr. Stephen Cochran Dr. Carlos Coello Dr. Karen Coello Dr. Scott Cohen Dr. Santiago E. Colon Dr. Eugenio Conte Dr. Thomas Copulos Dr. Anthony Corbo Dr. Adrian Correa Dr. Robert Cowie Dr. Edward Cronauer Dr. Mark Cullen Dr. Charles Curley Dr. Stephen Cwikla Dr. Grace Dai Dr. Hilary Dalton Dr. Christian Edgar Davila Dr. James Davis Dr. Wilbur Davis Dr. Alberto de Cardenas Dr. Victor Dea Dr. Sara Dean Dr. Kevin Dean Dr. Vivian DeLuca Dr. Ping Ping DeLucia Dr. Dennis Demirjian Dr. Mark Denunzio Dr. Andrew P. Derwin Dr. Nicholas DeTure Dr. Charles DeWild

2010 2011 2004 1999 2014 2008 2003 2014 2004 2008 2006 1997 2008 2011 2003 2002 2000 2008 2008 2010 2002 2014 2002 2002 2002 2007 1997 1997 2008 2002 2014 2002 1997 2015 2011 2013 2003 2015 2015 2014 2004 2015 2015 2015 2010 2011 2012 2002 2014 2002 1999 2002

Please volunteer To learn more, contact Florida Program Coordinator Megan Manor at mmanor@ DentalLifeline.org or 850.577.1466.

Last year, 396 volunteer dentists and 216 volunteer labs treated 210 people with disabilities or who are elderly or medically fragile.

Volunteer Today!

Try one case

n Review the patient profile in advance. n Choose to see or decline any patient. n Determine the treatment plan. n See patients in your own office. n Never pay lab costs. n No paperwork for office staff.

DDS Will: n Ensure that patients arrive on time to appointments. n Be the liaison between your office staff and patient to facilitate everything. n Arrange for assistance from specialists and laboratories.

You treat the patient.

DDS does everything else.

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Dental Lifeline

LIFELINE from 61 Dr. Andrea Diamond 1997 Dr. Marcos Diaz 2007 Dr. Peter Dillon 2011 Dr. Tim Doerner 2004 Dr. Michael Dorociak 2004 Dr. Alissa Dragstedt 2015 Dr. Paul Eckstein 2011 Dr. Mitchell Edlund 2014 Dr. Michael D. Eggnatz 1997 Dr. Jeffrey M. Eisner 1997 Dr. Karl B. Ellins 1998 Dr. Jeffrey F. Elliott 2008 Dr. Ross Enfinger 2011 Dr. Eric B. Epstein 2006 Dr. Mitchell Epstein 2004 Dr. Juan C. Erro 1997 Dr. Enrique C. Escofet 1997 Dr. Maria Escoto 2011 Dr. Rebecca A. Faunce 2002 Dr. David Feinerman 2014 Dr. Randy M. Feldman 2006 Dr. Sheryl Fensin 1997 Dr. Alan Fetner 2011 Dr. Howard Finnk 2012 Dr. Sinisa Firic 2011 Dr. Alberto Fischzang 2011 Dr. James Flach 2008 Dr. Mark Forrest 1997 Dr. Robert Foster 2008 Dr. Eric Fox 2011 Dr. Marc Frankel 2013 Dr. Ann Freedman 2002 Dr. Ronald Friedensohn 2003 Dr. Craig Friedman 2008 Dr. Randy L. Furshman 1997 Dr. Marie A. Gale 2006 Dr. John Gammichia 2008 Dr. Georgina Garcia 1998 Dr. Bobby Garfinkel 2009 Dr. Steven Garrett 2014 Dr. Robert D. Gehrig 2002 Dr. David Genet 2012 Dr. Gregory Gertsen 2015 Dr. Michael Gertsen 2015 Dr. Daniel Gesek 2002 Dr. Elizabeth K. Gesenhues 2002 Dr. Mario Ginzburg 1997 Dr. Andrea Giraldo 2008 Dr. Karen Glerum 2002 Dr. Yedda Gomes-Ruane 2008 Dr. Richard B. Goodman 2003 Dr. Frederick Grassin 2014 Dr. James Green 2014 Dr. Nancy S. Greenbarg 1997 Dr. Mark Greskovich 2003 Dr. Tara Griffin 2008 Dr. Larry B. Grillo 1997 Dr. Kenneth Grossman 2008 Dr. Luz Guerra 2008 Dr. Paul A. Guidi 2005

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Dental Lifeline

2008 Dr. Joseph G. Gulle Dr. Blayne Gumm 2012 Dr. Maria Gundian 1997 Dr. Jose M. Gurevich 1997 Dr. Darlene Hachmeister 2011 Dr. Merritt D. Halem 2002 Dr. Holly Hamilton 2008 Dr. Michael Harris 2014 Dr. Mary S. Hartigan 2002 Dr. Gregory W. Hartley 2002 Dr. Lee S. Hauer 1997 Dr. Georgia Hernandez 2002 Dr. Victoria Herrera 2013 Dr. Theodore Herrmann 2010 Dr. Steven Hewett 2015 Dr. Gregory G. Hill 2003 Dr. Timothy Hogan 2007 Dr. Mike Hopkins 2005 Dr. Carol Horkowitz 2004 Dr. Debbie Hoskins 2014 Dr. Thomas Hughes 2006 Dr. Mitchell Indictor 2002 Dr. Kenneth Irigoyen 2002 Dr. Ivan Izquierdo 2008 Dr. Margot Jobson 2008 Dr. Marc Johnson 2004 Dr. John R. Jordan Jr. 2003 Dr. Harvey L. Kansol 2002 Dr. Keith Kanter 2010 Dr. Richard Kanter 2004 Dr. Frederic I. Kaplan 1997 Dr. Robert E. Karol 2002 Dr. Peter Kaufman 2014 Dr. Richard M. Kernagis 2005 Dr. Michael W. Kessler 2002 Dr. Melvin Kessler 1997 Dr. Milan Khakhria 2004 Dr. Edward Kirsh 2001 Dr. Jerry Klein 2002 Dr. Ronald Kobernick 2008 Dr. William Kochenour 2015 Dr. James Kornegay 2008 Dr. Roger Koslen 2002 Dr. George Kostakis 2015 Dr. Stephen J. Kotkis 1997 Dr. Arlyn Koula 2008 Dr. Thomas B. Krakauer 2002 Dr. Stephen M. Krist 2003 Dr. David Lach 2002 Dr. Brett Laggan 2015 Dr. Timothy M. Lane 2002 Dr. Thomas R. Lane 1996 Dr. Lewis C. Larson 2004 Dr. Jennifer Laskey 2012 Dr. Idalia Lastra 1997 Dr. Jerry Layne 1998 Dr. Nhat Le 2000 Dr. Jayson R. Leibowitz 1998 Dr. Ira Lelchuk 2003 Dr. Henry Lennon 2002 Dr. Esteban Leon 2014 Dr. Ron Leventhal 1998

Dr. Kenneth Levine Dr. Jason Lewis Dr. Luis Llamas Dr. Michael Logue Dr. Gary Lubel Dr. Terry Lunday Dr. John Lundgren Dr. Ziyad Maali Dr. Disha Mankame Dr. Dipak Mankame Dr. Bruce D. Manne Dr. George Mantikas Dr. Alberto Mantovani Dr. Phillip Marciano Dr. Valerie Marino Dr. Rosemarie Marquez Dr. Chadwick Marshall Dr. James Martin Dr. Kenneth Martin Dr. Jennifer Martinez-Amores Dr. Michel Matouk Dr. Daniel Mazor Dr. Laura McAuley Dr. Julie M. McCarron Dr. Tom McCawley Dr. Olin McKenzie Dr. Matt McLellan Dr. Charles McMillian Dr. Charles McNamara Dr. Stephanie McRae Dr. Uday Mehta Dr. Carl Melzer Dr. Oscar Menendez Dr. Lina M. Miranda Dr. Mark W. Mitchell Dr. Sy Moe Dr. Patrick Mokris Dr. Bertram Moldauer Dr. Raul G. Molina Dr. Jacqueline Molina Wasserman Dr. Arthur Molzan Dr. Halina Montano Dr. Vivian Morad Dr. Ofilio J. Morales Dr. Rory Mortman Dr. Richard Mufson Dr. Daniel B. Mullett Dr. Neeraj Nagella Dr. Rhonda H. Nasser Dr. William P. Neale Dr. Jennifer N. Nguyen Dr. Eduardo Nicolaievsky Dr. Marta L. Nieto Dr. William Nipper Dr. Brian W. Nitzberg Dr. Elizabeth Nixon Dr. Thomas R. Nordman Dr. Rodolfo Olmos Dr. Jeffrey Ottley Dr. Cara Overbeck Dr. Stephen Parr Dr. Anish Patel

2008 2014 1998 2004 2000 2008 2008 2008 2014 2004 2006 2015 2002 2005 2008 2014 2015 2008 2008 2008 2013 2000 2003 2002 1999 1997 2002 2010 2014 2010 2014 1998 2015 1997 2006 2005 2008 2014 1997 2008 2015 2008 2007 2002 2008 1997 2002 2014 2002 2002 2008 2014 1997 2014 2013 2008 1998 2015 2015 2014 1997 2015

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Dr. Divyang Patel Dr. Kevin Payton Dr. Jeannette Pena Hall Dr. Elizabeth Perez Dr. Theodore Peters Dr. David Pfent Dr. Yuchi Phen Dr. Nancy Phillips Dr. Rene Piedra Dr. Lawrence Pijut Dr. David Piper Dr. Mary Ann Pittman Dr. Adriana Porter Dr. Mary Porter Dr. Juan-Carlos Quintero Dr. Vyasa Ramcharan Dr. Jorge Ramirez Dr. Brian Rask Dr. John L. Redd II Dr. Richard Reiss Dr. Daniel Rentz Jr. Dr. John M. Richards Dr. Steven Rifkin Dr. William Roark Dr. Paul Rodeghero Dr. Katherine Rodriguez Dr. Guillermo Rodriguez Dr. Vicky Rodriguez Dr. Jose Rodriguez Cepero Dr. Robert Rollings Dr. Fredda Rosenbaum Dr. Jerry Rosenbaum Dr. Ronald E. Rosenbaum Dr. Scott Ross Dr. Steven Roth Dr. Jeff Rothenberg Dr. Leonard Rothenberg Dr. David Russell Dr. Charles Russo Dr. Cesar R. Sabates Dr. Juan M. Salvat Dr. Richard Salzmann Dr. Carlos Sanchez Dr. Gabriel Sangalang Dr. Veronica Sanmartino Dr. Howard Schare Dr. C. Scott Schmitt Dr. Eric Schuetz Dr. Ross Schwartz Dr. Anthony Schweiger Dr. John Schwerer Dr. Manuel R. Seage Dr. Brent Sears Dr. P. Stuart Seider Dr. Ram Setlur Dr. Arthur Shapiro Dr. Willie Sherman Dr. Richard L. Sherman Dr. Charlie Shofnos Dr. Alberto Silber Dr. Rafael D. Simbaco Dr. Michael Simon

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2008 2000 2002 2015 2005 2008 2002 2015 2004 2013 2002 2008 2008 2008 2002 2004 1999 2008 2002 1997 2004 2002 1997 2008 2011 2013 1997 1997 1997 2002 2002 2003 2008 1998 2006 2010 1997 2008 2014 1997 2002 2002 1999 2015 2002 2003 2007 2015 2014 2002 2002 1998 2014 1997 2015 2008 2008 1997 1997 1997 1997 2003

2012 Dr. Daniel Slaybaugh Dr. Bradford Smith 2004 Dr. Maria V. Souto 1997 Dr. Rodrigo Souza 2014 Dr. Sandra Spadafora 2008 Dr. Claire Stagg 2002 Dr. Jeffrey Stevens 2010 Dr. Richard Stevenson 2014 Dr. Jennifer Stidham 2008 Dr. Jessica Stilley 2011 Dr. Cary Stimson 2006 Dr. Erin Sutton 2002 Dr. Martin Swartz 1997 Dr. Chakshung Szeto 2008 Dr. Liwen Tao 2015 Dr. Andrew Taylor 2008 Dr. Timothy Temple 2010 Dr. Andonis Terezides 2014 Dr. Beatriz E. Terry 2002 Dr. Murad K. Thakur 2002 Dr. Chris Thompson 2008 Dr. Veronica Thompson 2008 Dr. Don Tillery Jr. 2004 Dr. Marc Tindell 2013 Dr. Steven Tinsworth 2008 Dr. Iris Torres-Rivera 2008 Dr. Linwood Townsend 2002 Dr. Andrew E. Trammell 2002 Dr. C. Michael Turner 2002 Dr. Helen Turner 2008 Dr. Rafael J. Valdes 1997 Dr. Michael J. Vallillo 2004 Dr. Thomas Van Buskirk 2000 Dr. John Verville 2002 Dr. Al Villalobos 2002 Dr. Bernardo A. Villela 1997 Dr. Robert Vogel 2003 Dr. Daniel H. Walkup 2004 Dr. James Walton 2008 Dr. Douglas Wasson 2015 Dr. Mark Webman 1998 Dr. Monica B. Weick 2002 Dr. Gary R. Weider 2010 Dr. Brion Weinberg 1999 Dr. Melvin Weinberg 1997 Dr. Sy Weiner 1997 Dr. Douglas B. Weinman 1997 Dr. Mark L. Weiss 1997 Dr. Brian Wells 2014 Dr. Wendy Westberry 2014 Dr. Jan Westberry 2002 Dr. R. S. Westberry 2002 Dr. Dean Whitman 2010 Dr. Marcus Williams 2008 Dr. James G. Wilson 2002 Dr. Wade Winker 2003 Dr. Jiann-Jang Wu 2007 Dr. Gary Yanowitz 2002 Dr. Arturo A. Ydrach 2006 Dr. Lisa Yurkiewicz 2007 Dr. Brett Zak 2008 Dr. Paul Zaritsky 2013

Volunteer Laboratories (In State) Absolute Perfection Dental 2003 ADV Dental Laboratory 2014 Advanced Cosmetic Solutions 2014 Advanced Lab Services 2007 Aesthetic Arts 2011 Alaso Denture Service 2014 Aleman Dental Lab 2006 Aloma Dental Lab 2006 AMA Dental Art 2011 AMK Dental Lab., Inc. 1999 Ampere Dental Laboratories 2005 Andreou Dental Lab Art &Technology Dental Laboratory, Inc. 2014 Artistic Dental Creations INC. 2010 Artistic Dental Lab 2014 Associated Dental Lab 2012 Autry Orthodontic Appliances 2005 Avant Garde Dental Lab 2010 B & V Dental Lab 2003 Barcelo Dental Inc. 2014 Barron’s Dental Laboratory Inc. 2003 Bayshore Dental Studio 2008 Biomet 3i 1997 Biotech Dental Prosthetics 2010 Blessed Hand Dental Studio 2008 Bloch Dental Laboratory 1998 Bon-A-Dent Dental Laboratory 2003 Bonita Dental Lab 2005 Brlit Dental Laboratory, Inc 2014 Buchanan Dental Studio 2004 C & C Dental Lab 2014 Cad Cam Ceramics 2014 Callahan Dental Lab 2008 Calton Dental Lab 2004 Cambridge Dental Studio 2014 Caredent Crown & Bridge Lab 1998 Carlos Ceramics Dental Lab 2014 Ceotec Dental Lab 2008 Ceram-Tek 2012 Ceramic Arts Dental Lab 1997 Charles Frucht Dental 2015 Collins Dental Lab 2007 Contemporary Dental Lab 1997 Coral Dental Ceramics, Inc. 1997 Cordova Dental Ceramics 2003 Cosmetic Creations Dental Studio 2014 Cosmos Dental Castings 2007 Crawford Dental Laboratory 2002 Creative Dental Studio 1999 Creative Dental Systems 2007

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Dental Lifeline

LIFELINE from 63 Creative Institute of Dental Arts 2004 Creative Restorations 2004 Custom Crown & Bridge, Inc. 2015 Dave’s Dentures 2012 David Lockwood Dental Lab 2003 David’s Dental Lab 2011 Daytona Dental Lab 2004 DC Dental Lab 2015 DCS Dental Laboratory 2005 DDS Lab 2008 Del Valle Dental Lab, Inc. 2001 Denise McNally Lab 2011 Dental Arts Prosthetics 2012 Dental Ceramic Center 2005 Dental Prosthetics 1997 Dental Technologies, Inc. 2000 Dental Tecks 2009 Dentec, LLC 2015 Destiny Dental Lab 2015 Direct Dental Lab 2014 Doral Dental Lab 2015 DSG Clearwater 2004 DSG Group Practice Solutions 2015 Dunbar Dental Ceramics 2014 Dutch Wilkes, CDT, CDL 2008 Dynamic Ceramic 2010 Eastern Dental Lab 2007 Elite Dental Lab 2008 Eurolab, Inc. 2003 Federal Dental Lab 2011 Fernando Comas Dental Lab 1998 Fine Arts Dental Lab 2013 First Impressions Dental Lab 1997 Florida Laboratories 2000 Forest Oak Dental Lab 2004 Foster Dental Lab 2005 Gagliano Dental Lab 2004 Galsky Dental Laboratory, Inc 2004 Gemini Ceramis, Inc. 2008 Golden Palm Dental Lab 2011 Goldsmith Dental Lab 2004 GPS Dental Lab Inc. 2004 Hall Dental Lab 2006 Hansen/Incarnati Dental Lab, LLC 2014 Harmony Dental Laboratory 2002 Heise Dental Lab 2003 Hennessey Dental Laboratory Inc 2007 HLB Dental Prosthetics 2010 Hoecker Lab, Inc 2013 Implant Technical Support 2008

Incisal Edge, Inc. 2013 Intra Lock International, Inc. 2009 Irish Dental Lab 2006 Island Dental Lab 2010 JJC Dental Lab 2011 John Stucchi Dental Lab 2005 JT Dental Lab 2012 K.O. Dental Lab 2005 KCD Dental Lab, Inc. 1999 Knight Dental Group 2001 Larry’s Dental Lab, Inc 2013 Lawson Dental Laboratory 1900 Luigi Dental Lab 2004 M & J Partials, LLC 2011 Maclarty Dental Lab 2010 Majestic Dental Arts, Inc. 2008 Mardentprosthetics Dental Laboratory 2015 McClure Dental Lab 2014 Miami Dental Arts 1997 Mid Florida Dental Lab 2015 Midtown Dental Lab 1999 Mirror Dental Studio 2011 Mondel Dental Laboratory 2004 Montero Dental Lab 1999 Mulloy Dental Lab 2012 Murray Dental Arts Laboratory 1997 Natural Prosthetic Dental Lab 2006 Nelson Dental Lab 2006 Noble Dental Lab 2008 Northwest Dental Lab, Inc. 2010 Nova Dental Lab 2012 Nu Dimension Dental Studio 2015 Ocean Dental Laboratory 2013 Oral Arts Dental Lab 2006 P&R Dental Lab 2007 Pat’s Dental Lab 2006 Patrick Reeves Ortho Lab 1998 Patterson Dental 2014 Pensacola Dental Lab 2003 Perdue Dental Lab 2006 Pinellas Dental Lab 2006 Precision Dental Lab Sarosota 2005 Precision Esthetics 2011 Precision Esthetics Dental Laboratory 2014 Precision Fit Dental Lab, Inc. 2015 Premium Prothetics 2005 PRIDE Dental Lab 2002 Prodental Lab 2015 Progressive Dental Lab 2005 Progressive Dental Reconstruction 2014

Rebeck Dental Lab, Inc. 2015 Rebour Dental Lab 2003 Reggie Dental Lab 2015 Reliable Dental Arts Lab 2008 Sakr Dental Arts 2013 Samper Dental Laboratory 2004 Science & Arts Dental Lab 2012 Scott’s Dental Lab 2011 Sheen Dental Lab 2001 Signature Dental Lab 2004 Simon Dental Lab 2012 Smile Art Dental Lab 2010 Smile Makers, Inc 2015 Smith Haste Dental Lab 2006 Smith Sterling Dental Laboratories 2006 Sorrento Smiles Dental Lab 2014 Spring Dental Lab 2010 Stuart Dental Laboratory 2007 Sun Coast Dental Laboratory 2004 Sun Dental Lab 2004 Sun Dental Labs 2008 Sunshine Dental Lab 1997 Sunshine Professional Dental Lab, Inc. 2004 Survey Castings Dental, Inc. 1999 Surveyor Dental Arts, Inc. 2010 Team Solutions Dental 2014 Technics Dental Lab 1997 Techno Dent Lab Services, Inc. 2003 Tele-Dent Dental Lab 2013 TLC Dental Lab 2012 Top Quality Partials 1999 Touchstone Dental Lab 2003 Ultradent Dental Laboratory 1999 Unident Dental Lab 2013 Universal Dental Studios, Inc. 2011 University Dental Lab 2002 V. J. Dental Laboratory 1999 Valdez Dental Lab 2006 Valdez Dental Laboratory 2007 Vencol Dental Lab 2003 Verdent Inc. 2014 Victory Dental Lab 2015 West Coast Chompers Dental Laboratory 2013 Williams Dental Lab 2008 Yashiki Dental Studio 2006 Zahntechnique Inc. 2001

DENTAL LIFELINE NETWORK • FLORIDA

DDS IS A PROGRAM OF THE FLORIDA DENTAL ASSOCIATION AND DENTAL LIFELINE NETWORK • FLORIDA

BOARD OF DIRECTORS Cesar Sabates, DDS, President Georgina Garcia, DDS, Vice President Mike Eggnatz, DDS, Secretary/Treasurer

Florida Donated Dental Services (DDS) Fiscal Year 2014-2015

PATIENT TREATMENT

BOARD Members At-large

Number of Patients Treated................................................2101,

Ralph Attanasi, DDS Curtiss Briggs Alain Carles

Number of Patients on Wait List......................................... 563 Number of Volunteer Dentists............................................ 396 Number of Volunteer Labs....................................................216

Jeff Ottley, DDS Ethan Pansick, DDS Idalia Lastra, DMD Edgar Rivera

SPONSORS AND FUNDERS

FINANCIAL Value of Care to Patients Treated .......................... $860,560

1

Average Value of Treatment/Case .............................. $4,4032 Value of Donated Lab Services ..................................$59,4513

SINCE FLORIDA PROGRAM INCEPTION (1997) Total Patients Treated......................................................... 1,504 Total Value of Care to Patients Treated 1 ............. $5,786,143

Florida Dental Association Florida Dental Association Foundation Dental Lifeline Network Don’t miss our updates on the Dental Lifeline Network and its Donated Dental Services (DDS) program! Sign up today at www.bit.ly/signupDLN and follow us on social media.

1 Of this amount, 32 patients received $76,913 in ongoing care from DDS volunteer dentists who provided these patients with initial restorative treatment and have elected to continue providing routine and ongoing care.

2 Does not include treatment for patients receiving ongoing care.

3 Value also included in Value of Care to Patients Treated.

Florida DDS 850.577.1466 877.224.3969 (Toll-Free) 850.577.1467 (fax)

www.DentalLifeline.org

Florida Donated Dental Services (DDS) is a program of Dental Lifeline Network, a national humanitarian organization providing access to comprehensive dental care for society’s most vulnerable people with disabilities or who are elderly or medically fragile and have no other way to get help. Nationally, DDS has more than 15,000 volunteer dentists and 3,700 laboratories.

With assistance from: 3M ESPE Argen DENTSPLY International GC America Henry Schein Dental

Philips Oral Healthcare

Strategic Partners:

American Association of Orthodontists

Shatkin F.I.R.S.T., LLC

American Dental Association

American Association of Women Dentists

Straumann

Academy of General Dentistry

American College of Dentists

Vident

American Academy of Implant Dentistry

American College of Prosthodontists

Zest Anchors

American Academy of Periodontology

American Dental Assistants Association

Ivoclar Vivadent

Zimmer Biomet

American Association of Endodontists

Hispanic Dental Association

American Association of Oral and Maxillofacial Surgeons

National Association of Dental Laboratories

Patterson Dental Company

National Dental Association The Pankey Institute

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Dental Lifeline

Volunteers for Dental Lifeline Network • Florida Transform Life of Patient with Cleft Palate “I want to personally thank you for all the work you have done for me.

You have changed my life with a new-found confidence that I never had before. Thank you from the bottom of my heart.”

— Selvedin, DDS patient “This was the final treatment that Selvedin needed. DDS is an organization that has really been impressive and something that I would recommend. It’s not a burden on our practice. I look at it as our duty to take care of people who don’t have access to care.”

— Dr. Timothy Hogan, DDS volunteer oral surgeon “Dr. Hogan asked me to see Selvedin who is a very nice and appreciative young man. It’s a plus to be able to help people in the comfort of your own office through DDS.”

— Dr. Robert “Brooks” Rollings, DDS volunteer general dentist

Selvedin, age 19, lives with his family who emigrated from Bosnia to Cape Coral, Fla. He works in a restaurant kitchen and studies biology at a community college with the help of financial aid. Selvedin hopes to become a cardiac surgeon and create a better life for himself and his family. Born with a cleft palate, Selvedin was referred to the Donated Dental Services (DDS) program by Dr. Timothy Hogan, a volunteer oral surgeon with DDS and the Florida Children’s Medical Services Cleft Lip and Palate program.

A long-time patient of Dr. Hogan and the cleft palate team, Selvedin had experienced a bone graft, lip revision, rhinoplasty and nasal surgery. He needed an implant to replace a permanent lateral incisor, which was not covered by Medicaid. Dr. Hogan placed an implant donated by Zimmer Biomet and Dr. Robert Rollings, a DDS volunteer general dentist, fitted two crowns contributed by Dunbar Dental Ceramics. Dunbar is one of 216 labs that volunteer for Florida DDS. Selvedin is extremely grateful to both DDS volunteer dentists, the volunteer lab and the implant manufacturer who participated in his treatment.

thursday, June 16

REGISTRATION NOW OPEN! REGISTER BY APRIL 4TH & SAVE UP TO 25%.

The Madow Brothers  ROCK Your Practice!

friday, June 17

Dr. Mark Hyman  The Secret Sauce!

saturday, June 18

Lucas Boyce  Living Proof

Donated Dental Services (DDS) is a program of Dental Lifeline Network • Florida and the Florida Dental Association, with funding provided by the Florida Dental Association Foundation and Dental Lifeline Network. DLN provides access to full dental treatment for people with disabilities or who are elderly or medically fragile.

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www.floridadental.org

Gaylord Palms reseort & convention center



orlando,florida



www.floridadentalconvention.com

Exhibit Marketplace #3D Diagnostix Inc. 3M Oral Care

AA-dec A. Titan Instruments ACCEN Dental Accutron Inc. ACTEON North America ADA Members Retirement Program Advantage Technologies Advice Media AFTCO Air Techniques Inc. AMD Lasers American Association of Dental Office Management Aseptico Aspen Dental Atlanta Dental Supply Atlantic Dental Sales/ Brewer Design

EXHIBIT HALL HOURS THURSDAY, JUNE 16 FRIDAY, JUNE 17 SATURDAY, JUNE 18

9 AM - 6 PM 9 AM - 6 PM 9 AM - 2 PM

DEDICATED EXHIBIT HALL HOURS: How many times have you felt torn between going to the Exhibit Hall and attending our invaluable CE sessions? To ease that dilemma, we’ve added dedicated Exhibit Hall hours each day from 12-2 PM. During this time no educational sessions will take place.

Start making a list now of what you need in your office. Please support the exhibitors who support the Florida Dental Association!

CHILDREN UNDER 12: Unless attending an educational session, children under 12 do not need to be registered and do not require a badge. Children are only allowed in the Exhibit Hall if accompanied by a registered parent or guardian. Infant strollers and carriages are not allowed in the Exhibit Hall, unless medically necessary. For the safety and convenience of others, the use of baby carriers is strongly encouraged.

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B Bank of America Practice Solutions BankUnited N.A. Belmont Equipment Berryhill, Hoffman, Getsee & DeMeola LLC Bien-Air Dental BioHorizons BIOLASE Biotec Bisco Dental Products Black Tie Digital Marketing Brasseler USA Bright House Networks Business Solutions

C CareCredit Carestream Dental Centrix Inc. Citi Healthcare Practice Finance Classic Craft Dental Laboratory Clear Optix ClearCorrect Coast Dental Colgate

COLTENE Consumer Fusion Inc. Convergent Dental Inc. Cool Jaw Crest + Oral-B CUTCO Cutlery

D Dansereau Health Products Darby Dental Supply LLC Demandforce DenMat Dental Care Alliance Dental Health & Wellness Dental Medical Sales Dental PC Dental Sleep Solutions Dental USA Inc. DentalEZ Integrated Solutions DENTSPLY Caulk DENTSPLY International DENTSPLY Maillefer DENTSPLY Professional DENTSPLY Rinn DENTSPLY Tulsa Dental Specialties Designs For Vision Inc. DEXIS LLC Digital Doc LLC Doctor’s Choice Companies Inc. Doctors Disability Specialists DoctorsInternet.com Doral Refining Corporation Doxa Dental Inc. DrQuickLook Inc.

E-F Elevate Oral Care Engle Dental/Solmetex Enovative Technologies EOS Dental Marketing Essential Dental Systems ExtraDent FDASupplies.com Fidelity Bank First Citizens Bank Florida Combined Life Florida Dental Association Florida Dental Association Services Forest Dental Products Inc.

orlando,florida i www.floridadentalconvention.com

Fortis Law PA Fortress Insurance Company Fortune Management Fotona / Lasers4Dentistry

G Garfield Refining Company Garrison Dental Solutions GC America Inc. Gendex GlaxoSmithKline Golden Touch Dental Lab Good On Ya Greater Expressions Dental Centers Greater New York Dental Meeting Greenberg Dental & Orthodontics

H Hager Worldwide Halyard Health Hawaiian Moon Heartland Dental Henry Schein Dental Henry Schein Practice Solutions Henry Schein Professional Practice Transitions Heraeus Kulzer Hu-Friedy

I I.C. System Inc. ICW International iMedicor Implant Direct Implant Educators Infinite Therapeutics Infinite Trading Inc. Instrumentarium Insurance Credentialing Specialist Ivoclar Vivadent Inc.

K Karl Schumacher Dental KaVo Kenwood / CGX Radios Kerr Corporation Kettenbach LP Knight Dental Group Kuraray America Inc.

L Lares Research Lending Club Patient Solutions Liberty Dental Plan Lighthouse 360 LumaDent Inc.

M MacPractice Main Stree Hub Medidenta Meisinger USA LLC Microcopy Microflex / Ansell Midmark Corporation Millennium Dental Technologies Inc. MIS Implant Technologies Modular & Custom Cabinets LLC Myofunctional Research Co.

N-O NOMAD NSK Dental LLC Officite Orascoptic

P Pacific Dental Services Panoramic Corporation Patterson Dental PDT Inc. / Paradise Dental Technologies Pelton & Crane PeriOptix by DenMat Philips Sonicare & Zoom Whitening Planmeca USA Inc. Porter Instrument Co. Inc. Precision Dx / Global Dental Solutions Professional Sales Associates Inc. Proma Propel Orthodontics Prophy Magic ProSites Pulpdent Corporation

Rock Paper Simple Royal Dental Manufacturing Inc.

EXHIBITORS AS OF 1/14/16

S Sage Dental SciCan Inc. SDI (North America) Inc. Shamrock Dental Co. Inc. Shofu Dental Corporation Sierra Dental Products Inc. Sirona Dental Inc. Snap On Optics Solutionreach SOREDEX Sun Dental Labs Sunrise Dental Equipment Sunset Dental Labs Sunshine Health Superior Dental Design Services & Upholstery SurgiTel | General Scientific Corp.

T-U The Doctors Company TriNet Ultradent Products Inc. Ultralight Optics Inc.

V-W Vatech America Video Dental Concepts Vitamix VOCO America Inc. Wand Dental (Milestone Scientific) Water Pik Inc. WEAVE Wells Fargo Practice Finance White Towel Services

X-Y-Z i XPdent Corp.

Yodle Zenith Insurance Company

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Appointments will range from 10-15 minutes so you can maximize your time and have specialized attention for your business needs!

Attendees will be able to search for products, find the company they would like to meet and request an appointment with that company. Once appointments are confirmed, you can print your schedule or access them on the mobile app. Slots will fill up quickly, so request your appointment time before you leave for FDC! As an added bonus, attendees that complete six or more appointments over the three days will be entered to win one of five $200 American Express gift cards.

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EXHIBITORS IN BLUE ARE FDAS CROWN SAVINGS MERCHANTS.

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speaker preview

Aesthetic Dentistry for Tots and Teens

By Dr. Fred S. Margolis

“

Introduction

With the development of aesthetic restorations, there is no reason for a child to go to school with silver stainless steel crowns on his/her anterior teeth.

”

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Today’s parents are concerned about aesthetics for their children.

Aesthetic dentistry can provide the beautiful smile that parents and children desire. Self-image is important for our young patients so they can look and feel good about themselves. We’ve all experienced the wonderful smile a patient gives us when we have turned the “ugly duckling into a beautiful swan.” We are so fortunate to have the dental materials and devices that allow us the opportunity to provide the very best in aesthetic dentistry.

Some of the techniques and materials we have available for our teenage patients’ smile creations include: porcelain veneers; direct composite veneers; microabrasion; bleaching; orthodontics, including clear braces and aligners; direct and indirect composite restorations; implants; and, porcelain crowns. This article will provide a brief synopsis and illustrate the various aesthetic restorative options available for our child and adolescent patients, as well as some of the latest innovations in dental restorative techniques. My intent is to broaden the scope of aesthetic dentistry for children and teens.

Primary Anterior and Posterior Teeth Anterior primary teeth can be restored with various tooth-colored restorations. Unfortunately, we have many children who suffer from early childhood caries. Fortunately, we do have aesthetic alternatives. With the development of aesthetic restorations, there is no reason for a child to go to school with silver stainless steel crowns on his/her anterior teeth.

We have wonderful aesthetic crowns as alternatives, including: celluloid strip crowns; open face stainless steel crowns; stainless steel crowns with white facings; and, acrylic or polycarbonate crowns. A child who has one or more missing anterior primary teeth can have an aesthetic maintainer fabricated to replace missing teeth.

a common aesthetic concern. When these conditions occur on the facial surfaces of anterior teeth, direct composite veneers are an option to improve the aesthetics of the smile. Figures 1a-1d illustrate the use of direct-bonded composite resin to mask the enamel hypocalcification/enamel hypoplasia on the facial surface of a permanent central incisor. Microabrasion also can be used in some situations to reduce the white and/or brown hypocalcified areas in the enamel (Figs. 2a and 2b). In the case of anterior teeth that are imperfect in shape and/ or size, composite or porcelain veneers also can be used (Figs. 3a-4b). Class III carious lesions also can be restored aesthetically (Figs. 5a and 5b).

Fig. 1b: Opaquer placed over discolorations due to hypocalcification (Creative Color, Cosmedent).

Fig. 1c: Completed composite resin restoration (Vitalescence, Ultradent).

Fig. 1d: Resin coating placed over composite veneer (G-Coat Plus, GC America).

Primary Posterior Teeth Fortunately, many choices are available to cosmetically restore primary posterior teeth. Figures 6a and 6b illustrate the aesthetic technique that may be used for restoring carious primary molars.

Permanent Posterior Teeth Class I, II and V caries also can be aesthetically restored. In Figures 7a-7d, two Class II restorations are shown.

Fractured Anterior Teeth

Figs. 2a and 2b: Enamel hypocalcification before and after microabrasion (Opalustre, Ultradent and Prema, Premier Dental).

Fractures of primary and permanent anterior teeth can be restored with composite materials (Figs. 8a-8d). Porcelain veneers also may be used for permanent anterior teeth.

Permanent Anterior Teeth

New Innovations

There are several alternatives for aesthetically restoring permanent teeth in children and teenagers. Let’s take a look at several common aesthetic problems we find in young patients and the aesthetic alternatives available today. Enamel hypocalcification and hypoplasia are

There have been several innovations that have made the preparation and restoration

orlando,florida i www.floridadentalconvention.com

Fig. 1a: Enamel hypocalcification.

Figs. 3a and 3b: Correction of anterior diastema with direct-bonded composite veneers.

Please see AESTHETIC, 72

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of primary and permanent teeth more efficient and practical for the dentist, and more comfortable for the patient. Among the most significant innovations is in the area of adhesive dentistry. Dental manufacturers continually have improved the materials for self-etching prior to placing the restorative material of choice. There now are primers that are antibacterial and bonding agents that contain fluoride. These additions help eliminate the need for cavity cleansing and allow for stronger, longer-lasting restorations, while virtually avoiding postoperative sensitivity. In addition, the fluoride release provides secondary caries prevention (Fig. 7a).

Other innovations include: simpler and easier to use composite polishing kits, such as the SS White Jazz Supreme Kit; Erbium, Chromium:YSGG Laser for hard tissue cavity preparation (Waterlase MD, Biolase) (Fig. 9); alginate substitutes; segmental matrices (Figs. 7b and 7c); nonstick matrices; mouth prop for isolation that incorporates both an intraoral light and saliva evacuation (Fig. 10); disposable bleaching trays; digital operating microscopes (Fig. 11); and, plastic burs for the safe removal of caries (SS White Smart Prep).

Fig. 11: Digital operating microscope (CamSight).

Krämer N, Reinelt C, Richter G, et al. Nanohybrid vs. fine hybrid composite in Class II cavities: clinical results and margin analysis after four years. Dent Mater. 2009; 25:750-759.

Krämer N, García-Godoy F, Frankenberger R. Evaluation of resin composite materials. Part II: in vivo investigations. Am J Dent. 2005; 18:75-81.

Figs. 8a and 8b: Fractured primary central incisor and composite restoration (TPH3, Dentsply CAULK).

Figs. 5a and 5b: Class III caries in permanent maxillary incisors; preparations were done with the Erbium laser (Waterlase MD, Biolase); final restorations (Venus Diamond Composite, Heraeus Kulzer).

Dentists who care for children and adolescents have the wonderful task and ability to create beautiful restorations for these young patients. With the advent of many wonderful techniques, devices and materials, we can have “fun” while achieving professional satisfaction from creating beautiful restorations that help children and adolescents improve their self-image. I hope each of

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Magne P. Composite resins and bonded porcelain: the postamalgam era? J Calif Dent Assoc. 2006; 34:135-147.

Ritter R. Using a nanohybrid composite with ceramic-like properties. Dent Today. 2009; 28:74.

Olivi G, Margolis F, Genevese MD. Pediatric Laser Dentistry: A User’s Guide and Atlas. Chicago, Ill: Quintessence Publishing; 2010.

Owens BM, Johnson WW. Effect of new generation surface sealants on the marginal permeability of Class V resin composite restorations. Oper Dent.

2006; 31:481-488.

Fig. 9: Using the Erbium; Chromium:YSGG laser (Waterlase MD, Biolase).

Figs. 6a and 6b: Primary tooth with Class II caries and restoration with a flowable composite layer followed by regular-bodied composite (Venus Diamond Composite, Heraeus Kulzer).

Conclusion

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Figs. 4a and 4b: Correction of abnormal tooth size (Nos. 7 and 10) with prepless porcelain veneers (Lumineers, DenMat).

you accept children into your practice so that you, too, can have the wonderful experiences those of us who treat children on a daily basis enjoy.

Suggested Readings Daou MH, Tavernier B, Meyer JM. Clinical evaluation of four different dental restorative materials: one year results. Schweiz Monatsschr Zahnmed. 2008; 118:290-295.

Drummond JL. Degradation, fatigue, and failure of resin dental composite materials. J Dent Res. 2008; 87:710-719.

orlando,florida i www.floridadentalconvention.com

Figures7a to 7d: Two Class II restorations are shown.

Fig. 10: Mouth prop with light and evacuation (Isolite, Isolite Systems).

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Dr. Margolis is a pediatric dentist in Highland Park, Ill. and can be reached at kidzdr@ comcast.net. He will be speaking at FDC2016 on Friday, June 17 and Saturday, June 18. On Friday, he will present his lecture, “Aesthetic Dentistry for Teens and Tots” in the morning and the “Aesthetic Dentistry for Teens and Tots” workshop in the afternoon. On Saturday, he will present, “Behavior Modification Techniques for the Pediatric Dental Patient” in the morning and “Pediatric Oral Pathology: The Red, White and Blue” in the afternoon.

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Are You a Dental Superstar?

By Drs. Richard H. Madow and David M. Madow

“

So, even though our patients may be ‘just another mouth,’ dental superstars do all of the little things right so each patient feels like he or she is the most important patient in our practice.

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The days of the dental profession being introverted nerds who frightened people, hurt them and then sent a bill fortunately are long over. These days, we are friendly, devoted health professionals with upbeat attitudes who improve our patients’ health and lives!

How do we let people know? You have to be a dental superstar!

What do the real rock stars do? They test limits and do the unexpected. They get noticed. So do the dental superstars. But, how do you become one? How do you rock your practice to the top?

Dental Superstars Are Media-savvy Rock stars have publicity agents and record labels pitching them 24/7. And while we may not have that in dentistry, it’s pretty easy to get noticed by the media. Local TV stations and newspapers are always looking for interesting stories. Be the one to get them excited about dental health! Hold a charity event like “Dentistry from the Heart,” and you’ll be swamped by reporters.

Social media has made great publicity within everyone’s reach. Write blogs, make your presence known on health-related sites, accumulate Facebook likes and constantly feed valuable information (not blatant ads) to your current and potential patients. The list practically is endless.

Dental Superstars Are Known in the Community Rock stars are known to everyone. They get out there. It’s why everyone has heard of Justin Bieber and fantastic bands like Dawes languish in obscurity.

So, get out there. Have a team meeting at a busy local restaurant with the whole team wearing their sharp-looking uniforms. Participate in community events, sponsor a team or help out during drives. Have a huge office sign. Go to local elementary schools to give dental health presentations.

orlando,florida i www.floridadentalconvention.com

Make sure the doctor and team members “think local” when it comes to banking, shopping, hairstylists and all the other chores we need to do. Introduce yourself and invite people in these businesses to your practice. Do whatever it takes so that people consider your practice to be “the” dental office in your community.

Dental Superstars Change with the Times You can’t be a dental superstar and only be doing “cleanings, crowns and fillings” just like you were 20 years ago. People want a variety of sophisticated procedures, and they want them from you. Sedation, implants, Invisalign, Six Month Smiles, laser periodontal therapy — it’s all within your reach.

Dental Superstars Are Accessible

The real dental superstars know you gotta give the people what they want. Don’t make it difficult to become a patient in your practice. Block time in your schedule for new patients and emergencies. Don’t have rules and policies (e.g., “no cleanings on the first visit”) that make it tough for patients.

Work with them and with their stubborn and stingy insurance companies. Be flexible and understanding. Putting up barriers and hoops is the fastest way not to be a dental superstar.

Everyone wants a picture with a rock star. Dental superstars do the next best thing. Make sure everyone you come in contact with gets one of your business cards. This goes for doctors and team members. The more creative you are, the better — and don’t forget to carry a Sharpie, too. If you received great service at a restaurant, write, “Thanks for the great service” on your business card and hand it to the manager. Let them know you offer the same kind of excellence at your dental practice.

There are millions of great musicians who languish in obscurity, and there are tons of clinically excellent dentists whose practices are underperforming. Let’s make this the year you truly become a dental superstar and “Rock Your Practice To The Top!”

Dental Superstars Make it Memorable

This article first ran on DrBiscuspid.com.

Reprinted with permission.

Rock stars know that even though their concerts may be in “just another town along the road,” to the fans it is an important evening they may never forget.

So, even though our patients may be “just another mouth,” dental superstars do all of the little things right so each patient feels like he or she is the most important patient in our practice. Make sure you take them back on time for their appointment. Be 100 percent sure patients are comfortable during procedures. Don’t appear to be rushed. Call your patients in the evening to see how they are doing. It’s not one big thing, but 100 little ones that differentiate your practice from the rest.

Dental Superstars Give the People What They Want Rock stars know that if they want to play every song from their new album in concert, they also have to play the hits. James Taylor may be sick of playing “Fire and Rain,” but you better believe he delivers a beautiful version of it every time he hits the stage.

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Drs. Richard H. Madow and David M. Madow, better known as The Madow Brothers, are motivational dental speakers in Reisterstown, Md. and can be reached at brothers@madow.com. They will be speaking at FDC2016, and will be the keynote speakers for Thursday, June 16, presenting their lecture, “ROCK Your Practice to the Top!” Later that morning, they will present, “How to Love Dentistry, Have Fun and Prosper” and then “The Ultimate Dental Bootcamp” in the afternoon.

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L A C LO Y L E V I &L 1

REMINDERS!

HERE'S ONE RIGHT NOW! Renew your license by Feb. 28, 2016!

Every biennium, we request a list from the Board of Dentistry of dentists who have not yet renewed their license. FDA MEMBERS in this category receive a reminder to renew.

2

WCDDA ANNUAL MEETING 2016

CE BROKER

The FDA automatically posts all your FDA completed CE courses to CE Broker. In addition, FDA MEMBERS receive a discount on CE Broker upgrades.

3

FREE CE: ONLINE AND FDC

FLORIDA DENTAL CONVENTION: FDA MEMBERS pre-register for FREE and can earn up to 18 FREE CE credits.

FDA ONLINE CE: Earn up to 30 FREE CE hours per year. Available 24/7, only to FDA MEMBERS.

4

LIAISON WITH BOARD OF DENTISTRY

The FDA sends staff and an appointed FDA MEMBER to every Board of Dentistry (BOD) meeting. Whenever your license, your ability to practice or your pocket book is affected, the FDA is part of the decision making process at the BOD.

5

GATHER FOR FUN & CONTINUING EDUCATION IN YOUR DISTRICT.

INFORMATION

Do you have questions about the biennium, the renewal process, CE Broker or your FDA-earned CE credits? Contact Brooke Martin at bmartin@floridadental.org or 850.350.7103. Information! It's one of the benefits provided to FDA MEMBERS. Find more information at www.floridadental.org.

Contact us at fda@floridadental.org or 800.877.9922.

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

NEDDA CE: JACKSONVILLE DENTAL SOCIETY & CLAY COUNTY DENTAL SOCIETY FRIDAY, MARCH 11, 2016 Sheraton Jacksonville Hotel Speaker: Dr. Vince Kokich Jr. – The Interdisciplinary Team: Creating Esthetic Success in the OrthoRestorative Patient www.nedda.org • 904.737.7545 • ddeville@nedda.org

ACDDA ANNUAL CONFERENCE

FRIDAY, APRIL 1, 2016 Embassy Suites Hotel, West Palm Beach

Speaker: Dr. Paul Homoly Register at www.acdda.org www.acdda.org • 561.968.7714 • acdda@aol.com

CFDDA ANNUAL MEETING

FRIDAY & SATURDAY, APRIL 14-16, 2016 Marriott Orlando World Center

Speaker: Drs. Jeffery Sevor and Lawrence Dario www.cfdda.org • 407.898.3481 centraldistrictdental@yahoo.com

SFDDA ANNUAL BUSINESS MEETING

WEDNESDAY, APRIL 20, 2016 • Location TBD www.sfdda.org • 305.667.3647 • sfdda@sfdda.org

For a complete listing: www.trumba.com/calendars/fda-member.

speaker preview

Child Abuse and Neglect: As Dental Professionals, How Can We Help and What Are Our Responsibilities?

“

By John P. Kenney DDS, MS

To report, go to https://reportabuse.def.state.fl.us/, call 800.962.2873 or fax a report to 800.914.0004. If you suspect or know of a child or vulnerable adult in immediate danger, call 911.

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As dental professionals, we have a legal and a moral responsibility to be aware of the signs and symptoms of child abuse and neglect.

Florida statutes also cover elder abuse and domestic violence. This article will not discuss those occurances, but it would be prudent for all dental offices to review the statutes and determine their legal and moral responsibilities.

Child abuse, like all forms of abuse, is a learned behavior. We parent the way we were parented, we treat our spouse the way we saw our parents treat one another, and we treat our parents or grandparents how we may have seen older relatives treated. As professionals, abuse is an epidemic that we must address.

One form of domestic violence cannot be separated from another. Today, extended families in the immediate vicinity are not commonplace as we have become a more mobile and isolated society. We see “children” having children, ill-prepared for what a pregnancy or child care entails. All of these issues and many more contribute to child abuse in this country.

In our individual dental practices, most of us see children on a regular basis as patients. If not, we may interact with them as they accompany a parent or other caregiver to our office.

Each encounter is an opportunity to observe these children and apply some simple diagnostic criteria to these observations. Abuse may be physical, sexual, emotional or simply neglect. Just like any diagnosis, all staff must use all of their faculties to come to a hypothesis, and then proceed to confirm to provide treatment or direction. Offices should have a pre-plan in place to deal with all forms of abuse, either suspected or actually clearly present in the dental office environment. Physicians, hospitals, child care institution administrators and law enforcement officers have the capability to take a child into protective custody if they believe the child to be in imminent danger. This ability is not extended to the dental professional in Florida.

Under the 2015 Florida Statues, Ch 827, child abuse means: “The intentional infliction of physical or mental injury on a child; an intentional act that could reasonably be expected to result in physical or mental injury to a child; active encouragement of any person to commit an act that results or could reasonably be expected to result in physical or mental injury to a child.” Florida also defines aggravated abuse and malicious behavior within the statute.

Mental injury is defined as: “Injury to the intellectual or psychological capacity of a child as evidenced by a discernable and substantial impairment in the ability of the child to function within the normal range of performance and behavior as supported by expert testimony.”

Neglect is defined as: “A caregiver’s failure or omission to provide a child with the care, supervision and services necessary to maintain the child’s physical and mental health, including but not limited to, food, nutrition, clothing, shelter, supervision, medicine and medical services that a prudent person would consider essential for the well-being of the child, or the caregiver’s failure to make a reasonable effort to protect a child from abuse, neglect or exploitation by another person.”

Under Chapter 39 of the Florida Statutes, “any person” is a mandated reporter. Any person who knows, or has reasonable cause to suspect, must report; however, as health care professionals, you are required by the statute to provide your name to the state hotline. Failure to report suspected child abuse or neglect subjects one to a felony charges in the third degree (FL 2015 Statutes Ch39 Sec205).

We will begin with neglect, and then discuss physical harm. Does the patient/accompanying child present dirty or unkempt, perhaps dressed inappropriately for the climate? Yes, in Florida there are not often bitterly cold days; however, on a beastly hot and humid day is the child in long sleeves and pants? Are they wearing shoes or sandals? No foot coverings when the outside pavement is extremely hot could be considered abuse or neglect. The long clothes could be covering bruises or other signs of physical abuse. Is there any malodor present? Is the child dirty or perhaps showing evidence of head lice? In infants and toddlers, perhaps a diaper has needed changing for some time? Is the parent appropriately aware of their child and the child’s needs, or do they show indifference or lack of compassion? There are many different parenting styles, but basic needs must be met. From a dental standpoint, has the child been seen by you or a pediatric/other dentist? Is there visible decay present on the teeth? As a reminder, a dental exam is not a quick ride up and down in mom or dad’s lap, but minimally the use of a mirror and explorer to check the oral cavity/teeth for signs of decay or other pathology. Untreated serious (e.g., abscessed teeth, deep caries and multiply affected), but identified dental decay may constitute dental (medical) neglect if there is no effort to treat the decay. The American Academy of Pediatric Dentistry defines dental neglect as “Willful failure of a parent or guardian to seek and follow through with treatment necessary to ensure a level of oral health essential for adequate function and

freedom from pain and infection. Untreated rampant caries, untreated pain, infection or swelling, and lack of continuity of care, once informed that above conditions exist, constitute dental neglect.”

Are there signs of nutritional deficit, such as a child who is considerably under or overweight? Is the child under the routine care of a physician for this issue? Are there obvious other medical issues that are not being addressed?

Approximately two-thirds of all physical injury in all forms of abuse (child/domestic partner/elder/special needs) occurs in the head or neck area. Orofacial injuries present on children we see in our office are considered to be highly suspicious. We need to determine the origin/mechanism of any injury. Does the history given by the caregiver conflict with the nature of the injury? A false history may be inconsistent, contradictory or vague. The caregiver may claim that the child is clumsy or accidentprone, or you observe multiple injuries in various stages of healing. When a child falls, the most likely place for an injury will be elbows, knees, forearms and forehead.

Injuries on the upper arms, back of the legs, back of the hands or bilaterally on the face after a “fall” should raise suspicion. There may be a claim that the child suffers from a vague or rare disease; however, the caregiver cannot give the name of a treating physician or details of the disease. A torn labial frenum can be suspicious, as is damage to the lingual frenum. Again, is the history and mechanism plausible? Are the parents Please see ABUSE, 80

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acting appropriately? Also, interrupted linear marks on the face or arms about 1 cm apart can be from a hand slap. This mechanism also can tear a labial frenum on a small child. If the circumstances/appearance is not plausible, look further for signs of abuse.

An abused child may appear unusually aggressive or withdrawn. It has been noted that when a doctor of the same sex as the abuser enters the treatment room, there could be a notable behavior change. There may be evidence of previous healed injuries.

During a dental exam, perhaps missing, partly avulsed or fractured teeth are present without adequate explanation. This also can occur on permanent teeth in older children.

When abuse is suspected, if the child victim is competent to explain in their own words what happened to them, it is recommended to separate the parent from the child and try to elicit some information from the child. When this is in direct contradiction to the parent’s version, or the parental version does not coincide with the clinical appearance of the injury and the child’s does, suspicions must be raised. Sometimes the abusive parent (or in cases of domestic abuse, the partner, or caregiver for a senior) will accompany the patient to the office/operatory and attempt to deflect responsibility on to the abused person, or intimidate them into saying things like, “I don’t know how it happened,” or making up a very implausible story that does not fit with the mechanism of injury in your professional opinion.

Has there been a delay in seeking treatment? Would a prudent parent have

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taken the child to the doctor/dentist or emergency room much sooner than presenting for treatment at your office? Is the explanation plausible for any delay? If this is a new patient, why are they in YOUR office? Look at their home address. If not a referral from an existing patient, what made them choose you if they must come an unnecessary distance for treatment? If you are the only nearby provider for their insurance, then that is a logical reason.

Could it be that they are known in their own community, and this child or another sibling has been previously injured? Seeking care at different offices (hospital or doctor “shopping”) is a sign of possible abuse. This is why state Central Registries are so important — the family may already be known to the Central Registry. Many individuals do not see a dentist as a “threat” to discover child abuse, as they do a pediatrician or emergency department doctor.

This is all the more reason for the dental professional to be alert and aware of the signs and symptoms of abuse.

Another area of concern is sexual abuse of your child/teen patients. For example, a patient you have seen for some time who readily cooperates for an exam or instruments in their mouth now all of a sudden has a deep-seated fear of an oral examination, prophy, etc. Is there evidence of a sexually transmitted disease in the oral cavity, or petechia on the roof of the mouth from possible sexual contact? Does the child walk with a guarded gait or have difficulty sitting in the dental chair? Is the parent/guardian/caregiver (especially of the opposite sex) hovering over the child or answering questions for them even if they are capable of responding themselves?

Whenever abuse is suspected, the practitioner must document the observations and findings in the chart. It should be countersigned by another witnessing staff member. Place any statement by a parent, caregiver or patient into quotes: Parent (mom/dad, etc.) or patient states, “quote.” Women who are pregnant or premenstrual are at a higher risk to abuse and also while pregnant to be abuse victims themselves! We owe the patients in our care our diligence as a practitioner to provide the best care possible. This extends to protecting the patients we see from physical, sexual or emotional abuse.

To report, go to https://reportabuse.def.state.fl.us/, call 800.962.2873 or fax a report to 800.914.0004. If you suspect or know of a child or vulnerable adult in immediate danger, call 911.

References: Florida 2015 Statutes, Chapters 39 and 827.

Dr. Kenney is a pediatric dentist in Park Ridge, Ill. and can be reached at frnscdds@aol.com.

He is a diplomate of both the American Board of Pediatric Dentistry and the American Board of Forensic Odontology. He will be speaking at FDC2016 on Friday, June 17, and presenting his courses, “Dentistry from the Cradle to the Grave” in the morning and “Bite Marks, Battered Patients and Bad Dentistry” in the afternoon.

orlando,florida i www.floridadentalconvention.com

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The FDA’s online classified system 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!

ANNOUNCING: Oral & IV Emergency Sedation Seminar.

Sedation Ready is offering a unique training program that provides your dental team with the tools to handle medical emergencies during oral or IV sedation that may arise in your office. The 9 CE credit ADA-approved course provides lecture/hands on emergency scenarios with SIM-LAB technology to exclusively train you and your dental team. To book a training near you visit: http://www. sedationready.com/booking.

ENDODONTIST-TAMPA BAY AREA. Quality associate needed for busy, modern endodontic office. New graduates encouraged to apply. Send CV to julieh@aeoftb.com.

As an added benefit, we will continue to publish the basic text of paid, online classified ads in Today’s FDA, at no additional cost to you. All ads posted to the online classified system will be published during the contracted time frame for which you have posted your online classified advertisement.

General Dentist and Specialist Openings for Multiple Offices in South and Central Florida. Grow with us: Large intimate group practice seeks experienced, highlyproductive General Dentists and Specialists for busy growing general and multi-specialty practices. Sage Dental Group operates 34 large, well-established practices in Broward, Palm Beach, Dade, and the Treasure Coast with new practices starting to open in the Orlando Market. Our beautiful and modern facilities are in premium locations and state-of-the-art equipment and digital X-rays with a supportive staff and professional management team. Cash, private, and insurance. Highest compensation in industry.

Full schedules, excellent benefits, malpractice insurance reimbursement, and CE. http://www.Mysagedental.com.

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

Today’s FDA is published bimonthly; therefore, all active ads online will be extracted from the system on roughly the following dates of each year:

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

Issue

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Jan/Feb March/April May/June July/Aug Sept/Oct Nov/Dec

Jan. 15 March 15 May 1* July 15 Sept. 15 Nov. 15

* The May/June issue is scheduled to be mailed out two weeks earlier than normal to reach members before the annual Florida Dental Convention.

Please visit the FDA’s NEW classified website at www.floridadental.co/classifieds.

January/February 2015

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

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

www.floridadental.org

Pediatric Dentist Opening- Miami. Come join our team in Miami! Great Expressions Dental Centers has a current opening for a part-time Pediatric Dentist to join our Miami, FL practice. Our Specialists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. **Please watch more about our Doctor Career Path (http://www.screencast. com/t/M3xWM5CYN) and apply via this ad to join our team! “Look for the Smile Above Our Name!” Apply Here: http://www.Click2Apply.net/97k7tqgzgn.

Pediatric Dentist Full Time Role: Fort Myers. Come join our Page Field (Fort Myers) office! Great Expressions Dental Centers has a current opening for a full time (4 days/week) Pediatric Dentist in our newly renovated and multi-specialty, Page Field office in Fort Myers, FL. Our Specialists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. Relocation or sign-on bonus possible as well! **Please watch more about our Doctor Career Path (http:// www.screencast.com/t/M3xWM5CYN) and apply via this ad to join our team! “Look for the Smile Above Our Name!”

Apply Here: http://www.Click2Apply.net/s569ssgtqj.

General Dentist. Private practice in Sun City Center/ Ruskin needs Florida licensed full time General Dentist to cover Dentist going on maternity leave from September to December 2015 with opportunity for permanent placement.

This qualified Dentist should have strength in endodontic and restorative dentistry, excellent communication skills with a comprehensive approach to patient care. We have a beautiful, modern, digital office with a wonderful patient population and a very enthusiastic team. deep106@aol.com.

Oral Surgery opening w/ multi-specialty group! Christie Dental is a multi-specialty dental group with approximately 55 dentists and specialty doctors in nearly 20 practice locations in the Brevard and Ocala Florida area. Christie Dental offers individuals and families a full range of dental care, including general dentistry, hygiene and specialty care, such as pedodontics, oral surgery, endodontics, orthodontics and periodontics. We currently have a wonderful opportunity for an Oral Surgeon to join our team in the Space Coast area, on a full or part-time basis.

This is an opportunity which provides a high number of referrals from inside and outside the Christie Dental group. We offer a comprehensive compensation and benefits package which includes medical, life, disability and professional liability insurances, flexible spending and 401(K) with employer match! pschwartz@amdpi.com.

General Dentists and Specialists. A blockbuster opportunity. Full or part time for General Dentists, Endodontists, Orthodontists, Pedodontists, Periodontists, and Oral Surgeons. Generous compensation with unlimited potential. Guaranteed referrals. Join our group specialty care practice with a significant general dental component. Established in 1975 in Aventura, Coral Springs, Delray Beach, Boynton Beach, Stuart, Ft. Pierce and Melbourne. Call: Kelly Oliver 954.461.0172. Fax resume to: 954.678.9539. Email: careers@dentaland.net.

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

www.floridadental.org

Kool Smiles – Associate Dentist Opps in 16 States!

Associate Dentists – Full Time, Part Time, and MultiSite opportunities. UP TO $70,000.00 SIGN-ON BONUS + RELOCATION!!! EARN UP TO $650 DAILY GUARANTEE OR % OF COLLECTIONS!!! At Kool Smiles, our dentists don’t just shape smiles — they shape the lives of families every single day. We are the nation’s leader in general dental care to under-served kids, teens, and adults. Our compassion and drive make us the best at what we do every day. Currently, Kool Smiles is operating in over 125 locations in AR, AZ, CT, DC, GA, IN, KY, LA, MA, MD, MS, NM, OK, SC, TX, VA. This is the time to join not just an amazing company, but a place where you will be a part of making smiles happen every day! You are just one step away from earning a great living and doing something greater! At Kool Smiles we offer: Generous compensation; Earn up to $650 daily guarantee or % of collections; 401(K) with company match; Outstanding benefits, including paid time off, malpractice insurance, health insurance, life insurance, continuing education, licensing reimbursements and Visa and permanent residency sponsorship; Excellent training, education and advancement opportunities; No practice management expenses and headaches — we take care of it! Kool Smiles Dentists find inspiration, challenge, and reward every day at their job. Do you? Contact one of our recruiters today at http://www.koolsmilesjobs.com/ connect!

Kool Smiles - Dental Specialists Needed! Kool Smiles has Oral Surgeon, Pedodontist, Orthodontist, and Dental/ Medical Anesthesiologist Full Time and Part Time opportunities available in AR, AZ, CT, DC, IN, KY, LA, MA, MD, MS, OK, SC, TX, & VA! At Kool Smiles, our dentists don’t just shape smiles — they shape the lives of families every single day. We are the nation’s leader in general dental care to under-served kids, teens, and adults. Our compassion and drive make us the best at what we do every day. At Kool Smiles we offer: Generous compensation; 401(K) with company match; Outstanding benefits, including paid time off, malpractice, health, & life insurance, continuing education, licensing reimbursements and Visa/permanent residency sponsorship; Excellent training, education and advancement opportunities; No practice management expenses and headaches — we take care of it! Kool Smiles Dentists find inspiration, challenge, and reward every day at their job. Do you? For more information contact Emily Platto at eplatto@benevis.com!

Full time Dentist Associate position available in Venice, Florida. Three doctor high tech practice with great patients and staff. Prefer GPR or 5 years’ experience.

Comp projection high 200’s plus benefits. Call Tom at 941.488.1075 or email to: tom@venicedentist.com.

Associate Dentists. We are seeking a high energy, highly motivated associate dentist to work with an established dentist relocating to Venice, Florida. The practice is currently a one doctor practice and is expanding to add a second doctor. Ideal candidates will have the desire to train and be mentored in advanced areas of dental care such as endo, oral surgery and implant dentistry. Ownership potential will be based on candidate performance. If you want to change people’s lives through the profession of dentistry, while living in a place that people dream of living in, contact us today! To associate with a Doctor that is relocating to the area. drpaul@doorcountydentistry.com DENTIST. General Dentist F/T or P/T Busy offices. Palm Beach County. Excellent financial opportunity. Complete lab on premises. Per diem guaranteed plus commission.

Email zufi@comcast.net, Fax 561.738.2116.

Dental Associate needed. Need an Associate for a busy Florida East Coast Dental Practice in Brevard County. Fulltime or Part-time General Dentist to join our Team in Port Saint John (Cocoa). Must be willing to do Anterior and Molar Endo. Must have a DDS/DMD from an accredited University and active State Dental Board license. Also open to Endo only 1 or 2 days a month. ifixmolars@aol.com.

General Dentist Opportunity with intensive Training 1 on 1. Sebring Dental practice needing a FT General Dentist.

We will consider a new graduate or GPR that wishes to learn at an accelerated pace. We have a lab in the office with a FT lab tech, 3 DAs and even a FT hygienist. Our office is very clean with great lighting, 7 operatories and digital X-rays. We have a guaranteed daily rate with monthly profit sharing. We pay $2,500 of your malpractice insurance, no contracts. We also provide health insurance, STD&LTD, 401K w/match, paid CEs and paid vacation. *relocation assistance is considered.* Current dentist is taking home $20K gross per month. Must be a dentist with a DDS or DMD degree and no issues with license or insurance problems. mioconnor@aspendental.com.

Pediatric Dentist Opening- Miami Gardens, FL. Come lead our Miami Gardens, FL Specialty team at our North Dade office! Great Expressions Dental Centers has a current, select opening for a full-time Pediatric Dentist to join our Multi-Specialty North Dade office located in Miami Gardens, FL! Enjoy a rewarding role with a dedicated staff while having a strong internal referring network of 15+ local practices! **Sign-on or relocation possible ($$$)! Benefits / Perks: Leaders in the practice: Clinical freedom and treatment autonomy for every Doctor; Patient Focus: Established and Growing Patient Foundation; Multi-Specialty practice; Compensation — six figure annual base vs. percent of production! Doctor Career Path – Partnership/Investment Opportunities; Full Benefits Offered — Healthcare & Dental Benefits, 401K, Short Term/ Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues; Mentorship – Study Clubs, Chairside Mentoring, GEDC University Courses. Please view our Doctor Career Path video: http://www.screencast. com/t/M3xWM5CYN. Apply via this ad to learn more about Great Expressions! For More Information Contact: Ross Shoemaker, MBA | Doctor Recruiting Manager | Great Expressions Dental Centers Practice Support Center - South | 1560 Oakbrook Drive, Norcross, GA 30093 USA, phone 678.836.2226 | ext 72226 | fax 770.242.3251 |web www.greatexpressions.com. Look for the Smile Above Our Name! http://www.Click2Apply.net/vxs7m5hmqy Apply Here.

Pediatric Dentist Full Time Role: Fort Myers. Come join our Page Field (Fort Myers) office! Great Expressions Dental Centers has a current opening for a full time (4 days/week) Pediatric Dentist in our newly renovated and multi-specialty, Page Field office in Fort Myers, FL. Our Specialists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. Dentists can expect unlimited production based earnings vs. six figure base; with a large, internal referring network of General Dentists; full benefits (such as medical, dental, 401k, continuing education); paid time off; malpractice coverage; a stable patient base with full office staff in place; and long-term practice or regional career growth with possible investment opportunity. Relocation or sign-on bonus possible as well! **Please watch more about our Doctor Career Path (http://www.screencast. com/t/M3xWM5CYN) and apply via this ad to join our team! Ross Shoemaker, MBA | Doctor Recruiting Manager | Great Expressions Dental Centers Practice Support Center - South | 1560 Oakbrook Drive, Norcross, GA 30093 USA, phone 678.836.2226 | ext 72226 | fax 770.242.3251 |web www.greatexpressions.com. Look for the Smile Above Our Name! http://www.Click2Apply.net/vtspj4tntm Apply Here.

General dentist wanted for high quality fee for service office in south Palm Beach County Office. We will market and promote an associate with the potential for a future purchase of the practice. Jlissauer@aol.com.

Please see CLASSIFIEDS, 84

January/February 2016

Today's FDA

83

Your Classified Ad Reaches 7,000 Readers!

CLASSIFIEDS from 83 Endodontist-Ocala, FL. Christie Dental is a multi-specialty dental group with approximately 55 doctors in nearly 20 practice locations in the Brevard and Ocala area. We currently have a part time opportunity for an Endodontist to join our team in the Ocala one day a week. This is a great opportunity to supplement your schedule with proven patient demand & referrals with future growth opportunity.

Christie Dental is primarily a fee for service and PPO provider. Contact Kate Anderson: kateanderson@amdpi. com or 781.213.3312.

LAKELAND - Dentists Needed. Lakeland Volunteers In Medicine is looking for either one full-time or two parttime dentists to work in our 3 room dental office. Flexible schedule. Competitive salary. kim.katsaras@lvim.net.

PEDIATRIC DENTIST. Dental Care Group Kids is interested in hiring an enthusiastic and caring Pedodontist for our Aventura and Pembroke Pines office. We are a warm and child friendly atmosphere with modern and sophisticated state-of-the-art equipment. Minimum 2 years in practice, credentialed with Medicaid a plus.

Salary to be discussed upon your interview visit. vilma@ aventurapediatricdentistry.com.

Pediatric Dentist Opening- Miami Gardens, FL. Come lead our Miami Gardens, FL Specialty team at our North Dade office! Great Expressions Dental Centers has a current, select opening for a full-time Pediatric Dentist to join our Multi-Specialty North Dade office located in Miami Gardens, FL! Enjoy a rewarding role with a dedicated staff while having a strong internal referring network of 15+ local practices! **Sign-on or relocation possible ($$$)! Benefits / Perks: Leaders in the practice: Clinical freedom and treatment autonomy for every Doctor; Patient Focus: Established and Growing Patient Foundation; Multi-Specialty practice; Compensation — six figure annual base vs. percent of production! Doctor Career Path — Partnership/Investment Opportunities; Full Benefits Offered — Healthcare & Dental Benefits, 401K, Short Term/ Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues; Mentorship — Study Clubs, Chairside Mentoring, GEDC University Courses. Please view our Doctor Career Path video: http://www.screencast. com/t/M3xWM5CYN. Apply via this ad to learn more about Great Expressions! For More Information Contact: Ross Shoemaker, MBA | Doctor Recruiting Manager | Great Expressions Dental Centers Practice Support Center - South | 1560 Oakbrook Drive, Norcross, GA 30093 USA, phone 678.836.2226 | ext 72226 | fax 770.242.3251 |web www.greatexpressions.com. Look for the Smile Above Our Name! Apply Here: http://www.Click2Apply.net/ n3wvjbn5t7.

Excellent Opportunity In The Tampa Bay Area. Multispecialty practice on the west coast seeks motivated periodontist for full time position. LANAP certification is desirable but not a must. Great working environment.

Close to the beaches and excellent recreational opportunities. Salary, health, 401K, and bonus. Respond at gulfcoastdentist@gmail.com.

General Dentist Needed - Port Charlotte. We are looking for a dentist who constantly strives for excellence and building lifelong relationships with their patients. A great number of dentists today are frustrated with the aspects of managing a private practice. DDPG can help you build your dental career around being a doctor. With top notch staff and support, this is where you can be in charge of directing a great career in dentistry. lwagner@ddpgroups.com.

General Dentist-Tampa Bay Area. Thriving group practice (single location) in the Tampa Bay area seeking motivated general dentist for full time position with excellent earning potential. Desirable area close to beaches and great recreational activities. Salary, health,401k, bonus. Respond at gulfcoastdentist@gmail.com.

84

Today's FDA

January/February 2015

Pediatric Dentist Wanted Town of Palm Beach FL. Pediatric Dentist opportunity of a life time: Be the first and only pediatric dentist in the wealthiest zip code in the USA, 33480: The Island of Palm Beach Florida; just over the intra-coastal waterway from down-town West Palm Beach, FL. Fridays and Saturdays to start, then as your practice grows, more days if you want. Office is one of the most prestigious adult cosmetic, implant and general dentistry practices established in 1958. Current doctor has been owner since 1992 and is a leading expert in marketing for dental practices and still works four days per week.

Practice is 100% fee-for-service. Patients have included the top corporate and industrial families in the USA, celebrities and politicians. New younger families moving in all the time. Two schools are a 10 min walk from the office, several more are one mile away. Three private, one public. We are NOW ready to start marketing pediatric services; get in on the ground floor! Email inquiries to: Dr. Josephs at: drjosephs@palmbeachdentist.com.

Jacksonville, FL - Associate General Dentist Opening.

Great Expressions Dental Centers has a current opening for a full-time (5 days/week) General Dentist to join one of our Jacksonville, FL practices. Our dentists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. When considering a career with GEDC, Dentists can expect unlimited production based earnings, full benefits, malpractice coverage, a stable patient base, and long-term practice or regional career growth. We do it all for you. You became a dentist to help people. It’s your profession and your passion. But the demands of owning and managing an office are not only financially taxing but time consuming.

Which is why Great Expressions Dental Centers is built on a provider-first philosophy. The highest standards.

Our National Doctors Panel has set standards for clinical excellence, including clinical protocols, sterilization, materials, standards of care, quality assurance, charts and charting, consent forms and many other items that have allowed us to become the gold standard in the industry.

Focus solely on a steady flow of patients. With GEDC you don’t need to worry about overseeing the business aspects of the office, such as malpractice insurance, employee insurance, payroll, marketing/advertising and the litany of other concerns that go along with owning your practice.

Instead, focus on being the clinical leader within your office. Work/Life balance. We believe in the importance of a work/life balance. So we make every effort to ensure you have time for family, friends and vacations (you know, that thing called a “personal life”). Relocation or sign-on bonus possible as well! **Please watch more about our Doctor Career Path (http://www.screencast.com/t/M3xWM5CYN) and apply via this ad to join our team! Molly Johnston | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 300 East Long Lake Rd Suite 311| Bloomfield Hills, MI 48304 USA, phone 248.430.5555 |Ext. 72467| fax 248.686.0170 | web www.greatexpressions.com. “Look for the Smile Above Our Name!”

Seeking Full Time General Dentist. We are a Private well established multi-specialty practice serving the St. Petersburg/Clearwater area for over 40 years. Our practice is comprised of General Dentists, an Orthodontist, a Periodontist and an Oral Maxillo Facial Surgeon. We have an opportunity for a general dentist seeking a full time associate position with the potential for partnership.

Seeking an experienced and motivated person. This position has great earning potential and the opportunity for mentorship. Email or fax St. Pete Dental 727.525.3686 or dr.b.spdc@gmail.com.

General Dentist. Busy, successful private denture practice.

Beautiful new building with the latest technology and our own on-site lab. Located near Tallahassee, Florida.

We are looking for someone who is proficient with cosmetic and restorative procedures, as well as, implants, dentures and extractions. Patients and marketing will be provided. Expected Salary $600-800 + per day. beth@ beachtondenture.com.

General Dentist Opening - South Florida. Come lead our Miami, FL team as our full time Dentist! Great Expressions Dental Centers has an immediate, select opening for a full-time General Dentist to join our established Miami, FL practice! Enjoy a rewarding role with a dedicated staff with a strong patient base! Benefits/Perks: Leaders in the practice: Clinical Freedom and Treatment Autonomy for every Doctor; Patient Focus: Established and Growing Patient Foundation; Compensation: Six-figure draw vs. percent of production; Doctor Career Path: Partnership/Investment Opportunities; Full Benefits Offered: Healthcare & Dental Benefits, 401K, Short Term/ Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues; Mentorship: Study Clubs, Chairside Mentoring, GEDC University Courses. Please view our Doctor Career Path video: http://www.screencast. com/t/M3xWM5CYN. Apply via this ad to learn more about Great Expressions! For More Information, Please Contact: Ross Shoemaker, MBA | Doctor Recruiting Manager | Great Expressions Dental Centers Practice Support Center - South | 1560 Oakbrook Drive, Norcross, GA 30093 USA, phone 678.836.2226 | ext 72226 | fax 770.242.3251 |web www.greatexpressions.com, email Ross.Shoemaker@greatexpressions.com. “Look for the Smile Above Our Name!” http://www.Click2Apply.net/ x2wnhdykfp Apply Here. PI92030768.

General Dentist. Part time Associate needed in Central Florida near beaches. Private practice. Do you want to be busy from day one? Great patient flow, high tech office with Cone beam, Cerec and digital X-rays. Please forward a CV and a good time to contact you. Send to fl_dmd@ yahoo.com.

General Dentist Opening - Tampa, FL. Great Expressions Dental Centers has a current opening for a full-time General Dentist to join our Tampa, FL practice. Our dentists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. When considering a career with GEDC, Dentists can expect unlimited production based earnings, full benefits, malpractice coverage, a stable patient base, and long-term practice or regional career growth. We do it all for you. You became a dentist to help people. It’s your profession and your passion. But the demands of owning and managing an office are not only financially taxing but time consuming. Which is why Great Expressions Dental Centers is built on a provider-first philosophy. The highest standards. Our National Doctor Panel has set standards for clinical excellence, including clinical protocols, sterilization, materials, standards of care, quality assurance, charts and charting, consent forms and many other items that have allowed us to become the gold standard in the industry. Focus solely on a steady flow of patients.

With GEDC you don’t need to worry about overseeing the business aspects of the office, such as malpractice insurance, employee insurance, payroll, marketing/ advertising and the litany of other concerns that go along with owning your practice. Instead, focus on being the clinical leader within your office. Work/Life balance. We believe in the importance of a work/life balance. So we make every effort to ensure you have time for family, friends and vacations (you know, that thing called a “personal life”). **Please watch more about our Doctor Career Path (http://www.screencast.com/t/M3xWM5CYN) and apply via this ad to join our team! Relocation or signon bonus possible as well! Molly McVay | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 300 East Long Lake Rd Suite 311| Bloomfield Hills, MI 48304 USA, phone 248.430.5555 |Ext. 72467| fax 248.686.0170 | web www.greatexpressions.com. “Look for the Smile Above Our Name!” Must have a DDS/DMD from an accredited University and active State Dental Board license. http:// www.Click2Apply.net/qk2xfz6x35 Apply Here.

Associate Placement Services. ASSOCIATE PLACEMENT SERVICES Statewide Opportunities. Need an Associate?

Need a job? General Dentist or Specialist? Call Melanie Aranda 561.310.0599 @ Doctor’s Choice email : maranda@ doctorschoice1.net.

Dentists. A traditional fee for service general practice seeking full- or part-time associates. Locations in Tampa, Clearwater, Largo, St. Petersburg, Port Richey, Pinellas Park and Bradenton. Immediate income, paid vacation, health insurance, 401k, flexible days. Established in 1981. NO CAPITATION. Please send CV to Corp@ FloridaDentalCenters.com, or fax 727.446.8382.

Part-time Dentist. Non-profit clinic in Stuart for low income and Medicaid patients needs licensed part-time general dentist with strength in extractions, dentures and restorative dentistry. Salaried position 2-3 days per week.

Please send us your resume to ccccenter@bellsouth.net or fax to 844.269.6899.

General Dentist. Come lead our Del Prado, FL team as our full time Dentist! Great Expressions Dental Centers has an immediate, select opening for a full-time General Dentist to join our solo, Del Prado, FL practice (1127 Del Prado Blvd S., Suite D and E Cape Coral, Florida 33990)!

Enjoy a rewarding role with a dedicated staff with a strong patient base! Benefits/Perks: Leaders in the practice: Clinical Freedom and Treatment Autonomy for every Doctor; Patient Focus: Established and Growing Patient Foundation; Compensation: Six-figure draw vs. percent of production; Relocation or Sign-On Bonus ($$$) possible as well! Doctor Career Path: Partnership/Investment Opportunities; Full Benefits Offered: Healthcare & Dental Benefits, 401K, Short Term/Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues; Mentorship: Study Clubs, Chairside Mentoring, GEDC University Courses; Please view our Doctor Career Path video: http://www.screencast.com/t/M3xWM5CYN. Apply via this ad to learn more about Great Expressions! For More Information, Please Contact: Ross Shoemaker, MBA | Doctor Recruiting Manager | Great Expressions Dental Centers Practice Support Center - South | 1560 Oakbrook Drive, Norcross, GA 30093 USA, phone 678.836.2226 | ext 72226 | fax 770-242-3251 |web www.greatexpressions. com. email Ross.Shoemaker@greatexpressions.com. “Look for the Smile Above Our Name!” http://www.Click2Apply. net/2jb2v9xzdm Apply Here.

General Dentist. Excellent opportunity for a Floating GENERAL DENTIST to join our team at Florida Community Health Centers, to work at our Fort Pierce and Okeechobee locations. The practice is 60-80% Pediatrics, the candidate must be experienced and comfortable working with children and adults. Requirements: Must have an active Florida Dental License. The ideal candidate is patient driven, enjoys working with underinsured patients & is culturally sensitive. Competitive Salary & Benefits package includes retirement (pension plan and 403(b)), Health Insurance, 18 days’ vacation plus 7 holidays, 3 floating holidays and CME time. FTCA Malpractice Insurance coverage and possible NHSC Loan repayment opportunity. To apply, please email CV to jobs@fchcinc.org or fax it to Medical Director at 561.844.1013.

Associate. Seeking an experienced highly motivated associate with exceptional clinical communication skills. Must be goal oriented self-managed leader who shows a great work ethic. We are looking for a long term candidate to work with our exceptional dental team.

Practice is completely computerized and paperless with equipment such as diagnodent, 3M scanner, Picaso Laser, digital x-rays, intraoral camera, and more to come!. paulhortondmd@comcast.net.

Pediatric Dentist! (Country Walk & West Kendall) This is a tremendous earning opportunity for a Pediatric Dentist to join a high quality single owned multi-specialty practice.

These highly successful dental practices are located in Country Walk & West Kendall, Florida. Signing Bonus; Potential Partnership/Investment opportunity; Clinical freedom and treatment autonomy for every Doctor; Annual Compensation six figure guarantee and/or percent of production. Excellent earning potential; Full time or Part time schedule available (very flexible); Established and Growing Patient Foundation; State of the Art equipment & beautiful facilities with Digital Radiography, Electronic & Paperless charting (fully digital across the board); Long Term security in a highly respected practice. Come work with a focus-driven practice that empowers the professional growth of each member, thereby offering patients state of the art restorative and cosmetic services in a modern, patient pleasing environment. Please contact Dr. Nick Lekkas, drnicklekkas@altimadentalgroup.com or 954.383.4973 for an interview.

General Dentist Opportunities - Jacksonville, FL. Great Expressions Dental Centers has select openings for General Dentists to join our Jacksonville, FL dental team! For more than 35 years, Great Expressions Dental Centers has been exceeding patients’ expectations offering general dentistry, endodontic, periodontic, oral and maxillofacial surgery, orthodontic, and pediatric dentistry services in a comfortable, friendly environment. We are always looking for motivated and qualified dental professionals and with over 200 dental centers in ten states, the opportunities are unlimited. Compensation: Unlimited Earnings with a six figure draw and % of Production. Please watch more about our Doctor Career Path: http://www.screencast. com/t/M3xWM5CYN. Benefits/Perks: Leaders in the practice: Clinical freedom and autonomy; Patient Focus: Stable and Long term patient base; Multi-Doctor and Solo practices; Doctor Career Path — Partnership/Investment opportunities; Full Benefits — Paid Healthcare Benefits, 401K, Short Term / Long Term Disability, Paid Time off; Full Malpractice Coverage; Continued Education — CE Reimbursement, Invisalign Training, Whitening Opportunity, Paid ADA & State Society Dues; Mentorship — Study Clubs, Chairside mentoring, Onboarding, Multispecialty, GEDC University courses. Relocation or sign-on bonus possible as well. Please apply via this ad for consideration! Molly McVay | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 300 East Long Lake Rd Suite 311| Bloomfield Hills, MI 48304 USA, phone 248.430.5555 |Ext. 72467| fax 248.686.0170 | web www. greatexpressions.com. Job Requirements: Must have a DDS/ DMD from an accredited University and active State Dental Board license. http://www.Click2Apply.net/bjp2mbbgq4 Apply Here.

Full Time Dentist Needed in Key West, FL. Full time Dentist position available with a well-established practice in beautiful Key West, FL. Looking for an experienced dentist who will see patients of all ages and demographics. This productive office has a blend of fair-share pay, Commercial Insurance, and Medicaid patients. Must have current FL license, DEA license, and Liability insurance. Please submit resume via email dstacy@rhnmc.org.

Clinical Assistant/Associate Professor. The University of Florida College of Dentistry is seeking applications for a full-time clinical track faculty position in the Department of Restorative Dental Sciences, Division of General Dentistry at the Assistant/Associate Professor rank. The University of Florida College of Dentistry (UFCD) is one of the leading dental schools in the United States devoted to improving and promoting oral health throughout Florida, the nation and worldwide through excellence in teaching, research, patient care and service. Responsibilities include serving as Team leader in the DMD Team Clinical Program, participation in intramural faculty practice, excellence in academic pursuits and service, and some limited participation in the development of departmental research and/or other scholarly activities. Applicants must be experienced and able to deliver departmental and college curricular content in the predoctoral student DMD clinic and/or didactic setting. Applicants must be able to supervise students in all aspects of restorative dentistry including comprehensive treatment planning, periodontology, endodontics, operative, fixed and removable prosthodontics, basic surgical procedures, and participate in faculty practice. As well as being a strong clinician, applicant should be organized, open minded, dedicated to teaching predoctoral students, comfortable with technology, knowledgeable in the electronic health record, current in evidence based dentistry and possess excellent communication skills both verbal and electronic.

Experience with CAD CAM is also desirable. Minimum requirements include a DDS, DMD, or equivalent dental degree and commitment to working with and building teams. Post-graduate training, teaching experience, scholarly activities, and private practice experience is strongly preferred. Salary and rank are commensurate with credentials and experience. The University of Florida is an Equal Opportunity Institution dedicated to building a culturally diverse and inclusive faculty and staff. The selection process will be conducted in accord with the provisions of Florida’s Government in the Sunshine and Public Records Laws. Search committee meetings and interviews will be open to the public, and all applications, resumes, and other documents related to the search will be available for public inspection. The review of applications will begin immediately and position is to be filled as soon as possible. To apply, please go to http://jobs.ufl.edu/ and search for job number 495227. Applicants should attach a curriculum vitae, a cover letter describing their interest containing a statement of academic objectives, and a contact list of three references with their application for consideration. For more information about the University of Florida College of Dentistry, visit: www.dental.ufl.edu.

Endodontists - Naples & Tampa Bay. Exceptional opportunities to work full-time or part-time in one of our area practices. Two opportunities available, one in Naples the other in Tampa Bay. We provide modern facilities and equipment, full management/collection services. We schedule exclusive referrals and provide specialists with all needed resources allowing you to focus completely on patient care. Highly competitive and unlimited earnings potential! Excellent benefits are also available with full time employment. Exceptional opportunity! Great facility - State of the art equipment. Strong patient referral system.

Outstanding staff trained and rewarded for keeping the Dentist productive. Strong emphasis on quality care.

Huge upside income opportunity based on productivity.

Excellent benefit package (medical plan, 401k, malpractice ins, CE). Established business systems and metrics in place.

If you looking for a long-term Endo opportunity with a guaranteed per day income and huge upside earning potential in a well-run, modern practice, contact us today. Interested Endo’s should email resume to bames@ dentalcarealliance.com for immediate consideration! www. dentalcarealliance.com.

Please see CLASSIFIEDS, 86

www.floridadental.org

www.floridadental.org

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Associate Dentists. Full-Time Associate Dentists roles throughout Florida! As one of the country’s largest dental support organizations, we have more than 170 affiliated dental practices in eight states. For more than twenty years, we’ve taken great pride in our revolutionary approach to dentistry. Dental Care Alliance was created by dentists and our focus has always been on improving the well-being of both patients and dentists. Our platform is powerful and cultivates lasting relationships. Experienced, licensed Clinical Directors ensure superior standards of care, and our affiliated dentists share our commitment to practicing with honesty, integrity and compassion. The future is now. We currently have Full-Time Associate Opportunities throughout the State of Fl - Tampa Bay, Orlando, Sarasota, Naples, Space Coast, and more! State of the art practice facilities. 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. Whether you are and experienced dentist, or a recent Grad, we have opportunities for you. Interested Dentists should email resume/cv bames@dentalcarealliance.com. Learn more about us @ www.dentalcarealliance.com.

General Dentist Opening - (Downtown) Tampa, FL. Come lead our Downtown Tampa, FL team as a full time General Dentist! Great Expressions Dental Centers has an immediate opening for a full-time General Dentist to join our Downtown Tampa, FL practice (1006 N. Florida Avenue Tampa, Florida 33602). Enjoy a rewarding role with a dedicated and experienced staff! Compensation: Competitive Six Figure Annual Draw with Percent of Production. Sign-on Bonus or Relocation Assistance possible. Benefits/Perks: Leader in the practice: Clinical Freedom and Treatment Autonomy; Patient Focus: Established and Growing Patient Foundation; MultiSpecialty office; Doctor Career Path — Partnership/ Investment Opportunities; Full Benefits Offered — Healthcare & Dental Benefits, 401K, Short Term/Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues; Mentorship — Study Clubs, Chairside Mentoring, GEDC University Courses. Please view our Doctor Career Path video: http://www.screencast.com/t/ M3xWM5CYN. Please apply via this ad for consideration, Molly McVay | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 300 East Long Lake Rd Suite 311| Bloomfield Hills, MI 48304 USA, phone 248.430.5555 |Ext. 72467| fax 248.686.0170 | web www.greatexpressions. com. “Look for the Smile Above Our Name!” Job Requirements: Must have a DDS/DMD from an accredited University and active State Dental Board license. http:// www.Click2Apply.net/hk6w8py7qm Apply Here.

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Pediatric Dentist Opening: Fort Myers, FL. Come lead our Pediatric Specialty team at our Page Field (Fort Myers) office! Great Expressions Dental Centers has a current opening for a full time (4 days/week) Pediatric Dentist in our newly renovated and multi-specialty, Page Field office in Fort Myers, FL. Enjoy a rewarding role with a dedicated staff while having a strong internal referring network of 8+ local practices! **Attractive Signon or Relocation possible as well ($$$)! Benefits/Perks: Leaders in the practice: Clinical freedom and treatment autonomy for every Doctor; Patient Focus: Established and Growing Patient Foundation; Multi-Specialty practice; Compensation — Six Figure Annual Base vs. Percent of Production! Doctor Career Path — Partnership/Investment Opportunities; Full Benefits Offered — Healthcare & Dental Benefits, 401K, Short Term/Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues; Mentorship — Study Clubs, Chairside Mentoring, GEDC University Courses. Please view our Doctor Career Path video: http://www.screencast.com/t/M3xWM5CYN. Apply via this ad to learn more about Great Expressions!

For More Information Contact: Ross Shoemaker, MBA | Doctor Recruiting Manager | Great Expressions Dental Centers Practice Support Center - South | 1560 Oakbrook Drive, Norcross, GA 30093 USA, phone 678.836.2226 | ext 72226 | fax 770.242.3251 |web www.greatexpressions. com. email Ross.Shoemaker@greatexpressions.com. “Look for the Smile Above Our Name!” http://www.Click2Apply. net/9jg5wh8kpt Apply Here.

Full-time General Dentist Needed. Busy, expanding dental practice has an opening for an experienced (5-20 years) general dentist to join our team. Guaranteed salary and benefits. Must have experience in crown and bridge, extractions, and operative. Immediate opening in Pinellas county. Background check required. Send resume to: vmonti@happydentistry.com. Monticciolo Family and Sedation Dentistry.

General Dentist in Juno Beach, Florida. Florida Licensed General Dentist needed in Juno Beach, Florida. We are a well-established, growing, traditional, solo private practice in need of a part-time associate who is passionate about providing excellent dental care. We’re blessed with an enthusiastic, experiencer staff that knows how to treat people right. Work in a state of the art facility, in a premium location, with a great work schedule, and excellent income potential! email resume to mkuhl65107@aol.com.

Dentist Needed- Fort Myers, FL. Come lead our Fort Myers, FL office as a full time Dentist in a high production practice! Great Expressions Dental Centers has an immediate, select opening for a full-time General Dentist to join our Fort Myers, FL office! Enjoy a rewarding role with a dedicated, fully trained staff with a great patient base! **Relocation or Sign-On Bonus ($$$) possible as well!** Benefits/Perks: Leaders in the practice: Clinical Freedom and Treatment Autonomy for every Doctor; Patient Focus: Established and Growing Patient Foundation; Compensation: Six-figure draw vs. percent of production; Doctor Career Path: Partnership/Investment Opportunities; Full Benefits Offered: Healthcare & Dental Benefits, 401K, Short Term/Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues; Mentorship: Study Clubs, Chairside Mentoring, GEDC University Courses. Please view our Doctor Career Path video: http://www.screencast.com/t/M3xWM5CYN. Apply via this ad to learn more about Great Expressions! For More Information, Please Contact: Ross Shoemaker, MBA | Doctor Recruiting Manager | Great Expressions Dental Centers Practice Support Center - South | 1560 Oakbrook Drive, Norcross, GA 30093 USA, phone 678.836.2226 | ext 72226 | fax 770.242.3251 |web www.greatexpressions. com. email Ross.Shoemaker@greatexpressions.com. “Look for the Smile Above Our Name!” http://www.Click2Apply. net/29nk4jn4rk Apply Here.

Front Desk/Dental Assistant. Do you like helping others?

Are you enthusiastic about everything you do? We are a private practice that specializes in family, implant, and cosmetic dentistry. We are committed to providing the best dental care to our patients in a gentle, caring, and friendly environment. We are seeking to add a Front Desk/Dental Assistant to our family. We are a very team oriented office that loves to have fun while providing excellent service.

We are seeking the following attributes: Charismatic; Problem Solver; Quick learner; Dentrix software knowledge preferred; CDA and Radiology/ EFDA preferred; Ability to do Treatment plans; Ability to talk/educate patients; Insurance knowledge; Excellent customer service skills; Ability to multi-task; Please submit a cover letter, resume, and professional references via fax at 407.293.3004 or email info@myclassicsmile.com.

Associate Dentist. ASSOCIATE DENTIST — FULL TIME. PRIVATE PRACTICE DENTAL OFFICE. General Dentist needed for our private practice located in New Port Richey, FL. We are seeking a caring and compassionate dentist who is looking for a long term opportunity. Ideal candidate has a passion for dentistry and patient care, has a willingness to learn and adapt with our practice and understands the importance of a patient-centered office. We are a PPO/FFS Privately Owned dental office. No HMOs or Medicaid. To be considered: Current Florida Dental License. Compassion. Ability to connect with the families and provide excellent service. Outstanding communication and customer service. A professional presence and excellent clinical skills and chair-side manner. Some perks include: Medical Benefits; Guarantee pay plus bonus on production; 3 weeks paid vacation; CE allowance. If you are an experienced professional interested in joining a team invested in providing remarkable service to the community then we want to know you. APPLY ONLINE: https://www. appone.com/MainInfoReq.asp?R_ID=1181322.

Lead Dentist Opportunity. Group practice in Wildwood has a great opportunity for a dynamic Lead Dentist to join the team! Prime location inside Signature Village. Beautiful, state-of-the-art facility with modern technology including lasers and Cerec CAD/CAM for same day dentistry.

Organized management team with streamlined process will be there to take care of the business side an allow the dentist to focus on building patient relationships. Great comp package including full benefits, malpractice, and CE as well as future ownership potential. Opportunity available February 2016. Please reach out to us to learn more! rooneya@pacden.com.

Lead Dentist Opportunity in Dr. Phillips. Exciting opportunity for a motivated Lead Dentist to open a beautiful new office in Dr. Phillips. Located at Sand Lake and Turkey Lake, the provider can offer the highest quality care while utilizing the latest technology, including Cerec 4.0 omni-cam (powderless), Sirolaser, and Velscope. You can expect the autonomy to see your own patients and create your own treatment plans while creating patients for life. Integrated specialties available on-site to allow the whole family to be treated under one roof. Great office dynamic/excellent support team/great patient flow/lots of potential. Exciting comp plan/income potential as well as full benefits including malpractice insurance, 401K with match, medical/dental/vision, and over 70 hours of CE each year. Future ownership/buy-in potential. Please contact us to learn more! rooneya@pacden.com.

Dentist – Associate. Our high quality, professional Dental office is looking for an experienced Dentist to join our office. If you are warm, friendly and a highly talented dentist you would be a perfect fit for our office.

Our emphasis is on high-quality dentistry. Patients seek us out for everything from single crowns to full mouth reconstruction using implants. We place and restore our own implants... (although the qualified dentist does not need to place implants). Prosthodontists preferred but well-qualified general dentists are equally considered.

Excellent compensation and benefits. Minimum 5 years of experience. fendrich@lhpdental.com.

www.floridadental.org

Pediatric Dentist. Excellent opportunity for a compassionate, ethical, pediatric dentist looking for a part-time or full-time position. This well respected private Pediatric dental practice has been established for 23 years.

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

Lakeland Volunteers in Medicine seeks full time dentist to provide clinical dental services and preventive dental care in a community health center setting. Degree from accredited dental school mandatory. Completion of residency preferred. Must want to work with patients from diverse economic and ethnic backgrounds. Requires a comprehensive knowledge of primary dental care in outpatient settings. Knowledge of the principles and practice of modern dentistry as related to public health organizations and community health programs as well as current social and economic problems pertaining to public health and their impact on primary health care. Category 1 OSHA Blood borne pathogen exposure classification is required. Compensation, benefits, and work schedule negotiable. Send resumes to shr@shrllc.com.

Lakeland Volunteers in Medicine seeks part time dental hygienist to provide oral hygiene and appropriate preventive services to dental patients of the center. Degree from accredited school of dental hygiene required.

Unrestricted license to practice oral hygiene in FL and current CR (BLS) certification mandatory. Candidate must possess comprehensive knowledge of oral hygiene care in outpatient settings as well as knowledge of the principles and practice of modern oral hygiene and periodontal patient care. Willingness to work with patients from diverse economic and ethnic backgrounds. Candidates must be cognizant of the public health, social and economic factors which impact on the overall health of their patients.

Must possess ability to creatively work with other health care professionals from a variety of disciplines to solve problems through individual and/or programmatic actions.

Compensation package negotiable based on experience.

Send resumes to shr@shrllc.com.

Lakeland Volunteers in Medicine seeks full-time dental assistant. Certification as Dental Assistant preferred and current CPR (BLS) required. Experience required in assisting dentists and dental hygienists in the direct provision of primary care dental services to patients in all phases of general dentistry. Knowledge of modern dental materials, their storage, handling and applications is required. Must have demonstrated ability to work with persons from a wide diversity of social, ethnic and economic backgrounds. Individual must be able to creatively work with other health care professionals from a variety of disciplines to achieve maximal results for the center’s patients from a system of integrated primary health care. Salary dependent upon experience. Benefits. Send resumes to shr@shrllc.com.

General Dentist Associate Wanted. Currently we are seeking an outstanding GP associate dentist to add to our already amazing team. Beautifully decorated Boca Raton office with latest technology. Candidate must possess great communication and clinical skills. Must have a passion for professional and personal growth. A great comprehensive package is available. Please email CV to greatbocasmiles@ yahoo.com.

www.floridadental.org

Associate Dentist position in Palm Coast. Looking for an Associate that is motivated to become a partner. Busy fee for service practice in Palm Coast, FL has need for a new associate as one partner is having health issues and will be going on disability. Current partner is a female dentist and would appreciate a female dentist taking over her patients, but all inquiries will be entertained. Send CV to info@ floridafamilydentistry.com.

General Dentist - Bonita Springs, FL. Great Expressions Dental Centers has an immediate, select opening for a full-time General Dentist to join our Bonita Springs, FL office (located: 25195 Chamber of Commerce Drive, Bonita Springs)! Enjoy a rewarding role with a dedicated staff with a great patient base! Compensation: Compensation — Six-Figure Draw and Percent of Production. Attractive Sign-on or Relocation possible as well! Benefits/Perks: Leaders in the practice: Clinical Freedom and Treatment Autonomy; Patient Focus: Established and Growing Patient Foundation; Multi-Specialty office; Doctor Career Path — Partnership/Investment Opportunities; Full Benefits Offered — Healthcare & Dental Benefits, 401K, Short Term/ Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues; Mentorship — Study Clubs, Chairside Mentoring, GEDC University Courses. Please view our Doctor Career Path video: http://www.screencast. com/t/M3xWM5CYN. Apply via this ad or contact Stacey Bruwer at 248.237.6853. http://www.Click2Apply.net/ mvm76v2wtv Apply Here.

Part-time Orthodontist - Page Field, FL. Great Expressions Dental Centers is seeking a part-time Orthodontist to work in our Page Field, FL practice (located at 5100 S. Cleveland Avenue, Units 315 & 316). Our Orthodontists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. Orthodontists can expect an attractive annual base vs. allocated collections percent, malpractice coverage, a stable patient base, trained Orthodontic staff, local referring network of 8 practices and long-term practice or regional career growth with possible investment opportunity. We do it all for you. You became a dentist to help people. It’s your profession and your passion. But the demands of owning and managing an office are not only financially taxing but time consuming. Which is why Great Expressions Dental Centers is built on a provider-first philosophy. The highest standards. Our National Doctor Panel has set standards for clinical excellence, including clinical protocols, sterilization, materials, standards of care, quality assurance, charts and charting, consent forms and many other items that have allowed us to become the gold standard in the industry. Focus solely on a steady flow of patients. With GEDC you don’t need to worry about overseeing the business aspects of the office, such as malpractice insurance, employee insurance, payroll, marketing/advertising and the litany of other concerns that go along with owning your practice. Instead, focus on being the clinical leader within your office. **Please watch more about our Doctor Career Path http:/www.screencast.com/t/ M3xWM5CYN. and apply via this ad! Stacey Bruwer, M.A. | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 300 East Long Lake Rd Suite 311| Bloomfield Hills, MI 48304 USA, phone 248.237.6853 |Ext. 72468| fax 248-686-0118 | web www.greatexpressions.com. “Look for the Smile Above Our Name!” Must have a DDS/DMD from an accredited University and active State Dental Board license Orthodontist License and Certifications. Apply Here: http://www.Click2Apply.net/fc52sypvsk.

Pediatric Dentist Opportunity- Miami Gardens, FL. Come lead our Miami Gardens, FL Specialty team at our North Dade office! Great Expressions Dental Centers has a current, select opening for a full-time Pediatric Dentist to join our Multi-Specialty North Dade office located in Miami Gardens, FL! Enjoy a rewarding role with a full staff while having a strong internal referring network of over 15 local practices! Compensation: Six Figure Annual Base vs. Percent of Production! **Attractive Sign-on or Relocation possible as well ($$$)! Benefits/Perks: Leaders in the practice: Clinical Freedom and Treatment Autonomy for Every Doctor; Patient Focus: Established and Growing Patient Foundation; Multi-Specialty office; Doctor Career Path — Partnership/Investment Opportunities; Full Benefits Offered — Healthcare & Dental Benefits, 401K, Short Term/Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues; Mentorship — Study Clubs, Chairside Mentoring, GEDC University Courses. Please view our Doctor Career Path video: http://www.screencast.com/t/M3xWM5CYN. Apply via this ad to learn more about Great Expressions! For More Information Contact: Ross Shoemaker, MBA | Doctor Recruiting Manager | Great Expressions Dental Centers Practice Support Center - South | 1560 Oakbrook Drive, Norcross, GA 30093 USA, phone 678.836.2226 | ext 72226 | fax 770.242.3251 |web www.greatexpressions.com. “Look for the Smile Above Our Name!” Apply Here: http://www.

Click2Apply.net/vfydnmxfg8.

Associate Dentist - Fort Myers, FL. We are looking for a full time (5 days/week) General Dentist to work in our established neighborhood practice. We have a friendly office staff and a great work environment. This dentist can expect a very lucrative income (DOE), full benefits (such as medical, dental, 401k, continuing education), paid time off, malpractice coverage, a stable patient base, and long-term practice or regional career growth with possible partnership opportunity. Job Requirements: Must have a DDS/DMD from an accredited University and active State Dental Board license. Contact Us: Stacey.Bruwer@Greatexpressions.com.

General Dentist Opportunity in Private Practice. Currently seeking an Associate General Dentist for an established, well run private practice in the Fort Myers/Naples, Florida area. The practice is in network with several PPO plans and is an outstanding working environment with an excellent culture, strong office manager, friendly patient base and is a great opportunity for the right dentist. If you are looking for an associateship in a highly ethical, traditional private practice we encourage you to apply. Submit CV to info@ drmelaniepugh.com. To learn more about the practice visit: www.drmelaniepugh.com. www.facebook.com/ melaniepughdmd. www.doctorbase.com/pugh.

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Endodontist - St. Augustine, FL. Great Expressions Dental Centers has a current opening for an Endodontist (3-4 days/week) to work in our Jacksonville, FL practices located in St. Augustine, Riverside and San Pablo, FL. Our specialists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. When considering a career with GEDC, specialists can expect unlimited production based earnings with a competitive base, benefits, malpractice coverage, a stable patient base, long-term practice or regional career growth and a local referring network of 20 practices.

Relocation or sign-on bonus possible as well! We do it all for you. You became a dentist to help people. It’s your profession and your passion. But the demands of owning and managing an office are not only financially taxing but time consuming. Which is why Great Expressions Dental Centers is built on a provider-first philosophy. The highest standards. Our National Doctor Panel has set standards for clinical excellence, including clinical protocols, sterilization, materials, standards of care, quality assurance, charts and charting, consent forms and many other items that have allowed us to become the gold standard in the industry.

Focus solely on a steady flow of patients. With GEDC you don’t need to worry about overseeing the business aspects of the office, such as malpractice insurance, employee insurance, payroll, marketing/advertising and the litany of other concerns that go along with owning your practice.

Instead, focus on being the clinical leader within your office. Work/Life balance. We believe in the importance of a work/life balance. So we make every effort to ensure you have time for family, friends and vacations (you know, that thing called a “personal life”). **Please watch more about our Doctor Career Path and apply via this ad! Molly McVay | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 300 East Long Lake Rd Suite 311| Bloomfield Hills, MI 48304 USA, phone 248.430.5555 |Ext. 72467| fax 248.686.0170 | web www.greatexpressions.com. “Look for the Smile Above Our Name!” Job Requirements: Must have a DDS/DMD from an accredited University and active State Dental Board license. Endodontist Dental License and certification. http://www.Click2Apply.net/wkwxkk4f4h Apply Here.

Dentist Associate wanted (West Palm Beach). Busy Dental Office is looking for an Associate (2 to 4 days/week) who is comfortable treating children of all ages. You will work in a private practice with experienced staff and friendly office environment where you can provide quality care to patients.

We offer competitive compensation. Please send your resume to drleminh1@firstcaredental.net.

General Dentist Wanted. General practice in Lake City, Florida seeking full time associate or part time. Collectionbased pay. Fee for service and PPO practice. Health insurance, flexible schedule. Please contact Melanie Holden, DMD 772.214.8029 or myeagerdmd@gmail.com.

Periodontist. Former Periodontist made 1 million + in last 2 years. 5 Conveniently located dental offices throughout the panhandle, seeking Specialist. We have a strong existing patient base & excellent opportunity to receive referrals from our doctors. Our doctors enjoy a professional practice experience with a comprehensive compensation. We have 2 surgical suites, that we provide IV sedation, a staff that is skilled in all specialties. The beautiful and sunny panhandle of Florida is where our talented team calls home. Our flourishing practice is just a short distance to the sugar white beaches and lifestyle that makes Florida an extremely desirable place to live. Nestled in the Pan Handle, we benefit from both a booming economy and a lower cost of living that is impossible to experience in other areas of Florida. Although we have three convenient locations, we are not a chain. Patients, not the Shareholders of a Dental Corporation (Aspen etc), come first. We are a true multispecialty team working together to provide optimal results for our grateful patients. Our Pensacola office is the largest practice in Florida Panhandle. We have relocated to a brand new state of the art facility in Crestview which is just 20 miles north of Destin’s warm blue waters. Furthermore, we have a boutique location just east of Destin in the beautiful Sea Side area. With five dedicated practitioners and a support staff of nearly thirty members, we operate as a thriving fee for service private practice. Due to our outstanding reputation and effective marketing, we are literally bursting at the seams! Our revenue as well as the demand for our services is still growing as we do. It is obvious that our wonderful patient pool truly appreciates our dentistry. Our proven systems are designed to manage the stress and frustrations experienced by most dentists.

This is complimented by our highly trained staff that performs expanded functions (making temporaries, case presentation etc) to facilitate patient flow. This staff driven approach ensures that you enjoy the practice of team dentistry. While so many other practices and dentist are competing for patients, we have abundant harvest of patients which we would like to share. This is the ideal situation for someone who desires to maximize their earning potential by joining our exceptional dental team.

Compensation is generous with guaranteed minimums.

New graduates will be welcomed and mentored. You are invited to visit our practice and “see” for yourself how a Florida life-style and lucrative practice can benefit you. megancdc@gmail.com.

Part-time Endodontist - Page Field, FL. Great Expressions Dental Centers has a current opening for a Part-time Endodontist in our Page Field, FL practice (located at 5100 S. Cleveland Avenue, Units 315 & 316). Our dentists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. When considering a career with GEDC, Dentists can expect unlimited production based earnings, malpractice coverage, a stable patient base, and long-term practice or regional career growth. We do it all for you. You became a dentist to help people. It’s your profession and your passion. But the demands of owning and managing an office are not only financially taxing but time consuming.

Which is why Great Expressions Dental Centers is built on a provider-first philosophy. The highest standards.

Our National Doctor Panel has set standards for clinical excellence, including clinical protocols, sterilization, materials, standards of care, quality assurance, charts and charting, consent forms and many other items that have allowed us to become the gold standard in the industry.

Focus solely on a steady flow of patients. With GEDC you don’t need to worry about overseeing the business aspects of the office, such as malpractice insurance, employee insurance, payroll, marketing/advertising and the litany of other concerns that go along with owning your practice. Instead, focus on being the clinical leader within your office. Work/Life balance. We believe in the importance of a work/life balance. So we make every effort to ensure you have time for family, friends and vacations (you know, that thing called a “personal life”). **Please watch more about our Doctor Career Path and apply via this ad! Stacey Bruwer, M.A. | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 300 East Long Lake Rd Suite 311| Bloomfield Hills, MI 48304 USA, phone 248.237.6853 |Ext. 72468| fax 248.686.0118 | web www. greatexpressions.com. “Look for the Smile Above Our Name!” Job Requirements: Must have a DDS/DMD from an accredited University and active State Dental Board license Endodontist Dental License and certifications. http://www.Click2Apply.net/3wshcptq24 Apply Here.

Special Opportunity for General Dentist. Special opportunity available for unique candidate in a general dental practice. We seek an individual passionate about dentistry with a minimum of 5 years of experience (possibly with previous ownership experience) who is clinically proficient in complex fixed, perio and implant restoration and who has attended either Dawson, Pankey or Spear to support their clinical experience in the practice. A proven positive record must also be a part of this candidate’s background, i.e. production numbers.

They must be patient friendly, project confidence and possess a genuine empathy for our patients. In addition, they must appeal to a conservative patient base and have an entrepreneurial spirit. Most critical is the desire to make a commitment to the practice evidenced by a desire to work and or live in The Villages. What we offer is an opportunity to buy into a well operated, established, fee for service practice located in a desirable geographic location with professional staffing, high end equipment and 7 operatories. Specifics and percentages of contract to be discussed with potential candidate. Please call 813.352.2457 for more information.

General Dentist and Specialist. Exciting opportunity for a general dentist in Melbourne, Fl. Great place to live and raise a family. Great beaches, 15 minutes from airport centrally located to Miami, Tampa and Orlando. We have a thriving practice pioneered the concept of modern dentistry, latest technology a highly skilled support and dynamic staff and a commitment to ongoing training and education. You’ll have the opportunity to earn more income than a dentist in a traditional practice without the headaches of running a business. You’ll work with a state of the art technology and have valuable opportunity for continued education, training and mentor-ship. Join us in promoting excellent dentistry in the community and improving the quality of life for millions of people.

Experience and Qualities: DDS/DMD from an a credited university and active state dental board license; A strong sense of ethics and the ability to act with integrity; A willingness to be coached and trained by clinicians; A hunger to achieve financial success and independence.

Rewards: Training and expertise to advance your practice; Tools and resources to achieve your professional goals; Ability to become an owner dentist for a neighborhood practice; You’re ready to take your dental practice to a new level. Please forward resume to Fax 321.752.4274 or email to coonoordmd@gmail.com — See more at: http://floridadental.co/classifieds/general-dentists-andspecialists-2/general-dentist-and-specialist.html#sthash.

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Associate Dentist in Orlando (Lake Nona Area).

EXPERIENCED GENERAL DENTIST-Fantastic opportunity for a General Dentist looking for an associate position in Orlando (Lake Nona area)! Due to our growing practice and increasing number of patients, we are looking for an experienced highly motivated associate with exceptional clinical and communication skills. The successful candidate must be a goal oriented self-managed leader who loves to learn. We are looking for a long term candidate to work with our exceptional dental team and share our leadership style based on a “servants heart”. Our practice is completely computerized and paperless with equipment such as Cerec and Galileos CT Scan, laser, digital X-rays and intraoral cameras. We proudly employ talented and caring hygienists, attentive assistants and knowledgeable front desk professionals. This is a full time position. Requirements: Active Florida License 1 year of clinical experience and 1 year GPR (Experienced in molar endo) OR 2 years of clinical experience (Experienced in molar endo). 9145 Narcoossee Rd Suite A-100, Orlando, FL 32827. See more at: http://floridadental.co/classifieds/ general-dentist/general-dentist-associate-1.html#sthash.

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Part-time Associate. Seeking PT Associate with 5 years’ experience for an established privately-owned, busy general practice in Gainesville. Please send resume to: magnoliafamilydental@yahoo.com or call 352.373.7361. See more at: http://floridadental.co/classifieds/general-dentist/ part-time-associate.html#sthash.qA9lAclJ.dpuf.

General Dentist - Citrus Park, FL. Come lead our Citrus Park, FL team as a full time General Dentist!

Great Expressions Dental Centers has an immediate opening for a full-time General Dentist to join our Citrus Park, FL practice (6552 Gunn Highway Tampa, Florida 33625). Enjoy a rewarding role with a dedicated and experienced staff and updated practice! Compensation: Competitive Six Figure Annual Draw with Percent of Production; Sign-on Bonus or Relocation Assistance possible. Benefits/Perks: Leader in the practice: Clinical Freedom and Treatment Autonomy; Patient Focus: Established and Growing Patient Foundation; MultiSpecialty office; Doctor Career Path – Partnership/ Investment Opportunities; Full Benefits Offered – Healthcare & Dental Benefits, 401K, Short Term/Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues; Mentorship – Study Clubs, Chairside Mentoring, GEDC University Courses; Please view our Doctor Career Path video: http://www.screencast.com/t/ M3xWM5CYN. Please apply via this ad for consideration.

Molly McVay | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 300 East Long Lake Rd Suite 311| Bloomfield Hills, MI 48304 USA phone 248.430.5555 |Ext. 72467| fax 248.686.0170 | web www.greatexpressions. com. “Look for the Smile Above Our Name!” Must have a DDS/DMD from an accredited University and active State Dental Board license. Apply Here http://www.Click2Apply. net/g85g2r97c8. See more at: http://floridadental.co/ classifieds/general-dentist/general-dentist-citrus-park-fl-1. html#sthash.jr0EHuKV.dpuf.

For Sale/Lease FOR SALE: Pediatric Dental Art Collection and Web Domain. Distinctive collection of pediatric dental themed art DECORATIONS and registered web DOMAINS: “TheKIDZDDS.com/.net” to instantly create a unique brand for your practice. Decorations and Domains sold separately. Treasured wall art and fun display pieces geared toward kids to fill an entire office. Let my retirement offerings jump start your career. Call Dr. Rick Lebowitz at 352.430.1498 or email TheKidzDDS@hotmail.com. Get details, photos, and pricing. Create exciting memorable first impressions!

KODAK/CARESTREAM & SCHICK INTRAORAL X-RAY SENSOR REPAIR. Specialize in repairing Schick CDR & Kodak/Carestream RVG 5100 & 6100 dental X-Ray sensors.

Repair & save $1,000s over replacement cost. We purchase old/broken sensors. www.RepairSensor.com/919.924.8559.

GENDEX & DEXIS INTRAORAL X-RAY SENSOR REPAIR. We specialize in repairing Gendex & Dexis dental X-Ray sensors. Repair & save thousands over replacement cost. http://www.RepairSensor.com]www.RepairSensor. com/919.924.8559.

SALE OR LEASE: Brandon, Fl. Brandon, Fl. FOR LEASE Beautiful 2000 sf lakefront office space available for custom build out. Adjacent to Endodontist. Ideal for Oral Surgeon or Periodontist. Contact Julie at 813.654.3636 or julieh@ aeoftb.com.

LEASE OPTION: Park Professional Center Furnished and empty office available 2168 & 1270 Sq. FT Park Professional Center, GREAT AND CONVENIENT LOCATION NEAR COUNTRYSIDE SHOPPING CENTER & RTE 19, STARBUCKS, PANERA, MACYS, Dillard’s too mention a few. TWO OFFICES AVAILABLE FOR LEASE: OFFICE 1. Fully furnished Dental Office for Lease, Ideal for a New Graduate or for a Satellite office, with all equipment either for lease or for sale, included 2168 sq ft office. Recently renovated new roof, a/c unit. OFFICE#2. Empty Office 1270 SQ/FT. Recently painted, New carpeting and ready to go for your practice. FLOOR PLAN INCLUDES: 4 offices, 2 bathrooms, Business office and a waiting room, was completely hooked up for an Oral Surgeon and a past Podiatrist office. CONTACT INFORMATION: Richard Norian 617.285.4824, or Ben Kreloff ProCorp Realty 727.643.2314.

FOR SALE: Orlando - #FL112. 5 Ops Well-Established Practice Dr. willing to stay on as associate! Orlando has unlimited recreation, a variety of restaurants, golf courses, professional sporting events, festivals, and spas. We are also less than 2 hours from either coast offering swimming, fishing, boating, and more. Please contact: Henry Schein Professional Practice Transitions Paul Rang, DMD, JD, paul.rang@henryschein.com, 407.671.2998 | 800.262.4119 x12 #FL112.

FOR SALE: Clay County, FL - 4 Ops-1,200 Square Foot Office-Great Location with High Visibility!! #FL164 4 Ops 1,200 Square Foot Office Great Location with High Visibility!! 40 Year Established Practice ~2,000 Active Patients--$600K Gross on 2 ½ days per week and No Marketing! **HIGHLY MOTIVATED SELLER!!!** Tampa is a vibrant city that takes pride in its rich, cultural heritage.

Residents can experience delicious culinary cuisine, exceptional shopping, and year-round fantastic weather!

Local attractions include Busch Gardens, The Florida Aquarium, Lowry Park Zoo, Clearwater Marine Aquarium, the Straz Center, MOSI and much more. Professional sporting events abound with teams such as the Tampa Bay Buccaneers, Tampa Bay Lightning, and the Tampa Bay Rays. The nearby gulf offers white sandy beaches with unlimited water sports activities! Beautiful place to work, live and play!! Please contact: Henry Schein Professional Practice Transitions, Paul Rang, DMD, JD, paul.rang@ henryschein.com, 407.671.2998 | 800.262.4119 x12 #FL164.

Fully equipped office (Clermont). 4 ops fully equipped.

All computers, X-ray machines, cabinetry, instruments included. Lease to be negotiated with leasing company.

Listed at $55,000. Make an offer and start a new practice tomorrow. ajavriett@yahoo.com.

Practice for Sale/Pensacola, FL. 1.3 million gross, 3.5 days, 3,300 sq ft, great location, 5 chairs, lab, Galileos 3D cone beam, CEREC, Dentrix, Gendex sensors, IOC’s, building available for lease or purchase. Contact: margaretdjuric@ gmail.com.

Rent my office. Fully equipped/supplied office that I use twice a week. This would be good for someone wanting to start their own practice or for a specialist wanting to expand to another location. normank426@aol.com.

Buyers and Sellers: We have over 101 Florida dental practice opportunities; and maybe the perfect buyer for your practice. Call or e-mail Doctor’s Choice today!

561.746.2102 or info@doctorschoice1.net.

Please see CLASSIFIEDS, 91

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CLASSIFIEDS from 89

Established coastal southwest Florida boutique fee for service 3/4 OPS retiring 2 1/2 - 3 days, 941.828.2684, 772.696.5326.

WHAT ARE THE MOST FREQUENT/MOST SERIOUS DISCIPLINARY VIOLATIONS? Practicing below the standard of care is number one. Failing to maintain adequate patient records is the second most frequent violation. It is mandatory that the board suspend or revoke your license for improper delegation and felonies under Chapter 409 (Medicaid fraud), Chapter 817 (fraudulent practices) or Chapter 893, F.S., (drug abuse prevention and control).

WHAT IS THE STANDARD OF CARE? It is what would pass as acceptable treatment among your peers. It is not perfection, but if you fall below what a reasonable doctor would have done in the same situation, you may be liable for malpractice and disciplined. Board of Dentistry rules and Florida legislation also set forth minimum standards of care (e.g., failing to have an automatic external defibrillator in your office or not properly reporting “adverse occurrences”).

WHAT SHOULD I KNOW ABOUT PATIENT RECORDS? A dentist must maintain written dental records for at least four years from the date the patient was last examined or treated. Usually, these dates coincide but not always (e.g. missed appointment and emergencies). Dental records include your day-to-day patient appointments. But, note that seven years is typically the statute of repose on malpractice liability, so keep them at least that long. Also, note that participating provider agreements and hospital privileges may contractually require longer retention periods.

If you decide to destroy records of patients who are no longer active, you should refer to your written policy on records retention and management. You may destroy old records in any manner that protects patient confidentiality. If you hire a shredding company, please remember to have them sign a Business Associate agreement. Don’t throw them away in the garbage or a dumpster that is publicly accessible.

When a patient asks for records, you must provide copies of all reports and records including X-rays in a timely manner, with due regard for the patient’s health needs.

WHAT SHOULD I KNOW ABOUT “PATIENT ABANDONMENT” AND TERMINATING THE DOCTOR/PATIENT RELATIONSHIP? Improperly terminating the doctor/patient relationship is commonly known as “patient abandonment.” If the patient suffers harm because of how you or your employees terminated the relationship, you may be held liable. Make it your written office policy to send patients leaving your practice a written notice or confirmation that your office is no longer treating them as a patient of record.

Don’t make the letter effective “immediately.” Immediate termination doesn’t give the patient enough time to locate another doctor. Please remember that you remain legally and ethically responsible for providing emergency care. Don’t deny it to them by a poorly-worded notification letter that might be admissible as evidence against you.

WHO DO I CALL IF I SEE UNLICENSED PRACTICE OF DENTISTRY OCCURRING? Call the Unlicensed Activity Unit (ULA) hotline of the Department of Health at 1-877-HALT-ULA (1.877.425.8852) or visit their website (floridahealth.gov/ licensing-and-regulation/enforcement/report-unlicensed-activity). Unlicensed practice is a felony in Florida and should be reported immediately.

These legal questions and answers are provided by Graham Nicol Esq., FDA Chief Legal Counsel, Health Care Risk Manager, and Florida Bar Association Board Certified Specialist in Health Law.

TURN KEY. Pembroke Pines dental office equipment for sale, lease assumable pending landlord approval. Desirable location near mall. Great opportunity for new practice or that second office. Six fully equipped modern operatories, lounge, private office, sterilization area and alb. All are wired for computers, water, suction, compressed air and NO2. Purchase of dental equipment includes all dental chairs (ADEC), reception room furniture, digital panorex, file cabinets, suction and compressor. Practice is not included as Doctor is relocating to larger facility. louiebaker121@gmail.com.

DENTAL SUITE MOVE IN READY.SOUTHEAST COAST FLORIDA FT. LAUDERDALE. MOVE IN READY fully built out medical/dental office with $500,000 worth of leasehold improvements!!! No extra expense for plumbing, electrical, or cabinets. Plus: marble floors, vinyl wall paper, elevator opens directly into suite, beautiful front desk and 2 Dr. offices.

Great signage opportunity/visibility in a desirable upscale location 2480 E. Comm. Blvd. between Federal Hwy. and the Intracoastal. There are 3 great opportunities for signage: (1) Directly facing Comm. Blvd., (2) On the 25th Street side of the building facing westbound traffic on Comm. Blvd. (3) Ground sign facing Comm. Blvd. possibly zoned for an electronic sign. Close to Imperial Point and Holly Cross Hospitals. Approx. 3,000 sq. feet.

Location & suite offer great opportunity please direct inquires to Dr. Barry Kligerman, BarryKligerman@gmail.com or 954.854.8153.

DENTAL PRACTICE APPRAISALS. DENTAPPRAISE “ballpark” and “premier” editions.

For sale, purchase, mediation, estate planning, partnerships. Created by experienced dental practice brokers. For details and brochure Polcari Associates, Ltd 800.544.1297 or info@ polcariassociates.com.

Associate Endodontics. Too many patients for one endodontist! Hi-tech, high quality, growing endodontic practice. Expansion into new, state of the art building expected in late 2016. Looking for an associate endodontist who is interested in avoiding the corporate, insurance driven, low fee, work dog, business model. Work in an environment where quality and concern for the patients predominate. Located on the West Coast of Florida. Lots of water sports, golf, professional football, baseball, & hockey activities. Disney, Sea World, Universal Studios theme parks only two hours away for outing with the kids! Motivation for ABE Board Certification preferred. Send CV to teresa.stpeteendo@yahoo.com Bonita Springs sublease. A 1900 square foot, fully equipped, three operatory office available to sublet up to four days per week in Bonita Springs, Florida. Contact me directly at drmcmillan@newbite.com. Michael McMillan DMD. Mobile Dental Practice For Sale. Busy Mobile dental practice for sale. Currently treating Nursing Homes, Assisted Living Facilities, Adult Day Care programs, Pace Program, and Medical Insurance facilities in the Tampa Bay Area. All facilities under contract, and adding new facilities monthly. State of the art equipment, Van, and technology. Unable to continue with the growth and am selling the practice, accounts, and equipment/instruments/ computers/etc. Be your own boss with minimal overhead! Email : mobiledcd@tampabay. rr.com.

Oral/Maxillofacial Practices For Sale in FL. Gross Income 2015 $1,586,974 *Annualized Jan-Aug $1,190,231. Asking Price $ 1,089,000. Practice 1: Open since 1991 this Oral & Maxillofacial Surgery practice is situated in a busy, populated shopping center that is in excellent condition. Now available for purchase, it is located in a highly desirable area in a professional medical space. Inside this 1500 sq. ft. practice you will find a spacious reception area (seats 4), 1 surgery suite, 3 consultation rooms, 2 private offices. This main office is close by to 5 to 6 miles of the Atlantic Ocean beaches. Practice 2: This first satellite office that is also available is centered in a professional medical building surrounded by a lush environment of palm trees. This practice is 1800sq. ft. and located in the second-most populous county in Florida, this desirable space comes with a spacious reception area (seats 4), 1 surgery suite, 3 consultation rooms, 1 private office, with a large window that provides a wonderful view, and 1 utility closet. Practice 3: This second satellite office that is as well available is in a professional medical building right across the way from water’s edge. This 2000 sq. ft. practice, located in Monroe County, Florida in a professional medical building, is surrounded by backcountry fishing, reef and wreck fishing, as well as offshore deep sea fishing. It comes with a reception area (seats 4), 2 surgery suites, 4 consultation rooms, 1 private office, and 1 lounge area. The practice is well kept up and has great visibility and accessibility. 100% Financing Available. Call ProMed Financial for more information!

888.277.6633 or Email maryann@promed-financial.com. (Ref# D150).

OFF THE CUSP

JOHN PAUL, DMD, EDITOR

I’ve Got it B.A.D.D., Too When I was in college, I could keep a lot of things in my head. I knew how much I had charged on my credit card and my bank balance for any given month. I could tell you all my friends’ phone numbers, and what channel and time most shows came on TV. Lately, I have trouble remembering where I wrote these things down. Dr. Hugh Wunderlich wrote about Bipolar Age-related Dental Disease (B.A.D.D.)1 once and felt it was due to too many calendar days under the bridge. After some reflection I have come to the conclusion that this is a repetitive stress injury caused by children.

Case in point: Last Friday afternoon my dear wife took a much needed break from being Mom to do whatever struck her fancy. My task was to watch over our lovely children and make pizza for dinner when she got home. With plenty of time to fulfill my duties at a leisurely pace, daughters 1 and 2 had no trouble convincing me we should go out and play on the swings. Everyone was entertained for 20 minutes until they realized they weren’t watching TV. No problem, the girls watch “their shows” for a bit and I’ll start prepping pizza toppings. I proceed to stare into the refrigerator. There is a tug on my pants leg as Harper announces, “I want guk.” Fortunately, she makes up for her lack in English with some proficiency in sign language, so I know she wants milk. Get a bottle, pour some milk, microwave to child-acceptable temperature. She takes me by the finger and leads me to a chair where I can sit as she reclines upon me and enjoys her refreshment. Finished with her drink, she hands me the bottle, announces, “All done,” and jumps from my lap to terrorize the princess castle village that makes my living room look like a ritzy gated community. Might as well wash the bottle out, we’ll need it again later.

In the kitchen I remember there was a chore on my mind from earlier as Brogan tugs my pants leg and asks for the iPad. That is her code that she would like some alone time on the potty and will need to be entertained — can’t just read a magazine. I find the tablet, realize it was never charged after its last use and start looking for a charging cord — can’t use one of the thousands that fit anything but Apple. I find one that is Steve Jobs-approved and hasn’t been chewed by two- or four-legged animals and get the potty started.

this as the first symptom, but in my defense, while I enjoyed the tea I was reading “Are You My Mother?” for the fifth time today.

Finish the book and the tea, and return the glass to the kitchen. Vaguely remember supper, and there should be some urgency of time. Harper announces, “I pooped.” I am grateful she is wearing a diaper and highly motivated to take control of the situation before she either removes the diaper herself or reaches into it to prove her statement.

Take the child to her room, gather diaper, scented hazmat bag, and wipes (there is no such thing as too many wipes). With the skilled hands of a dentist, I deftly exchange the soiled nappy for a clean one, and tie a knot that hermetically seals the hazmat bag. The child screams because it is her job to carry the bag to the trash and it’s still in Daddy’s hand. Just as we deliver the trash my wife returns home and I realize I have completed only 50 percent of my chores. I may be addle-brained, but I’m not just old — I’ve had help. I send Harper to her mother’s arms with instructions to “Tell mom how much she loves you” as I run inside to rescue my pride and finish my chores.

“Hello, Pizza Palace?”

I’m feeling pretty good about my parenting skills. Children have been fed, no one is screaming, fighting or otherwise in immediate danger of bodily injury. Strolling back through the house, I find myself in the kitchen and remember I am supposed to make pizza. This time I start by taking out a cutting board, then I return to staring in the refrigerator. Done with her duties, Brogan tells me she needs a snack. She would like a smoothie. We gather milk, frozen bananas, frozen mangos and the blender. Spin up a healthy snack and place it in a child-safe cup. Clean the blender. Return to staring into the refrigerator. Notice the iced tea and think a glass sure would taste great. Pour a big glass and return to my seat. I should have noted

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1 “I’ve Got it B.A.D.D.” Off the Cusp, Today’s FDA, Vol. 21, No. 12, December 2009.

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

www.floridadental.org

NEW DENTAL GRADUATES GET THE GIFT OF COVERAGE All new dental graduates who become FDA members and practice in Florida will have their first year of professional liability coverage from The Doctors Comany completely paid for by their FDA colleagues!

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