Transcend Newsletter, Summer 2018, Washington AGD

ISSUE 38 | SUMMER 2018

GOLD AND ITS APPLICATION IN MODERN DAY DENTISTRY Sampada Deshpande PAGE 22

IN THIS ISSUE THE VALUE OF MENTORSHIP PAGE 7

THE STEM OF DENTISTRY (PART 1) PAGE 18

UPCOMING EVENTS LISTING PAGE 26

GOING ABOVE AND BEYOND IN DENTISTRY

PREMIER BUILDERS DENTAL FACILITIES

Premier builder of medical, dental, commercial, retail and manufacturing facilities in the Pacific Northwest. With over 30 years of experience we build relationships based on trust, dependability, integrity and quality craftsmanship.

2 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

C O N S TA N T I N E B U I L D E R S . C O M

The WAGD TRANSCEND magazine is published quarterly as a service to the membership of the Washington Academy of General Dentistry

CONTENTS

WAGD 2015-2019 LEADERSHIP ROSTER Teresa K. Kang, DDS, President 2017-2019, CDE Committee & Gala Chair

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A Note From the Editor

by Dr. Carl Youngquist

5

The McCarran-Ferguson Act

by Jeanie Kennedy

7

The Value of Mentorship

by Brandon Walker

8

Measuring the Quality of Care

by Ralph A. Cooley, DDS, FAGD

10

Exploring the Landscape of Leased PPO Networks

by Srinivasan Varadarajan, Esq.

12

Why You Need Long Term Care Insurance

by WDIA

13

Dental to Medical Cross-Coding Tips

by Charles Blair, DDS

15

Sweat The Small Stuff

Puneet S. Aulakh, DDS, MAGD, Past President 2017-2019, Webmaster, CDE Orthodontic Program Coordinator

21

Dzon M. Nguyen, DDS, MAGD, President-Elect 2017-2019

William Howard Student Competition

by WAGD

Steven L. Thomas, DMD, MAGD, At Large Board Member 2017-2020, CDE Committee Kimandeep K. Raked, DDS, At Large Board Member 2016-2019 Marissa N. Bender, DMD, Treasurer 2016-2019 Carl W. Youngquist, DDS, MAGD, Editor

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Is This The End Of General Dentistry As We Know It?

by Srinivasan Varadarajan, Esq

Gary E. Heyamoto, DDS, MAGD, CE Chairperson, MasterTrack Program Coordinator, At Large Board Member September 2016-2019 Guy M. Hanson, DDS, MBA, MAGD, Region 11 AGD Trustee November 2017 Linda J. Edgar, DDS, MEd, MAGD, PACE Program Approval Representative, Dental Care Chair, At Large Board Member September 2017-2020 Ravi S. Sinha, DDS, Region 11 AGD Regional Director November 2017

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Upcoming Events for The Pacific Northwest

27-35

Valerie Bartoli, ED, CDA, Executive Director, Region 11 AGD Executive Director Bryan C. Edgar, DDS, MAGD, Legislative Chairperson Theron A. Manson, DDS, Membership Chairperson, At Large Board Member September 2015-2018 Emerson G. Godbolt, DMD, Membership Committee

Upcoming Continuing Education Classes

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AGD Member Benefits

Emily D. Hobart, DMD, Membership Committee Thanh Dung N. Nguyen, DMD, MAGD, Public Relations Officer, At Large Board Member September 2016-2019 Ernesto Ricardo Schwedhelm, DDS, U of WA Dental Student Coordinator, At Large Board Member September 2017-2020 Timothy A. Hess, DDS, MAGD, U of WA AGD Student Chapter Chair University of Washington Dental Student Representatives

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Lynda Phan & Evan Mitchell, Class of 2018

2017 AGD Membership Application

38

AGD Member Savings & Offers

39

Applying for PACE Approval

by Dr. Linda Edgar

Christine Chen & Amelia Skifstad, Class of 2019 Federal Adviser Liaisons Cynthia V. Feleppa, DDS, FAGD & Tyler J. Rumple, DDS

WAGD TRANSCEND COMMITTEE Sir Speedy Print/Signs/Marketing, Publisher Carl W. Youngquist, DDS, MAGD, Editor Valerie Bartoli, ED, CDA, Editor

News contributions, information, advertising and letters to the editor are welcome. Readers are encouraged to submit letters to the editor on any topic.

All submissions may be edited at the discretion of the Editor and TRANSCEND MAGAZINE Committee and may be published on a space available basis.

by The Abrams Report

The opinions expressed by the authors in the WAGD TRANSCEND magazine do not necessarily reflect the official position of the Washington Academy of General Dentistry. Advertisers are not necessarily endorsed by the WAGD.

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The Washington Academy of General Dentistry Committee reserves the right to refuse advertising.

The Stem of Dentistry Pt. 1

by Herbert Edwards, DDS, MS, MAGD

19

A Visit to WAGD

by Herbert Edwards, DDS, MS, MAGD

20

Gold and Its Application in Modern Day Dentistry

by Sampada Deshpande

Find us online Washingtonagd.org Follow us on Twitter @AGDWashington Find us on Facebook facebook.com/WashingtonAGD Find us on LinkedIn Washington AGD

SEND ALL CONTRIBUTIONS TO: Washington Academy of General Dentistry TRANSCEND Magazine 19415 International Blvd, Floor 4-Suite #410, SeaTac, WA 98188 FOR INFORMATION ABOUT ADVERTISING CONTACT Valerie Bartoli at (253) 306-0730 or Washingtonagd1@yahoo.com www.washingtonagd.org

SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 3

A NOTE FROM THE

r o t i d E

Carl Youngquist, DDS, MAGD

Do you have something you’d like to share in Transcend?

Maybe you have a technique that can improve the quality of our dentistry, or a time-saving clinical tip? Perhaps you know of an invention that could benefit dentistry, or you have designed one yourself?

If you have done a case-presentation at Mastertrack or at a study club, would you like to have it printed here? How about an inspiring or humorous story to tell?

Any ideas on how to meet the dental needs of our underserved poor?

If it is of interest to you, it’s probably going to be interesting to the members of the WAGD and the readers of Transcend. Submissions for the next issue are due by September 15, 2018. Send us your articles, pictures, questions and comments to: youngquistcarl@gmail.com ■

Preferred dental General ContraCtor of the WaGd

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AGD IMPACT ARTICLE | AUG 2017

THE MCCARRAN-FERGUSON McCARRAN-FERGUSON ACT: What a Repeal Could Mean for Dentistry

By Jeanie Kennedy

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n March 23, the U.S. House of Representatives passed Rep. Paul A. Gosar, DDS’s (R-Ariz.) sponsored bill, H.R. 372, the Competitive Health Insurance Reform Act of 2017, by a vote of 416-7. The House bill was referred to the U.S. Senate Judiciary Committee. As of print date, no Senate language yet exists.

H.R. 372 amends the McCarranFerguson Act to declare that nothing in that act modifies, impairs or supersedes the operation of antitrust laws with respect to the business of health insurance, including the business of dental insurance, according to www.congress. gov. Republicans, Democrats, dentists,

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physicians, patients, consumers and a broad swath of stakeholders support H.R. 372. The insurance industry is largely against it.

H.R. 372 is under the authority of the House and Senate Judiciary Committees.

The bill could be added to health reform legislation. In terms of the reconciliation process, only the jurisdictions of the House Energy and Commerce and House Ways and Means committees were included in the repeal-and-replace bill, the American Health Care Act of 2017 (H.R. 1628).

The Senate Parliamentarian would likely find H.R. 372 to be non-germane, thus not include it in a larger health care vehicle. However, indications are such that the president of the Senate (Vice

President Mike Pence) could overrule the Senate Parliamentarian and deem H.R. 372’s language germane. If this process was employed, the McCarranFerguson repeal could be signed into law if it was packaged in a vehicle such as the Affordable Care Act (ACA) repeal and replacement bill. Additionally, the bill could be passed into law as a freestanding bill.

Background

The McCarran-Ferguson Act exempts conduct of the dental insurance industry that is considered to be within the “business of insurance” from the Sherman Antitrust Act of 1890 and the Clayton Antitrust Act of 1914, both that ensure competition.

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AGD IMPACT ARTICLE | AUG 2017

Signed into law March 9, 1945, the act was a response to the Supreme Court decision, U.S. v. South-Eastern Underwriters Association. The court held that the federal government could regulate insurance companies under the Commerce clause of the U.S. Constitution. Because of the court decision, there was a perceived conflict of federal vs. state regulation of the insurance industry. Subsequently, Congress acted and passed McCarran-Ferguson into law.

The McCarran-Ferguson Act protects state supremacy in insurance regulation and gives states flexibility to allow some types of regulated coordination between insurance companies. Regulators have allowed insurance companies to share actuarial and loss information, in order to calculate risk assessments. It is argued that the act provides for unfair methods of competition with respect to the business of health insurance, and, effectively, establishes state insurance cartels.

The (partial) repeal of McCarranFerguson is expected to restore the application of federal antitrust and competition laws to the health

insurance industry. It should be noted that H.R. 372 is not seeking to entirely repeal the McCarran-Ferguson Act; rather, it adds an addendum to section 3 of the act (15 U.S.C. 1013).

The purpose of the “repeal” would be to ensure that the conduct of health insurance insurers is subject to the same antitrust and unfair trade laws as the conduct of other types of businesses. If passed into law, dental insurers would be subject to federal laws against bid rigging, price fixing and market allocations.

The carve-out from competition exists even though the insurance market has changed dramatically since 1945. The McCarran-Ferguson Act is credited with creating artificially higher premiums, unfair insurance restrictions, policy exclusions and a lack of choice.

Discussion

State and federal regulation of health care insurers is extensive. Nonetheless, almost no other sector — not dentists, physicians, hospitals or pharmacies — in the health care industry is shielded by antitrust protections.

McCarran-Ferguson Repeal FAQs Question: Will dentists’ reimbursements stop decreasing?

Answer: If McCarran-Ferguson is repealed, the health insurance companies could no longer control the dental insurance market to their current extent. As a result, other insurance companies may decide to form, or existing insurance companies may create other dental specific divisions.

With greater competition in the marketplace, insurance reimbursements could be expected to increase in the long-term.

Question: What effect would the McCarran-Ferguson repeal have on dental coverage?

Answer: If McCarran-Ferguson is repealed, dental coverage may, but not necessarily, increase down the road due to lower anticipated premiums.

Question: Would the McCarran-Ferguson repeal create a boon for my practice?

Answer: Not necessarily. As discussed, the McCarran-Ferguson repeal would be a step toward allowing market forces to operate. Other legislation would also assist in that effort. Allowing each state to compete for business is another potential solution that would interject even more free-market principles into the dental market.

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H.R. 372 also makes clear that the Federal Trade Commission would have greater oversight on unfair or deceptive practices in the health insurance industry rather than relying on state insurance commissioners to investigate consumer complaints. State oversight is presently inconsistent. Only a few states, such as Florida and California, aggressively pursue consumer insurance grievances.

Since the passage of the ACA on March 23, 2010, health insurance markets have become less competitive, lacking in transparency, while providing consumers with fewer choices.

Additionally, health care premiums and deductibles have increased, as have the costs our nation spends on health care.

When considering health care reform, the repeal of McCarranFerguson is one part of a broader reform effort in the United States. The repeal could assist in allowing freemarket principles to begin to permeate the health insurance and would be a key step to providing more competition to the state insurance markets.

Bottom Line

Economic models generally assume that when markets have more competition, the consequences are lower prices, better quality, more variety and better service. If H.R. 372 is signed into law, prognosticators forecast cheaper health insurance premiums and more choices.

However, in and of itself, the repeal of McCarran-Ferguson may provide only incremental changes; broader health care reform may be needed to enact policies that would decrease government control and allow free-market principles to thrive. Coupled with other legislation designed to activate the free market economy, dentists can anticipate an even lower consumer cost of insurance and more availability of choices. F

Jeanie Kennedy is the manager of dental practice and policy at AGD. To comment on this article, email impact@agd.org.

| agd.org |

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THE VALUE OF MENTORSHIP Brandon Walker

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he value of mentorship cannot be overstated. I recall my first memorable experience with mentorship while serving overseas in Japan as a Marine Special Communications Signals Collection Operator. In the midst of a long and arduous training mission, my Platoon Sergeant, Chris Rodriguez, asserted that so long as I always worked hard and did what was right (e.g. taking the moral high ground despite the popular opinion), he’d always have my back. The impact of his honest, no-nonsense leadership still resonates with me today, more than a decade later, as I continue my transition from ten years of honorable service in the Marine Corps to an equally fulfilling career in dentistry.

I recall questioning whether I would experience in dentistry the high-quality mentorship and leadership I had become accustomed to in the Marines. When I was accepted to the University of Washington School of Dentistry (UWSoD) Class of 2020, I vowed to share with my colleagues the wealth of knowledge, skills, and experience I acquired as a leader of Marines. I understood that my tendency to speak the hard truth, fight the status quo, and present fresh ideas would likely force people out of their comfort zones, but if the Marine Corps taught me anything, it is that discomfort breeds growth, and normalization of discomfort breeds courage. Perhaps by fostering courage among my peers, the leadership I sought would take form.

One’s courageous inclination to lead is often engrained by great mentors like Chris Rodriguez, but the fear of being underutilized can also be a driving factor for many of us veterans. The nature of a Marine’s duty as our country’s first line of defense requires a high level of training – no task is too large, and nothing is ever “good enough.” Everything we do is pursued with great attention to detail to ensure the best possible outcome. Cutting corners almost certainly leads to mission failure or loss of life. Working hard, committing to excellence, and trusting in seasoned mentors is a sure-fire plan that contributed to my success as a Marine. The same mentality will ensure I am never underutilized as a developing clinician, advocate, and community leader.

Over the years I have learned that the most successful mentor/ mentee relationships are almost never a coincidence. The late

renowned author Dr. Wayne Dyer believed that no one attracts what they want, but rather what they are. He called this concept the “Power of Intention,” and I experienced it first-hand in 2016 when I was matched through the Washington State Dental Association’s (WSDA) Mentorship Program with Dr. Nathan Russell, who inspired me to immerse myself in the world of organized dentistry and become the first dental student to be accepted into the WSDA’s Leadership Institute.

Asked why he wanted to be a mentor, Dr. Russell expressed his desire to “give back, pay it forward, return the favor, and help someone else’s path for the betterment.” He too was blessed with mentors that helped him transverse the trenches of dental school. “New graduates who are successfully mentored,” he asserts, “become better dentists, clinicians, and advocates for oral health. They are better with patients and all aspects of patient care.”

Dr. Russell’s stance on mentorship is echoed by countless other practicing dentists, particularly those who frequent the Washington Academy of General Dentistry (WAGD) learning center for their continuing education. In fact, I met Dr. Timothy Hess while attending my first course as an AGD Student Member, and he too has challenged me to become the best version of myself every day since. “The professional person has no right to be other than a continuous student,” he says, quoting G.V. Black, the father of dentistry in the United States.

He adds, “Every dentist has the responsibility to be a teacher to patients, staff, students and colleagues.”

It is clear a unique obligation is shared throughout the dental community to help pre-doctorate students realize the importance of both advocating for our great profession and engaging in the self-motivated pursuit of knowledge. Thanks to top-notch mentors like Dr. Russell and Dr. Hess, I have learned more about dentistry than could ever be taught within the walls of dental school, and I too want to “pay it back.” Through my continued involvement in organized dentistry, I hope to inspire my fellow classmates to find value in mentorship, commit to lifelong learning, and keep the bar set high for generations to come. The future of our profession is in our hands. ■

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AGD IMPACT ARTICLE | OCT 2016

Measuring the Quality of Care The Importance of Dentist Involvement in Determining Quality Measures

By Ralph A. Cooley, DDS, FAGD

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The need to ensure accuracy where quality and efficiency of health care are evaluated in the United States has been on the rise due to legislative mandates and increasing expenditures, and this need is starting to exist in dentistry. Understanding what is happening today concerning quality measures in dentistry and how it impacts the general dentist is essential in order to have an organizational impact on the delivery of dental care in the 21st century.

QUALITY OF CARE, QUALITY MEASURES AND THE NEED TO ASSESS

Understanding the meaning of certain terms is essential for understanding how quality of care is measured in health care organizations today. The Institute of Medicine defines quality of care as “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” Quality measures are also defined as “the mechanisms that enable the user to quantify the quality of a selected aspect of care by comparing it to an evidence-based criterion that specifies what is better quality,” according to the National Quality Measures Clearinghouse.

However, as dentists, we already do a lot of this within our own practices. We establish quality expectations with our dental team members and provide the best care using our professional judgment, while being mindful of the needs of each individual patient.

So why do we need centralized quality measures to be used to evaluate what is done in dentistry today?

The answer is that there has been and continues to be inconsistency in the development and implementation of dental quality measures by various parties upon the practice of dentistry, and this needs to be addressed.1 Private payers have long used administrative data analyses to assess various quality or performance-related aspects of their benefit plans. Government programs such as Medicaid and Medicare will continue to use quality measurement to evaluate the effectiveness of their various programs.2 A growing number of quality measures and reporting initiatives have resulted in a proliferation of measures that are often duplicative and unduly burdensome on health care providers and increase the potential for confusion among the public.3 Organizations that have developed dental quality measures in the past include federal agencies such as the Centers for Medicare & Medicaid Services (CMS), Health Resources and Services Administration (HRSA), Agency for Healthcare Research and Quality, commercial private purchasers/payers, data analytics companies supporting these commercial health plans and the National Committee for Quality Assurance.4

DQA MEASURE DEVELOPMENT PROCESS Topic selection

Environmental scan

Proposed measures and specifications

DENTAL COMMUNITY INPUT

DENTAL COMMUNITY INPUT

DENTAL COMMUNITY INPUT

Proposed measure concepts

Validation testing

FINAL MEASURES

Therefore, dentists should be involved in determining what quality measures are truly meaningful for evaluation.

HOW THE DENTAL QUALITY ALLIANCE IS DEVELOPING MEASURES

In 2008, the federal government, through CMS, proposed to the American Dental Association the idea of establishing a Dental Quality Alliance (DQA) to lead efforts in quality measurement development in dentistry. The mission of the group is “to advance performance measurement as a means to improve oral health, patient care, and safety through a consensus-building process.”5 The Measures Development and Maintenance Committee of the DQA is charged with the development and maintenance of dental performance measures. This process includes the following: refining the topic, identifying the availability of published measures related to the topic, and development of the rationale and specifications of the measures, along with the protocol for testing the measures. The committee oversees the testing of the measures to satisfy criteria set forth by the National Quality Forum (NQF), an independent nonprofit organization that evaluates health care quality measures.6 DQA measures are developed through extensive testing for four criteria: validity, reliability, feasibility and usability. The intent is to evaluate dental health services to allow dental plans and programs to monitor these services in a way that is as fair and reasonable as possible for dentistry. The measurement development process is shown above.

To date, the DQA has developed and approved 14 pediatric measures targeted at addressing dental caries in children, along with prevention and disease management.7 Of these, 12 are claims administrative quality measures that have been developed with the intent to evaluate state and federal programs such as the Medicaid and state Children Health Insurance Program (CHIP) and dental plans. DQA has developed two eMeasures that require electronic health records data for computation.

These measures have been developed in partnership with the University of Florida in the testing process, and seven of the quality measures have been endorsed by the NQF. 8 CMS has incorporated the DQA dental sealant for 6–9-year-olds measure into the CHIP Reauthorization Act core set of children’s health care quality measures, with reporting starting in 2015.9 Covered California, a state-based marketplace operation within the state, has adopted DQA measures for its qualified dental plan contracts for plan year 2016. HRSA

has adopted the DQA dental sealant eMeasure to be reported by Health Center Program grantees that started in 2016.10

ADDITIONAL RESOURCES

There is a need for all areas of the oral health care community to stay abreast of changes in dental quality measurement and the impact on the profession of dentistry. The DQA has extensive educational resources at www.ada.org/dqa, including Quality Measurement in Dentistry: A Guidebook, which offers more insight in this area. The website also contains up-to-date information on what is happening with existing measures and what is on the horizon. F References 1. Dental Quality Alliance (2012). Pediatric Oral Health Quality and Performance Measures: Environmental Scan. www.ada.org/en/ science-research/dental-quality-alliance/dqa-measure-activities.

2. Ojha D, Aravamudhan K. Leading the Dental Quality Movement: A Dental Quality Alliance Perspective. Journal of the California Dental Association.

April 2016, Vol. 44, No. 4 p.240.

3. Ibid.

4. Dental Quality Alliance (2016). Guidebook: Quality Measurement in Dentistry. www.ada.org/~/media/ADA/Science%20and%20Research/Files/ DQA_2016_Quality_Measurement_in_Dentistry_Guidebook.pdf?la=en 5. Dental Quality Alliance (2016). Procedure Manual for Performance Measure Development and Maintenance: A Voluntary Consensus Process. www.ada.org/~/media/ADA/Science%20and%20Research/Files/ DQA_2016_Measure_Development_Procedure_Manual.pdf?la=en 6. Dental Quality Alliance (2016). Guidebook: Quality Measurement in Dentistry. www.ada.org/~/media/ADA/Science%20and%20Research/Files/ DQA_2016_Quality_Measurement_in_Dentistry_Guidebook.pdf?la=en.

7. Dental Quality Alliance (2016). Guidebook: Quality Measurement in Dentistry. www.ada.org/~/media/ADA/Science%20and%20Research/Files/ DQA_2016_Quality_Measurement_in_Dentistry_Guidebook.pdf?la=en 8. Ibid.

9. 2015 Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP (Child Core Set). medicaid.gov/medicaid-chip-program-information/ by-topics/quality-of-care/chipra-initial-core-set-of childrens-health-carequality-measures.html.

10. Ojha D, Aravamudhan K. Leading the Dental Quality Movement: A Dental Quality Alliance Perspective. Journal of the California Dental Association.

April 2016, Vol. 44, No. 4 p.240.

Ralph A. Cooley, DDS, FAGD, is an associate professor at University of Texas School of Dentistry in Houston, following 34 years of private practice.

He serves on the AGD Dental Practice Council and represents AGD on the Dental Quality Alliance.

To comment on this article, email impact@agd.org.

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AGD IMPACT ARTICLE | SEP 2017

DENTAL BENEFITS

Exploring the Landscape of Leased PPO Networks

By Srinivasan Varadarajan, Esq.

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ost general dentists are aware that a Preferred Provider Organization (PPO) refers to a managed-care program, which relies upon networks of dentists that agree to accept reduced fees for services to patients, in exchange for more patients being steered to in-network dentists.

Employers often contract with either third-party administrators or third-party payers to make subscriptions to PPO plans available for their employees. In most PPO arrangements, third-party payers reimburse dentists for services based upon fee schedules, which, along with copayment provisions, dictate how much of the balance the patient would pay.

Dental PPOs have become increasingly prevalent in recent years. According to the American Dental Association (ADA), dentists participate in approximately six dental plans on average, with PPOs occupying 80 percent of the dental plan market and increasingly emphasizing that plan beneficiaries use in-network dentists.

One way that PPOs increase the value of their dental plans is by gaining access to more networks through network leasing.

Note: For the purpose of simplicity, the term “PPO” is used here to broadly refer to various third-party arrangements, including insurance companies, third-party payers and third-party administrators, which may offer participation in a PPO plan.

What Is Network Leasing?

Network leasing, sometimes referred to as network sharing, refers to a mechanism by which a PPO shares its network of dentists with other PPOs, such that the first PPO’s in-network dentists must then accept patients as in-network providers of the other PPOs. General dentists may be participating with numerous PPOs without knowing it.

In some cases, the dentist who has signed a contract with one PPO will discover that he or she is actually in-network with a different PPO only when he or she submits a claim for services and receives an explanation of benefits (EOB) indicating reduction to a contracted fee and restriction against balance-billing the patient.

In today’s market, not only do PPOs lease their own networks to other PPOs, but separate network organizations now exist that lease networks for a living. Some network organizations

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own the networks, but do not offer any PPO plans of their own.

Network organizations, such as network leasing companies, then lease their networks to multiple PPOs. A dentist who signs a contract with one PPO may inadvertently agree to participate with hundreds of PPO plans from across the nation.

The landscape of leased or shared networks presents both benefits and risks for the practicing general dentist.

Benefits of Leased Networks Whether a general dentist can leverage network leasing to his or her own business benefit depends largely on the terms of the contract he or she signs. More specifically, it depends on whether the dentist’s PPO participation contract requires all other PPOs that access its network to then comply with the provisions of the signed contract, including the fee schedule.

Usually, this is the case. However, it is important to read your PPO contract to understand whether your contract includes language that its provisions shall remain effective and controlling in the event that the network is leased or shared.

If a general dentist is presented with multiple PPO contracts with network leasing provisions but with different fee schedules, network leasing provides the general dentist with

| AGD Impact | September 2017

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Ultimately, network leasing provides general dentists with both opportunities and pitfalls. As with any contractual agreement, it is important to understand what you are agreeing to before you agree to it. the opportunity to sign the contract with the most beneficial terms and indirectly access the patients of the other PPOs through the shared network. In this way, leased networks may provide general dentists with the opportunity to have the benefit of a more lucrative fee schedule indirectly via network leasing than by directly contracting with the other PPOs. Risks of Leased Networks While indirect participation with PPOs through leased networks can provide general dentists with better fees than direct contracts with those PPOs, this is not a benefit if the general dentist had not wished to participate with those PPOs. While participation with leased network PPOs may bring in more patients, it also limits reimbursement and balance-billing.

However, there may also be other risks associated with some leased network schemes. Three notable schemes are cherry-picking, silent PPOs and stacking. All three schemes generally apply when a dentist has signed multiple PPO contracts.

Cherry-picking occurs when the dentist has signed contracts to participate directly with multiple PPOs. When multiple PPOs use the same leased network, the lowest fee schedule among all the directly contracted PPOs may sometimes be applied to all the PPOs with which the dentist directly participates.

Meanwhile, a silent PPO is a rental network scheme in which a company scans all of a dentist’s participation contracts to find the lowest fee schedule and then leases out that network to bind dentists to the lowest fee possible for services provided to his or her patients. A silent PPO does not expend resources to steer patients to the dentist as in-network for the additional PPOs but still procures rental fees while reducing the reimbursement to the dentist, thus avoiding any financial responsibility for the silent PPO. Laws in 14 states currently prohibit or limit this scheme.

Lastly, stacking is the practice of payers using multiple networks to bind dentists to the lowest fee amongst them.

So, what can you do? Read your PPO participation agreement before you sign it. Leased network provisions are identifiable by statements such as, “From time to time, company X may lease (or share or rent or market) its network with other companies.” Language such as “the terms and intents of the Participation Agreement, including the fee schedule, shall remain effective and control all dental services provided through leasing PPOs” may indicate that the contracted feeschedule will apply to all PPO plans using the leased network.

Additionally, your contract may have provisions that require the PPO to provide notice identifying companies to which the network is leased. Your contract may also have terms requiring the patient’s identification card to indicate that the patient’s plan uses your PPO network, so that you can make a decision about accepting the patient before providing services or submitting claims.

Ultimately, network leasing provides general dentists with both opportunities and pitfalls. As with any contractual agreement, it is important to understand what you are agreeing to before you agree to it. F Srinivasan Varadarajan, Esq., is the director of dental practice and policy at AGD. To comment on this article, email impact@agd.org.

Contact AGD at practice@agd.org with any questions about leased networks or other dental benefits strategies.

What Can General Dentists Do? The fundamental principle of participating with a PPO as an in-network dentist is the acceptance of lower fees in exchange for the steerage of additional patients to the practice. More broadly, a contract is a bargained-for exchange. Some leased benefit schemes violate this principle. | agd.org |

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SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 11

BUSINESS SPONSORED ARTICLE

WHY YOU NEED LONG TERM CARE INSURANCE

By WDIA

As you build your financial portfolio both for your financial security now and in anticipation of enjoying a long retirement, you need to factor in the cost of care for when you need assistance in your home or become a resident of a nursing home or assisted living facility.

The average length of stay at a nursing home is 2.5 years, which in Washington State could cost you over $282,000.

You can designate money in your portfolio to cover the costs or you can purchase Long Term Care Insurance.

For 2017, the average annual cost of a nursing home in Washington was $113,350; an assisted living facility was $56,000 and in-home care with a health aide was $60,000.

Long Term Care Insurance will help you meet the cost of your spouse’s and your care should you need assistance with daily living. It gives you the flexibility to choose when and where you receive care and to provide emotional and financial support for your family.

70% OF PEOPLE OVER THE AGE OF 65 WILL REQUIRE LONG TERM CARE SERVICES AT SOME POINT IN THEIR LIVES. Long Term Care Insurance is similar to Disability or Life Insurance in that you are paying a monthly premium to have a pool of money available to you when you need it. Unfortunately, “Long Term Care” is not an accurate description of the benefits provided on a Long Term Care Insurance policy: “Family Freedom Coverage” may be a bit more accurate. This type of insurance frees you from the substantial financial burden of paying for care while

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it frees your family from the burden of caring for you at the detriment of their time, finances and physical and emotional well being.

41% OF PEOPLE RECEIVING LONG TERM CARE ARE BETWEEN THE AGES OF 18 & 64.

Since the need for assistance, not age, is the trigger for receiving long term care benefits, this insurance will cover you should the unexpected happen at any age. For example, if at age 47 an illness or accident leaves you needing care, you would be eligible to receive benefits.

This would allow your spouse to continue working or caring for your children while a professional caregiver came to your home to help you with your daily needs such as bathing, dressing or getting in and out of bed.

Washington Dentists’ Insurance Agency strongly encourages you to add Long Term Care Insurance to your insurance portfolio. Along with Disability and Life Insurance, Long Term Care Insurance will protect your family and you from the large financial burden that an accident or illness may cause. Purchasing coverage will relieve your family of having to center their lives on your personal care while giving you the freedom to choose where you would your care to take place. ■

To learn more about Long Term Care Insurance and to receive quotes, please contact WDIA at 206-441-6824 or 1-800-282-9342 or at info@wdiains.com.

AGD IMPACT ARTICLE | JAN 2017

CODING

Dental to Medical Cross-Coding Tips

By Charles Blair, DDS

M

any dentists are asked to submit dental procedures to a patient’s medical plan, requested by the patient’s dental plan or the patient. In some cases, dental team members feel overwhelmed and frustrated submitting medical claims for dental procedures such as surgical extractions, trauma-related procedures and biopsies. However, submitting a medical claim is not as challenging as it may seem or different from submitting a dental claim.

Understanding the Code Sets Successful medical billing begins with an understanding of the various code sets available that allow for proper cross coding and/or the use of the appropriate code set. Always report what

you do using the most accurate code to describe the procedure performed. It is imperative that only procedures and diagnoses supported by the clinical documentation be reported.

Administrative simplification provisions as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) include a requirement to adopt standard transaction sets. Within these transaction sets are standard codes sets for reporting medical and dental procedures. As of December 2000, Current Dental Terminology (CDT), Current Procedural Terminology (CPT®), Healthcare Common Procedure Coding System (HCPCS) and International Classification of Diseases (ICD) code sets must be accepted by all HIPAA-covered entities.

ICD-10 was implemented effective Oct. 1, 2015. While there are ICD-10-PCS (Procedure Coding System) and ICD-10-CM (Clinical Modification) code sets, dentists will only report the ICD-10-CM code set. Any reference made to ICD-10 in this column will be in reference to ICD-10-CM. Here’s an explanation of common coding terminology: • CDT: The CDT code set is the most common set, known and used by dentists to report dental procedures. CDT procedure codes are used when reporting dental procedures to a dental payer. Many medical payers will accept the CDT code when there is no applicable medical cross code (CPT) or when the CDT is the most accurate code to describe the dental procedure performed. It is advisable to contact the medical payer prior to claim submission to determine if submission of CDT codes is allowable. This code set is maintained by the American Dental Association.

• CPT: CPT is often referred to as Level I codes and used to report procedures to medical payers. This code set is maintained by the American Medical Association.

• HCPCS: A HCPCS code consists of five alpha-numeric characters, and the code set is often referred to as Level II codes, which is primarily used to report medical services, equipment or supplies. For dentists, this code set is used to report oral sleep apnea and temporomandibular joint disorder appliances, which are considered to be durable medical equipment. The HCPCS code set is maintained by Centers for Medicaid and Medicare Services (CMS).

WANT TO LEARN MORE? A new medical coding publication, “Medical Dental Cross Coding with Confidence,” is now available for purchase.

To learn more about an AGD-member special offer, visit www.practicebooster.com/agd.

14

| AGD Impact | January 2017

• ICD: An ICD code is commonly referred to as a diagnosis code.

ICD codes are used to report diagnoses, symptoms and procedures. ICD codes communicate to the payer why a procedure may be medically necessary and may decrease the need for lengthy narrative. ICD-10-PCS is a procedure coding system used only by hospitals in an inpatient setting. ICD-10-CM is the clinical modification developed for use by physicians and other health care professionals; e.g., dentists for use in outpatient settings. Dentists will only use the ICD-10-CM code set, regardless of where the procedure is performed, even if in a hospital. The ICD code set continues to be developed by the World Health Organization, but in the United States, it is maintained by the National Center for Health Statistics and Centers for Disease Control and Prevention.

SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 13

AGD IMPACT ARTICLE | JAN 2017

Submitting the Medical Claim Form Submission of a clean claim will help eliminate claim rejections and frustration. Many claims submitted by dental practices are rejected by medical payers due to the use of an outdated form, incomplete information and the improper placement of required information.

The current form required by all medical payers is the CMS 1500 (02-12) Medical Claim Form. Some dental practice management software is capable of printing a medical claim form; however, some do not have this capability. There are many affordable sources for completion of the medical claim form, and forms may be purchased from office supply companies in large or small quantities. Some payers will accept a handwritten claim form. However, it is advisable to submit a printed claim form, as claim forms are scanned and read by computer software and must be legible to prevent a rejection. There are few payers that will only accept an electronic medical claim; most will still allow a form to be submitted by mail.

It is important to follow the claim form instructions exactly when submitting a medical claim. Common claim form errors include, but are not limited to, the use of punctuation (i.e., a decimal point in the ICD code), the absence of a description when reporting an unlisted CPT code, and use of the appropriate modifier or qualifier, when required.

Always report what you do using the most accurate code to describe the procedure performed. It is imperative that only procedures and diagnoses supported by the clinical documentation be reported.

As with the dental claim form, the medical claim form is a legal document, and the treating doctor is responsible for the information reported on the claim form. It is important for dentists to invest in staff training and resources to ensure accurate completion of any claim form to all third parties.

Additionally, it is imperative that dentists and team members document the clinical notes thoroughly to the greatest level of specificity. F Charles Blair, DDS, CEO of Dr. Charles Blair and Associates Inc., is the publisher of several coding publications, as well as the founder of Practice Booster, which optimizes insurance administration and aids in maximizing reimbursement. To comment on this article, email impact@agd.org.

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15

BUSINESS SPONSORED ARTICLE

THE ABRAMS REPORT

SWEAT THE SMALL STUFF

I am sick and tired of people saying don’t sweat the small stuff. The small stuff matters. Those little, significant details are why I trust my medical doctor. Those tiny details are what transforms our dinner table during the holidays. Famous brands like Neiman Marcus, The Ritz and fine dining establishments attract affluent customers with discerning taste, because of their attention to detail and remarkable customer service.

Think about it. Most of our problems occur because someone wasn’t paying attention to the details or they failed to communicate those details with others. Failure to acknowledge and communicate details can have an enormous impact on someone’s expectations or the task at hand. In business, exceeding expectations is the magic sauce for creating great first impressions and an illustrious career. It doesn’t matter if you’re a dental office, a sales person, consultant or doctor. Details bring color to the black and white and transform good outcomes to great outcomes! It’s no secret that tiny details like remembering to say thank you, acknowledging someone’s effort, responding to a client in a timely fashion, cleaning up after yourself or remembering someone’s birthday, matters.

When I receive correspondence with misspelled words and bad grammar I try to ignore it. However, when I receive a text, email or voice message that lacks clarity or requires another touch, I consider it an unnecessary delay. It creates more work and distracts me from other work. Don’t misunderstand me. I am guilty for sending out some dysfunctional texts while traveling or multitasking but when I submit business correspondence I am deliberate and proof my work for clarity, accuracy and grammar. Business people want to work with others, like them. Knowing ones’ attention to detail qualifies them for collaboration and partnership, or not.

The details matter. Your curb appeal and the décor of your waiting room and reception area matter. The cleanliness and friendliness of your office matters. The way your office phone is answered matters. The efficiency of your practice

matters. We operate a business with limitations. You can only serve as many people as your practice can handle in the hours you are opened for business. Attention to detail can make all the difference!

HERE ARE A FEW IDEAS (DETAILS) FOR YOUR DENTAL OFFICE •

Complimenting patients for being on time goes a long way towards relationship building and it rewards good behavior.

•

When the patient is exiting the office after a positive cosmetic or restorative procedures, ask them for a referral.

•

Institute a Thank You (reward) program for patients who refer others. Active referrers become repeat offenders.

•

Call the patient in the evening after they’ve had a painful procedure. Showing you care establishes trust and builds relationships.

•

Customized new patient and medical history forms are important and will provide usable, valuable patient information. It will help in diagnosis, treatment planning and will promote elective dentistry. I.e.: Have you ever considered clear aligners (Braces) to straighten your teeth?

Would you like a whiter smile?

SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 15

BUSINESS SPONSORED ARTICLE

•

Customize your patient instructions for post op patient bags. The content in these bags and the instructions should be procedure specific (gauze, sticky wax, cold pack, neutral sodium rinse, chlorhexidine, lip gloss, desensitizer and marketing material). A one fits all bag does not show much attention to detail especially for a specialist. Invite the patient to visit your website, like your Facebook page and to write a review.

•

Suggest a whitening treatment before a patient does any anterior work (veneers or crown). Offer a significant discount off the fee if bundled with the crown. You may even want to extend the offer to significant others and family.

•

Make it office policy that every hygiene patient gets perio charted at least once a year. A strong hygiene program will populate a growing perio department.

The Dr. and team must believe in the oral/systemic link. If charting is only about making money, it will never become part of the office culture.

•

Take a tooth shade on all new patients at their first appointment. Have the patient participate. Let them select the shade they think is most like their incisors? Be sure to have your shade guide set up darkest to lightest for dramatics? If ever there was a conversation starter.

We ship 99% of your orders with next day delivery and virtually no back orders. But that isn’t what makes us the industry leader.

HSD offers various price points and more product options in every dental category, which supports different business models, but that’s not our magic sauce either.

Some clients believe their field sales consultant give Schein a competitive advantage. We have the highest sales consultant to doctor ratio (better coverage) and pair every rep with a tele-sales professional, but that is not why more practitioners trust Schein. *Over the next eighteen months, HSD will hire dozens of certified technology integrators and equipment service technicians. We are doing this to improve our coverage and capacity to maintain and integrate our client’s technology requirements.

None of this explains why Schein grew from a catalog company in 1995 to the world’s largest supplier of healthcare products and services to office-based practitioners today. The magic sauce is a combination of a few critical ingredients; leadership, people, reinvention, investment, commitment and a relentless focus on those tiny details; the small stuff.

•

Your patient’s e-mails and cell phone numbers (calls and texting) have replaced snail mail and home phones. Be sure to ask every patient - what’s the best way to communicate with them. Use a communication program like Demand Force to remind patients, confirm appointments and reactivate patients?

It isn’t easy balancing those ingredients when you consider market forces, the economy and an everchanging landscape. Change doesn’t happen easily or quickly but the journey towards improvement never ends.

Contrary to what most people think, the key to success in a dynamic world is constant reinvention and a customer centric business model. Over the last few years, Schein has invested millions of dollars (not a minor detail) to develop programs and services for the emerging dental marketplace. This type of investment is why Schein is the most trusted resource for practitioners worldwide.

•

Utilize patient procedure consent or denial forms?

Use them for denying x-rays, perio treatment and root canals? Eliminate the exposure and disruption caused by non-compliant patients.

Attention to detail does not suggest perfection.

WHY DO YOU THINK HENRY SCHEIN IS THE WORLD’S BEST RESOURCE FOR DENTISTS? Henry Schein Dental has the largest selection and inventory of clinical materials and equipment in the dental business but that’s not why they have a 40% market share.

16 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

This coupled with the focus on improvement is what sets the stage for a winning strategy. Customers don’t expect perfection but they expect your best effort and they want to know you care. This goes for Henry Schein and every other business! The small stuff matters! ■

SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 17

SCIENCE • TECHNOLOGY • ENGINEERING • MATH

OF DENTISTRY

(PART 1)

THE

By Herbert Edwards, DDS, MS(biol), MAGD

T

he path to becoming a dentist in North America is one that emphasizes the importance of science, technology, engineering, and mathamatics (STEM) at each step along the way. Nearly all of us obtained a four year university degree along that path, many in a STEM field. Those of us who did not major in a STEM field still found ourselves required to take courses in biology, chemistry, organic chemistry, physics, mathematics, and related topics to prepare us for admission requirements inclusive of scoring well on the DAT examination sections specifically dealing with chemistry, biology, organic chemistry, and mathematics. Once in dental school we again took a variety of required courses with a STEM emphasis (biochemistry, microbiology, physiology, anatomy, dental materials science, histology, biostatistics, etc.) The written component of the board exam tested us over these areas and we were required to pass it before moving forward with our remaining dental education on the way to graduation and licensure. To get to where we are today, as licensed dentists, we had to successfully demonstrate ourselves knowledgeable in key STEM topics.

Dentistry is, after all, a health science and we are therefore all justifiably able to view ourselves as scientists, and in fact, should view ourselves as such.

help our patients achieve improved outcomes. When was the last time a product rep visited your clinic touting his wares: “We have the second best composite on the market!”? It never happens. Everyone claims to have “the best” product or service to sell us. We all know this is impossible, of course, so how do we determine which claims are valid and which ones are simply unsupported hyperbole based on incomplete or shoddy evidence? We need to tap into our STEM backgrounds, utilize our critical thinking skills and consider the true value of the evidence being presented to us. Are there peer reviewed studies to support the claim of the product? Who sponsored those studies? Are there other studies that show contradictory results? Do the claims violate any of the laws of physics or chemistry? I once had a salesman from a well-known dental company tell me, “Our composite resin has ZERO polymerization shrinkage!” I knew that the material he was selling utilized bis-GMA chemistry, so inquired politely but directly, “Don’t all bis-GMA resin systems exhibit inherent polymerization shrinkage?” He responded, “Normally, yes, but we have overcome it!” Holding my ground, I asked, “Could you send me the published studies that demonstrate this?” He assured me, “Absolutely, I will send them!” I never saw or heard back from him again.

Many of us have found, however, that once we enter the world of the practicing clinician the emphasis on STEM is often neglected. Products and services are marketed to us with little to no robust scientific evidence to demonstrate their value in bettering our performance as clinicians to

Countless products and services are peddled to us in this manner. Reach into your STEM knowledge toolbox and examine such claims critically. Your patients will be appreciative and you’ll avoid being led down questionable paths that do nothing to improve outcomes. ■

18 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

A VISIT TO WAGD

By Herbert Edwards DDS, MS(biol), MAGD

Conor Scanlon, a senior biology major attending Whitman College in Walla Walla, Washington, visited the Washington Academy of General Dentistry Educational Center on 28 April. He received a personal tour of the facility from WAGD president, Dr. Teresa Kang.

Mr. Scanlon has an interest in dental materials. As part of his biology curriculum at Whitman College, he participated in an in vitro study with WAGD member dentist, Dr. Herbert Edwards, obtaining university credit for his research that applied toward his graduation requirements. Mr. Scanlon’s project was a comparative study of calcium ion release and recharge potential in various dental restorative materials as compared to a dentin control.

On 29 April, he participated as a student guest speaker, presenting his research findings at the MasterTrack session.

He had the pleasure of meeting many AGD dentists and UW dental students who were in attendance for the Howard Competition. Mr. Scanlon enjoyed his dental research and is planning to take the DAT and apply to dental school. We hope to see him again at the WAGD Educational Center someday. ■

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SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 19

GOLD AND ITS APPLICATION IN MODERN DAY DENTISTRY

Presented by Sampada Deshpande, UWSoD Class of 2018, at the 2018 William Howard Student Case Competition

T

he 2018 William Howard Competition presents UWSOD students with a fine opportunity to showcase their clinical or academic work, hear from peers, and network with potential mentors at the WAGD. The announcement for the award, and instructions to applicants, came by in late 2017 and the main competition was held in April of 2018, leaving students plenty of time to put together clinical photographs, references, and hold necessary discussions with their respective advisors. I chose to present, for the award, the clinical work I had completed as part of the Tucker Cast Gold Selective at the UWSOD. I took this course in the fall quarter of 2017 and had had the opportunity to work with Dr. Tim Hess, Dr. Richard Tucker Jr., Dr. Otterholt, and Dr. Allan, among several others excellent clinicians, STAND during thatWITH time. OneTHE of the reasons why I chose to BEST IN DENTISTRY present my Cast Gold work was as a thank you for the

amazing support I had received from the attendings teaching this course. Not only did they provide me with a critical understanding of the technique that goes into preparing good cast gold work, they were also excellent mentors, teaching me about life after dental school, how to run your own practice and how to incorporate cast gold into modern day dentistry (and make it profitable!). Needless to say, taking the Cast Gold Selective has been one of the highlights of my dental school education and I am very appreciative of the platform that the WAGD provides in the form of the prestigious William Howard Memorial Award to recognize work carried out by the students at the UW. I cannot wait to continue learning more, begin working towards a Fellowship, and join a strong community of dentists, when I move back to California for work this Fall. â–

To receive your AGD Fellowship or Mastership Award at AGD2018 in New Orleans, complete the requirements, and submit an application by Dec. 31, 2018.

BECOME AN AGD FELLOW OR MASTER agd.org

STAND WITH THE BEST IN DENTISTRY

To receive your AGD Fellowship or Mastership Award at AGD2018 in New Orleans, complete the requirements, and submit an application by Dec. 31, 2018.

BECOME AN AGD FELLOW OR MASTER agd.org

20 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

UNIVERSITY OF WASHINGTON

W

WILLIAM HOWARD STUDENT COMPETITION

illiam Howard Student Competition is a joint partnership between WAGD and the ADI-USA Section since 2002. It was first started then by Dr. Kathryn Poleson, the ADI Northwest Regent. 16 years later, this program still runs strong thanks to the many helps from the WAGD, ADI, and the University of Washington School of Dentistry Faculty members.

In the early years, the competitions were held at the UW School of Dentistry on the weekends, or at the Airport Marriott, Cedarbrook Lodge and now at the WAGD Continuing Education Center. It was an annual event with the participation from students, judges from WAGD Board, and the WAGD Master Track Program. There were memorable moments: in one year we had two first place winners.

There are 4 prizes: First Prize $1,000., Second Prize $500., Third Prize $300., and Fourth Prize $200.

We would like to thank the many leaders in the Organized Dentistry who have helped with our Annual University of Washington Howard Memorial Student Competition: From the WAGD: Drs. Bryan and Linda Edgar, Dr. Dave Carlsen, Dr. Mike Melkers, Dr. Jeanine McDonald, Dr. Todd Haworth, Dr. James Cunnington, Dr. Gary Heyamoto, Dr. Steven Thomas, Dr. Puneet Aulakh, Dr. Teresa Kang ; from UW School of Dentistry: Dr. Tai C. Aw, Dr. Ricardo E. Schwedhelm, and from King County Dental Society: Dr. Timothy Hess, Dr. Steve Albright and many others from WAGD Master track program. Also, Dr. Guy Hanson, AGD Trustee for AGD 11th Region and ADI Northwest Regent. A small foot note here is that many are also members of the ADI. Last but not least, Ms. Valerie Bartoli, our WAGD Executive Director. â–

2015 From Left to Right: Dr. Dat Giap, AGD Past President Dr. Linda Edgar, Mr. Cameron Lasley, Mr. Christian Okafor, UW School of Dentistry Professor Dr. Ricardo Schwedhelm.

2016 From Left to Right: Ms. Caroline Olsen Smith (First Place), Dr. Dat Giap, Dr. Ricardo Schwedhelm, Professor at UW SOD, Ms. Ani Vulpoi (Second Place), and Mr. Mahfur Rahman (Third Place).

Dr. Puneet Aulakh WAGD President (3rd from left), ADI Fellow Dr. Gary Heyamoto (4th from left), 3rd Place winner Dr. Natasha Garibov (5th from left), 2nd Place Winner Dr. Stephanie Kim (6th from left), 1st Place Winner David Primrose (7th from left), Seattle-King County Dental Society Past President Dr. Timmy Hess (8th from left), ADI Fellow, Past AGD President Linda Edgar (9th from left).

SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 21

AGD IMPACT ARTICLE | NOV 2017

T

he traditional practice of general dentistry has long painted a picture of the solo or small group prac-tice, sometimes with the dentist’s family members working at the front desk or as the dental assistant, providing care under a fee-for-service model.

This picture is not, however, at the core of what has made the traditional practice of general dentistry a cost-effective modality of care. Rather, the heart of the profession has been prevention-focused, patient-centered primary oral health care.

Over the past few years, the traditional practice of general dentistry has faced numerous challenges. Proponents of the midlevel provider continue to advocate before various states for these non-dentist practitioners to provide care without the direct or indirect supervision of a dentist. Meanwhile, the definition and scope of a dental “specialist� is evolving to increasingly overlap the practice of general dentistry.

At the same time, it has become increasingly challenging to manage the business of general dentistry. Specifically, many gen-eral dentists have been compelled to go in-network with PPOs in order to fill their chairs, despite dental insurers reducing fees and placing other restrictions and requirements upon partici-pation. American Dental Association (ADA) data from 2012 indicated that not having to deal with dental benefits and other administrative issues was among the top reasons dentists opt to work in corporate dentistry settings or settings affiliated with a dental service organization (DSO), rather than in non-DSO settings. By having the ability to execute group buying power, with consolidated overhead, the growth of corporate dentistry challenges the individual dentist to be creative in efforts to stay competitive, be it partnering with other dentists to develop group practices or expanding the scope of his or her practice.

22 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

Last but not least, dentistry continues on its slow but deliberate march toward adopting a value-based approach to paying for care. Unlike strict fee-for-service models, value-based payment models relate payment to the value or quality of care provided, rather than strictly to the type or volume of services rendered.

These challenges do not stand independently of one another, but rather, paint a picture of a prospective compression and commercialization of primary care dentistry, to bring dentistry in greater alignment with medicine, but with a greater focus on population health outcomes.

THE MIDLEVEL PROVIDER

Midlevel providers are non-dentists who work outside of the dentist’s direct or indirect supervision, and in some cases, diagnose and treat the dental patient. Some midlevel providers may have as little as two or three years of post-high school training and may be allowed to provide irreversible dental procedures.

In the United States, Minnesota, Maine and Vermont have implemented the midlevel provider model, while Alaska, Washington and Oregon allow these providers to practice solely in tribal areas. In 2016 and 2017, proponents of midlevel providers drove the introduction of legislation to implement this model in Massachusetts, Connecticut, Arizona, Kansas, Maryland, Michigan, New Hampshire, New Mexico, North Dakota, Ohio and Texas. Midlevel provider proponents have been largely unsuccessful in these states, but such legislation is expected to be reintroduced in these and other states in the coming years.

A concern is that using such providers for the care of underserved patients may not be economically feasible or in line with the prevention model. According to the May 2016 AGD Impact article, “A Review of the Minnesota Dental Therapist Model,” the Minnesota Board of Dentistry reported that there were 42 licensed dental therapists in the state in June 2015. The article goes on to say that “two licensees lived out of state. During this time, only three DTs [dental therapists] practiced in the region defined in the Robert Wood Johnson Foundation study, and only eight practiced in HPSAs [Health Professional Shortage Areas]. More than a quarter practiced in Hennepin County, home to the state’s largest city, Minneapolis, while 73 percent practiced in the seven-county Twin Cities metro area.”

This is consistent with the findings of a 2005 ADA study, “The Economic Aspects of Private Unsupervised Hygiene Practice and Its Impact on Access to Care,” which found that the overhead costs of maintaining a practice drove independent midlevel providers away from underserved areas.

IMPENDING CHANGES TO THE DEFINITION AND PRACTICE OF DENTAL SPECIALTIES

For years, many states have determined what constitutes a dental specialty based upon the recognition of specialties by the ADA. Recent cases have challenged this notion. Specifically, the American Academy of Implant Dentistry (AAID) has, along with other plaintiffs, filed suits in states such as Florida, Texas and, most recently, Indiana. The lawsuits successfully challenged, on United States constitutional grounds, regulations

16

... A concern expressed by some is that midlevel providers may replace the general dentist as the primary oral health care provider and develop direct referral relationships with specialists for the practice of general dentistry and specialty care. that deferred to ADA designations of specialty for determining when a dentist may advertise as a specialist.

In October 2016, the ADA House of Delegates (HOD) adopted ADA HOD Resolution 65, which amended Section 5.H. of the ADA Principles of Ethics and Code of Professional Conduct (or the “ADA Code”) in two substantive ways.

First, Resolution 65 broadened the specialties that can be ethically announced to include not only ADA-recognized specialties, but also any specialty legally recognized by the dentist’s state, provided that the dentist meets the educational requirements required for specialty recognition within that state.

Second, Resolution 65 declared it ethical for a dentist who announces or advertises as a specialist to practice in all facets of dentistry, unless a specialist announces that his or her practice is “limited to” his or her specialty.

In essence, the amendments to the ADA Code removed some ethical hurdles to the individual states’ exercising their discretion, both in defining a specialist for the purpose of advertising as one, as well as in defining the scope of practice for a specialist.

With regard to defining a specialist for the purpose of advertising as one, a state may, for example, choose to recognize an implant dentist or a dental anesthesiologist as a specialist, even though the ADA does not define implantology or dental anesthesiology as dental specialties. On one hand, this may benefit general dentists who have attained the education required by such a state to qualify as a specialist (e.g. in dental implantology) for the purpose of advertising as one. On the other hand, depending upon the statutes and regulations established by individual states, some states may allow a dilution of the meaning of a specialist, allowing an influx of various specialties to arise in competition with general dentistry.

In the coming years, professional organizations, including AGD, may play a key role in working with

| AGD Impact | November 2017 SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 23

AGD IMPACT ARTICLE | NOV 2017

states to explore educational requirements for defining a specialty in a manner that is neither overly restrictive nor overly permissive, such that the role of a general dentist as primary oral health care provider remains clear.

Another effect of the amendment to the ADA Code, whereby a specialist advertising as a specialist may now ethically practice in any area of dentistry, may be especially impactful on the practice of general dentistry. For example, in Arkansas, HB 1250 became law on March 16, 2017, and provides that a specialist license does not limit a licensed dentist’s ability to practice in any other area of dentistry for which the dentist is qualified, including general dentistry.

Such legislation may impact referral relationships.

Today, many general dentists foster collaborative relationships with their specialist colleagues. General dentists and pediatric dentists serve as the primary oral health care providers for patients, referring patients for more complex procedures. For example, a general dentist may refer a patient to an endodontist for a root canal, and the patient would return to the general dentist for the crown or other restoration.

Removal of the ethical bar against the practice of general dentistry by one who advertises as a specialist now empowers states to enact statutes and regulations to allow that same endodontist to practice as the patient’s primary care dental provider, providing restorative care, hygiene services and more. This may significantly impinge upon the role of the general dentist as a primary oral health care practitioner.

Additionally, in states that adopt the midlevel provider model, such as in Minnesota, which established the dental therapist and advanced dental therapist roles, a concern expressed by some is that midlevel providers may replace the general dentist as the primary oral health care provider and develop direct referral relationships with specialists for the practice of general dentistry and specialty care.

LEVERAGE OF THE DENTAL BENEFITS INDUSTRY

Broadly, AGD members have increasingly faced challenges with some of the following trends with insurance companies: reduced reimbursements and phase-out of higher reimbursement plans; loyalty program with penalty for non-exclusive participation; delayed payments alleging incomplete claims/ radiograph requests; utilization audits and resulting “overpayment” refund requests; post-payment patient

ineligibility findings and resulting refund requests; network leasing; reduced benefits in the absence of diagnostic code submission; denial of coverage for periapical radiographs without presentation of symptoms; onerous PPO contract provisions; misleading information provided to patients; low annual limits; coverage for certain procedures limited to provision by specialists; requirements that referrals be to in-network specialists only; charges associated with requirements to accept electronic funds transfer (EFT) and demands to accept EFT; and refusal to honor direct assignment to non-network dentists.

Despite the increased volume of complaints, dentists have increased their participation with PPOs. According to Netminder, which compares provider network data, dentists were participating in more PPO networks and in larger PPO networks in 2013 than in 2009. The increased leverage of PPOs will likely compel general dentists to reduce or consolidate administrative costs, favoring group practice models.

CORPORATE DENTISTRY

According to November 2015 data featured in the ADA Health Practice Institute report, “How Big are Dental Service Organizations?” 7.4 percent of dentists in the United States are affiliated with DSOs. This percentage jumps to 10.2 percent for women, and 16.3 percent for dentists aged 21–34. The numbers also vary greatly by state, with Arizona leading the way with 17.5 percent of dentists affiliated with DSOs. According to the 2013 report, “AGD Investigative Report on the Corporate Practice of Dentistry,” corporate dentistry refers to any variety of practice modalities in which management services, at a minimum, are provided in a manner that is organizationally distinct from the scope of activities performed by a dentist within only his or her practice. Depending upon the model, dental management companies, DSOs, management service organizations and/or dental management service organizations provide or administer management services.

One model of corporate practice uses practicing dentists as shareholders who develop and implement business functions and expectations. Another model uses professional corporations — sometimes one per state, sometimes many per state or one per many states — with oversight over multiple practices and the responsibility of administering business services and expectations of outside owner(s) through business services contracts.

According to the report, while some models use outside owner(s) who are not investors or equity firms, other models do use investors or equity firms. While the former may base profits primarily on a percentage of actual net revenue of contracted dental practices, the latter also may base profitability on Wall Street valuations, including the use of the present value of future expectations of gross receipts to paint the business as a more lucrative opportunity for prospective investors.

24 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

Ultimately, the growth of corporate models may vary based upon the priorities of up-and-coming generations of dental school graduates, as well as the effects of the Patient Protection and Affordable Care Act of 2010 (PPACA), or its prospective revisions or replacements, and the varying and continually changing structures and contracts of DSOs. While some economists expect continued growth of large group practices, including models of corporate dentistry, others predict that the market share of corporate models has reached a plateau or will reach a plateau at or about 20–25 percent of all practice modalities.

NUMEROUS OTHER TRENDS

Several additional trends, notably affiliated with health care reform, are also expected to provide challenges and opportunities for the dental practice. While most accountable care organizations (ACOs) have yet to integrate dentistry into their value-based and capitated payment models, it is not unlikely that this will happen, and group practices will likely be in a better position to integrate with ACOs and value-based payment models. Moreover, the effects of the PPACA have influenced trends in children versus adults seeking care. The ADA Health Practice Institute found that between 2000 and 2013, the percentages of the child and senior population with a dental visit increased, while the percentage of other adults who visited a dentist decreased. Prospective changes to the practice of general dentistry associated with federal regulatory changes and a move toward greater alignment of dental care with medical care, as well as technological advancements and the possibility of leaps in regenerative dentistry and other cuttingedge opportunities, are other trends that are not addressed at length here, but should be on the radar of general dentists.

ADVOCACY AT AGD AGD would like all patients to receive the best possible oral health care and maintains that direct or indirect supervision by a licensed dentist is necessary to ensure patient safety. Although the access-to-care issue is complex, AGD has focused on oral health literacy and community water fluoridation as two viable strategies for reducing oral health disparities.

AGD also assists members by advocating for federal legislation (H.R. 372) for partial repeal of the McCarranFerguson Act, which shelters insurance companies from antitrust law, as well as advocating for state legislation to prohibit fee-capping of non-covered services, among other matters.

In addition, AGD advocates for dental practices by developing policies on dental benefits issues, meeting with dental directors and presenting at American Association of Dental Consultants meetings and assisting individual members with review of PPO contracts and claims issues.

To learn more about AGD’s priority issues and advocacy efforts, visit agd.org.

18

| AGD Impact | November 2017

WHAT DOES THIS ALL MEAN?

It means that general dentistry may have to evolve in order to remain sustainable and successful into the future. It also means that there may be an opportunity for general dentists who increase collaboration with other dentists and physicians, and provide additional services, to find greater success in the new health care landscape.

In some states, midlevel providers and specialists may collectively be allowed to provide the primary oral health care that general dentists provide today. This may compel general dentists to expand their role as the primary oral health care provider by ensuring that they adopt a broader systemic health view of oral health care — from screening for oral cancer to screening for diabetes — and working consistently with the patient’s physician on systemic health issues such as sleep apnea, prenatal health and osteopathic care.

Moreover, the continued rise of DSOs, coupled with greater participation in multiple PPOs and large PPOs, may drive more general dentists to practice in group practices to have the buying power and consolidated overhead costs of corporate chains. The time and effort dedicated to practice management and administrative duties are likely to increase in light of dental benefits challenges and evolving payment systems, further driving general dentists to form group practices or otherwise affiliate with DSOs. Ultimately, however, the heart of the profession of general dentistry lies in prevention and in being the primary care practitioner and dental home for patients. These core tenets need not be lost, and AGD will continue to play an active role in standing for general dentists and their patients, not only to ensure sustainability in a changing world, but to strengthen the foundation the profession was built upon, regardless of how it evolves. F Srinivasan Varadarajan, Esq., is the director of dental practice and policy at AGD. To comment on this article, email impact@agd.org.

SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 25

for The Pacific Northwest

UPCOMING EVENTS

DATE

EVENT TITLE & SPEAKER

DIVISION

Aug 23, 2018

The Thriving Fee for Service Practice in 2018, Dr. Steven Rasner

Washington AGD & UWSOD

Aug 24-25, 2018

Atraumatic Extractions for the GP, Dr. Steven Rasner

Washington AGD & UWSOD

Aug 24, 2018

Dental Clinic Open House, Washington AGD

Washington AGD

Sept 6, 2018

Online Reviews & Reputation Management: Google, Yelp & More, Ian McNickle

Washington AGD

Sept-June

Clinical Orthodontic Education for G.P’s (10 Sessions), Dr. Binh Tran

Washington AGD

Sept 7, 2018

Dental Forensics: Primer for Volunteers, Dr.’s Tanaka, Hess & Heyamoto

Washington AGD & UWSOD

Sept-June

Clinical Implantology Continuum (10 Sessions), Dr. Alan Yassin

Washington AGD

Sept 20, 2018

Oral Surgery for the G.P’s, Dr. Alan Yassin

Washington AGD

Sept 21, 2018

Oral Surgery, Seattle King County Clinic, Dr. Alan Yassin

Washington AGD

Sept 21, 2018

Mistakes Dental Assistants Make & How to Avoid Them, Kevin Henry

Washington AGD

Sept 22, 2018

Prosthodontics, The Implant Focus, Dr. Alan Yassin

Washington AGD

Sept 22, 2018

Protecting Your Patients & Your Practice from, Cyber Ransonware, Terre Harris

Washington AGD

Oct 26, 2018

Prettier Direct Composites, Dr. David Clark

PCDS, SKCDS, UWSOD,

Nov 8, 2018

Social Media Best Practices, Ian McNickle

Washington AGD

Nov 9, 2018

Smiles for Veterans, Day of Giving Back

Washington AGD & Henry Schein

Nov 15, 2018

Organize & Keep Patient Revenue, Susan Gunn

Washington AGD

Nov 16, 2018

Wholly Molar, Dr. Brian Novy

Washington AGD

Nov 17, 2018

How to Eat Candy, Dr. Brian Novy

Washington AGD & UWSOD

Nov 17, 2018

The Hygiene-Dentists Healthcare Team, Dr. Kevin Kwiecien

Washington AGD & Henry Schein

Nov 18, 2018

Evolution’s Bite, A Story of Teeth, Diet, & Human Origins, Dr. Peter Ungar

Washington AGD

Jan 24, 2019

Local Anesthetic: Part 2, Dr. Simon Prior

Washington AGD

Jan 25, 2019

Medical Emergencies, Dr. Simon Prior

Washington AGD

Jan 26, 2019

Comprehensive Orthodontic Treatment for G.P’s, Dr. Binh Tran

Washington AGD

Jan 26, 2019

Anterior Esthetics Layering Composite that Rivals Porcelain, Dr. Kevin Brown

Washington AGD

March 1-2, 2019

Oral Surgery for the G.P’s, Dr. Karl Koerner

Washington AGD & UWSOD

March 29, 2019

Washington AGD, Vendor Fair

Washington AGD & Henry Schein

April 25, 2019

Removable Dentures & RPD, Dr. Nadim Baba

Washington AGD

April 26, 2019

Pediatric Pathology: Oral Diseases in Children, Dr. Oda & Dr. Kutcipal

Washington AGD

April 27, 2019

How to Survive the Worst Day of Your Life, Dr.’s Ogata, Taylor & Baer

Washington AGD

April 27, 2019

Practical Proficiency in Endodontics, Dr. John West

Washington AGD

Washington AGD, www.washingtonagd.org or #253-306-0730 Seattle King County Dental Society, www.skcds.org or #206-443-7607 Pierce County Dental Society, www.pcds.org or #253-274-9722 Snohomish County Dental Society, www.scdentists.org or #360-419-7444

26 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

CONTINUING EDUCATION

8.23.2018 THE THRIVING FEE FOR SERVICE PRACTICE IN 2018: MAINTAINING INDEPENDENCE & PROFITABILITY A CLASS FOR THE ENTIRE DENTAL TEAM LOCATION:

SPEAKER: Dr. Steven Rasner

Washington AGD Educational Center 19415 International Blvd, #410, SeaTac, WA 98188

DATE: Thursday, August 23, 2018 TIME: 6:00 PM to 9:00 PM TUITION: $120 per Attendee

POINTS OF DISCUSSION:

SUBJECT CODE: 550 CREDIT HOURS: 2.5 (Lecture) INCLUDED WITH REGISTRATION: Dinner, Parking & all materials

DESCRIPTION: This powerful and inspiring presentation

was designed to provide a real world answers for breaking away from third-party carriers and regaining your independence. Drawing from the experience gained in 30 consecutive years of increased growth and profitability, Dr. Rasner explains the protocols and foundations that can elevate any dental practice to extraordinary levels of success. Protocols that will motivate patients to go out of network for your services, guaranteed. Practice management strategies that skyrocket case acceptance and increase cash. Protocols to decrease the bumps in your day. Use it on Monday production-enhancing clinical gems including enteral sedation, atraumatic extractions and an intro to surgical and prosthetic implant dentistry.

Leadership principles that have kept his staff of 21 together for an average of 17 years, without going broke! The psychology of winning: the mental toughness we all need to bounce back from that bad week. Lastly, where balance fits into the dynamic of success. How the super achiever can give back to the world and not miss out on the most important parts of the journey: family, and a full life.

FOR MORE INFORMATION:

Valerie Bartoli Washington AGD 253-306-0730 washingtonagd1@yahoo.com

■■ ■■ ■■ ■■ ■■ ■■

The Fail-Proof Blueprint for the new graduate

■■

Why patching that filling, bonding with the new patient, & waiting to present comprehensive care down the road is killing your practice

■■

The hidden jewels: the $250,000 that 99% of practices leave on the table each year

■■

Protocols: what they are and why you’ll never grow without them

■■ ■■

The weakest link to your profitability

■■

How to keep staff with you for many years without going broke

■■

Why most practices waste marketing dollars chasing the wrong market and more....

The Fail-Proof Blueprint for the stagnant practice Four simple principles for 90% case acceptance The art of getting paid up front Real world ways to reduce overhead What you need to become a superstar when you weren’t born one

How to solve any problem in your day in the fewest possible steps

TO REGISTER: Phone: 253-306-0730 or Online: Washingtonagd.org

As a Non-Profit entity, Washington AGD does not endorse, partner or solely support companies, products or speakers, but rather recognizes speakers, products and sponsors for their services to our Washington AGD educational program, do not necessarily state or reflect those of the Washington AGD. Washington AGD Approved PACE Program Provider #219331 FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry, AGD or WAGD endorsement. Washington AGD PACE Provider (6/1/2018-5/31/2024).

SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 27

CONTINUING EDUCATION

8.24/25.2018

ATRAUMATIC EXTRACTIONS FOR THE G.P. LOCATION:

SPEAKER: Dr. Steven Rasner

Washington AGD Educational Center 19415 International Blvd, #410, SeaTac, WA 98188

DATE: August 24 & 25, 2018 TIME: 8:00 AM to 5:00 PM TUITION: AGD Members: $895 Non-AGD Members: $995 Active Military Dentists w/proof of Military ID: $805.50

SUBJECT CODE: 310 CREDIT HOURS: 16 (Lecture & Participation) INCLUDED WITH REGISTRATION: Breakfast, Lunch, Parking & all materials

DESCRIPTION: Is it possible to master in two days multiple surgical procedures that you’re currently referring out? The answer is a resounding yes. This action-packed two-day class, will provide a stepby-step blueprint for success at a wide array of oral surgical procedures. It will be a question-inviting atmosphere. From pre-op patient preparation to scheduling to post-op instructions, you will leave prepared to return to your practice and immediately provide these procedures.

The course has been carefully designed to integrate didactic, audio and visual aids, and extensive handson attendee participation with a wide range of procedures for each individual.

FOR MORE INFORMATION:

Valerie Bartoli Washington AGD 253-306-0730 washingtonagd1@yahoo.com

28 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

DIDACTIC:

■■ ■■ ■■ ■■ ■■ ■■ ■■

Safe patient selection

■■ ■■ ■■ ■■

Teeth with immediate implant placement

Oral sedation protocol Antibiotic coverage Atraumatic extractions Teeth broken below the gingiva Multiple extractions Teeth adjacent to delicate esthetic restorations Socket grafting A review of angiogenesis Surgical implant surgery introduction Suturing 101: Interrupted, Continuous, Horizontal & Vertical Mattress: Where When – How Case presentation and fees

TESTIMONIAL: Dr. Frank Spear “Steve is a living example of what happens when intensity coupled with his ability to motivate both staff and patients are put into motion.”

TO REGISTER: Phone: 253-306-0730 or Online: Washingtonagd.org

As a Non-Profit entity, Washington AGD does not endorse, partner or solely support companies, products or speakers, but rather recognizes speakers, products and sponsors for their services to our Washington AGD educational program, do not necessarily state or reflect those of the Washington AGD. Washington AGD Approved PACE Program Provider #219331 FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry, AGD or WAGD endorsement. Washington AGD PACE Provider (6/1/2018-5/31/2024).

12 SESSIONS STARTING ON

9.07.2018

COMPREHENSIVE HANDS-ON ORTHODONTIC PROGRAM FROM DAY ONE, YOU WILL BE TREATING PATIENTS IN A CLINICAL SETTING! CLINICAL FACULTY: Dr. Binh Tran, DDS. MAGD & Lily Stefoglo, EFDA DATES: Friday 2018: September 7, October 5, November 2, December 7, January 11,

2019, February 1, March 1, April 5, May 3, June 7, July 12 & August 2, 2019

■■ Orthodontic supplies ordering and managing

TIME: 9:00 AM to 6:00 PM

inventory

LOCATION: Washington AGD Educational Center

■■ ■■ ■■ ■■

19415 International Blvd, #410, SeaTac, WA 98188

TUITION: AGD Member Dentist $12,000, Non-AGD

Member Dentist: $14,000 (Payment Plans Available) Staff Tuition: AGD Member Staff with Dentist: $2000 & Non-AGD Member Staff with Dentist: $4000 (includes: Lunch, Live Patients and On Site Materials)

Post treatment retention and monitor Surgical and TAD in Orthodontic.

Pediatric to Geriatric orthodontics.

A training manuals are in digital format/Flash Drive and related reference papers is included.

■■ Attendee will be trained in how to start

SUBJECT CODE: 370

orthodontic service in their office.

CREDIT HOURS PER SESSION: 8 (Participation)

■■ Attendee will treat and present a minimum of

COURSE CONTENT/OBJECTIVES:

■■ Attendee is requested to start treatment in

two of Dr. Tran patients.

Total Hours = 96

their own office and present those cases.

■■ Dentists will be provided 2 “Live” patients from

initial consultation to final retainer delivery and monitor: Initial orthodontic examination and comprehensive treatment plan.

■■ Orthodontic records and management system ■■ Photography and Case presentation ■■ Orthodontic Office and Financial management system

■■ Ceph Analysis and FACE principles ■■ Orthodontics Principles and Mechanics for Angle class 1,2, and 3

■■ Clinical Orthodontic practice: from banding to debanding.

FOR MORE INFORMATION:

Valerie Bartoli Washington AGD 253-306-0730 washingtonagd1@yahoo.com

■■ Monthly quiz and a final exam will be given to confirm learned concepts

■■ Final Plaque and Certificate presentation with Dinner (spouse invited)

TESTIMONIALS Dr. Binh Tran has been an exceptional instructor. He teaches, motivates and inspires us to achieve our goal – as students and in dentistry. He is the only instructor that I know who is available to answer our questions and guide us throughout the course.

TO REGISTER: Phone: 253-306-0730 or Online: Washingtonagd.org

As a Non-Profit entity, Washington AGD does not endorse, partner or solely support companies, products or speakers, but rather recognizes speakers, products and sponsors for their services to our Washington AGD educational program, do not necessarily state or reflect those of the Washington AGD. Washington AGD Approved PACE Program Provider #219331 FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry, AGD or WAGD endorsement. Washington AGD PACE Provider (6/1/2018-5/31/2024).

SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 29

CONTINUING EDUCATION

9.07.2018 DENTAL FORENSICS: A PRIMER FOR VOLUNTEERS SPEAKERS: Dr. Kyle Tanaka

Dr. Timothy Hess

Dr. Gary Heyamoto

DATE: Friday, September 7th, 2018 TIME: 9:00 AM to 5:00 PM LOCATION:

Washington AGD Educational Center 19415 International Blvd, #410, SeaTac, WA 98188

TUITION: $199 per Dentists and Staff SUBJECT CODE: 145 CREDIT HOURS: 7 (Lecture & Participation) INCLUDED WITH REGISTRATION:

Light Breakfast, Lunch, Parking & all materials

COURSE LOGISTICS:

Registration: 8:30 – 9:00am Time: 9:00am to 5:00pm Lunch: 12:00am to 1:00pm

COURSE DESCRIPTION: Dentists have played

very important roles identifying victims of major catastrophes, such as natural disasters, airplane crashes, and terrorist activities. Dental professionals were integral in identifying victims

of such tragedies as the Oklahoma City Federal Building bombing, the 911 World Trade Center attacks, the bombing of Pan Am Flight 103 and locally, the 2014 Oso, Washington landslide.

Dental professionals have an unique skill set that makes them indispensable to the medical examiner or coroner’s office. With some basic training and credentials, the dental professional will be qualified to volunteer to assist in future emergencies.

This course will focus on the use of the WinID program. WinID is a dental computer software that can assist forensic odontologists’ human identification efforts. WinID makes use of dental and anthropometric characteristics to rank possible matches. Participants are encouraged to download and install a copy of WinID from the American Board of Forensic Odontology (ABFO) on a Windows based computer prior to the course, found at www.washingtonsgd.org.

TO REGISTER: Phone: 253-306-0730 or Online: Washingtonagd.org

FOR MORE INFORMATION:

Valerie Bartoli Washington AGD 253-306-0730 washingtonagd1@yahoo.com

30 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

As a Non-Profit entity, Washington AGD does not endorse, partner or solely support companies, products or speakers, but rather recognizes speakers, products and sponsors for their services to our Washington AGD educational program, do not necessarily state or reflect those of the Washington AGD. Washington AGD Approved PACE Program Provider #219331 FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry, AGD or WAGD endorsement. Washington AGD PACE Provider (6/1/2018-5/31/2024).

SESSIONS STARTING ON

9.20.2018

2018-2019 MASTERTRACK! The Washington AGD is dedicated to providing you with a first-class continuing

dental education in a setting that is friendly, warm, and supportive. Our program is for those dentists, AGD member or Non Members that are seeking a wellbalanced interdisciplinary post graduate education.

DATES: September 20-23, November 15-18, January 24-27 & April 25-27 TIME: 8:00 AM-5:00 PM LOCATION: Washington AGD Educational Center 19415 International Blvd, #410, SeaTac, WA 98188

TUITION: $5,000 AGD Member Dentist and Non-

AGD Member Dentist: $6,000

SUBJECT CODE: Multi Coded CREDIT HOURS: 96 (Lecture & Participation) AUDIENCE: Open to ALL Dentists SPEAKER LINE-UP FOR 2018

■■ Thursday, September 20: Dr. Alan Yassin “Mastering Your Surgical Skills”

■■ Friday, September 21: Dr. Alan Yassin “Seattle King County Clinic” Oral Surgery-Day 2

■■ Saturday, September 22: Dr. Alan Yassin “Prosthodontics” The Implant Focus!

■■ Sunday, September 23: Masters Case Presentation

■■ Thursday, November 15: Susan Gunn “Organize & Keep Patient Revenue”

■■ Friday, November 16: Dr. Brian Novy “Wholly Molar”

■■ Saturday, November 17: Dr. Peter Ungar

“Evolution’s Bite, A Story of Teeth, Diet, and Human Origins”

SPEAKER LINE-UP FOR 2019

■■ Thursday, January 24: Dr. Simon Prior “Local Anesthesia Part 2: Technical Considerations” Local anesthesia course with hands on component”

■■ Friday, January 25: Dr. Simon Prior “Medical Emergencies”

■■ Saturday, January 26: Dr. Binh Tran & Ortho Residents, “Comprehensive Orthodontic Treatment for the G.P.”

■■ Sunday, January 27: Masters Case Presentation

■■ Thursday, April 25: Removable Dentures & RPD Course with Dr. Nadim Baba

■■ Friday, April 26: Dr. Dolphine Oda & Dr. Libby

Kutcipal “Pediatric Pathology: Most Common Oral Diseases in Children”

■■ Saturday, April 27: Dr. Greg Ogata, Dr. Barry

Taylor, Dr. Ted Baer) “How to Survive the Worst Day of Your Life”!

■■ Sunday, April 28: Masters Case Presentation & UWSOD Dental Student Case

TO REGISTER: Phone: 253-306-0730 or Online: Washingtonagd.org

■■ Sunday, November 18: Masters Case Presentation

FOR MORE INFORMATION:

Valerie Bartoli Washington AGD 253-306-0730 washingtonagd1@yahoo.com

As a Non-Profit entity, Washington AGD does not endorse, partner or solely support companies, products or speakers, but rather recognizes speakers, products and sponsors for their services to our Washington AGD educational program, do not necessarily state or reflect those of the Washington AGD. Washington AGD Approved PACE Program Provider #219331 FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry, AGD or WAGD endorsement. Washington AGD PACE Provider (6/1/2018-5/31/2024).

SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 31

CONTINUING EDUCATION

9.21.2018

EMPOWERING DENTAL ASSISTANTS, DIGITAL PHOTOGRAPHY & WATERLINE MAINTENANCE, A HANDS-ON WORKSHOP! SPEAKERS: Kevin Henry & Tija Hunter DATE: September 21, 2018 TIME: 9:00 AM-4:00 PM TUITION: $99: DA, RDA, CDE, EFDA &

CREDIT HOURS: 6 (Lecture & Participation) AUDIENCE: Open to Dentists, Dental Assistants, CDA & EFDA LOCATION: Washington AGD Educational Center

SUBJECT CODE: 550

or Online: Washingtonagd.org

Dental Students, $199: Dentist

19415 International Blvd, #410, SeaTac, WA 98188

TO REGISTER: Phone: 253-306-0730

Our Speaker, Kevin Henry has seen a lot of mistakes made by dental practices around the country. Some have caused a practice to lose team members. Some have caused a practice to lose a significant amount of money. One even cost a dentist his license. Learn how to avoid the mistakes these practices made in this fast-paced, informative lecture.

COURSE OUTLINE WITH KEVIN HENRY AND TIJA HUNTER

■■ ■■ ■■ ■■

9:00 AM-10:30 AM “Empowerment in the morning – 5 mistakes dental assistants make … and how to avoid them” 10:30 AM-Noon, “Waterline maintenance refresher course and best practices” Lunch: 12:00 PM-1:00 PM “Sponsored by DTSS” 1:00 PM-4:00 PM “Digital photography Hands-on course”.

Focusing on best practices, tips for best photos, how to use them in case presentation, etc.

Tija Hunter has more than 37 years of dental chairside experience. She is the office manager and chairside assistant to Dr. Eric Hurtte of O’Fallon Missouri. Named one of the Top 25 Women in Dentistry/2015 by Dental Products Report Magazine, she is a former Vice President of the American Dental Assistants Association (2016/2017) where she holds the honor of Master. Editorial board member for Dental Products Report Magazine, contributor to Dental Products Report, Dental Assisting Digest, and Dental Economics Magazines, and IgniteDA. Director of the Dental Careers Institute with five locations in the United States and author of six CE study courses.

FOR MORE INFORMATION:

Valerie Bartoli Washington AGD 253-306-0730 washingtonagd1@yahoo.com

32 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

As a Non-Profit entity, Washington AGD does not endorse, partner or solely support companies, products or speakers, but rather recognizes speakers, products and sponsors for their services to our Washington AGD educational program, do not necessarily state or reflect those of the Washington AGD. Washington AGD Approved PACE Program Provider #219331 FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry, AGD or WAGD endorsement. Washington AGD PACE Provider (6/1/2018-5/31/2024).

SESSIONS STARTING ON

9.22.2018

2018-2019 FELLOWTRACK! The FellowTrack program is an interdisciplinary hands-on education targeted towards new dentists looking for a perfect opportunity to educate themselves!

DATES: September 22-23, November 17-18, January 26-27 & April 27-28 TIME: 9:00 AM-5:00 PM LOCATION: Washington AGD Educational Center, 19415 International Blvd, #410, SeaTac, WA 98188 (FellowTrack Room)

AUDIENCE: Open to ALL Dentists

SPEAKER LINE-UP FOR 2018-2019

TUITION: $2500 AGD Member Dentist and Non-AGD

Member Dentist: $3500 (Payment Plans Available

SUBJECT CODE: Multi Coded CREDIT HOURS: 48 (Lecture & Participation) Offering an opportunity to interact and learn from

our seasoned MasterTrack Dentists. Program topics are carefully selected to fit the interests of the progressive dentist and the fast changing dental landscape.

The FellowTrack program will meet four times a year on Saturday & Sunday starting September 2018.

Each session will offer 12+ credits and as an added bonus, each session runs concurrently with our MasterTrack program. This gives participants of our FellowTrack program the opportunity to collaborate with seasoned dentists that are earning their way to

■■ September 22 & 23, 2018

Subject: 550 “Protecting Your Patients & Your Practice from, Cyber Ransomware”, Speaker, Terre Harris, Harris BioMedical

■■ November 17 & 18, 2018

Subject: 130 “The Hygiene-Dentists Healthcare Team, You Are Not Alone”, Speaker, Dr. Kevin Kwiecien

■■ January 26 & 27, 2019

Subject: 780 “Anterior Esthetics Layering Composite that Rivals Porcelain” Dr. Kevin Brown

■■ April 27 & 28, 2019

Subject: 070 “Practical Proficiency in Endodontics”, Speaker, Dr. John West & DENTSPLY Endodontics.

TO REGISTER: Phone: 253-306-0730 or Online: Washingtonagd.org

Mastership with the AGD. Then on Sunday’s, case presentations are done by the MasterTrack dentists and are open for group discussion on how they treatment plan and what they are doing progressively throughout the treatment.

Our Masters always look forward to our Sunday presentations to discuss with each other their success and failures.

FOR MORE INFORMATION:

Valerie Bartoli Washington AGD 253-306-0730 washingtonagd1@yahoo.com

As a Non-Profit entity, Washington AGD does not endorse, partner or solely support companies, products or speakers, but rather recognizes speakers, products and sponsors for their services to our Washington AGD educational program, do not necessarily state or reflect those of the Washington AGD. Washington AGD Approved PACE Program Provider #219331 FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry, AGD or WAGD endorsement. Washington AGD PACE Provider (6/1/2018-5/31/2024).

SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 33

CLINICAL IMPLANTOLOGY CONTINUUM SEPT 2018 ­­— JUNE 2019 CONTINUING 5.18.2018 SEATTLE, WA EDUCATION

1 YEAR/10 SESSION HANDS-ON, CADAVER AND LIVE SURGERY CERTIFICATE

300 CONTINUING EDUCATION HOURS

ALAN YASSIN DDS MS MSD COURSE DIRECTOR

Periodontist and Oral Surgeon Fellow, International Association of Oral & Maxillofacial Surgeons Clinical Instructor/University of Washington Diplomate, American Board of Periodontology eligibility Diplomate, German Board in Oral Implantology DGZI

Dr. Yassin is dual trained dentist in both Periodontics and Oral & Maxillofacial Surgery.

He received his master’s degree in Oral and Maxillofacial Surgery in 2006 and his second master’s degree in Periodontics in 2017 from University of Washington in Seattle.

Since his graduation from the Dental School at the University of Aleppo/Syria in 2001, Dr. Yassin has been practicing dentistry and oral surgery in private practices, hospitals and academic institutions. Currently he is practicing periodontics and implant dentistry in Washington State, dividing his time between Seattle, Bellingham and Tacoma.

Besides his outstanding academic and clinical skills, Dr. Yassin is also committed to his passion for teaching, sharing expertise with his students and colleagues. From serving as a clinical attending in the Oral Surgery Departments at Damascus Hospitals for 5 years, to his recent position as affiliate faculty at the Periodontics Department of the University of Washington, Dr. Yassin lectures on esthetics and advanced implant surgery at national and international conferences and symposiums, in addition to extensive online courses and webinars.

LAYLA YASSIN DDS MS COURSE CO-DIRECTOR Clinical instructor, affiliate faculty in the OMS Department at the University of Washington Member of the American Association of Oral and Maxillofacial Surgeons.

Member of the American Academy of Implant Dentistry AAID.

ALAN YASSIN, DDS MS MSD, DIRECTOR LAYLA YASSIN, DDS MS, CO-DIRECTOR

With Other Multi Specialty Faculty Members To learn more about our faculty members and curriculum, visit:

www.WashingtonAGD.org

As a Non-Profit entity, Washington AGD does not endorse, partner or solely support companies, products or speakers, but rather recognizes speakers, products and sponsors for their services to our Washington AGD educational program, do not necessarily state or reflect those of the Washington AGD. Washington AGD Approved PACE Program Provider #219331 FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry, AGD or WAGD endorsement. Washington AGD PACE Provider (6/1/2018-5/31/2024)

34 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

COURSE DESCRIPTION:

We are proud to offer the first, local, one year/10 session course; “Washington Academy of General Dentistry Clinical Implantology Continuum”, a hands-on and live surgery certificate, where you can learn from our highly skilled faculty members, periodontists, prosthodontists, implantologists and oral surgery experts, gaining an indepth experience in implantology to bring your surgical and clinical skills in implant dentistry to the next level.

Course runs from September through June at WA AGD Seattle center. Each in-house module will be 2-3 days per weekend and participants will learn about and practice with three implant systems through 300 CE hours.

Program includes 65 planned surgeries, with each participant completing a minimum of two surgeries, several hands-on sessions, and two full days of hands-on surgical experience in the Cadaver Lab at the University of Washington. Participants will master basic and advanced concepts in implant dentistry with an Inclusive perspective in implantology fundamentals and an evidence-based clinical approach.

COURSE HIGHLIGHT:

■■ ■■

300 continuing dental education hours.

■■

Learn: Treatment planning, surgical placement, & restoration of implants.

■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■

Ten, 3-day weekend sessions spread out over 1 academic year.

(September to June).

Seminar, hands-on & surgical intensive training.

Clinically oriented course with more than sixty-five planned surgeries.

Each participant will perform minimum of 2 live surgeries under direct supervision.

Two full days of cadaver training at the University of Washington Anatomy Lab. Various background faculty members.

Comprehensive interdisciplinary treatment planning approach.

Each participant will restore his/her case during the course.

All inclusive, no hidden fees for implant surgeries or restorative phases.

Three dental implant systems (Straumann, Biohorizons, Hiossen).

Purchase of any implant system is NOT required.

5 high end dental clinics at the WA AGD educational facility located in Seattle.

Limited attendance, Maximum of 30 participants per course Doctors are strongly encouraged to operate on their own patients.

Dental assistant training by certified surgical assistants.

In-depth review of anatomy, pharmacology, and management of medically compromised patients.

Networking dinner on each session to build your own support network for future collaboration.

Pursue an AGD recognized certificate in implant dentistry training.

A first step towards further advanced dental implant credentialing.

Out of state dentists are eligible to obtain a provisional educational license Proof of malpractice insurance is required.

The course is designed for dentists with a current US license.

Reasonable payment plans are available.

COURSE DATES & OUTLINE:

Module 1 (September): INTRODUCTION TO IMPLANT DENTISTRY

FRIDAY 14TH Seminar: biomechanics, anatomy SATURDAY 15TH Implant systems introduction / Half day Hands on, all systems (Plastic Jaws)

Module 2 (October): TREATMENT PLANNING & BASIC SURGICAL SKILLS FRIDAY 12TH Seminar: Interdisciplinary Treatment planning SATURDAY 13TH Seminar: Basic surgical skills SUNDAY 14TH Cadavers Hands on at the UW (Surgical skills)

Module 3 (November): IMPLANT SURGERY: PRINCIPALS

FRIDAY 9TH Seminar: Implant surgery, Ridge Preservation SATURDAY 10TH Cadavers Hands on at the UW (Implant placement, all 3 implant systems) SUNDAY 11TH LIVE 8-10 SURGERIES

Module 4 (December): DIGITAL IMPLANT DENTISTRY

FRIDAY 14TH Seminar: Surgical/Restorative Digital Implantology SATURDAY 15TH Full day Hands on guided surgery/Digital planning on Software & PLASTIC JAWS SUNDAY 16TH LIVE 8-10 SURGERIES

Module 5 (January): OSSEOUS AUGMENTATION

FRIDAY 18TH Seminar: Bone grafting, Sinuslifting SATURDAY 19TH Full day Hands On, Bone graft PIG HEADS SUNDAY 20TH LIVE 8-10 SURGERIES

Module 6 (February): SOFT TISSUE MANAGEMENT

FRIDAY 8TH Seminar: Soft tissue augmentation SATURDAY 9TH Full day Hands on, CTG FGG PIG JAWS SUNDAY 10TH LIVE 8-10 SURGERIES

Module 7 (March): RESTORATIVE IMPLANT DENTISTRY

FRIDAY 8TH Seminar: Prosthetic concepts – Half day Hands on/Impressions PLASTIC JAWS SATURDAY 9TH LIVE 8-10 SURGERIES

Module 8 (April): IMPLANTS IN THE ESTHETIC ZONE

FRIDAY 5TH Seminar: Immediate Implant – Half day Hands on implants PIG JAWS SATURDAY 6TH LIVE 8-10 SURGERIES

Module 9 (May): FULL ARCH SOLUTIONS

FRIDAY 10TH Seminar: Fixed vs Removable – Half day Hands on Hybrid restorations PLASTIC JAWS SATURDAY 11TH LIVE 8-10 SURGERIES

Module 10 (June): COMPLICATIONS IN IMPLANT DENTISTRY

FRIDAY 14TH Seminar: complications – Half day Hands on Periimplantitis PLASTIC JAWS SATURDAY 15TH – Implant Dentistry Business/Insurance Codes, Wrap up & Exam

COURSE TUITION:

LOCATION:

Payment plan available through Wells Fargo with: No setup fee, Reasonable interest rate. For more information: Contact Sabrina Morrow (Wells Fargo Healthcare Development Manager PNW 206-755-1790

Valerie Bartoli • Washington AGD • 253-306-0730 washingtonagd1@yahoo.com • www.WashingtonAGD.org

AGD Member Dentist with 1 Dental Assistant: $21,950 NON Member Dentist with 1 Dental Assistant: $23,950 Additional Dental Assistant Tuition: $2000 per Assistant

Washington AGD Educational Center 19415 International Blvd, #410, SeaTac, WA 98188

FOR REGISTRATION AND INFORMATION:

SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 35

AGD Member MEMBERBenefits BENEFITS The Academy of General Dentistry (AGD) is the only organization that exclusively represents the interests and serves the needs

The Academy of General Dentistry (AGD) is the only organization that exclusively of the general dentist. Start taking advantage of our member represents the interests and serves the needs of the general dentist. Start taking benefits today—join the AGD by visiting www.agd.org or calling advantage of our member benefits today—join the AGD by visiting www.agd.org 888.AGD.DENT (888.243.3368). or calling 888.AGD.DENT (888.243.3368).

Continuing Education

Discover quality continuing education (CE) opportunities—at both the local and national level, and in a variety of formats—to help you provide the best patient care, learn about the latest technologies and procedures, and emerge as the educated voice of general dentistry. Plus, you can submit CE to the AGD in a variety of convenient ways—via the Web, email, mail, or fax—and we’ll track your courses with our members-only CE transcripts.

Achievement Awards

Stand out among the competition, gain instant credibility in your profession, and establish your commitment to lifelong learning and quality patient care with the prestigious AGD Fellowship and Mastership awards, the only achievement-based awards in general dentistry.

Advocacy and Representation

Join the organization that serves as the voice of general dentistry. The AGD ensures that general dentists and supporters of the profession can speak up when it matters most, helping members unite their voices on legislative and regulatory activities affecting their right to practice within the United States.*

Annual Meeting

Take advantage of discounted registration to the AGD’s annual meeting, where you can earn CE, checkout the latest products and technology, and network with your colleagues.

Practice Tools

Access a variety of tools to help you manage your practice more efficiently: Check the AGD Product Review Directory before you buy, download sample consent, employee, and practice policy forms from the AGD’s Practice Management Library, and get personalized assistance with third party payer problems, as well as free insurance contract analysis.

888.AGD.DENT

Career Tools

Take advantage of the AGD Marketplace & Career Center, where dental connections are made. Search available job listings, buy a practice or equipment, post your own résumé at no cost, and find additional resources to help you plan for your next career move.

Patient Resources

Get enrolled in the Find an AGD Dentist directory, which is searchable by prospective patients through KnowYourTeeth. com, the AGD’s consumer-facing website. You also may direct your current patients to learn more about their oral health through www.2min2x.org, an educational website created by the Partnership for Healthy Mouths, Healthy Lives—of which the AGD is a proud member—and the Ad Council. Plus, offer educational reading materials in your waiting room with AGD oral health fact sheets, which cover a range of topics and are customized with your practice information.

Publications and Media

Stay informed on the latest general dentistry news and research with complimentary subscriptions to the AGD’s awardwinning print publications, AGD Impact and General Dentistry, along with extra content available exclusively in the digital editions. You also can listen to the AGD Podcast series and read our blog, The Daily Grind.

Member Savings

Receive immediate access to the AGD Member Savings & Offers program, which provides you with exclusive savings and special offers on the personal and professional products and services you need most. *Canadian dues rates reflect limited advocacy benefits.

membership@agd.org

36 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

www.agd.org

PROMOTIONAL CODE: _______________

REFERRAL INFORMATION If you were referred to the AGD by a current member, please note his or her information below:

Member’s name

2018 AGD Membership Application

City, state/province, or U.S. Federal Services branch

Join online at agd.org, or call us at 888.243.3368 or 312.440.4300.

MEMBER INFORMATION First name

MI

Last name

Designation (e.g. DDS, DMD, BDS)

Do you currently hold a valid U.S./Canadian dental license? ¨ No Type of membership: (Check one.) ¨ Active general dentist

Date of birth (mm/dd/yyyy) Required for access to the members-only sections of the AGD website

¨ Yes: ________________________________________________________________________ License number

State/province

¨ Associate (dental specialist)

¨ Resident

Date renewed (mm/yyyy)

¨ Dental student

¨ Affiliate

If you are not in general practice, please indicate your specialty: __________________________________________________________________________________ Current dental practice environment: (Check one.) ¨ Solo ¨ Associateship ¨ Other ____________________________________

¨ Group practice ¨ Hospital

¨ Faculty ___________________________________ Please indicate institution

¨ Resident

¨ Corporate

¨ Federal Services ___________________________ Please indicate branch

If you are a member of the Canadian Forces Dental Service, please indicate your preferred constituent: ¨ U.S. military counterpart ¨ Local Canadian constituent

CONTACT INFORMATION

Preferred billing/mailing address: ¨ Business ¨ Home Preferred method of contact: ¨ Email ¨ Mail ¨ Phone

Your AGD constituent is determined by your business address, unless one is not available.

Business address

City

Name of business (If applicable)

State/province

ZIP/postal code

Phone

Fax

ZIP/postal code

Home address

City

State/province

Phone

Primary email

Website address

EDUCATIONAL INFORMATION Dental school

Are you a graduate of an accredited* U.S./Canadian dental school? ¨ Yes

State/province

Country

Are you a graduate of (or resident in) an accredited** U.S. or Canadian postdoctoral program? ¨ Yes ¨ No ¨ Currently enrolled Type: ¨ AEGD ¨ GPR ¨ Other Postdoctoral institution

State/province

Date of graduation (mm/yyyy)

Country

Start date (mm/dd/yyyy)

¨ Other

Search “Academy of General Dentistry” to connect with us on:

DUES INFORMATION

PAYMENT

Please check membership type applying for: U.S./ Canada ¨ Active General International (in Canadian dollars) Puerto Rico Dentist ...................................... $392 ............................$434 ............................... $324 ¨ Associate ................................... 392 .............................. 434 .................................. 324 ¨ Affiliate........................................ 196 .............................. 217 .................................. 162 ¨ Resident ........................................ 78 ................................. 89 ..................................... 65 ¨ 2017 Graduate .......................... 78 ................................. 89 ..................................... 65 ¨ 2016 Graduate ....................... 156 .............................. 174 .................................. 130 ¨ 2015 Graduate ....................... 236 .............................. 260 .................................. 194 ¨ 2014 Graduate ....................... 314 .............................. 347 .................................. 259 ¨ Dental Student.......................... 17 ................................. 22 ..................................... 17

¨ Check (enclosed) ¨ Visa ¨ MasterCard ¨ American Express

0 Total Amount Enclosed:............................................................... $________ Dues rates effective through September 30, 2018.

End date (mm/dd/yyyy)

Stay Social With the AGD!

Gender: ¨ Male ¨ Female Ethnicity: ¨ American Indian ¨ Asian ¨ African-American ¨ Hispanic ¨ Caucasian I am interested in participating in the AGD Mentor Program as a: ¨ Mentor ¨ Mentee

Please refer to back side for constituent dues.

¨ Currently enrolled

*Official accreditation is given by CODA in the U.S. and CDAC for all Canadian provinces. **Accredited dental residencies qualify for the resident membership rate. Official proof of enrollment must be provided to AGD.

OPTIONAL INFORMATION

1. AGD Headquarters Dues: .................................................................... $________ 2. AGD Constituent Dues: ........................................................................ $________

¨ No

Note: Payments for Canadian members can only be accepted via Visa, MasterCard, or check.

Expiration date (mm/yyyy)

Please print name as it appears on the card.

I hereby certify that all of the above information is correct, and that by signing this application agree to all terms of membership including completion of 75 hours of continuing education every three years for active general dentist and associate members.

Signature

Return this application with your payment to: Academy of General Dentistry, 560 W. Lake St., Sixth Floor, Chicago, IL 60661-6600.

If paying by credit card, fax to 312.335.3443.

Date SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 37

For more information, visit www.agd.org/savings.

AGD Marketplace & Career Center The place where dental connections are made.

AGD Marketplace & Career Center: A 20 percent discount on online postings

All-Star Dental Academy:

$400 discount on dental team online training program

CareCredit: Offices can enroll for only $25 to offer patient financing Dentist’s Advantage:

A free year of professional liability coverage for new graduates, 10 percent discount on premium for AGD members, 15 percent discount on premiums for AGD Fellows, and 20 percent discount on premiums for AGD Masters

Dental Card Services Alliance:

Free terminal and no termination fee for AGD members on credit card processing

Earnest:

$400 welcome bonus for refinancing student load debt

Engel Institute:

A 5 percent discount on implant training courses

Hagan Barron Intermediaries:

Discounts on health, life, disability, and other personal insurances

Healthy Paws: 10% discount on policy premium to insure your pet Hotel Storm:

Exclusive savings on hotels - up to 55% off other travel sites

Liberty Mutual Insurance:

Discounts on auto and home insurance

Officite:

Up to a 40 percent discount on website, social media marketing, and search engine optimization services

The Online Practice:

Up to a 50 percent discount on website templates and online visibility services

Solutionreach:

$1 activation fee and additional subscription discounts on patient relationship management tools

Vatech America:

Discounts on training, support, and education with the purchase of a 2-D or 3-D digital imaging scanner

Virgin Hotels Chicago:

A rate of $155 to $220 per night for a room and a 20 percent discount on suites

38 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | SUMMER 2018

YOUR VOICE FOR EXCELLENCE THROUGH EDUCATION AND ADVOCACY

PACE Approval Representative: Linda Edgar, DDS 220 292nd Street, Federal Way, WA 98023 Office: 206-940-6112 Email: drlinda@edgardds.com Fax: 253-517-8766

APPLYING FOR PACE APPROVAL Approval for CE Credits from the Academy of General Dentistry (AGD).

The Academy of General Dentistry (AGD) Program Approval for Continuing Education (PACE) was created to assist members of the AGD and the dental profession in identifying and participating in quality continuing dental education (CDE). PACE approves program provider organizations, not speakers or specific courses. The program provider approval mechanism is an evaluation for the educational processes used in designing, planning, and implementing CE. Approval by the AGD does not imply endorsement of course content, products, or therapies presented, nor does this approval imply that a state or provincial board of dentistry will accept courses. Approved program providers are expected to comply with all relevant state and federal laws. CE offered by approved program providers will be accepted by the AGD for Fellowship/Mastership credit.

GET THE APPLICATION

Go to www.agd.org Click on the Education tab and then PACE Apply/Renew Tab to get the application. To qualify for PACE approval, all organizations should have offered a planned program of CDE activities for at least 12 months.

Note:Â If your organization has not offered a planned program of continuing dental activities during the 12 months immediately preceding the application date, you may apply for a maximum of one year approval.

FEE

AGD Members: If you are an AGD Member or Associate Member (Specialists are Associates) the FEE is $195 for 4 years. Please make your check out to Washington AGD. AGD Members do have access to the AGD membership database.

Non-AGD Members: If you are NOT an AGD Member or Associate Member the FEE is $595 for 4 years. Please

make your check out to Washington AGD. Non-AGD Members do not have access to the AGD membership database. If you would like to become an AGD member, please submit the enclosed membership application along with the membership dues. Please make your check out to the AGD.

YOUR PACE APPLICATION

Two (2) copies of your PACE Application must be mailed to me along with One (1) copy of your membership application with the appropriate checks.

Mail to:

Linda Edgar, DDS Washington AGD PACE Approval Representative 220 292nd Street, Federal Way, WA 98023

You may fill out your form electronically and e-mail it to me at drlinda@edgardds.com.

CE credits that are PACE approved are state approved for the Washington State Continuing Education Requirement If you have questions call me at 206-940-6112.

SUMMER 2018 | WASHINGTON ACADEMY OF GENERAL DENTISTRY | 39

Constituent of the Academy of General Dentistry Valerie A. Bartoli, Executive Director 19415 International Blvd, #410, SeaTac, WA 98188 P 253-306-0730 | F 206-212-4969

Find us online Washingtonagd.org

Follow us on Twitter @AGDWashington

Find us on Facebook facebook.com/WashingtonAGD

Find us on LinkedIn Washington AGD

OUR MISSION: To serve as an advocate for general dentists, to promote improved delivery of patient care by fostering continuing education and to increase public awareness of quality dentistry and those who provide it throughout the State of Washington.