NOVEMBER/DECEMBER 2007 VOL. 40, NO. 2
Bulletin
DEPRESSION
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A Partial Advantage That’s Hard to See
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postsurgical aesthetic aid
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Dr._______________________________ Phone _______________
616.261.9191 800.632.9131 5830 Crossroads Commerce Parkway Wyoming, MI 49509 www.dentalservices.net/davis
Address ________________________________________________ City ______________________ State______Zip________________ E-Mail _________________________________________________ 5830 Crossroads Commerce Parkway Wyoming, MI 49509
Contents Editor
Bruce Weny
Associate Editors
Jeff Smith Tara Meachum Seth Vruggink Aric Smith James Papp
Advertising Editor
Elaine Fleming Executive Secretary WMDDS 511-F Waters Building Grand Rapids, MI 49503 (616) 234-5605 efwmdds@aol.com
West Michigan District Dental Society Executive Board 2007-2008 President Amy De Young President-Elect Doug Killian Vice President Douglas Klein Secretary-Treasurer Joseph Kirkwood Editor Bruce Weny Immediate Past John Frey President Directors Seth Vruggink Larissa Bishop Tyler Wolf Area Representatives Kent County Paul O’Grady Ionia-Montcalm Christopher Morgan County Mecosta County Margaret Gingrich Ottawa County Ryan Lebster MDA IV District Trustees
President’s Message ........................................................................................................2 Editor’s Thoughts...........................................................................................................4 Trustee Report ................................................................................................................6 Depression: A Treatable Illness......................................................................................8 Finding Fulfillment In What We Do...........................................................................10 Community Dental Health Outreach Program .........................................................13 Dentoalveolar Distraction Osteogenesis.....................................................................14 Program Review ...........................................................................................................16 Classified Ads................................................................................................................18
Connie Verhagen Norman Palm
Big Rapids Dental Study Club Officers, 2007-2008 President Erick Perroud Vice President Erick Perroud Secretary Christa Stern Treasurer Erick Perroud
Advertiser Index ...........................................................................................................19 New Member Profiles ..................................................................................................20
Holland-Zeeland Dental Society Officers, 2007-2008 President Ryan Lebster Treasurer Robert Ankerman Secretary Immediate Past President Ionia-Montcalm Dental Study Club Officers, 2007-2008 President-Secretary Lowell Swartz Vice PresidentKirkwood Faber Treasurer Kent County Dental Society Officers, 2007-2008 President Paul O’Grady Vice President Brad Van Hoose Secretary Brant Erbentraut Treasurer David Armbrecht West Michigan Dental Foundation Officers, 2007-2008 President Tom Harmon Vice President Don VanderLinde Secretary Matt Gietzen Treasurer Carl Kruyswyk The Bulletin of the West Michigan Dental Society is published six times a year (Directory issue, Sept./Oct., Nov./Dec., Jan./Feb., Mar./Apr., and May/June). The opinions expressed in The Bulletin are not necessarily the opinions of the West Michigan District Dental Society. Contributions to The Bulletin are welcome and should be addressed to The Bulletin Editor, 255 Washington SE, Grand Rapids, MI 49503. Requests for purchase of advertising space should be directed to the Advertising Editor, Elaine Fleming, (616) 234-5605. The deadline is the 1st of the month prior to publication. © 2007-2008 West Michigan District Dental Society Bulletin
Mission Statement The Bulletin is the newsletter of the WMDDS and its mission is to inform the membership of upcoming and recent events, state & local issues related to dentistry, and as a forum for its officers, representatives, and members to discuss appropriate topics of interest to the membership. Communication & Advertising Policy The Bulletin will publish submitted articles from members and others that relate to the practice of dentistry, small business, social, or political issues affecting dentists, or other subjects of interest to the membership. All published items are subject to space restrictions and the community standards of the WMDDS. The editors reserve the right to reject any article or advertisement deemed inappropriate and to edit submissions as they see fit. Submission & Publication Policy: Articles and advertisements must be submitted no later than the 1st of the month preceding publication date. The Bulletin is published in September/October, November/December, January/February, March/April, May/June, and the fall directory issue. Direct submissions or correspondences to: Dr. Bruce Weny • 255 Washington SE • Grand Rapids, MI 49503 Phone: 616.451.2336 FAX 616.222.1345 • Email: Bweny@aol.com Include “Newsletter” in the subject line
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
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PRESIDENT’S MESSAGE
Colleague Rivalry By Dr. Amy De Young, WMDDS President OSU, my Dad helped me stake up my 8-foot-tall inflatable Wolverine in front of Tom’s office. Tom’s patients and staff seemed to really enjoy that prank, and Tom was a very good sport about all of it. My staff really began to take part in the fun and helping me come up with things to foster our friendly rivalry. Tom and I both put our 8-foot-tall mascots in front of our own offices before the game one year. My Wolverine waved politely at Tom’s Brutus the Buckeye for a few days. However, my staff and I were having difficulties with the brightness of the scarlet and gray of Brutus’ sweater. We decided to make Brutus a veryone has heard of sibling rivalry, but have you Michigan shirt of his very own. I’m still not sure how long it heard of colleague rivalry? That is what I call the funtook Tom to realize that Brutus was rooting for the other filled bantering that takes place between Tom team! The shirt did come off of Brutus … and we haven’t seen Lambert and myself mid-November of each year. Since I it since. moved into this office space in November 2000, I have enjoyed One year we all enjoyed a U of M tailgate party for lunch in “enhancing” the rivalry of our dental alma maters. Many of you Tom’s parking lot. With the music blasting and the maize and are aware that I graduated from the University of Michigan blue being very prominently and Tom graduated from Ohio displayed, our staff members State University. While I am were able to enjoy some lunch sure that we both received wonand some fun – even if it was at derful dental educations, the Dr. Lambert’s expense. Later rivalry of the football teams of that same afternoon, a small but these two power-house schools mighty marching band serepredates all of us. naded Dr. Tom with the U of M I guess it all started when fight song. I kind of thought we (fortunately) Michigan beat may have taken it too far at that OSU in November of 2000. I point, but Tom just laughed had just started practice right about it. Lots of Buckeye nuts across the street from Tom and and gigantic bunches of scarlet could not resist the opportunity and gray balloons have made to announce my presence in the their way into my office as well. vicinity. On the Monday follow- Brutus the Buckeye beats up a poor, defenseless Wolverine. But my favorite prank was the ing the big game, I hung my photos that were emailed to me “anonymously” of Brutus the University of Michigan shower curtain in my front window Buckeye beating up on a poor, defenseless Wolverine. and left a message at Tom’s office with the U of M fight song We have delivered goodies such as M and M candies in the playing at a noticeable level. I told Tom that I was glad to be team colors. Of course the scarlet and gray ones somehow got in the area and hoped he felt the same way. That afternoon I all smashed up before they were delivered. I wonder how that received a basket full of scarlet and gray goodies. This was cerhappened? Rice Krispie treats dyed maize and shaped like a tainly the start of a friendship and rivalry that would prove to block M, a cookie cake with lots of maize and blue frosting be the source of many laughs over the next several years. (guess what all their tongues looked like after eating that … In the years that followed, there were many pranks played hee hee hee), a pizza with a block M of pepperoni, the back and forth. One of the years that U of M managed to beat
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WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
PRESIDENT’S MESSAGE
wonderful chocolate and peanut butter Buckeye candies, and even breakfast consisting of “Buckeye O’s” cereal have all been part of the menu over the last several years. I feel quite fortunate that Tom does not seem to like to rub in the fact that in the eight years that we have had this “friendly rivalry,” Michigan has only beat OSU two times. Maybe things will change in the years to come. Whatever the outcome of the game, we enjoy the journey to the game and our staff and patients also get a feel for the great camaraderie that we share. In the business of dentistry, many of us can become a bit isolated and wrapped-up in our own practices. It is really nice to have colleagues that you can share a laugh with every so often. Thanks Tom! We’re looking forward to next year! Go Blue!!!
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
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EDITOR’S THOUGHTS
Dental Boutiques
About This Issue By Dr. Bruce Weny, WMDDS Editor
Grand Rapids Community College is offering L. A. Boutique! and Technique Boutique! for Registered Dental Hygienists and Registered Dental Assistants. These are customized one-on-one personal training courses to review, update, improve or practice your skills with a one or two hour customized courses.
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ver the past six years, the five counties that make up the West Michigan District Dental Society have lost five dentists which may have been the result of untreated depression. Some of these dentists were members of the Dental Society some were not. Some had been in practice for many years, others had just started practice. Some were young, some were older. Any one of us could have been one of these dentists. Depression is a fact of life, and it was particularly hard for these our colleagues. We all go through it to some degree, and some find it difficult to find a way out. These were not weak people. They were intelligent and driven people, just like the rest of us. The hurt they lived through and the confusion they left behind must have been most difficult. The Bulletin will continue to run informal articles on the subject and/or where to find helpful services throughout the year. Dr. Brad Van Hoose submitted an article on correcting a bony defect in the pre-maxilla. Many of you have seen cases where there is too much bone lost in the very esthetic area of incisors. The result is a big dark hole inferior to the nose or superior to the chin. If the patient has a high smile line it will show and have an unfortunate esthetic result. This is an effort to provide the restorative dentist with enough bone to allow for a more pleasing look in the gingival area. My special thanks to Dr. Tara Meachum for her articles on the new dentists and for being scribe on the “Miller” course on evaluating new dental products.
L. A. Boutique! Do you need a refresher course on Local Anesthetic techniques? L. A. Boutique is a one-on-one personalized training session which will focus on areas that you may need to review or practice. Cost: $100 per hour.
Technique Boutique! For Registered Dental Hygienists • Administration of Local Anesthetics • Administering Nitrous Oxide • Application and removal of dental dams • Ultrasonic scaling • Radiographic techniques and/or interpretation For Registered Dental Assistants • Monitoring nitrous oxide • Application and removal of dental dams • Packing and carving amalgam restorations • Taking final crown and bridge impressions and bite registration • Radiographic techniques and/or interpretation Cost: $100 per hour For more information or to register, go to www.grcclearn.com or call 616.234.3400.
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WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
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TRUSTEE REPORT
Actions of the ADA House of Delegates and Amalgam in the Wastewater By Dr. Norm Palm, MDA Trustee • Approved the ADA budget of $113,089,500 on revenue of $114,082,300. • Approved a dues increase of $9 for 2008: ADA dues set at $498. • Referred to the ADA Board review of the policy on stated reserves as a percent of the ADA budget with a report to be made to the 2008 House.
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y best regards to you as 2007 comes to a close and a New Year begins. I wish you a healthy and prosperous 2008! This report to you will summarize the actions of the 2007 ADA House of Delegates which met September 28 thru October 2 in San Francisco. I was part of our MDA delegation, and this House, like the others I have had the privilege to attend, ran smoothly and served your interests well among a myriad of issues. I know as you read these bullet points, you may have questions or desire more detail, so contact me as you wish at stsorminnorman@msn.com. Also, some of what is listed may seem unimportant, but believe me, when taken in its entirety all these issues affect our profession, so thanks for paying attention to what is happening around you outside of your practice. At the ADA level, resolutions for House action come from ADA Councils, the Board of Trustees, and the state associations. They are discussed prior to House action in a forum much like a hearing. There are five such reference committees and I’ve grouped the actions of the 2007 House by reference committee: Reference Committee on Budget, Business, and Administrative Matters • Amended the ADA bylaws regarding the duties of the Council on Members Insurance and Retirement Programs. • Approved the renovation of the ADA Washington, D.C. office. • Voted support for the Chicago Olympics, 2016. • Voted support for the ADA Foundation campaign for dental education: Our Legacy.
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Reference Committee on Communications and Membership • Approved minor changes in dentist membership categories related to disability. • Amended the Principles of Ethics Code of Professional Conduct and Judicial procedure. • Voted against ADA membership for the dental team. Reference Committee on Dental Education and Related Matters • Advanced further definition of the curriculum integrated format for dental schools. • Approved Guidelines for the Use of Sedation and General Anesthesia by Dentists and Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students. • Voted against an ADA policy on Requirement of a Year of post-Graduate Clinical Training for all Dental School Graduates. • Voted against Independent Verification of Graduates of Dental Education Programs. • Voted against a Task Force for Ethics and Professionalism. • Approved accreditation standards for dental hygiene education programs. • Approved an Update on Allied Dental Workforce Models. Reference Committee on Dental Benefits, Practice, Science and Health • Approved Activities to Improve Oral Health Literacy. • Approved Activities for Real-Time Claims Adjudication. • Approved Activities related to the Monitoring and Resolution of Code Misuse. • Approved Planning for a 2009 Access to Dental Care Summit. • Approved Planning for a Medicaid Provider Summit. • Established a Policy Statement Relating to State No Fault and Workers’ Compensation Programs.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
TRUSTEE REPORT
• Approved modification of CDT licensing fees. • Advocated plans for responding to the increasing problem of dental tourism. • Revised Guidelines for Participation in the ADA’s Seal of Acceptance Program. • Adopted Interim Guidance in Fluoride Intake for Infants and Young Children. • Approved the development of a Brochure on Dental Restorative Materials. • Amended the Policy “ADA Action Plan on Amalgam in Dental Office Wastewater to include amalgam separators. Reference Committee on Legal and Legislative Matters • Amended the ADA bylaws – editorial language regarding references to “two-thirds vote”. • Approved a Statement on Universal Health Care. • Approved SCHIP reauthorization at 200% of the federal poverty level. • Voted against limiting sitting ADA trustees announcing for ADA elective offices. • Voted against restrictions on the introduction of new business to the ADA House of Delegates. • Amended the Manual of the House of Delegates regarding Attorney-Client session. • Voted against the formation of a legal assistance fund out of reserves for assistance to state associations on legal and public relations matters. • Voted against several resolutions proposed by the Alaska Dental Association related to aftermath of the DHAT settlement by the ADA.
their permit from the MDEQ, and within each permit are specified limits for discharge of a number of chemicals, compounds, and heavy metals. At this time, as renewals are occurring, most communities are being given a discharge limit of 1.3 parts per trillion for mercury. If the community fails this limit, they are required to file a Mercury Minimization Program as part of the renewal application from each WWTP to the MDEQ. A number of WWTP’s in our area have been contacting dentists regarding this issue, presenting detailed options for mercury reduction in the waste water. If you have been earmarked in this way, I strongly recommend you contact the MDA and get a copy of a publication produced by your state association entitled “MDA Member Guide to Amalgam in the Dental Office Wastestream.” Please note that the 2007 ADA House has incorporated the use of amalgam separators into the description of Best Management Practices. The MDA is most concerned about the variability of options for mercury reduction being put forth by WWTP’s. The MDA has opened a dialogue on the matter with the MDEQ and EPA in hopes of serving your interests as best as possible. Again, if you have questions, feel free to contact me and I will do what I can to assist you regarding this regulatory problem.
There has been a great deal of activity in our area regarding amalgam in the waste water. Regulators do not make a distinction between mercury and amalgam in promulgating allowable levels of discharge of mercury. The EPA sets mercury discharge limits for each state; Michigan’s maximum is 1.3 nanograms per liter, or 1.3 part per trillion. The Michigan Department of Environmental Quality (MDEQ), responsible for meeting this limit, regulates the mercury discharge from the more than 400 individual Waste Water Treatment Plants (WWTP) in Michigan. Every five years each of these WWTP’s must renew WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
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DEPRESSION & DENTISTRY
Depression: A Treatable Illness
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epression is a serious medical condition that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who have depression.
Types of Depression Depression comes in different forms, just as is the case with other illnesses such as heart disease. The three main depressive disorders are: major depressive disorder, dysthymic disorder, and bipolar disorder. Major depression (or major depressive disorder) is manifested by a combination of symptoms (see symptom list below) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. A major depressive episode may occur only once, but it is more common for several episodes to occur in a lifetime. Chronic major depression may require a person to continue treatment indefinitely. A less severe type of depression, dysthymia (or dysthymic disorder), involves long-lasting symptoms that do not seriously disable, but keep one from functioning well or feeling good. Many people with dysthymia also experience major depressive episodes during their lives. Another type of depressive illness is bipolar disorder (or manic-depressive illness). Bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression), often with periods of normal mood in between. When in the depressed cycle, an individual can have any or all of the symptoms of depression. When in the manic cycle, the person may be overactive, over-talkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, an individual in a manic phase may feel elated and full of grand schemes that might range from unwise business decisions to romantic sprees.
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Symptoms of Depression Not everyone with a depressive disorder experiences every symptom. The number and severity of symptoms may vary among individuals and also over time. In addition, men and women may experience depression differently. Symptoms of depression include: • Persistent sad, anxious, or “empty” mood • Feelings of hopelessness, pessimism • Feelings of guilt, worthlessness, helplessness • Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex • Decreased energy, fatigue, being “slowed down” • Difficulty concentrating, remembering, making decisions • Trouble sleeping, early-morning awakening, or oversleeping • Appetite and/or weight changes • Thoughts of death or suicide, or suicide attempts • Restlessness, irritability • Persistent physical symptoms, such as headaches, digestive disorders, and chronic pain, that do not respond to routine treatment. Some Facts About Depression • Depressive disorders are common: they affect an estimated 9.5 percent of adult Americans in a given year, or about 20.9 million people. • The median age of onset for mood disorders is 30 years. • Depression (not including bipolar disorder) is the leading cause of disability among men and women of all ages in the U.S. and worldwide, according to the World Health Organization’s World Health Report, 2001. Treatments The majority of people with depressive disorders improve when they receive appropriate treatment. The first step to getting treatment is a physical examination by a physician to rule out other possible causes for the symptoms. Next, the physician should conduct a diagnostic evaluation for depression or refer the patient to a mental health professional for this evaluation. Treatment choice will depend on the patient’s diagnosis, severity of symptoms, and preference. A variety of treatments, including medications and short-term psychotherapies (i.e., “talking” therapies), have proven effective for depression. In
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
DEPRESSION & DENTISTRY
general, severe depressive illnesses, particularly those that are recurrent, will require a combination of treatments for the best outcome. It usually takes a few weeks of treatment before the full therapeutic effect occurs. Once the person is feeling better, treatment may need to be continued for several months – and in some cases, indefinitely – to prevent a relapse. For More Information on Depression National Institute of Mental Health Public Inquiries & Dissemination Branch 6001 Executive Boulevard Room 8184, MSC 9663 Bethesda, MD 20892-9663 Toll-Free: 1-866-615-NIMH (6464) FAX: 1-301-443-4279 TTY: 1-301-443-8431 Email: nimhinfo@nih.gov Web site: http://www.nimh.nih.gov NIH Publication No. 03-5299 Printed March 2003. Reprinted December 2004 Visit the NIMH website at http://www.nimh.nih.gov for information that supplements this publication.
• Addition of Non-Federal Government logos and website links may not have the appearance of NIMH endorsement of any specific commercial products or services or medical treatments or services. If you have questions regarding these guidelines and use of NIMH publications, please contact the NIMH Information Center at 1-866-615-6464 or at nimhinfo@nih.gov. Dr. Dane Ver Merris, Ed.D., Licensed Psychologist, is a consultant to the Society for this issue of the Bulletin. You can contact him at: Dane Ver Merris, Ed.D. Licensed Psychologist 5060 Cascade Rd SE Telephone 616.454.2911 Another resource for information on Depression: Pine Rest Christian Mental Health Services 300 - 68th Street SW Grand Rapids, Michigan Telephone: 616.455.9200
NIMH publications are in the public domain and may be reproduced or copied without the permission from the Institute (NIMH). NIMH encourages you to reproduce them and use them in your efforts to improve public health. Citation of the National Institute of Mental Health as a source is appreciated. However, using government materials inappropriately can raise legal or ethical concerns, so we ask you to use these guidelines: • NIMH does not endorse or recommend any commercial products, processes, or services, and publications may not be used for advertising or endorsement purposes. • NIMH does not provide specific medical advice or treatment recommendations or referrals; these materials may not be used in a manner that has the appearance of such information. • NIMH requests that non-Federal organizations not alter publications in a way that will jeopardize the integrity and “brand” when using publications.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
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DEPRESSION & DENTISTRY
Finding Fulfillment In What We Do By Christopher D. Morgan, DMD
“I decided to just let you pull it, Doc.” Wow. Gee, thanks, I think … There goes the first ninety minutes of my workday. I suppose that if I had known what my schedule really was (and I didn’t have to start my day with a root canal, post and crown), I would have slept in, or better yet, I would have gone for an early morning run. All of us deal with this sort of “cliché” more often than we would like to admit. So, why does it matter? Well, I will tell you why it really matters to me. It is because I base a lot of my esteem upon my chosen occupation. I take complete pride in my dentistry, from the initial diagnosis all the way through the final cementation of the last crown. I can’t wait for an anxious patient’s shoulders to drop and to see a genuine smile (a bonus for deep furrowed crow’s feet) upon completion of care. Remember, we all have invested eight years of studying and an atrocious amount of money, not to mention our hearts and souls, to learn how to be a dentist. Our reward is that we have the opportunity to feel good about our hard work. So, why am I preaching to the well-tuned choir? It is because we all feel the same type of stress. Some more than others. Furthermore, we are all at risk of coping with this daily stress in bad ways. Epidemiological studies show that 10% of all dentists are depressed. This is higher than “the average person in America.” Only 15% of these “ depressed dentists” actually seek treatment. So, of the 600 members in the WMDDS, we can assume that at least 60 of them are clinically depressed, and six might be seeking some sort of treatment. What about the 54 that are either at risk, or are already in need of treatment?
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I thought that I would share my feelings about an action plan to confront these issues of stress. First, we need to be honest to ourselves and accept that it is normal to feel depressed and overwhelmed. However, these are only perceived emotions. They are not necessarily “real” concerns. You can change your perceptions. Second, we need to become more comfortable discussing and/or exploring our personal “shortcomings,” especially when they seem to metastasize into our personal lives. The realization of the fact that the very things that makes us wonderful dentists (dedication, perfectionist, goal driven, uncompromising) are also the very same bedrock upon which we judge ourselves. Knowing this, it is hard to expect anything else than to feel self-doubt, inferior, overwhelmed, overworked, and under-appreciated. These are all signals to our minds that we need to make a change in our lives. Changes to find fulfillment in what we do. I have gone through the task of identifying key needs in my life. I have searched for help, even when I didn’t think that I needed it. Guess what I found? We all need help. We need to find fulfillment, even when our daunting daily goals and relentless failures begin to depress us. There are plenty of ways to seek advice. I understand that I am only 33 years old, and many people reading this are far more mature than I am. However, I am comfortable advising anyone and everyone to overeducate ourselves in self-help and psychology. It might be hokey-pokey. It can be way off, but most often, it is very real. In order to bring this brief article to a close, perhaps the most important idea that I wanted to share is that we need to help our colleagues. Nobody should be expected to predict who needs a little help and who needs a lot of help. But, if you don’t ever talk to your neighboring dentist, you’ll never be able to decide how you can be a real colleague in our profession and help someone in need of a simple conversation or perhaps, a listener! Christopher D. Morgan, DMD P.O. Box 49 1315 E. Howard City Edmore Rd. Edmore, MI 48829
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
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WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
C O M M U N I T Y D E N TA L H E A LT H O U T R E A C H P R O G R A M
Volunteers are the Hands of the Lord By JoAnne Hodder, RDH, BS, CDHO Chair
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olunteers are the true success of the Community Dental Health Outreach program. The Grand Rapids Dental Hygienists’ Society and the West Michigan Dental Foundation, in partnership with Mel Trotter Ministries Dental clinic, sponsored this program. Working together, we were able to make not only a difference, but a change in the oral health of our underserved clients. This year we reached out to underserved families – adults and children – in Grand Rapids through a northeast elementary school, Community Services, children’s programs at Mel Trotter Ministries, and residents of Mel Trotter Ministries. There were 18 dentists, 22 dental hygienists, and 5 dental assistants who volunteered a total of 373 hours to treat 132 underserved clients. This included 47 children and 85 adults. Many volunteers worked in the clinic several different days to treat this number of clients. We also had two extern assisting students from Evergreen working there as well as Deb Wright, the in-house dental assistant, and Doreen Henson-Sturgis, the dental clinic coordinator at Mel Trotter Ministries.
The program began on June 7 and ended August 17, 2007. This free dental clinic provided $59,005 of free services, which included $23,512 for restorative and $35,493 for preventive services. In comparison, in 2006, 71 clients (17 children ages 3–17 and 54 adults) were treated by 9 dentists, 13 hygienists, and 6 assistants (all volunteers) for a value of $29,000. It was a challenging summer, but our volunteers rose to this challenge. Yet the challenge goes on. The dental clinic at Mel Trotter Ministries sees only residents in the fall, winter, and spring. Restoring their smiles is a continuous process. There is one dentist who is faithful to two mornings a week. A handful of other dentists volunteer a half-day a month. A couple of hygienists volunteer on a regular basis. But the need is great. More dentists are needed for restorative, and hygienists are especially needed now for preventive treatments. If you can volunteer a few hours a month, or every other month, or a couple times in the next few months, please call Doreen Henson-Sturgis, Mel Trotter Ministries Dental Clinic at 616.454.8249, ext. 286 to schedule.
Let your hands be the hands of the Lord, here and now. WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
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W H AT ’ S H O T
Dentoalveolar Distraction Osteogenesis By Bradley G. VanHoose, DDS, MS
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lveolar augmentation is required for the atrophic alveolar ridge when treatment involves a conventional or implant-supported prosthesis. Bone grafting, guided bone regeneration, and alloplastic materials have been used for this purpose. There are inherent advantages and disadvantages to each of these methods. When using bone grafting, a donor site is unavoidable and it is possible that some resorption of the grafted bone will occur. In the guided bone regeneration technique it is difficult to provide adequate space for the regeneration and to obtain sufficient bone volume. This technique is useful for limited defects of the alveolar ridge. Alloplastic materials have the disadvantage of not being suitable for implant placement. Distraction osteogenesis defines the technique in which bone generation and soft tissue proliferation is achieved by means of the distraction, lengthening, of the pre-existing native bone. Gavriel Ilizarov, a Russian orthopedic surgeon, is credited with developing the armamentarium and describing the biological basis of this process. Distraction osteogenesis is based on the law of tension stress which involves the principle that gradual tension on living tissues creates stress that can stimulate and maintain the regeneration and active growth of certain tissue structures. The concepts described by Ilizarov have been adapted and modified for use in oral and maxillofacial surgery. An alveolar distraction device has been developed for reconstruction of alveolar process deformities using the distraction osteogenesis process. When placed into a properly formed segmental osteotomy, the distraction device allows for controlled elevation of the segment resulting in coronal displacement of the alveolar crest. The transport slowly displaces the overlying soft tissue producing expansion. As a result of the distraction process, the volume of both bone and soft tissue has been increased. The reconstructed site is then suitable for further rehabilitation with osseointegrated implants, prosthetic pontic placement, or movement of a tooth with orthodontics. It is now possible using miniature, internal distraction devices to apply distraction technology to correct deformities of the dentoalveolar process. The process of alveolar distraction involves mobilization, transport, and fixation of a healthy segment of bone adjacent the deficient site. A mechanical device, the alveolar distraction
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device, is used to provide gradual, controlled transport of a mobilized alveolar segment. When the desired repositioning of the bone segment is achieved, the distraction device is left in a static mode to act as a fixation device. Displacement of the osseous segment results in positioning of a healthy portion of bone into a previously deficient site. Because the soft tissue is left attached to the transport segment, the movement of the bone also results in expansion of the soft tissue adjacent to the bone segment. As a result of the gradual distraction, the alveolar housing, including the osseous and soft tissue components, are enlarged in a single, simultaneous process. Indications Combined deficiencies in bone and soft tissue Compromised wound healing environment Create site for dental implant placement Improve ridge esthetics for pontic Improve periodontal environment for adjacent teeth Expand alveolus for orthodontic tooth movement Advantages Using vital bone Low amount of bone resorption Low infection rate Predictable results Generate soft tissue Limitations Must have a minimum quantity of bone (8mm required for placement of the device) Transport and anchorage segment must have adequate strength to withstand forces of mobilization and transport Expansion occurs only in the direction of transport (maximum amount approximately 50mm) Patient must cooperate with activation process (2 turns x 0.5mm/day) Potential Complications Fracture of transport segment Fracture of anchorage segment Premature consolidation Undesirable transport vector Soft tissue and bone necrosis
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
W H AT ’ S H O T
#9. She had undergone multiple periodontal surgeries involving synthetic bone grafting and soft tissue repositioning. As a result, she had severe gingival recession and vertical bone loss. The teeth were deemed non-restorable and the patient was treatment planned to have the edentulous space restored with implants. Due to the nature of the vertical bone loss and deficiency of soft tissue, conventional autogenous onlay bone grafting would not predictably result in an increased bone height sufficient for implant placement. The patient elected to undergo alveolar distraction to reconstruct the anterior maxillary gingival and bony defects. The alveolar ridge was lengthened approximately 10mm vertically and 3mm horizontally.
Sequence of Distraction Process Distractor Removal
Start
5–7 days Latency
2 x 0.5mm/day Distraction
6–8 weeks Retention
4 weeks Implantation
Patient Treatment Case A 32-year-old female patient was consulted regarding her complaint in the appearance of her front teeth. Patient had a long history of periodontal problems involving teeth #8 and
Mark Your Calendar! West Michigan District Dental Society Invites you to attend the “In Like a Lion, Out Like a Lamb” Social Event March 7, 2008 at 6:00 pm San Chez, downtown Grand Rapids Wine tasting paired with tapas All members, spouses and guests are welcome at this social event Watch your mail for more information
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
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PROGRAM REVIEW
The Reality View on Products and Techniques Submitted by Tara Meachum, DDS
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pproximately 170 West Michigan dentists were presto detect proximal lesions. Dr. Miller rounded out the “C’s” by ent at Frederik Meijer Gardens on Friday, October reviewing ceramics, composites, and curing lights. A couple of 26th, to hear Dr. Michael Miller speak about “The newer devices that he thought were worth mentioning are the Reality View on Products and Techniques.” Although Dr. Cosmetic Aligner (www.cosmeticaligner.com) which is similar Miller has many credentials, he is probably best known as the to a stick bite and costs approximately $1.20 apiece, and the co-founder, President, and Editor-in-Chief of Reality. QwikStrip (by the way, don’t type quick strip into your internet Dr. Miller believes that we have a big responsibility to our search … trust me!) which is great for interproximal reduction. patients when it comes to choice of materials in dentistry. It’s As far as composites go, his team evaluated aspects such as: not fair to use them as guinea pigs in our practice. That is why polishability, handling, color, durability, porosity, translucency, he created Reality (www.realityesthetics.com). His company tests and fluorescence. A composite heater (Calset Composite all sorts of dental materials and rates them based on lab results Warmer by AdDent) makes composite more sculptable and and independent research. All manufacturers are invited to might be worth a try. Finally, with curing lights, the Bluephase participate in his studies at no charge; so in Dr. Miller’s mind, 16i from Ivoclar tested to be the strongest while the Flashlight the only reason a manufacturer from Discus might be the least would choose not to participate expensive. Dr. Miller said the is if they’re not confident about pricing at Discus is like a their product. Bangkok Flea Market. You can Dr. Miller summarized dencall and ask what the pricing is tal materials from A to Z (well, today and if they’ll throw somefrom B to W anyway) beginning thing else in to seal the deal. with bite registration materials The new Kerr Demi is nice and ending with wedges. because it comes with 2 Li-Ion Instead of giving us a synopsis batteries which are better than of exactly what materials were NiCad or NiMH batteries. rated the highest and so on, he Some diamonds Dr. Miller summarized what types of tests brought up were the G-Force were done and what the general Dr. Michael Miller speaks about “The Reality View on Products and line by Garrison as being the Techniques” on October 26. findings were. For example, he fastest and the Zir-Cut diamond shared with us that bleaching lights such as Zoom were no by Axis as a nice diamond to cut through Zirconia. more efficient than the take-home systems. If you want the Dr. Miller spent some time discussing headlamps. Some of actual information on specific products, you can subscribe to the battery packs associated with the cordless lights are so Reality by visiting his website. heavy they’ll pull your pants down. The Peri-Star from Going on to the C’s, he discussed that extraoral cameras PeriOptix costs about $800, has a light-weight pack, and were in a megapixel race. With Photoshop, there really is no comes with two batteries so you can rotate them if one runs difference between 3 and 12 megapixels. If you take a bad out of “juice.” The Halo 5000 from Enova weighs 1¼ lbs. and shot, you can usually enlarge and crop the photo so you look the battery pack sits on the side of your head. It’s a heavy light, like a pro. There are two main companies that produce caries but you have nothing on your belt. In other words, you’ll look detectors, Kavo (Diagnodent) and Dentsply (Midwest Caries ridiculous but your pants will stay up. The last of the H’s Device). They both cost about the same and neither can detect included hemostatic agents. Dr. Miller said Magic Foam Cord, recurrent decay. The MCD is an LED that alerts the practiGingiTrac, and Expasyl aren’t as effective as traditional cord tioner to caries by an audible sound rather that a digital readand not worth the price. out. You can’t track anything over time with this system but The new B4 by Aquasil is great at increasing the wet-ability on the plus side, it doesn’t require any calibration and claims of your crown or bridge prep but is only packaged with the
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WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
PROGRAM REVIEW
Aquasil Ultra Kit. He’s trying to convince the company to sell it separately. Some of his top picks for PVS materials are Aquasil (Dentsply), Affinis Precious (Coltene/Whaledent), and Imprint 3 (3M ESPE). The V-Ring matrix system from TrioDent has had some good success. The ring is made of both stainless steel and NiTi and leaves a space for your wedge. The D.T. Lightpost from Bisco is the leader in the US for posts. Even thought the post transmits light by being fiberoptic, Dr. Miller recommends that you still use a dual cure cement. Some newer information regarding provisional cements is that eugenol has no effect on bond strength as long as the prep is thoroughly cleaned before final cementation. TempoSil by Coltene/Whaledent in a nice provisional cement because it cleans up so easily. For anterior teeth, Systemp Link by Ivoclar is clear and there’s really no clean up. He recommends that you coat your prep with chlorhexidine and dry before cementing. Clean off the residual cement only after it’s been
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
thoroughly cured and be careful because the cement will bond to fresh resin buildups. Dr. Millers favorite light cured veneer cement is RelyX (3M ESPE). He recommends purchasing clear and white opaque only. The other shads are so similar to each other you really don’t need them. NX3 (Kerr) is a nice dual cure that works with all adhesives. Clearfil Esthetic Cement and DC Bond Kit (Kuraray) is a dual cure resin cement that has the best bond strength. Embrace Pit and Fissure Sealant (Pulpdent) is one of the best all-around sealant materials. It tested well and exhibited no leakage during testing. Dr. Miller gave us a brief overview of what his company, Reality, is all about. If you’re interested in subscribing, be sure to visit his website. With this membership, you’ll be privy to unbiased dental product evaluations from both independent researchers and the Reality Research Lab. Thank you to Davis Dental Laboratory, Sullivan-Schein Dental, and MDA Insurance and Services for helping to sponsor this program.
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CLASSIFIED ADS
The classified ad rate is $10.00 up to and including 30 words; additional words 15¢ each. Space permitting, WMDDS members may place ads free of charge as a membership service. Ads should be submitted in writing and sent with payment to Elaine Fleming, WMDDS, 511-F Waters Building, Grand Rapids, MI 49503. Telephone numbers and hyphenations count as two words, abbreviations count as one word. Ads received after the first of the month prior to publication may appear in the following issue. Grand Rapids – Our very busy, well established general practice has an immediate opening for a full- or parttime dentist. Our stand-alone facility has eight operatories and a fully staffed denture laboratory. This is an excellent opportunity to practice in a diversified and growing practice. Salary based on percentage of production for an experienced, self-motivated individual. 150k to 200K annually. Please email: grandvalleydental@sbcglobal.net or call Pam at 616.245.2767. Storage Space for Lease – Safe, secure, 24/7 access. Ideal for records, models, or just stuff you need to store. Located in the basement at 1151 East Paris Ave. Contact Dr. Sam Bander at 616.949.5980 or drsam@sbcglobal.net for more information. Dental Practice For Sale – Jenison, Michigan. Established and growing dental practice on major Jenison traffic route. Great income potential. Call for details 616.245.2767 or cell 616.485.1348. Half of Building (2,424 Square Feet) for Lease. Other half is a full-service dental laboratory. Two year old building, excellent for a dental practice. Great location in Kentwood on the corner of Breton and 32nd Street. If interested please call 447.0190. For Sale – 1998 Gendex GX-Pan, $4500. Also available: 1970 Moss Lateral Ceph. Make offer. Call 538.5920 Mon.–Thurs.
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Established Dentist with an Existing Office in Grand Rapids Wants to Buy – in or partner with another dentist. Open to all options. Please contact P.O. Box 141661, Grand Rapids, MI, 49514-1661. Grandville: 2000+ sq. ft. office space available for lease in exclusive professional office building. Other tenants include endodontist, family dentist, pediatric dentist, oral surgeon and orthodontist. Building partnership buy-in also possible as investment. Call 616.531.6377 or 616.531.1260. Wanted – Kavo handpiece motors – new or used. I am looking to obtain one or more Kavo 182 slow-speed motors. If you have an old one available for sale, please call John Hanks, DDS, at 364.7039. Office Space for Lease – Great location! 2426 Burton St. SE, 915 sq. ft., 3 operatories, lab, private office, reception, business office, basement. Contact Dr. Sam Bander at 616.949.5980 or email at drsam@sbcglobal.net Space for Lease – Holland (great north side neighborhood location). Previous tenant was a family practice dentist. High visibility sign available. Building interior is ready for equipment installation. Three ops and small lab. Owner is willing to adapt building to needs. Call 616.245.9098 or 800.669.0717.
Dentist Needed – to provide services on state-of-the-art Mobile Dental Unit. Mobile Unit provides comprehensive dental services at schools throughout Ottawa County (Grand Haven, Holland, etc.) Dentist needed 1–2 days/week beginning immediately. Competitive wage. Please send resume to: Dental Program, Ottawa County Health Department, 12251 James Street, Suite 400, Holland, MI 49424. Busy Dental Practice for Sale – NW lower Michigan, beautiful and growing community, good school system, yearround recreation. Transition and terms negotiable. Contact Elaine Fleming at 616.234.5605 for information. Dentist with 15 years’ experience seeks associateship in the Grand Rapids area – Experienced in most phases of dentistry, including extractions, molar RCT, anterior and posterior composites, removable and fixed prosthodontics and pediatric dentistry. Available PT or FT. Please call Dr. Jonathan Berns at 616.949.1925. Grand Rapids NE dental building for sale/lease – 40 years as dental office has excellent following and recognition. This 2400 sq/ft brick building is fully remodeled in area of high growth, visibility and on high traffic count main road. Would make great startup, satellite, or income property. Lots of potential or owner and/or tenant with possible income lease in place. For details 616 262 8288.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
CLASSIFIED ADS
Experienced general dentist – just moved to Grand Rapids. Looking for a practice anywhere in the general area. Open to considering all options. Call 616.975.0464. For Lease – 1,500 sq. ft. (approx.) dental office suite with three operatories in newer (5-year-old) building. Beautiful water views. Located on Forest Hill Avenue south of Burton. Convenient, highly visible location. For more information, please call Janie at 616.942.3343. Dental Office Suite/Three Operatories for Lease – Desirable SE Grand Rapids location. Some shared space (reception room, lab, etc.) with two other general dentists. Great opportunity for general, specialty, or start-up. Excellent terms. Call 616.949.8990. Kentwood, Muskegon, Fowlerville – We have three practices for sale. These opportunities are excellent starters and satellite offices. Kentwood and Fowlerville have buildings also for purchase. Starting gross of $470,000 to $600,000. Financing and working capital available. Contact Dr. Jim David, Henry Schein PPT Sales at 586.530.0800 or daviddental@comcast.net. Associate/Partnership – Great opportunity for a full / part time general dentist. Profitable, fee for service office. This is a well established family practice. Excellent location in Spring Lake/ Grand Haven area. Call 616.842.1562 or e-mail dmirwin@chartermi.net.
Looking for an Associate or Buyer for Your Practice? For over fifteen years, Peak Performers has assisted hundreds of practices in finding the right candidates. The NEW Peak Associate Placement and Transition Programs allow you to customize the services you need for your search. You select the options that fit your individual needs and your budget. These options range from doing it yourself, to our renowned full service support. Utilize as little or as much of our resources and experience as you need. See additional information at www.peakdental.com or call 888.477.7325.
ADVERTISER INDEX
The Bulletin wishes to thank our valued advertisers who support organized dentistry by helping to defray the cost of printing and mailing. Advertising in the Bulletin is seen by over 90% of the dentists in the West Michigan District. This includes five of the fastest growing counties in the state: Kent, Ottawa, Ionia, Montcalm and Mecosta. For information on advertising rates, call Elaine Fleming, WMDDS Executive Secretary at 234-5605. Target your Market – advertise in the Bulletin! Centric Laboratories............outside back cover Davis Dental Laboratory................inside front cover Founders Bank & Trust.....................17 MDA IFG.............................................5 Professional Solutions.......................12 ProNational...............inside back cover Prudential Financial............................3 Sullivan-Schein .................................11
Call for Nominations The West Michigan District Dental Society’s Distinguished Service Award committee is requesting nominees for the 2009 Silent Bell award (to be presented 12/08). The Silent Bell, our Society’s highest honor, is awarded to WMDDS members, active or retired, who have made outstanding contributions to the dental profession and the community. Candidates should have high moral and ethical character. Contributions over a lifetime will be given greatest consideration. To submit a name for consideration, please send a letter stating why this person should be considered for the Silent Bell award along with a CV (if available). Information should be sent to the WMDDS office: Attn: Elaine Fleming West Michigan District Dental Society 161 Ottawa Avenue NW, Suite 511-F Grand Rapids, MI 49503 or by email to efwmdds@aol.com
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
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NEW MEMBER PROFILES
Amru Albeiruti Amru Albeiruti attended the University of Michigan for both his undergraduate and graduate studies and received his D.D.S. in 2003. He went on to work at Cherry Street Heath Service Clinic for about ten months. He heard horror stories of associateships that didn’t work out so well, and wanted to go in a different direction after graduating. He used working at Cherry Street as a stepping stone and remembers it as being a great experience. Amru then moved to Canton and worked at a group practice with three senior dentists for the next three years. They were wonderful mentors, and Amru learned a lot in his time there. Amru says it was very tough to leave that office, but he wanted to move back to West Michigan. Amru grew up in Cascade, and his family still lives there. He began looking for a practice to buy in the area. Amru couldn’t find exactly what he was looking for so in January, 2007, he opened the doors to Ada Hills Family Dentistry, the practice he started from scratch. The address is 6739 E. Fulton, Suite D20, near Amway. He’s happy with his decision, stating that he doesn’t have a major commute now and the environment is much more relaxed. He has just one employee, Karen, who doubles as his receptionist and assistant. To keep costs down, he takes care of all the hygiene himself and refrained from purchasing too much high-tech equipment. His patient base is slowly growing. One of his favorite aspects of dentistry is treating emergency patients. They’re always happy to see him and very grateful for any service he can provide. He makes it a goal to see emergency patients the same day and even stays after hours if he needs to. When Amru’s not at work, he likes to run, be outside, or read anything related to history. Sarah Elizabeth Mahar Dr. Sarah Mahar attended Hope College for two years, then transferred to the University of Michigan to complete her undergraduate study. It was there, in 2003, that she earned her dental degree. Shortly after graduating, Sarah worked in Okemos for one year in a private practice which had a dental spa setting. As a new graduate, she felt like she needed more of a mentorship than she was getting in Okemos, so
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Sarah also began working one day a week with her dad, Dr. Kirk Faber in Greenville. She hoped to soon move back to the west side of the state but her husband, Jason, an attorney, was offered a job in Detroit, so they moved to Sterling Heights for two years. While there, Sarah worked at an office in Sterling Heights while continuing to commute to Greenville weekly. This past spring, Sarah, Jason, and their one-year-old son, Max were able to move back to Greenville when Jason was offered a job in West Michigan. This prompted Sarah and her father to purchase the practice of Dr. Larry Smiley who was retiring from Belding. Sarah spends most of her time working at the Belding office while still going to Greenville once a week. Sarah’s favorite aspect of dentistry is restorative work. She likes the immediate results. With crown and bridge, she feels like you have to wait for the results and the laboratory does all of the esthetic work. When she’s not doing dentistry, she enjoys playing with her son, Max, traveling, and being outdoors. Scott VanTimmeren Dr. Scott VanTimmeren earned his bachelors degree in psychology at Hope College. He thought he might try medical school since his father is an anesthesiologist, so he spent some time in the operating room working with his father but decided to go in a different direction. It seemed to Scott that in the medical field, the doctors spent little time with their patients. He looked into some dental offices during his sophomore year in college and decided to follow that path. He liked the fact that in dentistry, he would be able to establish long term relationships with many of his patients. That aspect continues to be Scott’s favorite part of practicing in the dental field. Scott graduated from the University of Michigan in May, 2007, and immediately began associating full time with Partners in Dental Care. Growing up, Scott was a patient of Dr. John Vander Kolk’s at that same practice. In dental school, Scott was also a friend of Dr. Matt Gietzen, whose father, Dr. Tim Gietzen, is a partner at the practice. Partners in Dental Care is located at 2565 Forest Hill Ave., SE. Scott is currently living with a friend while he anxiously awaits the completion of Riverhouse Condominiums. In his free time, Scott is the assistant coach of Hope College’s hockey team working with his brother, the head coach.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | NOVEMBER/DECEMBER 2007
WEST MICHIGAN DENTAL SOCIETY 511-F Waters Building Grand Rapids, MI 49503
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