http://www.wmdds.org/2009/2009_wmdds_holiday_bulletin

HOLIDAY ISSUE 2009 VOL. 42, NO. 2

Bulletin

Editor

James Papp

Associate Editors

Seth Vruggink Jeff Smith Aric Smith Larrisa Bishop Sheryl Jenicke

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 2009-2010 President Douglas Klein President-Elect Seth Vruggink Vice President Larissa Bishop Secretary-Treasurer Ryan Lebster Editor James Papp Immediate Past Doug Killian President Directors Tyler Wolf Christopher Morgan Samuel Bander Area Representatives Kent County David Armbrecht Ionia-Montcalm Kathleen Ellsworth County Mecosta County Margaret Gingrich Ottawa County Thomas Phares MDA IV District Trustees

Contents President’s Message ...................................................................................................... 2 Editor’s Thoughts......................................................................................................... 4 The Right Man at the Right Time............................................................................... 6 Program Review ........................................................................................................... 8 Community Dental Health Outreach .........................................................................13 Trustee Report ..............................................................................................................14 GRDHS News ...............................................................................................................17 Classified Ads................................................................................................................18 Advertiser Index ...........................................................................................................20

Norman Palm Brian Cilla

Big Rapids Dental Study Club Officers, 2009-2010 President Erick Perroud Vice President Christa Stern Secretary Christa Stern Treasurer Erick Perroud Holland-Zeeland Dental Society Officers, 2009-2010 President Meredith Smedley Treasurer Robert Ankerman Secretary Immediate Past President Ionia-Montcalm Dental Study Club Officers, 2008-2009 President Chris Morgan Treasurer Kirkwood Faber Kent County Dental Society Officers, 2009-2010 President Brant Erbentraut Vice President David Armbrecht Secretary Lathe Miller Treasurer West Michigan Dental Foundation Officers President Donald Vander Linde Vice President Matthew Gietzen Secretary Devin Norman Treasurer Carl Kruyswyk The Bulletin of the West Michigan Dental Society is published six times a year (the directory issue, fall issue, holiday issue, winter issue, spring issue, and summer issue). 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, 4880 Cascade Road SE, Ste. B, Grand Rapids, MI 49546.

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. © 2009-2010 West Michigan District Dental Society Bulletin

About the cover Dr. Chris Smiley, Candidate for MDA Editor.

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 has six publications: the directory issue, fall issue, holiday issue, winter issue, spring issue, and summer issue. Direct submissions or correspondences to: Dr. James C. Papp • 4880 Cascade Road SE, Suite B • Grand Rapids, MI 49546 Phone: 616.940.9872 FAX 616.940.2854 • Email: DRJPAPP@aol.com Include “Newsletter” in the subject line

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PRESIDENT’S MESSAGE

Congratulations Lois Havermans – Steel Water Award Recipient

By Dr. Douglas R. Klein, WMDDS President

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n 1980, the West Michigan District Dental Society established the WMDDS Distinguished Service Award, better known as The Silent Bell, its highest honor. The Silent Bell is awarded to dentists in the five-county WMDDS area who have made outstanding contributions to their profession and community.

Recognizing a need to honor individuals or groups in the WMDDS area who have made significant contributions to dentistry or our dental community, but are not dentists, the WMDDS Board founded the Steel Water Award in 2007. The name, Steel Water, was given to this award honoring our history as the birthplace of community water fluoridation and shares its name with the beautiful sculpture adorning the east bank of the Grand River in downtown Grand Rapids commemorating this historic event. The first Steel Water Award was presented to the Dental Auxiliary Programs at Grand Rapids Community College on January 16, 2009.

I’d like to take this opportunity to sincerely thank the members of the Steel Water Award Task Force whose vision, diligence, and hard work have brought this long-overdue recognition to fruition: Dr. Eugene Bonofiglo (chairman), Dr. Larissa Bishop, Dr. James Wieland, Dr. David Hosking, and Dr. Arnold Baker. If you have the name of an individual or organization you would like to receive future Steel Water Award consideration, please contact a member of the Steel Water Award Task Force previously listed.

On January 8, 2010, the West Michigan District Dental Society’s Steel Water Award will be presented to Lois Havermans, RDH, CHES, Oral Health Team Supervisor, Ottawa County Health Department “Miles of Smiles. The

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presentation ceremony will be held at 11:45 am during the Molinari continuing education seminar. WMDDS members are welcome to attend the presentation. For more information, contact Elaine Fleming at 616.234.5605 or efwmdds@aol.com.

Lois Havermans graduated, with honors, with a Bachelor’s Degree in Dental Hygiene from The University of Michigan in 1974. Lois is currently employed by the Ottawa County Health Department as the Oral Health Team Supervisor and a Certified Health Education Specialist. As a supervisor in the Health Promotion Department, Lois provides technical assistance and mentoring to health educators in the areas of coalition building, legislative advocacy, and grant writing. For over 25 years, Lois coordinated the largest school fluoride program in the state, enrolling over 5,000 children annually. In addition, Lois, a Certified Health Education Specialist, coordinates a countywide Oral Health Education program made available to over 11,000 school children. In 2006, Lois was the recipient of a Michigan Department of Community Health grant. This grant was designated to pilot a sealant program in the school systems and a fluoride varnish program in Head Start centers.

Based on the success of the pilot projects, these programs are now being implemented statewide. Lois also receives numerous requests for oral health presentations from schools, hospitals, nursing homes, community groups, and state and local professional organizations.

The most exciting and challenging initiative that Lois has been involved in during her professional career has been her “Miles of Smiles” mobile dental initiative. The “dental office on wheels” provides free, comprehensive preventative, and restorative dental services for Medicaid-insured and lowincome and uninsured children. This program is implemented at school sites, Head Start centers, migrant programs, Ottawa Area for the Multiply Handicapped, and various community sites. The project included development of a state grant proposal used to design and fund a mobile dental unit, building the agency’s capacity to provide a new health service, mobilizing the service, and recruiting over 100 volunteer dental providers. Since project initiation, successful grant writing has resulted in over $835,000 in grant allocations. Major grantors have included: the Michigan Department of Community Health, West Michigan Dental Foundation, Delta Dental, the Community Foundation of the Holland/Zeeland area, and the WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2009

PRESIDENT’S MESSAGE

Holland Junior Welfare League. This funding has facilitated the expansion of the “Miles of Smiles” initiative to include targeted middle schools in addition to the elementary schools currently visited.

After 10 years of service, the structural integrity of the mobile dental unit was being compromised and needed to be replaced. With the past success of the “Miles of Smiles” initiative, the county approved a proposal for a new mobile unit.

The new mobile unit was dedicated in 1995.

Lois has been actively involved in legislative advocacy providing testimony on health issues at legislative hearings in Lansing. As the Legislative/Hygienist Network chairperson for the Michigan Dental Hygienists Association and a member of the Michigan Oral Health Coalition, Lois has assisted in coordination of several legislative initiatives. These initiatives have been successful in increasing accessibility to oral health services for many Michigan residents. These initiatives include reinstatement of Adult Medicaid dental benefits in 2003 (and working again in 2009 for reinstatement of those benefits); funding restoration for the MDCH Oral Health Program Coordinator position, cigarette tax revenue for health initiaWEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2009

tives, policy changes for public health hygienists providing services to underserved populations, and continued advocacy for increased funding for health initiatives.

Lois has held many local and state leadership positions within her professional affiliations: Chairperson of the Michigan Public Health Association Oral Health Section; and President, Legislative chair and Dental Health Education chair for Lakeshore Dental Hygienists’ Association. Lois is also on the Ottawa County Child Development Head Start Advisory Board.

Lois was twice the award recipient of the Michigan Dental Association’s “Public Service Award” in 1988 and 2003. She also received the Michigan Dental Hygienists’ Association “Hygienist of the Year” award in 1996, 2004 and 2009. She is also the recipient of the Ottawa County Health Department’s “Employee of the Year,” the Holland/Zeeland Dental Society “Service Award,” Muskegon District Dental Society’s “Community Service Award,” and the Muskegon Community Health Project “Partnership Award.”

As you can see, Lois Haverman’s recognition by the West Michigan District Dental Society is well-deserved.

Congratulations Lois!

The Miles of Smiles Mobile Dental Unit.

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EDITOR’S THOUGHTS

Introducing our Candidate for MDA Editor: Dr. Chris Smiley

By Dr. James C. Papp, WMDDS Editor Journal that gives a voice to our members and informs them on exactly what our Association can do and is doing for them.

These are challenging times where every dentist needs the support and services the MDA provides. Through the pages of our Journal, I hope to help our members access all that the MDA has offer to them.

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e are again fortunate to have the opportunity to support a WMDDS member for a leadership position with the Michigan Dental Association.

In the past we have sent Drs. Bill Creason, Gene Bonofiglo, Larry Marcotte, Arnie Baker, and Steve Dater to serve as President of our state Association. Recently Deb Peters joined Gene Bonofiglo as the only Speaker of the House of Delegates from our Society. For the first time, our WMDDS Board has endorsed a candidate for MDA editor, Dr. Chris Smiley. From an editor’s prospective, I have admired Chris’ contributions and efforts when he was editor of our Bulletin in the mid 1990’s. In fact, the structure/format of the Bulletin that you see today was designed by Chris.

A few weeks back, while I was thumbing through some of the Bulletin’s from the 1990’s, when Chris was editor, I stumbled on a section where Chris interviewed candidates for MDA editor. I thought it would be interesting to pose the same questions back to him. I encourage you to take the time to read this interview as well as the support article written by Dr. Steve Dater. Lets give Chris the support that he deserves.

Why do you wish to be MDA editor?

I enjoy writing to express an idea or present a topic. My experience as Editor of the Bulletin taught me so much about publishing, and I enjoyed being responsible for informing our members on the issues important to our profession. Being Bulletin Editor required me to be well versed in all phases of our dental society and its challenges, and it allowed me to develop the skills necessary to articulate these issues to our members. I enjoy that responsibility and hope to bring these skills to the state level.

In order to keep our Association viable, we need a dynamic

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What specific qualifications do you have for this office?

I am a past editor of the WMDDS Bulletin. During my tenure, changes were made that established its current magazine format. These efforts resulted in the International College of Dentists recognizing the Bulletin with their “Golden Scroll Award” for improvement.

I have served as an Article Reviewer for the Journal of the American Dental Association and I was honored to lecture at the American Association of Dental Editor’s Conference. I have authored articles that have been published in several state and national dental periodicals including many state journals, the ADA News, and even the on-line dental publication “DrBicuspid.com.”

I am an ADA-trained spokesperson. I have participated in newspaper, television, and radio interviews representing our profession’s views on issues ranging from amalgam safety to access to dental care. As a spokesperson, I have learned how to quickly research the latest information on an issue and present it in clear and concise terms.

My qualifications for editor include an extensive knowledge of the workings of the MDA. The editor must be able to communicate the value of our Association’s activities and services to our members. My time spent on the Board of Trustees and chairmanship of several committees and workgroups will serve me well in this task. Currently I am a liaison to the Committee on Peer Review and the Committee on Governmental and Insurance Affairs. I am also a past Vice Chairman of MDA-IFG, our for profit subsidiary that provides insurance and service products to our members at group rates. These activities have provided me with an intimate knowledge of what the MDA does and how it addresses the issues our members face.

My qualifications for editor include the ability to solicit

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EDITOR’S THOUGHTS

exceptional authors to contribute articles of interest for our members. Through my involvement with the ADA’s Board Advisory Committee on Evidence Based Dentistry (EBD), as a member of the EBD Champion’s Conference Organizing Committee, the ADA’s Council on Dental Benefit Programs, and the Dental Quality Alliance Steering Committee, I have had the good fortune to foster state and national contacts in the benefit, legislative, regulatory, scientific, and educational communities that will allow me to ensure a broad range of topical contributing authors.

I view my chief qualification to be my perspective as a practicing dentist. I face the same challenges as most of our members in providing optimal patient care, coping with a regulatory environment, meeting a payroll, and striving to keep current on our profession’s issues and evolving science. I will bring this perspective to the Journal to best serve the needs of our members.

pendent counsel. I will utilize a diverse group of colleagues and experts to serve on my advisory board to ensure quality, professionalism, and ethical balance in the materials we publish. The Journal can promote an opinion but it must never be opinionated. An advisory board that is diverse can point out where assumptions and facts may not be accurate, allowing articles and opinions to be properly vetted prior to publication.

How can the MDA Journal better serve its members?

It isn’t good enough to simply deliver the Journal to our members’ door. I want them to know what’s inside and find something within each issue that enriches their practice and professional lives. Through editorials I hope to foster thoughtful debate, inform the reader, and even get them to laugh on occasion.

Through planning, networking, and input from our members, I hope to have superior content and contributing authors that inspire our readers.

What specific goals do you have for the Journal?

It is my goal to maintain the tradiWhat does it mean to you tion of excellence for the Journal of to have the support of your the Michigan Dental Association. local members?

This tradition is not only a testaIt means the world to me to have ment to our current and past Chris reports to the ADA Council on Dental Benefits. Photo courtesy the support of my friends and colvolunteer editors, but also to MDA of ADANews. leagues. I have been overwhelmed staff including David Foe, who by the expressions of support and well wishes from our denserves as the Journal’s Managing Editor, and MDA Executive tal community. These are the people that know me best and I Director Drew Eason, who serves as the Journal’s Executive am truly honored to have their support.

Editor.

When Colette and I came to practice in Grand Rapids, we It is my goal to keep the Journal self sustaining so that we chose to become active in our local society and build frienddo not rely on dues dollars to fund publication. My goals ships with our colleagues. We both attended Marquette include providing our members with “golden nuggets” of University School of Dentistry and didn’t have a network of information that they can implement in their offices to classmates in town to rely on for support. West Michigan has improve their practice experience. A further goal is to raise always been warm and welcoming to us. In the end it’s these our members’ awareness of the value of our Association to aid friendships that matter most! them in accessing those resources.

Excellence requires superior contributing authors, as I have previously addressed. It also requires the editor to seek indeWEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2009

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F E AT U R E A R T I C L E

The Right Man at the Right Time

By Dr. Steve Dater

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hen James Papp asked me if I would write an article about our candidate for Editor of the Michigan Dental Association, Chris Smiley, I wasn’t sure what to do. How could I possibly tell you about my mentor and friend of over twenty years, all of his accomplishments and qualifications for Editor, and all his experience working for you in organized dentistry and keep it to the amount of space Jim asked me too?

Oh what the heck, here it goes.

For those who don’t know Chris, he started his service to organized dentistry back in 1989 with the WMDDS when he was co-chair of the membership committee. He served on numerous other committees at the local level, but most noteworthy is he served as our editor from 1991-1994 and also went through the chairs on the WMDDS board, serving as President in 19961997. Chris has also served as our Trustee to the MDA Board of Trustees from 1999-2002, along with serving in the MDA House of Delegates as well as the ADA HOD. Chris also served in our for-profit subsidiary MDA-IFG as the vice-chairman. Chris is currently serving on the ADA’s Council on Dental Benefits Programs and was chosen as the ADA’s representative to the Federal Dental Quality Alliance Steering Committee. Chris was also appointed to the ADA’s Evidence Based Dentistry

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Board Advisory Committee. Somehow he has also managed to volunteer at his church and maintain a general dentistry private practice with his much better half, his wife, Collette.

I know what you are saying: So what? What does this have to do with being the editor of the MDA? Well I believe that the MDA Journal is a cornerstone of our association. The editor must be someone who is in touch with the “grass roots” member, and yet has the experience to deal with the issues that face our association at all levels of the tripartite. The editor must be able to communicate relevant information to our membership in a way that keeps member dentists engaged with organized dentistry. They must be able to relate to the member dentist who is treating patients, dealing with insurance companies, and government regulation. Chris has that kind of experience. When the MDA and WMDDS were looking for someone to help with managed care issues in the mid-nineties, who did they ask to be the chair of their Task Forces?

Chris. When the MDA was looking for someone to look into the UCR language with insurance companies, who did they ask to chair the workgroup? Chris. When the MDA was looking for someone to facilitate the work group on Non-Accredited Dental Assisting Programs, I bet you can’t guess who they asked to do it.

That’s right, Chris. I think you are catching my drift here, and Chris has managed to continue to get these types of appointments now at the ADA level as well, as you can see mentioned above.

The editor also needs to be able to work with the Board. The editor is also a member of the Executive Committee. The editor also is a delegate to the ADA HOD. Chris also answers the bell here.

His experience as a past MDA Board Member has given him the insight to work with the Board. His seven years serving in the ADA HOD and his positions on the ADA Council on Dental Benefit Programs and his other ADA appointments WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2009

F E AT U R E A R T I C L E

has allowed Chris to build relationships with dentists from other parts of the country, which is invaluable when the MDA needs to work on issues at the ADA HOD. Chris will be able to hit the ground running. One more thing – he has written many articles that have been published in the local, state and national Journals, but I figured you would expect that from a candidate for editor.

In conclusion, I feel Chris will make a great editor for the MDA. His unique background of being so heavily involved with all levels of the tripartite in organized dentistry and being in a general private practice will enable Chris to perform his duties as editor and keep the “grass roots” member’s interests in the forefront. I hope you will all join in support of Chris to be the next editor of the MDA Journal!

If you would like to send Chris a note of support, offer suggestions, or contribute to the campaign, you can reach him at chris@smileydds.com or 3299 Clear Vista Ct., NE, Suite A, Grand Rapids MI 49525.

The Smiley Family: WMDDS members Drs. Colette and Chris Smiley and their daughters Margaret and Elizabeth with Jewel.

MARK YOUR CALENDAR West Michigan Dental Foundation Annual Golf Outing Friday June 4, 2010 Returning to beautiful Egypt Valley Country Club Watch for more information about this event!

Mission Statement: An organization dedicated to the improvement of oral health through the financial support of education and service programs to address the needs identified by the dental profession and the communities it serves in Kent, Ottawa, Ionia, Mecosta and Montcalm counties.

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PROGRAM REVIEW

Dr. Wilkerson Shares His Expertise in Occlusion Submitted by Dr. Seth Vruggink

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n Friday, October 16th, nearly 200 attendees were present at Frederik Meijer Gardens & Sculpture Park to hear a true leader, Dr. DeWitt Wilkerson, in the study of occlusion. Dr. Wilkerson came in from St. Petersburg, Florida to enjoy a beautiful Michigan fall day with the West Michigan District Dental Society. He has been in private practice with the Dr. Peter Dawson’s group since 1982.

His practice focus is on restorative dentistry, temporomandibular disorders and solving occlusal problems. He is also an associate faculty member at the L. D. Pankey Institute in Key Biscayne, Florida.

The course stressed what Dr. Wilkerson calls the key concepts of occlusal health and disease. Dr. Wilkerson contends that occlusal disease is the number one cause of most of the dental problems we see in our offices on a daily basis. This includes sore, broken, loose, and worn teeth, as well as masticatory muscle tension and masticatory system disorders. These dental problems are effects and every effect has a cause. Dentists should be focused on treating the causes of occlusal disease to improve the effects of signs and symptoms.

The four primary causes of occlusal disease are malocclusion, non-functional factors, joint instability, and parafunction.

Dr. Wilkerson took the group through his key considerations for every patient when approaching occlusal disease.

First, determining stability or instability of the system. Next, a joint treatment position must be determined. Dr. Wilkerson strongly believes in restoring the occlusal scheme in centric relation. True centric relation allows the lateral pterygoid to fully release. Interferences trigger contraction of the lateral pterygoid, displacing the joint and creating fatigue and discomfort. Several studies were presented showing the predictability and reliability of bimanual manipulation in determining centric relation.

Once determined using bimanual manipulation, centric relation must be recorded accurately using a stable registration material such as Delar wax. A facebow or earbow can then be used to relate the glenoid fossa to the maxillary teeth for articulation. The centric relation bite record then relates the mandibular condyle to the glenoid fossa.

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After centric relation is determined and recorded on an articulator, vertical dimension must be determined. Vertical dimension is determined by the repetitive contracted length of the elevator muscles. Even in severe wear cases, this vertical dimension can be unchanged due to supra-eruption of the alveolar processes. It is a common fallacy that worn teeth means a decreased vertical. Dr. Wilkerson has observed that for every 1mm the condyles displace from centric relation to maximum intercuspation, the anterior occlusion can be opened 2mm in centric relation.

The final key consideration for occlusal harmony is setting up the occlusal scheme.

This should include uniform contacts of all teeth in centric relation, anterior guidance and posterior disclusion in function.

Anterior guidance must established in harmony with the facial muscles determining the neutral zone, because when teeth and muscles are at war, muscles always win.

Once these key concepts are understood and in place, Dr. Wilkerson stresses the dentists need to understand and control non-functional factors, unrelated to the occlusal scheme that alter tooth structure. Toothpaste abrasion as well as chemical erosion through regurgitation, coke-swishing and fruitmulling are non-functional factors that can significantly alter the occlusal scheme. These factors must be controlled. Dr. Wilkerson stressed specific research findings that have shown toothpaste abrasion (not toothbrush) as a significant contributor to cervical wear and notching.

Dr. Wilkerson took the class on an incredibly detailed tour of the temporo-mandibular joint and muscles of mastication.

Visualization of what was occurring in the joint itself during function and dysfunction helped solidify the key concepts that were being stressed. Classification of temporo-mandibular disorders and treatment modalities were covered in depth.

The information provided was far more extensive than can be summarized in a brief article. It is my suggestion that if anyone has an interest in learning about function, dysfunction and treatment of the temporo-mandibular joint in incredible detail, Dr. Wilkerson’s lectures should be first on your list.

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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

Will The Mel Trotter Ministries Dental Clinic Re-Open in January 2010?

By JoAnne Hodder, RDH, BS, CDHO Coordinator

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or 109 years, the Mel Trotter Ministries has reached program, our volunteers also saw residents of Mel Trotter out to the needy to help them become free of their Ministries during the year from September through May. personal burdens of alcoholism, drug abuse, hunger, Thank you “for not refusing to do the something you could do”. and homelessness – regardless of race, color, or creed. The Due to an increase of other services at Mel Trotter Mission continues to guide them in attaining a faith-based life Ministries and a decrease in public contributions, there is no with goals, education, jobs, bible money in the budget for the dental study, and chapel. By establishing a clinic. Therefore, the dental clinic dental clinic onsite, Mel Trotter at Mel Trotter Ministries is closed “I am only one; Ministries has provided a forum to and will NOT re-open in January the Grand Rapids dental commu2010. Because the majority of But still I am one. nity to alleviate the dental pain, MTM residents are already restore the smiles, and educate this Heartside Health Center patients, I cannot do everything, underprivileged clientele. they are authorized to be patients at Seven years ago, the Grand the Cherry Street Clinic, and some Rapids Dental Hygienists’ Society residents may go to the Ferguson But still I can do something. joined forces with Mel Trotter Clinic. But, “You can still do someMinistries to use their dental clinic thing.” Volunteers are needed at I will not refuse to do the for a summer program. In 2004, we other dental health facilities in the called the program the Community Grand Rapids area, especially Something I can do.”

Dental Health Outreach. From Health Intervention Services and 2003-2009, with annual grants Metropolitan Hospital Assisted from the West Michigan Dental Breathing Unit. Many dental offices — Helen Keller Foundation to purchase supplies are setting aside a dedicated office and equipment, this program has time to provide free dental services provided over $291,000 in free preventive and restorative to underserved people. Perhaps someone has an idea of how services by volunteer dentists, hygienists, and assistants to to use the dental clinic at Mel Trotter Ministries to provide more than 600 underserved clients. Off-site services included free dental services. Please pray about this, accept the direcan endodontist, two oral surgeons, two pediatric dentists, and tion where God leads us, and remember: “I will not refuse to three orthodontists who volunteered their dental services in do the something I can do.” their private dental offices. This free dental program has proThank you and God bless all our faithful volunteers. vided over 1400 hours of free dental services since it began, which includes residents of Mel Trotter Ministries as well as adults and children from the community.

The dental clinic began with only one hygienist and one dentist, and then another one volunteered, and then another one, and eventually we had a program with a database of volunteers. Each of us cannot do everything, but each of us working together did something! In addition to the summer

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TRUSTEE REPORT

Pressure for an Expansion of the Dental Workforce is on the Increase

By Dr. Norm Palm, MDA Trustee

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he need to improve access to dental care for underserved groups continues to present an increasing dilemma for dentistry. I am sure you are aware of the proposed Community Dental Health Coordinator or CDHC as the American Dental Association’s endorsed new work force member, trained to be community based and able to provide limited dental care under the supervision of a dentist.

The CDHC has pilot programs in place for an American Native population in Oklahoma and a rural population in the Dakotas. The inner city pilot has been slow to be initiated.

Reportedly, a pilot will start soon in Philadelphia.

Two other proposed work force members come from nondentist sponsors and include the Dental Health Aide Therapist, or DHAT, and the Advanced Dental Hygiene Therapist, ADHP. It is important for you to know the current status of these two competing work force proposals. There has been substantial movement in the last several months to bring the DHAT forward into the main stream of the dental work force. At a later date I will give you information about the ADHP. This report will attempt to update you about the status of the DHAT. The DHAT is an auxiliary model that began in Alaska and is in the process of development in Minnesota. It is also presently proposed in Washington and California. The DHAT was sponsored in Alaska by the Alaska Native Tribal Consortium (ANTHC). ANTHC is a non-profit organization which provides health services to about 130,000 Alaska Natives. Established in 1997, ANTHC is owned and operated

by Alaska tribal governments and their regional health organizations. ANTHC is one of 22 co-signers of the Alaska Tribal Health Compact, a self government agreement with the

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Indian Health Service. Despite an attempt by the ADA to stop a DHAT program sponsored by ANTHC in 2005, the courts basically held that ANTHC was sovereign and the ADA settled its lawsuit in 2008 much to the chagrin of the Alaska Dental Association. ANTHC has been training Community Health Aides since 1968 and says they have nearly 500 CHA’s in the field in over 170 rural Alaskan villages. For ANTHC, a community dental health aide therapist was a logical extension of a medical work force auxiliary model to serve the same rural village resident’s dental needs.

Currently the W. K. Kellogg Foundation is supporting the Alaska DHAT training program with a four-year $2.8 million grant. DHAT’s are trained during one year at the University of Washington MEDEX program, which has trained physician assistants since 1976, and another year at the ANTHC DHAT training center in Anchorage. MEDEX is a regional training program that stresses broad, competency-based curriculum that focuses on primary care with an emphasis on underserved populations. The first year of the DHAT program is a five-day-a-week, full-day curriculum of classroom, laboratory and clinical work. The second year consolidates these skills with preclinical and supervised treatment of patients.

Students must pass benchmark exams in order to graduate from the program. After graduating, students enter a 400hour preceptorship where they must demonstrate clinical competency under supervision before being certified.

Certified DHAT’s are assigned to provide basic oral health services in remote tribal areas and remain supervised by “hub” dentists who coordinate, supervise, and are responsible for the overall care delivered. The services DHATs perform include restorative, pulpotomy, prophylaxis and uncomplicated oral surgery. Recertification is required every two years and continuing education is required for recertification.

The Kellogg Foundation and three other funders, Bethel Community Foundation, M .J. Murdock Charitable Trust, and Rasmuson Foundation, have funded a two-year comprehensive evaluation of the DHAT program to determine the impact it is having on access and the quality of care. The study is being done by RTI International, a researcher in evidenced based care affiliated with five health professional schools and the Sheps Center for Health Services Research at the University of North Carolina. The Ford, Pew, Allen and RW Johnson WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2009

TRUSTEE REPORT

Foundations have also been supportive of the DHAT program. Kellogg and Pew published a paper in May of this year comparing the DHAT to other proposed dental therapist models. It tacitly endorsed the DHAT. Minnesota passed legislation establishing an oral health therapist, essentially a DHAT, a month prior to this paper’s publication. The Minnesota Dental Association scrambled to have an effect on the legislative outcome in their state. The MDA and the University of Minnesota developed their own competing alternative provider proposal that maintained the dentist in a general supervisory role. As the MDA was endorsing a DHAT type proposal, which is against existing ADA policy on alternative providers, MDA received limited assistance from the ADA. In 2008, the ADA House of Delegates authorized up to $5 million for the pilot programs for the CDHC and their subsequent evaluation by an independent outside group as to the effect on access and the quality of care provided by CDHC’s. The hope was that outside foundations would come forward to help fund the CDHC’s development. That has not happened for reasons that are now obvious. Non-dentist groups appear to be endorsing the DHAT model over others and are advancing their own pilots and, soon enough I would expect, assistance with legislative action with local partners on a state by state basis. The ADA is struggling to even get a seat at the table when DHAT supporters are looking for partners in individual states. The ADA continues to collaborate with the Indian Health Service and is attempting to keep the DHAT a dental auxilary program for specified underserved Native American populations. Recently, New Mexico and Kansas have had DHAT overtures come forward looking for support. In January of this year, the Maine Dental Association sponsored legislation that endorsed a DHAT in response to an ADHP proposal. Maine has a biennial house and senate and the speaker of the house tabled both proposals until 2010. Earlier this month, it was reported that the Connecticut House of Delegates was considering a proposal supporting a DHAT pilot program. Such a supportive action would be viewed as being in direct violation with existing ADA policy similar to the circumstances in Minnesota.

Unknown is how effective the foundations will be in sponsoring any DHAT initiative. Unknown is how effective DHATs WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2009

will be in improving access to care, and how accepting the public will be of two-tiered care. However, the sponsoring foundations are large, well-funded groups with touted experience in health care policy initiatives. Pew Charitable Trust was founded in 1948 and has over $5 billion in assets. Its current mission is to serve the public interest by “improving public policy, informing the public, and stimulating civic life.”

The Trust funds the Pew Research Center, the third-largest think tank in Washington D.C. after the Brookings Institution and the Center for American Progress. The Kellogg Foundation is the seventh largest philanthropic foundation in the U.S. with $7.3 billion in assets. In 2005, it funded $243 million in grants and programs with 82% spent in the United States. In 1996 it began a multi-year water fluoridation program in conjunction with the Pan American Health Organization with a goal to “fluoridate the entire region of the Americas.”

As I write this piece, both the U.S. Senate and House health care reform proposals have funding for pilot studies for alternative dental providers as well as increased funding for children’s oral health care through the Medicaid system. The American Recovery and Reinvestment Act of 2009, the Obama stimulus bill, contained funding for the department of Health and Human Services for comparative effectiveness research. CER looks at outcomes of processes or models to deliver broad outcomes and the costs of producing these outcomes. A November 27 Wall Street Journal editorial discussing drug costs and health care reform mentions how CER could be used to “prove” the effectiveness of lower cost treatment models. The Center for Medicaid and Medicare services is reportedly seeking funding for studies of alternative dental providers using CER. As early as 2003, sub-groups in the Center for Disease Control have been interested in improving dental access through an expanded scope of existing dental providers or a new provider. A report entitled “The Effects of State Dental Practice Laws Allowing Alternative Models of Preventive Oral Health Care Delivery to Low-Income Children” stirred individual states to develop public health dental hygienists to provide care to underserved groups. States that use such public health hygienists make an exception to the level of dentist supervision permitted. Now it would appear there is a pro-

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TRUSTEE REPORT

gression to develop an alternative provider with a broader scope of treatment authorization. Public policy makers in concert with non-dentist groups like these foundations and other public policy advocates appear to be targeting the DHAT as the favored model. Reportedly, the cost of training a DHAT is $60,000, or more than five times less than that of a dentist.

It will be a distinct challenge for organized dentistry to assess all this activity and make a determination as to the best policy action to take on access and the DHAT. The interests of members, the profession’s integrity, and access for underserved patient groups need consideration. The dental education community may view the development of an alternative provider differently than dentists in the private sector. In addition, speaking with one voice on a policy will be difficult as DHAT programs will be implemented at the state and not the national level. States may feel compelled to take their own action and deal with non-dentist advocates of the DHAT and their own legislatures in a manner that suits them despite

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ADA policy. Fragmentation may also develop within state association memberships as differences of opinion manifest themselves on a strategic course of action, limiting the profession’s response.

As your trustee my role is to inform you, giving you information that will be necessary for you to have as our profession answers these challenges not just elsewhere but at some point here in Michigan. Thank you for staying informed.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2009

GRDHS NEWS

Thanks for Your Support

By Cheryl Bentley, RDH, President, GRDHS

T

he Grand Rapids Dental Hygienists’ Society would like to thank Dr. Brian Cilla and Dr. Norm Wilhelmsen for sponsoring the speaker for our annual fall seminar. It was an excellent seminar, full of helpful information on Burning Mouth Syndrome and Managing Pain. Of course, the morning was full of laughs. If you know Dr. John Gobetti, you expect nothing less. He is an exceptional speaker, with the ability to entertain while informing his audience. We are looking forward to future topics presented by Dr. Gobetti.

Drs. Cilla and Wilhelmsen not only support hygienists with financial contributions, they support the profession of dental hygiene with their words and actions. Speaking on behalf of the profession of dental hygiene, we are grateful for your recognition of the value of the licensed dental hygienist.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2009

Dr. Brian Cilla, Dr. John Gobetti, and Dr. Norm Wilhelmsen.

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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.

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.

SE Grand Rapids – Opportunity for a younger dentist to begin transition to their own practice. Recently remodeled office in an excellent location.

Gradually meet the patients and earn extra money as existing dentist takes additional time off over the next three to five years. If interested, email cascadedentistry@gmail.com.

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 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.

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.

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Dental Practices Wanted to Buy – Two dentists separately looking for a practice to buy in the Grand Rapids area. Contact Greg McGlaun of Proveer at 616.425.5523 or gmcglaun@proveerpm.com.

Dental Vacuum Pump – 2 Hp Matrix Model Max-2000. Excellent condition.

Recently appraised at $1200. Will take $800 or best offer. Contact Chase Klinesteker at 949-8665 or ckspoonpl1@aol.com.

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.

Dental Office for Lease – Sparta, MI. 2,000 sq ft., includes two x-ray machines, vacuum extraction, cabinetry, laboratory. $1,350 plus utilities.

Traffic flow/14,000 daily. 616.874.4192.

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.

RDH/RDA – Dental professional with over 5 years experience seeking fulltime, part-time or subbing opportunities where I will be able to utilize my professional experience with patients.

Please contact me at 616.262.8719.

Opening a Satellite Office. Looking for a good used panoramic x-ray and some other used equipment (in good shape). Please email: hanyb@juno.com or call my office at 616.774.9402 or cell phone 616.307.2213 (leave message). $190,000 Medical/Dental Office Building for Sale – Just south of 28th St. off Eastern Ave. in Grand Rapids.

2,345 sq. ft. For more information call Tyler DeGraaf at NAI West Michigan 616.242.1118.

For Sale – 2 Dental EZ chairs (one seldom used), Pelton Crane autoclave, Bio Sonic ultrasonic cleaner, Vacstar 2 vacuum pump 1 HP. No reasonable offer refused. Call 616.456.7620.

Spielmaker Accounting, Inc. – Specializing in medical practice accounting. Providing all aspects of accounting, payroll, and tax services.

Licensed. Over 20 years of practice experience. References available.

616.885.0432.

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.

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.

RediDental Emergency Dental Care is now accepting applications from dentists. This is a perfect opportunity to “moonlight” to bring in extra money.

Schedule not full? Consolidate your office hours and work a few with us for guaranteed pay. We have morning, evening, and weekend hours available.

Email resumé to dr.lebster@tds.net.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2009

CLASSIFIED ADS

Grand Rapids, Suburb – Associate needed for busy, general, restorative practice, with transition to partner as soon as possible. Two doctor, 4-hygienist, 10-operatory, highly profitable, Mercer-coached practice, based on quality, integrity, and community involvement. Our practice is located in Sparta, a rapidly growing community with a new high school, ten miles from Grand Rapids and 30 miles from the Lake Michigan shoreline. Our new facility opened in April 2008, has 5500 sq ft with an equally large lower level, is state of the art, and was needed to meet the demands of our growing patient base (377 new patients with comprehensive exams in the last 12 months). Needed is someone who sees the value of a practice that is close to a metropolis as well as recreational sports, and understands that the rewards, both financial and personal, are far greater in a setting where one can establish close relationships with their staff, patients, and residents of the town, rather than practicing in a highly competitive, anonymous, urban setting. You will have the option to live in vibrant Grand Rapids … Michigan’s second-largest city with the lowest unemployment of Michigan’s five largest cities and with an easy 10-15 minute commute, live in the country with acreage, or live in a small town with all that small-town living has to offer. Instead of signing an employment agreement with just a verbal promise to ‘buy into the practice … someday,’ consider joining a practice where there is a written agreement up front regarding your purchase and the valuation of the practice, and where the doctors are anxious to mentor their future partner and get personally involved in making them successful.

Visit our website www.spartadentstry.com and learn more about our long-term stable staff, the doctors, and our facility. Phone 616.887.7389 or email through the website, or email mcfalldds@sbcglobal.net.

RDH – 19 years hygiene experience, professional demeanor with excellent chairside manner with patients.

Seeking part-time or substitute opportunities. Flexible, proven individual/team performer, strong references. Call Kathy at 616.682.1967.

Associate Position Wanted – General dentist looking for a position in a private practice as an associate in the Grand Rapids and surrounding areas.

Open to all options (buy-in, partnership). Please call 616.307.2472 or email kmvdds@gmail.com.

Orthodontist Needed in Northern Kent County/Sparta – Two unequipped operatories ready in new, 2-dentist, 10-operatory, general dentistry building with room to expand to multi-chair practice. Ideal for satellite or start-up practice. Great referral base with six general dentists in Sparta and many more in just a 5-6 mile radius. See facility at www.spartadentistry.com.

Email mcfalldds@sbcglobal.net or call 616.887.7389. We are open to all scenerios of space sharing and partnerships.

RDH – 19 years Hygiene experience, professional demeanor with excellent chair side manner seeking part-time or substitute opportunities, flexible, proven individual/team player, strong references. Kathy 616.682.1967.

Gorgeous Brand New 9120SF Class A Grand Rapids, Michigan area – General practice with average revenues of $600,000. Great family community convenient to Grand Rapids. Fully paperless office with complete digital, computerized system in four fully equipped operatories. Contact Phil Stark, Peak Transitions 888.477.7325 or visit www.peakdental.com.Practice Wanted – Experienced general dentists wish to grow existing practice through buy-out or merger. Greater Grand Rapids. All options considered.

Contact smile01@sbcglobal.net.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2009

SE Grand Rapids/Cascade – Office suite available on 28th Street. Up to 3,000 sq. ft., remodel to suit, adjoining new office of established general dentist, perfect for a specialist. Lease or purchase option. Contact Randy Chambers, DDS at 616.974.9947, or Eric Trierweiler with Prime Development at 616.957.4733.

Grand Rapids, Michigan area – General practice with average revenues of $600,000. Great family community convenient to Grand Rapids. Fully paperless office with complete digital, computerized system in four fully equipped operatories. Contact Phil Start, Peak Transitions, (888) 477-7325 or visit www.peakdental.com.

Dental Office for Lease – Rockford, MI. 1,000 sq ft, includes some dental equipment and furnishings. $675/mo., plus utilities. Traffic flow/10,000 daily.

616.874.5300, Office Condo for Sale – Income producing! 3769SF new medical tenant on 5-year lease, 5351SF available to occupy.

High traffic corner. Norton Shores.

Call 616.776.0100.

Tired of your IRA losing money? Is your IRA insured? Invest in an insured, secured, diversified real estate note package paying income each and every month. 20% return on full purchase.

Investment is $500,000. Partials considered for a 15% return. Current owner has other business opportunity.

Call now. TPS Holdings, 616.299.5778.

Charlevoix County – Well established, solo general practice in Northwest Lower Michigan. Located between Charlevoix and Petoskey. Averaging $357,000 gross revenues the last three years on twenty-nine clinical hours.

Great potential to grow practice or add satellite office. Three equipped operatories, real estate with lake views available as well. Ken Smith Peak Transitions (888)477-7325 or www.peakdental.com.

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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!

Davis Dental Laboratory................inside front cover Founders Bank & Trust.....................17 Henry Schein ............inside back cover

HAPPY HOLIDAYS!

Hungerford, Aldrin, Nichols & Carter, PC ..........................................16 MDA IFG...........................................11 Midwest Capital Advisors.................20 Professional Solutions .................outside back cover ProNational ....................................... 9

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2009

WEST MICHIGAN DENTAL SOCIETY 511-F Waters Building Grand Rapids, MI 49503

PRSRT STD US POSTAGE PAID GRAND RAPIDS, MI PERMIT # 657

2010 Calendar of Events January 2010 January 8, 2010 – WMDDS Continuing Education Seminar – Dr. John Molinari and Steel Water Award presentation to Lois Havermans, RDH, CHES January 8, 2010 – WMDDS New Dentist Forum Social Event at 8:00 pm January 13, 2010 – WMDDS Board Meeting at 6:15 pm January 27, 2010 – Kent County Dental Society Meeting – Dr. John Leitner, speaker at 5:30 pm

February 2010 February 4-5, 2010 – WMDDS Tooth Time, Grand Rapids Children’s Museum February 25-27, 2010 – Chicago Mid-Winter Meeting, McCormick Place West, Chicago, IL February 24, 2010 – WMDDS Board Meeting at 6:15 pm

March 2010 March 5, 2010 – Dental Appreciation Night at the Griffins (Hockey Game) March 11, 2010 – WMDDS New Dentist Forum Meeting at Pietro’s at 6:30 pm March 12, 2010 – WMDDS Continuing Education Seminar – Dr. Jeff Morley March 24, 2009 – WMDDS Board Meeting at 6:15 pm March 22, 2010 – Western Michigan Steering Committee Caucus in Kalamazoo for delegation March 31, 2010 – Kent County Dental Society Meeting – Mr. Richard Klein, speaker at 5:30 pm

April 2010 April 8, 2010 – WMDDS New Dentist Forum Meeting at Pietro’s at 6:30 pm April 12, 2010 – WMDDS/Muskegon District Caucus for delegation at 6:15 pm April 14-17, 2010 – MDA Meeting at Rock Financial Showplace in Novi, Michigan