2015 WMDDS Summer Bulletin

SUMMER ISSUE 2015 VOL. 47, NO. 3

Bulletin

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Contents ­Editor

Dr. James Vincelj

President’s Message...................................................................................................... 2

Associate Editors

Dr. Seth Vruggink Dr. Derek Draft Dr. David Huyser Dr. Brian Licari

Editor’s Thoughts......................................................................................................... 4

Advertising Editor Elaine Fleming

Executive Secretary WMDDS

161 Ottawa Avenue NW

Suite 301

Grand Rapids, MI 49503

(616) 234-5605

efwmdds@aol.com West Michigan District Dental Society Executive Board 2014-2015 President Dr. Steve Conlon President-Elect Dr. Leonard Bartoszewicz Vice President Dr. Brian Mulder Secretary-Treasurer Dr. James Papp Editor Dr. James Vincelj Immediate Past Dr. Samuel Bander President Directors Dr. Lathe Miller

Dr. Kevin Rebhan

Dr. Kathryn Swan Area Representatives Kent County Dr. Kathleen Eisin Ionia-Montcalm Dr. Scott Ribitch County Mecosta County Dr. Erick Perroud Ottawa County Dr. Thomas Anderson

Sleep Apnea Need Not Affect Us From Infancy Until Death.................................... 6 The Hidden Signs of Sleep Apnea............................................................................... 8 Sleep Health Questionnaire.........................................................................................11 WMDF Golf Outing Raises Over $23,500...................................................................12 Meet the 2015 West Michigan Dental Foundation Scholarship Winners................14 WMDDS Dentists and Legislators Meet to Discuss the Issues..................................15 2015-16 WMDDS Continuing Education Programs.................................................16 MDA News....................................................................................................................18 Benefit Plan Snippets....................................................................................................20 Free Up Time to Work on Your Practice … Not Just In It.......................................23 Rise of the Machines!...................................................................................................24 Technically Speaking....................................................................................................26 Estate Planning.............................................................................................................28 Classified Ads................................................................................................................30

Big Rapids Dental Study Club Officers President Dr. Erick Perroud Vice President Dr. Christa Stern Secretary Dr. Christa Stern Treasurer Dr. Erick Perroud

Advertiser Index............................................................................................................31

Holland-Zeeland Dental Society Officers President Dr. Meredith Smedley Treasurer Secretary Immediate Past President

About the Cover

Ionia-Montcalm Dental Study Club Officers President Treasurer Dr. Kirkwood Faber Kent County Dental Society Officers President Dr. Kathryn Swan Vice President Dr. James Papp Secretary Dr. Kathleen Eisin Treasurer Dr. Christopher Leja West Michigan Dental Foundation Officers President Dr. Michael Palaszek Vice President Dr. Sarah Mahar Secretary Mrs. Dawn Kamyszek Treasurer Mr. Joe Van Laan The Bulletin of the West Michigan Dental Society is published six times a year (the winter issue, spring issue, summer issue, directory issue, fall issue, and holiday 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, 3050 Ivanrest SW, Suite B, Grandville, MI 49418.

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. © 2014-2015 West Michigan District Dental Society Bulletin

2015 MDA Matt Uday New Dentist Leadership Award............................................32

2015 West Michigan Dental Foundation golf outing. Enjoying the outing are Greg Feutz, Dr. Tim Meade, Dr. Ryan Zolman and Dr. Dale Shoemaker.

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 winter issue, spring issue, summer issue, directory issue, fall issue, holiday issue. Direct submissions or ­correspondences to:

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

Dr. James Vincelj • 6208 Kalamazoo Avenue SE • Grand Rapids, MI 49508 Phone: 616.554.5970 • FAX 616.554.5974 • Email: drvincelj@mac.com Include “Newsletter” in the subject line

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PRESIDENT’S MESSAGE

“Why Do You Want To Be A Dentist?”

By Steve Conlon, DDS, WMDDS President

“S

o, Mr. Conlon … you want to be a dentist?” That was the opening question of my interview at the University of Detroit Mercy (the old school on Jefferson Avenue) in early 1992. Dr. Mason, a periodontist and instructor at the University was the gate keeper of my “dental” future at Detroit Mercy. He and I would investigate this question for the next 60 minutes to determine if I was worthy of acceptance to the dental school for the following school year. Dr. Mason had taught at New York University’s School of Dentistry and, fortunately for me, was a bit of a foodie. After reviewing my application, he wanted to discuss not only why I wanted to be a dentist but also the New York City restaurant business as well.

My experience leading up to dental school was certainly unusual. I grew up in New York and spent my high school years in Manhattan. My mom was involved in the restaurant business in the city and got me my first job at thirteen in the kitchen of a northern Italian restaurant on the Upper East Side. I began my restaurant career as many do, doing menial tasks, putting away food orders, doing light prep work, washing dishes and so on. The Executive Chef had decided that he was going to teach me how to cook, and by age sixteen that was how I spent much of my time when not attending high school. I managed to cook in three different kitchens in NYC and one in Baltimore before graduating high school in 1985. I also attended a summer Culinary Arts Program at the Culinary Institute of America during the summer of my junior year.

Following graduation, I attended Michigan State University and enrolled in the Hotel and Restaurant Management program. I continued to work my way through college both cooking and managing a private summer resort in New York,

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received my degree and was well on my way in the hospitality industry. My first job following graduation would alter my career trajectory immensely. Tired of the hours required in hospitality and desiring a more reasonable work schedule, I took a position in corporate food service at a Siemens Automotive facility in Auburn Hills. The hours were great; Monday thru Friday and home most nights before six.

There was something missing though.… I no longer had any passion for what I was doing and questioned if this is how I was to spend the rest of my life. Secretly, I had always wanted to be a doctor. Following some good advice obtained from both a physician who was a member at a club I had once managed, my father-in-law (a dentist and graduate of U of D) and incredible support from my wife Melissa, I enrolled in Oakland University to take the core science classes needed to apply to either dental or medical school.

During my time at Oakland, I spent time investigating both medicine and dentistry as potential professions. Dentistry for me was clearly the better choice. I enjoyed working with my hands, embraced the opportunity to own my own practice, and as this would be my second career, was encouraged that I could be on my own treating patients following four years of training.

After discussing my unusual path that got me to this point in my life as well as reminiscing about many of the restaurants the doctor frequented while living in NYC, we got back to the original question as the hour had nearly come to a close.

“Why do you want to be a dentist, Mr. Conlon?” I answered with the typical clichés: ‘I want to help people, work with my hands, serve my fellow man, etc.” The interview went smoothly, the answers I gave were acceptable, and the good doctor saw fit to recommend that I be given an opportunity to be enrolled the following fall.

What does that question mean to me now that I am ostensibly halfway through my career? How would I answer the question “Why do I want to be a dentist?” Would I give similar responses to my interview 23 years ago? Do I still believe in my answers?

During my first twelve years of work I served people. I cooked for them, waited on them, cleaned up after them, made sure they were comfortable and that they had an enjoyable experience. I provided a service and was paid accordingly.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

PRESIDENT’S MESSAGE

As a dentist, I serve people, I wait on them, clean up after them, make sure they are comfortable, provide a service and am paid accordingly. However, the relationship with a patient rather than a customer is completely different. It is this difference which makes the profession of dentistry so rewarding for me. I am afforded the gift and responsibility of truly caring for my patients. I am entrusted with the intimate details of their health and often times their lives. I am expected to perform and exceed, if possible, the standard of care with every encounter and procedure. I am expected to continue to develop my skills throughout my entire career. I represent not only me but the entire profession in my dealings with public.

In return for this gift I have chosen to serve you, the membership of the WMDDS, and the profession of dentistry. I hope to make an impact and serve with honor and distinction over the next year. I hope that you will join me in serving our great profession. There is always room for more volunteers and many ways to serve. Feel free to contact me if you wish to give back or have any concerns. drconlon@sbcglobal.net or by phone at 616-554-5970.

So … “Why do you want to be a dentist?”

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EDITOR’S THOUGHTS

West Michigan Milieu

By James Vincelj, DDS, Editor, West Michigan District Dental Society

A

s I sit here writing my first editorial, I am constantly distracted by the hockey game on the television beside me. I do not apologize for this because I am Canadian and it’s in my blood. Growing up in Toronto, I was on skates at the age of two and in my first hockey camp at the age of four. Continually disappointed by the Toronto Maple Leafs not winning a Cup since 1967 (I was a one-yearold and don’t remember even seeing a TV), I was horrified when I chose to attend dental school at the University of Detroit Mercy, home to the arch-enemy Detroit Red Wings.

The constant ribbing by the locals there was at least relieved by the Blue Jays winning the World Series two years in a row.

After graduating, I escaped the dreaded red and white “hockeytown” and the grips of its octopi, returning to my beloved Toronto. But once there I grew weary. Still no Stanley Cups.

More people. More dentists. An ever-expanding city, both horizontally and vertically. The cost of living growing exponentially. Then one day as I sat in a pub with my face in a bowl of poutine and pint of Labatt 50 Ale near my left hand, contemplating my next career move, I got the call. It was my good friend from dental school, our current WMDDS president. He asked me to come work with him in Michigan, this place called Grand Rapids, somewhere on the west side. To that point the furthest west in Michigan I had been was some town where the real college football team is. A town called Ann Arbor. He lured me with tales of cheese and cherries, tall blonde people who danced in wooden shoes, and a lake. So I came, and I love it.

So here I am, ten years on, and I am ashamed to say my “dental community” consists of those professionals I know within a two-mile radius. Even worse, some I have never met

4

face-to-face. Yes we are a solitary profession, but a profession nonetheless. A profession of colleagues who are to support and educated one another. So I propose that we bring our profession together, at least within our community of the West Michigan District.

Who are we? Five counties, Kent, Ottawa, Ionia, Mecosta, and Montcalm. In order to a get a better picture of these parts of our Society, I will be asking the leaders of those counties to share articles pertaining to the ongoings within their own dental communities as well as their concerns. If we know each other better, we can support each other better.

Education? Beyond the sponsored WMDDS continuing education programs, the Bulletin will continue to offer themed articles offering insight into all areas of dental practice. Social events organized by member committees are also a great way to connect with other members across our area.

I invite all members to submit any interests or ideas they wish to share. We are always looking for articles that will enhance the scope of dental practice, feel free to write one!

From governance to social events, new dentists to well seasoned ones, the WMDDS hopes to continue to be an avenue of information and unity for colleagues in this beautiful part of our state. Feel free to contact me at drvincelj@mac.com.

2016 Mission of Mercy Date, Location Set The 2016 Michigan Mission of Mercy will take place June 9-12, 2016, at Macomb Community College in Warren, the MDA Foundation has announced.

Macomb Community College offers excellent facilities that lend themselves well to a large event such as the MOM, said 2016 MOM co-chair Dr. Stephen Harris.

The location is also within easy access to a large potential patient population, as well as within close proximity to a significant number of volunteers, Harris said.

Michigan MOM events have been held in 2013 and 2014, but no MOM will be held in 2015, Harris said. Michigan’s MOM is administrated by the MDA Foundation, the MDA’s charitable arm.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

5

SLEEP APNEA

Sleep Apnea Need Not Affect Us From Infancy Until Death

By Drs. Jeff Smith and Karen O’Rourke

M

any of us may be familiar with some of the consequences of undiagnosed and untreated adult sleep apnea, as well as some of its various treatments ranging from dental mandibular advancement appliances, to C-PAP machines in more severe cases, and even maxillary/mandibular advancement surgery. But what if we could recognize and treat our patients while they were still very young children, and prevent the need for more aggressive adult treatment (which in many cases fails because of patient non-compliance)?

Obstructive sleep apnea (OSA) is a medically-diagnosed condition. It occurs when the tongue falls back into the oropharynx during sleep and the airway is blocked until the patient is stirred by hypoxia or is awakened. The severity of OSA is often measured by the number of apneic episodes which occur in an hour. Besides the obvious deleterious effects that OSA has on the quality of sleep (disturbances in REM as well as rejuvenating Delta sleep), it has also been linked to other systemic conditions such as A.D.H.D., depression, heart disease, hypertension/stroke, esophageal reflux (GERD), obesity, headaches/chronic pain, restless leg syndrome, impotence, diabetes, cancer, and thousands of fatiguerelated car accidents each year.

A simple four-question screen can be used to identify adult patients who might be at risk for OSA. The questions are as follows: 1. Do you snore loudly?

2. Do you often feel tired, fatigued, or sleepy during the daytime?

3. Has anyone observed you stop breathing during your sleep?

4. Do you have, or are you being treated for high blood pressure?

A positive answer to two or more of these questions places a person into a “high risk” category for OSA.

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OSA can also be associated with several dental conditions and pathologies. A study in the journal Sleep Medicine reports that OSA is one of the highest risk factors for nocturnal bruxism.

During sleep, as the airway collapses, the brain subconsciously initiates clenching and grinding to open the airway and enable breathing. We know that bruxism is a major factor in temporalmandibular dysfunction. Treatment of OSA may prove beneficial in alleviating symptoms in some cases of TMD. In a University of Montreal study, when ten bruxers with OSA were treated with CPAP machines, they stopped grinding their teeth. When treating patients with worn dentitions, it is important to screen for OSA, so that the patient does not end up destroying their new restorations. Furthermore, half of the patients in this study showed an increase in their apneahyponea index when wearing flat plane splints. This may be because the splints decrease available space in the mouth and push the tongue posteriorly into the oropharynx. Further research is necessary to confirm these findings. Erosion from gastroesophageal reflux disease (GERD) is another cause for dental reconstructions. Studies have shown a high prevalence of GERD in OSA patients. Treatment of OSA in these patients may help to decrease the effects of GERD. Children and adults with asthma are at a higher risk for sleep-disordered breathing, and the longer the patient has had asthma, the greater their increased risk. When a child with chronic nasal obstruction is forced to breathe through their mouth, the tongue drops away from palate, and the upper arch collapses, dropping down and back. This tends to create an elongated mid-face and a narrow maxillary arch.

Since the mandible is on a hinge, it is carried down and back too. This may lead to a distal displacement of the condyle as the mandible retrudes. This retrognathia, secondary to mouth breathing, puts children at an increased risk for OSA as they become adults. Other reasons for insufficient palatal width in children are: thumb sucking, pacifier use, taking nourishment from a bottle instead of breastfeeding, and the pureed foods that infants are given to eat. Bottle feeding and soft foods require much less force and use of the child’s tongue and oral musculature, which is necessary for the development of a strong tongue-to-palate connection. Furthermore, breastfeeding forces the infant to breathe through its nose, which is vital for proper airway and oral development.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

SLEEP APNEA

OSA in children is associated with A.D.H.D., behavioral problems (such as inattention, aggressiveness, and difficulty with peer relationships), daytime sleepiness, and nocturnal enuresis (bed wetting). Simply asking the parent, “How is your child sleeping?” is not enough. We need to be asking better questions. For a more complete list of sleep symptoms in children, refer to the Sleep Health Questionnaire on page 11. The Centers for Disease Control and Prevention report that 11% of school age children are diagnosed with A.D.H.D., but what if a significant portion of these kids are really just sleep disorders in disguise? A 2006 University of Michigan study in the journal Pediatrics found that children scheduled for tonsillectomy (because of OSA) were four times more likely to have A.D.H.D. when compared with a normal sleeping control group. Furthermore, one year post-tonsillectomy, half of the A.D.H.D. group no longer met the criteria for that condition. In these kids, the A.D.H.D. had been resolved by treating a sleeping problem. It is interesting to note that over a million tonsillectomies used to be performed every year (because of breathing impairment, and/or repeated ear and throat infections), and that as the operation has become much less common in recent decades, the incidence of A.D.H.D. has increased.

Sleep-disordered breathing (SDB) is a general term hallmarked by snoring (usually accompanied by mouth breathing) and sleep apnea. SDB peaks from ages 2 to 6 years, but can also be seen in younger children. The American Academy of Otolaryngology reports that about 1 in 10 children snore regularly, and that 2 to 4 percent have sleep apnea.

(Interestingly, patients who snore without OSA or upper airway resistance have been found to display many of the neurocognitive impairment symptoms associated with OSA.) The risk for SDB is increased among children with enlarged tonsils, cross bites, and/or a convex facial profile. SDB may be responsible for behavioral problems by decreasing oxygen levels and increasing carbon dioxide levels in the brain, or by interrupting the restorative processes which occur during sleep. A recent long-term study in the journal Pediatrics followed a group of 11,000 kids in Britain and found that children aged 6 months who suffered from sleep-disordered breathing were more likely to have behavioral problems up to the age of 7 (when the study was ended), even if the disWEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

ordered breathing had abated much earlier. This implies that infant breathing problems have the potential to create longterm or even permanent neurological injury.

Adenotonsillectomy (AT) has long been the treatment of choice for SDB in children. Its cure rate is estimated to be about 80%, but some studies suggest a recurrence of SDB at adolescence, and an incomplete cure in as much as 75% of the cases after the surgery is done. The use of continuous positive airway (CPAP) is now suggested in kids with remaining symptoms of SDB after AT. However, the use of CPAP may have adverse effects on the child’s facial growth and development of the maxilla. The use of anti-inflammatory agents shows promise in opening up the nasal airways in kids.

Orthodontic and/or orthotropic treatments may be excellent options, as they may improve or even permanently cure SDB by enlarging the nasal passages and/or the oropharyngeal space via expansion of the palate. Widening the palate/maxilla also creates greater space for the tongue, so that it is not positioned as far posteriorly or inferiorly, and encroaching into the oropharyngeal space.

OSA patients have many facial and dentally recognizable features such as open mouths, droopy, tired-looking eyes with dark circles underneath, a convex facial contour from the nose to the chin, a narrow maxilla – recognized by a gap between the corner of the lips and buccal surfaces of the posterior maxillary teeth when smiling, retruded and/or narrow jaws, missing mid-arch permanent teeth, attrition, and tori.

Classic symptoms are snoring, bruxism, TMD, headaches, and mental/physical fatigue. Don’t forget that many of these symptoms may show up in your patient’s health histories.

Implement the children’s sleep questionnaire (see page 11) into your pedo records, and refer to the child’s primary care provider if you have concerns.

Ninety percent of the people affected by OSA are left undiagnosed. Because we typically see our patients more frequently and regularly than do their physicians, we are in a prime position to recognize the signs and symptoms of mouth breathing and sleep apnea. It should be our responsibility as dentists to intervene or refer our patients to their physicians at the earliest stages in order to prevent many of the problems that these people will suffer through life if their conditions are left untreated.

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SLEEP APNEA

The Hidden Signs of Sleep Apnea Compiled by Karen O’Rourke, D.D.S.

Patient: R.D. – 64-year-old white male Medical history: reveals congestive heart failure, history of defibrillator in 2009, GERD, anxiety, erectile dysfunction, and restless legs syndrome. Patient was referred for a sleep study approximately 15 years ago for loud snoring and witnessed apnea. He utilized a CPAP for one month, and then discontinued its use.

Current sleep study revealed AHI (Apnea Hypopnea Index) of 30, RDI (Respiratory Disturbance Index) 78, and the patient was noted to have moderate, frequent snoring (see Figure 1).

Physical exam: Exam revealed neck circumference of 18 inches, BMI 29 – patient was slightly overweight.

Dental exam: Exam revealed 13 missing posterior teeth, high arched palate, tori, 90% crowns with fractured porcelain and evidence of severe wear.

Discussion: Dentally we can connect the dots for our patients. Obstructive sleep apnea patients have a high incidence of severe clenching and grinding. This is the body’s autonomic response to help open the airway. Have increased suspicion when there are tori present, fractured teeth or fractured porcelain, tissue dehiscence, or bone loss around implants. This patient opted to return to CPAP use, and is doing quite well. He noticed a good improvement in mask design from 15 years ago.

Figure 1

Patient: W.R. – 58-year-old white male Medical history: Reveals high blood pressure, esophageal reflux (GERD), history of tonsillectomy, and loud snoring.

Current sleep study reveals AHI of 41. He averaged 18 obstructive apneas per hour (this is a 95% or more reduction in airflow), and 22 hypopneas per hour (this is 30% reduction in airflow with a 4% drop in oxygen saturation). This is not a very restorative sleep pattern!

Dental history: History of clenching, grinding, large tori, missing lower incisor (narrowing the arch), fractured #31.

This patient opted to be treated with a mandibular advancement appliance, and his wife is elated that he no longer snores. The dentist who made the appliance did not have the patient return for a sleep test, so we don’t know at this point the level of improvement in the obstructions. It is recommended that a follow up sleep test be done following any therapy to check its efficaciousness.

Figure 2

Physical exam: Appropriate weight, BMI 25; nothing that would alert the medical doctors to a potential diagnosis of OSA. Discussion: The medical history starts to raise our suspicions. Dentally, we see some signs that should add to our concern. As well as the clues above, this patient has a very narrow dental arch for his size. There is a lot of space between the teeth and the corners of the mouth; indicating a very narrow palate. (See Figures 2, 3). See photo of natural arch development for a comparison. Teeth fill the smile to the corners of the mouth. Teeth are aligned naturally, with no crowding and no orthodontics required (Figure 4).

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Figure 3

Figure 4

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

SLEEP APNEA

Patient: N.S. – 8-year-old white male Medical history: Was significant for allergies, anxiety, disruptive behavior disorder, developmental delay, bed wetting, snoring, bruxing, sleep walking, and restless sleep. He was diagnosed with Obstructive Sleep Apnea and an AHI of 11.

Following the sleep study he was referred for removal of tonsils and adenoids. His symptoms improved and his AHI came down to 4, but he was noted to snore and still have episodes when he stopped breathing. For children, they should have an AHI of zero. He was referred for maxillary expansion and orthodontic treatment.

Dental history: Gummy smile, narrow arch, deep Cl II bite, crowding and flat profile – showing maxillary and mandibular retrusion (Figures 5, 6).

Discussion: Protection of the airway must take precedence in the treatment plan for this child, and for that matter any child. Expansion and advancement of the maxilla with protraction, and advancement of the mandible will help bring these jaws back to the norm (Bolton norm on the facial outline), and help resolve symptoms of Obstructive Sleep Apnea as well as straightening the teeth. Retraction of the teeth or jaws, or extraction of permanent teeth will exacerbate the Obstructive Sleep Apnea and above symptomatology.

These dental findings are very common in children today.

Crowded teeth are a symptom of an airway issue, and should cause us to inquire further into medical symptoms. I have attached a one-page medical history adapted from the medical history form at DeVos Pediatric Sleep Disorders Clinic (see page 11). I think you will be as surprised as I was at the number of positive responses checked off by parents after I implemented this form in my office for all children.

Figure 5

AHI (Apnea-Hypoxia Index) Measurement for Obstructive Apnea Adults Normal............................................. < 5 Mild................................................ 5-15 Moderate...................................... 15-30 Severe.............................................. > 30 Children Anything over zero is a problem.

Figure 6

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

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SLEEP APNEA

Patient: J.B. – 14-year-old white male Medical history: Cerebral palsy.

Dental history: Class II, high narrow palate, retrognathic mandible, with permanent teeth #7 and #10 not present (Figures 7, 8, 9).

Discussion: Due to the low muscle tone resulting from cerebral palsy, the patient has assumed an open mouth posture since childhood. This caused the tongue to drop down and away from the palate, resulting in the upper arch narrowing, and the mandible growing in the position it was held: down and back. With the tongue being connected to the lower jaw, it was carried posteriorly into the oro-pharynx, resulting in obstructive sleep apnea.

Mike Napoli is a baseball player for the Boston Red Sox. He recently opted to treat his Obstructive Sleep Apnea with maxillary and mandibular advancement jaw surgery. You can follow his story in the news. Look at the under-development of his maxilla and mandible. He looks like the patient on the right with no dentures in place.

Figure 8

Figure 7

Figure 9

“An individual is more likely to have SDB (Sleep Disordered Breathing) in the presence of long adenoid face, midface hypoplasia, micrognathia/retrognathia, observable apnea, and observed cyanosis.”

— JADA, Feb. 2014

It is estimated that 90% of people with sleep apnea don’t know they have it. Left untreated, they will end up with a laundry list of illnesses like the male in the first case; or worse. This is a medical and dental issue in which both professions need to increase awareness and collaborate to help stem the tide of increasing illness.

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

SLEEP APNEA

Sleep Health Questionnaire – Current Sleep Symptoms Name:

Birthday:

What allergies does your child have?

Drugs:

Does your child have asthma?

Environmental:

Y

N

What diagnosed health conditions does your child have?

What surgeries has your child had?

Physician’s name:

Symptom

Phone:

Y

N

Symptom

Difficulty breathing during sleep

Morning headaches

Stops breathing during sleep

Learning issues

Snores

Resists going to bed

Restless sleep

Teeth grinding

Sweating during sleep

Wets the bed

Daytime sleepiness

Gets out of bed at night

Nightmares

Trouble getting up in the morning

Sleepwalking

Falls asleep in school

Sleeptalking

Naps after school

Screaming during sleep

Behavioral issues – ADD/ADHD

Kicks legs during sleep/uncomfortable feeling in legs

Reports feeling unable to move when falling asleep

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

Y

N

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WMDF NEWS

WMDF Golf Outing Raises Over $23,500 Submitted by Elaine Fleming

C

loudy skies and a little rain did not dampen the spirits of the 84 golfers attending the annual West Michigan Dental Foundation outing at Thousand Oaks Golf Club on May 15th. This was the first time the outing was held at Thousand Oaks and from the comments, everyone enjoyed the challenges of the course and the new venue.

A special thanks to the WMDF golf committee for organizing the event: Nicholas Vander Veen, chair Dr. Larissa Bishop Dr. Matthew Gietzen Dr. Steve Mancewicz Dr. Tim Meade Dr. Devin Norman Dr. Michael Palaszek Dr. Mark Powell Dr. Ryan Zolman Here are the winners at this year’s event: Scramble – Angie Konen, Don Konen, Dave Phillips, and Art Hohendorf Play Your Own Ball – Tom Nykamp, Don Vander Linde, Peter Zwier, and Scott Ptak Men’s Medalist – Steve Mancewicz Men’s Longest Drive – Greg Feutz Women’s Longest Drive – Hilary Lane Closest to the Pin – Don Schwartzfisher, EK Phares, Marty Vredenburg, and Adam Hoard

A special thanks to our sponsors for supporting our outing with their generous sponsorships: Lunch Sponsor – Davis Dental Laboratory Beverage Sponsor – Bredeweg & Zylstra PLC Eagle Sponsors – Grandville Dental Health Center – Drs. Bishop and Vander Baan Grand River Endodontics – Dr. Sarah Lennan Masterson Grandville Endodontics – Dr. Brian Licari Great Lakes Financial Insurance Agency/Ohio National Hannapel Orthodontics – Dr. Eric Hannapel Mac Dental Lab 12

Meade & Zolman Family Dentistry OMSA of Western Michigan, P.L.C. Oral Surgery Associates – Drs. Mulder, Kintz, and Dingman Patterson Dental Supply Dr. James Papp and Dr. Chris Leja Swan Orthodontics – Dr. Kathryn Swan West Michigan Oral and Maxillofacial Surgery, PC Birdie Sponsors – Benchmark Financial Design Group Chase Bank DDS Integration Henry Schein Dental Herremans Orthodontics Dr. Bruce Jackson MDA Insurance MDA Services Dr. Thomas Nykamp Old National Bank Partners in Dental Care PC Dr. Mark Powell Professional Consulting and Accounting Group, Inc. Smith Haughey Rice & Roegee Valleau and VanDeven Pediatric Dentistry Major Patron Sponsors – Dr. Brian Cilla Dental Arts Laboratories – Tracey Barrett (gift cards) Drs. Palm, Panek, Billups, Jesin, and Van Heukelom WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

WMDF NEWS

Thank you, too, to the following golf courses who generously donated items for the raffle: Scott Lake Country Club, Pilgrim’s Run, Maple Hill Golf, Ironwood Golf Course, The Rogue, Gleneagle Golf Club, and Treetops.

And finally, thanks to the volunteers who braved the rain and worked at contest holes the entire event: Second-year dental hygiene students from Grand Rapids Community College, Renee Biggs, Sara Horn, Kelli Fedder (who took a golf ball to the face through a broken cart windshield), employees from Patterson Dental, Old National Bank, and Chase Bank. We appreciate your help!

The Points of Light project

If you would like more information regarding our project or would like to register as a participant, please visit our website at: pointsoflightonline.org.

Your bank. For business.

Old National proudly supports the West Michigan Dental Community.

Specialties Include: • Equipment financing • Financing of partner buy-in and practice purchase • Flexible loan payments • Practice start-up loans • Real Estate Financing • Working Capital Lines of Credit

616-956-9030 WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

Member FDIC

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Meet the 2015 West Michigan Dental Foundation Scholarship Winners Each year, the WMDF in cooperation with several other local dental organizations, makes an investment in the future of West Michigan dentistry by awarding outstanding dental, dental hygiene, and dental assisting students. Here are the 2015 scholarship recipients: Matt Van Beek University of Michigan School of Dentistry Matt, raised in the Hudsonville area, is happy to be involved in dentistry as it affords him the ability to be a family man while being in a career that he loves. While not with his family or at school, Matt has found the time to be involved with research at U of M as well as volunteering in the Community Dental Clinic in Ann Arbor. After graduation in 2016, along with his wife and two children, Matt looks forward to being able to practice dentistry closer to his West Michigan family.

Matthew Borst University of Michigan School of Dentistry A native of Allendale, Matthew looks forward to returning to the West Michigan area to practice dentistry after his 2016 graduation.

During March of 2015, he joined a group of dentists and dental hygienists traveling to Guyana to provide dental care. As he completes his education, Matthew has set goals to broaden his knowledge base within each specialty, complete his current research, and continue to strive toward high achievement.

Trevor Coeling University of Michigan School of Dentistry Trevor is from Hudsonville where in the fourth grade he decided he wanted to be an orthodontist. Since then, he has been actively pursuing a career in dentistry. Trevor works hard both in and out of school. After graduation in 2016, his goal is to attend a graduate orthodontic program.

Adam Hoard University of Detroit Mercy School of Dentistry Adam was born and raised in Rockford and maintains his close ties to the Rockford community. He is a highly-motivated student; education is a major focal point in his life. He plans to practice dentistry in West Michigan and engage himself in the profession through community service and organized dentistry.

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Alexandra Maring University of Detroit Mercy School of Dentistry Alexandra grew up in Grand Rapids and hopes to return upon her 2017 graduation. Throughout her career as a student, she has been service oriented, including a mission trip to the Dominican Republic to work in a dental clinic. Her educational goal is to become an honest, skilled, and knowledgeable general dentist who seeks to do what is best for her patients. “I try to remember every day that it is a special opportunity to be training as a dentist.”

Chris Powell University of Michigan School of Dentistry Chris is a motivated dental student from the West Michigan area. His goal is to become a successful practice owner and serve his community to the best of his ability. Chris believes, “a dentist should be heavily involved in his community and support his patients as they support him.” He plans to seek an associateship in the West Michigan area after his 2016 graduation.

Jenna Witteveen Ferris State University Dental Hygiene (and BS in Allied Health Sciences) Originally from the Holland area, Jenna is now busy at Ferris State with school, work, and community volunteering. She has been in involved in numerous mission trips both in and out of the US. Currently, she volunteers in the Rock Urban Youth After School program. After graduation in 2016, she will be seeking a job in West Michigan.

John Zona University of Michigan School of Dentistry John hails from the Holland area where his parents still live. During his senior year of high school, he met his mentor in the field of dentistry who taught him that being an integral part of the community is very important. He set a goal for himself to become a general dentist. He looks forward to the personal relationships he will develop with his patients, the impact he will have on his patients’ oral care, and becoming a first responder for patients when concerns arise.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

LEGISLATIVE BREAKFAST

WMDDS Dentists and Legislators Meet to Discuss the Issues

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rea legislators, dentists from around West Michigan, representatives from the MDA, and community members with an interest in oral health met for the annual WMDDS legislative breakfast at Frederik Meijer Gardens & Sculpture Park on May 15th.

Dr. Leonard Bartoszewicz, chair of the Legislative committee, welcomed guests and everyone introduced themselves and stated why they were there. After breakfast, the legislators discussed which committees they serve on, their special interests, and answered questions. It was an opportunity to offer support and share concerns about the expansion of Healthy Kids Dental, Adult Dental Medicaid, mid-level providers, and other issues affecting the state and national budgets.

Attending: Dr. Daniel Armstrong, Dr. Sam Bander, Dr. Leonard Bartoszewicz, Rep. Winnie Brinks, Jordan Bush (representing US Rep. Justin Amash), Dr. Elizabeth Christopherson, Dr. Brian Cilla, Dr. Steve Conlon, Dr. Ed Cox (retired pediatrician and co-chair of the Kent County Oral Health Coalition), Rep. Brandon Dillon, Dr. Kathleen Eisin, Lisa Ellen (Area Agency on Aging of Western Michigan), Adam Erber (from the office of Dave Hildenbrand), Dr. Matthew Gietzen, Ben Greene (from the office of Rep.

Dr. Matt Gietzen, Dr. Lathe Miller and Dr. Kathleen Eisin

Chris Afendoulis, Josh Kluzak (MDA), Dr. Lathe Miller, Dr. Michael Palaszek, Dr. Daniel Peters, Courtney Panter (from the office of Rep. Lisa Posthumus Lyons), Dr. Kevin Rebhan, Deb Shields (from the office of Sen. Tonya Schuitmaker), Bill Sullivan (MDA), Dr. Kathryn Swan, Dr. James Vincelj, Kim Waslawski (HealthNet and Kent County Oral Health Coalition coordinator), and Kim Singh, MCDC clinics.

Left to right: Dr. Katie Swan, Jordan Bush (representing US Rep. Justin Amash), Dr. Steve Conlon, Rep. Winnie Brinks, Bob Greene (representing Rep. Chris Afendoulis), Dr. Kevin Rebhan, and Dr. Leonard Bartoszewicz.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

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2015–2016 WMDDS CONTINUING EDUCATION PROGRAMS

F r i d ay, O c t ob e r 2 3 , 2 0 1 5

Practical Tips – For the Everyday Esthetic Dentist Presented by Dr. Robert Margeas Frederik Meijer Gardens & Sculpture Park | 8:00 AM — 4:00 PM | 7 CEU’s For information, call Elaine Fleming at 616.234.5605 or email at efwmdds@aol.com

F r i d ay, J a n u a r y 2 9 , 2 0 1 6

WHY ARE WOMEN SO STRANGE AND MEN SO WEIRD? HOW TO COMMUNICATE EFFECTIVELY WITH THE OPPOSITE SEX Presented by Bruce Christopher Frederik Meijer Gardens & Sculpture Park | 8:00 AM — 4:00 PM | 7 CEU’s For information, call Elaine Fleming at 616.234.5605 or email at efwmdds@aol.com

F r i d ay, M a r c h 2 5 , 2 0 1 6

Double your Production Tomorrow Presented by Wendy Briggs and Dr. John Meis Frederik Meijer Gardens & Sculpture Park | 8:00 AM — 4:00 PM | 7 CEU’s For information, call Elaine Fleming at 616.234.5605 or email at efwmdds@aol.com

Registration forms will be mailed 2 months prior to each course and will also be available online at www.wmdds.org.

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

MDA NEWS

Does Your License Expire this Year?

Dentists receive just one license renewal notice from the state, 60 days prior to the license expiration date. Dentists who don’t renew their licenses by the deadline face serious consequences. Without a current license, you cannot legally practice dentistry. A late renewal, even for a brief period, may subject you to the loss of thousands of dollars in income.

Insurers will deny claims for any treatment provided while your license was expired. Malpractice coverage will not apply if you practice without a license. And, you may be forced to pay a late renewal penalty by the state.

Sixty hours of acceptable continuing education is required for every three-year license renewal period, so make sure you’re up to date on your CE as well. A copy of the MDA’s 2015-2016 Continuing Education Catalog was mailed to your office in June. Several courses are offered this summer.

If you’re among the one-third of dentists whose license expires this year, make a note on your calendar to make sure you renew your license by Aug. 31. Online renewal is available 45 to 60 days before the expiration of your license. Visit www.michigan.gov/mylicense.

Foundation Golf Outing Raises $31,000 The MDA Foundation 2015 Smile On Golf Outing made history, raising a record $31,000 for the MDA charitable organization.

The event took place May 8 at Indianwood Golf and Country Club in Lake Orion. More than 95 golfers attended the annual event, according to Dr. Susan Carron, MDA Foundation president.

The MDA Foundation provides student scholarships, funding for access programs dental health activities, and organizes the Michigan Mission of Mercy program. For more, visit the Foundation’s expanded website at: www.smilemichigan.com/foundation.

ALUMNI & FRIENDS GOLF OUTING Learn in the morning, golf in the afternoon, or just come to golf and have fun!

Friday, September 18, 2015 Polo Fields – Washtenaw* 2955 Packard Rd, Ypsilanti, MI Optional Continuing Education Course Topic: Pain Management

Golf Registration Includes: 18 Holes on a Private Course, Cart, Gift, PGA Pro, Lunch, Massage Therapist, Beverages, BBQ Buffet Dinner, Raffle & Awards.

For additional information, questions, or to register by phone, please contact: Gretchen Yankle at 734-615-2870 or yankleg@umich.edu. http://dent.umich.edu/alumni-friends

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

MDA NEWS

Dentists Are Mandated Reporters Poor oral health in children can sometimes be the result of neglect or noncompliance by a parent or guardian. Dental neglect is a form of child neglect, and licensed professionals should be aware of their obligation to act as a mandated reporter in the best interest of the child.

A dentist or such other professional who has reasonable cause to suspect child abuse or neglect must immediately make an oral report of suspected child abuse to the county department of social services. Within 72 hours after making the oral report, the reporting person must also file a written report.

“Child abuse” is defined as harm or threatened harm to a child’s health or welfare by a parent, legal guardian, or any other person responsible for the child’s health or welfare, or by a teacher or teacher’s aide, that occurs through non-accidental physical or mental injury; as well as sexual abuse, sexual exploitation, or maltreatment.

“Child neglect” is defined as harm or threatened harm to a child’s health or welfare by a parent, legal guardian, or any other person responsible for the child’s health or welfare that occurs through either of the following: negligent treatment, including the failure to provide adequate food, clothing, shelter, or medical care; or placing a child at an unreasonable risk to the child’s health or welfare by failure of the parent, legal guardian, or other person responsible for the child’s health or welfare to intervene or eliminate that risk when that person is able to do so and has, or should have, knowledge of the risk.

A person acting in good faith who makes a report or assists in implementing the reporting procedures is immune from civil or criminal liability which might otherwise be incurred. The reporting person is also presumed to have acted in good faith.

For more information, visit the website links below:

ONLINE

RADIOGRAPHY TRAINING THE MDA WAY

MDA Online Radiography Training is the most convenient, most economical way to ensure your assistants receive radiography training required by the state of Michigan.

With the MDA Online Radiography Training course, your dental assistant trains without classrooms, travel, or time away from work—all online, self-paced, under your supervision.

It’s affordably priced, too—just $235 per student for member dental office staff.

To find out more or to get started, visit

www.smilemichigan.com/pro/ radiography

Michigan’s Child Protection Law: http://www.michigan.gov/documents/DHS-PUB-0003_167609_7.pdf Mandated Reporter’s Resource Guide http://www.michigan.gov/documents/dhs/Pub-112_179456_7.pdf

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015 MDA-11762_RadiographyAd_1_3Page_FINAL#79C9.indd 1

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6/3/2015 12:21:43 PM

BENEFIT PLAN SNIPPETS

How can I be part of a plan when I didn’t sign up?

Network Leasing/Affiliate Carriers There are two ways in which this might happen.

1. You signed a contract with a network leasing company and that contract allows the leasing company to rent, lease or sell a network of dentists to dental plans, third-party administrators and any other entity.

2. You signed a PPO contract with a third-party payer that allows the third-party payer to rent, lease or sell the network of dentists to an affiliated carrier or any other entity.

Another similar situation is when you may have signed a contract that allows the carrier to place you in-network for all their plans. Such an agreement can actually be beneficial especially if: 1. It results in new patients coming into your office, and; 2. The fee schedules are not different from what you originally agreed to in your contract with the primary company.

On the other hand, if many of your cash patients become eligible for the discounted fee, it may adversely affect your practice.

Your practice may also be affected when the agreement between the primary and secondary carrier allows the secondary carrier to further discount your fee schedule. Again, this can happen without your explicit consent, depending on terms in your original contract.

Looking at contract clauses closely is very important to avoid such situations. Members can use the ADA’s Contract Analysis Service by submitting an unsigned contract to their state or local dental societies who will forward it to the Service. The Service provides a plain language explanation of contract terms for each agreement analyzed. The Service does not provide legal advice or recommend whether a contract should or should not be signed. The analysis will be subsequently sent to the member at no charge.

In an effort to promote transparency, the ADA’s Council on Dental Benefit Programs is working on concepts to support legislation that will require dental plans and third-party leasing organizations to properly disclose all such relationships and provide the dentist the opportunity to explicitly agree to such agreements before they are placed into affiliated carrier networks.

Until you have legislation in your state, make sure to check your mail. Some letters are marked “No action needed.”

Letters often talk about how the new program allows you to “grow your practice.” Always read these letters to understand what impact they have on your practice.

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Differences between PPO’s and EPO’s A Preferred Provider Organization (PPO) is a managed care plan combined with a network of dentists under contract to the third-party carrier to deliver specified services for set fees and according to the provisions of the contract. Traditional PPO’s pay a percentage of the maximum allowable fee to the contracted dentist. For dentists out of the network, the PPO may pay a lesser percentage for each covered service.

Newer models called Exclusive Provider Organizations (EPO’s) require that subscribers use only participating dentists if they want to have the services covered by the plan. In such instances, the patient will need to bear all costs of care if they choose to go out of network. There is no benefit payable to out-of-network dentists. While such closed panel plans have typically been used in dental health maintenance organizations (DHMO’s) they are starting to gain popularity with PPO’s as a mechanism to control costs.

Dentists and their patients should be well aware of the differences between an EPO and a PPO, which can sound a lot alike especially when an employer offers both. Please encourage your patients to become familiar with and understand their benefit plans.

Before signing any participating provider agreement, members can use the ADA’s contract analysis service through their state society. This service provides a plain-language explanation of the terms of the contract. One-on-one member assistance is also available at the ADA. For assistance please call 800-621-8099.

Claims Submission for Medical Plans with Embedded Dental Coverage Since the Affordable Care Act was passed, the number of medical plans offering embedded dental coverage has increased significantly. Even though these are medical plans, the plans will still accept dental claim forms and CDT procedure codes; however, there may be confusion as to where to send the dental claim.

Do you send the claims to the medical plan or is there a separate address for the dental benefits coverage? This is a relatively new concern that dentists have with these types of embedded plans.

Recently, a member dentist received a claim denial for a patient who had dental coverage through the patient’s medical plan. The dental office submitted the claim to the address for the medical plan which was printed on the patient’s ID card.

The doctor was surprised when the explanation of benefits (EOB) statement arrived at his office indicating that the claim was denied because “dental was not covered.” Upon investiWEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

BENEFIT PLAN SNIPPETS

gation, it became apparent that the dental benefit coverage was provided by a different company (a company that was not providing the medical coverage). Unfortunately, the address for dental claim submission was not on the patient’s ID card.

The dentist had to call a phone number provided on the ID card to obtain the information for the dental plan.

Given that more medical plans are offering embedded dental coverage, when a patient presents with a benefit plan that you may not be familiar with, we recommend that dental offices call the toll-free dental plan number to get information on the dental claim submission.

Always Report Your Full Fee On Claims Dentists should always report their full fee for the procedure code on the claim form, regardless of what the benefit amount is. The full fee represents the costs of providing the service and the value of the dentist’s professional judgment in providing the service. As dentists determine their fees for services rendered, the full fee could be any amount, beginning with zero dollars (i.e., $0.00). A $0.00 report on a claim form is a valid entry.

A contractual relationship with any payer does not change the dentist’s full fee. For example, dentists in a payers’ network agree to offer a discount and sometimes agree to additional processing policies that might stipulate a “least alternative benefit” or “bundling” that a service might be benefitted against. A common policy includes combining separate DO and MO restorations on a single tooth and paying for a single MOD. This is simply the payers’ benefit policy and should not influence your treatment plan. When this occurs, the payer’s EOB must clearly explain how the dental benefit plan’s provisions affected the payment amount. The explanation must not suggest to a patient that the treatment was somehow incorrect or unnecessary. Patient education prior to treatment in such instances is key to practice success.

It is likewise important that the dentist does not report a full fee that is artificially inflated over what he/she usually expects to collect when no benefit is involved. If the fee collected for a given procedure is never more than $90, then the dentist should not report a full fee of $100. The ADA Code of Ethics says that, “The fee for a patient without dental benefits shall be considered a dentist’s full fee. This is the fee that should be represented to all benefit carriers regardless of any negotiated fee discount.”

Over time, fees reported to the plan on claim forms are used to monitor trends and serve as the basis for the payer setting allowable amounts for the area. These analysis will not reflect the true market trends if the dentists in that area aren’t WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

submitting their full fee. Coordination of benefits is also dependent upon the fee reported on the claim form.

A dental plan administers a “benefit” to the patient, and is not intended to cover all charges. If you bill your full fee, the patient will receive the maximum benefit from their plan.

CDT Code and claim submission assistance is available from the ADA. Please call 800-621-8099 or send an email to dentalcode@ada.org. Assistance is also available when there are issues with a third-party payer. Please call 800-621-8099 or send an email to dentalbenefits@ada.org.

Payers using credit/debit cards for payment It is not uncommon today for dental benefit carriers and third party administrators (TPAs) to pay dental offices with a credit/debit card instead of the traditional paper check. In fact, this trend seems to be more popular with TPAs than it is with traditional dental plan carriers and has created concerns for dental offices.

VPay is an example of a company that provides this service and offers a virtual stored-value debit card program designed specifically for claims payments. VPay is delivered to the dental office either by fax or secure email. The dental office can process the payment just like it does any other credit card transaction – by entering the card number, security code, expiration date and amount.

VPay touts quicker reimbursement as an advantage to using the stored-value card; however, dentists have reported that the card may carry a higher processing fee than a traditional debit or credit card transaction.

You do not have to accept the stored-value card as payment if you do not wish to do so. You can request to opt out of using the stored-value card and instead receive a check as payment for services rendered. If that is your choice, you should call the toll-free number provided on the explanation of benefits (EOB) statement which accompanies the storedvalue card and inform VPay or the issuing company that a check is preferred and that you are not interested in utilizing the stored-value card for claim payments.

The ADA has received reports from some dentists indicating that some of these companies’ customer service representatives are reluctant to waive the stored-value card as payment; thus, you may have to escalate your request to a supervisor or manager with the company.

The ADA’s Council on Dental Benefit Programs (CDBP) recommends dentists carefully read the fine print accompanying EOB statements and suggests that members call CDBP staff at 800-621-8099 for additional assistance.

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

FINANCIAL NEWS

Free Up Time to Work on Your Practice ...

Not Just In It Brian LaFrenier, CPA, Audit Partner, Beene Garter, LLP 2. Is the firm you are considering reputable and qualified?

What additional resources will you have access to should a need arise?

3. Do they know your industry?

Monthly payroll duties are another aspect of practice management that can be time consuming for dentists and/or practice managers. Ensuring you’re in compliance, tracking excel files or paper timesheets and distributing paychecks can be a hassle – and costly if you make a mistake. A professional payroll firm can help ease the burden.

A

ny business owner will tell you that running a business is hard work. And dentists are no exception.

From managing a practice, employees, and financial affairs to providing quality patient care, you have a lot to juggle. It can be hard to find time to focus on running your business.

Outsourcing your accounting and financial reporting is a great way to free up some time. Rather than managing your books and financial reporting, you can send your information to a professional accountant to manage the account reconciliation, bill payment, and invoice tracking. Beyond that, a good accounting outsourcing service will function as a virtual controller giving you access to key financial data, which will allow you to make the best financial decisions possible for your practice. A few benefits of outsourcing your accounting include: 1. Management of account reconciliation, bill payment, and invoice tracking.

2. Timely financial reporting.

3. Analysis of operating trends, which can be used to improve efficiency, profitability and cash flow.

4. Comparison of actual financial results to budgeted figures, allowing you to determine where you can you cut costs and where you need to budget more.

Before deciding if outsourcing your accounting is right for your practice, consider the following: 1. How much time are you spending working on your accounting? Consider your hourly billable rate when determining the cost effectiveness of outsourcing the work.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

When reviewing payroll providers, consider the following: 1. Does the firm you’re reviewing keep your payroll up-­to-­ date with the latest applicable federal, state, and municipal tax codes and requirements?

2. Can their software integrate with your general ledger program to reduce redundant entry?

3. How will time be tracked? Do they offer a way for employees to access reports online?

Outsourcing the payroll and accounting functions offers another significant benefit – strengthening the practice’s internal control structure. Spreading out the responsibilities and having additional oversight on transactions, especially in small practices, can help strengthen segregation of duties among key employees.

The decision to outsource accounting and payroll processing could be the solution to provide you the additional time and capacity to treat patients and focus on other aspects of practice management. If you have additional questions, or would like to talk through what to look for in a provider, contact Brian LaFrenier at 616.235.5200. Connect with Brian LaFrenier on LinkedIn at: www.linkedin.com/in/blafy Like Beene Garter on Facebook at: https://www.facebook.com/BeeneGarter Follow Beene Garter on Twitter at: https://twitter.com/BeeneGarter

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FINANCIAL NEWS

Rise of the Machines!

By Bernard Bowhuis, CLU, ChFc, CFP®, CEO, Benchmark Financial Design Group, Inc.

Investment Advisor Representative of and Securities offered through Founders Financial Securities. Member FINRA, SIPC and Registered Investment Advisor Benchmark Financial Design Group, Inc. Bernard Bowhuis, CLU, ChFC, CFP®, CEO 2358 S. Garden Ct., Jenison, MI 49428 616.667.8834 | 616.443.4334 bbowhuis@mibenchmark.com | www.ddsMoneyCoach.com

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2003 title from an Arnold Schwarzenegger film told the tale of killer machines trying to destroy mankind and take over the world. Today, we are faced with the rise of other machines. No, I am not speaking about drones, rather the rise of a term in our industry known as “Robo Advisors.”

Robo Advisors are online investment and financial advice systems designed to provide the user with low-cost alternatives to working face-to-face with a financial advisor. Many of these systems offer their advice for fractions of a percent; and in some cases even at no out-of-pocket-cost.

See a video about Robo Advisors at: http://mediahub.financialpicture.com/view/2401/1660 The fact is, in many ways the internet has changed our life, and in most cases for the better. I find myself accessing the internet constantly during the day. Google has become my first source for everything from telephone numbers and addresses to other websites, or almost anything else I need to look up.

What impact will the Robo Advisor have on investment advice? Can a mathematical formula ever know you? Will a voice over the phone from a disinterested party be able to talk you out of making a bad choice? Will free advice that only points you to the sponsoring company’s funds give you true diversification or the best possible options?

Time will tell for some of the above questions. However, people crave connection. Professionals, such as dentists, may

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also be faced with challenges that are unique to your profession. One of the most active sites on the internet, Facebook, has over 1.35 billion users according to the Washington Post.

What does Facebook do at its most basic level? It allows us to connect with other people!

Numbers are predictable, rational, and constant. Put a dollar sign in front of them, and things change. There’s real emotion wrapped up in money – security, opportunities and dreams. Sure, a computer or Robo Advisor can tell you what you need to do to keep your money and grow it. It can even do that based on your comfort with risk or a specific goal about wanting to sail around the world, or pay for your twins’ double wedding. However, can it challenge your assumptions? Can it cut through your apprehension to steer you away from risks you should not be taking? Can it fully appreciate the nuances that you may have as a professional and possibly a business owner? Simply relying on a computer for advice may be similar to assuming that if I brush twice a day I never need a professional cleaning and check-up.

Financial advice is both science and art. The fact is, as financial advisors, sometimes we “outsource” investment allocation to professional money managers. That’s because our real value is the art of leading clients through a decisionmaking process, helping them resist emotional reactions when markets turn, or when personal circumstances cloud judgment. It’s a delicate job that requires trust built on personal relationships. A computer, even one with advanced algorithms, can only go so far.

In financial services, we should embrace what computers do best – analyzing data and providing insights. By so doing, we will create additional understanding of our clients, and greater capacity for human interaction that leads to even deeper relationships and better advice.

We have been using computers since I started in this industry in 1983. However, technology has now allowed us to give you even greater access to all of your accounts and still maintain a personal connection. Below is a link to view programs we have available specifically for the dental field: http://mediahub.financialpicture.com/view/2401/475 Technology will continue to change what we do and how we do it, but it won’t change why we do it: to connect with others and create a meaningful impact on their lives, and lead them to the realization of their goals.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

New from the ADA’s Center for Dental Benefits, Coding and Quality The ADA has created several short video tutorials designed to help dental offices understand key issues related to dental benefit programs. http://success.ada.org/benefit-video Besides videos, you’ll also find links to various ADA resources related to each subject.

Signing the Contract: Understanding PPOs will help explain key contractual provisions and available ADA resources to consider before making a decision to participate in a managed care plan.

Getting Paid: Common Processing Policies will educate you on the various types of processing policies utilized by dental benefit plans and how this affects claims processing.

Getting Paid: Coding on a Claim Form will provide you with an understanding of how to complete a dental claim form and appropriate use of the CDT Code.

Getting Paid: Avoiding Claim Errors & Addressing Denials will present information to help you can prevent claim content errors, what to look for when a claim is denied and how to properly appeal a payer’s claim payment decision.

Discount Dental Plans and In-Office Dental Plans will discuss discount dental plans and how they differ from traditional dental plans.

n

Does your Disability Income policy have enough muscle? Does it last to age 70? Have its own OCC definition? Provide maximum income of $17K per month? Reflect your choice of Cost of Living Rider? Include a Catastrophic Rider?

n

Will your Benefit Amounts do the distance?

Does the Benefit Amount cover your family needs, per your Detailed Needs Analysis?

n

Are you looking to trim your excess payments?

Have you applied the WMDDS discount to save tens of thousands of dollars over the life of your contract?

n

Would you like your Insurance Review to leave you feeling stronger and more confident?

ARE YOU

Financially Fit?

Let Molly Murray Help Get Your Policy in Shape!

Call Molly Murray today at 616.301.2599 for a complimentary financial fitness quote!

833 Kenmoor Ave. SE, Suite F, Grand Rapids, MI 49546

n 616.301.2599 n www.theinsuranceforprofessionals.com n molly.murray@glfia.com

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

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TECHNICALLY SPEAKING

DDS Integration: Six Year Anniversary!

Six years in the business. Gratitude, thoughts, maybe even some lessons turned advice worth sharing.

Submitted by Greg Feutz, President, DDS Integration

Greg Feutz is President of DDS Integration, a Grand Rapids based dental technology company.

I

n June of 2009 the figurative ship that is DDS Integration set sail. We’re now coming up on six years, and we are grateful beyond words to all those who helped us get here, most notably, our wonderful clients. A special thanks goes to a very special office in Okemos that urged/nudged/ dragged me into embarking on my own. It was their encouragement and persistence that ultimately convinced me that I could do this and that the dental market of West Michigan needed my services. Suffice it to say, they were right. It’s been a thrill and an honor every step of the way. I can’t imagine doing anything else.

We’re all in the business of small business, so I thought for this “anniversary edition” article I’d share some of what has helped my business succeed as well as how I’ve managed to find some balance in my life, despite being a small business owner. You’ll probably empathize.

Checks and Balances I am and have always been a trusting person. I learned the hard way that trust, while important and necessary, has its limitations. Whether you’ve heard my specific story or not, you’ve no doubt heard one similar where trust is granted without checks and balances. Put those systems into place and know you’ll never have to deal with it.

Hire people better than yourself We tend to think highly of ourselves. After all, we are great!

Here’s a little secret though: you’re probably really only great at one or two aspects of your business. For the rest, hire people who are better than you. Then you can focus on the things you are great at and not the ones you struggle with.

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Delegate & value your time Building off the last one, don’t try to do it all yourself. Find the balance between doing it yourself to save a couple bucks, and doing it yourself and losing production time. You may be able to fix a computer problem in an hour, but shouldn’t you produce for an hour while the tech guy fixes it in 10 minutes?

Delegate more to your staff, too. Your time is probably your biggest asset, don’t waste it.

Step back from your day-to-day thoughts How much time do you spend actually thinking about your business? I’m not talking about “what procedures do I have today,” “what was production last month” and those dayto-day type thoughts. My best ideas for how to grow, how to improve, and on and on, have come at times when I was not actively engaged with a typical day-to-day task. We get so caught up at being at work or working all the time we don’t leave time for reflection and serious thought. Flip this paradigm and you’ll be surprised what you come up with.

Get involved with a group or a coach This really helps to step back. I have scheduled time either weekly or monthly with a CEO roundtable and a business coach. These are times where we are talking about my business, someone else’s business, or business in general. It’s a great sounding board for your ideas and a great way to get unique perspective on how your business could be better.

I’m an IT guy learning how to run a business. Just like dental school, my computer degree didn’t teach me how to run a successful business. These people are excellent resources in getting there.

Make a McDonald’s This might not apply as much to dentistry, but I read a book called Emyth that talks about trying to make your business like McDonald’s. Certainly not in all aspects, but in the repeatability of it. Put systems in place that make your business able to run even when you’re not actively involved 100% of the time. For me, these systems were the right procedures, and most importantly the right staff with well-defined job accountabilities.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

TECHNICALLY SPEAKING

Balance Balance for me took 3–4 years to attain. Starting as a sole proprietor I fell into the trap of making my clients (and myself) believe that I was the only one that could do my job. Flat out, no one else was as smart, as careful, as caring, as friendly, and on and on. … Therefore, letting someone else do the work for me was not an option. I was darn good at my job, but I was married to it. Couple this with constant growth and it became clear that DDS Integration would reach its limits in the form of my calling it quits.

Through the steps above I began the process of making DDS Integration about more than just Greg, both to myself and my clients. Today, I have an incredible staff who can take on all the things I thought only I could do. Doing the job well yourself has a certain satisfaction to it, though what I’ve since learned is that seeing someone else do the job equally well has even greater satisfaction. My number one goal, taking care of clients, is still being met, while I now can be what I mistakenly thought I was all along, a true small business owner. DDS

Integration is better for it, my clients are better for it, and I am better for it.

Our small businesses are our livelihood, our source of income, and hopefully happiness. I again express gratitude to all you out there who have had a hand in making this dream a reality for me. My family, my clients, my staff, the WMDDS for its continued dedication and support to the dental community, and all of you out there I’ll meet in the future.

What are your thoughts?

Comment on our blog or Facebook article. We’d love to hear your opinions on your small business or ours!

Facebook: facebook.com/ddsintegration Blog: ddsintegration.com/blog

Note: This will also be on our blog (ddsintegration.com/blog) where the links will be live, perhaps easier than typing them.

WMDDS CPAs good ideas7.5X3.25.pdf 1 3/5/2015 2:27:22 PM

CPAs BRINGING NEW C

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“GOOD IDEAS!”

TO YOUR PRACTICE.

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CM

MY

CY

CMY

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RICK CHRISMAN, CPA MANAGING SHAREHOLDER rchrisman@hungerfordnichols.com (616) 949-3200

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

27

ESTATE PLANNING

The Upside of Downsizing

By Debra Greenberg, a director in the Personal Retirement Strategy & Solutions Group at Merrill Lynch Wealth Management

A

s people grow older, they often discover that less is more when it comes to housing. Either they find that they no longer need as much space—or doubt whether it’s worth maintaining a larger home. There can also be significant financial advantages to downsizing.

In addition to the profit you could receive from selling your home, your mortgage will likely be lower. Your property tax and energy bills are also likely be lower in your new, smaller home. The savings from downsizing can be redirected into other areas of your life; however, you need to consider the financial aspects of the move.

How will the move affect my budget?

You will need to consider more than just the purchase price or rental cost of your new home. You should compare the cost of living between your new and old locations. Also, factor in the cost of moving all of your belongings.

Will my income be affected?

When moving into a new place, you may also think about making other changes as well, such as working less or not at all. Be aware of how the changes might affect your income needs and long-term plans.

What if I sell my home before I purchase a new one?

If the closing date on your old house and the move-in date for your new place do not line up, you may need to find temporary housing. This situation could create a need for shortterm financing, but there are a number of credit solutions that can potentially help you cover this cost.

Where can I invest the money I save by downsizing?

First, think about where the money is most needed and how it could help you pursue your other goals. Are there any immediate needs you should finance? Could you take a portion of the proceeds from the sale and treat yourself to a vacation?

You may have a smaller home now, but your opportunities have expanded.

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For more information, contact Merrill Lynch Financial Advisor Edward S. Bujdos of the Grand Rapids office at 877.774.4201 or edward_bujdos@ml.com.

Edward Bujdos, CRPC, from the Eccker, Bujdos & De Jonge Group of Merrill Lynch, Grand Rapids office at 250 Monroe Ave. NW, Suite 600, Grand Rapids, MI 49503

This material does not take into account your particular investment objectives, financial situations or needs and is not intended as a recommendation, offer or solicitation for the purchase or sale of any security, financial instrument, or strategy. Before acting on any information in this material, you should consider whether it is suitable for your particular circumstances and, if necessary, seek professional advice. Any opinions expressed herein are given in good faith, are subject to change without notice, and are only correct as of the stated date of their issue.

Always consult with your independent attorney, tax advisor, investment manager, and insurance agent for final recommendations and before changing or implementing any financial, tax, or estate planning strategy.

Merrill Lynch Wealth Management makes available products and services offered by Merrill Lynch, Pierce, Fenner & Smith Incorporated (“MLPF&S”) a registered broker-dealer, Member SIPC and other subsidiaries of Bank of America Corporation (“BofA”).

Banking products are provided by Bank of America, N.A., member FDIC and a wholly owned subsidiary of BofA. “Merrill Lynch” refers to any company in the Merrill Lynch & Co., Inc., group of companies, which are wholly owned by Bank of America Corporation.

Investment products: Are Not FDIC Insured Are Not Bank Guaranteed May Lose Value © 2014 Bank of America Corporation. All rights reserved.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

Some of your most important connections can be found close to home Proud to serve the West Michigan Dental Community for more than 30 years.

Merrill Lynch financial advisors are committed to the individuals and businesses in West Michigan.

We can help you build upon your success, prepare for the future and create a strategy that’s uniquely yours.

Eccker, Bujdos & De Jonge Group Merrill Lynch Scott S. Eccker 250 Monroe Avenue NW Senior Vice President – Suite 600 Wealth Management Grand Rapids, MI 49503 Senior Financial Advisor PIA Program Portfolio Manager 616.774.4201 Edward S. Bujdos, CRPC® Vice President Senior Financial Advisor PIA Program Portfolio Advisor

www.fa.ml.com/ebdgroup

Zachary D. DeJonge Financial Advisor Natalie Sinquefield Registered Senior Client Associate

Life’s better when we’re connected® CRPC® is a registered service mark of the College for Financial Planning.

Merrill Lynch Wealth Management makes available products and services offered by Merrill Lynch, Pierce, Fenner & Smith Incorporated (“MLPF&S”), a registered broker-dealer and member SIPC, and other subsidiaries of Bank of America Corporation (“BofA Corp.”).

Investment products: Are Not FDIC Insured Are Not Bank Guaranteed May Lose Value The Bull Symbol, Merrill Lynch Personal Investment Advisory, Merrill Lynch and Life’s better when we’re connected are trademarks of Bank of America Corporation. © 2014 Bank of America Corporation. All rights reserved.

ARBKH4W4 | AD-12-14-0055.B | 470950PM-0314 | 12/2014

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

29

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, 301 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.

For Sale – Family practice in Grand Rapids NE that is part time with great potential, located in an excellent highvisibility location. There is 2050 sq.ft. with 5 ops and a 6th op is plumbed in. Opportunity for more footage if desired. Call 616.485.4884 for details.

Kavo Handpieces for Sale – 6000B have 5 at $400/handpiece, 6500B have 6 at $400/ handpiece, 647B have 8 at $200/handpiece, 640B have 2 at $200/handpiece, 649B have 2 at $200/handpiece.

Call 616.453.6323.

Dental Office Building for Sale – 1595 square feet on a very high traffic street.

Has been a dental office since 1960.

Very large signage, free standing brick exterior building with its own parking lot. Remodeled in 2010. New roof 2010. High efficiency furnace/ac 2009.

Four equipped ops, dark room, lab/ sterilization area, reception, business office, staff room, private office, basement and a lot more. Would be great for starting a new office or relocating your office if you want to own your building. Please contact hanyb@juno.com or call 616.307.2213 and leave a message.

General Dental Practice in Walker, MI – Two ops. Third room can be equipped. 825 active patients. New equipment. Well-maintained suite.

Lease transferable. Asking $100,000.

Interested parties please contact Dentaldad@aol.com.

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Part-time Dentist needed at Ferris State University’s Dental Hygiene Clinic – Dentist needed 1–2 days a week to provide legal clinical coverage, conduct and supervise clinical performance of dental hygiene students, and act as a dental resource person for clinical dental hygiene faculty, staff, and students. For further information, please email annettejackson@ferris.edu or call 231.591.2284. Detailed posting and application available at https://employment.ferris.edu/ Associateship opportunity in NE Grand Rapids – Busy, established practice; 3-4 days per week available.

Potential for future partnership.

Please call 616.742.6735 or email: beckwithfamilydentalcare@gmail.com Holland, Michigan – Associate dentist needed for busy practice one or two days a week. Would prefer Fridays. A bit early but will be retiring in three to five years. Fee-for-service practice with no medicare/medicaid. Please contact Kate at 616.399.4490.

Dental Dreams desires motivated, quality oriented associate dentist – for its offices in Muskegon, Kalamazoo, Battle Creek, Saginaw, Flint, Ypsilanti and Eastpointe – outside Detroit. At Dental Dreams, we focus on providing the entire family superior quality general dentistry in a modern technologically advanced setting with experienced support staff.

Our average colleague dentist earns on average $230,000 per year plus ben-

efits. Sign on/relocation bonus for certain locations. Please contact Kristyn McIntosh at 312.274.4530 or email kmcintosh@kosservices.com.

Exciting Opportunities – for dentists, hygienists, and assistants to provide children with quality dental care in schools in Southeast and Western Michigan. No evenings or weekends.

Email resumes to: jobs@smileprograms.com.

Dental Equipment for Sale – After merging my two offices – I have four rooms full of dental equipment for sale. Everything is in excellent shape and working conditions (no junk). All equipment is still installed and can be tested before you buy it. Dental chairs, delivery units, lights, x-rays, cabinets, panoramic, Dent-X 9000 zoom, compressor, separate air dryer unit, suction, lab equipment and much more.

Just ask and there is a chance I have it.

Please email your questions to hanyb@juno.com.

Panoramic X-ray Unit (Gendex GX Pan. 70, 98 kvp, Film Size 5” x 12”) for Sale – Was in a good working order when disassembled by dental technicians. No longer needed.

Asking $1000 OBO. Please email hanyb@juno.com.

Dental Office Available – in Rockford on 10 Mile Road. Available about April 2015. Approximately 3100 ft of office space and 1500 ft of basement.

Call 616.866.0921.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

CLASSIFIED ADS

Pre-Dental Student Seeking Summer Dental Experience – I am a Presidential Honors student studying biomedical engineering at the University of Alabama at Birmingham, enrolled in their Early Dental School Acceptance Program. Over the past summers, I have shadowed multiple practices, including oral surgeons, orthodontists and general dentists.

Last summer, I worked in an orthodontist’s office in the Chicago area. I am seeking to expand my pre-dental experience by working in a dental office or clinic over this summer in Western Michigan. Contact information: am.cruz@sbcglobal.net | 630.747.7903.

Beautiful Professional Dental Suite – Great turnkey opportunity for any dental professional, with many extras in a growing N.W. Michigan community. High-visibility location is within minutes of world-class cultural events, federal & state parklands, fabulous dining, four-season outdoor activities & great schools. Call selling dentist directly at 231-313-8407 or email: jarickert@charter.net. View photos at: http://www.threewest.net/ our-listings/?propertyId=76019-sale Looking for a Dentist – to provide general dentistry services for our veterans at the Grand Rapids Home for Veterans 2-3 days per week at a per diem rate of $600. There is also a production bonus as well, but it will only add a minimal amount to the per diem. The best part about this posi-

tion is that it offers great flexibility in terms of scheduling, both in terms of the days and hours worked. In addition, changes to the schedule can be easily accomplished from week to week as well. Interested parties should contact 616.502.0069.

Seeking Full- or Part-Time Employment – in a West Michigan general practice office, to contribute immediately to the success of an office with a willingness to work nights/ weekends to help bolster production and practice availability, as well as generate new patients. I have a desire to be included within the practice’s leadership team to contribute to decision making, developing strategies for practice growth, and to support team development and morale.

I’ve been consistently regarded as responsible, personable, a producer, positive, professional, and upbeat. I am currently in a hospital based GPR and am comfortable with all aspects of dentistry, including endodontics and surgery. For a copy of my resume and to discuss possible opportunities in-detail, please contact me at grapdds@gmail.com – or call 989.225.0753. Thank you.

For Sale – Lab Master Foster Model Trimmer, Model # MT115, like new $400. Contact 616.949.7510.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

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!

Beene Garter.......................................32 DDS Integration..... outside back cover Davis Dental Laboratory................ inside front cover Great Lakes Financial........................25 Henry Schein.............inside back cover Hungerford Nichols ..........................27 Lake Michigan Credit Union............17 MDA IFG............................................22 Merrill Lynch.....................................29 Old National Bank.............................13 ProAssurance.......................................5 Studio 2 Dental....................................3

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Dr. Margaret Gingrich, Recipient of the 2015 MDA Matt Uday New Dentist Leadership Award Congratulations to Dr. Margaret Gingrich, a general dentist from Big Rapids and recipient of the 2015 Michigan Dental Association Matt Uday New Dentist Leadership Award.

At the 2015 Michigan Dental Association House of Delegates, Dr. Gingrich was elected to serve a three-year term as trustee on the Michigan Dental Association Board of Trustees.

West Michigan District Dental Society is proud of you!

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SUMMER ISSUE 2015

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