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The voice of the Washington State Dental Association




th e wsda ne w s · issue 3, januar y · 2013 · · 1


2 路 th e wsda ne w s 路 issue 3, januar y 路 2013 路

2012 Clark County contingency at Dental Action Day

WSDA news




guest editorial


Cover story by Rob Bahnsen

pndc news


issue 3 · january 2013

29 cde 30-31

wdia news

cover: grassroots


letters to the editor


cover: legislative preview


in memoriam


mentor reception

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the source: mercer advisors

membership news

41, 43


18 19, 21

wohf news


clinical corner


shinn award


parrish or perish


leadership institute

Like us on Facebook: WSDA News Editor Dr. Mar y Jennings Editorial Advisor y Board Dr. Victor Barry Dr. Richard Mielke Dr. Jeffrey Parrish Dr. Rhonda Savage Dr. Robert Shaw Dr. Mary Krempasky Smith Dr. Timothy Wandell Washington State Dental Association Dr. Danny G. Warner, President Dr. David M. Minahan, President-elect Dr. Gregory Y. Ogata, Vice President Dr. Bryan C. Edgar, Secretary-Treasurer Dr. Rodney B. Wentworth, Immediate Past President Board of Directors Dr. Theodore M. Baer Dr. Dennis L. Bradshaw Dr. D. Michael Buehler Dr. Ronald D. Dahl Dr. Christopher Delecki Dr. Christopher W. Herzog

Dr. Dr. Dr. Dr. Dr. Dr.

Gary E. Heyamoto Mary S. Jennings Bernard J. Larson Christopher Pickel Lorin D. Peterson Laura Williams

Director of Government Affairs Bracken Killpack Art Director/Managing Editor Robert Bahnsen

WSDA Staff: Executive Director Stephen Hardymon

Manager of Continuing Education and Speaker Ser vices Craig Mathews

Assistant Executive Director Amanda Tran

Government Affairs Coordinator Michael Walsh

Director of Finance Peter Aaron

Membership Ser vices Coordinator Laura Rohlman

General Counsel Alan Wicks

Bookkeeper Joline Hartman

Director of Operations Brenda Berlin

Office Coordinator Leon Sandall

Director of Membership and Comunications Kainoa Trotter

Association Of fice: (206) 448 -1914 Fax: (206) 443 -9266 Toll Free Number: (800) 448 - 3368 E- mail: info@ w

th ee wsda wsda ne new wss ·· issue issue 3, 3, januar januaryy ·· 2013 2013 ·· ·· 33 th

In the event of a natural disaster that takes down the WSDA web site a n d e m a i l a c c o u n t s, t h e WS DA has establishe d a sep arat e email address. Should an emergency occur, memb ers can contact wash stat e d The WSDA News is published 8 times yearly by the Washington State Dental Association. Copyright © 2012 by the Washington State Dental Association, all rights reserved. No part of this publication may be reproduced without permission of the editor. Statements of fact or opinion are the responsibilit y of the authors alone and do not express the opinions of the WSDA, unless the Association has adopted such statements or opinions. Subscription price is $65 plus sales tax per year for 8 issues of the News. Foreign rate is $97.92 per year. Advertising is published as a service to readers; the editor reserves the right to accept, reject, discontinue or edit any advertising offered for publication. Publication of advertising materials is not an endorsement, qualification, approval or guarantee of either the advertiser or product. Communications intended for publication, business matters and advertising should be sent to the WSDA Office, 126 NW Canal Street, Seattle, Wash. 98107. ISSN 1064-0835 Member Publication American Association of Dental Editors. Winner: 2012: Journalism Award, Best Newsletter, Division 1, 2012: Platinum Pencil Award Honorable Mention (2), 2008: Best Newsletter, Division 1, 2007 Platinum Pen Award, 2006 Honorable Mention, 2005 Platinum Pencil Award, 2005 Publication Award; International College of Dentists

table of contents issue 3, januar y 2013

a day in the life

editorial dr. mar y jennings

Just FUND us!

Back in the old days, community dentist’s pleas were, “Help us! Help us any way you can…send…help…now!” And you did. With great pushing and guidance, our nation’s legislators have gone from spending $756.1 million on dental Medicaid in 1990 to $7.4 billion in 2010. During the 1990s, Washington state spent quite a bit of money building and funding the operations of Community Dental Health Clinics. We currently have about fifty federally qualified dental clinics. They form the primary safety net for dental patients in poverty. There are also quite a few private non-profit dental clinics that many of you staff and fund. Olympia’s Union Gospel Mission is a fine example of one. WSDA calculates that member dentists provide over 100,000 patients pro bono care each year. Because you are humble we believe this number is underreported. The University of Washington School of Dentistry, Children’s Hospital, Odessa Brown Dental Clinic, The Northwest Dental Residency and Lutheran Medical Dental Residency programs also contribute to the safety net. We are developing new strategies for treating low-income patients with special needs. Amy Winston and Bart Johnson partnered with the Seattle-King Dental Society and Swedish Hospital to build a small clinic in the hospital. This clinic treats patients referred from the emergency room, patients with difficult extractions that King County FQHC’s need help with, and low-income patients needing organ transplants. The clinic is doing quite well. We hope other hospitals adopt this program. Many of our dental societies have programs designed to screen low-income patients and set them up with private practice dentists. Our infrastructure has grown and with our hard work combined with insight, hopes and dreams it will continue to grow. So where are we now. Let’s start with children. It may surprise you that many people, including me, do not feel there is an access problem for children in this state. There are many things that have contributed to this concept. Washington state has the second lowest level of untreated dental caries in the nation. At 52.4 percent, we also have the 8th highest Medicaid utilization rate in the nation. The Pew Charitable Trusts just ranked us among the top fifteen states providing dental sealants for children. That speaks very well for all of our efforts. To contrast, Medicaid eligible children in Washington utilize dental care only 5.6 percent less than children with private insurance. While we want every child to go to the dentist, historically they have not. Utilization rates tend to be stable. At this time most low-income clinics can get children appointments the same day or within a day of being called by a parent. In urban low-income clinics, like my clinic, it feels like we are competing for Medicaid children. Currently Medicaid eligible adults are our most vulnerable population. Today there are approximately 488,000 Medicaid eligible adults in Washington. Of those, only pregnant women, long-term care patients, and the developmentally disabled are eligible for nonurgent dental care. That translates into about 38,000 patients having a comprehensive dental benefit at any given time. Our community health network was set up to provide care for both adults and children. Cutting adult Medicaid coverage in 2011 meant that clinics could not continue to see adults for free and stay afloat. Many patients of record that were offered sliding fee payments could not afford to continue their care. Our appointment books were suddenly empty, but adults with tooth pain still begged for free care. No clinic, public or private, can live without funding. The clinics have done the best they can by seeing children and seeking private funding to offset the cost of non-paying adult patients. In this economy, continued on page 35

Dr. Mary Jennings Editor, WSDA News

“WSDA calculates that member dentists provide over 100,000 patients pro bono care each year. Because you are humble, we believe this number is underreported.”

Dr. Mary Jennings, WSDA News editor, welcomes comments and letters from readers. Contact her at her email

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I don’t understand people very well. For instance, I don’t know why they aren’t always talking with their friends about my dental office and the amazing things we do for our patients. But let’s face it…most people only think about what we do when they’re in our office for a “cleaning” or filling. My dad was a great guy. He was a printer by trade, and with three dentist sons, his exposure to our profession was greater than most. He heard about dentistry more frequently than his six-month checkup. But, he really didn’t know much about my profession. Even with all the exposure he had over the years, he couldn’t tell you what an MOD was if you cornered him at the dinner table. So, why should the general public or our legislators be any different? They have a lot to do each day, and while oral health is important to all of us, it is simply one more thing in everyone else’s busy lives. Is it any wonder then that topics like mid-level providers and “access to care” come up? We scratch our heads and proclaim, “But they don’t understand….this won’t solve the problem!” And we are right — but that isn’t good enough. There have been a lot of challenges and changes in dentistry recently. In the last few months, it has been exciting to see my colleagues’ growing interest in what is happening in our profession. For instance, I’ve heard from many dentists on the midlevel provider issue. I appreciate those who have well thought out concerns about the direction of our profession, but there are also many who are not members of our Association, have never attended a Dental Action Day, or been to a local component evening program. It takes more than just an email regurgitating someone else’s thoughts in a cut-and-paste form letter. These last few years have been a wake up call for us — the choice is simple — are you a healthcare worker, or a healthcare provider? A healthcare worker shows up every day at the office and does a great job most of the time. They’re on top of things, do great fillings, perfect root canals, and can even squeeze in an emergency patient, while dealing with staff and management issues. They finish their day, “clock out,” and go home to their family. Sometimes they wonder why their concerns aren’t addressed, and why no one seems to understand how hard they work and what they do for their patients. A healthcare provider does pretty much the same; the difference is that they’re also engaged in their profession. They join their Association and go to the local dental society dinner meetings. They volunteer and become involved in the society or perhaps a local dental charity. They attend Dental Action Day (DAD) in Olympia, and speak and correspond with their local elected officials throughout the year to educate them about dentistry and what it means. They are Ambassadors of Oral Health for their neighbors and patients. One of our basic problems is that it is so easy to get lost in our office and not become engaged in our profession. When we do that we all lose. You lose out on the camaraderie, mutual support and knowledge to be gained by fully participating. Your profession loses out by having one less dental warrior out there fighting for the best approaches to oral health for our community. For some reason, it has become acceptable to sit behind a monitor and fire off an email to get a point across, and once we hit send, we pat ourselves on the back, say, “Job well done, that will tell them,” then log off and go home. We don’t understand why those messages don’t always have their intended effect; after all, it was sent by a doctor! I am telling you, it isn’t good enough. Your message is important, deserves to be heard, and will have impact when you have chosen to engage your profession and personally interact in other ways with your colleagues and legislators. Dentistry is under assault, and sitting by and letting someone else do the work and then complaining when your “voice” isn’t heard is no longer acceptable. This is not like a raffle

continued on page 35

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Dr. Kirk King DentPAC Board

“Dentistry is under assault, and sitting by and letting someone else do the work and then complaining when your ‘voice’ isn’t heard is no longer acceptable. This is not like a raffle where you ‘need not be present to win.’”

guest editorial dr. kirk king

Are you a healthcare worker or provider?

pndc news 2013 highlights


Location, location, Location: We’re confident that Bellevue is going to be a great location for the PNDC. With great facilities (Meydenbauer Center and Hyatt Regency Bellevue), over-thetop shopping experiences and hip foodie destinations within walking distance, Seattle’s sister city really packs a punch. Welcome Reception Join us as we celebrate our move to Bellevue with a blow-out bash on Thursday. With hor d’oeuvres, adult beverages and special prizes, the evening will be a fun and festive way to cap off the first day of the 2013 PNDC! Third Session - Earn an additional 2.5 hours of CDE You asked for it, we listened. Stay on for a Thursday evening session on endodontics by nationally-recognized speaker Dr. John West, entitled “21 Endodontic Practice Builders that Can Be Immediately Applied to Your Practice.” Free Yoga & Pilates David Barton Gym is different than most health facilites: drop dead gorgeous, with certified trainers guiding your every move. It’s the supermodel of gyms, and they’re giving away the goods — namely free yoga, Pilates classes and day passes for PNDC attendees. Classes are limited, sign up early.


Mobile App: Last year we rolled out the app to considerable acclaim — this year, we’ve improved it and added new functionality. The app will be doubly useful this June with two locations in play. Download it from the App/ Play Stores onto your smart phone today! OP/Online Registration The Official Program (OP) mails early February. Chock-full of course descriptions, speaker bios and scheduling information, the OP is your go-to resource when planning your PNDC schedule. Prefer the electronic version? We’ll post it online before you receive your printed version in the mail!


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Kanka Dr. John Kanca provided the validation of acid etching dentin and made it an everyday possibility. Dr. Kanca is acknowledged worldwide as one of the foremost authorities on bonding to dentin and has lectured extensively internationally. Kinzer Dr. Kinzer practices with Dr. Frank Spear in Seattle, and is a faculty member of Spear Education at the Scottsdale Center for Dentistry in Scottsdale, Ariz. Pattison Ms. Pattison is currently an Associate Professor and former Chair of the Department of Dental Hygiene at USC. Pattison is the co-author of the textbook, Periodontal Instrumentation and has contributed several chapters to the last five editions of Carranza’s (previously Glickman’s) Clinical Periodontology. These publications have been translated into numerous languages, and are widely used around the world. She has lectured in universities across the country and at specialty meetings. Hess - BOTOX® Workshop Dr. Hess has been teaching hands-on BOTOX® and dermal filler courses to dentists and doctors, including programs for the Academy of General Dentistry’s Master and Fellowship Tracks. Dentists are extremely qualified to provide these safe and reversible procedures based on their level of training and expertise in head and neck anatomy.

pndc news 2013 highlights


Medicaid Workshop If your office accepts Medicaid patients, this course is for you. PNDC offers attendees an opportunity to learn the single payment system – ProviderOne. A ProviderOne trainer will walk attendees through the system; submit claims, and much more.

JUNE 13 & 14, 2013

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cover stor y building a grassroots network

WHY WE’RE INVOLVED Drs. Lindsey and Josh Papac

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Hear from the full spectrum of grassroots dentists — from advocacy newbies Drs. Josh and Lindsey Papac, long-time grassroots participant Dr. Rob Merrill, Dr. Robin Henderson — who partners with her husband, Scott Henderson, and Dr. Marissa Bender, who decided that being passive wasn’t cutting it any more. wsda ne w s · issue 3, januar y · 2013 ·

It’s not for everyone — it’s not for people who don’t want their voice heard, it’s not for those willing to let others direct their future, and it’s not for anyone who cares about dentistry. For the rest of you, however, it’s imperative. Many of you will find your political footing at the WSDA’s Dental Action Day (this year’s event is January 25, falling right about when this issue hits) — and for all five of the people profiled here, it’s one of the places they got their feet wet. But as important as Dental Action Day is, true political advocates know that the real work is done throughout the year — networking in coffee shops, private homes, and town hall meetings —face-toface connections that help establish dentists as experts in their field. We spoke with Dr. Rob Merrill, Dr. Marissa Bender, Drs. Josh and Lindsey Papac, and Dr. Robin Henderson (along with her husband Scott) — each at a different point in their dental career and their advocacy journey — to talk about what they’re doing on behalf of dentistry, and why they got involved in the first place.

Dr. Rob Merrill

Merrill, an orthodontist in private practice since 1990, may have said it best when he said “A lot of times, when people go to see legislators they have their hands out — they

“A lot of times, when people go to see legislators they have their hands out – they want money for this, or money for that. I’ve always strived to be different, by being there primarily as a resource – not asking them to do anything besides listen to me, and by bringing something to them that they consider valuable.” ­— Dr. Rob Merrill want money for this, or money for that. I’ve always strived to be different, by being there primarily as a resource — not asking them to do anything besides listen to me, and by bringing something to them that they consider valuable.” Merrill first came to understand the role of advocacy in 1994, while attending a lecture given by Michael Dunn at the American Association of Orthodontists’ annual meeting. “He was talking about the importance of being involved in grassroots politics,” said Merrill, “And he said something like ‘If you’re not at the table when decisions about your future are being made, you’ll be on the menu.’” Not content to be someone’s entreé, Merrill decided to begin his advocacy journey when he returned to his home in Washington’s 12th Legislative District. Prior to that, he’d met with legislators at component society meetings and written the occasional letter, but upon his return he rang up Doc Hastings, his 4th Congressional District congressman, and asked to meet. (Note: The 12th legislative district is part of the 4th congressional district; 12th is state, 4th is federal.) The meeting could well have been uncomfortable— Merrill had supported Hastings’ opponent in the previous election — but Merrill led with his desire to become involved in the process and be a resource for Hastings, and everything went smoothly. Today, Merrill still meets with his legislators at Dental Action Day every two or three years — even though the trip from his East Wenatchee home takes five hours. “It’s quite

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cover stor y what advocacy means

Let’s face it: getting involved in political advocacy isn’t something that everyone is dialed-in to.

Photo courtesy of Scott Henderson

cover stor y building a grassroots network

Dr. Robin Henderson and daughter Sophie enjoy one of the perks of grassroots advocacy — personal relationships with legislators

a slog to get over there,” he says, “But it was one of the things that Denny Homer really encouraged us to do — even if we couldn’t do it every year. I probably go every two to three years — more so in recent years. It’s important for us to go because that’s where the legislators are working. They know that you’ve taken time out of your office or away from your family to talk about dental issues. They’re going to make time to see you. It’s insufficient if that’s the only contact you have with your legislator, though.” To that end, Merrill makes sure he gets face time with many of them throughout the year — scheduling coffee or lunch with them, and hosting and attending fundraisers. Sometimes, Merrill sees legislators at other local events, and he uses each opportunity to reconnect with them. This summer, for instance, one of the local homeless shelters was dedicating new temporary housing for families. Merrill was at the dedication, as were Sen. Parlette and Rep. Condatta — and Merrill took opportunity to talk with them about dental issues. He says, “If we are involved within our communities — as we should be — we will have opportunities to rub shoulders with our legislators because they want to be out among their constituents. I also meet with them privately, if I have a DentPAC check to give them. Additionally, if there’s a dental issue that comes up during the session,

I will email them 3-4 times over the course of the year.” And while that may sound daunting to some, the way Merrill breaks it down makes sense. He explains, “There are people who think they can’t get to know their legislator — but the truth is legislators want to get to know you. The reality is that we’re seen as leaders in the community. And while many dentists might shy away from talking politics in their office with their patients, the legislators don’t know that for certain — they just know that we’re well respected, and that we typically have thousands of patients whom we see regularly. And that means that if they’re doing things well, I can be saying good things about them, and if they’re not, I could be saying bad things about them to potential voters.” And if you think hosting a fundraiser is difficult, think again. Merrill dismisses the notion saying, “They’re looking for people who are willing to help them, and because there aren’t that many who are — you get noticed quickly. They don’t want to disappoint constituents, particularly someone who has gotten others to give them money. Without that money they can’t run a campaign to try and keep their job.” Every two years, Merrill hosts a fundraiser for the state’s congressman, making sure that local legislators are invited. He explains, “I invite our legislators to come as contribu-

tors — not simply as invited guests. It does a number of things — it gives legislators an opportunity for face time with the congressman, which they like and want. It gives the congressmen the opportunity to get some additional money from the legislators who attend, and it boosts my role as an advocate for dentistry. From the congressman’s perspective, I’m raising more money for his campaign, and because I’ve gotten legislators there for him in my home, he views me as more influential. The legislators view me as more plugged in because I have the congressman there in my home. I’ve been doing it since 1996 — it’s not hard to develop a network.” And while Dr. Merrill has had years to grow his influence in state politics, his point is welltaken: legislators need ground troops and people willing to help them raise money to keep their jobs. And he’s not only involved in dental advocacy and grassroots efforts, he’s active in his community as well, having chaired his school district’s levy and construction bond campaigns a number of times, with skills he gathered because of the work he’s done in dental advocacy. He continues to serve his community and champion dentistry, as do his children, whom he encouraged to be a part of the political process from an early age, paying forward his expertise and penchant for advocacy.

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Dr. Robin Henderson

For Dr. Robin Henderson and her hus-

“When I first attended comp onent meetings years ago, I figured that just going to the meetings was enough. The more I learned about advocacy through the Leadership Institute, the more I wanted to be involved. And, seeing how being involved can make a positive impact has changed my perception.” — Dr. Marissa Bender

Dr. Marissa Bender

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band Scott, dental advocacy is a family affair. At a time when many dentists would slow down to focus on their children, the Hendersons have decided to include their daughter Sophie in their advocacy efforts – “She’s already come with us to Olympia,” Robin said recently, “And we’re looking forward to the time that we can start bringing her to Dental Action Day.” While Scott’s not a dentist, he’s always been by Robin’s side at Dental Action Day and at the House of Delegates, where, as a focused observer, he’s careful to stay behind the velvet rope. In taking this advocacy journey, the two say they enjoy it because it’s something they can all do together. The Henderson’s political involvement happened almost accidentally. A colleague friendly with Robin encouraged local legislator Cathy McMorris Rogers to stop in and see Henderson at her practice. Rogers was running for re-election, stumping in her district, networking with professionals in the area. It would be the start of a continuing friendship between the two, long before Rogers went on to serve in D.C. “Her visit that day made it easy for me to see her — whether at subsequent Dental Action Days, or local fundraisers,” said Henderson, who, noting that her first DAD was a little nerve-wracking, offered up a little advice. “The first time in Olympia can be intimidating, so make sure you coattail off of somebody! At our first DAD, we didn’t do that —we just showed up, wandered around, and happened by Senator Hewitt’s office. He’s from Walla Walla — it’s not our district, but it is our component. His legislative aide took us under his wing, told us to come back in ten minutes and she’d have him there for us — which she did. Later that same day, another Senator’s aide took us for a tour of the campus, showed us the lay of the land, went to lunch with us, and took us into the senate chambers! Because of those two people, we learned what to do, where to go, and how to make appointments . We were very fortunate, but we’d recommend that young dentists pair up with someone who has been before.” Now, say the Hendersons, being advocates is a lot less intimidating. “I realize that they are regular people just trying to do their best at their job like any of us,” explains Robin, “And the more information they have, the better job they can do.” For Scott, being involved in dental advocacy was a natural extension of being with Robin. The two met while she was in dental school, Scott observing her transformation from student to doctor, noting, “I’ve always told Robin that dentists are very humble people. The general public really has no idea how much they know, what it takes to become a dentist, and the abilities the job takes, because they make it look so easy. What they’re doing is really complex — especially the diagnostic piece of it — making hundreds, even thousands of diagnostic decisions all day long. If you’re the

Photo by Bev Sparks

Dr. Marissa Bender, a relative newcomer to advocacy, characterized her political involvement as passive until three years ago, when she enrolled in the Leadership Institute to expand her understanding of organized dentistry and advocacy. Calling the Institute “eye-opening,” Bender related how the experience took her from a passive participant to an active advocate of dentistry. Prior to that, she’d been involved at the component level, serving on the executive committee, and later rising through the chairs to become the President of the Snohomish County Dental Society today. She explains, “When I first attended component meetings years ago, I figured that just going to the meetings was enough. Then I went to the Leadership Institute and realized it was just the start. The more I learned about advocacy through the Leadership Institute, the more I wanted to be involved. And, seeing how being involved can make a positive impact has changed my perception. At first I thought other people could handle the work of advocacy, that they didn’t need me. I came to realize that quite the opposite is true — we need every voice we have, speaking in unison for dentistry.” Today, in addition to attending DAD and hand-delivering checks for DentPAC, Bender has written and emailed her legislators whom she’ll meet with again on January 25. “I’m confident that they will remember me,” she says, “And I will use the opportunity to continue to establish strong relationships and network with them.” Bender has characterized her initial meetings with 1st district legislators — Luis Moscoso, Derek Stanford, and Rosemary McAuliffe — as easy, an open exchange of ideas. “I wasn’t nervous about meeting them,” she explains, “I wanted to educate them about the state of dentistry. I emphasized the role of dental health education in schools, the complexities of access to dental care versus access to medical health care — and the differences between those — and why the midlevel bill isn’t really a solution to access. In return, they wanted to be able to tell their constituents what was available to them in their communities.” Bender’s advocacy future includes working more closely with DentPAC, once her three-year term on WSDA’s Budget and Finance Committee is over. But she’s also actively involved in her community — volunteering her time on the Medical Teams International vans, serving as Head Lector for her parish church, and volunteering her time as a member of the Dental Access committee for Providence Everett — a group trying to improve dental access in their area. Additionally, she’s one of 23 dentists in a community network taking oncology patients in need of free dental care before they can start their treatment

cover stor y building a grassroots network

Dr. Marissa Bender

cover stor y building a grassroots network

“Legislators really are willing to listen and learn from dentists. I feel like I’m a more responsible citizen, and I like that our daughter thinks that it’s completely normal to know elected officials.” — Dr. Robin Henderson Scott Henderson and Dr. Robin Henderson

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Photo by Bev Sparks

to them that this could change their career. They have a long time to go in their careers, and they are looking at things through a different set of filters, with different pressures on their careers. As senior dentists, we’re responsible for making personal invitations to young dentists and students.”

Drs. Josh and Lindsey Papac

When the Papacs met in dental school at the UW, Lindsey already had a slight advantage in advocacy experience, by virtue of her mentorship under Dr. Barry Feder. Lindsey’s mother is a hygienist in Feder’s practice, and he began to school Lindsey about advocacy as soon as he learned she was applying to UWSoD — even though she initially balked. “He said that I needed to get involved with legislative issues, but I’ve never been really political — and he would tell me, ’Look, this is your job, this is your future — you have to be involved.’” And so it was that during her first year of dental school she found herself at DAD, following the effusive Feder around. And while she doesn’t recall the issues or talking points that first year, she remembers the dawning realization that the work of the dentists and other students that day was a big deal, and important to her career. “I knew then that I wanted to get involved because my career was on the line, and I wanted to have a say.” Josh followed suit the year after, with encouragement from Lindsey and Al Minahan, son of WSDA President-elect David Minahan. Josh, too, realized that unless he went to Olympia, he couldn’t guarantee that his voice would be heard. “The first year I met with legislators it seemed like they enjoyed talking with students because they looked at us as ‘unspoiled.’ Students were encouraged to share their views, although it was generally more related to school issues, but we never felt marginalized — either by the doctors or the legislators.” While both remember that first time as a little intimidating , they soon got the hang of it. “As you move through the years you begin to get the ‘format’ of it,” relates Josh, “You get to know legislators, and you understand the issues more completely. Going back two and three years later with a really strong understanding of the subject matter was really helpful — you really feel like you grasp what’s involved, and it makes it a lot easier.” Along the way he and Lindsey formed comfortable relationships with two legislators they had met at DAD — Tina Orwell and Dave Upthegrove — whom they both characterize as easygoing and genuine people. In fact, that first year, Rep. Orwell made an indelible impression on Lindsey — by singling her out, and asking her opinion. For Papac there was an instantaneous connection “I think it was just the simplicity of a woman to woman connection in a sea of male dentists. She took the time to talk directly to

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me — I really liked that about her —I got a feel for her not only as a legislator, but, as a mom and a wife. It was great to be singled out in that situation, because it made me feel as though my opinion mattered to her.” For both, the best part of those early DAD experiences wasn’t necessarily the advocacy piece, though. It was the opportunity to meet, befriend, and learn from dentists who had been in practice for years, and were all too eager to help shape students from ‘raw materials’ to finished products. Josh relates, “I met people who we really consider mentors now — a lot of the senior doctors who went to DAD. I enjoyed the camaraderie aspect of it, and getting to know people who are well-known and respected in the WSDA — people like Jeff Parrish, Dave Minahan, and Bryan and Linda Edgar. We hit it off with Bryan and Linda right away — I think because we’re another husband/wife dental team. They’ve been great to us. Doug Walsh has been another great mentor figure, and was another person we met because of Dental Action Day.” Lindsey agrees, saying, “One of the real rewards of attending DAD was the networking opportunity. There is a common ground among attendees — and being there with a group of senior dentists, and having them get to know us was rewarding on so many levels. The networking possibilities were endless. Dental students should really look at it as an opportunity to possibly find a job — or a mentor.” Another high point for the two was attending ASDA’s National Dental Lobby Day in Washington D.C. while Lindsey was serving as Washington’s ASDA representative. There, they were able to get meetings with Senator Patty Murray and Rep. Maria Cantwell — both count the experience as one of the most exciting of their young careers. Today, Lindsey is an associate in a Burien practice, working with Dr. Randy Olson, and Josh is just wrapping up the purchase of a practice. And while their penchant for advocacy hasn’t waned, they are finding that their journey is shifting a bit. Josh’s practice and their new home are in the Lake Tapps area, meaning they’ll have to meet a whole new set of legislators for their new district. They’re in it for the long haul though, and expect to live in that area for the remainder of their careers. They plan to visit with their new legislators at 2013 DAD, and are looking forward to building relationships with them over the years, and eventually hosting fundraiser for legislators whom they identify as friends of dentistry. One thing’s for sure though — when they do, they might just give Rob Merrill a call for some pointers. After all, it’s all about networking. Want to be involved in Grassroots dentistry? Send Michael Walsh an email to, or call him at 800-4483368.

cover stor y building a grassroots network

patient, you don’t want to hear about all the variables, but that makes the process seem very simple. So it bothers me when outside groups with no training in dentistry try to come up with solutions to access, because they have such a limited understanding of what a dentist actually does.” While at the University of Michigan, one of Robin’s professors was a customer of Scott’s, and he explained what they were really teaching the dental students, “We can teach anyone to be a watchmaker, we can teach anyone to use their hands and perform the tasks, but what we’re really doing is teaching them how to think.“ Scott later told that same story to Rep. Joe Schmick, as it related to midlevel providers, saying, “I explained that that bill would not only have allowed midlevels to perform procedures that couldn’t be reversed, but it would have given them the right to diagnose, and even write prescriptions, without that crucial piece of training – learning how to think. It made an impression.” Like Bender and Merrill, the Hendersons call on their legislators outside of Dental Action Day, meeting up for coffee, lunch, or at fundraisers — strengthening their advocacy network. Because they live out at the far end of the state, it usually means the Hendersons have to travel to them, but the meetings are congenial and fun. “It’s really like sitting down with a friend. It’s very relaxed and easy,” says Robin, “Legislators really are willing to listen and learn from dentists. I feel like I’m a more responsible citizen, and I like that our daughter thinks that it’s completely normal to know elected officials.” This summer, Henderson was trying to meet up with one such legislator, when he suggested that Robin drive his car in the Johnson, Wash. Independence Day parade. Scott explains, “Johnson might have been a town 50 years ago, but now it’s a grain elevator with a main street. But on 4th of July, hundreds of people line the main street, which is barely a car wide. It’s the only parade I’ve ever been in where a crop duster starts the parade by buzzing the crowd. The road ends at the grain elevator and the folks in the parade march to it, then turn around and go back the other way, so this really narrow road has a parade going two directions. It’s crazy, and it was the best parade I’ve ever been to. It was truly a slice of small-town America.” And for the Hendersons, a patriotic reminder of how fun and easy being grassroots advocates can be. For Robin and Scott Henderson, the future lies in the ability to get younger dentists involved — “I think we have to take a personal interest in bringing new people into the fold,” says Robin, “Of the 300 people who attended DAD last year, probably 250 are the same ones who have attended for years, and we’re getting older. We need to reach out to the younger dentists we know and bring them along with us, and explain

cover stor y legislative session preview


The Legislature convened its 105-day long session on Monday, January 14, 2013. This session will feature many of the same issues faced in previous years. Here’s what we can expect to see in Olympia in 2013:

New Leadership

The 2012 elections have brought several new individuals into positions of power. Earlier this month, Jay Inslee was sworn in as Washington’s 23rd Governor. Even though Democrats retained control of the Governorship, the executive branch staff will have considerable turnover. On the legislative front, the most significant change has been the adjustment of power in the Senate from the Democratic caucus to the new “Majority Coalition” caucus. After the November elections, Democrats held 26 seats and Republicans held 23 seats. In December, two Democrats, Rodney Tom of Bellevue, and Tim Sheldon of Potlatch, announced they would vote with all 23 Republicans to form a coalition and name new committee leaders. Under the new coalition, Senator Tom will serve as the Majority Leader and Senator Sheldon will serve as President Pro Tempore. This year, the Senate Republican Caucus will be led by Mark Schoesler of Ritzville and the Senate Democratic Caucus will be led by Ed Murray of Seattle. The Senate Health Committee will be chaired by Randi Becker of Eatonville. In the House there have been fewer changes but still some important items to note. House Republicans netted one additional seat in the 2012 elections, so the new balance is 55 Democrats to 43 Republicans. Additionally, several prominent House members from 2012 retired, moved to the Senate, or lost their election. The House Health Committee has had significant turnover; the 2013 committee will have two new Democrats and six new Republicans. Eileen Cody of Seattle will remain chair and Joe Schmick of Colfax will continue on as ranking member.

Budget Deficits Remain

During the 2013 session, the Legislature will be responsible for writing Washington’s 2013-15 biennium operating budget. Revenue projections from the fall estimate that the state will have about $2 billion more in tax revenue than was available for the 2011-13 budget. However, if the state were to continue to fund all current programs and other obligations already on the books for the next biennium, the state would still be $900 million short. To further complicate matters, the Washington State Supreme Court recently ruled that the state is not adequately funding public education. The so-called “McCleary Decision” will require the state to increase funding for public education by about $1 billion. All told, the current budget deficit is expected to be around $2 billion. The current fiscal outlook will mean that the state’s budget will once again be the most important issue facing the Legislature in 2013. Both Governor Inslee and the Senate Majority Coalition leadership have publicly stated that they would like to close the budget shortfall without new taxes. WSDA is closely monitoring how potential budget decisions will impact the dental safety

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Dental Medicaid Funding

January 2013 marks the beginning of the third consecutive year without a comprehensive dental benefit for most Medicaid-eligible adults. This funding cut has dealt a devastating blow to Washington’s dental safety net, and has significantly limited the ability of both community health centers and private practicing dentists to treat low-income adults. Cutting adult dental Medicaid funding ensures that the state only pays when the cost of providing care is at its most expensive. The limited emergent care dental benefit does nothing to address the underlying issues that cause dental emergencies. Restoring funding for adult dental Medicaid will be one of WSDA’s top legislative priorities. Data and firsthand experience shows that the state’s issue with dental access is inherently an issue of financing and not workforce. WSDA will continue to work with the Coalition to Fund Dental Access to restore funding for this important program. (A potential option for financing adult dental Medicaid is discussed in the Health Care Reform section).

Dental Midlevel Providers

The Children’s Alliance and the Washington Dental Access Campaign have vowed to support dental midlevel provider legislation for the third consecutive year. At the 2012 House of Delegates, delegates passed HD-13-2012 Alternative to Dental Midlevel Providers by an overwhelming majority. HD-13-2012 authorized WSDA to support a supervised dental extender model as an alternative to the dental midlevel model advocated by the Children’s Alliance and several other advocacy organizations. WSDA discussed this model with key legislators and the Children’s Alliance this fall. The Children’s Alliance has formerly rejected our proposal and is seeking legislation that allows a new practitioner to diagnose and perform irreversible procedures without the supervision of a dentist. Based on this development, WSDA is not seeking introduction of the HD-13-2012 model at this time. WSDA will focus exclusively on defeating any unsupervised midlevel provider legislation.

WSDA and WSDHA Are Joining Forces

The Officers of WSDA and the Washington State Dental Hygienists Association recently agreed to jointly support legislation on providing hygiene services to homebound patients and topical anesthesia. A legal interpretation by the Department of Health has prohibited dental hygienists from placing topical anesthesia under general supervision and dental assistants and EFDA from placing topical anesthesia altogether. The joint WSDA/WSDHA effort

would clearly allow all registered and licensed dental staff to place topical anesthetic. The other joint proposal by WSDA/WSDHA would allow qualified hygienists to perform preventive services under the general supervision of a dentist in the homes of individual homebound patients. Homebound patients are individuals who cannot travel due to age or disability.

Health Care Reform

Major health care reform policy legislation was passed during the previous two legislative sessions. As a result, most of the major policy decisions regarding health benefits exchanges and other key topics have already been determined. The major legislative issues that remain deal with the long-term financing of the health benefit exchange, and the option of expanding Medicaid eligibility for adults with incomes below 138 percent of the federal poverty level (FPL). The Supreme Court’s 2012 ruling on the Affordable Care Act determined that expanding Medicaid eligibility for adults was optional and not required. Washington is expected to opt into the increased eligibility because the federal government will pay for between 90 and 100 percent of the cost for newly eligibles for the next ten years. WSDA is working with the Health Care Authority and other organizations to determine if a reinstated dental benefit for adults could be paid with a 90 to 100 percent match from the federal government. The campaign to reinstate adult dental Medicaid funding becomes much easier if the state’s contribution is minimized.

Licensure Grace Period

WSDA is once again seeking passage of legislation that would provide a 30-day grace period for dentists whose licenses are not renewed on time. WSDA supported similar legislation in 2010, but the bills did not receive a hearing in either health committee.

Washington Physicians Health Program

WSDA supports legislation that will increase the surcharge placed on dental license renewals from $25 to $50 for the Washington Physicians Health Program (WPHP). The WPHP helps dentists, physicians, and other practitioners recover from impairing illnesses such as addiction or other physical or mental conditions. The WPHP is a non-profit organization, and is not affiliated with the Department of Health. The program is funded by practitioners enrolled in the program, donations, and the license fee surcharges on health practitioners. The surcharge on dental licenses has been $25 for more than ten years. The surcharge on physicians’ and physician’s assistants’ licenses have been $50 for the last four years.

Want the latest news?

Go to - we’ll keep you informed every step of the way.

th e wsda ne w s · issue 3, januar y · 2013 · · 15

cover stor y legislative session preview

net, the University of Washington School of Dentistry, and dental practitioners.

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Reception photos courtesy of Steve Steinberg, Director of Communications, UWSoD

membership news mentor reception photos

The Burke Museum puts a fresh spin on the Mentor Reception Nearly 100 students and mentors turned out for the 19th Annual Mentor Reception this past November 29. The long-running event, held in association with the UW Dental Alumni group and sponsored by WDIA and ASDA, was in need of a little revitalization, so organizers moved it to the Burke Museum of Natural History and Culture on the UW campus. The move really paid off — attendees were delighted with the new digs, which lent itself to mingling, relaxing and networking — the entire point of the evening. “It really was a magnificent backdrop for the reception,” said WSDA President Dr. Danny Warner, who along with Dr. Joel Berg, Dean of the UWSoD, spoke to the crowd. The event is held to provide students and their mentors a chance to meet face-to-face, as busy schedules often only allow for phone calls or emails to be exchanged. Guests were encouraged to walk through the museum and visit, taking time to get to know one another better. Currently, 110 UWSoD students participate in the program, and all have mentors from around the state. They’re encouraged to communicate with their mentors on all aspects of dentistry, education and practice management, among other things. If you would like to know more about the program, please contact Membership Services Coordinator Laura Rohlman at 800-4483368, or email

th e wsda ne w s · issue 3, januar y · 2013 · · 17

membership news mentor reception photos


What’s your ROI?

Your WSDA membership has many tangible benefits — savings on products and services through our many endorsed partners, exclusive access to The Source, our online Business Resource Center (, deeply discounted entry to the Pacific Northwest Dental Conference, a free subscription to the WSDA News, and more. But it also has many, additional hidden advantages. As a member you’re in one of the most effective and persuasive legislative lobbying groups in the state, you receive a reminder when your license is about to lapse (which could save you thousands of dollars if you miss your renewal), and scores of other vital benefits. So what does all this value add up to? We calculated your Return on Investment based on minimum usage of the following benefits:

With Membership • Advocacy for the profession • The Source: An Online Business Resource Center

W/O Membership

Your Savings

• Not Available

• Membership Benefit

• No Access

• Membership Benefit

• WSDA News Magazine – • Not Available Award-winning eight-issue publication

• Membership Benefit

• WSDA Update – Electronic notification of news that affects your profession

• Not Available

• Membership Benefit

• Pacific Northwest Dental Conference (PNDC) – Earn up to 16.5 credits for $200

• Non-member price is $1,750

• Membership Benefit

• Online CDE Tracking – Mag-strip membership cards keep all your CDE in one place

• Not Available

• Membership Benefit

• •

Dental Action Day (January 25) – Organized meetings with your legislators

• No Representation

• Membership Benefit

WSDA Endorsed Companies Program – exclusive discounts

• No Discount

• $1,670*

• WDIA & NORDIC - Endorsed insurance • WDIA: 10% discount on disability* programs with specific product discounts NORDIC: 5% discount with webinar*

• $150* • $107*

• Webinars – Complimentary CDE from the convenience of your computer

• Not Available

• Membership Benefit

• Find a Dentist Feature – Public listing on and

• No Listing

• Membership Benefit

• Online Membership Directory – Members only complete contact information on

• No Listing or Access

• Membership Benefit

• •

Annual License Renewal Reminder – Email • Not Available • Estimated $10,000 notification reminding you to renew your license in lost revenue** Free assistance with legal questions general to the • Costly Legal Fees practice of dentistry and questions regarding rules and regulations pertaining to the practice of dentistry

• $300/hour/legal fees

• Free CDE – Retired volunteers receive a free PNDC badge

• Not Available

• Membership Benefit

• Contract Analysis – Third-party insurance

• Not Available

• $300/hour/legal fees*

• Free WSDA Peer Review - Mitigating patient complaints before they get to DQAC

• Not Available

• $300/hour/legal fees*

• WSDA News Magazine and Classified Ads - $50

• Non-member price $100

• $50/classified*

• Relief Fund – Relief grants for emergency needs and daily living expenses

• Not Available

• Membership Benefit

• Electronic ADA & WSDA Logos for use on practice website and electronic communications

• Not Available

• Membership Benefit

TOTAL Savings*


1 8 · th e wsda ne w s · issue 3, januar y · 2013 · *Estimated single member usage ** Estimate based on one week’s lost insurance revenue

wohf news give kids a smile events

Left to right: A Kitsap County child smiles at their annual event, Walla Walla’s famous Tooth Fairy holds a GKAS participant.


Make your GKAS event a hit with WOHF

Tom Tidyman Director of Programming and Development, WOHF

Are you planning an event for Give Kids a Smile Day?

February 1 is National Give Kids a Smile day, but here in Washington we’ve always encouraged our members to use the entire month to help those in need receive dental care. The Washington Oral Health Foundation can help in many ways - by helping you promote your event through schools and media outlets, by helping to coordinate larger events involving more than one practice, by providing educational materials, volunteers and program materials, and by serving as a liaison between your practice, area schools and Boys & Girls clubs across the state. The Foundation exists to support WSDA members in a variety of ways throughout the year, but especially during Give Kids a Smile events. As Tom Tidyman, the Foundation’s Director of Programming and Development says, “Any time a WSDA member wants to give back to their community, WOHF would like to be available to lend support however we can.”

Need help

If you have an event and need our help, or if you would like to plan an event, but are unsure if you have the time to make it successful (you do, and we’ll help!), call or email Ruth Abate, WOHF Director of Operations and Community Outreach at 800-448-3368 or Abate says, “We have the resources to make your Give Kids A Smile event a huge hit, and the ADA can help, too. Log onto their site at givekidsasmile.aspx to get helpful tips on how to establish a meaningful and successful Give Kids A Smile event in your community.”

Already have an event in the works?

We want to hear about it — we like knowing what’s happening all around the state. Let us publicize your good deeds in the WSDA News and on our blog. Simply send highresolution images, a paragraph or two about your event (who was involved, how many kids were seen, how much dental work was given away, etc), and the date and time of your event, to WSDA News Managing Editor Rob Bahnsen at The ADA wants to know, too - log on at to register your event.

th e wsda ne w s · issue 3, januar y · 2013 · · 19

Ruth Abate Director of Operations and Community Outreach, WOHF

“Any time a WSDA member wants to give back to their community, WOHF would like to be available to lend support however we can.”

Yo u ’ r e t h e r e f o r y o u r p a t i e n t s . We ’ r e h e r e f o r y o u .


800-448-3368 FA C E B O O K U S 2 0 · th e wsda ne w s · issue 3, januar y · 2013 ·

Your donations at work A gift of $50: Purchases new education materials for our volunteer dentists, dental assistants and dental students to use at a school presentation. A gift of $100: Allows our staff to print brochures and coordinate volunteers for a community health fair. A gift of $250: Funds staff and supplies at our Boys & Girls Club clinic for one day of treatment. A gift of $500: Provides toothbrushes, toothpaste and floss for an entire school that we present our education and prevention message to. A gift of $1,000: Sponsors three Boys & Girls family nights to engage both kids and parents about oral health


WOHF’s Annual Phone-A-Thon is their biggest fund raiser Your donations help WOHF: Schedule more Medical Team International dental vans in counties with limited dental resources and with high numbers of unemployed and underserved residents. Purchase products and produce oral health information for families, which are then used to fill oral hygiene kits distributed in Washington’s Title I schools during the school term. Continue to expand the WOHF Boys & Girls Clubs Oral Health Initiative to more of the 137 clubs across Washington — with the potential to impact the health and futures of 167,000 members and their families. Continue to provide turnkey programs and resources for WSDA members that include scripted PowerPoint presentations, videos, teaching models, printed and online education materials for all ages, plus on-site training and support.

New this year — more callers

The WOHF Phone-A-Thon has always been the organization’s biggest fundraiser, car-

ried out by a cadre of dentists dedicated to the work the Foundation does around the state. And while WOHF staffers are relying on some of those same folks again this year, they’re also organizing callers from around the state who will ring up their colleagues throughout the month of March on behalf of the Foundation. “We’re hoping that by spreading out our calls over a month and employing a regional approach to calling, we’ll be able to reach more members from across the state than ever,” said Tom Tidyman, Director of Programming and Development for WOHF.

Reaching out

This year Tidyman and Ruth Abate, Director of Operations and Community Outreach for the Foundation, have a second goal for the event: they want to pick your brain about what is needed in your community. “Along with the appeal, we thought it was more important than ever to ask dentists what we can do for them,” Abate said recently. WOHF wants to support communities across the state to fulfill its mission of improving and enhancing oral health in Washington — but to be effective, the organization needs ambassadors in every corner of the state, illuminating the needs specific to your community. The Foundation provides programming and distributes oral hygiene kits to schools, organizes and serves as liaison between providers like Medical Teams International vans and the communities in need, and provides resources for WSDA members to use in their communities to help get the word out about oral hygiene and tobacco cessation.

Tell WOHF what you need

So, this year, when you get a call from a dentist volunteer asking you for a donation to the Washington Oral Health Foundation, take a moment to think about what needs your community has, and give that information to the person calling. Tidyman said, “Tell us how we can work together and achieve that goal. We’re eager to partner with member dentists across the state.” Contact Tidyman or Abate at or

th e wsda ne w s · issue 3, januar y · 2013 · · 21

wohf news phone-a-thon

in the news shinn wins humanitarian award

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Additionally, recipients must have “distinguished themselves by outstanding, unselfish leadership and at least a ten-year commitment to their fellow human beings in the field of dentistry, through the dedication of extraordinary time and professional skills to improve the oral health of underserved populations in the United States and abroad.” For Shinn, it was the unlikely sound of a child crying, high in the Himalayas, that set him on the humanitarian course that continues to this day. It was 1990, and Shinn was in Nepal to soak up the culture and the mountains, when, at a Sherpa lodge 10,000 feet up, he heard the incongruous sound of a child in pain. The five year-old girl was just days from death from an abscess, and locals had no idea how to treat it, or even what had caused it. For Shinn, it was a moment of clarity — he knew what his life’s work must become. Vowing to return to the region, distribute toothbrushes, and teach the local populations the value of good oral hygiene, Shinn did just that — making four trips to Nepal between 1992 and 2000. Shinn not only brought toothbrushes, but also helped design and construct a dental clinic in the village of Namche Bazar, and later trained locals to take over the work he had started — delivering treatment to local children. In 1993, Shinn received a request to start a similar treatment program in Tisikita, Costa Rica, and later traveled with a dental outreach group to Cochbamba, Bolivia. There he worked with a large orphanage system — finding dental disease similar to what he’d discovered in Nepal. Shinn realized the problem was widespread, and for 12 years he continued his outreach work in Bolivia, working with children and establishing an empowerment program that some 50,000 children have participated in to date. The success of that program created media buzz about his work overseas, and with that attention came many additional requests for assistance worldwide. To meet the growing demand, Shinn founded Smile Power, a non-profit organization dedicated to bringing dental care to children around the world. SmilePower was able to partner with groups in Guatemala, Jamaica, the Cook Islands, Micronesia, Uganda and elsewhere, to provide dental care to impoverished children. And though Shinn now serves as a staff dentist at Lindquist Dental Clinic for Children in Gig Harbor, he and wife Faria still travel to Uganda, Jamaica and Haiti to continue their outreach work for their non-profit organization, For World Wide Smiles. His humanitarian work has taken him to some 40 countries across the globe, averaging four international trips a year, Shinn says, “Volunteering makes life so much more delicious and exciting and worth living. When you work for money, you can have all the things money can buy. When you work unconditionally, you get to have all the things money can’t buy.” For his work on behalf of children around the world, Shinn has been honored in the past with the National Jefferson Award — the nation’s highest honor for public service — and the 2003 Citizen of the Year award from the WSDA. Dr. Shinn will receive a plaque and a $5,000 donation to For World Wide Smiles during the ADA’s 154th annual session in New Orleans Oct. 31-Nov. 3.

DR. SHERWIN SHINN Winner · ADA Humanitarian Award · 2013

th e wsda ne w s · issue 3, januar y · 2013 · · 23

in the news shinn wins humanitarian award

For his work in Nepal and around the world, WSDA member and former Citizen of the Year Dr. Sherwin Shinn was recently named the 2013 recipient of the ADA Humanitarian Award, given annually to the person whose volunteer commitment and leadership has had a broad impact on oral health and the improvement of the human condition.




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After handling thousands of transactions over the past two decades, PARAGON consultants know that no two clients and no two transactions are the same. A practice transition is a very personal event that requires very special attention. Nothing is taken for granted. We customize every single transaction to satisfy the needs and goals of our clients. We handle each transaction as if we are the client. This is just one of the many reasons why PARAGON is so unique.


Judge for yourself! Call us for a complimentary consultation. No obligation… just a very worthwhile education! Sign up for our free newsletter at Approved PACE Program Provider FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement 4/1/2012 to 3/31/2016 Provider ID# 302387

Your local PARAGON consultant is Mark Fleming, D.D.S. Contact him at 866.898.1867 or

2 4 · th e wsda ne w s · issue 3, januar y · 2013 ·

2013 LEADERSHIP INSTITUTE “I truly hope to make a difference — we have the obligation of teaching our future generations to always be committed to providing the very best dental care with the highest ethical standards.” — Dr. Naghmeh Izadi

The Leadership Institute kicked off the year with the first of six events scheduled for 2013, the Past President’s Roundtable and Association background session. The Institute was designed to foster new leadership in the WSDA by pairing participants with WSDA Board members who mentor them throughout the process. Members selected to this year’s class are Dr. Michelle Caldier, Dr. Daniel Geare, Dr. Naghmeh J. Izadi, Dr. Jonathan Judd, and Dr. Kishore Shetty, each chosen for their commitment to organized dentistry and their dedication to advocacy. Program mentors are Dr. Bryan Edgar, Dr. Gary Heymoto, Dr. Lorin Peterson, Dr. Laura Williams and Dr. Rod Wentworth. On January 4, Participants met with the Association’s senior staff members individually to understand that staff person’s role, and that of their department within the WSDA. Later they met key past presidents of the WSDA including Dr. Rod Wentworth, Dr. Mark Walker, and Dr. David Houten for an extensive Q & A session about the WSDA. Besides the scheduled events, participants are encouraged to meet privately with their mentors during the year to discuss perspectives, leadership issues and questions, and to further enhance the collaborative nature of the leadership process. The programming goal is intended to educate and illuminate the leadership process, without overwhelming participants with too many activities. Here is a list of the remaining events for the year:

January 24/25 - DentPAC Meetings/Dental Action Day (DAD)

Spring - Committee Meeting of Participant’s Choice

June 20-21 - Board of Directors Two-Day Meeting

September 19-21 - House of Delegates. continued on page 27

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leadership institute welcome meeting

Leadership Institute participants, left to right: past Presidents Dr. David Houten and Dr. Rod Wentworth, Dr. Michelle Caldier, Dr. Jonathan Judd, Dr. Gary Heyamoto (mentor), Dr. Kishore Shetty, Kainoa Trotter, Dr. Daniel Geare, Dr. Lorin Peterson (mentor), Dr. Naghmeh J. Izadi and Past President Dr. Mark Walker.





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In their own words: Information about the 2013 Leadership Institute participants: Dr. Michelle Caldier

Dr. Michelle Caldier is Chair of the SKCDS Access to Care Committee, an Executive Council Member and a member of the Event Planning Committee in the Seattle King County Dental Society. “I would like to help lead our state find viable, sustainable solutions to our access problem, and learn more about the legislative process and how I can participate in improving the access to care for the underserved population. I am very passionate about improving the quality of oral care for the underserved, and acknowledge that I can only make a small impact as an individual.”

Dr. Naghmeh J. Izadi

Dr. Naghmeh J. Izadi is an Executive Committee member of the Snohomish County Dental Society and has been a member of the society since 2001. “My goal is to be able to make a positive impact on our profession by staying involved in the dental society, and to make a difference by representing my honest, hardworking colleagues who are committed to excellence in dentistry. I truly hope to make a difference — we have the obligation of teaching our future generations to always be committed to providing the very best dental care with the highest ethical standards. One person alone does not have much power — together and united, we can make a difference.”

Dr. Jonathan Judd

Dr. Jonathan Judd is currently a Delegate to the WSDA House of Delegates and Secretary Treasurer of the Spokane District Dental Society. Past posts include being a member and the chair of the Continuing Education Committee of the Spokane District Dental Society. “I would like to be involved and help shape the profession of dentistry for my generation and those dentists that come behind me. Dentistry is facing many challenges on several fronts: access to care, decisions of the legislature that affect small business and the practice of dentistry, as well as reimbursement, to name a few. I believe that now, more than ever, our profession needs a collective voice to be able to effectively address these issues and be involved in the decision-making process. As a public health dentist who has worked in a federally qualified health center for the past seven years, I believe I can come to the table with a different viewpoint and work with my mentors and colleagues to advance our profession.”

Dr. Daniel Geare

Dr. Daniel Geare is a past Delegate from King County, and currently serves on the Self Instruction Committee for the AGD. “I am interested in intercepting the future issues that will be facing organized dentistry and the profession, including managing and controlling the midlevel provider process to protect the public and the business viability of practicing dentists, addressing the trend of reduced insurance reimbursements, creating a forum and system to increase patient access through a statewide volunteer program, standardizing legislative contacts and interactions, creating closer partnerships with insurance carriers in order to mitigate future WDS type problems, reforming the outreach program to attract new members and interest existing members into greater participation and feedback. My profession is a gift and a blessing. I have a moral responsibility to act ethically, grow and contribute to the profession that has given me so much. Being part of organized dentistry is part of that responsibility. I am at a point in my development and career that I can give back more than I have thus far.”

Dr. Kishore Shetty

Dr. Kishore Shetty is a Site Visitor for the Council on Dental Accreditation with the ADA, serves on the Board for the Washington Academy of General Dentistry, and is that organization’s Membership Chair. “I am a passionate supporter and advocate of the dental profession and always strive to work with organized dentistry for advancing our profession. I have completed formal training programs in oral medicine and hospital dentistry with additional specialization in dental anesthesiology. I am very passionate about a number of issues facing our dental profession and would like to represent the issues on behalf of organized dentistry. Leadership in organized dentistry does not come without its challenges. I realize from my experiences that oral healthcare, especially clinical delivery, is a cacophony of different backgrounds, biases, experiences, values and priorities. The pursuit to be more involved has led me in many enriching and rewarding directions clinically, and has drawn to me to seek leadership opportunities in organized dentistry. It would be an excellent opportunity to expand the range of my expertise and, most likely over the long term, aide in my continued involvement in WSDA. I hope to gain the necessary skills to constructively address the enormously complex problems which we presently face in dentistry.”

th e wsda ne w s · issue 3, januar y · 2013 · · 27

“Dentistry is facing challenges on several fronts: access to care, decisions of the legislature that affect small business and the practice of dentistry, as well as reimbursement, to name a few. I believe that now, more than ever, our profession needs a collective voice to be able to effectively address these issues and be involved in the decision-making process. As a public health dentist who has worked in a federally qualified health center for the past seven years, I believe I can come to the table with a different viewpoint and work with my mentors and colleagues to advance our profession.” — Dr. Jonathan Judd

leadership institute welcome meeting

leadership institute, continued from page 25

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2 8 · th e wsda ne w s · issue 3, januar y · 2013 ·

King County

Snohomish County · 2012

Tuesday, January 29 Speakers: Drs. Bobby Butler and Mark

January -- No Meetings


Topic: Is the Tooth Fractured? Diagnosis

and Decision Making in Today’s Clinical Practice Location: The Harborside Restaurant, Seattle Time: 6-9 p.m. (CDE Credits: 2) For registration contact SKCDS at 206448-6620 or

Tuesday, February 26 Speaker: Dr. Ankur Gupta Topic: The 10 Most Profitable Changes I

made to My Dental Practice Location: The Sheraton Hotel, Bellevue Time: 6-9 p.m. (CDE Credits: 2) For registration contact SKCDS at 206448-6620 or

Friday, March 1 Annual Seminar Speaker: Terry Donovan, DDS Topic: Restoration of the Worn Dentition Location: Lynnwood Convention Center Time: 8:30AM - 4:30PM

(CDE Credits: 7) Co-sponsored with University of Washington School of Dentistry and the Snohomish Co. Dental Society. To register call SKCDS (206)443-9308.

Tuesday, April 30 Speaker: Dr. Grant Chyz Topic: Fundamental Techniques for Suc-

cess with Posterior Composites Location: Salty’s on Alki, Seattle Time: 6-9 p.m. (CDE Credits: 2) For registration contact SKCDS at 206448-6620 or

Friday, May 3 Speaker: Dr. Tim Hess Topic: Review of Facial Aesthetics: Clinical

Applications of Botox and Dermal Fillers in the Dental Practice with Live Demonstration Location: Airport Marriott Hotel, SeaTac Time: 8 – 4 p.m. (CDE Credits: 7 ) Co-sponsored with Washington AGD. For registration contact SKCDS at (206) 4486620 or

Wednesday, February 20 SCDS General Meeting Speaker: Dr. Mark Drangsholt Topic: TBA Location: Mill Creek Country Club (CDE Credits: 1)

Friday, March 1 Annual Seminar Speaker: Terry Donovan, DDS Topic: Restoration of the Worn Dentition Location: Lynnwood Convention Center Time: 8:30AM - 4:30PM

(CDE Credits: 7) *Co-sponsored with University of Washington School of Dentistry and the Seattle-King Co. Dental Society. To register call SKCDS (206)443-9308.

Wednesday, March 2 SCDS General Meeting Speaker: Dolphine Oda, DDS Topic Oral Pathology Location: Mill Creek Country Club (CDE Credits: 1)

Wednesday, April 17 SCDS General Meeting Joint meeting with Snohomish Co. Dental Hygiene Society Speaker: Kimberly Hanson Huggins, RDH Topic: TBA Location: Mill Creek Country Club (CDE Credits: 1)

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Friday, April 26 BLS for Healthcare Providers & First Aid Courses

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Wednesday, May 15th General Meeting Speaker: Dr. Danny Warner, President, Washington State Dental Association

Topic: WSDA Update & Current Issues Location: Mill Creek Country Club (CDE Credits: 1)

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th e wsda ne w s · issue 3, januar y · 2013 · · 29

Linnell Isoshima Steven Kanzaki 1206 Olympic Avenue Edmonds, WA 98020 Pager: (206) 399-0242 Fax: (425) 712-1859

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wdia news disability coverage

3 0 路 th e wsda ne w s 路 issue 3, januar y 路 2013 路

ages or if you are not covered at all, then you will want to consider increasing your existing coverage and/or obtaining other types of disability coverage. Here are some important types of disability policies:

Personal Disability

Personal Disability is personal income replacement to cover your loss of earned income if you become disabled. This coverage would be used to pay your home mortgage, water and electric bills, car payment, groceries, gas, children’s tuition: anything that your paycheck covers for your family. Without Personal Disability, all your monthly expenses would have to be paid from your savings.

Overhead Expense

Business Overhead Expense is specific to covering your business expenses if you become disabled. This coverage allows your business to continue to run while you are recovering from a disability or in the process of selling your practice. Expenses that are covered by this policy include: rent, staff salaries, electricity, dental supplies, janitorial and maintenance work, etc. Without Overhead Expense coverage, you may not be able to keep your business running while you are recovering from a disability.

Business Loan Protection

Business Loan Protection (also called Business Reducing Term coverage) specifically covers your mortgage or equipment loan payments to the bank if you become disabled. A practice loan is thousands of dollars per month and without Business Loan Protection, you would be paying for your loan out of your pocket. Although each type of disability policy provides coverage for a different aspect of your life, the benefits on each policy are triggered by you no longer being able to perform the duties of your profession. Having multiple policies at the correct coverage amounts ensure that every part of your life will be protected. Washington Dentists’ Insurance Agency would like to encourage you to keep all your insurance policies in force and to make sure that you have the amount of coverage you need. As a member, we encourage you to review you insurance needs annually. WDIA is your insurance company and we need the support of dentists in Washington to continue our work in the support of the dental profession. Please contact WDIA at 1-800-282-9342 or for a free annual insurance review or for quotes on Disability Insurance.


How it can protect you and your family

th e wsda ne w s · issue 3, januar y · 2013 · · 31

wdia news disability coverage

Last year, Washington Dentists’ Insurance Agency worked with several dentists who became disabled by accidents or unforeseen illnesses. A disabling event can touch anyone no matter what their age or their health, and it can cause financial hardship if you are not fully covered by the right kinds of disability insurance. Although insurance is not a tangible item you pay for each month like your home or electricity, it is still incredibly important to keep your disability insurance in force and up to date with your needs. Your disability insurance is there to protect you and your family if the worst should happen, but if you are under insured, those gaps in coverage may cost you. If you become disabled, savings may cover the costs in one aspect of your life, but it is unlikely that you would have enough funds to cover your personal and business expenses indefinitely. Washington Dentists’ Insurance Agency encourages dentists to acquire different types of disability insurance to ensure that all personal and professional expenses will be covered for the well being of themselves and their families. The best way to protect yourself, your family and your practice is to make sure your insurance policies have the full protection you need. If the amount you need is less than what you currently have in monthly benefit on your disability cover-

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Dr. John R. Liu Dear Editor: As a general dentist who works on a population that many times require general anesthesia in order to properly treat and help maintain oral health in many of my patients, I want to tell you that I loved your editorial in the current WSDA News issue #2, Dec 2012 you wrote recently. There is absolutely no other way to properly and safely treat many of my patients if I did not have a dentist anesthesiologist in my practice. I am aware of the recent denial for specialty of this group of individuals with post doctural education and was greatly disappointed in the “No” vote for specialty. Thank you again for your editorial. I never respond to things like this, its not in my personality, but I felt compelled to give you a standing approval for your opinion and glad that my feelings about the denial for this group of individuals as a specialty recognition was indeed something that needs to be noticed. I am sure you may know, this, I believe is the THIRD time it has been denied. Dr. Melissa Ramsey Walla Walla, WA

th e wsda ne w s · issue 3, januar y · 2013 · · 33

letter to the editor drs. john liu, melissa ramsey

Dear Editor: It was with much dismay and noted incredulity that I read the recent headlines in the November 5, 2012 ADA News. Dr. Robert A. Faiella, recently installed President of the ADA, in his address to the ADA House of Delegates on October 23rd is quoted in the headline: “It’s not loyalty but principle that drives our policies”. The ADA House of Delegates rejecting the application to recognize anesthesia as a specialty within dentistry contradicts this statement and headline in the ADA News. The application for recognition of anesthesia as a specialty has now come up several times and gone through the ADA’s process of extensive review by the Council on Dental Education and Licensure using criteria set by the ADA. Again, as in times past, CDEL, the Committee on Recognition of Specialties and Interest Areas in General Dentistry and the ADA Board of Trustees supported the application. Anesthesia followed and fulfilled all the guidelines and criteria set forth by the ADA for recognition as a specialty. For the application to be yet again denied by the House of Delegates says to me that the ADA subverts its guidelines and principles to the loyalties of the special interests in the House of Delegates. I strongly believe in the idea put forth by Dr. Faiella’s statement about principle driving policies. However, if we hope to have the ADA as an organization in which “not loyalty but principle that drives our policies” the ADA will need to reexamine the specialty recognition process by which special interests exert influence in the final step disregarding principle, procedure, and policy.

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Call Toll Free Phone (866) 348-3800 Fax (866) 348-3809 16300 Christensen Rd. Suite 213 Seattle, WA 98188 3 4 路 th e wsda ne w s 路 issue 3, januar y 路 2013 路

Dr. Marvin Alonzo Johnson

Dr. Rex J. Nelson

Dr. Rex J. Nelson died Wednesday, March 21, 2012, at Eastern Idaho Regional Medical Center. He was 87. Nelson was born March 25, 1924, on the kitchen table at the family farm located near Weston, Ida. He was the third child born to Roy Oscar Nelson and Marie Jensen Nelson but the only child to survive infancy. His early years were filled with hard work on the farm and roaming the hills and streams of Franklin County in search of rabbits, squirrels, fish and gold nuggets from his grandfather’s mining claim. The family lost their farm during the Depression, resulting in frequent moves to find farm and construction work. Nelson assisted his mother in preparing meals for the laborers and helped his father in the fields. He was paid with a bicycle, a horse and a hunting dog. His family eventually settled in the Rigby area, where his father managed a dry farm. Nelson graduated from Rigby High School in 1942 and then moved to Weiser, Ida., to learn welding. After a short stint working in the naval shipyards, he moved to Salt Lake City to work in a sporting goods store

and prepare to join the Army Air Corps. During WWII, He served as a B-17 pilot with the 493rd Heavy Bombardment Group quartered at Debach, England, flying numerous bombing and humanitarian missions over Germany, France, Belgium and Czechoslovakia. In February 1946, Nelson and his high school sweetheart, Coral Baird, eloped for a double wedding with their friends Dale Nielsen and Leone Cordon. He worked as a furniture and appliance salesman, and Coral worked at the Land Bank while they “remodeled” a family garage into a threeroom “castle.” Rex and Coral had two sons, Kent and Douglas. His National Guard unit was deployed to the Korean Conflict, where he flew reconnaissance missions in a small, singleengine Cessna, armed with an M-16 rifle and a pistol. Nelson later retired with the rank of Lieutenant Colonel. After the Korean War, Nelson enrolled as a 28-year-old freshman at ISU. He finished dental school six years later at the University of Minnesota. He and Coral opened a dental practice in Idaho Falls, only to suspend it while his guard unit was activated during the Berlin Crisis. Afterward, Rex resumed his dental practice, working with Coral as a receptionist and bookkeeper until her untimely death in June 1965 at the age of 42. In October 1966, Nelson married Rae Kay Hosie. They had a daughter, Whitney. Rae’s accounting and business skills brought new life into the dental practice, and together they became avid hunters, campers, boaters, skiers, dog trainers and horse breeders. Together they enjoyed many service and professional activities, including the Exchange Club, dental associations and playing host to numerous parties and fundraising events at the “hobby” ranch on South Park Road. He helped form a local dental study group and served as a representative to the National Dental Association. He retired from dentistry in 1980 following an unfortunate fall down a flight of stairs. The injury led to his interest in becoming a licensed realtor. He particularly enjoyed the Island Park “cabin” market. In retirement, Nelson lived in Seattle, Island Park and Idaho Falls. For the past two years, he has enjoyed the Fairwinds Retirement Community. Nelson is survived by his former spouse, Rae Kay; his sons, Dr. Kent (Carolyn) Nelson of Surprise, Ariz., and Doug (Billie) Nelson of Idaho Falls; and daughter, Whitney (Dennis) Nelson-Heenan of Newburg, Ore.; along with nine grandchildren and 21 great-grandchildren.

th e wsda ne w s · issue 3, januar y · 2013 · · 35

private donations are difficult to find and keep. Guess what happens when you lose your adult population? You don’t need your hygienist as many hours, if at all. I have worked shoulder to shoulder with these dedicated dental souls, and now I worry about their jobs. Welcome to my real world workforce problem. It is always difficult to be a poverty dentist. It is hard to pick up the pieces when your patients have neglected their care and health to the point of where their needs may be so severe that they are almost outside of the scope of practice for a general dentist. It is much harder when there is no money to treat them. It breaks my heart to see money being spent in emergency rooms that could go so much farther in the safety net clinics we worked so hard to build. We need to rethink our funding. We need to utilize our current resources. The community health network we built is ready to work. Just fund us! * Most of the data here came from WSDA’s “Strengthening the Dental Safety Net,” written by Bracken Killpack. Thank you Bracken!

guest editorial, continued from page 5 where you “need not be present to win.” If you are not active and involved, you have no right to complain when decisions do not go your way. Your voice will be dismissed after the fact, but respected and considered if you have been involved in the process throughout, and rightly so. In my component, the Seattle-King County Dental Society, we have around 1200 “active” members. Fewer than 70 frequently attend our programs, and usually it is the same 70 faces each time. Unlike a gym membership where they are kind of hoping you don’t show up, we’re hoping you do. Your component needs to stop hoping you will be there and be able to count on you being there. Your mission is to choose to be engaged and then act on it. That means signing up for the Grassroots program, attending DAD, going to a local component society event, asking your fellow colleagues why they aren’t members of the Association and inviting them to join (especially the colleagues you work with). Pick one (or pick them all), but do something — get engaged, save your profession, stand up to be counted, and be proud of being a healthcare provider.

editorial, guest editorial continued

Dr. Marvin A. Johnson was born Dec. 27, 1919 in Lovell, Wyo., and passed away Nov. 9, 2012 in Tacoma, Wash. He was 92. The oldest of five children, Johnson attended a year at Chilicothe Business College in Missouri and afterwards enlisted in the Army. He served during WWII in the European theater, and later on patrolled the coastline of Washington and Oregon. After the war he distinguished himself as an expert cavalry horseman in the Wyoming National Guard, and was active in the Army Reserve. Johnson graduated from the University of Washington School of Dentistry in 1952 and taught there for more than 54 years, while maintaining his private dental practice in Lakewood, Wash. He retired from private practice at the age of 87, and from teaching at the age of 89. He was admired by his colleagues around the world for the quality and craftsmanship of his dental restorations, and was honored multiple times by the Pierce County Dental Society, and the Washington State Dental Association. He was invited and joined the exclusive Crown and Bridge Academy. Johnson is survived by his wife Judy, his brother Fred, and his sisters Myrna and Susie Nell. He is also survived by his children Elizabeth (Bob) Hauser and Mark (Diane) Johnson, and his 10 grandchildren and 14 great-grandchildren. He was preceded in death by his first wife and their daughter Susie, and brother Bud.

editorial, continued from page 4

in memoriam drs. johnson, nelson

in memoriam


         

     


       



 

   



                           

   

    

  


  


 



 

 

 

 

 

   3 6 · th e wsda ne w s · issue 3, januar y · 2013 ·

Effective retirement plans for small businesses What is the single most effective tax-planning strategy for you as a small business owner? Creating and implementing an employersponsored retirement plan.

401(k) PSP – the 401(k) component of this option allows for flexibility in employer contributions and the ability for participants to take loans from the account, as determined by the plan document

Plan Objectives

401(k) Safe Harbor – allows owner to make larger contribution to him/herself (as both employer and employee) in exchange for making required 3 percent contributions to all eligible employees, regardless of their participation level

There are numerous employer-sponsored retirement plan options available to you. First, it is paramount that you have a clear vision for the retirement plan you will sponsor and fund. Plan objectives and variables for consideration may include any/some/ all of the following: • Maximizing your own retirement savings • Leveraging tax credits and deductions available to plan sponsor/business owner • Remaining competitive as an employer to elevate employee retention and loyalty • Investing in your employees and business for the long term • Funding flexibility vs. ease of administration vs. overall cost spectrum Once you have solidified your retirement plan goals and expectations, your financial planner will be able to advise you of the plan (or combination of plans) most appropriate for your personal and business needs. To ensure that you as the owner/sponsor receive both primary and maximum savings, tax and contribution benefits from your plan, it is important to review and evaluate carefully the complete demographics of your business – inclusive of your capacity for regular and consistent annual savings/funding, along with the income levels, ages, length of service and census of eligible plan participants. It is also vitally important for you to understand and accept the funding parameters (both maximums and minimums), start-up and ongoing operational costs, administrative workload and fiduciary responsibilities (both internal and external) of the plan you ultimately select. Conducting a cost/benefit analysis of your options in advance of selection is a worthwhile exercise undertaken with your wealth manager.

Plan Options

The most common types of retirement plans are ‘Qualified’ (ex: 401(k), profit sharing, Safe Harbor or Defined Benefit) or IRAbased (ex: SEP or SIMPLE). Following are brief overview descriptions of the plan options available in each category: PSP (Profit Sharing Plan) – a means of sharing discretionary business profits with employees in the form of retirement funding

Pro-rata – same contribution of earnings percentage used by the owner must also be applied to eligible employees (ex: if owner contributes 10 percent of earnings to his/her plan, must also fund employee plan with 10 percent of each employee’s salary as employer contribution)

Integrated – calculation is based on income (amount over the social security amount)

Defined Benefit Plans – sponsor required to participate/contribute for a minimum of three years; more expensive – involves the services of an actuary SIMPLE IRA (Savings Incentive Match Plan for Employees of Small Employers) – available to small businesses with fewer than 100 employees. The owner must either match participant contribution dollar-for-dollar up to 3 percent or make a 2 percent nonelective employer contribution to all eligible participants. Contributions are immediately 100 percent vested. SEP IRA (Simplified Employee Pension) – employer contributions are discretionary and can range up to 25 percent of pay for each eligible employee. Participant contributions are not allowed – funded entirely by employer contributions. Contributions are immediately 100 percent vested.

Qualified Plan Advantages

A Qualified Retirement Plan offers the small business owner the opportunity to save for retirement in a tax-efficient manner and also to receive favorable tax treatment in the form of deductions and credits. When designed and administered effectively, an employer-sponsored retirement plan can (and should) provide the most tax benefits to the owner/sponsor. Employer contributions to a retirement plan are tax deductible when made and may be subject to a vesting schedule. This tax advantage may help your business avoid a higher tax bracket and/or the additional 0.9 percent Medicare taxes scheduled to take effect in 2013. Employer contributions are not taxed to an employee until distributed from the plan. As both employer and employee, you receive a deduction on the contribution you make to yourself as well as the opportunity for tax-deferred compounded growth of both employer and employee portions of plan contributions held within the plan. Tax credits are available for a portion of your plan’s start-up costs – equivalent to 50 percent of set-up and administration costs ($500 maximum) per year for the first 3 years of the plan’s existence. Asset protection from creditors is another important benefit afforded by a qualified retirement plan.

Value and Ease of IRA-based Options

For the small business owner who is new to retirement plan sponsorship and/or who has limited savings/funding abilities, the IRA-based plan option is often the preferred employer-sponsored retirement plan solution. An IRA-based plan offers sponsor benefits which include lower administration and contribution costs, less paperwork (no IRS filing on behalf of the plan) and discrimination testing is built into plan parameters. An IRA-based plan offers similar tax benefits as a qualified plan with fewer administrative requirements and similar tax-deductible business expense status for all employer match contributions.

Cross-tested/Age-weighted – calculation is based on age

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continued on page 39

the source mercer advisors

Mercer Advisors:

Earn up to

We invite you to join us in the

18 CE credits!

City of Roses

for the 2013 Oregon Dental Conference®

April 4–6

Oregon Convention Center Portland, Oregon

55 speakers will present over 90 courses at the 2013 Oregon Dental Conference.

A sampling of our course offerings: The Oregon Dental Association is an ADA CERP Recognized Provider. A DA CERP is a ser vic e of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. The Oregon Dental Association designates this activity for a maximum of 18 continuing education credits.

Joel Berg, DDS, MS Pediatric Dentistry Terri Bradley Billing Harold Crossley, DDS, MS, PhD Pharmacology Thomas Dodson, DMD, MPH Oral Surgery Henry Gremillion, DDS TMJ J. Mel Hawkins, DDS, BScD (AN), FADSA Anesthesia

Christine Hovliaras, RDH, BS, MBA, CDE Hygiene Samuel Low, DDS, MS, MEd Periodontics Louis Malcmacher, DDS, MAGD Hot Topics in Dentistry Judy Kay Mausolf Practice Management Ian McNickle, MBA Web and Social Media Brian Mealey, DDS, MS Periodontics

Uche Odiatu, DMD Health & Wellness Stephen Poss, DDS Restorative Betsy Reynolds, RDH, MS Hygiene Christine Sedgley, MDS, MDSc, FRACDS, MRACDS(ENDO), PhD

Endodontics Martin Trope, DMD Endodontics

Visit for more information or to register for the 2013 ODC.

Something to Smile About For 104 years, Kitsap Bank has been the trusted financial partner for our customers and our community.

Contact us for all your practice banking needs! • • • • •

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Kerry Keely Vice President Commercial Loan Officer 360-876-2297

Bob Banks Senior Vice President Commercial Market Manager 360-876-7800 • 800-283-5537

3 8 · th e wsda ne w s · issue 3, januar y · 2013 ·

Plan Administration and Support

Along with the tax-advantaged savings benefits afforded you as the sponsor of an employer-funded retirement plan, plan sponsorship also requires of you a certain and specific level of administrative and fiduciary responsibility – the scope of which is determined by the plan type you select. Depending upon the time and effort you wish to expend on the plan, it may behoove you to work with an expert who can design, administer and manage the plan type most advantageous for your retirement savings objectives and expectations, as well as being the most realistically aligned with your contribution funding abilities over both the short- and long-term. A Qualified Plan is more complicated and expensive to maintain than an IRA-based plan because it must comply with specific and ever-changing Internal Revenue Code and Employee Retirement Income Security Act of 1974 (ERISA) requirements in order to qualify for its tax benefits.

Learn More

To learn more about the myriad retirement plan options available and/or how our Retirement Plan Services and Wealth Management teams can best serve your unique financial/business circumstances, please contact our Mercer Advisors Bellevue Office (located on First Street) at (425) 709-2300 or (877) 642-4636 to schedule a complimentary consultation. Mercer Global Advisors Inc. is registered with the Securities and Exchange Commission and delivers all investment-related services. Mercer Advisors Inc. is the parent company of Mercer Global Advisors Inc. and is not involved with investment services.

th e wsda ne w s · issue 3, januar y · 2013 · · 39

the source mercer advisors, continued

Mercer Advisors, continued from page 37

Call 1-800-232-3826 for a FREE PRACTICE APPRAISAL, a $2,500 value!

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4 0 · th e wsda ne w s · issue 3, januar y · 2013 ·



DENTIST NEEDED — Family practice in Walla Walla is looking for an Associate FT General Dentist. Must be comfortable performing all aspects of general dentistry. Please respond to:

GENERAL DENTIST NEEDED — Apple Valley Dental & Braces is seeking a General Dentist for our growing group practice in Eastern Washington. We offer a great salary and great benefits. We are looking for someone who is confident, energetic and a people person! Earnings are production based and we are busy! Please contact Jolene Babka, Corporate Manager, at (509) 823-4484 for further information.

OPPORTUNITY WANTED — General Dentist looking for an office in need of a dentist on Fridays and Saturdays in Western Wa. I have 19 years of private practice experience in all aspects of dentistry. Prefer endo and surgery. Call (360) 402-9370 or Email

Associate position — Des Moines. Compensation is percent of production. No lab cost. Team has been with me for over 20 years. Fax resume to: 206-2430687 or email to: Dentist/Consultant — Part time (min. 4 hrs/day) for national claim review company. Work from your home or office. Must have active Washington license. Fax resume to (212) 686-4703. Office Space To Share ­Edmonds general practice, Two ops available Excellent opportunity - dentist getting close to retiring and selling practice and/or office Contact Dr. Zwink at drrobertzwink@ Associate Wanted — Seeking FT/PT experienced General Dentist to join established family and cosmetic dental practice in Tacoma and Puyallup. Dentist must be skilled and personable and will be provided a great opportunity with high pay potential at our state of the art facility. Please fax resume to: (253) 891-1442 or e-mail to: Vancouver, Wash. — Gentle Dental offers exciting opportunities for general dentists and specialists throughout the Pacific Northwest. We are seeking committed professionals for our existing and our brand new state-of-the-art facilities. If you’re interested in joining a progressive group practice and are dedicated to providing quality care, please contact Ron Brush by phone at: (971) 295-9914 or by e-mail DENTIST NEEDED — Jamestown Family Dental Clinic in Sequim, Wash. has an opportunity for a knowledgeable dentist w/ exp. providing general dentistry services to patients of all ages. Requires DS/DMD degree, general practice residency or equiv. training, dental practice license in Wash. and DEA registration. Four daysa week, competitive salary, benefits as negotiated by contract. Apply: http://jamestowntribe. Indian preference. Call (360) 582-4876. Closes 1/31/12. General Dentist — Associate Partnership Opportunity, Tacoma Washington. Please contact Luda Munoz: lmunoz@ or (360) 553-7812.

PEDIATRIC OPPORTUNITY AVAILABLE — Pediatric dentist opportunity. South King County, multiple office sites. Solid seven figure practice. Existing patient base. Part time but will eventually lead to full time. Potential to buy in. Email CV to OPPORTUNITY AVAILABLE — Opportunity for dentist interested in T.M.D. / facial pain practice. Poulsbo Wa. Call (360) 9818796, PART-TIME GP IN BELLEVUE — We are looking for an associate in Bellevue to work 2.5 days Wed-Fri. More days possible. We are a top office in our area. Beautiful modern office with state of the art technology. Fantastic patients and team. Fully digital. Must be highly skilled and experienced. Please email resume to bellevuedentists@ DENTIST OPPORTUNITY IN GRAHAM, WASH. — Seeking experienced dentist for busy, well established, successful, fee for service, group dental practice. Full-time position available. Excellent immediate income opportunity ($180,000 to $375,000 + per year) depending on productive ability and hours worked. Secure, long-term position. You can concentrate on optimum patient treatment without practice management duties. Modern well-equipped office with excellent staff, and lab services provided. If you are bright, energetic with a desire to be productive, very personable, and people oriented, and have great general and specialty clinical skills, Fax resume to Dr. Hanssen at (425) 484-2110. GIG HARBOR — Opportunity in the beautiful Pacific Northwest. Associate needed for busy Gig Harbor office. Great staff, set your own hours. Also, other specialists needed. Call Carol at (360) 779-7219. DENTIST OPPORTUNITY IN PORTLAND, OR — Do the clinical dentistry you want to do. We offer paths in which you can manage or open your own practice with profit sharing. Pdxdentist@yahoo. com.

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OFFICES FOR SALE OR LEASE LYNNWOOD, NORTH SEATTLE — Dental office condo for sale or rent. Owner financing or four months free rent. 1,300 square feet. Three ops. Dr. Hertl (206) 3007060. Email FOR SALE — Beautiful stand alone redecorated 2,000 sq ft, open concept bldg with five ops and plumbed with N2O. This practice is nestled in the foothills of Mt Rainier, just a 50-minute drive from Seattle. The area offers a recreational paradise, with skiing just 40 min away and great schools. 0ngoing practice for over 25 years with loyal patients and a experienced staff. For more details call (253) 797-1353. DENTAL OFFICE SPACE AVAILABLE NOW — Recently remodeled dental office in the Southcenter area, 1,350 Square Feet. Oxygen, nitrous, water, air already plumbed in so it’s ready for you to start practicing! Some dental equipment is available. Growth area, large traffic. Call Medical Centers Management (253) 508-1293. Mill Creek — Beautiful, modern dental office space available for lease to a specialist. Convenient location in close proximity to several general dentists. Tenant improvements tastefully completed. Serious inquiries only. If interested, please contact SPACE SHARING OPPORTUNITY — Presently working three days/ week and have ample room to share space in our five chair downtown Seattle general practice office with in-house lab and technician. Bring your patients and staff and share the rent, utilities and supplies. Contact Rick Nicolini DDS at 206-310-5709 or OFFICE SPACE TO SHARE — Excellent opportunity for specialist who wants to work one or two days a week or a start-up practice for any practitioner. Front office support. Contact Melissa at (425) 481-1038 or email

classifieds issue 3, januar y 2013


WORK WITH A RESPONSIVE, EXPERIENCED BANKING TEAM We offer a banking partnership built on the best service and the most experienced Dental lending experts in the region. Our experienced team can assist you with financing equipment, real estate, transitions, new practices and more.




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Aaron Pershall - Randy Harrison HAPPY HOLIDAYS AND THE BEST IN 2013 TACOMA – G/P collecting around $400K in 2011. Neat and tidy 3 operatory office with recent upgrades! EVERETT, WA – Very high profit Denturist practice collecting around $290K. Includes dental equipment. CHEHALIS, WA – Great merger or start up alternative! G/P collected $200K in 2011. Flexible lease! KENT, WA – G/P collecting $350K. Nicely appointed office features 4-ops, pano, and newer cabinetry.

ANCHORAGE, AK – Wonderful Fee-for-Service G/P collecting $2M+. Well managed office with recent updates. Seller available for transition and work-back.

IDAHO PARTNERSHIP – Group practice seeking partner. Multiple rural locations available with updated equipment and great staff! Numerous transition/ownership options.

FAIRBANKS, AK – Exceptional G/P collecting $1.6M+. Excellent cash flow! 100% fee for service! Newer facilities, CT scanner, Cerec, and more! Flexible transition options.

CENTRAL, ID – Excellent satellite opportunity! Highly Profitable G/P on just 2 days/week. Incredible lease! Associate position available!


WESTERN OREGON OMS – Excellent, high profit practice with tremendous growth potential. Great location close to a major hospital. 4 2 · th e wsda ne w s · issue 3, januar y · 2013 ·



Dental office to share — Three to four days a week in Federal Way. Good location - on a busy street, close to a shopping center, and freeways. Three operatories. Bring your own staff or we can share some of ours. Good for a startup practice or a specialist. Please email at seattlesmiles@

NEXT/ANNIE MILLER & ASSOCIATES — New dental practice listings and sites for sale in Bellevue, Kirkland, Federal Way, Renton and Tukwila. Call today for tours and info. Annie Miller, Re Max Eastside Broker’s Inc. (206) 715-1444 or email at

Locum Tenens — ­ Guest Dentist Need some time away? Vacation, maternity, etc. I can be there. Over 25 years of personable, patient oriented general practice experience. Doug Seymour DDS (425) 488-2508.

FOR SALE BELLEVUE — Beautiful Bellevue dental practice near Crossroads Mall. Open and spacious with three existing operative rooms, and room to expand. Pano and Ceph machine in office. Digital x-ray system in place. Convenient location on a main street near Microsoft. For more information, please call (425) 213-6606. Tired of debts? — Try rural Dentistry. Work three days, average collection over 550K. hunting, skiing in recreational paradise and paid off your debts in less than six years! Adding oral surgery, perio, and endo for growth. 30 yrs ongoing practice with loyal patients, and strong, diligent staff. Stand alone building with very reasonable rent or for sale. No brokers Please. LM: 360-201-2148, NEXT/ANNIE MILLER & ASSOCIATES — Providing consulting services to the dental community for the past 35 years. New practice start-ups, practice transitions, sales and valuations. Dental space planning and architecture; real estate leasing and acquisitions, employment benefits; staffing resources and training; financing. Call today for your free consultation… we can’t mint money for you, but we can sure save what you have now! Annie Miller (206) 715-1444. Email: annie@nextnw. com. FOR LEASE — 300 Pelly Ave N. Dental suite available in Renton, walking distance to the prestigious Landing, as well as Boeing. 1,361 sq. ft. on 2nd floor, with only two other dentists in building. Three operatories, open configuration, plumbed with electrical, air, vacuum, and plumbing. Corner lot with heavy traffic flow. Rate is $23.26/SF/Y NNN, Triple Net is $5.60 (incl utilities). Contact Dennis Schmuland (425) 417-1206. GREAT OPPORTUNITY! OLYMPIA, WASH — Great opportunity for GP or a specialist. A well designed turnkey four-op practice on the street with all the equipment to start and run a practice. Low rent, great potential, low investment. Contact Dr. Yathi Lingam at (360) 236-7885 or email

FOR LEASE, BURIEN, WASH — Brand new, 2,700 foot, six op dental office with pano room, lab, break room, two restrooms and private offices. Completely wired and plumbed for state of the art digital dental office. $10/ft, NNN or $2,200/mo. Must see to believe and appreciate. Great opportunity for start up or relocation. Contact (206) 909-3863.

EQUIPMENT FOR SALE USED/REFURBISHED EQUIPMENT — ADEC, Gendex, Pelton Crane, Dentalez, Porter, Air Tech, Midwest, Midmark and etc. Lab equipment. Parts are also available for almost all equipment. Call Dental Warehouse at 800-488-2446 or http:// MOBILE DENTAL SYSTEMS — Mobile dental operatory suitable for a variety of locations ie..assisted living, missionaries. Excellent condition stackable containers. approximately 45 lbs Contact (360) 981-8796. Priced to sell — a- dec C a s c ade R adius 1040 chair, deliver y system, light, doctor’s, assistant’s stool $1,900. DentalEZ compressor, replaced regulator, $150, Tuttnauer Valueklave steam sterilizer, $150. Please call Dr. Zakaria (206) 364-7680. EQUIPMENT FOR SALE — Pre-owned Pelton Crane chairs with lights: three chairman ($1,000/each) and two coachman ($1,500/each). Good to excellent conditions. Please email: mygumdr@ or call (206) 367-6767.

EQUIPMENT WANTED EQUIPMENT WANTED — Looking for wide range of used equipment. Adec, Kavo, Midmark, Pelton Crane, Midwest, Gendex, Air Techniques, Apollo, Porter, Cerec, Sirona. If you want to sell equipment, call (206) 260-3563.

th e wsda ne w s · issue 3, januar y · 2013 · · 43

Protect Your Online R eputation — Studies show potential patients (even referrals) will Google you before they schedule. 1 negative review costs an average of 30 new patients. New eBook shows how to protect your hard earned reputation and brand. Free at LOCUM TENENS DENTIST — Want to take a vacation? Need a knowledgeable, reliable ad personable dentist to help with your practice while you’re away? Experienced locum tenens dentist will provide exceptional care to your patients. Over 25 years of private practice general dentistry. Serving all of Washington and Oregon. References available upon request. Contact Bob Houtz, DDS at (360) 457-9568. HAVE SEDATION, WILL TRAVEL — Make fearful patients comfortable with IV Conscious Sedation. I am set up to come to your office and sedate your patients so that you can perform needed treatments the patients avoid due to fear. I have 16 years experience providing safe IV Conscious Sedation. Serving Washington & Oregon. Richard Garay, DDS. (360) 281-0204, LOCUM TENENS — Are you looking for an associate to help increase profit or to take over some days so you can have some days off? Or maybe you’re looking to transition out of your practice? University of Washington graduate with experience. Looking for the right opportunity. Email inquiries to MOBILE I.V. SEDATION — Have your patients treated in your office with safe and proven techniques. Set your practice apart from others. Attract new patients. Increase quality referrals. Neil E. Bergstrom, DDS (360) 825-6596. Traveling Endodontist — Looking for GP offices that would like their endodontic patients treated in-house. My two dental assistants and all high tech equipment ready to travel to your office one to two days/month. Efficient and productive office systems in place. High production income split without having to refer. Patients simply love this service. References available. Please call (360) 303-2421.

classifieds issue 3, januar y 2013


parrish or perish continued

parrish, continued from page 46

care be delivered more cheaply? Is their only real difference their reimbursement model? If you hire an associate and pay her based on collections, how does that differ with some corporate pay-for-production models? Are you mentoring your associate or spending more time on the golf course? Are you checking her charts and treatment plans? (Is your own record keeping up to today’s standards—another topic currently attracting DQAC’s attention?) Who’s really in charge? Can “private practice” include all forms of group practice—including “a chain”? Are we solo practitioners motivated any less by the need to make money and thereby fudge on our treatment plans? (See KING 5 News: Why no one stopped dentist accused of massive overtreatment. July 20, 2012.) When you go on vacation and hire a locum tenens dentist, how much follow-up do you do upon your return? How is that care being billed? When your associate leaves unceremoniously, will you share a chart needed for a legal proceeding? Where does a “private practice dentist” with multiple offices and associates fit in this continuum? Is there an inherent competence in private practice vs. an inherent incompetence in corporate practice? (And when DQAC gets done answering this question, let’s have the same question answered for non-profit clinics.) The modes of dental delivery are changing rapidly, and we all need to be aware of those changes. DQAC should treat all dentists exactly the same way as they do “solo dentists”. WSDA needs to welcome corporate dentist associates as we would any dentist…and, if necessary, be as critical as with any dentist. Solo practitioners probably have as many bad actors as any other form of practice. But if there is evidence that there is a chain violating the law by not being truly dentist-owned, the State needs to have the cajones and enforce the law. If there is evidence of overtreatment or shoddy work, no matter the practice setting, throw the book at them! But the times are a-changing!

U n i v e r s i t y

o f

W a s h i n g t o n

sChooL of Dentistry


D e n taL


eDUCat ion January 25

Perio Decision Making: Make Your Practice Thrive, Not Just Survive Timothy G. Donley, DDS, MSD

FEBruary 1

Medicine and Pharmacology Review for Dentistry: Day 2 of 6 - Cardiology (part 2 of 2) Bart Johnson, DDS, MS


Open Wide! Clinical Pathologic Correlations for Today’s Dentist Darren Cox, DDS, MBA and Jasjit K. Dillon, DDS, MD, BDS, FDSRCS


Law/Lewis Lectureship in Pediatric Dentistry Morning Topic: What Early Childhood Caries is Doing to Children and How to Really Fix the Problem Afternoon Topic: Dental and Maxillofacial Radiology in Pediatric Dentistry Paul S. Casamassimo, DDS, MS and Johan Aps, DDS, MSc, PhD


Medicine and Pharmacology Review for Dentistry: Day 4 of 6 - Gastrointestinal and Endocrine Bart Johnson, DDS, MS


Ernest Jones Memorial Lecture Smile Design, Esthetic and Occlusal Techniques Gerard Chiche, DDS

aPrIL 6

Hands-On CAD/CAM Restorative Experience Gary Severance, DDS


Treating the Female Patient: Medical and Dental Considerations Barbara Steinberg, DDS Crown Lengthening Workshop Tim Hempton, DDS

13 19

Risk Factors, Diagnosis and Management of Dental, Periodontal and Mucosal Conditions Associated with Systemic Disease Oral Medicine Faculty


The Eighth Washington Dental Service Foundation Distinguished Professorship in Dentistry Symposium Dean Joel Berg; Philippe Hujoel, PhD, DDS, MSD, MS; James N. Sledge IV, DDS, FACD, FICD; Jessica Lee, DDS, MPH, PhD; Art Nowak, DMD, MS; Larry Kuhl, DDS, MEd and Linda C. Niessen, DMD, MPH

MarCH 1

Restoration of the Worn Dentition Terry Donovan, DDS


Medicine and Pharmacology Review for Dentistry: Day 3 of 6 - Hepatic and Renal Bart Johnson, DDS, MS

New Online Courses at including Bloodborne Pathogens! Registration Information: REGISTER Telephone: (206) 543-5448 Toll Free: (866) 791-1278 NOW! For more detailed course information and to register online visit


University of Washington is an aDa CerP reCogniZeD ProviDer ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

4 4 · th e wsda ne w s · issue 3, januar y · 2013 ·



IN HOUSE PERIO — Board certified Periodontist looking for GP offices that would like their periodontic /implant patients treated in-house. References available. Please call (201) 780-9156.

PACIFIC PROFESSIONAL PR ACTICE SERVICES — Two new practices available! PNWPPS has been serving the dental community since 1998 by prov iding specialized services including practice tran sistion s, practice con sulting for marketing, cost control, startup and construction or remodeling. We also act as buyer representative, perform fraud investigation and lending services. When we say full service we mean full service. (20 6) 39 9 -5677 or (425) 24 6 - 073 4 or conradelledge@

MODERATE SEDATION COURSE — Instructor: Steven Ganzberg, D.M.D., M.S. Dates: April 19-21 at UCLA and May 15-19 at Wendel Family Dental Centre (Vancouver, WA), 2013. Cost: $11,995. A deposit of $5,000 due by February 1, 2013. Course is 80+ hours with 20 patient cases. Contact: Lori, 360-944-3813 or Space is limited. AGD #218643.

THINKING OF SELLING YOUR PR ACTICE? — And need a broker? Before you pick up the phone, there’s someone you should call first. Norm Culver, DDS has been seminaring and consulting with dentists on practice transitions for years. With this expertise, he knows how to help you find the best broker for the sale of your particular practice. Dr. Culver is an independent consultant and not a broker — so there is no cost to you. (206) 784-6941 or email GUEST DENTIST — Time off, vacation, maternity leave? Temporary placement for day, week, or longer. Experienced, team and patient-oriented GP. Joe Schneider, DDS, FAGD. (206) 878-1237.

CONSTANTINE BUILDERS INC. (CBI)WSDA endorses CBI as their preferred builder of Dental facilities with over 25 years of experience from ground up buildings, renovations, remodels, and interior tenant improvement projects. All projects are completed on time and within budget. CBI provides the highest level of quality service with integrity that exceeds our client’s expectation. Please see our display ad on page two and website at for additional information and how you can become another satisfied client. Telephone (206) 957-4400, O. George Constantine.

DONATED EQUIPMENT NEEDED: Sonbridge Dental Clinic, a faith-based community dental clinic now in the planning stages in Walla Walla, and we need the following items donated: Amalgam separator, Scan x system and plates, basic hand instr uments, oral surgery instruments, handpieces fast and slow (any brand), computers (hardware), AED, oxygen cart system, phone system 1 or 2 phones only, Lab lathe

Large exophytic vascular swelling, area of teeth numbers 17 and 18 History of present illness:

This is a 30-year-old Hispanic male who had had a fast-growing swelling over the six to eight weeks prior to his visit (Figure 1). It involved the left posterior mandible in the area of teeth numbers 17 and 18 extending to the left retromolar pad area. It was described to be 4 x 4 cm in size and ulcerated. The patient reported that it bled easily but was not painful. There was no evidence of underlying bone involvement. The patient’s past medical history is negative for smoking. This “Clinical Corner” case was contributed by Dr. Tracy Johnson of Oral & Maxillofacial Surgery, Lakewood, Wash.

Test your knowledge!

An answer to this case study can be found on the University of Washington’s Web site at edu/departments/oral-surgery/case-of-themonth.html. Click on “Case of the Month” and look for the January 2013 entry.

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clinical corner issue 3, januar y 2013

GUEST DENTIST — Will fill in at your practice for maternity leave, injury, illness, family emergency, etc. 35 years of general dental practice experience. Personable and patient oriented. Dr. Ed Kardong (206) 842-6300.



classifieds issue 3, januar y 2013


parrish or perish

Inherent superiority and competency

Dr. Jeffrey Parrish “If everyone is thinking alike, then somebody isn’t thinking.” — George Patton

You all have seen the recent headlines: “Dental Chain Accused of Hurting Kids, Bilking Taxpayers” and in New York, “Lawsuit: Aspen Dental clinics operating illegally”. Or the Frontline TV specials: “Complaints about Kid’s Care Follows Kool Smiles” or “Patients, Pressure and Profits at Aspen Dental”. And this from the Center for Public Integrity: “Sen. Charles Grassley (R-Iowa) says that his investigators have found evidence of abuses by corporate dental chains treating children on Medicaid. For months now, Grassley’s staff has been asking questions of three dental chains serving poor children on Medicaid. Each is owned by a private-equity firm. The chains are Kool Smiles, Small Smiles and ReachOut HealthCare America.” It was unspoken, but palpable, when I first began in organized dentistry — that those of us who were UW SOD graduates believed somehow we were better dentists than those who arrived here from schools outside Washington. That was self-evident by the fact that we used G-3 explorers, survived Stibbs, had to master gold foil and passed the “most difficult board in the US.” National surveys and old dentists’ tales further reinforced that west coast (especially Washington) dentistry was superior to that practiced elsewhere, and the faculty at UWSoD was the keeper of that legacy, educating us in such a demanding fashion that we would live up to that “known fact” of superiority. But as more and more “outsiders” (i.e., those trained elsewhere) flocked to this state, it became apparent that maybe, just maybe, there were other dentists who were equally well trained. If WSDA was to attract these non-UW grads to membership, we had to be careful about how we spoke of others who were out of our paradigm. Honestly, tell me your reaction when I say someone practices at “a for-profit clinic” or a “corporate practice”? Do you immediately assume overtreating, poor quality care, brand new grads learning their trade on unsuspecting, poorly-paying patients — pressured to treatment plan aggressively, making little to no money but managing to eat and pay off their dental school loans? Obviously they are here only until they scrape together the money or the opportunity to get into “private practice” somewhere. No one makes a career in “corporate dentistry”, right? The ADA, DQAC — and apparently Sen. Grassley — have all developed a rather large curiosity about corporate practices and the care being provided to their patients. DQAC has opened conversations with corporate providers regarding their internal operations in an effort to verify or dispel the assumptions often made about what goes on there. If Frontline and other media outlets are to be believed, there are abuses. If the owners of these corporate practices are to be believed, everything is hunky dory, and they are not different from any group practice anywhere else. Former employee dentists sometimes report pressure to over-diagnose and get paid on the basis of “you eat what you kill”. Corporate practice patient surveys show a high degree of satisfaction. Corporate models are providing care (at a profit) to uninsured and Medicaid patients that private practice cannot or will not. As often is the case, the real truth probably lies somewhere in between. Non-dentist ownership of a dental practice is illegal in Washington and probably for good reason: who’s really in charge and what’s their motivation? But the State has for decades refused to even investigate suspected corporate ownership by non-dentists, let alone do anything about it. You can bet the bigger “chains” are not so bold or stupid as to not have that base covered somehow by being owned by dentists, but the New York lawsuit cited above alleges otherwise. But those of us who have spent our lives in “private practice” need to consider some aspects of large corporate group practices and not be so quick to judge. Are there truly benefits of scale that could allow them to have better record-keeping systems, more oversight/ review/mentoring by senior experienced dentists or better patient coverage on a 24/7/365 basis? If the facility is open more hours per week and with bulk supply purchases, can continued on page 44

The views expressed are those of the writer and do not necessarily reflect the opinion or official policy of the WSDA.

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WSDA News, Issue 3, January 2013  

The Official Publication of the Washington State Dental Association

WSDA News, Issue 3, January 2013  

The Official Publication of the Washington State Dental Association