WSDA NEWS Issue 5 APRIL 2017

Issu

WSDA 7 201 ril · · ap e5

news

The voice of the Washington State Dental Association

PACIFIC NORTHWEST DENTAL CONFERENCE WHAT’S HOT THIS YEAR AT THE CONFERENCE

Also in this issue: TACKLING THE OPIOID EPIDEMIC th e wsda ne w s · issue 5, april · 2017 · www.wsda.org · 1

“Our experience working with Constantine Builders was with utmost respect and professionalism. Their team presented us a beautiful office in a timely fashion.

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a day in the life

WSDA members honored in Olympia: left to right: WSDA Director of Government Affairs Mellani McAleenan, Dr. Amy Cook, Senator Karen Keiser, WSDA President-Elect Dr. Cindy Pauley, Dr. John Gibbons, WSDA Executive Director Mr. Bracken Killpack (see page 12)

WSDA news Cover story by Rob Bahnsen SDDSF Gala photos by James & Kathy Mangis and Jenn Alberts

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editorial

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guest editorial

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opiates: like a bullet in a gun

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members honored by senate

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legislative news

14-18 19

cover story call for nominations

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wdia news

issue 5 · april, 2017

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sddsf gala

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coy call for nominations

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dqac news

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in memoriam

37 newsflash 39, 41, 43, 45

classifieds

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clinical corner

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first person: dr. joseph vaughn

Like us on Facebook: www.facebook.com/WashingtonStateDentalAssociation WSDA News Editor Dr. Mar y Jennings

Dr. Ashley L. Ulmer Dr. Amy M. Winston

Continuing Education and Events Coordinator Sarah Quigley

Editorial Advisor y Board Dr. Brittany Dean Dr. John Evans Dr. Julie Kellogg Dr. Stephen Lee Dr. Joseph Vaughn

WSDA Staff:

Membership Ser vices Coordinator Rachel Gunderson

Washington State Dental Association Dr. Bernard J. Larson, President Dr. Cynthia R. Pauley, President-elect Dr. Nathan G. Russell, Secretary-Treasurer Dr. Bryan C. Edgar, Immediate Past President Board of Directors Dr. Theodore M. Baer Dr. Marissa N. Bender Dr. Dennis L. Bradshaw Dr. Christopher R. Delecki Dr. Linda J. Edgar Dr. Todd R. Irwin Dr. Christine L. Kirchner Dr. Eric J. Kvinsland Dr. Randall H. Ogata Dr. James W. Reid

Executive Director Bracken Killpack Assistant Executive Director Kainoa Trot ter Controller Peter Aaron Director of Government Affairs Mellani McAleenan Director of Operations Brenda Berlin

Membership and Communications Coordinator Emma Brown Bookkeeper Joline Hartman Administration and Financial Coordinator Tom Harshbarger Association Of fice: (206) 448 -1914 Fax: (206) 443 -9266 Toll Free Number: (800) 448 - 3368 E- mail/web: info@ wsda.org/wsda.org

Ar t Director/Managing Editor Robert Bahnsen Director of Continuing Education and Events Emily Rademacher, CMP Government Affairs Associate Emily Lovell

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In the event of a natural disaster that takes down the WSDA web site and email accounts, the WSDA has established a separate email address. Should an emergency occur, members can contact washstatedental@gmail.com.

The WSDA N ews is pub lishe d 8 time s ye arl y by t he Washington State Dental Association. Copyright © 2017 by the Washington State Dental Association, all rights reser ved. No part of this publication may be reproduced without permission of the editor. Statements of fact or opinion are the responsibility 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: 2016: Platinum Pencil Award, 2015: Platinum Pencil Award Honorable Mention, 2014: ADA Golden Apple Award for Outstanding Achievement in the Promotion of Diversit y and Inclusion, 2013: Journalism Award, Platinum Pencil, 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 5, april 2017

26

editorial dr. mar y jennings

What role does being a Legacy play?

Dr. Mary Jennings Editor, WSDA News

“Legacy in the professional world is akin to nepotism and cronyism in the corporate world. Is the applicant a wonderful chip off the old block? Do friends help friends open doors?

Is dentistry the applicant’s heart’s dream or their family’s dream? This cuts a lot of different ways. ”

Dr. Mary Jennings, WSDA News editor, welcomes comments and letters from readers. Contact her at her email address: mjenningsdds@gmail.com.

A WSDA member recently contacted me asking why the application to dental school asks the applicant to list any family members who are dentists. She said it was mandatory to answer that on the application. She wondered how that information was interpreted and if the process is fair.

She asked dentists she knew who had served on admission committees how they interpret the applicant’s data. Some people said that being a legacy was always a plus. Others said the pendulum had swung the other way, and that it showed favoritism and is not fair. Still others said that dentist’s children are held to a higher level because their parents should groom them to be perfect candidates.

It’s an interesting question. Legacy in the professional world is akin to nepotism and cronyism in the corporate world. Is the applicant a wonderful chip off the old block? Do friends help friends open doors? Is dentistry the applicant’s heart’s dream or their family’s dream? This cuts a lot of different ways.

Unlike the corporate world, failing out of dental school carries an academic stigma and huge debt, and denies another applicant a spot. It is hard on everyone involved. The member who posed the question is right. It is important to understand the application process and to get this right.

I reviewed the Associated American Dental Schools Application Service Application and contacted them. They do not set the criteria. The schools do so in partnership with the American Dental Education Association. It was a different world in so many ways when I applied over 30 years ago. It makes my stomach lurch to think about how sensitive biographic information like family income, parents’ education level, immigration status, and relationship to dentists may be interpreted in these tempestuous times and across geo/political regions.

I called several dental schools out of the now more than 60 to get a feel for how an applicant’s information is handled. My sample size was not statistically significant. Each had a slightly different flavor, but all were thoughtful.

One old East Coast school’s advisor said the advantage they give to legacy students is that they all get the courtesy of an interview. He said in some ways it was as much a counseling session as an initial interview. His team wants to see what drives each legacy student to be a dentist. Some candidates are ready and able. The ones with poor grades are counseled on ways to increase their chances and sent back to improve. He said very few do the work and come back. But some do and have become outstanding dentists.

He said that sometimes he is the one to break it to both legacy and non-legacy families that this person is really not ready, not prepared, or not that interested in becoming a dentist. He spoke of how painful it is for all parties to try to pass someone through who is not a good fit for this very particular profession. He said he likes legacy students because they know that dentistry is a very hard, exacting job that lends itself to a nice lifestyle.

He said that there is an expectation that a dentist’s family members should be solidly prepared, but it is only one small part of many that are all weighed together before a final determination is made. He thinks his system is fair.

Closer to home, I called Dr. Joel Berg, Dean of the University of Washington School of Dentistry. He answered my questions and allowed me to access to his team. He said that CODA had recently complimented their admissions process. He said the UW has more than 1,000 applicants for 63 seats. The applicants are now averaging a very high 3.7 GPA. I learned the UW’s application process is comprehensive and purposefully focused.

They focus on GPA, dental knowledge, community service, and regionality. They are in the business of producing qualified dentists for our region. More than 15 people review a candidate’s information before the process is complete. They have had great successes with legacy students. Legacy impacts the dental knowledge criteria. It is reasonable to assume that someone related to a dentist has a better understanding of the profession. They continued on page 35

The views expressed in all WSDA publications are those of the individual authors and do not necessarily reflect the official positions or policies of the WSDA.

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I have been working on the Pacific Northwest Dental Conference since 2009, and I love PNDC! As a member of the Board of Directors, I now have a different responsibility with PNDC, and I want to take this opportunity to share with you where we are and what we are doing to better your conference.

At the conclusion of last year’s meeting, several of us sat down to brainstorm as to what we need to do to keep PNDC relevant to meet the members’ needs, have the best education for a broad base of learners, and maintain its value both to attendees and to non-dues revenue for the Association.

First, we knew there were a few immediate changes we could accomplish for the 2017 conference, such as building a stronger assistant and hygiene course lineup, and expanding the course offerings on Saturday. (Adding Saturday was a change made in 2016 that was well received.) But we also knew that PNDC must continue to adapt, so we decided to form a task force to look at all aspects of our meeting. The purpose was to plan for the future.

We partnered with the Oregon Dental Association (ODA) and hired a meeting-consulting group, Velvet Chainsaw Consulting. Its task was to evaluate each meeting independently, identify our strengths and weaknesses, and explore ideas and options to make each meeting better. We were open to any and all ideas.

After weeks and weeks of data evaluation, our joint task force with ODA spent two and a half days looking at the results and learning great ideas. We spent half a day looking at the science of learning and ideas on how to innovate learning styles to improve attendee experiences and takeaways. It was exhausting, but time well spent.

A question that keeps coming back to me is, “How do we make more meetings interactive, which improves learning?” Another idea that has stuck with me is bringing 20 percent innovation into each meeting to improve the experience of attendees and remain at the forefront of continuing dental education.

Now, let me answer some questions I have heard multiple times, which will hopefully address specific issues about the future of PNDC.

Dr. Dennis Bradshaw WSDA Board of Directors

“At the conclusion of last year’s meeting, several of us sat down to brainstorm as to what we need to do to keep PNDC relevant to meet the members’ needs…”

Q: Where will the meeting will be this year and beyond?

A: The meeting is contracted in Bellevue, through 2019. Visit Bellevue works very hard to help us put on the best meeting possible in the space they have.

Q: I heard the meeting might join with Oregon and flip-flop between Portland and the Seattle area. Is this true?

A: We are exploring many options of what our meeting can and should be. The WSDA and ODA met with a consulting group together to learn about our meetings and share common best practices. We evaluated mountains of information and data together. We do not have any plans to combine our meetings.

Q: Why don’t we move back to Seattle?

A: The Washington State Convention Center is in very high demand as a meeting space.

As such, they have minimum requirements that are above what our meeting currently reaches. One is a minimum of hotel rooms booked. With more than 70 percent of our attendees coming from within 50 miles, we simply don’t rent enough hotel rooms.

Q: Will the meeting change its format or options of education and exhibits?

A: The Board of Directors has established a task force to look at all aspects of the meeting and use the information we learned from Velvet Chainsaw Consulting to explore ways to keep our meeting excellent and create a conference that becomes an innovator and leader in the industry….maybe even a “disruptor.”

I encourage you to come to this year’s PNDC and provide us with feedback of what you want the conference to look like in the future. If you can’t wait until June to share your ideas, email us at pndc@wsda.org. Your input is critical to our success!

As a member of the task force working on PNDC and its future, I can promise you that we will look at every option, and explore new and different ideas to keep PNDC relevant.

We will work to build a conference that leads by innovation, while continuing its tradition of incredible value and quality education for you and your team!

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wsda.org/pndc The views expressed in all WSDA publications are those of the individual authors and do not necessarily reflect the official positions or policies of the WSDA.

guest editorial dr. denny bradshaw

The PNDC in 2017 and beyond

in the news tackling the opioid epidemic: what dentists can do

LIKE A BULLET IN A GUN

TACKLING THE OPIOID EPIDEMIC: WHAT DENTISTS CAN DO

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How are people getting the prescription drugs in the first place, how are they becoming addicted, and what role do dentists play in the opioid epidemic? Ricardo Quintero, Diversion Program Manager for the Drug Enforcement Agency (DEA), had this to say, “There are many factors to getting hooked on opioids, but the fact is that people are becoming addicted. Heroin is flooding our streets, and users flow across all socioeconomic backgrounds. There is no divide. People from all walks of life are affected.”

We also spoke with Dr. Stephen H. Anderson, an ER physician in Washington, and Dr. Amy Cook, a WSDA member, to find out what dentists in the state can do to help slow the supply of pills to the street by changing how they prescribe pain medications and educating their patients. ER physicians have been actively fighting the opioid battle since 2008, when they decided to take ownership of the problem and work to reduce the number of pills “diverting” to the street because so many opiate overdoses were landing in their gurneys. Now people like Anderson and Cook are championing the cause, working to educate dental professionals about the dangers of pain medications.

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in the news tackling the opioid epidemic: what dentists can do

Across the country, accidental deaths from opioids have been skyrocketing. It’s difficult to read a paper or a news website without some sort of mention of the growing crisis. Sadly, Washington isn’t immune from the problem, and although the number of deaths from prescription opioids has dropped from 464 in 2005 to 287 in 2015, that number is misleading because in the same time period, the number of deaths from heroin overdoses has nearly tripled, from 120 in 2005 to 345 in 2015. And while you might not initially see a correlation, the fact is that people are becoming addicted to prescription medications like Oxycodone, OxyContin, and Vicodin, and when they can no longer acquire or afford those, they’re turning to heroin, which is cheaper and easier to get. These drugs have become like a bullet in a gun.

in the news tackling the opioid epidemic: what dentists can do

“As a GP, I don’t need to prescribe opioids very often, but like so many of us, I was taught in dental school that if I do an simple extraction I should automatically write a prescription for 20-30 Vicodan. I don’t do that anymore, it’s just not necessary. I have a conversation with my patients before and after the procedure, and most people know themselves and what they need and will refuse opioids. ­— Dr. Amy Cook

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“Way back in the ‘90s,” explains Anderson, “there was a big push to address people’s pain. Doctors and dentists were told that they had a toolbox they could use, and we had tools like Tylenol and ibuprofen in one side, and in the other side of the toolbox we had opiates like OxyContin and oxycodone. We were taught that opiates relieved pain, and we were encouraged to reach for them first.” Around the year 2000, Anderson says, doctors started to see an uptick in overdose deaths attributable to prescription opiates and providers began to realize that they were part of the problem.

In 2008, physicians in Washington realized just how catastrophic the issue was when it became the No. 1 cause of accidental deaths in the United States. “Think about that,” Anderson says. “More than car accidents, more than any other cause of accidental death, it was opiate overdose.” An epidemic was emerging.

How did we get here? Anderson says, “We were warned by the Rolling Stones years ago about ‘running to the shelter of your mother’s little helper,’ and Grace Slick sang, ‘One pill makes you larger, and one pill makes you small.’ Part of the problem was that baby boomers bought into the idea that pills made things better, and divesting them of that idea means that patients have to accept that we may not be able to alleviate every ounce of pain. We don’t want to create a new problem while trying to resolve another.” Today boomers are at the center of the bell curve of addiction, the greatest number in terms of population of opioid-addicted people.

The quickest rising populations of addicts, however, are at the two ends: older people, who are at a huge risk for becoming addicted, and youth. “The issue is that as pill counts on the street decline, people are turning to heroin because it is far cheaper than pills,” says Anderson, echoing Quintero. “Youth are much more likely to use heroin. When we were younger, my vision of a heroin addict was the cover of Jethro Tull’s Aqualung album, a shabby street urchin who only used pills if he couldn’t score heroin. That’s not the vision of a heroin addict any longer. In 2017, we’re seeing people who had something that caused a small amount of pain, a doctor or dentist who prescribed a 10-day course of opioids, and a patient who is hooked and turns to heroin. It’s housewives, football players, and grandmas, believe it or not. It’s people walking among us. Fifty thousand people died from opioid overdoses last year.”

1 in 5 will become addicted

The problem, according to Anderson, is that 1 in 5 patients who are given a 10-day prescription of opioids will become addicted.

Many providers write those longer prescriptions out of convenience, and Anderson says that has to stop. “I think that doctors and dentists are trying to keep patients out of pain. It has been the norm in many areas, like orthopedics and oral surgery,” he says.

“I’m not trying to attack anybody, but the idea of 10 days of pills, when the reality is that most people only use three or four, has to change. Most people put them in their medicine cabinet and then their kids or the neighbor’s kids find them, and they end up in circulation. Educating patients to say no to longer prescriptions, and getting doctors and dentists to prescribe less will help.”

In 2008, in the midst of a spike in opioid deaths, ER physicians in Washington developed guidelines for prescribing opiates for chronic pain. They also created the Emergency Department Information Exchange (EDIE), a program operating in six states now, and scheduled to push out nationally. EDIE works like this: When you check into the hospital, your information is sent to the cloud, where it searches to see if you’ve been in the ER more than five times in the last year. That information alone informs the ER physician that you’re at significantly higher risk for a lot of other problems. It also searches to see if there is a case-management plan for things like schizophrenia, diabetes, or any other disease you might have that is managed, not cured. If there’s a case-management plan up there, the information gets downloaded to the

ER in the first two minutes that it is registered. So even before ER physicians walk in the room, they have a report saying, “The patient has been to 32 ERs already this year, typically shows up for dental pain trying to get Percocets. Try not to give them to him.”

Or it might say he has low back pain or diabetes, and to work on those. By providing a resource showing if a patient has been shopping docs for prescriptions, the program helped reduce the number of opiate prescriptions coming out of the ER department by 24 percent. “When you look at people who are addicted to prescription opioids, and you ask them where they get their opioids, only 3 percent get them from drug dealers,” Anderson says. “Fifty to 60 percent of people get them from a friend or family member who says, ‘Try these, they worked for me.’ The remainder are stolen from someone’s medicine cabinet. We realized that step one had to be decreasing the pill count on the street, and the way to do that is to educate the providers as to why this is important.”

Getting dentists involved

“We’ve done a pretty good job with the medical community, but the dental community is only just now waking up to the issue,” says Anderson, who concedes that dentists comprise a smaller portion of the equation, but they’re important nonetheless. (Family medicine doctors are still the biggest prescriber of opiates.)

“We started to engage the dental community about five years ago, and dentists like Dr. Amy Cook took note of what we were saying,” Anderson says. “Dentists are still part of the equation, and we need to engage them as well, encourage them to go back to the toolbox, and reach for alternatives that aren’t opiates. Decreasing pill counts on the street is still the big message that we need to get to dentists.”

Cook agrees, saying, “My husband is a police chief, and as I get to know people in his world of law enforcement, the DEA, detectives, and city mayors, I’ve had people ask me how responsible I think dentists are in terms of contributing to the opioid problem.

At first I didn’t understand, and didn’t feel that dentists were responsible for contributing to the problem very much. After I was asked a couple of times, and I became more involved in the issue, I realized that dentists had to get on board.” For her part, Cook is much more circumspect when prescribing opioids, talking with patients beforehand and providing information about over-thecounter alternatives. “As a GP, I don’t need to prescribe opioids very often, but like so many of us, I was taught in dental school that if I do a simple extraction, I should automatically write a prescription for 20 to 30 Vicodin. I don’t do that anymore. It’s just not necessary. I have a conversation with my patients before and after the procedure, and most people know themselves and what they need and will refuse opioids. But a lot of people will say that they have leftover opioids from a previous procedure, which tells me they were overprescribed in the past.”

The danger, of course, is what happens to the remaining pills.

Cook’s husband locks all prescription medications in a safe, but she worries that most people don’t. “As a dentist, I never knew we were supposed to do that,” she says, “Or that I should tell my patients to do that. I tell my patients to keep it out of sight, because anyone coming into their house could be looking for it, and if your house is up for sale, know that anyone in your house could access your medicine cabinet and any drugs you keep there. As dentists this is not on our radar. There is this perception out there that only patients who are new to us or are a little rough around the edges will be looking for drugs, but anyone can become addicted easily.

Even the clean-cut ‘normal’ patient could be addicted.” And lest you think that people stealing drugs at open houses is an urban myth, Ryan Leaf, football’s once-heralded player, has admitted to visiting open houses pretending to be interested in purchasing, when really he was rifling homes in search of opiates.

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in the news tackling the opioid epidemic: what dentists can do

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One of the tools Anderson says helps is the prescription monitoring program (PMP). The problem with the PMP, he says, is that it is clunky and, from a workflow perspective, it is a nightmare.

It’s free, but time is money when you’re in a busy office, and if doctors or dentists have to take five minutes moving through four different screens with passwords, they not likely to want to use it.

“Rather,” says Anderson, “I’ll be inclined to say I’ll look if I get a bad feeling about someone. But I’m not going to look everybody up that I want to write a prescription for, and I should. The problem is, it’s not just the 22-year-old who is shopping for opiates, it’s the 32-year-old housewife with a kid out in the waiting room who you can’t really understand why you’re negotiating over Percocet with.” However, an innovative solution is available. “Through a joint program with Collective Medical Technologies (the company that runs EDIE), the state, and ACEP, we built a program that queries the PMP on every patient who checks into the ED,” Anderson explains. “Based on high-risk patterns we agreed on, if the search triggers an alert, the PMP is sent to us inside the EDIE alert that appears on our ED track boards and in the triage summery.”

The system’s triggers don’t pick up things such as a single prescription for Tylenol 3, but will red flag more than three prescriptions in a year, or a long-acting opiate, or an opiate with benzodiazepine. Most importantly, the information is pushed to Anderson automatically, as opposed to him having to check for it. The legislature is talking about mandating that providers have to check the PMP, which has worked in some states to decrease overdoses and opiate prescribing, but it doesn’t get a warm reception from providers, who say it obstructs their workflow. With the new system, there is no workflow obstruction because providers get an alert as soon as they start to write a prescription.

Anderson’s hope is that dentists and the WSDA will push for a similar system to be made available in dental practices, but realizes they face obstacles ER physicians don’t have. “What would be best is… an automatic loop that pushed the PMP to you,” he says. “There are HIPAA concerns, which we’re exempted from in emergency medicine. While we’re trying to decide if patients have a medical emergency, we’re allowed to collect data from any source that we can find. HIPAA was written that way specifically to make our job a little easier. Think beyond borders, obstructions, and hurdles, and start thinking about what we could design to put in offices and oral surgery suites to alert people up front about at-risk patients and encourage them to look at the PMP before prescribing.” Anderson even advocates for allowing other staff in the practice to pull up information for the dentist, regardless of HIPAA concerns. He says, “Engaging the PMP and using it is, I believe, critical. If you can build something like the EDIE that pushes the information to you about every person who is at risk, that’s the gold standard that everyone should aspire to and advocate for.

Asking the PMP to allow an office manager to pull up the information would work, too. It was originally written to comply with HIPAA, because regulators worried that someone sitting at their home computer would access information about people. I hate to be Machiavellian about this, but if that happens once or twice a year, that’s a shame, but this problem is too big, and we need to do something about it.”

Education and training

Cook uses the PMP, but notes that most dentists don’t even know it exists, and concedes that registration can be a hassle. The DEA’s Quintero encourages providers to sign up for the PMP so that they and law enforcement can partner in the fight against illicit opioid use. “If a dentist checks the PMP, and there is a per-

son presenting in the practice who is a possible doctor shopper, dentists can call the authorities,” he says. Quintero is quick to add he’s not trying to tell providers what to prescribe, “Our role here is to make sure that anyone who has a DEA registration is aware of the opioid problem in America, and promote conversations between them and their patients,” he says. “We do ask them to make an evaluation of what they have. Whether that means choosing another option other than opioids, or writing a prescription for a smaller supply. Between that and education, we can limit what makes it into the street.” Education is at the heart of what the DEA endorses, and representatives regularly speak at opioid summits put on by hospitals and to groups. “We talk to the community about ways to prevent diversion, and we provide education and training, not only within the pharmaceutical community, but also with practitioners like dentists,” Quintero says. “We talk about the opioid problem out in the streets, and what our individual roles are in addressing the issue. We need to get our communities back from the opioid problem, in part by siphoning off the supply of opiates to the community through education. We need education to be successful, working with practitioners, law enforcement, pharmacists, teachers, and others to get the information out to as many people as possible. Even regular citizens can benefit from education about opioids, especially since so much of the diversion happens at home with kids and neighbors taking leftover opiates from medicine cabinets.”

Leftover medications – what’s the best course of action?

For years, patients have wondered what to do with leftover pain pills. Even providers weren’t sure. Cook says, “In the process of talking with law enforcement representatives, I became aware that there are drop-offs for opiates. I started calling around and learned that the Auburn Police Department has a 24-hour drop-off for pills. There are pharmacies that will take drugs, but they’re not consistent, and some will only accept certain drugs, so you have to call ahead. I spoke to Bartell Drugs, for instance, which was listed online as a drop-off. But when I called, they explained that they discontinued the service because so many people dropped off drugs that the program and responsibility became too cumbersome. Check in your area to see who accepts them.” Anderson, concurred, saying, “For years, the only people who would take back opiates were the sheriff’s department or the DEA. A couple of years ago, they changed the law, allowing hospitals and pharmacies to take back drugs. When they changed the law, two interesting things happened. First of all, nobody did it. Everyone worried that there would be liability. The pharmacy director at my hospital once told me, “It’s easier for me to get rid of nuclear waste than a dozen Percocets.” Anderson explains that hospitals have been slow to get onboard because of the requisite paper trail, but he hopes someone will take the initiative and compile a list of pharmacies with take-back programs. Until then, he said, “If your pharmacy doesn’t have a program, consider changing who you do business with.”

We hope you’ll take this information and use it to guide you in the future. Educate patients about the dangers of opiates, consider non-opiate options, or write smaller prescriptions with the understanding that you can always write a refill, if needed.

Resources:

Visit the PMP page here: https://tinyurl.com/WAPMP If you would like to arrange for an opiate summit in your area, please email Ricardo Quintero, Diversion Program Manager at the DEA, at ricardo.quintero@usdoj.gov.

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in the news tackling the opioid epidemic: what dentists can do

Using the prescription monitoring program

member news wsda members honored with senate resolution

WSDA members honored with Senate resolution

Left to right: Senator Joseph Fain, Dr. Amy Cook, Dr. John Gibbons, Mr. Bracken Killpack, and Senator Karen Keiser

BESTOWING HONORS DRS. AMY COOK AND JOHN GIBBONS AND THE WSDA HONORED WITH SENATE RESOLUTION

On March 31, Dr. Amy Cook and Dr. John Gibbons stood before the Washington State Senate representing all WSDA member dentists to accept a Senate resolution honoring the work WSDA members have done throughout the state. The resolution honors the work of members on behalf of the underserved: Medicaid/Apple Care patients; the uninsured; and those with special needs. The Senate resolution specifically mentions WSDA members’ work at the King County Clinic, Cook’s bill at last year’s House of Delegates encouraging all WSDA members to “Take 5” new Medicaid patients, Gibbons’ work to extend the state’s ABCD Program (Access to Baby and Child Dentistry) to children with disabilities, and the personal efforts of Dr. Cook to continue accepting Medicaid patients despite the state’s low reimbursement rate. The resolution was sponsored by Senators Keiser, Fain, Liias, Wellman, Kuderer, Hunt, Hasegawa, and Rolfes, and was a result of Dr. Cook reaching out to Sen. Keiser as part of her grass roots advocacy efforts.

Bracken Killpack, executive director of the WSDA, said, “It was exciting to hear the Washington State Senate recognize our members for the work they do in communities across the state. We’ve

said it all along: Our members work tirelessly on behalf of Washingtonians who would otherwise not have access to proper dental care. I’m so proud of Drs. Cook and Gibbons, and all WSDA members who give back with their time, talents, and expertise. They truly represent organized dentistry.”

Dr. Cook said, “This recognition is important to all Washington State dentists. There is so much buzz and disagreement about access issues, but people outside of dentistry are not aware that so many of us provide complimentary care in our private offices outside the Medicaid system. Becoming a Medicaid provider and committing to maintain five Medicaid patients can go a long way to establish a dental home for those in need across our state. It is clear that the Key Arena event, though well-meaning, has not been successful in getting those patients to follow through with consistent care in an appropriate setting. I am proud of the Washington State Dental Association dentists who overwhelmingly voted to increase Medicaid with the Take 5 Program, Dr. John Gibbons’ expansion of access for children with disabilities within the ABCD Program, and our own opioid awareness commitment.”

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The opioid abuse crisis has garnered much attention in recent months, by local and national media, and by national and state regulatory bodies. Prescription opioids are considered a gateway drug for heroin, and while deaths from prescription drugs have gone down, heroin-related deaths are on the rise. In recognition of the epidemic, WSDA supports the Surgeon General’s “Turn the Tide” pledge and Gov. Jay Inslee’s executive order directing state agencies to work with public and private partners, like WSDA, across the state.

At the House of Delegates meeting last September, WSDA members passed resolution HD-12-2016, addressing the dentist’s role in reducing opioid abuse in Washington State and encouraging the use of the Prescription Monitoring Program (PMP), education, communication when referring patients, prescribing the fewest number of pills or tablets possible, and sharing information with patients about safe disposal and storage of unused prescriptions.

WSDA has also been working with the Bree Collaborative (Bree), a group formed in 2011 so that “public and private healthcare stakeholders would have the opportunity to identify specific ways to improve healthcare quality, outcomes, and affordability,” and which created a work group to focus specifically on opioids. Their meetings have included a particular emphasis on acute care for minors. Meeting participants have repeatedly raised concerns about the prescription of opioids to minors during the treatment of sports injuries and teeth extractions.

Bree held an “Opioid Prescribing in Dentistry Summit” on March 9. WSDA staff and member dentists were in attendance, along with representatives from the Dental Quality Assurance Commission, Department of Health, University of Washington School of Dentistry, Health Care Authority, and Washington State Society of Oral and Maxillofacial Surgeons, as well as a number of other health professionals. Bree’s stated mission for the meeting was to “bring together dentists, oral surgeons, patients, physicians, health insurance companies, and others to reduce inappropriate opioid prescribing and together align practice with evidence.” Attendees created a “writing group,” which first met on March 29, to work on the development of guidelines for the prescription of opioids to children under a certain age that WSDA and others could agree to support. WSDA members and staff continue to participate, and any product will undergo a thorough vetting process prior to adoption.

WSDA is also engaged in the state legislative process and has been working with legislators on several bills that would increase the number of people who could receive PMP data, encourage or mandate drug take-back programs, and limit the number of pills prescribed.

SHB 1047 would have required manufacturers that sell drugs into Washington to operate a drug take-back program to collect and dispose of prescription and over-the-counter drugs from residential sources. This bill was met with controversy because the pharmaceutical industry objected to the fact that it would bear the responsibility for the cost of the program. It is unlikely to pass the legislature this year.

One of two bills expanding access to the Prescription Monitoring Program (PMP) and allowing the Department of Health to distribute data for quality improvement purposes appears likely to pass this year. E2SHB 1426 passed the House of Representatives with a strong vote and was heard in the Senate Health Care Committee. Another bill that includes these provisions, along with a requirement that the various health boards and commissions adopt rules establishing requirements for prescribing drugs, SSB 5248, is also moving through the process.

A similar House bill, ESHB 1339, would require the healthcare provider regulatory authorities to adopt rules establishing requirements for prescribing opioid drugs, but the requirements are stricter than those found in SSB 5248. It would also require practitioners to complete one hour of continuing education regarding best practices in the prescribing of prescription drugs. This bill also passed the House with a near unanimous vote and was heard in the Senate Health Care Committee.

SSB 5248 would require boards such as the Dental Quality Assurance Commission (DQAC) to promulgate rules establishing requirements for prescribing opioid drugs.

The rules may contain exemptions based on education, training, amount of opioids prescribed, patient panel, and practice environment. It would also require DQAC to consider the Agency Medical Directors’ Group and Centers for Disease Control guidelines, and allow them to consult with the Department of Health and WSDA. Because SSB 5248, in its current form, allows the healthcare regulatory boards and commissions, such as DQAC, more flexibility in how they would establish rules, it is the legislation preferred by the WSDA. The bill would address the expansion of the PMP, as well as the rulemaking requirements, so if it were to pass, the other bills would not be necessary. WSDA supports the passage of SSB 5248 in lieu of the others.

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Mellani McAleenan Director of Government Affairs

“WSDA is also engaged in the state legislative process and has been working with legislators on several bills that would increase the number of people who could receive PMP data, encourage or mandate drug take-back programs, and limit the number of pills prescribed.”

legislative news legislation aimed at the opioid epidemic

Legislation aimed at the opioid epidemic

pndc news what’s hot at the 2017 pndc?

WHAT’S HOT AT THE 2017 PNDC? With the PNDC fast approaching (June 15 to 17 in Bellevue), we wanted to showcase speakers who exemplify the kind of educational excellence it brings to western Washington. This issue, we’re focusing on choices directed at dental team members.

While the conference benefits our members in many ways beyond the educational component (it is the WSDA’s largest source of non-dues revenue, helping to keep your dues low), attendance by dental staff always eclipses that of dentists. Because of that, we’re going to highlight lectures and workshops we think you should make sure your staff attends – and some, like Dr. Greg Yen’s lecture about his direct-care payment model, which both dentists and staff will benefit from.

S AV E PNDC REGISTER FOR THE

BEFORE APRIL 28 wsda.org/pndc

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If You Do Not PRE-pare, You Will Need to RE-pair!

For Practice Success

Friday, June 16, 7:30 – 10:30 a.m.

Target Audiences: Dentists, EFDA/Assistants, Front Office, Hygienists, Lab Techs

Broken Appointments: The Black Holes of Scheduling Success Friday, June 16, 1 – 4 p.m.

Target Audiences: Front Office

Meet Cindy Ishimoto

One great example is Cindy Ishimoto, a lecturer we’re bringing in from Hawaii to talk with your staff about preparation in her lecture titled “If You Do Not PRE-pare, You Will Need to RE-pair! For Practice Success.” Her experience comes from living it. Ishimoto became an assistant at age 18, went to hygiene school, and married a dentist. When her husband’s business became so successful that they needed help to manage it, they hired a consultant, who later hired her to consult. Between her consulting work and her hands-on experience running a successful practice, Ishimoto “gets” the business of dentistry. She’s also a seasoned singer and performer who loves being in front of an audience. Her knack for humor and delivery will make the experience even more enjoyable.

In this lecture, Ishimoto will attack some core issues that every practice faces”: Do you have anxiety about scheduling holes created when patients cancel? Do you feel like you’re not able to close the deal with patients? Ishimoto is going to school everyone on the dental team about their role in the three core systems: scheduling; collections; and the continuing care program. She’ll also show how being prepared for these roles can help move the practice forward. Ishimoto explains, “This lecture is a great team experience because everyone on the team is responsible for all three systems.

They each hold a specific puzzle piece, and if they don’t move their individual puzzle piece, they will never take the system to the highest efficiency and effectiveness.”

According to Ishimoto, an office can’t schedule to meet goals if assistants and hygienists don’t work to help seal the deal chairside.

She explains, “Clinical assistants help patients through the educational piece of why a procedure is important. We can’t do anything if the patients don’t believe they need it. The front desk people and business assistants are only selling a chunk of time, a financial arrangement. How much does it cost, and how long do I have to be here? If the sale twists on that, the patients don’t move forward.

It’s educating the patients that if they’re on a three-month visit plan because they have periodontal disease, going four months or five months could kick them right back into active disease instead of remission. So there’s a direct link between filling the schedule and effective clinical closure.” And while you might think collections are just the purview of your business and front desk staffs, Ishimoto disagrees, saying, “In terms of the collections system, in order to get money out of people’s pockets, they have to value what they have received, or what they are going to receive. If it doesn’t go well, if patients don’t understand what they just got,

they may be disinclined to complete the treatment plan. We can’t assume that everyone does a great treatment plan, explains what the investment will be, and clarifies to the patient that a treatment plan is only an estimate based upon two-dimensional images, so costs could be higher. In that sense, it’s the clinical team who helps educate and inform the patient about what’s going on (in terms of) the level of care they’re receiving.”

Ishimoto calls continuing care the “backbone of the practice,” explaining that “in order to keep our patients healthy, they need to keep up with their regimen of when they come to the office.

If they’re not coming in and we have lots of holes in our hygiene schedule, the doctor will never be productive because he’ll be doing exams and X-rays and finding decay and fractured teeth. Twothirds of a doctor’s production comes from patients coming for their continuing-care visits. Only one-third of the doctor’s production comes from seeing new patients. They may only see one or two new patients a day. Managing continuing care effectively means more opportunities to diagnose dentistry.”

Doing things differently

What will attendees take away from the lecture? Ishimoto says, “What they’re going to take back are the basics that are easy to implement, and ones that they won’t necessarily need to have permission from the doctor to do. Most of the time, what I’m recommending isn’t about spending money or buying equipment, it’s about doing things differently. For example, what are the three things patients need to hear before leaving the clinical zone in order to help them understand the value and urgency to reserve their next appointment? What are the three or four financial options we can offer patients when they say, ‘I don’t know if I can afford it?’

What can we do to help them work the cost into their family budget?” Again, Ishimoto encourages dentists and their entire team to attend this lecture, explaining, “If only one team member attends the lecture, they’re going to have to teach things to everyone that may not make sense because only one brain was listening. But if the whole team attends, you have the collective mind, and everyone can share what they learned from their personal perspective.”

Canceling cancellations

In Ishimoto’s other lecture, “Broken Appointments: The Black Holes of Scheduling Success,” she’ll talk about effective measures staff can take (and yes, everyone has to be on board, not just front office staff) to head cancellations off at the pass. After all, according to Ishimoto, the most common reason patients cancel is because “something came up,” which she says is just BS for “I got a better offer.” According to Ishimoto, when the practice has a talented front office staff, a doctor and his clinical team may never even notice that a patient cancelled — they’re that good at filling scheduling holes — but it doesn’t address the core issue. “We’ll talk about where the cues need to start,” says Ishimoto, “which is chairside, with the clinical staff. Are they talking with the patient about the importance of the next appointment, or did they just ask to book him a two-hour appointment? If a patient calls to reschedule, are they making it easy for him, or are they taking the time to remind him how imperative that appointment is to his oral health? If your staff says, ‘Let’s reschedule you,’ they’re essentially giving the patient permission to cancel. When we make it easy to reschedule, they become prone to that. A reschedule is as dangerous as a cancelled appointment. You still have a hole to fill.”

Statistically, Ishimoto says, it can take 15 phone calls to fill

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pndc news what’s hot at the 2017 pndc?

We have some especially fun and informative speakers who will teach your staff skills and techniques that they can begin using the Monday after the conference, bringing new efficiencies, new knowledge, and new methods to improve the functionality of your practice. [Editor’s note: For a complete list of all PNDC lectures and workshops, visit wsda.org/pndc-schedule]

pndc news what’s hot at the 2017 pndc?

an hour of a hygienist’s time. Staff may not be aware when they lose an hour of time, but the accumulative effect can really hurt.

Collectively for the month, they could lose as many as 24 hours, or three full days in a month. Practice management software has difficulty tracking lost hours because doctors work out of two or three chairs, so each column has a lot of open time. Since computers think linearly, staff has to measure it themselves, but the lost time can be calculated. “You have to want to track it,” says Ishimoto, “and most practices don’t. But left unchecked, all kinds of things can happen, and doctors are free to micromanage staff, which can increase stress. We don’t ever want a doctor with an hour free. They don’t want to micromanage, but now they feel they should because they’re sitting around. That’s the sign of a disease they want to cure. With every cancellation, the dentist is thinking, ’That appointment is worth X amount of dollars, how am I going to make that up?’”

Ishimoto also will discuss technology (and its limitations), and how she wants offices to consider tech a safety net, not an answer.

“There’s an assumption that patients need to be reminded about appointments. Some do, some don’t. The challenge with tech is overkill. Most of the people on the business team who work with the system don’t know when something is too much. In this lecture, I’ll talk about how we can personalize our approach, as opposed to globalized vomit of sending everyone everything. Tech has good and bad. For me, the bad thing is the overkill of contacts. The receiver can turn off the onslaught by replying, ‘Yes, I’m coming,’ but many of these systems continue to send out messages regardless.

Tech can help by decreasing a task list for the team. But without the work of the team incentivizing the appointment for the patient (Why do I need to come? What are the ramifications if I don’t?), then no amount of tech is going to get people to their appointments.”

Assisting in Implant Surgery

Thursday, June 15, 1 – 4 p.m.

Friday June 16, 7:30 - 11:30 a.m. (repeat) Target Audiences: EFDA/Assistants, Hygienist

Sage advice from Ellen Gambardella

plains. “Every two years you should have a refresher course. This will be a great refresher for those people, and they’ll walk away learning something new. For those who are just starting out? Oh, my goodness, it’s a bonanza. They are going to learn so much in the workshop!”

Gambardella will pour over the details of implants, the preparation involved, and how the clinical team is often considered an unbiased opinion by the patients, making their role in patient acceptance vital. And while assistants and hygienists working with a GP may well only need information about one type of implant, Gambardella explains that “an assistant working with a maxillofacial surgeon may have referrals from many doctors. One of those GPs may use a Straumann, while another GP may be comfortable with a different type. So if you’re working in a specialty practice, you really do need to know more than one system. Regardless, the ongoing training is essential because the team has to be current with the changes that are taking place in the industry. They’re always coming out with new implants and surfaces that are more compatible with osseo integration.” Assistants and hygienists play such a vital role in patient education and acceptance, they’re also critical for treatment success. Gambardella will review how to plan ahead, how to stay organized, and how to be a second pair of eyes for the doctor. “The doctor is looking at the implant from one perspective,” she says, “while assistants and hygienists see it from another. The two have to be able to communicate.”

Gambardella will also review proper preparation, especially as it relates to infection control. She says, “As with all dental procedures, infection control is of the utmost importance, especially when you’re placing implants. It’s critical to prevent cross-contamination throughout the procedure, including with the implant.

If there is any cross-contamination on the implant, you may not have a successful result, not to mention all of the infection control that goes on after surgery. I would say that infection control is of the utmost importance.” Gambardella is a popular presenter who often sells out. Make your workshop reservation online today!

From How…to WOW! Become the Awesome Dental Assistant

Ellen Gambardella has been lecturing for 30 years. She brings her expertise to the PNDC again this year with a key workshop devoted to assisting in implant surgery. She was a full-time teacher speaking on the side, but when she retired from teaching, she transitioned to lecturing at dental conferences across the country.

Gambardella stays fresh through her vast array of dental contacts, taking loads of continuing education, and keeping her head buried in a book. Because so many GPS are adding implants to their arsenal, assistants who aren’t keeping up with the technology run the risk of falling behind and becoming obsolete, she says. It’s also important to stay abreast of the options, their differences, and the instrumentation protocols for each type of implant. But what if you’re already assisting your dentist in the placement of implants?

Why attend this workshop? “I equate it to CPR,” Gambardella ex-

Thursday, June 15, 8 – 11a.m.

Target Audiences: EFDA/Assistant

Efficient and Predictable Provisionals Thursday, June 15, 2 – 5 p.m.

Target Audiences: EFDA/Assistants

The dentist’s perspective · Lori Trost, DMD

Dr. Trost is a dentist who practices part time when she isn’t lecturing. “It’s a great balance,” she says. “I keep my fingers wet and still stay clinically savvy, and I do a lot of research, as well.

It’s a great blend for me. I’m a real geek/nerd when it comes to reading and research.” Trost’s two lectures are aimed at assistants and EFDAs. They cover how to be a better assistant, and how to create better provisionals. We wondered, would her lecture titled “From

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procedures a temporary has to be made. “Think about that,” Trost says. “There’s a lot of wasted time, and a lot of studies right now that show us that offices lose when they have to remake or even recement temporaries. If they do two of those a month, they’re losing almost $6,000 of revenue a year. It’s not the cost of the actual temporary, it’s the cost to get the patient back in. It’s a disruption of the schedule. I’ll teach people how to create temporaries that last and make the patient is happy.”

In addition, Trost will cover traumatic injuries and the way that dentistry can help provide emotional recovery. “Broken teeth and traumatic injuries are a huge part of the clinical presentation. They’re so important to getting people back on their feet and feeling good about themselves again,” she says. “ Sports injuries, elderly people falling, and just doing crazy things leave people in situations where they need a temporary. And the more experience an assistant gets doing them, the more they’re able to improvise and think on their feet when they’re confronted with a really crazy case.” Trost will provide attendees with a wealth of information, and give them a break in the middle of the lecture to test run some of the materials that will help set up assistants for success.

She’ll also encourage them to work collaboratively with their dentists about the choice of materials. She explains, “I think that the decision of what materials to use for temporaries is best done as a choice that the dentist and assistants make together, if possible. For example, in my practice it was easy to train assistants who were new, young, and fresh because it was the only thing they had ever known, but other assistants might have had a style or method in their wheelhouse that I was able to adopt into my practice. Good team members, dentists, and assistants learn what works best in their hands. And by attending my lecture, an assistant who isn’t having success with a particular material may have a light bulb moment where she realizes that by making a lateral move, she can be successful. For instance, by staying in the same category, but changing manufacturers. It’s good stuff to learn!”

Taking the stress out of provisionals

Kathy Bassett started her career in private practice, but now lectures and is a full-time professor at Pierce College. What’s unique about her clinical career, she says, is that 80 percent of her time was in expanded function doing just restorative and anesthesia.

She has worked in oral surgery, perio, pediatrics, and general practices, giving her a breadth of experience. Additionally, Basset co-authored one of the definitive textbooks on local anesthesia. “There are three general anesthesia textbooks that are used in classrooms across the country. One of them is Malamed’s, which has been used for 40 years, and most of us learned on,” she says.

“The second one I co-authored with Dr. Arthur DiMarco of Eastern Washington University (“Local Anesthesia for Dental Profession-

To paraphrase our current president, “Who knew how stressful provisionals could be?” Trost explains, “They create a lot of anxiety. The key to doing them properly, and ensuring a predictable outcome is to have a game plan going in. I’ll teach a couple of different methods to overcome obstacles.” For example, say you have a patient who had an accident and half the tooth is missing, and is going to need a root canal and a crown. “Obviously,” says Trost, “you can’t just mold something in there. I show strategies that will take you from A to Z to create a predictable outcome.”

Currently, about 48 percent of billable procedures in offices across the country are for crown and bridge work, and for each of those

Complementary and Alternative Local Anesthesia Thursday, June 15, 2017, 8 – 11 a.m.

Target Audiences: Hygienists

A trove of experience · Kathy Bassett

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pndc news what’s hot at the 2017 pndc?

How…to WOW! Become the Awesome Dental Assistant” be strictly relevant for a new assistant? No, she says, explaining, “The lecture is pretty broad spectrum. I have a lot of attendees who’ve been in the dental field 20-plus years, and I have ones who are brand-new out of school. Dentistry is changing and evolving so much and so fast, you have to stay current. For instance, there are more than 70 different types of composites on the market right now. Not that we’re going to cover all 70, we don’t have the time, but within that range we’ll talk about the different types of composites. It’s a critical conversation because we spend about a third of our time placing composites. It’s a massively done, repeated procedure.”

Trost says assistants need to know what types of materials they’re using and be totally prepared to make it a more efficient procedure. “You really need to figure out how the methods and techniques have evolved, what’s current, and what’s the best for a given procedure,” she explains. “There are flowable composites, and there are bulk-fill composites that allow you to place in 4mm increments versus 2mm increments. Most composites have been layered in over time, so if you have a class 2 composite restoration you’re replacing, it’s more efficient to layer in 4 mm at a time than 2 mm. It can expedite the whole process. We talk a lot about light science through clinical cases. We show how all of that has evolved, and what is working.”

The other aspect Trost will explore is taking initiative in the practice, and why it’s so vital. She explains, “In dentistry, there are many things that compete for our focus. On average, we’re distracted every seven minutes, ranging from a coworker entering the operatory, to the phone ringing, to a request from someone.

So when we look at fine tuning, it’s about being prepared. It’s not about what’s now, it’s about what’s next. When we find good assistants who are in that mindset, it helps the practice run better.

So we learn about taking initiative to prepare for what’s next. Fine tuning is huge. The more we can improve that, the better.” This ultimately benefits the patients because they see your workflow is smooth, and they see the balance, harmony, and synchronization in the practice and how you handle the office, she says.

Trost will also cover what’s current, and tips and tricks assistants can use chairside when anesthesia is being delivered or they’re giving post-op instructions to patients, and how to make things more efficient and predictable.

pndc news what’s hot at the 2017 pndc?

als”). We are the only book out there that was written by a team of a dentist and a hygienist. I think one of the things that is really valuable is that our book has been looked at from both perspectives, and we’re having the conversation as a dentist and hygienist, together.” Bassett will lecture about all aspects of anesthesia at the PNDC, including CCLAD technology, and the new nasal anesthesia delivery methods, like Kovanase. She also will cover new rules in the state and talk about why they’re important to anyone who delivers anesthesia to patients. She explains, “I’m an expert witness in a case right now. And while I might have answered this differently three months ago, I now realize how important it is to refresh your memory, explore different approaches to techniques, and be able to give evidence that you are current and up to date on your skills.” Basset told us that, in the deposition, a hygienist was asked when she had last taken a course in anesthesia. Her answer wasn’t supportive. “As part of your professional risk management, you have to show continued competency in skill sets that are considered a little more risky,” says Bassett. (Depending on the kind of practice you work in you, may do more or less anesthesia.) “I did the majority of the anesthesia for the entire practice, and hygienists who work with endodontists will likely do all or most of the anesthesia for the practice. Some dentists aren’t comfortable with letting their hygienists do it, and some hygienists lack the confidence. If you are charged with administering the anesthesia in a practice, whether as a dentist or a hygienist, this class will be relevant for you.”

As of January 2017, Washington state law mandates that hygienists can give local anesthesia without the dentist present in the office. There are set parameters about when that agreement can be made and how it is documented. Bassett will cover the general supervision laws in Washington, and the responsibilities of dentists and hygienists under the law. “I think it’s really important to talk about that,” Bassett says, “because one of the things that happens a lot is that the doctor will say, ‘Hey, I will be back at 1:15, get that patient numb for me so they’re ready to go when I return,’ which in the past was commonplace, but illegal. This law takes the stress off of those of us who were asked to do that. It also makes it easier for patients who need to come in three or four times a year for their cleanings because now the doctor doesn’t have to be present.

We can already see patients when the doctor is not in the office if they’re a patient of record, but the new law opens the door for me to perform those procedures without the doctor in the office. We’ll review all of this information for attendees.”

Computerized anesthesia delivery

Bassett will also cover CCLAD in her lecture. This is a computer- controlled method of delivering anesthesia. While by no means new tech, Bassett says it is underutilized, especially given that, in the scheme of things. it’s not expensive — around $2,500.

She explains, “CCLAD takes all of the guesswork out. When you have an injection, it’s all about the rate of delivery and the amount of pressure being applied during the administration. It totally depends on the individual and whether they’re male or female and have small hands or large. It’s what I refer to as ‘fluid dynamics.’ A computer-controlled device has a microprocessor in the delivery system that controls all of that. Everyone gets a uniformly consistent injection. Additionally, the hygienist or dentist doesn’t have to use their hand muscles in awkward ways to give that injection.

The win-win is that it’s more comfortable for the patient, and it reduces cumulative trauma and strain that clinicians don’t really think about when they’re giving injections.”

Saving Your Autonomy: How to Evolve Your Practice to the Direct-care Model Thursday, June 15, 2017, 3:45 – 5:15 p.m.

Target Audiences: Dentist, Front Office

Changing your payment model · Dr. Greg Yen

Every dentist has struggled with insurance reimbursements and insurance providers in the course of running their practice. Over the years, companies have tried to create payment options that circumvent the insurance process altogether, but they’ve run afoul of state laws and regulations prohibiting prepaid medical and dental wellness plans and similar memberships. This past year, WSDA met with the insurance commissioner’s office to talk through ways that such a plan could be structured to comply with existing laws.

WSDA member Dr. Greg Yen took the information and developed a plan that he’ll present at this year’s PNDC. “Start up is easy,” says Yen. “Everything that encompasses a program such as this is already done in a dental practice (e.g., give discounts, make ledger adjustments, and create codes). Prices need to be determined, and then you’re pretty much good to go.” After that, Yen explains, there is little to no paperwork on a day-to-day basis. He recommends that the first member of a program be either a relative or a fictitious character (stuffed animals work great), so that the front office can practice. “It really is straight forward,” he says. “Patients are very grateful for the discounts and perks, and are very forgiving because they know it’s new and, most importantly, it’s for them.”

Getting started

Yen concedes that there can be some tinkering and evolution to the process, but reaffirms that keeping it simple is the path to success. “Some offices have a tendency to get into what I call ‘bureaucracy mode,’ and create so many clauses that their program sheets end up resembling a loan application. Yikes! I cannot stress it enough, simple is better. I’ll show you what I mean in this lecture.”

As for the patient, Yen calls it a no-brainer, explaining, “They are extremely grateful for the direct consumer option, which ‘middle men’ will find hard to beat on price. It is extremely transparent.

After discounts and perks, (patients) will know exactly what their costs will be, to the penny, for every procedure.” And although the program could be offered to patients with insurance, Yen says it’s targeted to those without.

A sustainable prevention program

The main benefit to providers, Yen says, “is that it promotes an economically sustainable prevention program. There are no narratives, no paperwork, no insurance clauses to deal with (revealed or hidden), and no 1970s-based calendar max’s. The program is customizable to fit your practice, and will create loyalty to your practice because you get all the credit. For patients, the program will promote prevention, is easy to understand, and provides the best value for dental care. They don’t pay for anything they don’t need. And what about equipment to get started? Yen says, “I forgot to mention that you do need to buy one piece of mandatory equipment to make this happen…. a ream of paper. My IT guy just fainted.”

Engaged, educated staff + smooth practice

As you can tell, we’ve upped the wattage this year on educational offerings for staff because we believe that the better informed and educated your staff is, the smoother, more successfully your practice will run. We encourage you to bring your staff to the PNDC for these and many other lecture and workshop offerings. See you at the PNDC! [Editor’s note: For a complete list of all PNDC lectures and workshops, visit wsda.org/pndc-schedule]

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Have you ever wondered how to get more involved with the WSDA or ADA? Now is your chance!

We encourage members to apply as a candidate for an open state or national elected position.

open positions: During the 2017 WSDA House of Delegates (held September 14-16 in Stevenson, Wash.), the House will vote to fill the following elected positions. For a complete description of any position, please email Brenda Berlin at brenda@wsda.org.

To run for any of the following open positions, please complete and return our candidate nomination packet by June 30, 2017: http://tinyurl.com/2017NomPack Candidates should be present during the WSDA House of Delegates, held September 14-16 at Skamania Lodge in Stevenson, WA. All terms begin when the WSDA House of Delegates adjourns on September 16, 2017, with the exception of the ADA Delegates, whose terms begin on January 1, 2018, and 11th District Trustee, whose term begins at the 2018 ADA House of Delegates.

Please email Brenda Berlin at brenda@wsda. org with any questions.

11th District Trustee to the ADA Board of Trustees

Open Positions: 1 Term: 4 years (beginning October 2018) Requirements: WSDA member The 11th District Trustee position rotates among all five states in the 11th District. Once every 12 years, Washington selects the 11th District Trustee.

President-elect

Term: 1 year as President-elect, 1 year as President, 1 year as Immediate Past President, 3 years as ADA Delegate Requirements: WSDA member. Must have been a member for the preceding five consecutive years.

Board of Directors

Open Positions: 4 · Term: 3 years Requirements: WSDA member

Committee on Budget and Finance Open Positions: 1 · Term: 4 years Requirements: WSDA member

Committee on Government Affairs Open Positions: 1 · Term: 3 years Requirements: WSDA member

Delegate to the ADA House of Delegates

Open Positions: 3 · Term: 3 years (beginning January 2018) Requirements: Per WSDA bylaws, one delegate position will be reserved for a person that has never been elected to the ADA House and has previously served at least one year as a WSDAappointed alternate delegate, ASDA delegate, or alternate delegate to the ADA House.

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house of delegates news call for nominatios

Call for nominations

wdia news keeping the process moving

WDIA STAFF

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ers, and policyholders; and all the other details that make insurance, frankly, not all that interesting.

But WDIA is different in that it’s an agency that was predicated on serving just one type of customer: dental professionals. Because of that, when you call, they’ll know the types of issues you face because they’ve heard them before. They’ll understand the circumstances surrounding your insurance needs, and they’ll know what products will work for you, and which ones likely will not. A couple of issues ago, we introduced you to half of the staff at WDIA. Now you’ll meet the rest. Some of these folks are the voices you hear when you call in with a question about your policy, and some of them work diligently behind the scenes, resolving workflow issues so that you get information and policies even faster.

What we like about this crew is their sense of balance.

From knitting and salsa dancing, to baking and museum curation, they all have passions they cultivate and nurture outside the workplace.

wdia news keeping the process moving

The Washington Dentists’ Insurance Agency is like any other agency, and at the same time, it’s not. Like all the others, there are scads of moving parts: insurance policies at different stages; communication among carriers, produc-

Supporting key players

continued on next page

Photo, left to right: Loren Hendrickson, Megan French, Kristin Cappellano and Melissa Castle

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Photo by Jordan Stead

Kristin Cappellano and Melissa Castle keep the train running, so to speak. In their role as production assistants, they are charged with directly supporting Matt French and Kerri Seims, and keeping the pair on top of their game. They prep files (which can take anywhere from a few hours to a couple of days, depending on a customer’s medical history and how quickly calls are returned), email clients, and pull quotes, leaving Seims and French free to meet with clients and sign the requisite paperwork. Cappellano spends about half her day emailing

wdia news keeping the process moving

Photos, cockwise from top left: Melissa Castle takes a break to make cookies for WDIA staff, a display from the Shanaman Sport Museum in Tacoma, Going to the dogs: Kristin Cappellano loves spending time outdoors with her Golden Retriever, Jude

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Moving to Seattle

Kristin Cappellano moved to Seattle from Spokane to take advantage of the big city and to be closer to her sister, a student at the UW. This place is still new to her, and she loves exploring the many neighborhoods and soaking up the energy. She explains, “Moving here makes you more aware of what’s going on in the world and locally, politically, environmentally, and socially. Seattle is a city that breeds desire to be in the know, and I love that.”

But while she likes what Seattle has to offer, her heart still belongs to Spokane. “I will move back the second that I want to raise a family. The longer I’m away from it, the more I realize there are molds that are difficult to break free from,” she says. Still, I think (Spokane) has many advantages. Homes and land are still reasonable, and it’s a great place to raise a family. I loved my formative years there.”

It was in Spokane that Cappellano first started dancing. Once in Seattle, she and her sister began to explore the vibrant dance scene. “Opportunities really opened up for us once we got here,” she explains. “There are so many more people in Seattle, and it is easier to find places to dance. We go to The Little Red Hen, Salsa Con Todo, Century Ballroom in Seattle, and salsa dancing events on Alki Beach. The salsa community in Seattle is very nice.

You don’t necessarily have to go with someone. They’re very welcoming.” Cappellano loves salsa so much that she jumped at the chance to travel to Cuba with a local dance club. The experience taught her more than just the differences in salsa styles. It was an opportunity for a cultural exchange. She says, “Salsa dancing isn’t the same there as it is here in the U.S., so we had a lot of new techniques to learn. It’s more of a communicative dance there, with prescribed roles for each dancer. The people were wonderful, and so welcoming. They really enjoy Americans because they haven’t had much exposure to us, especially the younger generation. There are a lot of places where traveling as an American has a stigma attached to it because we consume so much, but it is different in Cuba. It has always taken a real effort to go if you’re an American, so the people have a real appreciation for the few who have traveled there. That could all change now, of course. They’re very excited to share there, especially their dance.”

New challenges

Recently, Cappellano took up a new endeavor: training for her first triathlon this May in New Orleans. Friends who had already planned their trip suggested she come along and run one of the shorter distances, but Cappellano had other ideas. Although she’s a total novice to triathlons, she pledged to hit the deck and train along with them. Because of that, she spends a lot of her mornings “flopping around in a pool,” or heading out for a run. “If I’m going to go through all of this trouble to train, I’m going to go the whole distance,” she says. “It’s a very regimented program. I’m not a runner, biker, or a swimmer, so I’m learning a lot about myself emotionally. It’s really fun, and my friends are patient.” We wish her luck and an injury-free first race!

A passion for baking

Melissa Castle, who earned her degree in journalism from Seattle Pacific University (just across the canal from the WSDA office), grew up in Poulsbo, Wash., and never dreamed of working in insurance. She studied journalism in the hopes of becoming a travel writer. What she discovered is that jobs in journalism are few and far between, and it’s even harder to find someone to pay you to travel. “Travel writing is no longer a thing, and people would rather look at pictures than read about it,” she says. Last year, she and a friend decided to combine their shared love of travel with Castle’s love of baking, and spent three weeks exploring small towns (and their bakeries) in Australia. Towns like Koo Wee Rump (“three blocks long with four bakeries and a thrift store,” jokes Castle), where she first discovered a local delicacy, Lamingtons, a cake coated in frosting and rolled in coconut. As soon as she returned to Seattle, she tried making the tricky dessert (“it’s tough to frost the cake all over without destroying it,” she says), although the recipe’s tips and tricks are closely guarded family secrets. She continues to work on getting it right, and is enjoying the process.

Castle started baking when she was 6 years old alongside her father, who was the chef in the family. She has continued to explore and learn ever since. She says, “The goal is to open my own bakery before I turn 40. For the past seven years, I’ve been actively learning more about the craft. I like the chemistry aspect of it. It’s difficult, and it tests you in ways that other types of cooking don’t.

While I was in college, it was my way to step away from school, homework, and tests because it was something that I had to focus on intently. It relaxed me, and helped me to enjoy the moment and not get stuck in the other stresses of school.” Castle has a baking blog, but she admits it’s hard to get noticed in the sea of blogs devoted to all kinds of food. But she’s undeterred, powered by enthusiasm and the love of baking.

Keeping French on track

At WDIA, Castle assists Matt French, the Director of Insurance Services. “I help him meet and schedule clients, help with the process of getting the right disability and life insurance, and I’m the point of contact for the clients,” she explains. “I make sure their paperwork is completed and that they’re happy, and then I schedule the final meeting for Matt.” Her role is to keep French moving forward, and there are myriad details that make up her work.

“Matt is a really fun person to work with, but he has a lot of balls in the air, and many of the details live in his head, not on paper. It can be challenging work, and I have to read his mind sometimes.

I’ve definitely gotten better at it, but I would have been lost without coaching from Paddy Moran, his previous assistant. [Editor’s note: We profiled Moran in Issue 3.] Matt and I have discovered a middle ground so we can stay up to date with all of the clients.”

According to Castle (and all of WDIA’s employees), the best part of working at the agency is the people. “We have a tightknit community here. I can talk with Matt and Kerri about anything, and we’re all very close. We have a couple of busy seasons, holidays and graduation time, but it’s always high-spirited. People give you space if you’re having a hard day, but it is a friendly, upbeat office.”

Castle recently celebrated her year anniversary with WDIA, a job she took as a lark because it was time to focus on her career, and an office assistant seemed as good a start as any. “When you think about insurance,” she says, “you think of gray, dreary people, and it’s the exact opposite here.” Castle is happy she took the job, and proud that in just a year she has moved up the ranks. Insurance, gives her the freedom to pursue the things she loves most, and is satisfying to boot.

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wdia news keeping the process moving

clients with questions and concerns, rather than phoning them, explaining, “Much of what we do is confidential, so we have to speak directly with the doctors, but their staff tend to be very good at running interference.” She understands that running the gauntlet is just part of the job. “The dentists get a lot of unwanted calls throughout the day. It’s nice when we can establish a rapport with them so we don’t have to try to work through their staff,” she says. “Things tend to go a little more smoothly. Building a relationship with the dentist is important to what we do.”

wdia news keeping the process moving

Loren Hendrickson out on a hike with her dogs (plus one of her daughter’s)

Recent addition to the WDIA staff

Loren Hendrickson is the newest person to come on board at WDIA, and she brings with her a wealth of experience in Customer Relationship Management (CRM) tools, especially Salesforce.

WDIA uses Salesforce’s TechCanary as a virtual “one-stop shop,” if you will, allowing a view to WDIA customers. “We’re able to see all of the policies they own and keep the workflow for the producers and the salespeople forward thinking,” Hendrickson explains.

“We can track all of the policies, conversations, and emails we’ve had with people, and have it in one place so that anyone in the office can pull up the history of a customer and know where that customer stands. Eventually, we’ll be able to run a series of reports that will tell us a great deal of information about our customers, but we have a lot of work ahead of us to get there. We’re converting from an old system, and data management is always a challenge.”

Luckily for Hendrickson, some of the groundwork of the process was already laid when she was hired. “They did a lot of work over the past couple of years to get the process started. Certainly this year I expect to make it a lot shinier, and start figuring out what else we can be doing,” she says. “It shouldn’t take too long, but then the question becomes how do you grow the system, and what can we do to make life easier for both the agents and the customers? I’m trying to help the business see where technology can add value, and where it won’t. We’ll identify case by case.”

Surviving the boom

Saying she goes “all the way back to the days of the 3.5-inch floppy disc,” Hendrickson began her career installing CRMs for a

small software consulting company. At the time, she was a parttime employee and a full-time mom to her two children. She says, “I had the privilege to be home a fair amount when my kids were younger, which was really nice. When they got older, I went back to work full time and took what I knew of CRM and Salesforce to a position with a software startup doing Salesforce administration. There’s a lot of reporting, commissions, and database management. After about a year and a half, I was laid off in the 2000 dotcom bubble burst.”

The layoff wouldn’t be the last, but that was practically part of the business model back then: Find a startup, work your butt off, sell the startup, lose job, repeat. “I actually got laid off twice in 2006,” Hendrickson explains, “but I was always able to use my work in CRMs to get the next job. I did all sorts of things, from a project for the Gates Foundation, to running the Salesforce side of things when the Dalai Lama came to town with Seeds of Compassion.” After that, she went to work for another startup, which was then acquired by EMC, one of the largest storage technology companies in the world. “I never wanted to work for a large company. I wanted to work for a small company, but they kept getting bought out by larger companies,” she says. “This past fall EMC was purchased by Dell, and I was laid off again. In all, I was in the position for seven years under three different companies.”

Along the way, Hendrickson’s role changed significantly, from Salesforce to analytics, to managing teams of engineers. The changes in job title took their toll. She explains, “I no longer liked my job, so I put myself on the chopping block. I’ve dabbled in a lot of different areas of technology, but CRM has been a con-

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Back in a small setting

With Hendrickson’s wealth of experience in Salesforce, WDIA was a great fit for her and the agency. She’s back in a small firm setting, and WDIA gets the benefit of her years of experience in CRMs. She says, “My role is to help bring the organization to some more future-thinking approaches to using technology. We want to make Salesforce the core of the technology of the group, and look at what we can do to enable a good flow of the process and add value to our members. It’s a fine line to figure out how to best balance top-notch service versus efficiency for the customer. For instance, nobody likes being on hold with Regence for a long time, but maybe if you’re on hold you’ll ultimately get a faster result.

That’s just one of the challenges we’re interested in solving.”

Getting to Seattle

Hendrickson might not have ever made it to Seattle, had she and her husband, Greg, not vacationed here on a lark. She explains, “We stuck a pin in a map to see where we wanted to go next, came out to Seattle on vacation and loved it, came out the following year to scout around, and moved here the next year. The city has gotten bigger than I would have liked, and the traffic gets me down. I liked Seattle a little better when it was a smaller city.”

Greg works in the tech field, too, and is in a couple of bands that last year played 58 gigs in the wineries between Leavenworth and Lake Chelan. The couple recharges on weekends at their place in Plain, Wash., a tiny hamlet with a two-block space that includes a winery, a breakfast /large storage spot, a hardware/grocery story/ gift shop, and an old school gas station with a laundromat in the back. “I love going over with Greg on the weekends, hiking in the woods with our dogs, Casey and Sasha, and swimming in the rivers and lakes. Depending on the gig, I might go with him or I might have quiet time.” During her quiet time, Hendrickson’s able to pursue her passions for knitting and quilting. The day we met to talk, Hendrickson was wearing a pair of socks she’d made, and the pattern and detail were astonishing. “I make my own yarn, and I have two spinning wheels. It is rare that I’m not wearing socks that I have knitted myself,” she says. “There’s a Tuesday night knitting group at a local shop in Greenwood that I’m a member of, and I’ve even considered going to the sheepherding trials. They’re great events that combine wool and dogs. I’ve been to the Vashon Sheepdog Classic, and it’s a lot of fun, and a great day for a picnic.”

Megan French

In her 12 years at WDIA, Megan French has worn many hats, from temp to operations manager to everything in between, all while keeping up with museum curating, her real passion. She discovered curating positions were elusive, even after earning her master’s degree in 2004. “I couldn’t find a job in the museum profession,” she explains. “There are tons of great museum jobs in Seattle and Washington, but no one ever leaves their position unless they die or move.” She knew that she didn’t want to move out of state for work because her husband, Matt, was already working at WSDA. French had been working at WDIA part time for a while, so she was familiar with the office when she came on board to manage operations. Over the years, her job has changed from managing day-to-day operations along with lots of production, to just production work, to her current position, which entails administrative work and some production, as needed.

Shifting priorities

For the most part, her shifting priorities had to do with the arrival of the couple’s child, Liam. “I was only supposed to be here a year. I really thought I’d be working either in an academic setting or with a museum, but I’ve learned a lot of transferable skills here,” she says “I never knew what I was capable of doing until I had to do it here. I was always an organized person and able to multitask, but with WDIA you have no idea how much you have to be able to do at once, and the speed that you have to be able to perform those tasks! I never thought I would be able to manage the details of 60 different policies in underwriting, but it’s part of the job here.” Moreover, her work at WDIA has helped her redefine what her dream of museum curating looks like. French has stayed connected to the curatorial world through her continuing work as collections curator with the Shanaman Sport Museum in Tacoma. “It’s a contract that I got when I first graduated, and I’ve stuck with it all of these years because it’s fun and it doesn’t put a huge time demand on me. I do a bit of everything there, and I can work at my own pace. They don’t have a full-time staff, and they’re not open regular hours.” A typical assignment includes cataloging donations of memorabilia, entering them into the online database, and adjusting exhibits as necessary. The position calls for some community work, like her current effort to catalog 1,200 sports programs and create flip books for each, which will be available online. “Because of the work with the museum,” French explains, “I feel like I’ve never been totally out of museum culture, so it’s worked out well for me over the years. Working at WDIA has opened my eyes and made me realize what I would be willing to do if a museum position came open. Prior to receiving my master’s, the thought of doing collections management, archival work, and hands-on work with artifacts was interesting. Now because of my work at WDIA, I realize I’d rather be doing more administration work at a high level, than the nitty-gritty day-to-day work. If I ever went back to the field, I’d be looking for something much different than I thought before. The work I do at the museum is very calming and therapeutic, but I couldn’t do it full time for a job. I’d rather be working on strategy.”

Working with her husband

We wondered, what’s it like working with her husband, Matt?

“Oh, there’s no issue working in the office together at all,” says French. “We get along fine in the office. I’m not his assistant, so we don’t have a lot of daily interaction. It’s more of an issue when we get home. We’re not very good about leaving work at the office.” Recently, their son helped them understand just how bad the problem had become. “Liam sits between us at the table for supper,” French explains. “And we were so involved about talking about work that one day he announced, ‘Bob at WDIA sent me an email.’ That’s when we knew we were talking about work too much. He wanted to be involved in the conversation, so he invented a crisis at WDIA involving Bob, the imaginary employee.” Regardless, French enjoys her role at WDIA, explaining, “I like that we’re always helping members. Insurance is important for people, and we’re here helping members and their staff. The work we do matters.”

We’re proud of the people at WDIA and the work they do on behalf of our members, and we like that they have varied, fascinating interests outside of work. They stay balanced and happy, and, ultimately, they’re able to serve you better.

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wdia news keeping the process moving

stant thread throughout my career. I’m pretty good at figuring out what’s not working and setting it right.”

member news spokane district dental society foundation gala

SPOKANE DISTRICT DENTAL SOCIETY FOUNDATION GALA GALA RAISES $103,000 TO SUPPORT RESIDENCY PROGRAM

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A night of fun and celebration

Nearly 280 people were in attendance, with dentists from the “west side” joining their eastern Washington colleagues at the Davenport Grand Hotel for a night of food, dancing, socializing, and fundraising. With both live and silent auctions, a show by Spokane Aerial Performing Arts, and live music by the Cronkites, the gala had something for everyone. Local wineries poured their juice, and attendees bid on desserts for their tables. “We focus on making it a really fun night celebrating our many programs and those who support the SDDS Foundation,” said Wendy Johnson, Executive Director of the Spokane District Dental Society.

WSDAF’s new mission at work

As part of its new mission, the WSDA Foundation will fund foundations and their programs, as well as other efforts focused on delivering oral health to Washingtonians across the state. The WSDA Foundation, formally called the Washington Oral Health Foundation, was completely restructured last year at the behest of WSDA members who envisioned it as something with a greater reach and impact than before. Dr. Chris Dorow, a WSDA Foundation director, said, “It’s a dramatic change, but I think the future of the Foundation is brighter than it has ever been. I think it’s going to be easy for people to support and be proud of. Now we’ll we have a foundation that’s easy to understand and explain.”

Photos, opposite page, clockwise from top left: Julie Humphreys and Xavier Zielenski, Dr. Rob Heinrich and Kim Heinrich, Dr. Emerson Godbolt and Aubrie Ler, Katie Huckabee and Brent Huckabee and friend; Photos this page top: Dr. Amy Winston, Dr. Mark Paxton, Dr. Ashley Ulmer; bottom left: Andrew Roehrig, Alexa Ellingsen, Patricia Ellingsen and Dr. Ron Ellingsen; bottom right, Mr. Jason Little, Dr. Christine Kirchner, Dr. Tim Hess.

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member news spokane district dental society foundation gala

The seventh annual Spokane District Dental Society Foundation Gala was a rousing success, raising $103,000. Proceeds from the February 10 event will be used by the SDDS Foundation to expand Spokane’s residency program and more. Of that amount, more than $47,000 was contributed by the Washington State Dental Association Foundation in matching funds during the popular “Raise a Paddle” portion of the auction. WSDA Executive Director Bracken Killpack was delighted with the fundraising results, especially given how the money will be used. “This is exactly the kind of effort the WSDA Foundation wants to fund across the state because it helps tackle the access to care issue, while working to produce the next generation of top-notch dentists,” he said. It’s a win-win.”

call for nominations 2017 citizen of the year

About the Award The WSDA’s Citizen of the Year award is given to the member who has performed outstanding volunteer service, either domestically or overseas, which serves to help a community in need, reinforce the value of volunteering to the dental community, and promote the image of dentistry. The coveted award is the highest honor the association can bestow on one of its own.

This year, the WSDA Board of Directors voted to expand qualifying volunteer work to include work done on behalf of an employer or in a practice. Additionally, because charity begins at home, the board decided that priority would be given to dentists performing good works here in the state.

Last year, Dr. Loree Bolin was the WSDA’s Citizen of the Year.

Since 2007, the intrepid world traveler, athlete, and dentist has volunteered her services, creating programs that bring children healthcare, education, clean water, and programs designed to help them thrive.

If you know someone like Dr. Bolin who has given selflessly, please nominate them for this important recognition of good work. Apply online at wsda.org/coy-nomination-form

Dr. Jacqueline Angell, 2015 Citizen of the Year

The late Dr. Bart Johnson and Dr. Amy Winston, Citizens of the Year for 2014

Dr. Ray Damazo 2013 Citizen of the Year

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Purpose: The award exists to recognize a member dentist who has given outstanding service to a domestic and/or foreign community; to encourage others toward such activity; to reinforce values of volunteer service desirable in society; and to promote the image of dentistry.

Nominations: • Nominations can be made online: wsda.org/coy-nomination-form

Criteria for Selection: • The nominee must be a WSDA member • The award will be based on civic activities, elective and volunteer, including, but not limited to: Service organizations Youth groups Schools Non-salaried government positions Church-sponsored community services Personal commitment to community service through volunteering Service to all 501(c)(3) Foundations • Priority will be given to nominees whose service has been in Washington state

Nominations: • Nominations may be made by an individual member or a component dental society. Former nominees may be renominated. Letters of support from organizations with which the candidate has been involved are encouraged.

• Nomination deadline: The first Friday in June of each year (June 2, 2017)

Selection: • Selection of the state award winner will be made by the Task Force on Recognition of the Washington State Dental Association

Presentation: • The award will be presented at the annual House of Delegates meeting September 15, 2017, Skamania Lodge in Stevenson, Wash.

2017 WSDA CITIZEN OF THE YEAR AWARD

Dr. Loree Bolin 2016 Citizen of the Year

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call for nominations 2017 citizen of the year

Nominate a peer today!

Let’s talk about financing your dental practice.

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All loan programs subject to program and underwriting approval. See loan officer for details.

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Moderate Sedation With Parenteral Agents (WAC 246-817-760)

The Dental Quality Assurance Commission (DQAC) recently adopted amendments to include specific requirements and exceptions for dentists when sedating pediatric patients.

The adopted rule amendments update monitoring and equipment requirements to align with the American Dental Association and the American Academy of Pediatric Dentistry’s current standards, and set minimum patient safety standards while administering moderate sedation with parenteral agents.

Specifically, the adopted rule amendments add monitoring and equipment requirements with three exceptions for dentists when sedating children related to intravenous infusions, monitoring expired carbon dioxide (CO2), and monitoring end-tidal CO2, as well as requires all dentists administering moderate sedation with parenteral agents to monitor appropriate patient vitals.

A copy of the rule can be viewed at http://www.doh.wa.gov/Portals/1/Documents/2300/2017/OTS-7964-4.pdf. The updated rule is effective April 8, 2017.

Other Rules in Progress: Dentist Continuing Education Requirements (WAC 246-817-440)

DQAC is considering amendments to clarify existing continuing education (CE) requirements. DQAC’s subcommittee, the Dental Continuing Competency Committee, has been discussing several topics, such as: clarifying what is appropriate CE subject matter; determining the minimum/maximum number of hours in specified subject matter; methods to obtain CE, including web-based options; determining if hours in ethics will be mandatory; and considering continued competency mechanisms.

Infection Control (WAC 246-817-601-630)

DQAC’s subcommittee, the Dental Infection Control Committee, is looking to update current dental infection control standards to ensure proper safeguards are in place to prevent disease transmission within dental offices. The subcommittee is considering the adoption of the Center for Disease Control and Prevention’s Infection Prevention & Control Guidelines, but there is still a great deal of research and discussion that needs to occur surrounding the practicality, benefits, and impact of adopting such guidelines.

Examination Content (WAC 246-817-120)

DQAC is considering rule amendments to address additional clarifications to the rule, such as: whether a complete clinical examination from one organization is required for initial dentist licensure; if there should be a limited number of attempts to pass an examination; and whether the Canadian clinical examination is acceptable.

WSDA has been actively participating in full commission and subcommittee meetings, and will keep the membership apprised of any significant developments.

Get involved

Interested in participating in one of DQAC’s subcommittees? Contact Emily Lovell at emily@wsda.org for information.

Source: Department of Health

th e wsda ne w s · issue 5, april · 2017 · www.wsda.org · 31

Emily Lovell Government Affairs Associate

“The Dental Quality Assurance Commission (DQAC) recently adopted amendments to include specific requirements and exceptions for dentists when sedating pediatric patients.”

dqac news recent rule changes

DQAC activity: recent rule changes

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3 2 · th e wsda ne w s · issue 5, april · 2017 · www.wsda.org

Earl M. Ness, DDS, MSD

Dr. Earl M. Ness passed away suddenly at his home in Spokane, Wash., on Jan. 10, 2017. He was 68. Ness was born on June 29, 1948 in Chicago, the only child of Ramsey A. and Dorothy Rose (Carey) Ness.

He later moved with his family to the San Fernando Valley, Calif., where he attended junior high and high school. He was a beloved father, grandfather, partner, friend, and colleague.

Ness served in the U.S. Army from 196769 as a helicopter crewman in South Korea during the Vietnam War. He majored in the health sciences at ULCA and received his DDS degree at Northwestern School of Dentistry in 1978. He returned to California to establish his dental practice in Carpinteria, near Santa Barbara. He was continuously interested in furthering his education and started attending a study club conducted by Dr. Roger Stambaugh, Chairman of Graduate Periodontics at USC, and the USC Odontic Seminar (the longest-running study club in the world), mentored by Dr. Alex Koper, a prosthodontist. He was also an active participant in the Western Society

of Periodontology Team Sessions and later served for many years as an associate board member. In order to satiate his thirst for more knowledge, he moved to Seattle to attend the University of Washington School of Dentistry, where he received his Certificate of Prosthodontics in 1991.

Ness was a very active lecturer for numerous study clubs, including: Dr. Dan Cullum, oral surgeon, Coeur d’ Alene, Idaho; Dr. Greg Wilde, periodontist, Silverdale, Wash.; and Drs. Roger and Kathy Stambaugh, periodontists, Burlington, Wash.

He also conducted study clubs in Yakima and Spokane, Wash., and lectured extensively on the topic of implant restorations.

Several years ago he joined Dr. Greg Wilde, periodontist, in his Silverdale practice and commuted between his practice in Spokane and Kitsap County. Ness had a passion for dentistry and an uncompromising commitment to excellence. He pushed the envelope of known techniques in restorative dentistry and questioned established dogma. He was an innovator who started using implant-retained hybrid prostheses 30 years ago in Spokane.

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When he went to Kitsap County, Ness did not have a standard approach to all cases, but rather spent time really getting to know his patients and designed each case for its’ specific needs. He mentored three study clubs and was deeply committed to advancing his own skills, as well as the skills of other dentists. He was also active in the WSDA and assisted with several PNDC meetings.

His patients called him wonderful, a perfectionist, friend, a gem, incredible, thoughtful, skilled, caring, and great. He established many close friendships over the years, had a keen sense of humor, and enjoyed fine wine, fast cars, and motorcycles. Many colleagues, friends, and patients will miss his smile, wit, charm, and intellect. He was honored at a Celebration of his Life in Coeur d’ Alene on March 25, 2017.

Ness is survived by his twin sons, John (Allison) and Matthew (Rose); grandson Nolan (son of John and Allison); and longtime devoted partner Carolyn of Kirkland, Wash.

in nmemoriam dr. earl ness

In memoriam

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ADA.org/MyADA Login to complete your profile for the chance to win! *All active licensed members practicing in the U.S. are eligible to win. Visit ADA.org/fadrules for official rules.

3 4 · th e wsda ne w s · issue 5, april · 2017 · www.wsda.org

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said they did not think that being a legacy was a disadvantage, but it would not make up for poor grades and other weak areas.

With competition this high, there is a very thin margin for any applicant weakness.

I was told that in future applications, the personal information may not be mandated. I asked the East Coast advisor what would happen if it was omitted. She said that the background information is used to get a feel for the challenges and opportunities an applicant may have. A poorer student may have to work and not be able to shadow or volunteer as much. A dentist’s child may have had experience that tips the scale favorably. Being the first member of one’s family to make it through college is a true achievement. She thought it would not be helpful for the candidate to omit this information. The committee wants as much information as possible, so it can gain a holistic and thoughtfully fair picture of the candidate.

Like our member friend, I was concerned about how an evaluator’s personal

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bias in reviewing sensitive personal history was handled. Admissions committees are gatekeepers of valuable resources that affect students, families, and ultimately our patients.

Although my research was limited, I found the process to be thoughtful. I think large committees with many eyes help keep the process as fair as possible. I believe the people I spoke to understood the impact and ripple their decisions have on the lives of applicants and their families. I felt I was speaking with people who had become experts in the field of watching young people develop and also fail. I found them very aware that the community at large watches the process.

I am glad that dentists are watching and questioning things. I am glad our member asked about this. Everything we do, especially things done behind closed doors, should always bear the light of day.

I have never sat on an admissions committee, but many of you have. How do you feel things are going in your school these days?

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WSDA dentists pitch disability support idea to ADA

Drs. Greg Ogata, Ted Baer, and Ron Marsh presented to the ADA Health and Wellness Committee on March 10 at the ADA headquarters in Chicago. The subject of the presentation was implementation of an ADA-sponsored Disability Support Program. As disabled dentists, they believe they have a personal and professional obligation to other members of the profession.

The proposed plan was sent to the 11th District last year and was to be presented in the ADA house. Currently, it is under consideration. This new plan expands the existing disability efforts and centers on direct assistance to injured and ill dentists.

The ADA Wellness efforts have concentrated on ergonomics, opioid abuse, mental health, and addiction. Those topics, as well as wellness education, have been the primary goals. The Washington State team seeks to expand the existing program to help all disabled dentists, including those with a severe illness, such as cancer, stroke, or injury.

The team hopes that a pilot program is implemented immediately because the need is great. They seek to avoid unnecessary political delay by going to the committee level of the ADA. They proposed a five-point program that will have minimal cost from their standpoint. It calls for: 1. The immediate establishment of an ADA disability hotline 2. Upgrading the existing website pages to include detailed disability crisis checklists that can be used by dentists and their spouses and families 3. The formation of a peer disability support team of dentists who have survived disabling events

assist in these efforts, if needed. Feel free to contact fellow ADA delegates or ADA Council/Committee members you know to voice your support.

These efforts to help dentists facing disability from addiction, accidents, injury, and illnesses were generously supported by the WSDA. The team greatly appreciates the concern and assistance provided

by Executive Director Bracken Killpack and his staff. Efforts to get a state-level program in place are ongoing.

If you know anyone who is disabled, ill, sick, or injured, please have them contact members of the team for help. Volunteers are needed to act as peer counselors for other dentists who are facing crisis. Survivors of disability are invaluable in this role, but anyone can contribute.

Dr. Mike Huey receives Silver Beaver Award for leadership

WSDA member Dr. Mike Huey recently received the Silver Beaver Award from the Boy Scouts of America. The Silver Beaver is the highest award that a local council can give to a volunteer Scout leader for service to youth.

As a movement whose leadership is overwhelmingly volunteer, the Boy Scouts of America recognizes the need to acknowledge those individuals who truly go above and beyond to guarantee a quality Scouting program.

Upon nomination by their local Scout council and with the approval of the National Court of Honor, recipients of this award are registered adult leaders who have made an impact on the lives of youth through service given to the council. These leaders implement the Scouting program and perform community service through hard work, self-sacrifice, dedication, and many years of service

4. Assigning an ADA department to be responsible for the hotline and navigation/ triage system, as well as referral to peer dentists 5. Requiring that all ADA electronic and paper publication advertise this program in all communication indefinitely.

The ADA Wellness Committee will likely submit a detailed proposal to the ADA Council on Dental Practice for action in May. The team may get together again to

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newsflash issue 5, april 2017

newsflash

Health is

preventing disease, not just treating it.

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Kariana Peters, DMD, Managing Dentist

Kelly Musick, Dentist Recruiter kmusick@willamettedental.com Tel: 503.952.2535

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OPPORTUNITIES AVAILABLE

OPPORTUNITIES AVAILABLE

DENTIST NEEDED — Growing general dental offices are seeking caring, competent dentist with great people skills to join our team at greater Seattle area.

Excellent opportunity for potential partnership.

Please email resume to mydental88@gmail.com.

SPOKANE — Seeking full-time general dentist, able to work a varied shift schedule including weekends; must be able to do all aspects of general dentistry including molar endodontics and 3rd molar/surgical extractions; able to adapt to new systems and paradigms; great opportunity to grow and learn; 1-5 years experience preferable. Unlimited income potential! Send resume to Dr. Bradley J. Harken; bradharken@hotmail.com.

DENTIST, COVINGTON — Part time, three days per week available in a busy, fee for service family dental practice. We are looking for an experienced doctor who is energetic, productive, great with patient communication and a team player with other doctors and staff. Must have excellent general and specialty clinical skills including molar endo and oral surgery. Implant placement would be a plus.

Modern office with great staff and compensation.

For more information please email CV to mhoffine@comcast.net.

DENTIST OPPORTUNITY — Central Washington, Seeking experienced dentist for a busy, well established successful multi-specialty group dental practice to work 3+days a week. Come join our professional, modern office and become apart of our wonderful team. Please send resume and direct any inquiries to felixzario509@yahoo.com.

EAST VANCOUVER — Experienced, motivated dentist needed for busy and growing private practice, 4-5 days/week.

Private and state insurances seen. Modern, new equipment, digital office. $10K/month base salary or 30% production.

Email resume or inquire at: drkussad@gmail.com.

OPPORTUNITY AVAILABLE — We are seeking a periodontist to perform periodontal surgeries 1-2 days a month to support two large practices in Snohomish County. We have several cases ready to be scheduled. Please contact Dr. Doug Brajcich at 425334-6912 or email excellentdentalcare@gmail.com.

Thank you!

DENTIST NEEDED — Young, energetic, business minded general dentist wanted in the Bothell/Mill Creek area. Part Time/Full Time option available.

Please email resume to: dmgdentaldesign@gmail. com.

ASSOCIATE — Full-time Associate needed in Tumwater, WA. Partnership is a strong possibility. Great location and most importantly has an experienced caring staff to support you. Please email resume to rbond@cramerbonddentistry.com.

DENTIST NEEDED — Seeking skilled dental associate with 2+ years experience. 3-4 days/week for a general practice. Offices in Lynnwood / North Seattle. Must be able to work on Saturdays. Please send resumes to dentaladsml@gmail.com.

PROMINENT DENTAL PRACTICE — Spokane Washington looking for full time associate. Enthusiastic, hard working dentist desired. Seeking an ideal candidate that is highly skilled, dedicated to providing unmatched patient care and desiring a long term commitment to the practice. Applicants can expect to perform all aspects of dentistry including: root canal therapy, crown and bridge, oral surgery, general restorative and much more. Great pay and benefit. Ownership options available.

Please send resume: employment@sleepdentistryspokane.com visit: sleepdentistryspokane.com.

GENERAL DENTIST ASSOCIATE POSITION — Option to buy. Existing DDS with is looking to be retired within the next year or sooner. This private practice (30+ year patient base) is open Mon-Thurs (Mon-Wed 8-5, and Thurs 9-3). Prefers someone with at least five years of experience. Part time to start, (3 days) building into full time. Substantial patient base! Salary DOQ. Email: lori.leonarddds@outlook.com.

PART TIME ENDODONTIST — Looking for a parttime Endodontist to work a day or two day a month.

Nice modern office located in Bothell Area. Please respond with resume to bellevuedentists@gmail.com.

MATERNITY COVERAGE — Hiking country. In search of general dentist coverage from September 11th, 2017 - October 26th, 2017. The practice is located in Okanogan County with plenty of outdoor activities to fill your free time! Practice hours Mon-Thurs 8-5. Small community with great patients, so chairside manner is crucial. Experience with extractions preferred. Please forward resume or questions to dr.chase@smilesbybrooke.com.

MERGER OPTION — Have you thought of scaling back, retiring, or getting rid of the overhead? We are a solid well established Tacoma office looking for a like-minded merger with your practice or outright buy out. Open to your suggestion and discussion. Let’s talk, we LOVE what we do! All interested parties in greater Tacoma and surrounding areas please email Michelle at topinvisaligndoc@ gmail.com.

DENTISTS NEEDED — Dental Professionals is recruiting dentists for temporary and permanent positions throughout western Washington – Vancouver to Bellingham and the Olympic Peninsula.

No fee to you and you pick the days and geographic locations that you are available to work. This is a great opportunity to earn supplemental income or find a permanent position. If interested please call Bob at (206) 767-4851.

PERIODONTIST NEEDED — Large private group practice in brand new state of the art building looking for part time periodontist in Silverdale, WA. Digital office with CBCT. Thriving practice in need of a specialist to come in 2-4 days per month. Please send CV to silverdaledental@hotmail.com.

MULTI-SPECIALTY GROUP PRACTICE OPPORTUNITIES — At Willamette Dental Group, we believe that health is preventing disease, not just treating it.

When you work at Willamette Dental Group, the organization’s progressive approach frees you to do what matters to you – and to your patients. What makes this multi-specialty group practice unique is a commitment to proactively facilitating the best possible health outcomes. We currently have openings in Oregon and Washington for General Dentists, Endodontists, Oral Surgeons, Pediatric Dentists, and Locum Tenens Dentists, and offer competitive guaranteed compensation, benefits, paid vacation, malpractice insurance, inhouse CEs, and an in-house loan forgiveness program.

Please send your resume to Kelly Musick (kmusick@ willamettedental.com) and visit www.willamettedental.com/careers to learn more!

GENERAL DENTIST, SUNNYSIDE — Full time position. Work beside specialists. Offering a great schedule, great compensation and guarantee. Great opportunity to expand skill set as you work or a perfect opportunity for an experienced dentist to utilize a wide range of skills. For more information, please contact Jolene Babka at jbabka@applesmiles.com.

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ASSOCIATE OPPORTUNITY, YAKIMA — We have a great associate opportunity for a new graduate or a long term home for a seasoned dentist looking to be compensated well with less of the headaches and stress. Group practice composed of general dentists, orthodontists, and oral surgeons. For new grads it’s the perfect opportunity to learn your craft by working side by side with generalists and specialists while being paid very well. Base salary of $150,000 for new grads plus bonuses. Base salary of $175,000 plus bonuses for experienced dentists. Opportunities to earn much more with our full schedules! Both positions have the opportunity to earn well above $200,000. Full benefits package. State of the art clinics and equipment. Mix of children and adult dentistry. Mix of State and private insurance. Full time opportunity available. Moving expense reimbursement offered.

Please send inquiries to jbabka@applesmiles.com.

FULL-TIME ASSOCIATE IN BELLEVUE — We are looking for full time associate in Bellevue to work 4+ days a week . 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.

Ready to learn and be a part of the team. Outstanding earning potential. Please email resume to bellevuedentists@gmail.com.

DENTIST NEEDED — Join our mission driven team of ten dentists and well trained support staff in providing quality, comprehensive general and restorative dental care to our patients. 4/10 hour workdays provide a good life work balance and the opportunity to enjoy the areas recreational activities with your family. Comprehensive benefits, sign on bonus, Employer match 401(k), relocation, generous paid leave and CDE. HPSA score 23. Potential for loan repayment. Start date: September 2016. For more information contact : Colleen Hazel, PHR, HR Generalist / 509.764.6105/chazel@mlchc.org. Or visit our website at www.mlchc.org to apply online.

DENTIST NEEDED — Yakima Neighborhood Health Services (YNHS), a Community Health Center in Central Washington State, is looking for a full time dentist to serve low income and underserved individuals and families in a new dental clinic in Granger, WA. Provide full scope preventive and restorative care all ages, six months to elderly. YNHS is an eligible site for National Health Service Corp and Washington State Health Professional loan repayment programs. YNHS also has a special focus to serve the homeless of Yakima County. Dental providers work alongside committed HCH staff to care for high needs homeless individuals. Full time for providers is 40 hours per week. YNHS offers a competitive compensation package, inclusive of malpractice coverage, paid leave, CME, retirement / life / disability. See our website at www.ynhs.org for the breadth in our services and diversity in our staff. We are looking for individuals who share a sense of compassion for the underserved, and passion for quality.

classifieds issue 5, april 2017

OPPORTUNITIES AVAILABLE

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PART- TIME DENTIST — Needed 2-3 days per week in Spokane Valley general practice. We value someone with excellent clinical and interpersonal skills to join North Pines Dental Care. Please email: rosemaryosborn@comcast.net.

GENERAL DENTIST, TRI CITIES — Great associate opportunity for a new graduate or a long term home for a seasoned dentist looking to be compensated well with less of the headaches and stress. Group practice composed of general dentists, orthodontists, and oral surgeons. For new grads it’s the perfect opportunity to learn your craft by working side by side with generalists and specialists while being paid very well. Base salary of $150,000 for new grads plus bonuses. Base salary of $175,000 plus bonuses for experienced dentists. Full benefits package and moving allowance. State of the art clinics and equipment.

Mix of children and adult dentistry. Mix of state and private insurance. Position available in coveted Pasco, Washington facility this Spring. Please send inquiries to jbabka@applesmiles.com.

DENTIST NEEDED — Associate/partner dentist wanted in Silverdale. Wonderful staff. I have practiced in the area for 17 years. Third office here has been open five years and is doing well. Joe Ostheller DDS. (360) 471-6608. Text me!

GENERAL DENTIST REQUESTED, MAPLE VALLEY — Our multi-doctor, family practice is looking for an outgoing, professional doctor skilled in all aspects of dentistry to join our team. Our beautiful, modern office has been providing excellent dental care to our ever growing community for over 10 years. We offer a generous compensation package along with the opportunity to work with an established, efficient and personable team.

Please email your resume to wendyloconnell@yahoo.com or you may fax it to 425-413-8599.

DENTIST OPPORTUNITY IN WESTERN 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.

GENERAL DENTIST, SPOKANE — We have a great associate opportunity for a new graduate or a long term home for a seasoned dentist looking to be compensated well with less of the headaches and stress. Group practice composed of general dentists, orthodontists, and oral surgeons. For new grads it’s the perfect opportunity to learn your craft by working side by side with generalists and specialists while being paid very well. Base salary of up to $150,000 for new grads plus bonuses.

Base salary of $175,000 plus bonuses for experienced dentists. Opportunies to earn much more with our full schedules! Full benefits package and moving allowance. State of the art clinics and equipment. Mix of children and adult dentistry.

Mix of State and private insurance. Full time and part time opportunities available. Moving expense reimbursement offered. Please send inquiries to jbabka@applesmiles.com.

OPPORTUNITIES AVAILABLE

OPPORTUNITIES WANTED

NORTH CENTRAL WASHINGTON PEDIATRIC — Outstanding Opportunity. Pediatric Dentists needed for Associateship Wenatchee Valley Dental Village is a large private group practice and is seeking two or three pediatric dentists to join our busy and well-established 10-chair office. We provide comprehensive, quality-focused dental services to pediatrics and adolescents, including endodontics and in-office general anesthesia. Our experienced, bilingual staffing model consists of hygiene assisted restorative care for efficiency and stress management. The ideal candidate should be energetic, motivated and share a passion for treating children of all ages. Interpersonal and technical skills with strong work ethics and moral values are a requirement. Experienced current owners are willing to mentor. E xcellent compensation with a bonus program, 401(k), vacation, holidays, continuing education allowance, medical and malpractice insurance. Call Anne at (509) 886-2500 or email aknappert@wvdentalvillage.com.

OPPORTUNITY WANTED — 2016 USC graduate looking for an Endodontist position in Endodontic office or GP office. View my CV here: docs.google. com/document/d/1363Zn09JEFt8Jfxw1AlTfDpfU GZKBgBR0VgMMDaMuFs/edit?usp=sharing.

OPPORTUNITIES WANTED DENTIST NEEDED — Thriving high tech dental practice in healthy, growing community has a position for part-time general dentist. We desire to bring on a younger practitioner who wishes to associate in anticipation of a buy out or a mature dentist who would like to keep his or her skills up by working two or three days per week in an environment on the Olympic Peninsula that includes diverse recreational opportunities and a relaxed pace of life. Email dentalpracticeopportunity2@ gmail.com for more information.

POSITION WANTED — Successful practitioner/owner for almost 30 years. Currently seeking non-ownership dentist position. Part or full time. Willing to learn/adapt to established office protocol. drive.google.com/ file/d/0BxyJ9WnvqXMSOXB3azVhWXBHVGc/ view?ths=true.

PART TIME POSITION WANTED —Dentist with advanced training, based in Lynwood area, seeking part-time employment, 1-2 days a week.

Willing to make a reasonable commute. Flexible on days, Saturdays are an option. Please contact dentalcare855@gmail.com.

PART TIME WORK WANTED — Endodontist with seven years experience seeks part-time associate position. Puget Sound area preferred. Available from late June 2017. Contact conveygav@ msn.com.

OPPORTUNITY WANTED — University of Washington RIDE graduate looking for a part time associate position in the Seattle area. View my CV here: https://docs.google.com/document/d/1Lo34mcSje oNOakGekjmGrqQFXHlbP-GIfU3zT9t5Glg/pub.

OPPORTUNITY WANTED — 2016 University of Illinois Chicago, College of Dentistry graduate looking for a general dentist position in the Seattle area. View my CV here: http://drive.google.com/op en?id=0B6blGvDOSE36NTFOckdwY2lDME0.

ASSOCIATESHIP — Seeking Associateship in Whatcom County-Graduated from Tufts University School of Dental Medicine, 2016. View my CV here: drive.google.com/file/ d/0BxLG0RUgFDpnUlNNamNqdF9vbDg/view.

th e wsda ne w s · issue 5, april · 2017 · www.wsda.org · 41

OPPORTUNITY WANTED — 2016 Roseman University Of Health Sciences graduate looking for a general dentist position in Washington. View my CV here: http://drive.google.com/file/d/0B4KsU4tgzcZRnRselIzWHVyMm8/view?usp=sharing.

OPPORTUNITY WANTED — 2017 University of Pittsburgh School of Dental Medicine graduate looking for a general dentist position within 30 miles of Seattle. View my CV here: https://www.scribd.com/document/339699684/ Resume-Smriti-Madrecha?secret_ password=lSKuVegqZIA6bMM6os3G OFFICES FOR SALE OR LEASE FOR SALE OR SUBLEASE — Attractive, fully equipped, modern five operatory dental office in UW/Laurelhurst area. Exceptionally well-designed, and maintained – 1,900+ sf office with separate consultation op, sterilization room, private office for two DDS, handicap bathroom, full laboratory for technicians, and staff room. Attractive 3rd floor location provides excellent natural lighting in every operatory. Sale includes all dental and office equipment (dental chairs, lights, units, handpieces, instruments, x-ray equipment, office furniture and built-in cabinetry throughout, plus everything else that makes this office “truly turnkey.” Office appraised above $250,000; listing for $210,000 and open to all offers. Excellent value for relocation of established DDS or starter office for new grad. Email rleemfp@gmail.com for photos and additional information or call/text 206-949-2958.

SHORT SALE? — DRS-360 specializes in short sales. If you are upside-down in your dental practice and are hemorrhaging cash, please contact us for a Free Consultation at: 844-377-3601 or by email: info@DRS-360.com.

FOR LEASE — 3000 SF space in Class A building close to Swedish Edmonds Hospital available immediately. Ideal for dental specialist. Building has a GP, endodontist and pediatric dentist. Favorable TI allowance and rental rates. Call Grace 425-220-0564.

GENERAL PRACTICE FOR SALE — South King County. Large, profitable multi-disciplinary practice. Digital radiography. I-V Sedation. Separate digital pan/lateral ceph. CBCT. CEREC. Approximately 5,000 sq/feet. For more information contact: Jennifer Paine: (425) 216-1612 or Jennifer@ cpa4dds.com.

GENERAL PRACTICE FOR SALE — South Snohomish County. Fantastic visibility within close proximity to aerospace giant. Collecting $625K. 3 fully-equipped operatories. Lab. 1,000 sq/ft (approximate). For more information contact: Jennifer Paine at (425) 216-1612 or Jennifer@cpa4dds.com.

classifieds issue 5, april 2017

OPPORTUNITIES AVAILABLE

clinical corner issue 5, april 2017

CLINICAL CORNER Generalized and persistent oral surface ulcerations Contributed by

Dr. Edward Truelove, Oral Medicine, UW-SOD, Seattle, WA

History of present illness

This is a 44-year-old black female who presented with generalized oral ulcers that had been present since September 2016 (Figure 1). Her complaint started in February 2016 with an intermittent, persistent sore throat for several months that did not respond to antibiotics treatment. In September she developed multiple, generalized painful oral ulcers that made it difficult for her to eat; as a result, she lost 34 lbs. At that time, she also noted abdominal and thigh ulcers and developed pain and redness in her eyes. The eye lesions responded to prednisone eye drops. The patient’s past medical history is significant for sickle cell trait but she is otherwise healthy. She denies medication allergies.

Test your knowledge!

Visit https://dental.washington.edu/oral-pathology/case-of-themonth/ and see if your assessment of the case is correct.

Figure 1

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OFFICES FOR SALE OR LEASE

OFFICES FOR SALE OR LEASE

GENERAL PRACTICE FOR SALE — Eastside/ North. State-of-the-art office located in a prime medical-dental area of the eastside. Three fullyequipped operatories w/room for one additional.

1,685 sq/ft (approximate). Collecting 516K. Nitrous.

Digital x-rays. Softt issue laser. Intra-oral camera.

Treatment includes: adult prophylaxis; pediatric; root planing; periodontal maintenance; composite/ metal-free fillings; crowns/bridges; veneers; dental implants; root canals; mouth-guards; bite balancing. For more information contact: Jennifer Paine at (425) 216-1612 or Jennifer@cpa4dds.com.

FOR SALE, BELLEVUE — Ideal for a specialist or a general dentist start-up. Beautiful turn-key dental space for sale in Bellevue, top quality construction, DanNix design. Located on the growing Bel-Red corridor close to Microsoft, 520, new multi-family development, and the new REI corporate headquarters. Fully equipped with three operatories, all ADEC, Pano, plumbed nitrous, and separate storage space with compressor. The lease term is excellent and structured simply with base monthly rent. There is no triple NNN pass through for expenses. Please contact financial@ belmoddental.com for more details.

G/P PRACTICE FOR SALE, FEDERAL WAY — Annual revenues over $740,000. Annual revenues have increased each year over the last three years.

This practice generates a lot of cash flow. Four fully equipped operatories plus plumbed for one more.

Digital X-rays and a new computer system. Well established practice that has been located in the same location for the last 12 years. The building is located on Pacific Hwy S. which is one of busiest thoroughfares in Federal Way. Building has great visibility and signage directly on the Pacific Hwy. Contact: Buck Reasor, DMD, bucjbucxkReasor Professional Dental Services, info@reasorprofessionaldental.com. 503-680-4366.

DENTAL PRACTICE FOR SALE — Wenatchee WA. Modern downtown office. collection over $672K average last three years. 3.5 days week. Doing basic dentistry. Room to grow. Low overhead Asking $450k parkbus@live.com.

PERIODONTAL/RESTORATIVE PRACTICE FOR SALE — Kitsap County, WA. Turn-key. $683K production. Digital, Piezo, Nobel/Straumann Implant Systems. Active periodontal/restorative patients.

Build referral practice starting with immediate income producing patients. PPIC95@icloud.com.

GENERAL DENTIST OFFICE FOR SALE DOWNTOWN SEATTLE — Premier 30 years established, 10 Operatories, 4 hygienists. Cerec, CBCT, ITero, Solea, Microscope, Digital, Paperless. Bright modern office in heart of the city. Wonderful experienced staff. Strong Implant and Surgical component. Premier Invisalign Provider. In-office lab. Will transition if desired. Please contact: k1100rs@icloud.com.

FOR LEASE — 2500 SF brand new retail space ideal for oral ortho/Oral surgeon, hard corner with traffic lights in Mill Creek. Retail is part of a new housing project with over 350 apartments. High growth area. General dentist and pedodontist moving in soon. Inquiries@ parmpal32@hotmail. com or call 425-442-9798.

FOR SALE, VANCOUVER — General dentistry practice for sale in Vancouver WA. Practice is well established and has been in the same location since 1980s. Practice has low rent and low overhead. Three operatories, paperless, digital ( dexis) X rays, wireless intraoral camera. Practice is in a busy intersection across from Safeway. Annual collections $ 430,000. Well trained staff. Please email indentation534@gmail.com.

FOR LEASE — Beautiful first floor office in a three story professional building. Has been the location for an Oral and Maxillofacial surgeon for nearly 30 years. Two surgical and three exam rooms with lots of parking. Post op room and private door to drive up. One block from Medical center and hospital. Park like setting with private gardens and floor to ceiling windows. Owner of the building is a General Dentist who is an owner occupant. Also an endodontist, orthodontist and other general dentists in the building.

There is a need for another Oral surgeon in the valley!

Owner will make the lease attractive. Call for more details and a showing. (509) 670-7593.

EASTERN WASHINGTON CHELAN — Practice for sale. Established 1978. New building and equipment 2006. Four complete ops, 1500 sq.ft building, digital x-rays and pano. By owner/ dentist. Doctor wishes to retire. Will stay to transition new doctor. Reply: crgav523@aol.com.

FOR LEASE — Excellent terms. Well-located, fullyequipped dental office at 7317 NE 141st Street, Kirkland, WA, serving fast-growing Juanita/Kenmore/ Bothell/Woodinville. The space, designed by Officewraps, accommodates 4-5 patient chairs, x-ray, consult room. Contact: Ann Bishop 425.278.6308 bishop@wallaceproperties.com. Request brochure.

FOR SALE — General practice in Battle Ground WA. Three fully equipped operatories, busy main street location. Contact Vicki at (360) 521-8057 or lyledkelstrom@gmail.com.

FOR SALE — Associate needed for GP with intent to purchase: Classy four ops, Eaglesoft, updated equipment. Northend Seattle professional center, near two I-5 exits & Aurora Ave. Gross $200K+, 400+ pts. Motivated seller. Please contact me with any questions.

Danette Hamilton,RDH (425) 208-5391.

NEW LISTING - Top of the line dental office for lease with high-quality finishes. Very convenient location right off of I-405 in Bellevue. The dental office is 1,242 SF with four operatories. Plenty of parking stalls for patients and staff, ADA access.

Email Steve Kikikis steve@omni-pg.com.

GP PRACTICE FOR SALE, WEST SEATTLE — Annual collections over $1,100,000. Five fully equipped operatories. Outstanding and productive hygiene program. Digital pano. Well established practice that has been in the same location for 37 years. Well trained and experienced staff will continue and assist with the transition. Contact: Buck Reasor, DMD, Reasor Professional Dental Services, info@reasorprofessionaldental.com, (503) 680-4366 G/P PRACTICE FOR SALE IN LINCOLN COUNTY — Annual collections over $430,000. Four operatories, doctor works three days per week.

Practice is located within 35 miles of Spokane.

Practice has been in same location since mid-60’s.

Doctor owns the building and will sell it now or in the future. Well-trained staff will assist with the transition and will stay with the practice after the transition. Well-established practice with an excellent collection policy in place. Excellent cash flow for a practice of this size. Please contact Buck Reasor, DMD, cell: 503-680-4366, Fax: 888317-7231, email :info@ reasorprofessionaldental. com, www.reasorprofessionaldental.com. PO Box 14276, Portland, OR 97293.

TOP OF THE LINE — Dental office for lease with high-quality finishes. Very convenient location right off of I-405 in Bellevue. The dental office is 1,242 SF with 4four operatories. Plenty of parking stalls for patients and staff, ADA access. Email Steve Kikikis steve@omni-pg.com.

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FOR LEASE — Built out dental space available for lease downtown Redmond Washington. Some equipment in place. Flexible terms. Up to six operatories, business office, and personal office. Contact Dr. Rod Robinson at (425) 822-6279.

NEW­— Pediatric Dental Practice For Sale in Pierce County. Annual collections of $450k. Great location! E-mail rod@omni-pg.com.

FOR LEASE – Maple Valley Dental office for lease. start-up or move your existing practice. Fully built out with five operatories, Plenty of parking in plaza. Approximately 1,524 sq. ft. with favorable lease terms. Email Steve Kikikis steve@omni-pg.com.

FOR LEASE — Highly visible Lynnwood Dental office for lease. Plumbed for four operatories, including nitrous and O2. 1,400 sq.ft. $24 per sq.ft and $3.62 NNN. email Steve Kikikis steve@omnipg.com.

FOR SALE — Investment opportunity in Maple Valley for sale. Mix of office and retail uses Asking price is 1.4 million for this visible building on .95 acres is 6,400 sq.ft Contact Steve Kikikis at steve@ omni-pg.com.

FOR SALE — Whatcom County General Dental Practice For Sale – Located in busy shopping complex and growing area. Annual collections over $500,000. Four equipped operatories, lots of opportunity for growth. Contact Rod Johnston @ rod@omni-pg.com.

FOR SALE — Price Reduced - South Sound Perio practice and real estate available for sale. Collections over $1.5 million. Great referrals and low overhead. Building is also for sale. Call Rod at Omni 206-979-2660 or rod@omni-pg.com.

FOR SALE — Grays Harbor - Fee For Service General Dental practice for sale. Annual collections over $200,000, four operatories, lots of parking on busy street. Contact Rod Johnston of Omni Practice Group at 206-979-2660 or e-mail rod@ omni-pg.com.

FOR SALE — West Olympic Peninsula General dental practice for sale. Annual collections over $800,000 on 3 days per week. Doctor and hygiene booked several weeks out. Only dentist in town.

Building also for sale. Contact Rod Johnston of Omni Practice Group at rod@omni-pg.com.

OUTDOOR LIFESTYLE — For sale with general dental practice. Work 3 days/wk with little competition, enjoy the outdoors the other 4 days/week.

Annual collections over $400k without trying.

Low overhead. Contact Jim Vander Mey at jim@ omni-pg.com

classifieds issue 5, april 2017

OFFICES FOR SALE OR LEASE

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OFFICES FOR SALE OR LEASE

EQUIPMENT FOR SALE

NEW LISTING – Bellevue dental office space up to 3,204 sq. ft. Plumbed for 7 operatories. Great parking and signage. Close to Microsoft, Group Health and other eastside businesses. Contact Steve at steve@omni-pg.com.

FOR SALE — Tukwila. Newly upgraded dental practice in Tukwila for sale. $725,500.00. Six ops with the latest in imaging upgrades, new computers, software and hand pieces. One of the last feefor-service practices left. Seller will pay for new floor covering throughout, leave the security deposit for the new buyer on the lease assessment and help with the transition. Call today for a tour.

Annie Miller, (206)-715-1444.

FOR SALE — Mobile Dental Office Equipment For Sale — AMC-20 Aseptico dental unit with fiber optic handpieces, curing light and scaler. Schick Digital Radiography with handheld Nomad X-ray gun. A-Dec dental chair and Stat-Im sterilizer.

Two dental carts full of dental supplies and instruments for a turn-key mobile practice, all contained in a 2013 Chevrolet Cargo Van. Email michelle@ michellecaldier.com for more information.

AVAILABLE, SOUTHCENTER — Just available.

1200 square foot fully equipped 4 operatory dental space. Cerec , Panoral, 4 chairs, lights, nitrous, air and vacuum all available and in place. Please call Dr. Jerome Baruffi at Medical Centers Management (206) 575-1551.

INTRAORAL X-RAY SENSOR REPAIR — We specialize in repairing Kodak/Carestream, Dexis, Gendex and Schick CDR sensors. Repair and save thousands over replacement cost. We purchase old/broken sensors. www.RepairSensor.com / (919) 924-8559.

NEW LISTING – Fully equipped dental office for sale in Arlington. Three operatories, dental chairs, and sterilization, equipment included in purchase.

No Patients Included. Approx. 950 sq. ft plus storage room. Asking $180,000. Email Steve Kikikis steve@omni-pg.com NEW LISTING – North Whatcom County general dental practice for sale. Annual collections of $400,000. Located next to Starbucks on busy street.

Newer equipment, pano, etc., Beautiful city on the Canadian border. E-mail rod@omni-pg.com.

FOR SALE — Marysville Medical Office Building with two additional tax lots for sale. Well kept 6,600+ medical building with three dental tenants in place. Residential home included in the sale.

Contact Steve Kikikis at 877.866.6053 ext 3 or Steve@omni-pg.com.

BELLEVUE/FACTORIA general dentistry/specialist office for lease. 1,249 sq. ft. 3-ops. (Or, 2,100 sq. ft. for ? ops) Winner location. Easy I-90/I-405 frwy access. Across the street from Factoria Mall.

15’ pole sign by Factoria Blvd. available. T.I. required for conversion. Landlord will contribute to concession (206) 915-2263 Mark.

BELLEVUE — General practice for sale in Lake Hills neighborhood. 20+ years. Great location with good street visibility. Three chairs with room for four, approx. 1,500 sq. ft. , fully digitized, Dentrix, Invisalign, mostly adult restorative and families. Ave. 600k+ annual production, staff wlling to stay, doctor will work through transition. Please reply to: Piega@delaneytransitions/ (425) 890-8271.

FOR LEASE, OLYMPIA — Ideal location on Martin Way near St. Peter Hospital, 2,000+ sq. ft. Five ops including chairs, panex and more. Perfect for startup/ satellite office, future purchase possible. Contact Don at uncledgh@aol.com.

YAKIMA/SUNNYSIDE — We have a great associate opportunity for a new graduate or a long term home for a seasoned dentist looking to be compensated well with less of the headaches and stress. Group practice composed of general dentists, orthodontists, and oral surgeons. For new grads it’s the perfect opportunity to learn your craft by working side by side with generalists and specialists while being paid very well. Base salary starting at $165,000 plus bonuses. Full benefits package and moving allowance. State of the art clinics and equipment. Mix of children and adult dentistry.

Mix of State and private insurance. Position available in Yakima/Sunnyside, Washington. Come try out the East side of the state where there’s 300+ days of sunshine, beautiful landscaping, the gorgeous Columbia River and family friendly communities! Please send inquiries to jbabka@applesmiles.com.

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 — Quality professional office Space for lease in the heart of the Renton Highlands in the Highlands Professional Plaza medical dental building. Excellent place for an oral surgeon and/ or endodontist to open a satellite office or start up practice. Currently there are two GP dentists, a pedodontist, an orthodontist and a large physical therapy clinic. This building has a proven track record of successful businesses because of its location and quality. The building sits across the street from Bartells, QFC, and Starbucks. There are six elementary schools and four high schools within two miles. Get close to where the people live and enjoy fast practice growth. Call (206) 595-9100.

FOR IMMEDIATE OCCUPANCY — A fully plumbed dental office. 1,350 sq ft , three operatories, air, water, vacuum, nitrous oxide and oxygen, private office, lab, staff lounge, separate staff entrance. This office has exceptional exposure to the Southcenter Mall traffic. Please call Dr. Jerome Baruffi at Medical Centers Management (206) 575-1551.

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:// cascade-dental.net.

OFFICE CONSTRUCTION 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 www.constantinebuilders.com for additional information and how you can become another satisfied client. Telephone (206) 957-4400, O. George Constantine.

SERVICES 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 over 19 years experience providing safe IV Conscious Sedation. Serving Washington and Oregon. Richard Garay, DDS. (360) 281-0204, garaydds@gmail.com.

EQUIPMENT FOR SALE FOR SALE — Rayscan 3D CBCT machine (Rayscan Alpha – EXPERT3D) Owned our previous machine for seven years. Purchased this one new for $65K, as it had similar capabilities. Later realized we want to upgrade for more features. Less than one year old, low shot count, still under parts warranty. (360) 692-0300 (Silverdale, WA).

DENTAL EQUIPMENT FROM REMODEL — Rolling chairs, valves, compression gauges, tools, towel and glove dispensers, computer, grinding equipment, pluming parts, loads of cabinets with formica interiors. Make offer. Chris 206 595-5791 FOR SALE: Gently used 2yr-old Digital Pano (Instrumentarium OP30)- $17k This unit has the Extra-Oral Bitewing program as well as TMJ Projection. The images are brilliant and easy to diagnose from. Buyer responsible for cost of moving, installing and insurance for the move. admin@ UptownDentalGigHarbor.com.

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CLASSIFIED ADS IN THE WSDA NEWS Visit wsda.org/news/classifieds/ to place your ad and select the issues you would like your ad to run in. Follow up your submission with a phone call to Rob at (206) 9735220 to submit your credit card information (sorry, no check payments), and your ad will be placed.

Sell your practice or fill a position quickly?

Don’t worry, you’re only charged for the ads that run. We’re flexible, and the process is painless and cost effective.

Pricing is as follows: Members: $50 for the first 30 words, $1 per word for each word over 30.

Non-members: $100 for the first 30 words, $1 per word for each word over 30.

classifieds issue 5, april 2017

OFFICES FOR SALE OR LEASE

first person dr. joseph vaughn

Prescribing smarter: How we can influence the opioid crisis

Dr. Joseph Vaughn Editorial Advisory Board

“At the end of the day, the decision is up to you, the doctor.

But with those three letters after your name comes a lot of responsibility.

Will you own it?“

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

Painkillers. Opioids. Drugs.

Are they on your mind today? Because they’re on mine.

With every walk-in. With every extraction. With every patient who looks me in the eye and says, “Doc, can I get a little something for pain?”

“Sure,” I say. And then I walk back to my computer, stare at my screen, and wonder what to do. What do I give? How much? Do they really need it?

I don’t know about you, but my answers have certainly changed.

A few months ago, my prescription pad was a carefree, generous space. I wanted my patients comfortable. I wanted them pain-free. I wanted a “good-experiences-only” policy.

So I took care of their pain and, in turn, thought I was taking care of my patients.

Vicodin, Percocet, Norco, Oxy, hydro. . . usually whatever the patient requested. If I took a tooth out, they got a narcotic. If they walked in with pain, they got a narcotic. We’re not talking outrageous amounts here. But in these moments, this is what I thought good healthcare looked like.

And now things look much different in the space where I practice. I still take teeth out every day, but opioids are few and far between.

Why? Well, it’s experience. Good ole anecdotal evidence. It’s discussions with colleagues.

And then it’s being a part of an organization that has committed to help control the opioid crisis in America.

In residency, we didn’t think about consequences. We didn’t even realize the consequences. And like a lot of dentists in our country, we didn’t think we belonged in a conversation about the opioid crisis. That’s a physician problem.

And then I saw a stat that said dentists prescribe 12 percent of America’s instant-release opioids. Only second to family physicians, who prescribe 15 percent.

And then I joined Neighborcare Health, who makes it their duty to help limit the amount of pills floating around Seattle. And so we greatly restrict our prescribing protocol.

And then four months ago, I found my hands pressing on the sternum of an unconscious woman as I gave her CPR while her 8-year-old son watched in tears from the corner of the room, only minutes after finding his pale blue mother on the couch and yelling for someone to help.

And as the paramedics arrived and assessed her, I heard one of them ask for “Narcan” just before escorting me out of the room.

Narcan.

It’s a reversal agent for opioid overdose. And so only a few minutes kept this family of three from becoming a family of two.

It doesn’t take extremes like this to prove that opioid use and abuse is a real problem that affects our world every day. We can help. And we should help. How? By caring enough not to over-prescribe. Avoid prescribing opioids to patients you haven’t treated. Never prescribe opioids without talking to a patient about what to do with the unused pills.

Don’t start with opioids, end there. There’s plenty of literature to suggest that ibuprofen and other NSAIDs are just as effective in post-extraction pain management. I always start with NSAIDs and then manage breakthrough pain with opioids on a limited basis. And 9 times out of 10, ibuprofen proves to be enough.

At the end of the day, the decision is up to you, the doctor. But with those three letters after your name comes a lot of responsibility. Will you own it?

Just the other day a patient presented to me for extractions. I had already extracted four teeth on him and had prescribed ibuprofen each time. Up to this point, he had never returned after an extraction asking for more meds. The ibuprofen was enough.

On this day, however, he told me that he went to the ER over the weekend, was seen by a dental resident, and had a tooth removed. Out of curiosity, I asked him what type of pain meds they gave him.

“Percocet. . . 24 of them.”

As tough as it is to admit, sometimes we are part of the problem. And so today, I ask for the help of all the new dentists out there. Show your patients compassion, not by prescribing more, but by prescribing smart.

Additional resources: 1. ADA Statement on the Use of Opioids in the Treatment of Dental Pain http://www.ada.org/en/about-the-ada/ada-positions-policies-and-statements/statement-on-opioids-dental-pain 2. Prevention of prescription opioid abuse: The role of the dentist http://jada.ada.org/article/S0002-8177(14)62264-9/fulltext

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THE OBVIOUS CHOICE

FOR WASHINGTON DENTISTS Trustworthy Just as your patients trust you, Matt and Kerri are trusted by their clients because they specialize in insurance products for dentists.

Reliable Matt and Kerri have years of experience advising dentists about insurance. They’ve been able to build and nurture solid relationships because they deliver service excellence time and time again.

Knowledgeable The WDIA Team will help you make informed decisions about the insurance policies you need no matter what career stage you’re in.

YOUR WDIA TEAM: Matt French · Kerri Seims 206.441.6824 · 800.282.9342 www.wdiains.com

Sole broker for:

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Washington State Dental Association 126 NW Canal Street Seattle, WA 98107

PRESORTED STANDARD U.S. POSTAGE PA ID SEATTLE, WA PERMIT NO. 8115

CHANGE SERVICE REQUESTED

We're not the norm…

Anytime we discover exposures our doctors are facing beyond professional liability, we work to develop and offer exceptional dentist-specific products.

For instance, NORDIC was one of the first northwest companies to offer dentists comprehensive cyber risk coverage.

Can the big box companies say that?

For more information about cyber coverage, call ……

NORDIC – the Gold Standard

800-662-4075 nordicins.com melissa.sanchez@nordicins.com

Sole broker for NORDIC

Endorsed by

4 8 · th e wsda ne w s · issue 5, april · 2017 · www.wsda.org