2014 membership quarterly fall

MEMBERSHIP

Quarterly FALL 2014

VOL 13 / ISSUE 1

inside...

The President’s Message SKCDS Recognizes UW Affiliate Faculty Members 2015-16 Elective Office Openings Announced 2201 Sixth Ave. Suite 1210 Seattle, WA 98121-1831 206.448.6620 www.skcds.org

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Seattle-King County Dental Society Membership Quarterly Managing Editor: Ms. Sandra R. Anderson Contributors: Ms. Jennifer L. Freimund Dr. Gary E. Heyamoto Dr. Alan M. Munk Publisher: Bill Newcomer, BNC Printing & Graphics, Vancouver, WA

FALL 2014 Volume 13, Issue 1

CONTENTS

President’s Message with Dr. Audrey Tatt .......................................................... 4 SKCDS Recognizes UW Affiliate Faculty Members ............................................... 5 2015-2016 Elective Office Openings Annouonced .............................................. 6 COMMUNICATIONS COMMITTEE UW Students Volunteer in Jamaica...................................................................... 7 Dr. Shane Ness, Chair Welcome New Members .................................................................................. 9 Dr. Victor Barry Dr. Daniel Geare Viewpoint: Biting Bad......................................................................................10 Dr. Gary Heyamoto Great Gatsby Gala..........................................................................................11 Dr. Molly McIntosh SKCDS Member is a Regular MTI Volunteer ..........................................................12 Dr. Christopher Pickel

Oral extraction clinic receives Golden Apple award ..................................................13 Dr. Oleg Shvartsur Congratulations ............................................................................................ 14 Dr. Douglas Walsh Dr. Judson Werner New Opportunities to Get Involved In Local Schools ..........................................15 Dental Action Day 2015 In February!..................................................................17 OFFICERS ADA/DQAC Regulatory Updates .......................................................................17 Dr. Audrey K. Tatt, President Proposed Bylaws Changes............................................................................. 19 Dr. Judson A. Werner, President-elect Dr. Patrick E. Taylor, Past President Wage/Economic Survey for SKCDS Dentist..........................................................19 Dr. Timothy A. Hess, Treasurer Exposures with Dr. Al Munk ............................................................................. 22 Dr. Elaine B. Lam, Secretary EXECUTIVE COUNCIL Dr. Ryan M. Fox, Executive Council 2015 Dr. James W. Reid, Executive Council 2015 Dr. Joseph A. Schneider, Executive Council 2015 Dr. Shane T. Ness, Executive Council 2016 Dr. Kimberly A. Winton, Executive Council 2016 Dr. Noah Letwin, Executive Council 2017 Dr. Megan L. Mulligan, Executive Council 2017 Ms. Jennifer Freimund, Executive Director Change of Address: To ensure continued receipt of issues, change of address must be reported to: SKCDS Central Office, 2201 6th Ave., Suite 1210, Seattle, WA 98121, as soon as possible -206.448-6620. Email: skcds@skcds.com The information in this publication is for the exclusive benefit of SeattleKing County Dental Society members. Neither the Society nor the publisher makes any express or implied warranties as to the information herein, including the contents of any advertising. Opinions in the Quarterly do not necessarily express the official policies of the Seattle-King County Dental Society, nor the opinions of the editor, unless so stated. Publications of advertising is not an endorsement, qualification, approval or guarantee of either advertisers or product.

For advertising and publishing details, contact: Mr. Bill Newcomer, BNC Printing & Graphics, 503.318.5916, 360.573.1201, bill@bncprinting.com; www.bncprinting.com

THANK YOU TO OUR ADVERTISERS Max Technologies ........................................................................................... 2 O’Brien Dental Labs, Inc. ................................................................................. 5 WDIA ........................................................................................................ 6 Flateez .........................................................................................................8 NORDIC ........................................................................................................ 8 Pacific Continental Bank ....................................................................................9 Shikosha Dental Lab.................................................................................... 11 AFTCO ......................................................................................................... 13 Dental Employment Services .......................................................................... 15 Mobile I.V. Sedation....................................................................................... 15 Sleep Apnea and Facial Pain Center ................................................................. 15 Robert L. Horchover Sleep Apnea & Snoring ..................................................... 16 Dental Professionals .......................................................................................16 Keller ~ Rohrback Law Firm ............................................................................... 16 Dental & Medical Staffing.................................................................................17 Durham Law Office .........................................................................................17 Home Owners Club .........................................................................................18 Nakanishi .....................................................................................................20 DP Incorporated........................................................................................... 21 Dental Group ................................................................................................. 23 Constantine Builders ..................................................................................... 24

2014 SKCDS FALL QUARTERLY l 3

The

President’s Message

care in an emergency room has sparked attention nationwide. We were recently awarded the Golden Apple for Excellence in Access to Dental Care by the ADA. When I listened to Amy and Bart speak at the dinner in their honor at the House of Delegates meeting in Vancouver, what struck me was their humility and the number of people they thanked. They have been instrumental in several programs that help the underserved, yet it has taken a team.

The Seattle-King County Dental Foundation awards grants to programs like the SCSC that help eliminate dental infection and pain among King County residents. The money for these grants comes from donations. Our big fundraiser is coming up on November 15th. The Gala should be a great event filled with fun and with the hope of raising a lot of money to continue our mission. If you cannot make it to the event (it is already sold out!) your donation would be most welcome.

Dr. Audrey Tatt

It’s time to give. Thanks!

With Thanksgiving and the holidays rapidly approaching, it is a great time to reflect and give thanks. I would also like to challenge you to give more of yourself. While dentistry has had its share of challenges recently, it is still one of the best professions and one that I am happy to be part of.

By the time you read this, the R.A.M. (Remote Area Medical) event will have taken place in the not so remote area of downtown Seattle. Why Seattle?

R.A.M. was invited by the Seattle Center to help serve our many adults who have not sought dental treatment because of financial barriers. I would like to give thanks to Dr. Jeff Parrish and Dr. Mike Karr, who helped organize the event, and to all the dental professionals who volunteered their time and provided treatment. The goal coming out of R.A.M. is to establish dental homes for these patients. As I write, the Children’s Alliance is gathering support for a midlevel provider in Washington. They are using R.A.M., with the long lines of people waiting for free dental care, as fuel for their solution to access problems in Washington. The midlevel provider bill is something we will continue to fight. You can lend your support by talking with your local legislators, or giving to their campaigns. I’m hoping that by the time you read this Dr. Michelle Caldier will be the new state representative for 26th Legislative District. Wouldn’t it be great to have a dentist in Olympia? There are many of our members who have been politically active, and I would like to say thank you. I would like to invite all of you to Dental Action Day in Olympia on February 20, 2015. (see page 17 for more details) Working hard on solutions to access that work are the recipients of WSDA Citizen of the Year: Dr. Amy Winston and Dr. Bart Johnson. The creation of the Swedish Community Specialty Clinic (SCSC) has resulted in over a million dollars of dental care provided. This model of treatment rather than palliative 4 l 2014 SKCDS FALL QUARTERLY

Perhaps with Delta Dental of Washington again choosing not to increase fees, you are not feeling very giving. Dr. Chris Pickel has been leading a task force at the WSDA which has been working on a product called LifeMap. This product will be in direct competition with Delta Dental of Washington.

LifeMap is unlike traditional dental insurance and will be easier and less costly to administer. I am excited to hear Dr. Pickel review LifeMap at our next evening membership meeting on January 13th at the DoubleTree in Southcenter. Remember that SKCDS is offering these evening membership meetings this year at no charge to our members. We just ask that you register. You can come meet with your colleagues, have some dinner, hear some informational updates (we are also going to highlight one member benefit each meeting) and hear about health insurance and your practice.

All attendees are eligible for a drawing of a $100 Amazon gift card (see the photo of Dr. Lloren and me below—she won the drawing at the September 30th meeting.) I hope to see you there! Recently I also heard from member Dr. Greg Yen about the Dental Wellness Club that he is offering. This is another program that offers alternatives to traditional dental insurance.

Our Society can only be as strong as our members make it. I would ask you to give as much of yourself as you can to make our Society and our profession stronger. Be sure to thank those around you that help make your practice and your life better. Thank you!

Cover Photo: Drs. Bart Johnson (Left) and Dr. Amy Winston (right) accept the WSDA annual Citizen of the Year Award from WSDA President Dave Minahan (center). Drs. Johnson and Winston were honored for their extensive contributions to dental access in the greater Seattle area.

SKCDS Recognizes UW Affiliate Faculty Members Remember that one influential teacher in school? Or, maybe it was a neighbor or family friend who gave good advice? We all need someone in our lives who can give us a little direction and wisdom at certain points in our journey. At University of Washington School of Dentistry (UWSOD), Affiliate Faculty are filling that role for students while providing valuable instruction in labs and clinics.

Affiliate Faculty are those dentists, both practicing and retired, who volunteer to instruct students in labs and clinics one or two days a week. The Affiliate Faculty engage very closely with students. They provide “mentor” relationships to those who are coming up through dental school. The Membership Committee has chosen to honor the Affiliate Faculty who are members of SKCDS. The Membership Committee recently became aware that we are deficient in membership amongst our UW SOD faculty. This has implications since the faculty is the first point of contact for students who will eventually become members in organized dentistry. Only about 45% of the FTE faculty members are also members of organized dentistry. Of the approximately 219 Affiliate faculty, about 52% are members of organized dentistry.

The Membership Committee would like to recognize the UW SOD Affiliate Faculty with small enamel pins that they can wear on their lab coats when working with students. The pins will include SKCDS and UW insignia, representing the faculty commitment to students and organized dentistry. Each SKCDS Affiliate Faculty member will be given a pin and a letter of thanks from SKCDS. The pins will be presented by Dean Joel Berg. It is the Committee’s hope that students will see the pins and begin to associate organized dentistry with their mentors and instructors.

SKCDS would like to thank the Affiliate Faculty for their service to the University of Washington School Of Dentistry. They show a dedication to the future of our profession not just by a commitment of time but also by sharing knowledge with the next generation of dentists. For these dental students, they are not only learning the art and science of dentistry but shaping their vision of the future through their interaction with mentors.

If you are interested in sharing your time as an Affiliate Faculty at University of Washington School of Dentistry, SKCDS would be happy to direct you to the right people. We strive to work closely with the University as we nurture and welcome our future colleagues and leaders.

2014 SKCDS FALL QUARTERLY l 5

2015-16 Elective Office Openings Announced In accordance with the Seattle-King County Dental Society Bylaws, the Leadership Committee will meet in late November or early December 2014 to formulate a slate for the 2015-16 Society year.

• Delegates to the WSDA—Up to seven (7)* openings for three year terms This position represents the Seattle-King County Dental Society at the governing body of the Washington State Dental Association’s House of Delegates. Delegates must attend at least one—and ideally two—evening We encourage your consideration of these open positions. There is a lot going caucuses before each meeting of the House of Delegates. The delegates on at the Society, and we welcome your participation. We also thank all of must also plan to attend the Washington State Dental Association’s House of our current volunteer leadership who give so freely of their time and talents Delegates meeting (usually held from Thursday evening to Saturday noon in on behalf of the Seattle-King County Dental Society.

September).

The following leadership positions are open:

*The number of Seattle-King County Dental Society Delegate seats for the WSDA House of Delegates is determined each year based on membership as • President-elect of January 2015; therefore, we do not know at press time how many seats The president-elect will automatically become president in the year following will be open. This change in how the seats are allocated was approved by the the year in this position. The president-elect will be a member of the Budget 2005 WSDA House of Delegates. and Finance and Program Committees as well as the Executive Council.

If you are interested in learning more about the duties of these positions or • Executive Council – Three (3) openings for three year terms wish to be considered for one of the offices, please call Jennifer Freimund at Executive Council members meet approximately 10 times a year and always 206.448.6615. in the evening with a meal provided. This is the governing body of the Dental Society, and it is an excellent way to participate in the organization.

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One Love – UW Students Volunteer in Jamaica!

This is the third year that University of Washington dental students have had significant participation in the Great Shape! Inc. 1000 Smiles Program.

This year 34 dental students and 2 supervising dentists represented UWSOD. Over two weeks, alongside 25 additional volunteers, students treated approximately 1,600 patients. Volunteers also provide oral health education to children in their schools from K-6th grade for 10 days. The following quotes and photos provide an impactful glimpse into this wonderful, annual trip. The students hope to make this a regular event and ultimately earn academic credit for the experience.

If you are interested in more information, please chance at a better job and livelihood, since a good feel free to contact Jackie Wong via e-mail: smile for tourism is so paramount. I am grateful that hokunani@uw.edu. One Love!

I am in a career where I can directly affect a person’s well-being and improve their self-confidence.

- Katie Vogel, 4th year UWSOD student In preparing for Jamaica, I knew it was going to be a trip of many firsts. My first passport stamp, my first trip with classmates, my first simple restorative work, and my first experience being looked to and referred to as a Dentist. But what I will remember most were the firsts I was not expecting.

I have never seen crowds of people wait in line to receive dental care, even for a cleaning. On day one in the clinic I saw a six year old with a textbook case of a dental abscess; the right side of her face swollen to the size of a grapefruit.

Multiple children who at age 8 had never been to the dentist, and whose rotten primary teeth proved it. I would like to see the partnership between Great Shape 1000 Smiles and UWSOD strengthened. It was clinical experience I won’t soon forget and a learning experience about culture, compassion, and care. The people of Jamaica are some of the most joyful people in A common saying that I heard in Jamaica was “a the world despite facing hardships and others can good smile gets you a job at a Sandals Resort, learn a lot from this humbling opportunity. I gained and a bad smile gets you a job in the sugar cane confidence as a clinician and I had my first fields.” About 90% of Jamaicans do not have experience of the happiness that our profession access to dental care and the disparity was evident grants when we serve those in need. in the patients we treated. I left Jamaica with more affirmation that I chose the right profession. - Taryn Vangerpen, 3rd year UWSOD student Handing a patient a mirror after performing some esthetic fillings and seeing the gratitude well I could not have asked for a better experience in in their eyes was overwhelming. Not only did I Jamaica with Great Shape. This opportunity by far return their smile, but also I gave them a second exceeded anything that I could have expected and

allowed me to grow not only as a student pursuing a career in dentistry, but also as a person. I actually had a woman take the time out of her day to bring me lunch that she had prepared herself to express how thankful she was; I cannot describe how good of a feeling it was to know that I had helped someone out so much.

- Cameron Kastl, 2nd year UWSOD student Overall, the Jamaican people made me fall in love with their outlook of life and it was a privilege to be of service to them. I felt we were both enriched by the experience and I am looking forward to returning as a licensed dentist in the future to be a provider, and act as an Attending to help other dental students grow like I have. --- KB (continued on page 8)

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(continued from page 8)

I couldn’t be more grateful for the experience I just had in Jamaica through the Great Shape program.

For me, this trip couldn’t have come at a better time. I am now rounding the corner into my final year of dental school and with that the lengthy list of looming requirements and the pivotal hurdle of the licensing exam in the not too distant future.

It is easy to get caught up in the fray and forget what attracted me to the dental profession. I was so impressed by how hard the staff at Great Shape worked and their big hearts for the Jamaican people. I would recommend this organization to all dental students who have the opportunity as it helped to clarify my respect for the profession and its versatility as a tool to serve. -- KP

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8 l 2014 SKCDS FALL QUARTERLY

Please welcome our new members!

JULY 2014 Dr. Stephen Chadwick Dr. Yanka Chalakova Dr. Jin-Nyung Chang Dr. Wai Shan Chiu Dr. Thomas Duffy Dr. Derek Hou Dr. Tina Jalali Dr. Shumaila Jamali Dr. Shreya Jumani Dr. Elizabeth Kaminsky Dr. Andrew Lee Dr. Felix Liou Dr. Mo Mahoutchi Dr. Ilya Miloslavskiy Dr. EmmyMurdock Dr. Daniel Seetin Dr. Chun-Ying Shih

Dr. Mili Trivedi Dr. Jeenah Yoo AUGUST 2014 Dr. Alfadhli Abu Dr. Leigh Armija Dr. Daman Awla Dr. Yonatan Adhut Dr. Raquel Capote Dr. Sean Collette Dr. Kimberly Espinoza Dr. Scott Howell Dr. Samantha Kofler Dr. Catharin Maney Dr. Imahn Moin Dr. Amanda Patterson Dr. Emily Preboski-Michel Dr. Esther Ra Dr. Eun Shin

$PAC-078_DENTAL_SeaKingCoDentalSoc_BW_7.5x4.75_Jan2013.indd 1

Dr. Kim Trieu Dr. Alex Wardian Dr. Monica Yu SEPTEMBER 2014 Dr. Michael Anderson Dr. Samuel Bobek Dr. Rose Chen Dr. Joannie Chu Dr. Jennifer Emerson Dr. Matthew Epstein Dr. Salma Helal Dr. Wendy Hung Dr. Amanda Jackson Dr. Adam Kennedy Dr. Janina McGill

Dr. John Owen, IV Dr. Jon Tarleton Dr. Tim Tran Dr. David Zhu

Members of SKCDS are encouraged to invite non-member dentists who are practicing in King County to join the Dental Society. A quick call to the WSDA Office at 206.448.1914 is all that is needed for them to apply for membership at all three levels: Seattle-King County Dental Society, Washington State Dental Association and the American Dental Association.

2014 SKCDS FALL QUARTERLY l 9 1/10/13 7:19 PM

Viewpoint: Biting Bad Stephen L. Kirkpatrick, DDS, PLLC, Olympia, WA of practice. Every dentist has their own opinion about occlusion, but from what I see of new patients, it isn’t practiced nearly enough. I haven’t done Pankey Institute or followed Peter Dawson, so you might dismiss what I say, but in my office we have very appreciative patients, most of whom never knew they had such an uncomfortable bite until I showed them and did a five-minute bite adjustment. Then their eyes light up and they tell me their teeth fit together now, and I hear the occasional “Wow!” I have become a genius in their eyes, and in their mouth.

the ML and DL cusps are cracked. I showed her the problem, adjusted, and she wondered why nobody had taken the time before.

4) A fifty year-old male had lost the DL cusp of #18. All lower molars had steep wear facets on lingual cusps, and same for DL of uppers. I filled #18, and delayed or prevented fractures in the other molars with a five-minute adjustment.

5) I saw a thirty year-old new patient after her second-ever seizure. Each one caused her to lose a lower molar, due to vertical fracture. Her remaining two lower molars had strong contacts on lingual Stephen L. Kirkpatrick, DDS cusps. Would she have lost those other teeth, if the Read these next clinical examples which I’ve seen bite forces had been cusp-to-fossa, on the correct in the last twelve months, try more adjustments parts of the teeth? Before sending her to the and you may become a zealot about occlusion, if oral surgeon, I adjusted those other two molars.

With this issue of the Quarterly, your Communications not already. We can gain patient trust in a mere Committee is introducing a new feature: an opinion five minutes with this “new” form of preventive Dental occlusion is where a rock meets a hard place. It’s the set of points where one or more piece. We welcome articles from members and dentistry. other experts on various topics or treatment 1) Two patients saw me from two different lower teeth collide with and gnash against one or philosophies having to do with the practice of offices, shortly after the dentists had seated a new more upper teeth. As unforgiving as that sounds, dentistry. These pieces do not represent the crown on a lower second molar. The patients had the effects are moderated by masticatory muscles opinions of the Seattle-King County Dental Society pain to cold and chewing, occasionally spontaneous, and the TMJs, though sometimes those are nor is the Dental Society advocating that you and the dentists had told each patient they would innocent bystanders and can become collateral follow any recommendations offered here. Rather, need RCT if the pain persists. In both cases, the damage. we seek to encourage thought and discussion main occlusal contact was on the DL cusp. There among our member dentists. We welcome any was no swelling, and percussion from the lingual Sudden changes in the bite, such as a high filling or letters to the editor in response to this feature; direction elicited no pain. I adjusted the offending the tightening of braces, will generate acute dental and, even more, we would welcome articles on DL cusp, averted RCT, and sent them back to their pain, especially to biting and to cold. Same for a new crown, if the occlusal contacts are wrong, other topics you think may be of interest and dentists. are willing to submit. The Communications 2) A forty-two year old female, of slight build but such as any contact on the lingual half of a lower Committee reserves the right to edit or not a bruxer, had previously lost #31 due to vertical molar. See below, for more on that. publish any submissions. Enjoy this new feature! fracture, and all other lingual cusps of lower molars Much more subtle and insidious are the gradual had fractured off to the gumline. She could have chronic changes that result from all of that gnashing This article matches my philosophies about dental used a bite adjustment and NG 15-20 years ago! of teeth, which creates stresses in teeth and the occlusion. Implementing these ideas will benefit (In her twenties.) surrounding structures. Some part of the body will our practices, our patients and our profession.

3) I saw a similar story in the mouth of another be the weak link, so that one of these problems Victor J. Barry, DDS; Communications Committee youngish female patient. Tooth #19 had a FGC, will occur: due to fractured lingual cusps. The DL cusp of #30 1) Repetitive stress fractures will develop under Opinion articles often don’t involve clinical was craggy and carved by the occlusion into a cusps, much like the way a small crack will extend situations, but this is one that is overlooked, mini-Matterhorn. Additionally, I caught a hint of in a windshield. Usually the first cusps to fracture under-appreciated and it borders on philosophy cracks in the mesial and distal marginal ridges, so

NEW FEATURE:

10 l 2014 SKCDS FALL QUARTERLY

(continued on page 18)

2014 Seattle-King County Dental Foundation Gala SOLD OUT!!

But wait— it is not too late to help!

WOW! As we go to press, our Seattle-King County Dental Foundation’s 2014 Auction is completely sold out! Our November 15th Gala, to be held at the Fairmont Olympic Hotel in downtown Seattle, promises to be a GREAT event! We aren’t sure if it is our exciting “Great Gatsby” theme, the wonderful cause or all the hard work of the Event Planning Committee, but we are tremendously excited to have sold the Gala out for the second year in a row.

But WAIT! It is not too late for you to support the Foundation. We welcome 100% tax deductible gifts to the Seattle-King County Dental Foundation all year round. You can easily make such a gift by calling us at 206.448.6620 or by going on the Foundation section of our website. You should be sure to make a generous contribution before December 31st so your deduction counts in this tax year.

But WHY, you ask? The Seattle-King County Dental Foundation (SKCDF) is the philanthropic arm of SKCDS. The Foundation is dedicated to eliminating dental pain and infection among the underserved citizens of King County. Established in 1992, the Foundation has made grants to over 30 non-profit and educational organizations, totaling well over $1,100,000.

Our work is important. We have made a difference.

We need to keep the momentum going. Please join us in solving access to dental care in King County with your tax deductible donation to the Seattle-King County Dental Foundation!

We need YOU!

Our Foundation has made grants to our dental clinic at Swedish that has just won the prestigious Golden Apple Award for Excellence in Access to Dental Care (see page 13 for the related article).

We have also funded numerous site visits by the Medical Teams International dental vans and have contributed to several community health clinics— like HealthPoint’s new Midway Clinic or Neighborcare’s Rainier Beach Clinic. All of our grants have been targeted towards removing all barriers to accessing dental care in King County.

2014 SKCDS FALL QUARTERLY l 11

SKCDS Member is a Regular MTI Volunteer Enumclaw, Washington, a remote area of King County, has a very difficult time locating dental volunteers. Local dentists Neil Bergstrom, Daniel Ryning, Jason McGonegle, James Johnson and Wendy Walker volunteer for the Enumclaw Youth and Family Services funded by the local hospital foundation. These wonderful individuals always invite their staff to “come play on the dental clinic” van. It would be so great to have more dentists.

Four clinics were cancelled this year. Many hands make light work. On August 14th the dental clinic manned by Dr. Bergstrom, Stephanie Murray and Fredda Smith, with help from stellar scheduler, Kyle Shannon, served twelve lucky patients.

Washington. The organization is committed to rise, understand the decay process; plaque causes mobilize and make a difference. decay, if you don’t floss and brush – we don’t fill.

Pain is quite a good motivator; seldom do they see The mobile dental clinics have two operatories a return patient with dirty teeth. It’s important the equipped with instruments and supplies to provide patient understand the mobile dental clinic is not urgent care to homeless and low income children a dental office; we recommend options the patient and adults. Volunteer dentists, dental hygienists can control, allowing them to make informed and and dental assistants provide triage and dental educated decisions about their oral health. care to very appreciative patients with limited or no access to dental care.

Fredda Smith has been a clinic manager for Clinics are sponsored by hospitals, churches, missions, senior centers, schools, food banks, Rotarians, and civic improvement organizations.

The sponsors provide a telephone line, restroom, reception area and a volunteer to schedule and receive patients the day of the clinic. The volunteers screen the patients to meet the financial requirements of no dental insurance, no access to care, and must be 200% of current poverty guidelines. The patient folder is prepared with a health history; a treatment notes page and a treatment plan page.

Clinic manager Fredda Smith welcomes the patients on board. She seats the patients, asks “How can we help you today?” The blood pressure is taken and recorded. If the patient has a specific tooth problem, a periapical and bitewing x-ray are taken and while the x-rays are processing a two minute flossing and tooth brushing lesson occurs. It’s very important that the patients

Medical Teams International for eight years, a job that challenges her fix-it skills, empowers her alarm clock, engages her humanitarian nature, and enables her quirky dental sense of humor. Often you can hear her say, “Are you having fun?”

Fredda is the South Puget Sound Clinic Manager but has been seen north in Bellingham, Sedro Woolley, Everett and Seattle. Her normal range area is from SeaTac to Centralia to Bremerton. Starting early is her key; sometimes I-5 traffic makes a snarl of her efforts to arrive an hour before clinic start time of 8 AM and clean-up takes at least as long after clinic, so you can see she lands on I-5 with all of you. She’ll wave if you honk. She serves twenty sponsored sites, helped at 149 clinics last year and works with many dental volunteers.

Drs. Sue Weston and Al Bird have accompanied her on dental mission trips to Guatemala.

What does dentistry mean to Fredda Smith?

“Preserving a smile – the patients’ and mine!”

Forty-three procedures were done, the value of the clinic was $3,953 and doctor stepped off the dental clinic van at 2:15 pm. Dr. Bergstrom teased saying, “maybe you’d get more volunteers if you didn’t work them so hard!” Fredda Smith said, “Okay, do we need chocolate?”

Medical Teams International is a global humanitarian aid organization; our mission is to demonstrate Christian love to people affected by disaster, conflict and poverty. Locally there are twelve mobile dental clinics serving Oregon and 12 l 2014 SKCDS FALL QUARTERLY

Dr. Neil Bergstrom with MTI Colleagues

Our complex oral extraction clinic receives Golden Apple Award from the American Dental Association Our Oral Extraction program, offered in Swedish Community Specialty Clinic, which has provided complex oral surgery care for more than 1,800 low-income adults, has received the American Dental Association’s Golden Apple Award for Excellence in Access to Dental Care Programs. The specialty dental program—a partnership between the Seattle-King County Dental Society, Project Access Northwest, Seattle Special Care Dentistry and Swedish Medical Center — has provided more than $2.4 million in free care since its inception in 2011.

Before this clinic opened, many low-income adults had nowhere to go but the emergency room when they had acute dental conditions. This program ensures that everyone, regardless of their ability to pay, has access to specialty dental care in the right place, at the right time.

Patients with complex oral health conditions are referred to the Swedish Community Specialty Clinic’s dental program at the First Hill campus from safety-net dental clinics across King County.

Project Access Northwest, which provides case management services for the program’s patients, then screens and schedules the complex dental care five days a week, at no cost to eligible low income patients.

More than 30 dentists and oral surgeons volunteer at the clinic. In addition, the clinic is staffed by a dental residency program supervised by Seattle Special Care Dentistry. If you are interested in joining this team of volunteers, contact the Central Office at 206.448.6620 or at skcds@skcds.com.

The specialty dental program receives financial support from the Pacific Hospital Preservation and Development Authority, the Washington Dental Service Foundation, Seattle-King County Dental Foundation and the Swedish Foundation. The Golden Apple Award recognizes the unique, innovative partnership we’ve developed to increase access to specialty dental care. This national recognition is so important in highlighting the innovative role that the partnership plays in addressing these needs.

The American Dental Association’s Golden Apple Awards Program is in its 26th year and recognizes outstanding activities and excellence in leadership from across the nation among dental societies and their volunteers.

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WWW.AFTCO.NET 2014 SKCDS FALL QUARTERLY l 13

CONGRATULATIONS Please join us in congratulating Dr. Princy S. Rekhi who recently finished the American Dental Association’s Institute for Diversity in Leadership training.

Dr. Dexter Barnes was inducted as a Fellow with the International College of Dentists (ICD) in 1993. Throughout the years, Dr. Barnes (Deck) has served in many capacities, Vice Regent, Deputy Regent and Regent of District 11. At this past ICD meeting in San Antonio, Dr. Barnes was elected as President for the 2015 year.

The high quality of the educational curriculum, faculty, mentors, sponsors, participants and leadership projects of the 2013-2014 Institute for Diversity in Leadership once again confirmed the value of this program that began in 2003. Guided by the Diversity and Inclusion The USA Section of the International College of Dentists (US/ICD), is part of Committee of the ADA Board of Trustees, the Institute program continues to the preeminent honorary dental organization in the world that recognizes and promotes excellence in leadership with an emphasis on service. It provides develop leaders. For example: support to its Fellows and respect for its peers while they address oral health • Institute alumni have been selected for positions as volunteers in ADA needs and education throughout the world and foster an atmosphere of collaboration with those who share their values. governance, including the ADA Board’s Strategic Planning Committee, as consultants meeting regularly with the ADA Board’s Diversity and Inclusion The International College of Dentists is a leading honorary dental organization Committee, the ADA New Dentist Committee, and as delegates to the ADA dedicated to the recognition of outstanding professional achievement, House of Delegates. meritorious service, and the continued progress of the profession of dentistry for the benefit of all humankind. Any member in good standing may • Institute participants have also served as board members and officers with “Sponsor” a dentist within the USA Section for Fellowship through the the Hispanic Dental Association, the National Dental Association, the American Constituent Chapter/State in which the candidate resides.

Association of Women Dentists, and the Society of American Indian Dentists.

• Additionally, alumni serve in community leadership positions outside dentistry.

In proposing the Institute to the ADA 2002 House of Delegates, the ADA Board described the objectives of the Institute as: “… to build lifetime relationships with minority dentists; to mentor promising leaders with potential to impact diverse communities; and to strengthen alliances with stakeholder institutions, including dental leaders, industry, public and governmental communities of interest.”

Congratulations, Dr. Barnes!

Dr. Feder elected as Vice President of Pierre Fauchard Academy Dr. Barry Feder was recently elected as International Vice President of the Pierre Fauchard Academy. The mission of the Pierre Fauchard Academy is to consistently focus on professionalism, integrity, and ethics worldwide and to advance dentistry to its highest level.

Tracking corresponding metrics since the first class, the program has demonstrated that while participants are going through the program, they report high satisfaction with the quality of the faculty and educational experience. They continue to provide positive reviews in subsequent alumni Dr. Feder is a former member of the Seattle-King surveys. Program faculty are from Northwestern University’s Kellogg School County Dental Society’s Executive Council and of Management. The June 2013 selection of the eleventh Institute class has been an officer for the Washington Dentists’ Insurance Agency and brings the total to 129 dentists who have been admitted since the beginning the Washington State Dental Association. He has served as Chair of the of the program.

Physicians and Dentists Credit Bureau and has been active with the Pierre Fauchard Academy for several years.

Congratulations, Dr. Rekhi!

14 l 2014 SKCDS FALL QUARTERLY

Congratulations, Dr. Feder!

New Opportunities to Get Involved In Local Schools

The importance of reaching children with information about oral health and creating dental homes goes without saying. For years we have partnered with the American Dental Association and their Give Kids a Smile program. This year we are joining forces with the Washington Oral Health Foundation and the Children’s Oral Health Institute to bring you a new and improved Adopt A School program!

Now more than one dentist may adopt a school and choose which age group they would like to present to. Presentations last about a half hour, and are held once a year. All props, videos and goodie bags will be provided by WOHF, and the Children’s Oral Health Institute will be supplying “Lessons in a Lunchbox” – orange lunchboxes covered with oral health fun facts and a surprise inside. This is sure to be a fun new way to help instill good oral hygiene values in the students and take them home to work with their parents to create a dental home. The goal of this enhanced program is to reach more children and create relationships with the teachers so the dentists will be invited back for years to come.

Schools still need to be adopted!

Dentist are still needed in the following cities. Those with the most need are marked with asterisks: Auburn, Bothell*, Burien*, Carnation, Des Moines, Enumclaw, Federal Way*, Kent*, Kirkland*, Maple Valley, Redmond, Shoreline, Tukwila*, Woodinville*.

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            ♦           

To get involved, contact Launa Lea, WOHF education programs coordinator, at launa@wsda.org or 206.973.5234.

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Dental Action Day 2015 In February!

ADA/DQAC Regulatory Updates

the risk of abuse and dependence of these highly addictive substances. For more information on HCPs and how the reclassification could affect your practice, visit success.ada.org.

DQAC is considering adding a retired active status dentist license. RCW 18.130.250 allows the Commission to create this license at a reduced fee, Mark your calendars! There is a new date for the with renewal conditions depending on continuing WSDA’s annual Dental Action Day. This annual Have you been checking your ADA and DQAC education requirements. This retired active license legislative day will be held on Friday, February emails lately? If not, here are a few regulatory would allow the dentist to provide service in times 20, 2015. Please plan to attend this very updates you may have missed: of emergency or need. important day to remind our legislators about The ADA released the CDT 2015 in early the role of dentistry in our communities. It is September. It includes books, training manuals DQAC is considering the addition of a new section time to address issues around keeping dentistry and even an app for iOS and Android to help to Chapter 18.340 RCW, which states that economically viable and providing much needed keep you up to date on coding! To purchase any military spouses who hold out-of-state credentials services to our most vulnerable citizens. Your of these CDT products, visit adacatalog.org or call as a dentist, expanded function dental auxiliary, dental assistant or dental anesthesia assistant voice is needed! The more members who attend, 800.947.4746. may be issued temporary practice permits. RCW the stronger our message is to those in the government. Breakfast starts around 7:15 am As of October 6, 2014, the DEA has reclassified 1.12.080 mandates that the term “spouse” also and the earliest appointments with legislators Hydrocodone Combination Products (HCPs) as applies to state-registered domestic partners. usually start around 8:00 am. For more Schedule II substances with tighter restrictions. information, or to register, please contact These HCPs include Vicodin, Lorcet, Lortab and DQAC will take these issues up at its October 24th Emily Lovell at the WSDA at 206.448.1914 or Norco. According to the DEA, this reclassification meeting. For more information on any of these emily@wsda.org. is to protect public health and safety by reducing regulations, please contact Jennifer Santiago at jennifer.santiago@doh.wa.gov.

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(continued from page 10)

are the lingual cusps of lower molars. Upper DL are next, though not as problematic.

2) Bone loss and mobility.

3) Muscle tension and/or spasms.

4) TMJ dysfunction.

These are so slow to develop that most patients and many dentists aren’t aware of the problems.

A patient can’t try on a different bite as they could a different pair of shoes. Patients adapt, avoiding one side or one tooth, until something more drastic occurs. In the early stages, it’s nearly pointless to ask them “How does your bite feel?” It hasn’t risen to their level of awareness. Another shoe comparison: for a short time, you can tolerate a small rock in your shoe, but eventually you have to do something about it. Bite problems can be similar, starting small and tolerated at first. Examples such as this have helped my patients understand how these problems have gradually happened, yet seemingly came out of nowhere.

a bite is gradually changing, even though that same bite would not earn a passing grade if we were back in dental school. Many dentists accept the patient’s bite, as if that’s the way it’s always been. They don’t see the need to change it. This position of “If it ain’t broke, don’t fix it” assumes that nothing is going wrong. Also, time is needed to explain and show the issues to patients, that if we don’t smooth down a bad contact, the entire cusp will fracture off. Though it would eventually save money for patients and insurance companies, the insurance might not cover a bite adjustment, especially a preventive one, and that could be an obstacle for the dentist.

Based on these and other experiences, I say that the majority of adults need corrective action, not only for their natural teeth, but also for crowns.

(Labs sometimes overdo the occlusal anatomy2.)

Thus, we need to be proactive, not just reactive, as to the bite. Otherwise, biting bad turns into breaking bad.

1. Menchel, MH. Pain Update: Acute Posttraumatic Jaw Pain. JADA 2014;145(6):578-579 2. Kirkpatrick, SL. Museum Syndrome. Journal of Dental Technology 2013;30(7):20-22

About Dr. Stephen L. Kirkpatrick: Dr Kirkpatrick is a 1979 graduate of UWSOD after That’s where this gets into philosophy of practice. which he practiced in the Indian Health Service. He This adjustment is so quick and effective, I usually has been in private practice in Olympia since 1981, don’t charge my established patients for such a and has continued some work with tribal clinics. minor procedure. Dentists give away bleaching or Dr. Kirkpatrick can be reached at www.OlySmiles.com x-rays or exams, why not something therapeutic and preventive? Even though an insurance executive famously told us we just need to be Here is another description that patients generally “more efficient,” I choose to be inefficient and understand: I show them the “mortar-and-pestle not let my dissatisfaction with insurance taint the effect” occurring on the distal marginal ridge of the doctor-patient relationship. lower second molars, creating stresses in the cusps (DL and DF) and how those can affect the jaw joints. We know those interferences as cross-tooth and balancing-side interferences, which can cause cusp fractures or TMJ derangement, especially if there’s a side-shift.

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TMJ issues could be a separate article, but I’ll mention one more. If the incisors hit more heavily than the posterior teeth, full closure of the posterior teeth would then force the condyles into a detrimental position. Some experts1 caution against adjusting the bite when there’s a TMJ derangement, choosing palliative treatment (warm packs, etc). However, the TMJs work better roaming forward, and with many patients, I think the TMJs already are borderline getting forced distally. The acute symptoms may be a result of that chronic issue. Thus, I feel that even a slight adjustment can usually bring some relief, and give patients the confidence that things will get better.

Unless there is pain or a fractured tooth, dentists don’t usually jump in and try to adjust the way 18 l 2014 SKCDS FALL QUARTERLY

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SKCDS Proposed Bylaws Amendment The WSDA House of Delegates passed a resolution that will change how recent dental school graduates become members. Basically, the changes are two fold: first, a dental graduate would automatically become a member of the tripartite upon graduation, and, second, thegraduate would not pay dues until they had been out for 18 months instead of the current 6 months. Our Bylaws need to change to reflect this House of Delegates’ resolutions. Below are the Bylaws’ sections that would be impacted along with the suggested changes.

These changes are published in the Fall 2014 Quarterly and will be approved at the January 13, 2015 general membership meeting by majority vote of the members present.

Section 4 A.

Chapter I: MEMBERSHIP

jennifer 10/17/14 11:28 AM Deleted: A

Application and Election In the case of immediate dental graduates, the membership application shall be simplified and membership may be granted administratively without a vote of the Executive Council. For applicants other than immediate dental graduates, application for membership shall be made to the Central Office on the official form furnished by the ADA, WSDA or SKCDS completely filled out and accompanied by the current dues of this Society, the State Association and the ADA. The application shall be referred to the WSDA for review and then forwarded to the Executive Council.

B. If the applicant is other than an immediate dental graduate and is found eligible for membership by a majority vote of the Executive Council,

the applicant shall be accepted as such without further process, except that such acceptance be published in the official bulletin of the Society

at its next printing jennifer 10/17/14 11:27 AM Chapter VIII: DUES Deleted: of $50.00 Annual dues in this Society shall be as follows:

1. A dentist who has not previously been an active member of any constituent Society of the ADA, upon becoming an active member of the

Society for the calendar year following graduation shall pay no dues for that year and $50.00 for the next year. Dues for the third

year shall be 50% of active member dues. This shall not apply to anyone who has been in dental practice or out of dental school for two

(2) or more years. Dues for the calendar year of graduation from dental school shall be zero ($0).

Should you have questions about these proposed Bylaws changes before the membership votes on them in January 2015, please feel free to contact the Central Office at 206.448.6620.

Wage/Economic Survey for SKCDS Dentists We are excited to introduce the first of a series of surveys to help assess the economic state of our dental community. This first survey asks about typical wages and benefits paid to employees in your geographic area of Seattle and King County.

Our goal is to access data from over 300 practices (just one quarter of all the dentists in SKCDS) to provide accurate and relevant data for your practices. This has the potential to be immensely more valuable than other surveys. Those surveys

published are based on less than 30 practices or www.skcds.org. For information, please contact based on national data that varies widely based Breanna at 206.443.7607 or breanna@skcds.com. on regional costs of living. In the future we plan to do other surveys on insurance utilization, WDS participation, practice productivity, and staff utilization.

The survey should only take about 5-7 minutes to complete. We will be collecting results until mid-November. We will announce the results at the end of November and make them accessible through the member section of the SKCDS website 2014 SKCDS FALL QUARTERLY l 19

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Rock ‘n’ Roll Dentist

By Al Munk DDS I feel like my mid-life crisis has been progressing quite nicely. I have managed to have a lot of fun without landing in jail or divorce court, committing adultery only in my mind like our ex-president, Jimmy Carter. My cartilage inventory, though dwindling, still exists in sufficient quantity for extensive golf, skiing and foolish motocross events. I’ve become increasingly friendly with orthopedic surgeons, knee braces and non-steroidal, anti-inflammatory drugs. All in all, a fine time to be 54 years old, having my own hair and teeth, and the ability to brush them both without the aid of a licensed practical nurse.

with suitable distortions, making us feel that we were having more fun at the time than we actually were. It is an effective mass delusion which advertisers of products from Cadillac to Ex-Lax have taken advantage of to sell us more stuff.

The great thing and the terrible thing about life is that you never know what is coming next. In my case, much to my amazement, I’ve become a Rock ‘n’ Roll Dentist. I can’t say that historically I was a particular fan of rock music.

I remember attending my first rock concert in 1969 at the UW homecoming festivities. Three Dog Night played and Ike and Tina Turner were the opening act. I met a girl at dinner one night at my dorm and asked her to the concert.

I wore my corduroy jacket, the only piece of clothing resembling dress-up togs that I owned. After the concert, I walked her back to her room and she invited me in. Things were looking up. Then she showed me an 8x10 glossy of her fiancé who was tall, dark and handsome and that was the end of that. I attended few concerts after that and though occasionally listened to rock music of the day on my roommate’s stereo.

Anyway, while listening to ZZ Top wail away on guitars on the radio, I suddenly felt like I could and should be doing the same thing. This may be early old-timers disease, or perhaps latent drug-induced post-traumatic stress syndrome. Anyway I went out and bought a white Fender Stratocaster guitar like Jimi Hendrix used to play and an amplifier with a hundred knobs on it, most of which make the guitar loud and evil sounding. I bang away on this axe like Eric Clapton, scaring the dog and bewildering my children, wondering if Pop has finally flipped his lid. I do not know myself. Oddly enough, the mother of my children is delighted with the recent transformation, though her judgment must be taken with a grain of salt, as she was one of the mud slitherers at Woodstock 45 years ago.

EXPOSURES

What will it be next? Hula-hoops or bungee-jumping? I do not know what awaits me on the way to the nursing home but it sure has been fun so far. If you see me at a seedy bar, cigarette dangling out of the corner of my mouth and raucous sounds blasting out of my amplifier, be kind, remembering that I was once an upstanding dentist and humorist, a loyal provider to my patients and family, before sinking into the abyss of immoral turpitude of rock and roll.

I owned a Sears Silvertone guitar at the time and could strum a few chords like most college kids. I later purchased an old Martin guitar, which I still have, though seldom play. It is a soft-sounding instrument with a faded finish and appropriately scratched with 50 years of use. It is like a comfortable, old pair of slippers. The sounds it makes are soothing and sweet like birds in the forest.

It likes to play folk, blues and ragtime pieces - a fingerpicking delight. But for some reason, it wasn’t enough. Enough what you ask? I didn’t know myself but was soon to find out.

That’s all for now from Ballard.

For some reason, about a year ago, I started listening to classic rock music on the radio. There are several stations catering to pre-geezer people such as myself whose long-term memories of life in their twenties have become enhanced

22 l 2014 SKCDS FALL QUARTERLY

The views expressed are those of the writer and do not necessarily reflect the opinion or official policy of the Seattle-King County Dental Society.

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