keeping up with our NEXT ADVENTURE
Annual Pacific Northwest CE Catalog www.washingtonagd.org
PREMIER BUILDERS DENTAL FACILITIES
Constantine Builders has built its business foundation on the ability to establish relationships based on trust, dependability, quality craftsmanship and integrity. We always put the client’s needs first with the firm belief that the best source for future business is satisfied clients.
C O N S TA N T I N E B U I L D E R S . C O M
Washington Academy of General Dentistry PACE Approval Representative: Linda Edgar, DDS 19415 International Blvd, #410, SeaTac, Washington 98188 Office: 206-940-6112 | Fax: 253-517-8766 Email: drlinda@edgardentistry.com
Applying for PACE Approval Approval for CE Credits from the Academy of General Dentistry (AGD). The Academy of General Dentistry (AGD) Program Approval for Continuing Education (PACE) was created to assist members of the AGD and the dental profession in identifying and participating in quality continuing dental education (CDE). PACE approves program provider organizations, not speakers or specific courses. The program provider approval mechanism is an evaluation for the educational processes used in designing, planning, and implementing CE. Approval by the AGD does not imply endorsement of course content, products, or therapies presented, nor does this approval imply that a state or provincial board of dentistry will accept courses. Approved program providers are expected to comply with all relevant state and federal laws. CE offered by approved program providers will be accepted by the AGD for Fellowship/ Mastership credit. • Get the Application Go to www.agd.org Click on the Education tab and then PACE Apply/Renew Tab to get the application. To qualify for PACE approval, all organizations should have offered a planned program of CDE activities for at least 12 months. Note: If your organization has not offered a planned program of continuing dental activities during the 12 months immediately preceding the application date, you may apply for a maximum of one year approval. • FEE AGD Members: If you are an AGD Member or Associate Member (Specialists are Associates) the FEE is $175 for 4 years. Please make your check out to Washington AGD. AGD Members do have access to the AGD membership database Non-AGD Members: If you are NOT an AGD Member or Associate Member the FEE is $550 for 4 years. Please make your check out to Washington AGD. Non-AGD Members do not have access to the AGD membership database. If you would like to become an AGD member, Please submit the enclosed membership application along with the membership dues of $475. Please make your check out to the AGD. • Your PACE Application Two (2) copies of your PACE Application must be mailed to me along with One (1) copy of your membership application with the appropriate checks. Mail to: Linda Edgar, DDS Washington AGD PACE Approval Representative, 1911 SW Campus Drive #762, Federal Way, WA 98023-6532 3
Continuing Dental Education Courses & Events Organization 2016
Organization
March 4: “BLS HCP CPR for the Healthcare Provider”, James Moquin, Heartstart March 4: “The Business Side of Dentistry”, Darin Richards, CFA March 4: “The Christensen Bottom Line”, Dr. Gordon Christensen March 5: “CrossCoding-Successful Medical Billing in Dentistry, Rose Nierman, RDH March 16: “Sleep Apnea from a Dental Perspective”, David Russian, MD March 19: Moulin Rouge SKCDS Auction & Gala March 25: “Ernest M. Jones Memorial Lecture”, Dr. Lee Ann Brady March 31: “Implant Study Club”, Dr. Terry LaBell & Dr. Jennifer Emerson April 1: “Pediatric Dental Trauma & Pulp Revascularization”, Dr. Nestor Cohenca April 2: “Restorative Endodontics”, Dr. Alex Fleury April 8: “Orthodontics with Live Patients” Dr. Binh Tran April 15: “Coding Errors & Excel in Insurance Administration”, Dr. Charles Blair April 16: “Excellent Dental Photography”, Dr. Geoff GreenLee April 19: “How to Manage Traumatic Dental Injuries”, Dr. Loubna Pla April 20: “Navigating Today’s Clinical Challenges”, Pam Hughes, RDH April 21: “Occlusion Nuts & Bolts, Dr. Michael Melkers April 22: “Office Based Laser, Oral Surgery, Dr. Robert Strauss April 21-22: “Botulinum Toxin-A for the Dentist”, Dr. Tim Hess April 23: “Office Based Laser, Pedo, Dr. Kaplan & Levine April 23: “Endodontics” Dr. Jordan West April 29: “Innovative Periodontics”, Dr. Samuel Low April 29: “BLS HCP CPR for the Healthcare Provider”, I Know CPR May 4: “Orthodontics with Live Patients” Dr. Binh Tran May 6: “Vendor Fair”, Building your Reputation with the Washington AGD May 6: “Back, Balance, and Beyond”, Gayle Masters, RDH, LMT May 7: “Neurotoxin Therapies for the Dentist”, Dr. Tim Hess May 13: “BLS HCP CPR for the Healthcare Provider”, James Moquin, Heartstart May 13-14: “WDS Foundation Distinguished Professorship Symposium” (Bellevue) May 20: “Oral Health Products for Home Use”, Karen Baker, MSPharm May 20: “A Path to Increased Practice Profitability- For Both You and Your Team” May 21: “Social Media to Engage Your Patients”, Margie Arnett, MS &Joe Arnett, MS May 26: “Implant Systems Study Club”, Dr. Heldridge & Dr. Emerson June 3: “Orthodontics with Live Patients” Dr. Binh Tran June 3: “University of Washington Award Ceremonies June 16-18: “Pacific Northwest Dental Conference, Bellevue, WA June 25: “Worthington Lecture in Oral & Maxillofacial Surgery”, Dr. Anthony Sclar July 8: “Orthodontics with Live Patients” Dr. Binh Tran July 14-17: AGD Annual Meeting (Boston) August 5: “Orthodontics with Live Patients” Dr. Binh Tran August 2 – 14: “Comprehensive Training in Parenteral Moderate Sedation September 2-3: “Oral Surgery for the GP: Less Stressful Procedures”, Dr. Karl Koerner September 15: “Periodontics”, Dr. Terry LeBell September 16: “Oral Med/Oral Diagnosis”, Dr. Dolphine Oda September 16: “Orthodontics with Live Patients” Dr. Binh Tran September 17: “Sports Dentistry”, Dr. Douglas Lambert September 17: “Oral Med/Oral Diagnosis”, Dr. Dolphine Oda September 17: “Towards Optimal Bonding”, Dr. Lou Graham
Washington AGD Washington AGD SCDS, UWSOD, SKCDS Washington AGD SCDS SKCDS UWSOD UWSOD, Washington AGD UWSOD UWSOD Washington AGD UWSOD UWSOD PCDS SCDS Washington AGD Washington AGD Idaho AGD Washington AGD Washington AGD UWSOD, SKCDS, WAGD SCDS Washington AGD Washington AGD PCDS UWSOD & SKCDS Washington AGD UWSOD UWSOD Washington AGD UWSOD UWSOD, Washington AGD Washington AGD Washington AGD WSDA UWSOD Washington AGD AGD Washington AGD Oregon AGD Washington AGD Washington AGD Washington AGD Washington AGD Washington AGD Washington AGD Oregon AGD
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September 21: “Managing & Treating Pregnant Patients”, Dr. Gandara & Melissa Moore-Sanchez SCDS Sept 21-Oct 1: “MAGD Annual Continuing Education Event” Dr. Mechanic & Dr. Whittle Montana AGD October 1: “Oral Cancer Foundation Walk-Kirkland, WA Oral Cancer Foundation October 1: “OAGD Annual Meeting; Implant Dentistry Symposium” Multiple Speakers Oregon AGD October 7: “Title Pending”, Dr. Ed Swift PCDS, SKCDS, UWSOD October 7-9: “Dental Sleep Training”, Dr. John Tucker Washington AGD October 14: “Washington AGD Membership Appreciation Gala” (Seattle) Washington AGD October 19: “Update on Digital Dental Technology”, Nakanishi Dental Lab SCDS October 21: “Business Side of Dentistry” Toby Daniels, Dental Wealth (Spokane) Washington & Idaho AGD October 28: “Basic Life Support for Healthcare Providers & First Aid” (Everett) SCDS October 28-29: “Pediatric Dentistry for the General Dentist”, Dr. Gregory Psaltis Oregon AGD November 3: “The Magic of Composites, Dr. Paresh Shah Washington AGD November 4: “Pearls of Everyday Practice, Dr. Paresh Shah Washington AGD November 5: “The Modern Restorative Practice, Dr. Michael Ditolla Washington AGD November 11-13: “Oral Sedation Dentistry” DOCS Educational Symposium DOCS Education November 17: “Annual Social & Foundation Fundraiser”, Magician Nash Fung SCDS November 11-12: “Revolutionary Prevention Protocols”, Dr. Brian Novy Oregon AGD December 8: “Bernie Taylor Pub Night; Evolution of Composites”, Dr. Carmen Pfeifer Oregon AGD
Continuing Dental Education Courses & Events Organization 2017
Organization
January 19: “Sleep Apnea Training” OSA University Washington AGD January 20: “Medical Billing for the GP, Dr. Chris Farrugia Washington AGD January 21: “Marijuana “What it is & How it Works, Dr. Carsten Washington AGD January 21: “Medical Billing for the GP, Dr. Chris Farrugia Washington AGD March 10: “Title Pending”, Dr. Mark Murphy & Dr. Dale Sorenson SCDS, UWSOD, SKCDS April 20: “Neurotoxin Therapies for the Dentist”, Dr. Tim Hess Washington AGD April 21: “Pontic Site Enhancement, Dr. Chris Farrugia Washington AGD April 22: “Pharmacology & Therapeutics, Dr. Mark Donaldson Washington AGD April 22: “Neurotoxin Therapies for the Dentist”, Dr. Tim Hess Washington AGD May 12: “Medical Emergencies in the Dental Office”, Dr. Stanley Malamed UWSOD, SKCDS, WAGD June 15-17: “Pacific Northwest Dental Conference (Bellevue) WSDA July 12-15: AGD Annual Meeting (Las Vegas) AGD July 28-August 4: “CE at Sea” 7 Night Alaska Cruise Washington AGD September 21-24: “Washington AGD MasterTrack”, (Seattle) Washington AGD October 6: “Washington AGD Membership Appreciation Gala” (Seattle) Washington AGD November 4: SKCDS Auction & Gala SKCDS November 16-19: “Washington AGD MasterTrack”, (Seattle) Washington AGD Organization Contacts Contact: Academy of General Dentistry (AGD) Phone Contact: DOCS Education Phone Contact: Oregon AGD Phone Contact: Pierce County Dental Society (PCDC) Phone Contact: Seattle-King County Dental Society (SCKDS) Phone Contact: Snohomish County Dental Society (SCDS) Phone Contact: University of Washington School of Dentistry (UWSOD) Phone Contact: Washington Academy of General Dentistry (Washington AGD) Phone Contact: Washington State Dental Association (WSDA) Phone
888-243-3368 206-971-5300 503-228-6266 253-274-9722 206-448-6620 844-355-0519 206-543-5448 253-306-0730 206-448-1914
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Continuing Education, Inc./University at Sea™ LIVE Continuing Dental Education Cruises www.ContinuingEducation.NET | 1-800-422-0711 October 15, 2016 Boston University Goldman School of Dentistry:
June 11, 2016 The Attachment Dentistry Ultimate Course:
Everything You Wanted to Know About Attachment Dentistry but Were Afraid to Ask!! 14 CE Credits 7-Night Alaska from Seattle, Washington Holland America’s ms Westerdam August 21, 2016
Implants and Esthetic Dentistry for dentists and Updates in Dental Hygiene for dental auxiliaries 9 CE Credits 8-Night Caribbean from New York City to San Juan Norwegian Cruise Lines’ Norwegian Gem October 28, 2016 Oral, Maxillofacial & Head and Neck Pathology:
14 CE Credits 7-Day Mediterranean from Barcelona, Spain Holland America’s ms Eurodam
Boston University Goldman School of Dentistry:
Endodontic Diagnosis, Case Selection, and General Risk Management 9 CE Credits 7-Night Bermuda from Cape Liberty, New Jersey Celebrity Cruises’ Celebrity Summit August 28, 2016 Dental Photography Made Simple:
One Picture is Worth a Thousand Crowns 12 CE Credits 7 Night Western Mediterranean from Barcelona, Spain Royal Caribbean’s Brand New Harmony of the Seas 6
January 21, 2017 Dental Treatment Planning & Sequencing:
The Keys to Predictable, Profitable Dentistry 14 CE Credits 7-Night Eastern Caribbean from Fort Lauderdale, Florida Royal Caribbean’s Harmony of the Seas March 11, 2017 Pediatric Dentistry:
14 CE Credits 7-Night Southern Caribbean from San Juan, Puerto Rico Royal Caribbean’s Adventure of the Seas
AKT PARTNERS WITH WASHINGTON ACADEMY OF GENERAL DENTISTRY Washington Academy of General Dentistry (WAGD) is pleased to announce a strategic partnership with AKT. “We’ve enjoyed a strong alliance with WAGD for over 15 years, and we look forward to expanding our services to their members,” said AKT’s Dental Business Consultant Doug Fettig, CPA. AKT works with hundreds of dental professionals helping grow their practices and create strategies that align with long term goals. The financial and business advisors work exclusively with dental professionals on important financial matters from dental tax planning, practice purchase, retirement and transition planning as well as practice management techniques and practice valuations. Beginning March 2016, AKT will begin education seminars for WAGD on a range of topics, including retirement planning, the business side of dentistry, reducing fraud and practice management strategies. AKT CPAs, Advisors and Consultants is ranked in the Top 100 Accounting Firms nationally, providing tax, accounting, and advisory and consulting services to businessess and individuals. We also work closely with business owners and individuals to manage their financial, wealth and tax planning strategies. Serving clients throughout the west from locations
in Oregon, California and Alaska, AKT has industry expertise working with construction, manufacturing, healthcare, nonprofit, telecommunications, food processing, agribusiness, a variety of privately help companies and individuals. Affiliates include AKT LLP, CPAs and Business Consultants, AKT Wealth Advisors LP, AKT Benefit Advisors LP, and AKT Retirement Plan Services LP.
Ten percent discount on a Practice Evaluation The Practice Evaluation process incorporates the expertise of various professionals, including CPAs and practice management consultants, to provide a detailed report outlining recommendations on how the practice may improve its business operations, increase profitability, and evaluate the overall health of the business. Services in the Practice Evaluation include: • Accounting • Tax planning • Retirement planning • Practice management • Cost segregation • Fee analysis • Benchmarking
AKT
Ranked a Top 100 Accounting Firm Nationwide Doug Fettig, CPA | 503.716.9316 Megan Urban | 503.485.2466 www.aktadvisors.com
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To be or not to be – HIPAA compliant
compliance issues and the need for covered entities and business associates to take their obligations seriously.”
patient records, including information stored on equipment with memories like photocopiers.
By: Melissa Moore Sanchez Manager, Sales and Marketing Northwest Dentists Insurance Company
So, how seriously are you taking your HIPAA compliance obligations? Cyber attacks continue to increase, particularly in the medical and dental industries - up over 40 percent in 2013, significantly higher than the business sector. The words “cyber risk” immediately conjures up images of a practice’s computer system being hacked into, and this
Cyber risk can also be malicious intent from an employee to either sell or fraudulently use patient information. Don Jackson, Director of Threat Intelligence at PhishLabs, a cybercrime protection company, says stolen health information can go for $10 each, about 10 or 20 times the value of a U.S. credit card number. The data was
can often be the case. But cyber risk also includes an employee mistake where patient data is unintentionally shared with an unauthorized party. It can mean the theft or loss of a mobile device (laptops, smart phones, memory sticks) that contain patient Protected Health Information (PHI). It can be improperly destroying (or not destroying)
obtained by monitoring underground exchanges where the information was being sold by hackers.
When Leon Rodriquez resigned his position as Director with the Health and Human Services, Office for Civil Rights, Jocelyn Samuels assumed the role. Ms. Samuels wasted no time putting her own stamp on the office’s already tough stance to enforce HIPAA compliance, stating “We continue to see a lack of comprehensive and enterprise wide risk analysis and risk management that leads to major breaches and other compliance problems. That is why enforcement is a critical part of our arsenal of tools to ensure compliance.” Samuels goes on to say “Resolution agreements that include a monetary settlement are only a small fraction of complaint and compliance reviews we undertake. These enforcements send out an important message about
To add insult to injury, HIPAA requires that you self-report, on an annual basis to the Office for Civil Rights (OCR), breaches involving fewer than 500 people. Breaches of 500 or more must
WE'RE NOT THE NORM… When we realized our doctors were facing exposures beyond professional liability, we worked to develop and offer exceptional dentist-specific products. 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
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A WSDA COMPANY
be reported to the OCR within 60 days of the event. Penalties can range from $100 to $50,000 per violation, capped at $1.5 million. Expect that the OCR will want copies of your policies and procedures including but not limited to: your Notice of Privacy Practices, your policies and procedures for protecting PHI, employee training, copies of your complete risk analysis before and after a breach, a detailed description of the breach, disciplinary measures (if it involved an employee), and remedial measures taken following the breach. You should be conducting staff training at least annually, documenting when the training took place, what was discussed and who attended. Any changes to the policy, whether implemented by you or the government, or new staff hiring, will require additional training.
Dr. John Tucker & Academy of General Dentistry Washington:
Dental Sleep Medicine
An Educational Symposium for Dentists and Their Teams! JOIN US IN SEATTLE on October 7th - 9th Sign up today at www.washingtonagd.org or call us at (253) 306-0730 Course Description
20 Continuing Education Credits • Screening for Obstructive Sleep Apnea in the Dental Practice
• How to Communicate with Physicians
• Oral Appliance Designs and Fabrication
• An Efficient Scheduling Protocol
• Documentation, Medical Billing and Reimbursement for the Dental Practice
• How to Master Case Presentations • How to Handle Patient Objections
Airport:
Seattle-Tacoma International Airport The Educational Center is 5 mins South of the Airport
John H. Tucker, D.M.D. Diplomat American Board of Dental Sleep Medicine Dr. Tucker maintains a private practice in Erie, PA. Dr. Tucker has a special interest in the treatment of obstructive sleep apnea and has been actively treating patients for the past ten years. He is a Diplomat of the American Academy of Dental Sleep Medicine and a member of the American Academy of Sleep Medicine.
• Communicating with Physicians and Sleep Laboratories • Building your Dental Sleep Team for Success
Registration: (253) 306-0730
Hampton Inn 19445 International Blvd SeaTac, WA 98188 Reservation Number: (206) 878-1700
Faculty
Medicine Practice
or visit www.washingtonagd.org or email Washingtonagd1@Yahoo.com
Hotel Suggestion:
• How to Bill Medical Insurance & Get Paid
• Marketing Your Dental Sleep
To register, call
Washington AGD Educational Center 19415 International Blvd, #410 SeaTac, WA 98188
• How to Select an Oral Appliance
• How Does Oral Appliance Therapy Help Treat Obstructive Sleep Apnea? • Implementation of Systems, Office Flow and Integration Into Your Practice
Course Location:
Participants Will Learn: • How to Build and Maintain a Solid Dental Sleep Medicine Practice
Tuition
AGD Member Dentist: $1295 AGD Member Dentist Staff with DDS: $395
Non-AGD Dentist: $1795 Non-AGD Dentist Staff with DDS: $595
(continued on page 28)
2016 Montana Academy of General Dentistry continuing education event in Bozeman, Montana. “SAVE THE DATE” When: September 30th through October 1st. Location: Riverside Country Club, 2500 Springhill Road, Bozeman, Montana Friday, September 30th: Corky Willhite DDS, FAGD “The Ultimate Esthetic Course and Undetectable Class IV Restorations”. Credit Hours: 7 CE Participation, Subject Code: 780 Esthetics Saturday, October 1st: Elliot Mechanic DDS. “Interdisciplinary Dentistry with a Focus on Implants: The Restorative Quarter Back”. Credit Hours: 7 CE Lecture, Subject Code: 690 Implants
For More Information: Dr. Annette Dusseau at (406) 544-9015 email: Annette@familydentalgroup.net Dr. Leslie Hayes at (406) 580-1714 email: blumun@prodigy.net
Tuition: AGD Member $500; Non-AGD $600 More information to come including cost for ancillary staff attendance. Montana AGD Approved PACE Program Provider FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry, AGD or WAGD endorsement. Washington AGD PACE Provider (1/1/2016-12/31/2019).
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AGD ACTION ALERT AGD members, On March 1, 2016, the Centers for Medicare and Medicaid Services (CMS) issued a memo outlining another delay in the enforcement of the requirement for providers of Medicare Part D drugs to enroll in the Medicare program or opt out. The new enforcement date is February 1, 2017. In order to ensure sufficient time to process prescribers’ applications or opt out affidavits, CMS is urging prescribers of Part D drugs to submit their Medicare enrollment applications or ...opt-out affidavits to their Medicare Administrative Contractors (MACs) before August 1, 2016. In order for Medicare to pay for prescriptions under Medicare Part D after February 1, 2017, a dentist must do one of the following: • Enroll as a Medicare provider; • Enroll as an ordering/referring provider; or • Opt out of the Medicare program. To help you comply with the requirement, visit the AGD’s Medicare Enrollment FAQ document at the Resources page. For more information on CMS’s change to the enforcement date, visit CMS’ website dedicated to Part D prescriber enrollment. To enroll online, or to access paper application forms, visit CMS’ Provider Enrollment, Chain and Ownership System (PECOS) website. Questions concerning the Part D enrollment/opt out requirement can be sent to practice@agd.org. Additionally, CMS has provided the following address for questions regarding Part D: PartDPolicy@cms.hhs.gov. Pathway to Fellowship “Advancing Excellence in Dentistry”
“Live Patient” Orthodontic Program
Pathway to Fellowship is a interdisciplinary hands-on education targeted towards new dentists looking for a perfect opportunity to educate themselves and start their progress toward the Fellowship in the AGD. This quality CE program offers opportunities to interact and learn from our seasoned MasterTrack Study Club! Program topics are carefully selected to fit the interests of the progressive dentist and the fast changing dental landscape. *Washington AGD Approved PACE Program Provider #219331 FAGD/ MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry, AGD or WAGD endorsement. Washington AGD PACE Provider (6/1/2014-5/31/2018).
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Testimonial: Dr. Binh Tran has been an exceptional instructor. He teaches, motivates and inspires us to achieve our goal – and students and dentistry. He is the only instructor that I know who is available to answer our questions and guide us throughout the course. This Washington AGD sponsored course is highly recommended be-
es. In addition we have his support outside the class that helped me add over 20 ortho cases in the last eight months since I started Dr. Tran’s course. I have driven every month from Portland and stayed in hotels just to take this course, and it is the best investment I’ve ever made in my dental education. The class is so much fun that I have not skipped a single session. Ravi Sinha, DDS Washing ton AGD Ortho course led by Dr. Binh Tran is one of the best courses I have ever taken. I can’t say enough about the way Dr. Tran has organized the course to provide a comprehensive program. His knowledge and skill is vast, and his way of making sure you totally understand is great. I highly recommend Dr. Tran and this Washington AGD program. Rose Bailey, DDS
You are invited to join Dr. John Tucker and Region 11 Academy of General Dentistry for:
CRUISING IN DENTAL
SLEEP MEDICINE 2017
DESTINATION: Royal Caribbean Explorer of the Seas through Alaska!
An Educational Symposium for Dentists and Their Teams! COME CRUISE to ALASKA while learning dental sleep medicine from the industry leaders!
7/28 - 8/4, 2017 SIGN UP TODAY: 800-422-0711— registrar@ContinuingEducation.NET Course Description:
CE Tuition: (Not Included with Cruise Price)
Cruise Ship:
SUBJECT CODE: 162 (Lecture & Participation)
Non-AGD Dentist: $1395
Cruise Pricing:
• Screening for Obstructive Sleep Apnea in the Dental Practice
Non-AGD Dentist Staff with DDS: $795
Interior room (L): $1,176.26
Registration: (Course & Cruise)
Ocean View (H): $1,676.26
20 Continuing Education Credits
• How Does Oral Appliance Therapy Help Treat Obstructive Sleep Apnea? • Oral Appliance Designs and Fabrication • Implementation of Systems, Office Flow and Integration Into Your Practice • Documentation, Medical Billing and Reimbursement for the Dental Practice
AGD Member Dentist: $995
AGD Member Dentist Staff with DDS: $395
• How to Bill Medical Insurance & Get Paid • An Efficient Scheduling Protocol • How to Master Case Presentations • How to Handle Patient Objections
Balcony over Ocean (D1): $2,106.26
Junior Suites w/ Balcony over ocean: $2,426.26 FOR MORE INFO:
http://www.continuingeducation.net/ Region11Cruise
Diplomat American Board of Dental Sleep Medicine
Dr. Tucker maintains a private practice in Erie, PA. Dr. Tucker has a special interest in the treatment of obstructive sleep apnea and has been actively treating patients for the past ten years. He is a Diplomat of the American Academy of Dental Sleep Medicine and a member of the American Academy of Sleep Medicine.
Participants Will Learn:
• How to Communicate with Physicians
Balcony over Ocean (E3): $2,026
Faculty: Dr. John H. Tucker
• Building Dental Sleep Teams for Success
• How to Select an Oral Appliance
Ocean View (I): $1,626.2
registrar@ContinuingEducation.NET
• Communicating with Physicians and Sleep Laboratories
• How to Build and Maintain a Solid Dental Sleep Medicine Practice
(based on double occupancy)
800-422-0711 AND
• Marketing Your Dental Sleep Medicine Practice
Royal Caribbean Explorer of the Seas
Cruise Port: Seattle, WA
Nearest Airport to Cruise Port: Seattle-Tacoma International Airport
Course Days/Times at Sea: Sat., July 29: 8:00 AM-5:00 PM
Sun., July 30: 8:00 AM-12:00 PM Wed., Aug. 2: 8:00 AM-5:00 PM
Cruise Itinerary: DAY
PORT OF CALL
Fri., July 28 Sat., July 29 Sun., July 30 Sun., July 30 Mon., July 31 Tues., Aug 1 Wed., Aug 2 Thurs., Aug 3 Fri., Aug 4
Seattle, WA At Sea Alaska Inside Passage Juneau, Alaska Skagway, Alaska Tracy Arm Fjord At Sea Victoria, BC Seattle, WA
ARRIVE
DEPART 4pm
7am 12 Noon 12 Noon 9pm 7am 8:30pm 7am 12pm 9am 6pm 9am 6pm 6am
11
4 Ways to Increase Your Production by $100,000
By Jim Philhower
With insurance reimbursement falling and overhead rising, the average dentist has had difficulty being as profitable in the past five years. In fact, the average dentist’s income has fallen more than 5%. Far too many dental practices spend an inordinate amount of time and productivity trying to increase profitability by reducing expenses. If you could reduce overall variable costs by 10%, the net effect would be a less than 1% reduction in overhead and an increase in your net monthly cash flow of a few hundred dollars. But focusing on a few small changes to increase production can have a big impact on cash flow and profitability. In fact, once fixed costs are covered, every dollar of increased production and collections will net $.80- $.85. Let’s examine four areas to increase your production by $100,000 in 2016. 1. Maximize Hygiene Visits for Both Preventative and Therapeutic Patients Recare and periodontal appointments usually represent the largest potential for practice growth. The average solo GP practice will have between 1,500 to 1,750 active patients. If we agree those patients should come in at least twice per year for preventive care, we would see between 3,000 to 3,500 hygiene appointments at a minimum annually. Yet we rarely see more than 2,000 total hygiene appointments in a practice. This includes prophies, scaling and root planing, and periodontal therapy procedures. Multiply the missing appointments by your average prophy fee and the lost production is substantial. Then add in the loss of doctor production since 75% to 80% of the dentist’s restorative work typically comes from the hygiene department. Couple that with the fact that the office did not record a periodic exam or necessary radiographs on a visit that did not happen and the lost production number grows exponentially. 2. Balance Fees Every year we still see dentists leave tens of thousands of dollars on the table by not having their fees balanced to a given percentile. While the increase in PPO participation over the past few years has limited the amount of increase the average office may realize by balancing its fees in a higher percentile, we still see many offices submit fees below what insurance companies are willing to reimburse. By balancing your fees in a fair percentile and submitting those full fees to the insurance companies, you can capture the full amount of coverage purchased and allowed for the patient by his or her employer, along with any increases in coverage. Balancing fees should be done at least every two years to help ensure maximum profitability. 3. Review Radiography Protocols How often do you want your patients to receive X-rays? For bitewings, we almost always hear once a year. What about major films? Is it three years for a panoramic and five years for a full mouth series? If so, why? Once you have established a standard of care for radiography, it is much easier to articulate it to your team and patients. It’s simple, but it is one of the biggest reasons that offices do not take radiographyto the doctor’s standard of care. Most dentists will agree that every new patient should receive a major film, yet rarely do the panoramic and full mouth series X-rays add up to the number of new patients seen in a given year – even when we factor in the new patients who brought a film with them. It adds up. Just one large film missed per day can equate to $25,000 annually. Without a protocol and focus, radiography can easily slip through the cracks. 4. Implement a Morning Huddle If someone were to ask me what is the best and least expensive way to increase productivity, profitability, and reduce stress in your practice, I would say, “Have a successful morning huddle.” Your morning huddle sets the tone and pace for the day, and is the best way to keep a team focused on patient care and production goals. The morning huddle agenda should consist of yesterday, today, and tomorrow. Yesterday, were all the patients called who required follow-up? Do we need to thank patients for (continued on page13)
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referrals? Today, are we booked to goal? Where is the opportunity in the schedule for same-day dentistry? Who needs a radiograph? Which patients are seeing the doctor but are not current in hygiene? Tomorrow, what does the schedule look like for the doctor and hygiene team? Are we scheduled to goal? Are all the lab cases in? Once you get your morning huddle systems in place, the actual huddle should not take more than 15 minutes. The morning huddle is not a place for gripe sessions, new equipment purchase requests, or patient protocol changes. Save big-picture discussions for weekly team meetings. For help implementing these strategies, visit www.HenryScheinBusinessSolutions.com and request a Henry Schein Practice Analysis. Jim Philhower, a 28-year veteran of the dental industry, is the director of North America Dental Sales Leadership and Development for Henry Schein Dental. He teaches dental teams throughout the world techniques to help reach their practice goals. Contact him at (800) 372-4346 or send an email to jim.philhower@henryschein.com.
4 Coding Tips To Stop Leaving Money On The Table
Jim Philhower, North America Dental Sales Leadership and Development for Henry Schein Dental
As the dental benefits landscape continues to shift to PPOs and reimbursement rates continue to shrink, many offices are struggling with increasing overhead and decreasing cash flow and profit margins. Coding correctly is critical for maximizing reimbursement, increasing cash flow, and minimizing any coding errors that could result in fines or worse. Every month we see dentists leave thousands of dollars on the table simply due to coding errors. Given the ever-changing world of coding, mistakes are inevitable. According to Dr. Charles Blair, there have been 135 coding changes, revisions, or deletions in just the past two years. To minimize your errors and maximize reimbursement, a thorough coding review should be conducted each year. The following are four codes to help you get started in 2016. 1. Fluoride Codes D1208 and D1206 Fluoride codes D1203 and D1204 for child and adult fluoride treatments were discontinued in 2013. They were replaced with code D1208, which is used for child and adult applications. We still see many offices reporting the old codes and most likely not being reimbursed for the procedures. There were also changes to the fluoride varnish code D1206 last year. Previous restrictions to patients with moderate to high caries risk have been eliminated. D1206 is applicable for child and adult reporting and pays a higher UCR than D1208. 2. D0140 Limited Oral Evaluation – Problem Focused or D9110 Palliative (Emergency) Treatment of Dental Pain D9110 is an underutilized code; overwhelmingly offices code D0140 for emergency visits when treating a patient for pain or discomfort. D0140 is an evaluation code and limited to the “one evaluation per six months” or “two evaluations per year” rule. Consider reporting D9110 for minor nondefinitive procedures to reduce discomfort, sensitivity, or pain at an emergency visit. D9110 is a procedure code and will not use one of the exam limitations. This palliative code pays a higher UCR than D0140. When reporting D9110, include the required narrative. Palliative D9110 should not be used in conjunction with (continued on page 15) a definitive procedure.
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What would you do “CHEST PAIN” In my last article, I talked about the importance of “putting in the practice” with regard to you and your teams’ emergency medical preparedness. What I am hoping to do is build on that with articles in the upcoming newsletters that you can read and discuss at your next staff meeting. I hope you will be able to apply the emergency medical cases that I present, and apply them to your current patients. You want to ask yourself who do we have as patient that would fit this scenario. My goal is to give your next emergency preparedness discussion a face. There’s no better way to prepare than to make it real.
64 year old male with chest pain It’s a Tuesday, around 2:30pm and you’re seeing a 64 year old male who states he started feeling pressure in his chest and shortness of breath 20 minutes ago. He denies nausea, but has a generalized weakness. His medical history includes several cardiac risk factors including hypertension (which is treated with an ACE inhibitor), mildly high cholesterol (that is controlled by diet) and he smokes a pack of cigarettes a day. Upon physical exam, you find he has a blood pressure of 180/100 with a heart rate of 112 its full and regular. He is breathing 16 times a minute and able to speak in full sentences and he is fully alert to self, place, time and events. You obtain an oxygen saturation of 96% as you place him on low flow oxygen. Due to your high index of suspension for Cardiac, you decide he is “SICK” and call 911. The Medics and EMT’s arrive 6 minutes later and take over patient care. Chest Discomfort - When you and your staff has a reasonable index of suspicion (IOS) that a patient’s symptoms are cardiac in origin, or that the patient is “SICK”, treatment must begin immediately. Here is where I want you to discuss what you were presented with and what would we do? 1. What were the Pt’s Signs and Symptoms? 2. How might the symptoms be different for a female Patient? 3. What are the minimum vital signs we need to obtain before 911 arrives? 4. What other signs or symptoms could you have obtained to help with your decision? 5. What medications would be appropriate for treatment? 6. If this Patient gets worse, what are we doing to preparing for that? One of the tools I provide in my classes is an emergency check list, this check list came out of discussions with Dr. Wendy Crissafulli and a book called The Checklist Manifesto. If you want a tool to help organize your patient information and help guide you during an emergency, it’s on my web site www.heartstartmedical.com Cardiac can be one of the most serious emergencies you face and what you do is critical to the patients’ survival, however expedited transport should also be the highest consideration. The longer the patient’s heart goes without adequate blood flow, the greater the chance for permanent heart damage or cardiac arrest; definitive treatment is not found in the pre-hospital environment. It is found in the hospital that is equipped and staffed to handle these types of emergencies, so expedited 911 and transport is an important tool for patient survivability. If there is any doubt Call 911 If you would like help getting your office prepared please feel free to call HeartStart Medical at 360-201-2052 or visit our website at HeartStartMedical.com for more information. My offer to you is a simple “Love it or your class is FREE!”
James Moquin, Owner HeartStart Medical 360-201-2052 | HeartStartMedical.com 14
(continued from page 13)
3. D0180 Comprehensive Periodontal Evaluation – New or Established Patient This evaluation code may be reportedfor established periodontal patients, patients showing signs or symptoms of periodontal disease, and for patients with risk factors such as smoking and diabetes. D0180 requires a complete and detailed periodontal evaluation, including full-mouth probing and detailed charting. D0180 may be reported at the same visit as a D4910; however, it may be downgraded to a D0120 fee. Do not report D0180 inaddition to a D0150 comprehensive evaluation. D0180 usually pays a slightly higher UCR than D0150. 4. D1352 Preventative Resin Restoration in a Moderate to High Caries Risk Patient – Permanent Tooth D1352 is a conservative restoration of an active cavitated lesion in a pit or fissure that does not extend into dentin, and includes placement of a sealant in any radiating noncarious fissures or pits. Do not report this preventive type resin restoration if the prep and decay extend into dentin. See D2391 for one surface composite. Do not report this preventative restoration if there is no active decay in the enamel. See D1351 for sealant. Do not report D1352 for a primary tooth. According to Dr. Charles Blair, some plans will pay more than two times the fee for a sealant but less than a one-surface composite, and some plans will pay the alternate sealant benefit. The average dental office can increase production tens of thousands of dollars a year simply by using these and other codes properly. We recommend combining a Henry Schein Practice analysis along with Dr. Charles Blair’s Practice Booster to maximize coding efficiencies, cash flow, and reduce costly errors. For help with coding, visit www.HenryScheinBusinessSolutions.com and request a practice analysis. Jim Philhower, a 28-year veteran of the dental industry, is the director of North America Dental Sales Leadership and Development for Henry Schein Dental. Jim teaches dental teams throughout the world techniques to help reach their practice goals. Contact him at (800) 372-4346 or send an email to jim.philhower@henrschein.com. Learn more at www.HenryScheinBusinessSolutions.com.
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COURSE DATES FOR 2016 Courses are scheduled in blocks. It is required to book all days of a block of courses when registering. Anterior Solutions: Introduction 2 day Course - Levels 1.0 & 3.0 April 29 and 30th 2016 June 24th and 25th 2016 September 16th and 25th 2016 December 2nd and 3rd 2016 Anterior Solutions Advanced: 3 Day Course - Levels 3.1, 3.2 & 3.3
March 11th and 12th 2016 October 7th and 8th 2016 8 CE credits per day Courses start at 7:30 am Breakfast and Lunch Included TO REGISTER CONTACT: Tanya Copeman 253-249-1182 tanya@bioclearmatrix.com
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Dr. Clark is on the cutting-edge of modern dentitstry. He founded the Academy of Microscop Enhanced Dentistry, is a course dire ot the Newport Coast Facial Institute, regularly teaches various courses and is on the editorial board of several journals. Dr. Clark conducts studies on a variety of subjects, publishes articles and develops new techniques and materials to better access, shape and restore teeth. L
March 24th, 25th, and 26th 2016 May 19th, 20, and 21st 2016 August 11th, 12th and 13th 2016 October 13th, 14th, and 15th 2016 December 8th, 9th, 10th 2016
Dr. David Clark, Founder
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DENTAL MARIJUANA “Gene, you want me to do what??” Dr. Sakai made a request last spring that I teach the club about marijuana. In fact, he suggested that further, we get experts and do a public program. Gene was concerned about the rising deaths from opiates and the fact that cannabis was now legal for both medical and recreational use in Washington and Oregon. “Dave, will it relieve pain in a safer way than other medications?” I am the primary mentor for the COORS AGD study club in Vancouver, Washington. My background is biochemistry, dentistry, and anesthesiology. I had an initial reluctance but that feeling tells me I should learn more. There is something important to learn. My anesthesia residency taught me a lot about receptor chemistry and the cannabinoid receptors are a more recent discovery. Much is still to be revealed. Some of the drugs I give people use the cannabinoid receptors. I have a starting point. Is there applicability in dentistry? Cannabis has been used by humans for at least 5000 years. The Scythians, Greeks, and Romans had medicinal uses for this plant. A cannabis extract was sold by Parke-Davis Pharmaceuticals in the first half of the twentieth century until it was outlawed. What do cannabinoids do? They take advantage of a natural hormonal communication system in animals that we now call the endocannabinoid system. There are two primary receptors and one subset. They are called CB1, CB1a, and CB2. They are “G” protein receptors that reside in cell membranes. That tells me what kind of side effects we might have since many other systems and drugs use “G” proteins. Cannabinoids are metabolized by the Cytochrome P450 system so that tells me what drugs might interact. There are no cannabinoid receptor in the medulla so they have little or no effect on respiration. That is a big plus. It’s a big reason why the toxicity is so low. There are many endocannabinoids that can effect mood, modulate pain, modulate inflammation, and modulate immune response. The plant based compounds can do these things also, a hack into the natural system.
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Prohibition has caused researchers to avoid studying cannabinoids for many years. Money was unlikely to be granted. That is no longer the case. Pharmaceutical companies see great opportunity to use these receptors. A large corporation would prefer to have a patented drug, a synthetic that they can control and sell. The hunt is on. Unfortunately, the synthetics have tended to be toxic. Ironic since the natural cannabinoids are recognized as some of the least toxic drugs, far less toxic than caffeine or acetaminophen. Can we or our patients use medical cannabis? The primary compounds are THC and CBD. THC causes people to get high and CBD does not. An emphasis on illicit recreational use caused growers to breed very high THC plants that have very low CBD levels. CBD has become famous for helping children with intractable seizures. Many of them get much better. THC and CBD can both relieve pain, approximately on the level of codeine or acetaminophen. Pain relief may also create the side effect of sleep. They aid people with a variety of ailments. Oral administration of cannabinoids tends to create a very
Highlights for 2016: Dr. Samuel B. Low Periodontics/Lasers Dr. Mark Donaldson Sedation/Pharmacology Dr. Arthur DiMarco & Ms. Kathy Bassett Anesthesia Dr. Lee Ann Brady Esthetics Mr. Kirk Behrendt Practice Management Dr. Terry Donovan Dr. Gerard Kugel Restorative Dr. Robert R. Edwab Oral Surgery/ Medical Emergencies Dr. Michael Sesemann Composites/Materials Dr. Jonathan A. Bregman Oral Cancer Dr. David Rothman Pediatrics Dr. Martin Trope Endodontics Ms. Trisha O'Hehir Dental Hygiene Dr. Leon Chen Hydraulic Sinus Condensing/ Sinus Perforation Ms. Jennifer Blake Dental Assisting Ms. Ann E. Spolarich Pharmacology
long lasting effect, perhaps as long as a day or more. That may be undesirable. Smoking causes a quicker onset and shorter duration. Smoking is not an attractive approach in view of the potential for damage to the lungs and the fact that many people do not smoke. Results will vary with patients. Undesirable side effects with THC can be memory loss or even paranoia. Why not use CBD? It is not desirable for recreational products, hard to extract, and that has made it difficult to obtain. Predictable content and therefor predictable dosing are difficult to obtain. Just because a product has numbers on the bottle may not reflect what is actually there. These are plant products and they are not regulated like a drug from Walgreen’s. Many of our patients use cannabis whether we like it or not. There is utility for nausea and vomiting, seizure disorders, modest skeletal pain relief, anxiety relief, depression relief, neuropathic pain relief, PTSD, suppression of immune responses, and many other conditions. They require no prescription. Can the problems that we treat in
a dental office be aided with cannabinoids? Some conditions may benefit we cannot expect predictability. With these natural extracts and products there is a low level of regulation and little standardization. Patients are self medicating and that means we need to educate ourselves to the effects. Both patients and doctors need to know. Cannabis isn’t going away. That’s why I salute Dr. Eugene Sakai’s wish that all of us to learn the authentic truth. The Washington Academy of General Dentistry has requested that our group of experts do a symposium in Seattle next year. Depending on availability we have a chronic pain patient, a psychiatrist, and neurophysiologist, a hospice care physician, and a dentist anesthesiologist. That’s what the AGD is about, continual improvement by deep learning. David Carsten, BS, DDS, MAGD, Dentist Anesthesiologist
2016 PNDC
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Total Team Experience Dr. Douglas Lambert Dr. Edwin McDonald Monica Monsantofils, RDH Lois Banta
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Educational grant provided by Dentsply, CareCredit and Solution Reach The PNDC is produced by the Washington State Dental Association.
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The Pacific Northwest Dental Conference (PNDC) will offer a unique, full-day course focusing on “The Total Team Experience.” This interactive course is designed for the entire office team (dentists, hygienists, assistants, and the front office member) to work together to enhance their individual roles and improve the overall functionality of the practice.
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Live Dentistry Stage: Digital Implant Dentistry: A Live Patient Surgical Demonstration Dr. Geoffrey Berg One Day Pankey Experience Understanding Aesthetic Materials, Methods, and Madness Dr. Michael Fling
Approved PACE Program Provider FAGD/MAGD credit. Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement. The current term of approval extends from 9/1/2013-8/31/2017. Provider ID#219279.
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Dr. Hess Asks “THE EXPERTS”
Mitchell Gardiner, DMD, FAGD mgardiner155@gmail.com
The American Heart Association and The ADA released the current guidelines for the prevention of infective endocarditis. The only patients who required prophylactic antibiotic coverage were patients who had the following conditions: Prosthetic cardiac valves Cardiac valve repair or replacement A history of infective endocarditis Heart transplant surgery Repaired congenital heart defects
No longer were patients who had a history of heart murmur or rheumatic fever in the group of patients that needed antibiotics before dental treatment. In December 2012 the American A: To answer that question let me pose Academy of Orthopedic Surgeons and a scenario: How would you handle this The ADA published the evidence- based clinical situation? I am seeing in my guidelines for preventing orthopedic practice a patient that I have treated implant infections during dental once or twice in the past with no issues. procedures. It stated that there was The patient is in to see me today for a insufficient evidence to recommend regularly scheduled cleaning and recall the use of antibiotic prophylaxis for exam appointment. In reviewing an dental patients with orthopedic joint updated medical history my patient who replacements. In 2014 the ADA Council appears to be a healthy 60 year old on Scientific Affairs and the American woman who tells me that she had hip Academy of Orthopedic Surgeons came replacement surgery 5 months ago and out with a joint statement affirming her orthopedic surgeon told her to be that prophylactic antibiotics were pre-medicated with an antibiotic before not recommended for patients with any dental procedures. She has not had prosthetic joints. any other medical issues to note and she has no known drug allergies. She The ADA recommends dentists review thinks she was told once by an internist these guidelines and consult with the that she had a slight heart murmur. patient’s orthopedic surgeon as needed, She did not get any prescription and consider the patient’s specific from her surgeon. What do I do? needs and preferences when planning treatment. Remember that as the treating dentist it is your responsibility to know current In this specific instance the standard of standards of care and to practice within care specifically states that antibiotics acceptable standards of care. In 2007 would not be called for in treating Q: My patient’s physician has told them they should have antibiotic prophylaxis prior to dental treatment. I don’t think they do. What should I do?
this patient. Remember, if something happens to the patient as a result of taking an antibiotic such as an anaphylactic reaction and it can be proven that you deviated from accepted standards of care by prescribing that antibiotic, you as the dentist are liable. Presently however there are many orthopedic surgeons who are still recommending antibiotics for their patients. So what do we do as the treating dentist? Most importantly it is the responsibility of the dentist to sit with the patient and explain the up to date current guidelines as it pertains to antibiotics and their treatment. There is a crisis in American health care today concerning over prescribing antibiotics for patients who do not need them. Bacterial resistance and untoward side effects are major problems. As dentists we are squarely in the middle of this crisis. I highly recommend contacting the orthopedic surgeon before a dental appointment and get medical clearance to treat the patient without antibiotics. Document the conversation held with their office concerning their recommendations. If they insist on antibiotic coverage have their office write the prescription and note it for future care in your office as well. If the patient insists on antibiotic coverage document the entire conversation that you had with them and that it is against your advice that they are taking the antibiotic. Remember, practicing within accepted standards of care is the standard that we are held to and any deviation from that standard that results in problems for the patient becomes the dentist’s liability problem. Review the current standards, talk to your patients about them, contact (continued on page 21)
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(continued from page 20)
the medical specialist for clearance to treat and fully document all of the conversations in your records. Mitchell Gardiner, Brief Biography
DMD,
FAGD
Dr. Mitchell Gardiner earned a degree in Zoology from Rutgers University in 1974. He earned his dental degree from the University of Medicine and Dentistry of New Jersey in 1977. After serving in the Navy, he became a full time general dentist in a multi-specialty practice in Shrewsbury, NJ. For over 25 years Dr. Gardiner has reviewed dental malpractice cases and he often serves as an expert witness in court. Dr. Gardiner lectures to dentists nationally and internationally on issues of malpractice. In addition to private practice, he is a clinical instructor in fixed prosthodontics at the Rutgers School of Dental Medicine. Dr. Gardiner is a Fellow in the Academy of General Dentistry, The American College of Dentists, and the International College of Dentists.
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Dr. Hess Asks “THE EXPERTS” opposing dentition. What are your recommendations as a laboratory technician to minimize wear created by zirconia restorations?
Daniel M. Swamy, CDT. CDT number 100632 – 00 Daniel Swamy attended University of Washington in Seattle and earned his Degree in Science in 1989. Paving the way to his own success, he transitioned from the dental laboratory business to pursue his passion for design, research, and development of new materials such as zirconia for aesthetic dental restorations. He is an innovative leader in the restorative dentistry arena. His back groundas an educator also allows him to work alongside some of the top prosthodontists, dental technicians, and clinicians. He has also served as an educator for dental industry leaders like Dentsply, Patterson/Sirona and esteemed affiliates of Sagemax Bioceramics. Daniel is currently the Vice President of Sagemax Bioceramics, the largest producer of dental zirconia, and is in charge of overseeing R&D and Technical Support for dental laboratory customers worldwide. Daniel M Swamy, CDT, AACD daniel@sagemax.com http://sagemax-dental.com Q: I know there is conflicting reports regarding zirconia and wear of the 22
A: Unfortunately, there is a lot of misinformation regarding the wear characteristics of zirconia. I highly recommend pre-polishing the occlusal surfaces of the crowns prior to applying glaze. Feldspathic glaze will wear at approximately 6 µ per year. Therefore after approximately two years the glaze will have worn off under normal circumstances. If the under structure is well polished, this surface wears perfectly against the natural dentition after glaze wear.(1) Glaze versus polished: The microstructure of glaze is relatively rough compared to a well-polished surface of zirconia.The tetrahedral state ofsintered zirconia resembles a tight matrix and particles are tightly arranged, therefore giving it a dense structure. Polished surfaces tend to be the best against natural dentition and wear in general. Optical properties are also enhanced in monolithic restorations when the surface has been polished, glaze applied and sintered in ceramic ovens. The luster of the crowns can also be controlled by this method. Monolithic vs layered: Whenever a layered restoration is fabricated, the veneered layer will be approximately 150 Mpa in strength. Monolithic crowns will be approximately 1000 Mpa in strength. This poses significant disparity in strength as well as fracture toughness. The veneered layer will also wear significantly quicker and be more abrasive. The bond between feldspathic
porcelain and the abutment is another factor that may contribute to its weakness. The one piece Monolithic restoration on the other hand, will resist fractures and accept higher load factors and has no weak veneered layer. Instructions for laboratory: Zirconia should be milled in well calibrated CAD/CAM’s instructions for tools and milling strategy should be followed. Care must be taken during the entire process so as not to create any stress fractures that may not be visible. Whenever possible leave the occlusal contacts of posteriors and lingual surfaces of anterior in parent zirconia. This will eliminate wear issues with layered felds pathic porcelains. Care must be taken to fire a wash bake that will enable ceramics to be bonded to the parent coping. Monolithic zirconia should be polished prior to glazing. The finished restorations should be sandblasted with 25 µ aluminum oxide internally. Recommendations for adjusting and polishing zirconia in office: Care must be taken to not over heat zirconia. A fine to medium grit diamond is preferred at low speed. This should be followed by a pre-polish with Carborundum infused rubber wheels. The final polish should be done with a 25 µ diamond infused polishing paste and a felt wheel. Whenever possible the crown should be re-glazed. This allows any micro fractures to seal. 1. Janyavula S, Lawson N, Cakir D, Beck P, Ramp LC, Burgess JO. The wear of polished and glazed zirconia against enamel. The Journal of Prosthetic Dentistry. 2013;109(1):22-9.
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INNOVATIVE PERIODONTICS: “Creating Success in Today’s Dental Practice” Samuel B. Low, D.D.S., M.S., M.Ed. Sponsored by the Washington Academy of General Dentistry, University of Washington & Seattle King County Dental Society Date: Friday, April 29, 2016 Time: 8:30 AM - 4:30 PM Credits: 7 Lecture Subject Code: 490 Location: Bellevue Westin Hotel - 600 Bellevue Way NE, Bellevue, WA 98004 Want to utilize your Hygienist’s time more productively? Looking for a quality resource for “what’s new” in dental products, systems and technology? With periodontitis being the major contributor for tooth loss in the practice of dentistry, resolving the disease process requires the entire dental team’s commitment to a systematic approach. This presentation will provide the participant with user-friendly protocols and technological solutions to find and manage periodontal disease. Take the frustration out of delivering periodontal care and gain success with patient case acceptance, tooth retention and financial reward.
Learning Objectives: • Standardizing the collection of periodontal data in an efficient manner to accurately determine the prognosis of restorative abutments considering when to extract and place implants. • Empowering the dental hygienist with expanded work descriptions beyond the “prophy”. • Investigating computer system approaches to risk assessment determination • Developing “realistic” non-surgical therapies and the respective reevaluation with emphasis on “new” anti-inflammatory systems including micro-ultrasonics and laser technology, and nutraceuticals as probiotics and anti-oxidants • Determining the efficacy of utilizing various laser wavelengths in sulcular decontamination, degranulation, new attachment, and bone regeneration • Reviewing successful parameters to determine tooth survival in short and long term prognosis • Establishing a quality periodontal maintenance program that enhances the restorative practice including third party reimbursement. • Creating positive interactions between dentists, periodontists, and dental hygienists through communication skills and continuous quality improvement to enhance esthetics, tooth retention, and implant placement
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“Neurotoxin Therapies for the Dentist” Timothy A Hess, DDS, MAGD Affiliate Faculty Oral Medicine UWSOD Saturday, May 7, 2016 8:00 am – 5:00 pm Credits: 8 University of WA Dental School Health Sciences Center Room D-209 Clinic portion: HSC, D-2 Clinic, Room D-251 Botulinum toxin-A (BTX-A) utilization by healthcare professionals is increasing. The dentist’s expert knowledge of the head and neck anatomy makes them an ideal provider of BTX-A therapies. This presentation will be didactic, based on the curriculum from the University of Washington School of Dentistry, and will also include demonstrations of BTX-A administration as well as hands-on participation by attendees. Educational Objectives will focus on by not limited to: 1) Introduction to BTX-A aesthetic and therapeutic procedures of the head and neck performed by dentists; 2) Preparation and administration of BTX-A; and, 3) Evaluation, communication and documentation of BTX-A treatments to achieve clinical success and meet patient expectations. Additional Information: This course is recommended for dentists wishing to implement Botulinum toxin-A aesthetic or therapeutic procedures. Dentists are encouraged to bring a staff member who assists in the procedures. Participants should bring: loupes, proof of malpractice coverage and one patient for the administration of BTX-A. *Dentists must purchase 100 units of Type With 100 Units BTX-A (either Xeomin® or BOTOX®) Xeomin®* for the course. *Additional Staff - $250 each
Dentist
With 100 Units BOTOX®* $1,800
$1,700
About our Presenter
Timothy Hess, DDS, MAGD, is a general dentist practicing in Auburn, WA. Dr. Hess is a 1994 graduate of University of Washington, an affiliate faculty of Oral Medicine, an Affiliate Instructor in Restorative Dentistry and the Director of the Tucker Institute at the University of Washington. Dr. Hess lectures and presents hands-on courses for BTX-A and dermal filler therapy. He has been published in the Journal of Prosthetic Dentistry, International Journal of Oral & Maxillofacial Implants and Operative Dentistry. He has lectured at the American Dental Association Annual Meeting, the Academy of General Dentistry Annual Meeting, the Pacific Northwest Dental Conference and the Canadian Academy of Restorative Dentistry and Prosthodontics. He currently lectures on implant failures due to restorative techniques and materials. He is a Master and has his Life Long Service Recognition from the AGD, Fellow in the International College of Dentists, Academy of Operative Dentistry, Pierre Fauchard Honor Society, International Team of Implantology, DOCS Sedation, Spear Faculty Club and President-Elect SKCDS.
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HIPAA breaches are not only time consuming, but expensive. Costs associated with a breach, not including fines, can easily balloon into six figures.The Experian DataBreach Industry Forecast for 2015 predicted the health care industry would be “plagued” with data breaches, stating that “the potential cost of breaches for the healthcare industry could be as much as $5.6 billion annually.”
Some of the expenses include: letters (printing) and postage for patient notification, establishing a Call Center to handle patient’s phone inquiries, ID theft or credit monitoring services, forensics investigation, and legal costs including defense and judgements. To be HIPAA compliant, you are required to assess your practice’s vulnerabilities concerning the safekeeping of PHI. Identify where PHIis received, maintained, stored or transmitted; identify and assess the risks for each of those areas; rank and prioritize the risks; and then create and implement policies and procedures to safeguard the PHI. Document each step. Create policies and procedures for responding to a breach and document. Regularly review and when necessary, update your policies and procedures, and document. Make sure computers are encrypted and security patches are current. Every step should be thoroughl documented for referencing, or in the event you need to produce it to the OCR. Did I say document?! To be HIPAA compliant is without a doubt, a time-consuming undertaking. But not to be could eventually create larger headaches and expenses farther down the road. NORDIC is pleased to offer our insureds, at no charge, a HIPAA Compliance Packet complete with HIPAA forms and step-by-step tools to complete a practiceassessment. We also offer cyber sponsored by the COORS study club and the Clark County Dental Society insurance designed specifically for dentists; and you don’t have to have your malpractice policy with NORDIC to be eligible. For more Club Green Meadows information, please contact us at (800) 662-4075,
Terry Tanaka, DDS
7703 NE 72nd Ave | Vancouver, WA 98661 5 May evening 6:30 PM “Problem Solving with Less Suffering” 6 May 8 AM to 3 PM (including lunch) “Problem Solving for Dentists”
Dr. Tanaka is one of the world’s most respected dentists. He has made important and diverse contributions to prosthodontics, pain management, anatomy, radiology, articulator design, implants, cleft lip and palate, endodontics, and education. His instructional tapes are used in more than 80 medical and dental schools. Terry has a keen interest in helping all dentists and patients solve difficult problems. This material is applicable to both restorative dentists and specialists. He has been a popular lecturer for more than 40 years. The evening program will introduce the longer program the next day. Dr. David Carsten, Dentist Anesthesiologist Cogito ergo vos somnii. PacificDentalAnesthesia.com | 360-600-2848 Blog: www.aReturntoEmpathy.com | www.beingwellagingwell.com Study Club: www.COORSdentists.org 26
R E F LE C T I O NS In June 2007, I was two years out of dental school when for reasons unbeknownst to me now; I decided to open a scratch-start office in Bellevue. I went to dental school in Detroit, had no local connection, and best of all, I had no prior business experience. However, this was dentisty, and how hard could it be? The economy was going great, I asked US Bank for a $100,000 loan and they offered me $300,000. After my buildout and setting up my office, I was half a million in debt. I asked what the bank what they wanted for collateral, they said not to worry about it, dentistry is a great field where everyone does well. Good luck. About a year later I got married, and it was large affair with nearly 500 people in attendance. A month after the wedding, Lehman Brothers collapsed. My timing was impeccable. In the meantime at my office, I made sure that the 3-4 patients I had booked every day at least saw each other, so that I would look busy. In retrospect, I should’ve been bankrupt by the end of 2008. As I look back, I have a good idea as to why I survived with all of my naivete and inexperience, and the reason being the Washington AGD and Mastertrack whom I owe a great debt. Dr. Puneet Aulakh,WAGD President
More than the lectures, hands on participation, and the camaraderie between the participants; it was the ability to lean on people in the Mastertrack for advice and guidance. You learn quickly after dental school that, not only do you not know a lot, but that there is SO much to learn. The main reason I am here today is because of Mastertrack and the people in Mastertrack. They are the reason I have my fellowship (FAGD) and mastership (MAGD) in the AGD, and they are the reason I am involved with the WAGD and the AGD as board member, delegate, and the WAGD president. In order to be a successful dentist, you have to have a support structure. The support structure includes having people you can ask questions, advice, and provide guidance. I have asked collegues about what they find to the best implant system, if I should buy a Wave 1, or what composite they use and why. I recall an incident where I had a patient come to me with an implant he had placed somewhere in Vietnam. I had no idea what type of implant it was, and thus I started out by sending an email to the group. By the end of the day, I had 5 answers to my question. Dentaltown a great resource, but it is also useful to call/ email our colleagues for advice and guidance. I always tell people there are 3 things that made me a better dentist: the WAGD, Dr. Tucker, and Mastertrack. Reflections on a start-up practice. Looking back If you could go back and do something differently, what would it be? I made many mistakes, but looking back; I wouldn’t change much because I learned from those mistakes. The learning was invaluable. If I had to do something differently, it was the fact that I bought too much equipment, and supplies. It is important to buy things that are necessary; it is not helpful to buy things you will never use or buy too much so that it expires. As a new startup, you don’t need a lot of inventory and you should not buy in bulk because you don’t know how much you will be using. As far as building out, you need a practical office. Do not try to build a palace. Save the palace for when your practice is more mature and you are moving/buying a building.
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What were some of the challenges you faced in starting up a practice? The biggest challenge I faced in starting up a practice was getting patients in the door, and looking busy. Making sure the 2 patients that had an appointment for that day would see each other!! If you’re running behind, its not because you are slow or the staff member did not come; it is because you are “busy”. Everyone likes to go to a busy office :-) The other challenge was making sure patients pay for their treatment at time of service. In the startup mode, you are just looking to get patients in the door and out the door, and you are not focused on collections. You may think if you are busy, you are making money. It is crucial to know if you are getting paid for the work you are completing on the patients. You don’t want your accounts receivable to get out of control. The last challenge I faced was not knowing dentistry beyond dental school. I needed education on molar endo, implant placement and restoration, surgical and 3rd M extractions, ortho, etc. There was more to dentistry than what I had learned in dental school. The Washington AGD and the Mastertrack study course they put together made me a complete dentist. If you could give one short piece of advice to a dentist about to start up a new practice, what would it be? It gets better. Don’t lose sight of the big picture. You’re building for the long term. Each day is an opportunity to learn. If the schedule has holes, practice your interpersonal skills. Experiment with dialogue, jokes, and explanations on how you do things. Don’t be discouraged. Take every experience and setback and look at it as an opportunity on how to improve yourself. For example, if an extraction took 2 hours, ask yourself how can you improve next time, how would you approach it differently, and what would you tell the patient to calm their nerves? Self reflection and self critique are two important qualities that can teach you to be a better dentist. If you had difficulty completing a root canal, ask yourself how can you improve next time; at least you got the patient out of pain, at the very least it was a gross pulpal that taught you that next time it’ll be a root canal. Build upon things you learn. I can’t stress this enough, but ask your friends, colleagues and mentors questions to continue the learning process. Can you name some products/services you used or discovered when starting up your practice. AGD/WAGD: CE, knowledge, mentorship. Looking back, I had the bare minimum skills when I opened up. The most important thing I did was to join the Mastertrack group that the WAGD had setup. The CE I received from the AGD allowed me to become a complete “general dentist”. It gave me the knowledge and confidence to become a better dentist. Dentaltown: There is no explanation needed. You have questions, Dentaltown has answers. SLR camera: The hardest part when a new patient comes in the door is building trust. I take a complete set of intraoral pictures and go over those pictures with the patient. After you blow up the tooth 30 times bigger, there’s not much explaining to do. I show patients what their teeth look like and there it is; you have this issue/cavity/lesion/calculus. There is no selling dentistry, you came in with this, and this is what we can do, and here are the photos of previous patients with the same issue and this is how we did it. The best part of using an SLR camera and providing photos is that it makes you a better dentist. You will make sure you do the best work you can because patients will request to see the before and after photos. When you show patients what you did, the work you completed will earn you their trust. A picture is worth a thousand words. (continued on page 29)
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After taking pictures you get a portfolio of before and afters (composites, RCT, crowns, veneers, Ortho, etc), it makes the discussing treatment to the patients that much easier. Taking photos using an SLR camera and or an intraoral camera, sets you apart. I feel too few dentists take time to do this and it’s a shame. Tucker Study club: Dr Richard Tucker Sr. was my mentor in Tucker Gold study club for 3 years. The professionalism and attention to detail he put in his work was inspiring. Because of him I strived to become a better dentist. Do want you would want done to you, and do it the best of your ability. If you know it’s not good enough, make it good enough. When asked, given all his accomplishments, what he wanted to be remembered for, he said, “I want to be known as a good denitst.” He will be dearly missed.
AGD 2016 BOSTON
REVOLUTIONARY CHANGES IN DENTISTRY July 14 to 17, 2016 • Hynes Convention Center • www.agd2016.org
AGD 2016 Registration Is Now Open! Join the AGD for its 2016 annual meeting, AGD 2016, July 14 to 17 at the Hynes Convention Center in Boston. During AGD 2016, there will be a comprehensive variety of FAGD/MAGD-accepted educational opportunities, including: • Two live patient demonstrations, with Todd B. Engel, DDS, founder of the Engel Institute. • A “Dental Pearls From AGD Masters and Fellows” lecture course, with AGD Masters and Fellows • “WOW! Complete Dentures in One Hour,” with Lawrence N. Wallace, DDS, developer of the Larell One Step Denture™. This participation course sold out shortly after AGD 2015 registration opened! • Courses for the entire dental team on topics such as dental sleep medicine, caries management, dentin hypersensitivity, and more. Visit www.agd2016.org today for more information and to join the conversation!
Approved PACE Program Provider FAGD/MAGD Credit. Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement. 6/1/2014 to 5/31/2018
2016-2017 MasterTrack Program
The Washington AGD is offering a hands-on program that showcases courses in at least 19 different disciplines. *For those dentists seeking a well balanced hands-on interdisciplinary education, this study club program will answer that call! *For those dentist seeking Fellowship in the AGD, this program contains all of the requirements to reach this goal. *For those seeking Mastership in the AGD, this program over 5 years contains all of the requirements to achieve Mastership.
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See you at the 2016 Membership Gala, October 14, Four Seasons Hotel, Seattle
From the Washington AGD
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We’re on the move! The Washington Academy of General Dentistry (AGD) is on the move in more ways than one! In February our Washington AGD Headquarters moved from our Milton location to our “New” Educational Center at Airport Plaza, 19415 International Blvd, SeaTac, WA. This move means easy freeway access for our members, whether coming from Interstate 5 & Interstate 405, easy walk for the SeaTac International Airport and soon to open one block from the center will be the Sound Transit Link Light Rail Station! Our move out of the pricey hotel business into this new center also means cost savings we can pass along to our members in complimentary courses and reduced-fee services. Watch our website, social media sites and newsletter for updates, including dates for our Open House!
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Washington Academy of General Dentistry 19415 International Blvd, #410, SeaTac, Washington 98188 Office 253-306-0730 | Fax 206-212-4969
MEMBERSHIP APPRECIATION GALA By the order of WAGD’S Secret Service your presence is requested. Your mission if you choose is to attend the 007 celebrations October 14, 2016 Wine Reception & Check In: 6:30PM-7:00PM Casino Table & Entertainment: 7:00PM-11:00PM
Ticket for Washington AGD Member Dentists are Complimentary as a thank you for your membership! Additional Guest Tickets $125 can be purchased for this event. Please RSVP!
Four Seasons Hotel 99 Union Street Seattle, WA 98101
RSVP Contact: Agent Valerie Bartoli
washingtonagd1@yahoo.com 253-306-0730 www.washingtonagd.org
NON PROFIT ORG US POSTAGE PAID PERMIT NO 243 PORTLAND OR