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December 2018

Office Design

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Office Design

14 6 8 30 34 38

Editor’s Note

An end to the year marks new possibilities

Periodontal Disease

When sales reps understand the risks of periodontal disease, they can better understand their dental customers’ concerns.

Needlestick and Sharps Injuries

Changing Gears

Burkhart account manager Katey Hakes finds satisfaction meeting the unique needs of each of her customers.

Dentistry may not be as dangerous as skyscraper construction or racecar driving, but it has its share of risks.

OSAP Dental Infection Control Boot Camp™

Addressing Workplace Bullying

Bullying in the dental office can take an emotional and financial toll on the practice.

Dental Overhead Lighting Wheels in Motion

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Piped vs. Portables

Piped nitrous oxide systems often offer the best solution – provided they are properly installed.

News

December 2018

First Impressions

One man’s passion for design has led to newfound mobility for those in need.

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EDITOR’S NOTE

LAURA THILL Editorial Staff

An end to the year marks new possibilities Whether we regard

December as the close to another year or a time to forge new beginnings for 2019, our paths are clear: Personally, and professionally, the year ahead presents a new start and a multitude of choices. For dental professionals, 2019 will present some of the best solutions we have seen thus far.

In this issue, experts weigh in on the value of a well-designed office space. From the sterilization center to the equipment, delivery systems and more, if the operatory is not designed around efficient workflow, function and opportunities for growth and expansion, dental professionals will not reap the full benefits of today’s sophisticated solutions. At the same time, a successful office design depends on the expertise of several key people, including the dental owner, the distributor design specialist and equipment manufacturers. Indeed, careful communication from the very beginning can help ensure the goals of the practice are met, while avoiding common mistakes. And each manufacturer brings a unique perspective to the process. To cite a few: • “A-dec territory managers are trained to think holistically about the patients, materials and instrument flow throughout the office, which is an essential element of good practice design,” says Ciarán Hynes, product management director, A-dec. • “When planning for future growth, you want to make sure your dental customers have dependable equipment that will last and not be an expense or a headache down the road,” says Carolyn Buck, national sales manager, Engle Dental. • “Instrument management and infection control is often saved until later in the design process, when it really should be an earlier focus,” says Chantel D. Willis, associate director, SBU, instrument management and infection prevention, Hu-Friedy. • “The design team will never avoid all mistakes, but it’s important to help minimize risks for the client by communicating and documenting all meetings and decisions,” says Tracy Thompson, director of sales, Porter Royal Sales Group. • “We encourage distributor design consultants to start a discussion with their dental customers about instrument storage early on,” says Nicolle Campion, president, Zirc Co. The First Impressions team wishes our readers a prosperous close to 2018. Our magazine stands on your ideas, and we’re proud to give voice to them.

December 2018

First Impressions

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Editor Laura Thill lthill@ sharemovingmedia.com Managing Editor Graham Garrison ggarrison@ sharemovingmedia.com Founder Brian Taylor btaylor@ sharemovingmedia.com Senior Director of Business Development Diana Craig dcraig@ sharemovingmedia.com

Director of Business Development Jamie Falasz, RDH jfalasz@ sharemovingmedia.com Art Director Brent Cashman bcashman@ sharemovingmedia.com Circulation Wai Bun Cheung wcheung@ sharemovingmedia.com Weekly Drill Editor Alan Cherry acherry@ sharemovingmedia.com

First Impressions is published bi-monthly by Share Moving Media 1735 N. Brown Rd. Ste. 140 • Lawrenceville, GA 30043-8153 Phone: 770/263-5257 • Fax: 770/236-8023 www.firstimpressionsmag.com

First Impressions (ISSN 1548-4165) is published bi-monthly by Share Moving Media., 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2018 by Share Moving Media. All rights reserved. Subscriptions: $48 per year. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address. POSTMASTER: Send address changes to Share Moving Media., 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors.

First Impressions editorial advisory board Shannon Bruil, Burkhart Dental Frank Cohen, Safco Steve Desautel, Dental Health Products Inc. Nicole Fox, Patterson Dental Suzanne Kump, Patterson Dental Dawn Metcalf, Midway Dental Supply Lori Paulson, NDC Patrick Ryan, Benco Dental Co. Scott Smith, Benco Dental Co. Tim Sullivan, Henry Schein Dental

Clinical board Brent Agran, DDS, Northbrook, Ill. Clayton Davis, DMD, Duluth, Ga. Sheri Doniger, DDS, Lincolnwood, Ill. Nicholas Hein, DDS, Billings, Mo. Roshan Parikh, DDS, Olympia Fields, Ill Tony Stefanou, DMD, Dental Sales Academy

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WHAT YOU MAY HAVE MISSED

Periodontal Disease When sales reps understand the risks of periodontal disease, they can better understand their dental customers’ concerns.

Periodontal disease begins with gingivitis – a mild form that causes the gums to become red, swollen prone to bleeding. The good news is that, with professional treatment and good oral homecare, gingivitis is reversible. Left untreated, however, gingivitis can advance to periodontitis. Plaque can spread and grow below the gum line over time, and toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response, causing the tissues and bone that support the teeth to break down. In turn, the gums separate from the teeth, forming pockets, which can become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Eventually, teeth can become loose and may need to be removed. The most common forms of periodontitis include: • Aggressive periodontitis. Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction, and familial aggregation.

• Chronic periodontitis. Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/ or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur. • Periodontitis as a manifestation of systemic diseases. This often begins at a young age. Systemic conditions, such as heart disease, respiratory disease and diabetes, are associated with this form of periodontitis. • Necrotizing periodontal disease. Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such, as HIV infection, malnutrition and immunosuppression.

Source: The American Academy of Periodontology. For more information visit https://www.perio.org/consumer/types-gum-disease.html.

December 2018

First Impressions

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Periodontal disease affects over 50 percent of adults 30 years and

older, according to research by the Centers for Disease Control and Prevention. Because genetics often play a role in periodontal disease, however, some patients mistakenly believe there is little they can do to control it. But, that’s not so, notes Amy Miller, RDH, business development manager, SDI (North America), Inc. Flossing, brushing with a sonic or electric toothbrush, the use of a water flosser and improved nutrition all can help slow down or reverse the disease. “Patients have many options for addressing periodontal disease,” she points out. “It’s important that they work with the entire dental team, from the periodontist to the hygienist and general dentist, to explore the oral antibiotics and mechanical tools available to them. In turn, the dental team should conduct a thorough risk assessment.”

Riva Star: A patented two-step process Scaling and Root planning – or the process whereby bacteria and tartar are removed from the tooth surfaces and beneath the gums – are common means for limiting periodontal disease. At the same time, periodontal disease can exacerbate tooth sensitivity, making the process more difficult for both the hygienist and the patient. “When the hygienist removes bacteria from the tooth surface, the surrounding tissue shrinks, exposing new and potentially sensitive dentin,” Miller explains. Dentin is sensitive to hot, cold and pressure, and in some cases, patients require anesthesia or nitrous oxide to help them make it through the cleaning process, she says. SDI’s Riva Star, a next-generation, two-step silver diamine fluoride desensitizer is FDA-approved for use in the United States with the same indication as fluoride varnish, giving patients a novel

December 2018

First Impressions

“It’s important that they work with the entire dental team, from the periodontist to the hygienist and general dentist, to explore the oral antibiotics and mechanical tools available to them. In turn, the dental team should conduct a thorough risk assessment.” – Amy Miller, RDH, business development manager, SDI (North America), Inc.

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solution to address their tooth sensitivity with immediate relief and over two years of desensitizing results. Riva Star’s key ingredients include silver fluoride (a silver capsule), which has known antibacterial properties, and potassium iodide (a green capsule), designed to bind silver ions and help avoid darkening around active cavities or decalcification. Both properties treat sensitive areas for up to five teeth. “Not only is Riva Star indicated for post-operative periodontal surgery and hygiene appointments, it’s also great for pre-hygiene for all sensitive and exposed root surfaces,” says Miller. “It is a great insurance policy to be applied by dentists after surgery, before the patient’s anesthesia has worn off.” Riva Star is a game-changer for all dental practices, including pediatric practices, Miller continues. “Clinicians should consider how many times each day they see patients with exposed root surfaces and sensitivity, preventing them from providing adequate treatment,” she says. “Riva Star is cost-effective, noninvasive and addresses sensitivity with other antibacterial properties. And when used according to the manufacturer’s directions, and the second step (potassium iodide) is applied, any darkening around an active cavity or de-calcification will be mitigated.” For more information, visit sdi.com.au.

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YOUR SMILE. OUR VISION.

FIRST PERSON

Changing Gears Burkhart account manager Katey Hakes finds satisfaction meeting the unique needs of each of her customers.

When Katey Hakes joined the dental products sales industry seven years ago, she looked forward to connecting with a new set of healthcare customers. After a seven-year hiatus from work while raising her children, she was ready to restart her career. When a sales position opened at Burkhart Dental in 2011, she saw this as a way to maintain her connection to healthcare, but on a more personal level. Her previous experience – 17 years as a territory account manager for Baxter Healthcare with oversight over the entire state of Idaho – prepared her well for her new role. At the same time, she recognized her dental customers faced a different set of challenges. Dentists are very much like smallbusiness owners, Hakes points out. “The daily pressures they face to make the right decisions for their employees, their patients and their practice is huge,” she says. Every dental practice is unique, she adds. “There are many different types of dentistry and many philosophies on how a dental practice can be successful.” Finding the right solutions for each of her cusKatey Hakes tomers means “changing gears every 30 minutes,” but it’s a challenge she welcomes. “There are so many ways to interact and work with dental practices, there’s really no right way to do my job,” Hakes says. “As the dental industry continues to change and evolve, I must continue to find the best solutions for each practice. I love the personal connection this enables me to develop with each of my dental customers.” The longer she works in the industry, the more experience she can offer her customers, she adds, noting that there’s always room for her to grow and improve.

she explains. And, while this may have impacted some manufacturer-distributor relationships, Hakes continues to work closely with her manufacturer partners. “I talk weekly to most of the key manufacturer reps in my geography, and travel with them about twice each month,” she says. “I also send manufacturer reps leads, so that they can communicate directly with the dental offices. I believe this is a more effective/ efficient way of working together because they can focus on the actual needs of our customers. Together, distributor and manufacturer reps can offer additional value to dental practices, she continues. “As a distributor sales rep who handles many different products, I often rely on my manufacturer rep partners to share their in-depth product expertise (as well as clinical information) with our dental customers.” Particularly as her dental customers formulate their goals for the coming year, the more value sales reps can offer, the better, notes Hakes. “My dental customers are looking to grow their practices and add new patients next year,” she says. “They hope to improve their staff systems and processes, their buying decisions regarding supplies and equipment, and their technology options. I look forward to bringing as many resources and as much value as I can to help them move forward and make the best decisions for their practices.”

Consulting solutions

Working with manufacturers Traditionally, manufacturers worked exclusively with a few distributors who, in turn, would work with the dental practice owners. In Hake’s experience, this is changing. “Dental practice owners no longer want to be told who they must buy products from,”

December 2018

First Impressions

Many decisions go into growing a dental practice, which means dental owners likely have a lot of questions for their sales reps and design consultants. Burkhart’s consulting service, Practice Support Team, helps clients with specific challenges, from scheduling to compliance. The Practice Support Team helps take clients’ practices to the next level, at no cost to the client. For more information visit https://www.burkhartdental.com.

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Office Design Dentists neednâ&#x20AC;&#x2122;t overspend to create their dream office space. A highly efficient office reflects careful plan-

ning, and a successful office design depends on the expertise of several key people, including the dental owner, the distributor design specialist and equipment manufacturers. Indeed, the priorities and concerns of one practice may be quite different from the next, and when manufacturer and distributor reps join forces from the very beginning, they can help dental professionals take the right steps to achieve their goals, while avoiding common mistakes.

December 2018

First Impressions

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Form and Function

Dental patients are drawn to an efficient and attractive practice, say experts. BY LAURA THILL Editor’s note: This article originally ran in the First Impressions 2018 Equipment Guide.

Designing a new dental office is no small undertaking. As with any proj-

ect, it’s a time-consuming and costly endeavor and without an expert’s guidance, dental owners risk making decisions that can adversely impact the future of their practice. Not only is it important to design a dental office “for the future,” it is essential to design with both form and function in mind, according to Jen Rhode, Integrated Design Studio manager, Henry Schein Dental, and Ben Oliver, equipment sales specialist, Henry Schein Dental.

“At Integrated Design Studio, we focus on creating a warm and inviting environment, as well as creating a space that offers function and efficiency,” says Rhode. “In order to achieve the ideal work environment and ultimate patient experience, we structure the space into three

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First Impressions

December 2018

OFFICE DESIGN finalizes equipment specifications, installation requirements and placement. “The average equipment budget for a startup dental practice is between $150,000- $200,000,” Oliver says, adding that dental owners’ initial concerns are how many rooms/operatories they should build and what technology they should add first. “Typically, practitioners start with three operatories, digital sensors and intraoral cameras,” says Oliver. That said, depending on the line of equipment they select – and the cost involved – it may be more practical to begin with two operatories, he notes. “If the practice owner needs four operatories, as well as technology, we offer a complete portfolio of cost-effective solutions to meet their budget,” he says. In many cases, dentists want digital impressioning up front, but may not have the budget to accommodate it. “To help meet their needs cost-effectively, we suggest different brands of operatory equipment, mechanical room equipment and other categories of equipment, thereby freeing up their budget for digital impressioning. By offering a wide range of equipment, we can provide a balance of quality and technology that dentists want.” If dental owners don’t plan for the long-term, they risk limitations down the road, Oliver points out. “We must design dental offices for the future, which means adding 3D printing and milling units,” he says. “Designing an office without the ability to have this technology would be like designing a car without the ability to navigate! – Jen Rhode, Integrated Design Studio manager, Henry Schein Dental “Designing an office around CAD/ CAM and 3D is crucial to its ability to be competitive while delivering the highest level of quality and convenient patient care,” he continues. “Clinicians often focus on how they can expand their practice based on the volume of patients, but we encourage them to consider how a remodel – with the integration of 3D and CAD/CAM technologies – can help enhance efficiencies and increase production. Two examples of this are in sleep dentistry and implantology. The top two nitrous oxide manufacturers offer digital portable nitrous options that are both efBen Oliver ficient and esthetic.”

zones: public, treatment and staff zone. Beyond flow and function of space, we partner with our team of equipment and technology sales specialists to optimize our customers’ space and identify equipment and technology needs, including chairs and delivery units, cabinetry, mechanical utilities, digital diagnostic equipment, imaging solutions and digital restorations.” Together, Henry Schein’s Integrated Design Studio team and equipment technology sales specialists strive to create a personalized office space designed around function, creativity and innovation. “We work with both general and specialty practices around expansions, remodels and new construction,” she says. “We offer space planning, 3D visualization and interior finish selection, such as furniture, fabric, flooring, paint, laminate, solid surface, wallcovering, artwork, décor and lighting.” Once the dental practice works with the equipment sales specialist, such as Oliver, to select its equipment, Rhode’s team

“ In order to achieve the ideal work environment and ultimate patient experience, we structure the space into three zones: public, treatment and staff zone. Beyond flow and function of space, we partner with our team of equipment and technology sales specialists to optimize our customers’ space and identify equipment and technology needs, including chairs and delivery units, cabinetry, mechanical utilities, digital diagnostic equipment, imaging solutions and digital restorations.”

Jen Rhode

December 2018

First Impressions

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OFFICE DESIGN

“We must design dental offices for the future, which means adding 3D printing and milling units. Designing an office without the ability to have this technology would be like designing a car without the ability to navigate!” – Ben Oliver, equipment sales specialist, Henry Schein Dental

Sterilization center The sterilization center is a primary consideration in designing an office, according to Oliver. “The sterilization center should be within 30 feet of all operatories and preferably have two entrances to offer easy access and improve workflow and efficiency,” he says. Often, a semi-open look is created by incorporating a glass wall to separate the sterilization space from the operatory hallway, enabling patients to see the dental team at work and helping to put them at ease, he explains. “The size of a steri-center is just as important as its location,” says Oliver. “For a mid-size office with four to six operatories, we suggest between 12-16 linear feet of sterilization space. A linear sterilization area utilizes the space more efficiently, but sometimes an L- shape is required. A galley style sterilization area is also a great way to design a steri-center, preferably with an entrance on each side. For dental practices with more than six operatories, the multiple steri-centers must be addressed to ensure proper flow.

Chairside ergonomics It seems dentists often prioritize the health of their dental team and patients over their own wellbeing, notes Oliver. “This is a topic that the equipment sales specialist should discuss with every doctor,” he points out. “For dentists new to the field, it is important that they create good ergonomic habits early on. It’s just as important for seasoned dentists to modify their habits to decrease spinal and musculature fatigue, which they likely have been experiencing for many years.”

December 2018

First Impressions

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For starters, equipment specialists should focus on the placement of the doctor’s instrumentation and his or her proper seating on the stool, notes Oliver. No matter where the dentist’s unit is located (i.e., chair-mounted, 12-o’clock-mounted or side-mounted), there are pros and cons, he says. “As our customers’ trusted advisor, we must discuss each option and pick the best fit for their practice. When it comes to stools, configuration and set-up is key.” Even the most expensive stool available on the market may not offer the appropriate size seat pan, height or tilt for a particular dentist, he points out. “Set-up is key, and an equipment specialist – together with the manufacturer – should help with this.”

First impressions Patients form their impression of the dental practice the moment they enter the waiting room. So, it’s very important that the front office reflect the level of care that the patient expects to receive, says Oliver. “Dentists should take a tip from Starbucks! On average, Starbucks completes a minor remodel every three to five years. Do they do this because the place is falling apart? No. They do this because the customers’ perception is their reality. “Clinicians must keep their practice up-to-date and relevant,” he continues. “Updates do not necessarily mean adding a flat panel TV and a Keurig in the waiting room. Rather, the dental practice should maintain a clean, contemporary, welcoming environment.” Amenities, such as beverage stations, a children’s play area, comfortable seating and charging stations, reinforce the professionalism of the dental practice and beckon patients, Rhode adds.

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OFFICE DESIGN

Planning Makes Perfect A concerted effort on the part of the manufacturer and distributor reps helps ensure a smooth office design project

Planning a new

dental office can be challenging for any dental owner. However, the priorities and concerns of one practice may be quite different from the next. Having an experienced territory manager and design consultant on hand from the beginning can help dental professionals take steps to achieve their goals while avoiding common mistakes. “Ideally, dental customers should be thinking about patient and material flow throughout the building at the earliest stages of the design planning process,” says Ciarán Hynes, product management director, A-dec. “Minimizing travel distances and optimizing the workflow, from sterilization to storage to consumption, is beneficial to any practice.” That said, some clinicians prioritize the patient experience and minimizing anxiety, while others prioritize productivity (i.e.,

December 2018

First Impressions

Ciarán Hynes

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optimizing work flows and minimizing operatory sizes). “An office focused on the patient experience may require larger operatories, with devices concealed in furniture to minimize patient anxiety, while an office focused on productivity and throughput may have smaller rooms with exposed equipment, minimal decoration and simple finishes,” he explains. Together, the manufacturer territory manager and the distributor design rep can keep the dental owner informed. “A-dec territory managers are Certified Ergonomic Assessment Specialists (CEAS) who can identify opportunities to promote healthy ergonomics for the dental staff,” says Hynes. “They are trained to think holistically about the patients, materials and

Doing it right

instrument flow throughout the office, which is an essential element of good practice design. Our territory managers can assist the distributor design reps by providing the necessary office layout information, including dimensions, clearances for accessing equipment, utility location requirements, mounting specifications for wall framing and floor specifications. They can share best practices for room layouts to ensure critical dimensions are in range for successful use. For instance, the distance between a supine headrest and the rear cabinet is critical for good operating ergonomics. Too close, and the doctor won’t be able to get into the 12 o’clock position when needed; too far away, and a class 5 movement or stool movement will be needed to reach instruments on the countertop. “The same principle applies to room widths,” he continues. “There is an ergonomic sweet spot, where patients can easily enter and exit the room and staff have sufficient space to operate unencumbered around the oral cavity, without bumping into cabinets, walls or other equipment. A-dec helps the distributor design reps create operatories that are functional and comfortable, while adhering to proper ADA accessibility requirements.”

From furniture to high-tech equipment, dental owners must envision how the pieces will come together to achieve the ultimate design. A-dec offers in-house consultation on best practices and design principles for all phases of a construction project, notes Hynes. “We provide downloadable 2D and 3D CAD assets, which enable our distribution partners and architects to draw design layouts to scale,” he says. “A-dec’s Autodesk Revit™ models allow for a more creative exploration of the office design via 3D renderings and virtual walkthroughs, ensuring the end result is just what the doctor imagined it would be.” A-dec also offers fullscale floor templates designed to help pinpoint where utilities should be installed, prior to laying floors, he adds. Dental owners inevitably must deal with budget constraints when planning an office project, Hynes points out. “While access to finance has greatly improved over the past five years, the amount of financing available remains capped,” he explains. “As real estate, core equipment and technology become more costly, doctors find they must do more with less.” That said, “it can be tempting for doctors to prioritize hightech equipment, such as digital imaging or CAD/CAM, over core foundation pieces,” he continues. “Unfortunately, this leaves a smaller share of wallet for chairs, delivery systems and other essentials, which, in the long run, can do more to improve patient retention, referrals and overall – Ciarán Hynes, product quality of care for both the pamanagement director, A-dec tient and the care team.” Distributor sales reps should encourage their dental customers to consider the lifespan-to-expense ratio when prioritizing equipment purchases, Hynes recommends. “Because dental technology is rapidly advancing, high tech products have considerably shorter lifespans than core equipment. If a doctor’s budget is limited, it makes sense to acquire the equipment with the longest lifespan first. A-dec equipment, including dental chairs, lights and furniture, has an expected lifespan in excess of 15 to 20 years. It is our belief that building a practice on a solid core equipment foundation – and then adding hightechnology products later, once the practice is established – is a prudent approach.”

“Our territory managers can help the distributor design reps create operatories that are functional and comfortable, while adhering to proper ADA accessibility requirements.”

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First Impressions

December 2018

OFFICE DESIGN

An Eye to the Future From the reception area to the operatory, office design can impact both the dental team and patients. BY LAURA THILL Editor’s note: This article originally ran in the First Impressions 2018 Equipment Guide.

An upfront investment of time and careful planning for an office de-

(Digital impressions/3D imaging and CAD/CAM should follow within three years, he adds.) Floor plans should be evaluated up front. For instance, an open concept might benefit some offices but not others. “Open floor plans can offer some advantages, such as fitting more equipment into a smaller space, or highlighting technology and sterilization practices,” he says. It can also serve to create a welcoming environment between the reception area and the rest of the office. At the same time, “open offices can introduce new concerns, such as privacy, comfort, sound travel and environmental control,” he adds. “The design expert must consider the dental practice’s business model and operations.” The dental office layout should maximize efficiency and flow, Reagles points out. It should define public and private spaces, ensure patient privacy and help the dental team members avoid unnecessary steps and movement. For instance, poorly placed or designed cabinetry in the operatory is often associated with ergonomic concerns that can impact the health

sign can save dentists much aggravation down the road, as well as help them avoid lost revenue. With the help of an office design expert, they should identify both immediate and future needs for their practice, according to Scott Reagles, an office design specialist with Patterson Dental. Reagles is part of a team of designers at Patterson Dental who focus on interior design, equipment selection and placement, and technology integration. “Dentists and their design experts must incorporate opportunities for future growth in their initial business plan,” he says. “They must look for a space or building that will accommodate the current and growth plan, and then design around all anticipated needs and capacity.” Adding as many spaces and rough-ins as their budget permits will help them avoid additional construction expenses later on, he notes. “Poor planning and design could add unnecessary costs and disrupt the practice’s operations when it’s time to grow.”

Office flow When designing a dental space, Reagles recommends starting with the operatories, the sterilization center and the mechanical room.

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“Dentists and their design experts must incorporate opportunities for future growth in their initial business plan. They must look for a space or building that will accommodate the current and growth plan, and then design around all anticipated needs and capacity.”

the dental staff straining to see properly of the dental staff. Similarly, a poorly deas they administer treatment. signed sterilization center can interfere with office efficiency and profitability, he adds. “Whenever possible, the sterilizaSetting expectations tion center should be centrally located to The reception area should not be overall treatment rooms and placed to limit looked in an office design, notes Reagles. travel for efficiency,” he says. “Placing it “The reception area can set patients’ exwhere it can be seen by patients coming pectation of their treatment experience and and going from treatment may reinforce influence whether they return for further that the office has nothing to hide when treatment,” he says. “When patients enter it comes to proper hygiene and their the office, everything from the way the front concern for safety.” door operates and looks to lighting, décor Office lighting can also have an efand furniture, can help them relax or elfect on the dental team, Reagles conevate their fears about the visit. Patients – Scott Reagles, an office design tinues. When properly installed, lightshould see – and interact with – a friendly specialist with Patterson Dental ing can soothe staff and help reduce face the moment they enter the office. patient anxiety, he notes. When the They should be able to expect a clean, upoperatory lighting cannot be adjusted, however, and patients to-date environment, with amenities to keep them comfortable and are forced to stare at overly bright or harsh lights, it can be entertained until their treatment begins. And, they should have upsetting for them. On the flip side, a poorly lit area leaves access to staff if they have any questions or concerns.” To learn more, visit https://www.pattersondental.com/Services/Office-Design.

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OFFICE DESIGN

Planning around instrument management A well-designed sterilization center is key to an efficient dental office.

Chantel Willis, associate

director of instrument management and infection prevention at Hu-Friedy, shares why the offices should focus on the sterilization center during the design process.

performing reprocessing duties, and less time chairside with patients or on valueadded activities that can help generate revenue for the practice. If the sterilizer load is unable to support the cleaning load, the dental practice risks running out of available, sterilized instruments, resulting in a back-up and longer wait times for patients. And, the staff inevitably will have to invest overtime to complete the loads to prepare for the next day. Unfortunately, undersized reprocessing equipment also results in overloading. Because the staff is so busy, and they don’t want to spend their entire day reprocessing instruments, they tend to overload an ultrasonic bath until instruments stick out of the water and sterilizers have pouches stacked on top of each other on the trays. As a result, instruments are poorly cleaned, non-sterile and they present a health risk to both the staff and patients. Every dental practice should have reIn every dental office, the sterilization center processing equipment that can accommotruly is the central hub. Everything flows in and then date the daily and growing workload. Ideflows back out. In fact, instruments used on patients ally, the practice should install at least one can pass through this area up to 100 times a day. 3-gallon or larger ultrasonic bath or auYet, too often instrument management and infection tomated instrument washer for cleaning, control are discussed later in the design process, and at least one 10-inch chamber sterilwhen budgets are spent and workflow is in place. izer and one immediate-use sterilizer (for Hu-Friedy representatives are well-versed in handpieces) for sterilization. Many times, sterilization area design and are available to parta practice will implement two large sterilner with distributor sales reps and their customers – Chantel D. Willis, associate director, SBU, instrument izers and an immediate-use sterilizer, parto talk about their instrument management and management and infection ticularly if the staff is using an automated infection control early in the design process. By prevention, Hu-Friedy instrument washer. This is an ideal set up understanding their present and future needs, we to support the office’s reprocessing needs. can ensure their dental office is set up appropriHaving the appropriate equipment is only one step in creating ately from the start and won’t limit their potential to grow. an optimal and efficient sterilization area. Hu-Friedy is here to help with this process. When distributor sales reps involve their HuSmaller is not cheaper Friedy representative as early as possible in the office design proOne problem we commonly see is reprocessing equipment that cess to discuss instrument management and the sterilization area, is too small to support the practice from the beginning. When this it helps ensure the dental practice will hit the ground running. happens, dental staff spend more time in the sterilization center

“Instrument management is key to any office design. This is a conversation that needs to take place early in the design process.”

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OFFICE DESIGN

The Ergonomic Solution

Smart decisions upfront can save dentists money down the road.

The dental chair is not just a resting point for the patient. A dependable

chair should provide the dental team with an ergonomic solution designed to last many years. “Dental chairs and delivery systems are the workhorses of the practice,” says Carolyn Buck, national sales manager, Engle Dental. “I once heard a dentist say he replaces his cheap chairs every two or three years! He thought he was getting a good deal, but when we ran the numbers over a 12-year period, we discovered he was spending $16,000 per operatory on new chairs, installation and service fees. This didn’t even factor in the production lost due to his equipment being down – an average of $3,000 per day, per operatory. “A dental chair should last 10-15 years,” Buck continues. “When planning for future growth, you want to make sure your dental customers have dependable equipment that will last and not be an expense or a headache down the road.” Engle is available to assist with the initial design process, she adds. Engle reps are trained to work closely with their distributor rep partners and dental customers to identify ergonomic solutions that suit the available space, she notes. “Our reps can provide technical dimensions and fullsize templates, including dimensions of the equipment to be installed and the schematics of the junction box to accommodate utilities,” she says. “In addition, our reps are great at identifying solutions for small operatories.”

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“When planning for future growth, you want to make sure your dental customers have dependable equipment that will last and not be an expense or a headache down the road.” – Carolyn Buck, national sales manager, Engle Dental

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One of a kind Engle’s one-of-a-kind fully hydraulic Traverse Chair is designed to save premium space within each operatory, according to Buck. “The chair can be used as a standalone or as part of a full operatory setup,” she says. “Furthermore, it enables all clinicians and staff in the operatory to position the patient perfectly and remain in an ergonomic position throughout the patient’s treatment. And, since Engle handcrafts each upholstery set, we can create custom upholstery, including dual-tone color schemes and the office’s logo, embroidered on dental chairs. These features help enhance the overall look and feel of the operatory.” When assisting with an office design project, distributor sales reps should be open to alternative brands of equipment, notes Buck. “An operatory doesn’t have to cost $50,000 or more!” Distributor reps should work with their manufacturer rep partners from the start of an office setup to avoid mistakes later on, she says. “Don’t be afraid to ask the manufacturer to line up some reference offices, to give customers a chance to see the equipment in action.”

A Fine-Tuned Office Establish an upfront strategy for organizing instruments and supplies.

An organized office can be key to running an efficient dental practice.

But, it requires some planning. Indeed, how and where the office organizes and stores its instruments and supplies impacts everything from cabinetry design to work throughput and patient flow. And, leaving a discussion about instrument and material storage for the end of the office design and planning process can be a mistake, according to Nicolle Campion, president, Zirc Co.

“ We encourage distributor design consultants to start a discussion with their dental customers about instrument storage early on.” – Nicolle Campion, president, Zirc Co.

Establishing an upfront strategy for organizing instruments and supplies will determine “how everything and everyone will work,” notes Campion. When instrument storage is an afterthought, the entire dental team risks facing increased costs and heightened stress for a long time to come. “We encourage distributor design consultants to start a discussion with their dental customers about instrument storage early on,” she says. “For instance, we offer several organizational tools, such as the Zirc Locking Tub system, a color-coded bin designed to organize

Nicolle Campion

materials by procedure. Clinicians have everything they need in one tub, which can be easily transported from central storage to the operatory.” That said, it is “crucial” for design consultants to establish upfront whether a practice will be utilizing a Tub system, she continues. “Where the Tub system is stored (i.e., in the operatory, in the sterilization center, or in both areas) determines what furniture is needed. For example, if the Tub system is centrally stored in the office, only a minimal amount of cabinetry should be required in the operatory, and the dental owner can apply the savings elsewhere in the practice.” Zirc offers ongoing organizational services, as well. “Our exclusive ZOBE kit – short for Zirc’s Organizational Box of Efficiency – ships to the practice at no charge and is filled with over 30 topselling Zirc products designed to address office organization,” says Campion. “The dental team can have fun exploring with this hands-on experience,” she explains. “One of our efficiency experts will consult with the office, learn about the practice and provide guidance on instrument and material management. We evaluate the array of procedures the practice performs, as well as the monthly volume of those procedures. This allows us to create a custom plan for organization. And, ZOBE can be shipped back to Zirc at no cost to the practice.” When the conversation starts early, clients have a greater chance of creating their ideal dental office, she adds.

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OFFICE DESIGN

Meeting of the Minds A successful office design depends on the expertise of several key people, from the dental owner to the distributor design specialist.

Regardless of their experience, no one individual has all the answers to ensure an effective office design, according to Tracy Thompson, director of sales, Porter Royal Sales Group. Rather, it takes a village of experts, including the dealer designer, the equipment specialist, the manufacturer rep, the architect, the builder and, perhaps most importantly, the dental owner and staff, he points out. Even for a partial redesign, such as incorporating nitrous oxide, Porter Royal Sales Group’s sales team consults on best practices, he points out. The Royal Dental Group works closely with its dealer rep partners on office design projects, notes Thompson. “We provide our dealers with extensive consultation on different design options, including dimensional, plumbing, electrical specifications, cabinet designs and more,” he explains. In addition, the manufacturer offers conceptual assistance with regard to equipment placement, helping maximize efficiency and ergonomics for the end user. That said, a design firm or the dental dealer generally takes the lead on office design projects, he adds. “The dealer design team is best trained for the planning of a dental practice and the details for maximizing efficiency of a practice.”

The customer’s vision Generally, dental owners are well aware of their current design challenges and can articulate what they hope to achieve in an office design, says Thompson. “Still, it’s important for design specialists to conduct an in-depth analysis of the dental customer’s vision,” he says. “The old adage, measure twice, and cut once, is particularly relevant when cutting concrete to run nitrous piping or custom cabinetry. A late change in the position of a wall may mean the custom sterilization center cabinet now is 2 inches short or, worse, 1½ inches too long for a room.” The distributor sales reps should ensure the customer takes time to consider the practice’s future, he notes. “It’s important to develop a realistic growth plan for the dental practice, with established milestones.

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“The design team will never avoid all mistakes, but it’s important to help minimize risks for the client by communicating and documenting all meetings and decisions,” he continues. Maintaining a log for each project can be beneficial on multiple counts, he points out. “Often, if the client is not made aware of your efforts on his or her behalf, they go unnoticed and unappreciated. Even more importantly, in the event of a catastrophic outcome, documentation is essential.”

Cabinetry Cabinetry – a key part of the office design – is not a one-size-fits-all solution, according to Thompson. Traditionally, dentists have been limited to generic cabinetry modules, he says. “Standardization for many of the common materials and instruments is necessary, but the ability to accommodate new innovations in dental procedures is vital,” he explains. “With the rapid Tracy Thompson growth of technology and dental materials, it’s imperative to be more creative with functional cabinet designs to accommodate these changes. “Porter Royal Sales Group’s Biotec Cabinet line is our most unique part of the dental office design,” Thompson continues. “We custom design our cabinets to integrate technology and organize instruments and materials for better efficiency, in an ergonomically sound manner. Whether we are working with a general practice or a dental specialty, Biotec cabinets feature high-quality construction (versus laminated wood modules) and fit the space and the style of practice. Our goal is to ensure the treatment area is a pleasant, welcoming setting for the patient, without sacrificing productivity or the health of the dental team.”

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INFECTION CONTROL

Needlestick and Sharps Injuries Dentistry may not be as dangerous as skyscraper construction or racecar driving, but it has its share of risks.

BY DR. KATHERINE SCHRUBBE, RDH, BS, M.ED, PHD.

Dental professionals face

a constant risk of sharps injuries and exposure to bloodborne pathogens, especially during the delivery of patient care. They are at particular risk for hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV). According to the Centers for Disease Control and Prevention (CDC) studies of healthcare personnel who have sustained injuries from needles contaminated with blood containing HBV, there is a 22 to 31 percent risk of developing clinical hepatitis in cases where the blood is both hepatitis B surface antigen (HBsAg) and HBeAg positive, and a 37 to 62 percent risk of developing serologic evidence of HBV infection. The average incidence of anti-HCV seroconversion after accidental percutaneous exposure from an HCV-positive source is 1.8 percent. And, the average risk of HIV transmission after a percutaneous exposure to HIV-infected blood has been estimated at approximately 0.3 percent.1 Even a risk that small is too great. Indeed, the Occupational Safety and Health Administration (OSHA) estimates 5.6 million workers in the healthcare industry and related occupations are at risk for occupational exposure to bloodborne pathogens each year, and the approximately 385,000 needlestick and other sharps-related injuries are sustained by hospital healthcare workers alone. Similar injuries are sustained in other healthcare settings such as dental facilities, nursing homes, emergency centers and clinics.2,3

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When accounting for both hospitals and other health care settings, studies have estimated that between 600,000 and 800,000 needlestick and other percutaneous injuries occur annually to healthcare workers.4 That said, other studies completed in medical facilities demonstrate that there is considerable underreporting of these injuries.5

Sharps safety protocols

Dental practices are very busy places with tight patient schedules, and many of the instruments and devices that are used are considered â&#x20AC;&#x153;sharps.â&#x20AC;? Sharps is a term for devices with sharp points or edges that can puncture or cut skin or other tissue; dental examples include syringe needles, ortho bands/ wires, instruments (i.e. scalers), scalpel blades, burs, files, suture needles and broken glass.3 What steps should be followed when a dental healthcare team member sustains an occupational exposure sharps injury? The procedure and protocol for this demonstrate a perfect

example of the interconnection between OSHA, a regulatory agency, the U.S. Public Health Service (USPHS) and the Centers for Disease Control and Prevention (CDC).

First aid and reporting Dental team members who sustain a needlestick or other sharps injury may think that they should wait until the patient procedure is completed to manage and report these injuries, but that is not the case. When a sharps injury occurs, the first priority should be the team member with the injury. According to the CDC, “first aid should be administered immediately and as necessary after an occupational injury. Puncture wounds from sharps and other injuries to the skin should be washed with soap and water and no evidence exists that using antiseptics for wound care or expressing fluid by squeezing the wound further reduces the risk of bloodborne pathogen transmission; however, use of antiseptics is not contraindicated. Also, the application of caustic agents (e.g., bleach) or the injection of antiseptics or disinfectants into the wound is not recommended. Exposed dental team members should immediately report the exposure to the infection-control coordinator or other designated person, who should initiate referral to the qualified healthcare professional and complete necessary reports.”6 According to OSHA, “exposure incidents should be reported immediately to the employer since they can lead to infection with HBV, HCV, HIV or other bloodborne pathogens. When a worker reports an exposure incident right away, the report permits the employer to arrange for immediate medical evaluation of the worker. Early reporting is crucial for beginning immediate intervention to address possible infection of the worker and can also help the worker avoid spreading bloodborne infections to others.”7 Thus, it is crucial to manage and report these injuries without hesitation or worry about workplace repercussions; accidental injuries can happen.

exposure incident, such as a needlestick. The standard states this evaluation and follow-up must be: • Made available at no cost to the worker and at a reasonable time and place. • Performed by or under the supervision of a licensed physician or other licensed healthcare professional. • Provided according to the recommendations of the USPHS current at the time the procedures take place. In addition, laboratory tests must be conducted by an accredited laboratory at no cost to the worker.7,8

The Occupational Safety and Health Administration (OSHA) estimates 5.6 million workers in the healthcare industry and related occupations are at risk for occupational exposure to bloodborne pathogens each year, and the approximately 385,000 needlestick and other sharps-related injuries are sustained by hospital healthcare workers alone.

Medical evaluation and follow-up OSHA’s Bloodborne Pathogens standard (29 CFR 1910.1030) requires employers to make immediate confidential medical evaluation and follow-up available for workers who have an

The CDC defines and outlines specific information to be included in the exposure incident report, which is recorded in the exposed dental team member’s confidential medical record and provided to the qualified healthcare professional for medical evaluation and follow-up. This includes: • Date and time of exposure. • Details of the procedure being performed. • The type of device used, and how and when it was being used, when the exposure occurred. • Details of the exposure, including the type and amount of fluid or material and the severity of the exposure.6 Additional information should be included in the report as well, including: • Whether the source material was known to contain HIV or other bloodborne pathogens and, if the source was

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INFECTION CONTROL infected with HIV, the stage of disease, history of antiretroviral therapy and viral load, if known. • The exposed person’s hepatitis B vaccination and vaccine-response status. • Details regarding counseling, post-exposure management and follow-up.6

can deal with the many concerns an HIV exposure might generate is an important element of post-exposure management.6 It is a good practice to seek a health clinic or medical provider who specializes in occupational health as the clinic or provider of choice for any post-exposure follow-ups.

The source individual The report, along with the job description of the exposed dental team member, must be taken to the medical provider that performs any serological tests. Records of all employees with occupational exposure must be maintained for 30 years after the employee terminates employment.8

Serological testing According to OSHA, a worker who participates in post-exposure evaluation and follow-up may consent to have his or her blood

The source individual is any patient whose body fluid is involved in the exposure incident.3 According to the CDC, if the HBV, HCV and/or HIV infection status of the source is unknown, the source person should be informed of the incident and tested for serologic evidence of bloodborne virus infection as soon as possible. Procedures should be followed for testing source persons, including obtaining informed consent in accordance with applicable state and local laws. Any persons determined to be infected with HBV, HCV, or HIV should be referred for appropriate counseling and treatment. Confidentiality of the source person should be maintained at all times.6

Dental team members who sustain a needlestick or other sharps injury may think that they should wait until the patient procedure is completed to manage and report these injuries, but that is not the case. When a sharps injury occurs, the first priority should be the team member with the injury. drawn for determination of a baseline infection status of HBV and HIV, but has the option to withhold consent for HIV testing at that time. In this instance, the employer must ensure that the worker’s blood sample is preserved for at least 90 days, in case the worker changes his or her mind about HIV testing.3,7 Although testing is an option for the exposed and injured dental healthcare worker, it may help to preserve peace of mind during the entire post-exposure process. As an example, although HIV infection following an occupational exposure occurs infrequently, the emotional effect of an exposure often is substantial; therefore, giving an exposed person access to persons who are knowledgeable about occupational HIV transmission and who

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Counseling When dental team members sustain a sharps injury and have possible exposure, OSHA requires that post-exposure follow-up include counseling the worker about the possible implications of the exposure and his or her infection status, including the results and interpretation of all tests and how to protect personal contacts. In addition, post-exposure prophylaxis for HIV, HBV and HCV, when medically indicated, must be offered to the exposed worker according to the current recommendations of the U.S. Public Health Service.7

The Written Opinion Once the medical healthcare provider has evaluated the employee and source patient’s test results, a written opinion is generated. According to OSHA’s standard, the employer must obtain and provide the injured employee with a copy of the evaluating healthcare professional’s written opinion within 15 days of completion of the evaluation. The written opinion should only include whether hepatitis B vaccination was recommended for the exposed worker; whether or not the worker received the vaccination; and

that the healthcare provider informed the worker of the results of the evaluation and any medical conditions resulting from exposure to blood or OPIM, which require further evaluation or treatment. Any findings other than these are not to be included in the written report.7 All other medical information must remain confidential per HIPAA laws. Although the process may seem cumbersome, if policies and protocols are in place, managing a sharps injury should be a streamlined and seamless process. Again, in large group practices and DSOs the infrastructure for a standard operating procedure or protocol should be in place. The flow-chart below illustrates the process for post-exposure evaluation and follow-up in a straightforward manner.9 This can be used as an initial resource for practices that are working to establish a protocol. Dental team members and practice management teams should not take the risk of sharps injuries lightly. In the provision of dental care, risk is present and any needed follow-up from an occupational exposure sharps injury must be completed in a timely and efficient manner. The CDC recommends that all dental practices establish written, comprehensive programs that include hepatitis B vaccination and post-exposure management protocols.1,10 The safety and health of the dental team members must be a priority in all practice settings.

Source: American Dental Association

References:

1. C enters for Disease Control and Prevention. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV and HIV and Recommendations for Postexposure Prophylaxis. MMWR Morbid Mortal weekly Rep 2001;50(RR-11). Available at https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm. Accessed September 17, 2018. 2. U S Department of Labor â&#x20AC;&#x201C; Occupational Safety and Health Administration. Healthcare Wide Hazards- Needlestick/Sharps Injuries. Available at https://www.osha.gov/SLTC/etools/hospital/hazards/sharps/sharps.html. Accessed September 13, 2018. 3. Miller CH, Palenik CJ. Infection Control and Management of Hazardous Materials for the Dental Team. 5th ed. St. Louis: Mosby Elsevier; 2013;198. 4. American Nurses Association. Fact Sheet. Available at https://www.nursingworld.org/~48de3c/globalassets/docs/ana/snsl-fact-sheet_final110110.pdf. Accessed September 14, 2018. 5. J ohn Hopkins Medicine. Medical Students Regularly Stuck by Needles, Often Fail to Report Injuries. Available at https://www.hopkinsmedicine.org/news/ media/releases/medical_students_regularly_stuck_by_needles_often_fail_to_report_injuries_. Accessed September 14, 2018. 6. C enters for Disease Control and Prevention. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV and HIV and Recommendations for Postexposure Prophylaxis. MMWR Morbid Mortal Weekly Report 2001;50(RR-11). Available at https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm. Accessed September 17, 2018. 7. O ccupational Safety and Health Administration. Fact sheet: Bloodborne Pathogens Exposure Incidents, 2011. Available at https://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact04.pdf. Accessed September 17, 2018. 8. U S Department of Labor. Occupational Safety and Health Administration. Bloodborne Pathogens Standard; 1910:1030. Available at https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030#1910.1030(b). Accessed September 14, 2018. 9. American Dental Association. Employer Obligations After Exposure Incidents OSHA. Available at https://www.ada.org/en/science-research/osha-standard-ofoccupational-exposure-to-bloodbor#Flow. Accessed September 18, 2018. 10. Centers for Disease Control and Prevention. Guidelines for Infection Control in Dental Health-Care Settings --- 2003. MMWR 2003;52(No. RR-17);13.

Editorâ&#x20AC;&#x2122;s note: Dr. Katherine Schrubbe, RDH, BS, M.Ed, PhD, is an independent compliance consultant with expertise in OSHA, dental infection control, quality assurance and risk management. She is an invited speaker for continuing education and training programs for local and national dental organizations, schools of dentistry and private dental groups. She has held positions in corporate as well as academic dentistry and continues to contribute to the scientific literature. Dr. Schrubbe can be reached at kathy@schrubbecompliance.com.

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PRACTICE POINTS

BY KRISTINE BERRY, RDH, MSEC, EXECUTIVE COACH

Addressing Workplace Bullying Bullying in the dental office can take an emotional and financial toll on the practice.

Workplace bullying is destructive not only to targets but also to the orga-

nizations within which it occurs. Leaders in the organization should address and prevent it promptly. Researchers and practitioners encourage many strategies, including: • The development of zero tolerance policies on workplace bullying. • Leadership development workshops and positive culture programs. • Systems designed to effectively manage and intervene workplace conduct and civility. • Specialized executive coaching designed to reduce abrasive work styles of both leaders and team members. • Conflict resolution training for all workers.

Defining bullying What exactly is workplace bullying? The academic literature on workplace mistreatment is fragmented and ranges from lowlevel workplace incivilities to more aggressive behaviors where intent to harm is clear. Examples of abrasive behavior include, but are not limited to: • Rudeness. • Downgrading or demeaning another’s capabilities. • P ublic ridicule and disrespect. • S wearing and shouting or other verbal abuse. • F ailing to control bodily functions. •C hronic complaining. • E xcessive reassurance-seeking. • S ingling out. • Ignoring.

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•C onstant targeted criticism or gossip. • Violating confidentiality. • Work interference that sabotages outcome.

There is no U.S. business standard for workplace bullying; different organizational cultures embrace differing standards of acceptable behavior. For the purposes of this article, the definition of bullying is “Actions and practices that a ‘reasonable person’ would find abusive, occur repeatedly or persistently, and result in adverse economic, psychological, or physical outcomes to the target and/ or a hostile work environment.1” This definition distinguishes bullying from an erratic rude remark made by a manager or owner having a stressful day or an employee that may, from time to time, be a little tough on his/her colleagues. Although such incivilities are inappropriate and are not to be condoned, they are not bullying. Bullying is repeated and persistent abuse that results in harm.

The cost of bullying Abrasive behavior has the potential to destroy individual wellbeing and organizational effectiveness. The costs can first be calculated in terms of work disruption. Abrasive behavior can impact productivity to the point of paralysis. Employees who face bullying in the workplace may experience several issues, including stress, depression, illness, insomnia and even suicidal behavior. Costs of organizational disruption include: • Attrition of valued employees. • Decreased morale and motivation, resulting in lower productivity.

• Higher incidence of stress-related illness and substance abuse. • Higher turnover rates. • Maximum use of well/sick days and mental health leave. • Increased legal actions based on hostile environments. • Retaliatory responses, such as sabotage (word of mouth and social media platforms).

Intervention Specialized coaching for abrasive leaders and/or valued team members is an efficient strategy because it tackles the underlying causes of workplace abrasiveness. Intervention starts when the abrasive leader’s supervisor and/or owner of the organization sits down with the abrasive personality to address his/her conduct. They should first voice the value of that person to the organization/ practice (Don’t bother intervening if the abrasive personality offers no value!).

Outcomes Keep in mind that the specific goals of coaching for abrasive leaders or team members or aggressors of bullying may vary depending on the coachee in question. Although the elimination of bullying behavior may be a common goal, results include factors related to the coachee, team and/or organization, namely: • Co-workers’ suffering ends and employees are heartened that the formerly abrasive cared enough to change. • Co-workers regard the HR, manager and/or owner positively for intervening and requiring respectful conduct. • The former abrasive is grateful for the company’s willingness to invest in him/her and offer a second chance through coaching. • The organization reduces the potential for litigation, attrition and anti-management/owner sentiment or community backlash, while retaining the abrasive’s technical expertise.

Leaders and colleagues who resort to bullying exact a toll on the health and profitability functioning of an organization. If the problem of abrasive leadership, clinical providers and/or management goes unaddressed, the toll will be heavier.

The organization’s supervisor or owner should explain that he or she owes it to the abrasive personality to make them aware of the growing problem. The supervisor/owner should emphasize that the abrasive personality is not the problem; rather, negative perceptions about his/her interactions with others are. “I had a choice whether or not to talk to you about this, and I feel a responsibility to let you know about these negative perceptions.” Then, the supervisor/owner should set limits and explain consequences. Steps on managing conduct and civility are as follows: •D etermine conduct expectations. • E valuate conduct and civility. • I f conduct is acceptable, recognize and reward it. • I f conduct is not acceptable, intervene. • P resent negative perceptions of conduct. • S et limits and consequences for continued unacceptable conduct. •O ffer help, such as training, specialized coaching or additional resources. •M onitor for improvement.

It may also be that the coaching is ineffective in reducing coachee’s bullying. In these cases, the abrasive leader or abrasive may be terminated; then, coaching can still be beneficial because the bullying behavior will be stopped and the organization is hailed for walking its talk and creating a work climate and culture that truly does not tolerate mistreatment. Leaders and colleagues who resort to bullying exact a toll on the health and profitability functioning of an organization. If the problem of abrasive leadership, clinical providers and/or management goes unaddressed, the toll will be heavier. Early intervention through policies, systems and/or a confidential process that respects the concerns of both the abrasive and the co-workers can solve this problem before it escalates into disruptive investigations, antagonistic relationships and loss of production.

1. Crawshaw, L. (2007). Taming the abrasive manager: How to end necessary roughness in the workplace. San Francisco: Jossey-Bass.

Editor’s note: Kristine Berry has worked as a clinician, dental board examiner, dental operations consultant, executive coach, educational manager for a global Fortune 500 company and an operational manager overseeing $23 million of revenue for dental service organizations in New Hampshire and North Carolina. She specializes in coaching and speaking on abrasive styles in the workplace and creating profitable and positive practices. To inquire about her availability, she invites you to contact her via www.kristineberry. com or kristine@kristineberry.com.

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December 2018

Safest Dental Visit

OSAP Dental Infection Control Boot Camp™

The Organization for Safety, Asepsis and Prevention (OSAP) – a community of clinicians, educators, policy makers, consultants and industry representatives who advocate for the Safest Dental Visit™ – will host its Dental Infection Control Boot Camp™ January 23-25, 2019, in Atlanta, Georgia at the InterContinental Buckhead Atlanta. The Dental Infection Control Boot Camp is a core educational course covering all the basics in infection prevention and safety, and a crucial building block for every dental professional with infection control responsibilities. The program National and international experts in infection prevention and patient safety will deliver a comprehensive curriculum. The course starts at 7:30 a.m. on Wednesday, January 23, and will conclude

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at 5:00 pm on Friday, January 25, for civilians. Federal Services attendees will have additional training sessions on Wednesday afternoon, January 23, and Saturday morning, January 26. OSAP will feature a special product presentation fair on Friday, January 25. Product personnel also will be invited to demonstrate their products during breaks on January 25. OSAP Corporate members receive a special discounted rate. The Boot Camp curriculum, along with information on the faculty, the agenda, continuing education and other details regarding the educational program, will be posted is posted online.

Who should attend? The OSAP Dental Infection Control Boot Camp is targeted to the following individuals: • Federal service employees responsible for infection control • Infection control coordinators in busy dental practices. in their duty stations. (There will be additional training • Educators responsible for infection prevention and sessions for Air Force, Army, Navy, Coast Guard, Public safety instruction. Health Service and Veterans Administration attendees.) • Compliance officers in group practices and on dental boards. • Consultants and sales representatives who want to • Federally Qualified Health Center (FQHC) personnel demonstrate a CORE level of infection control competency. responsible for infection control. The program will offer 24 hours of continuing dental education (CDE) credit. Federal Service personnel may qualify for an additional 4 hours of CDE credit.

Registration

2019 Basic Training • January 23-25, 2019, Atlanta, GA • Registration Open! Registration Fees Early Pricing by 10-31-2018 Received after 10-31-2018 OSAP Members and Federal Service Personnel $395 $475 Non-members $595 $675 Additional Attendees from Same Facility $295 $375

Received after 12-15-2018 $550 $750 $450

Register today! https://www.osap.org/events/register.aspx?id=1125225 The deadline for hotel and course registration is Monday, December 31, 2018. After December 31, 2018, there will be a $75 surcharge to register if space is available. Cancellations received in writing by December 31, 2018, will be eligible for a refund. A $75 administrative fee will be applied to all refunds. Cancellations received after December 31, 2018, will not be eligible for refunds.

Special Accommodations Attendees who require special accommodations to participate in the 2019 OSAP Dental Infection Control Boot Camp should include a description of their needs with their registration.

Networking and photos OSAP will offer registrants contact information to facilitate networking after the course. By registering, attendees give

OSAP permission to include their name and contact details on the list. Those who do not wish to be included on the list should email their exclusion request to office@osap.org by December 31, 2018. In addition, OSAP will take photos during the course. By registering, attendees give OSAP permission to use any images taken at the course in which they appear, as well as any written comments they submit on evaluation forms.

Questions about the program, logistics or registration should be directed to: Email: Office@OSAP.org • Phone: +1 (410) 571-0003 | US & Canada: +1 (800) 298-6727 Mailing Address: 3525 Piedmont Road | Building 5, Ste 300 | Atlanta, GA 30305 | USA For details, including the special OSAP discounted room rate, group transportation options and other travel details visit https://www.osap.org/?page=2019BootCampTravel. Editor’s note: OSAP focuses on strategies to improve compliance with safe practices and on building a strong network of recognized infection control experts. The organization offers an online collection of resources, publications, FAQs, checklists and toolkits that help dental professionals deliver the Safest Dental Visit for their patients. Plus, online and live courses help advance the level of knowledge and skill for every member of the dental team. For additional information, visit www.osap.org. www.firstimpressionsmag.com

First Impressions

December 2018

TECH TALK

Dental Overhead Lighting There are few

techniques in the healthcare field that are more complex in terms of lighting than operative dentistry. Dentists must deal with natural light, light from handpieces, overhead light, and lights designed specifically for operatories which are either chair mounted, ceiling mounted and fixed, or track mounted. With the digitization of the operatory, additional designs are being made to incorporate monitors on to chairs, as well as extra “arms” to house trays, small equipment, etc. One factor has not changed. The need for a properly illuminated oral cavity. There are two schools of thought currently on operative lights: use them or do not. In the absence of an overhead light, headlamps can be used.

LED Overhead Operatory Lights Proper illumination is needed for an efficient work environment. While halogen overhead operatory lights are still being sold, several dental manufacturers have embraced the new LED technology. Reasons to consider replacing older overhead dental lights: •M ost of the new designs are more aseptic • E asier to position with a third axis movement

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• Have a non-cure setting and will give the proper intensity and light color range required in dentistry • Provides a brighter light • Power consumption is greatly reduced • LED lights use significantly less power • Ambient room temperature will increase less than 1 degree if the light is on for eight hours.

LED Dental Headlights Clinicians are beginning to recognize that the quality of light in the working field is just as important as magnification. As the level of magnification is increased, the field of view becomes darker (available light is spread out). Headlights can counteract this problem by providing spot illumination that helps reduce shadows to the operating field. Further, this can help reduce

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TECH TALK

Since LEDs do not use heat to illuminate, the light source does not have to be replaced. LED headlights also require much less power and therefore can be run on batteries, which can be incorporated onto the headband or clip on battery pack. eyestrain and the need to reposition the over-head light. Most portable headlights on the market use Light Emitting Diode (LED) technology. Unlike conventional fiber-optic lights that create light by heating the tiny wire inside the glass, LEDs use semiconductor chips. Since LEDs do not use heat to illuminate, the light source does not have to be replaced. LED headlights also require much less power and therefore can be run on batteries, which can be incorporated onto the headband or clip on battery pack. The ability to run on batteries allows LED headlights to be portable, and the dentist does not need to be restricted by a fiber optic cable attached to a light source. Advantages of LED Headlights: •M ore durable because there is no glass or filaments to break. • P ortable (battery operated). • B etter color temperature. • L ess heat generated and more energy efficient. Factors to consider when purchasing a headlight: • Color temperature (deg Kelvin) Describes the color of the light emitted by the LED. Pure white is the most desirable color and is reflected in a color temperature between 5500-6500 degrees Kelvin. Lower temperatures will have a yellowish light while higher temperatures will produce more of a bluish light. • Light output (foot candles) The brightness of the light source is measured in foot candles. Foot candles are dependent on the distance between the light and the object. To have an accurate measure of light output make sure the company states

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the foot candles at a given distance (i.e., light output equals foot candles at x inches). • Weight Attaching a headlight to your loupes or headband will add additional weight. It is important to choose a headlight that is light enough for the clinician’s comfort. • Battery type LED headlights are powered by rechargeable batteries that can be attached to a lab coat, belt, or carried in a shirt pocket. • Battery life Batteries need replacement once the running time decreases to an unacceptable level. Most rechargeable batteries have a life expectancy of 1-2 years. • Composite sensitive filter Many headlights have a built-in orange filter to prevent light from polymerizing resin composite materials. • LED operating life Most LEDs have a lifespan of ~ 50,000 hours of use. • Type of mounting Headlights have mounts (custom or universal) that can be attached to dental loupes or headbands. Most general practitioners prefer mounting to loupes because they find it more convenient and not as bulky or heavy as mounting the headbands. The advantage of headbands is that the weight is evenly distributed around the head.

BY LAURA THILL

SALES FOCUS

Piped vs. Portables Piped nitrous oxide systems often offer the best solution – provided they are properly installed.

More and more dental offices rely on nitrous oxide/oxygen sedation to reduce patients’ anxiety and help them relax during complex dental procedures. For offices that use nitrous oxide/oxygen sedation even a few times each week, piped – or plumbed – systems could offer the most efficient and economical solution. Although there is an upfront cost for piping a nitrous oxide/ oxygen sedation system (i.e., the cost of a medical gas plumber, copper piping, a manifold system, zone valve emergency shut off systems, if required, and a verification/inspection fee), there are long-term cost savings and benefits of which some clinicians might not be aware, notes Michael Civitello, sales manager, Porter Instrument. “It makes sense for dentists to sit down and evaluate the long-term benefits before making a decision that they may later regret,” he points out. In some cases, portable e-cylinder carts continue to offer a viable solution, he continues. He recommends portable systems when: • The dental office is already built, and there are no options for running piping through a drop ceiling or basement. • The current dental owner will only be at that location for a couple of more years, after which he/she plans to build a new office or stay on as an associate. • The office has no plans to incorporate nitrous oxide/oxygen sedation into its regular routine, and only expects to use it a few times each year.

For dental offices looking to offer nitrous oxide/oxygen sedation more routinely, however, there are a number of benefits to adding piped or plumbed nitrous oxide systems, says Civitello, including: • The cost of gas from larger H/G type cylinders compared with E size can easily equate to a $10 savings per patient on the gas itself. “Multiply that times the number of uses per week, and calculate that out over five, 10 or 20 years. It’s a large expense.” • Portable e-cylinder systems may seem like a good idea, but compared to a centrally plumbed system, many dentists (as well as assistants) often find reasons to not use them. Portable systems are never ready for use; often are located in another room; require a constant change of cylinders; and take up valuable floor space. In addition, the cylinders generally arrive from the gas suppliers dirty and rusty, and they will be in plain sight of their patients. • With a central system, every operatory is ready for nitrous use. Having operatories set up for all types of uses helps avoid situations where one case may run long and the office must move a scheduled patient to another operatory, where nitrous may not be available. “Dentists don’t want to be in a position where they are unable to provide nitrous to patients who want or need it.”

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December 2018

SALES FOCUS

• If nitrous oxide/oxygen sedation is easier to use, it will be used more often. “The whole reason to have a nitrous system is to provide comfort and relaxation for patients, while at the same time make it easier for the dentist to provide the treatment. Dentists who have easy access to nitrous oxide/oxygen sedation are likely to offer it to their patients more often, in situations where it could be beneficial.” • Offices that can offer nitrous oxide – and, in turn, offer their patients a more comfortable, relaxed experience – can make a positive impression and facilitate more return visits. “Patients draw conclusions quickly based on what an office looks like and how it is set up. For

by offering nitrous oxide to every patient. This isn’t easy to do with a portable E-cylinder cart.” • As more general dentists bring in specialists to their offices, who rely on nitrous oxide/oxygen sedation, an accessible piped-in system is more important than ever. It’s never too early for dentists to start planning their exit strategy, and piped nitrous oxide should be part of it, Civitello adds. “If dentists plan to sell their practice at some point, they should keep in mind that it may not attract specialists, such as pediatric dentists or oral surgeons, who are used to relying on easy access to piped nitrous oxide.”

Rely on the experts Manufacturer equipment specialists can ensure that piped nitrous oxide systems are installed correctly and safely, and dentists and their sales reps should involve their nitrous equipment manufacturer representative early in the process, notes Civitello. “There are many flowmeter options from which dentists can choose, as well as several installation options,” he points out. Once the needs of the practice and the design of its operatories are clear, the manufacturer rep/ equipment specialist can recommend the best possible solutions, as well as advise on what is required from a code perspective. “Many Porter representatives have an ASSE 6005 Medical Gas System Generalist certification, which is essentially the same course that a Certified Medical Gas Plumber takes (without the hands-on/brazing portion).”

With a central system, every operatory is ready for nitrous use. Having operatories set up for all types of uses helps avoid situations where one case may run long and the office must move a scheduled patient to another operatory, where nitrous may not be available. instance, is it clean? Does it have modern equipment? That said, does the dentist really want to wheel in a portable cart that has rusty and dirty cylinders and various hoses hanging from it? Or would he/she rather have a built-in professional looking system that is designed for the space?” • Nitrous oxide can be very profitable for a practice. When centrally plumbed, the per-patient cost is very low, particularly when one considers the concurrent fees the office may charge (on average, $75). And, when patients are satisfied with their care, they are more likely to complete – or follow up with – their treatment, return for future care and refer their family and friends to the practice. • Many states are adopting expanded duties certifications for hygienists, permitting those who are qualified to administer nitrous oxide, provided the dentist is on site. “Think of the additional profit the hygienist can produce

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Equipment specialists can work with a dental office to address a number of important points, including: • Flush mount flowmeters. It’s important to consider the style and type of cabinetry in which the flowmeter will be installed, as not all flowmeters fit in all cabinets. The manufacturers rep can advise which flowmeter will work best in each cabinet style, and how best to position the flowmeter. • Outlet stations. If using outlet stations, it is critical to plan where the outlets will be located. Installing outlets on the wrong side of the room can be a disaster. • Piping. It is essential to pipe all operatories, even if they are not being set up with a flowmeter. Non-functional

“Dentists and/or general contractors absolutely should not hire Joe the plumber who is trained to fix toilets. This is where major mistakes can happen, and it can cost patients their life.”

says. “There is no disruption in the paoperatories can be piped, with a tient procedure, nor does anyone have termination-point shut-off valve to go to the tank room.” installed. If at some point the An experienced manufacturer rep practice wishes to expand, the can also ensure that the piped nitrous piping is in the wall; it will be easy oxide system is installed by a properly to access the piping and connect certified plumber, and inspected by an a flowmeter. (If an operatory is not independent third party, Civitello continpiped, and the office decides to ues. “It’s important that only a certified expand, it must bring in a medical medical gas plumber works on the piping gas plumber to cut pipes, rip system,” he says. “These plumbers have open walls, etc.) an ASSE 6010 certification. They are re• Detached tank room. When the quired to carry an identification card at tank room is detached from the all times and are the only ones allowed main office, both an automatic to handle the piping and installation.” In – Michael Civitello, sales manager, changeover manifold and zone Porter Instrument fact, they can’t have an apprentice assist valve will be required. An example them unless that individual is ASSE 6010 of this would be a tank room in certified, he points out. “Dentists and/or general contractors abthe basement or in a storage room located outside the solutely should not hire Joe the plumber who is trained to fix main building (with no internal door from the main office toilets. This is where major mistakes can happen, and it can cost to access). patients their life.” The piping system must be inspected by an independent Dentists should consider installing an automatic changeover verifier, notes Civitello. “This cannot be the person who did the manifold, rather than a manual changeover manifold, notes installation, and he or she must have an ASSE 6030 medical gas Civitello. “The manual changeover manifold may appear to system verifier certification. Dentists and/or general contractors save them some money,” he says. But, with this option, when cannot skip the verification to save $1,000. This is required.” the cylinder is empty, someone must go to the tank room to Installation is not complete until both the medical gas plumber close one cylinder and open another, wasting time. It can be and medical gas verifier have conducted all required safety and disruptive to a patient’s procedure and inevitably lose the pracfunctional tests, including the crossed lines test, he adds. “In the tice money. “With an auto-changeover manifold, when one cylend, these documents must be turned over to the dentist.” inder runs low, it automatically switches to a full cylinder,” he

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December 2018

REP CORNER

BY LAURA THILL

Wheels in Motion One man’s passion for design has led to newfound mobility for those in need. Editor’s note: To learn more about Wheelchair Labs, or to donate, visit www.wheelchairlabs.org.

Growing up a severe asthmatic, Lance Greathouse found himself sidelined

In the early days, Greathouse remembers working extensively with his father and brother, restoring Model T cars and reinventing some of the first VW sand buggies in the country. “After completing a project, I just wanted to move ahead to the next idea,” he says. When it became clear that electronics wasn’t his dad’s strength, Greathouse decided to pursue a college degree in electronics and computer engineering. Following his graduation, he went to work at his uncle’s dental office, cleaning and repairing equipment. “This experience was an immense help when I joined Benco Dental as a field service engineer,” he says. Photo by: www.headshotsaz.com

from most school sports. It was his mother’s idea to appeal to his creative side. “My mother managed to get me interested in everything science,” says the Benco service technician. From erupting volcanoes to designing science fair projects, “the fun was in making ideas come to life,” he recalls. Eventually, his skills would lead him to start his Glendale, Ariz.-based company, Wheelchair Labs, and design unique wheelchairs in honor of his brother, Brent Greathouse, who died of Multiple System Atrophy (MSA) in 2004.

One-of-a-kind chairs

An equipment support technician by day, Greathouse continued to work alongside his father, as well as various family and friend volunteers, evenings and weekends. Eventually, he became involved building props and “large fire machines” for events and a couple of television programs – Junkyard Wars and Robot Wars. When Brent’s illness progressed and left him wheelchair bound, however, Greathouse realized his inventions could be both zany and practical. “I decided to build Brent a wheelchair using tank tracks and the captain’s seat out of a military airplane,” he says. “Brent could take this chair anywhere he wanted to go!” When others saw him ride by, they’d inevitably ask about his chair. “Their attention would be on his custom chair, not on his disability,” he adds. Today, the wheelchair is adorned with a photo of Brent, and it serves as Greathouse’s office chair.

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Since Brent’s passing, the Wheelchair Labs team has worked to refurbish old wheelchairs and scooters, and circulate them to those in need. “We especially like to design and build oneof-a-kind electric wheelchairs and devices for people with special needs,” says Greathouse. “Most people don’t have the funds to commission such projects. We [raise money to] design and build wheelchairs to accommodate each person’s individual needs. Often, we work with the Purple Heart and local VA administration to bring electric mobility devices to programs for homeless veterans.” One chair in particular – a flame-throwing wheelchair – “really captures people’s attention and gives me a chance to tell them about our

Sometimes the ideas flow when he’s studying unused items in scrap yards or old dental parts that his dental customers are throwing away. program and how we can change others’ lives,” he says. In addition to chairs, his company specializes in one-of-a-kind barbecues and smokers. “One of our barbecues was featured in Popular Science and at the Ultimate Tailgating Machine,” Greathouse points out, noting the company’s newest model – the Steampunk Smoker Pellet Grill System. “We use the proceeds from these sales to cover the cost of batteries and other expenses at Wheelchair Labs. In 2018, Greathouse registered Wheelchair Labs as a 501c3 nonprofit company. His father still helps out at the shop, as do his mother, wife and sons, and several volunteers. “My entire family gets involved in one form or another,” he says. “We mostly work on weekends and some weeknights, after work.

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December 2018

REP CORNER

“Benco has been very gracious about giving me several volunteer days a year, so that I can help out at various disabled and veterans events,” Greathouse continues. “I’ve met so many interesting people over the years, and some of our work has been featured in magazines, such as Popular Science, Popular Mechanics, Wired, Forbes, WSJ and several TV programs.”

The most difficult part “People ask me what is the most difficult part of what we do,” says Greathouse. “Surprisingly, it’s not building or refurbishing wheelchairs, but raising the funds to support our work. We also service the chairs we donate for those who cannot afford to get their wheelchair repaired. We’ve distributed over 250 chairs and scooters through the USA and Mexico.” Greathouse literally dreams up many of his creations while sleeping, he explains. Sometimes the ideas flow when he’s studying unused items in scrap yards or old dental parts that his dental customers are throwing away. The recipients of his wheelchair concoctions are not the only ones who benefit. Greathouse himself continues to learn from this experience. “In the years I have worked with people with disabilities, I have developed a lot of patience,” he says. “I understand how the basic things in life can be such a struggle for some. I’ve also learned that listening to people – including my dental customers – is as important as the things we do for them.” And, sharing stories about individuals who have received a Wheelchair Labs chair has proved to be a great conversation-starter with his customers, he notes, particularly those who have seen him on television shows. “It’s important that I never have to turn anyone away,” says Greathouse, noting how much it means to him and his family to see his wheelchair recipients regain their mobility. “Often we are the last resort – that last hope – for those in need.”

December 2018

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NEWS

Industry News Burkhart Dental hires John J. Klavon as Special Markets Director Burkhart Dental Supply announced the hiring of John J. Klavon as its Director of Special Markets. Klavon is a seasoned dental professional and proven leader with extensive expertise establishing and managing special (strategic) markets departments. In this new position, Klavon will assist and support BurJohn J. Klavon khart Dental Supply’s associates and special market customers in navigating the ever-changing environment of the dental industry. Klavon has 26 years of experience in the dental industry. He brings expertise in strategic account management, strategic vision and business planning, customer interaction, and sales management. Prior to joining Burkhart, he was Field Director Manager, Strategic Markets, for Benco Dental. Klavon is a graduate of Michigan State University with a degree in finance.

Survey highlights gaps in oral health knowledge, generational differences in caring for little teeth A new national survey conducted on behalf of the American Academy of Pediatric Dentistry (AAPD) revealed that 74% of US parents do not take their child to the dentist by their first birthday, the age recommended by AAPD. Of the quarter of parents (26%) who do take their child to the dentist by their first birthday, millennial parents (29%) are more likely to take their child to the dentist by age 1 than any other generation. Additionally, while 96% of parents say oral health is important to their family, many do not think toothaches are a serious ailment, with 3 in 10 parents (31%) ranking toothaches as the least serious ailment compared to tummy aches, earaches, headaches and sore throats. Additionally, the survey found that 49% of parents with

kids between the ages of 4 and 7 help their children brush their teeth every time. Younger parents were more likely to regularly help their kids brush versus older parents: 80% of parents ages 18-24 say they help their child brush every time, while only 42% of parents ages 45-54 do the same.

ADA adopts further policy discouraging direct-to-consumer dental services A new policy from the American Dental Association (ADA) “strongly discourages the practice of direct to the consumer (DTC) dental laboratory services because of the potential for irreversible harm to patients.” The new policy expands upon a 2017 ADA policy, “Do-It-Yourself Teeth Straightening,” to include the sale of partial dentures, teeth whitening trays, snoring appliances, veneers, and mouth guards, in addition to DTC orthodontic services. The change, according to the organization, is due to the recently trend of laboratories offering to sell some products directly to consumers. “Bypassing the involvement and oversight of the dentist eliminates the dentist’s essential role in diagnosing oral health conditions, creating treatment plans to meet those needs, and safely managing treatment needs through the course of dental care,” the ADA said.

New Hampshire gets $1.85M grant from CDC aimed at dental health The New Hampshire Department of Health and Human Services will receive a $1.85 million federal grant from the CDC. The grant will allow the state’s oral health program to continue its schoolbased approach, whereby dental hygienists visit kids at their schools. The funds will also allow the program to promote the benefits of fluoridated drinking water and improve reporting on residents’ ability to afford dental care. Oral Health Program Director Hope Saltmarsh says that the program has been effective, citing data that show that from 2001 to 2014, the percentage of third graders with untreated dental decay decreased 14%.

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December 2018

NEWS

Benco Dental New Appointees Nick Buck, Equipment Specialist Benco Dental is pleased to welcome Nick Buck to the Rocky Mountain region. Buck earned a degree in business at Central New Mexico Community College and brings two years of industry experience to the Benco family. Mike Casillo, Equipment Specialist Mike Casillo joins Benco Dental in the SoCal region. Casillo earned a degree in business administration from Texas Tech University. He brings 17 years of industry experience to Benco customers in his region.

Michael S. McCarthy, Regional Manager The Benco Dental team in the Trailblazer region welcomes Michael McCarthy. McCarthy earned a B.S. degree in management from the University of Phoenix and is currently pursuing an MBA degree at Cedarville University. He brings 14 years of industry experience to Benco. Mike Mulligan, Equipment Specialist Mike Mulligan joins Benco Dental in the Gateway region. Mulligan earned a Bachelor of Arts degree from Washburn University. He brings 17 years of sales experience to Benco customers in his region.

Cynthia Coletti-Manning, Equipment Specialist The Benco Dental team in the Hudson region welcomes Cynthia (Cindy) Coletti-Manning. Coletti-Manning, a Certified Dental Assistant, brings six years of sales and dental industry experience to Benco.

Jim Reed, Equipment Specialist Jim Reed joins Benco Dental in the Lonestar region. Reed studied at Ohio State University and served in the U.S. Army. Reed brings 11 years of sales experience to the Benco family.

Kevin Curran, Equipment Specialist Kevin Curran joins Benco Dental in the Derby region. Curran earned a degree in business at Pittsburgh Technical College. He brings 20 years of dental industry experience to Benco.

Stacey Sassine, Regional Manager Benco Dental is pleased to welcome Stacey Sassine to its Midway region. Sassine earned a degree in psychology and sociology from Millikin University. She brings 13 years of sales experience to Benco.

Matt Lea, Equipment Specialist Benco Dental is pleased to welcome Matt Lea to its Citrus region. He earned a degree in criminal sociology at Mississippi State University and brings seven years of industry experience to Benco customers.

Todd A. Starker, Equipment Specialist Benco Dental is pleased to welcome Todd Starker to the Desert region. Starker earned a degree in accounting at Georgia State University and brings four years of sales experience to the Benco family.

Bernard Long, Inside Sales Manager Bernard Long joins Benco Dental at its home office in Pennsylvania. Long earned a degree in marketing at Lewis University. Long brings three years of sales experience to Benco customers.

David Webb, Equipment Specialist David Webb joins Benco Dental in the Cascade region. Webb studied electronics and cryptology in the U.S. Navy. He brings dental and sales experience to Benco.

December 2018

First Impressions

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Henry Schein Appointee Announcements Jess Kubeck, Field Sales Consultant Kubeck will be representing Henry Schein in the Westchester County, New York area. She is new to the dental field and recently graduated from Fairfield University with a Bachelor’s degree in Business Marketing.

Mark Decker, Field Sales Consultant Mark will be representing Henry Schein in the Grand Rapids, Michigan area. He is new to the dental field and previously worked as a Marketing Manager for TBX and Audi.

Joe Schmetzer, Field Sales Consultant Schnetzer will be representing Henry Schein Dental in Cincinnati, Ohio. He previously spent two years as a National Sales Representative for Paycor Inc.

Braden Paterson, Field Sales Consultant Paterson will be representing Henry Schein Dental in the Little Rock, Arkansas region. He is new to the dental field and previously worked as a sixth grade Math Teacher at Springdale public schools.

Michael Bamberger, Field Sales Consultant Michael will be representing Henry Schein Dental in the Long Island, New York territory. He has 10 years of experience in the dental field, and most recently worked as a Management Consultant for Katzenbach Consulting. James Woo, Field Sales Consultant Woo will be representing Henry Schein in the Orange, California region. He has over one year of experience in the dental field, working as a Territory Manager for Digital Doc. Lori Morales, Field Sales Consultant Lori will be representing Henry Schein in the Houston, Texas area. She has 16 of experience in the dental field, most recently working as a Territory Representative for SolutionReach. Pierce Stover, Field Sales Consultant Pierce will be taking on a new role with Henry Schein Dental in the Long Island, New York region. Pierce has been a member of Team Schein for over two years, previously working in special markets customer care. Allan Der Martirosian, Field Sales Consultant Allan will be representing Henry Schein in the Philadelphia, Pennsylvania region. He has four years of experience in the dental field, all of which he spent working as a Sales Representative at Osteohealth. Jacob Brown, Field Sales Consultant Brown will be representing Henry Schein Dental in the Portland, Oregon region. He is new to the dental field and recently graduated from Oregon State University with a Bachelor’s degree in Marketing.

Chris Calvetti, Field Sales Consultant Chris will be representing Henry Schein Dental in the Pittsburgh, Pennsylvania area. He is new to the dental field, and previously owned a company called Healthcare Injection Solutions. Cody Rampaul, Field Sales Consultant Cody will be representing Henry Schein in the Knoxville, Tennessee area. He has two years of experience in the dental field, and previously held the role of Business Development & Growth Director for Care Services Management. Alexander Hahn, Field Sales Consultant Hahn will be representing Henry Schein Dental in the Chicago, Illinois region. He is new to the dental field and previously worked as an Inside Sales Executive for Novum Pharma. Brock An, Professional Practice Transitions Consultant Brock will be representing Henry Schein in the southwest Florida region. Brock will help practice owners transition their practices’ to new owners. Beyond selling practices and transition consulting, he will work with dentists and practice owners throughout their careers on practice valuations, transition planning, buying practices, associateships, and other aspects of their practice lifecycle. Brock has been with Henry Schein’s Dental Division for the last 12 years as a Field Sales Consultant in the Houston, Texas market.

www.firstimpressionsmag.com

First Impressions

December 2018

NEWS

Patterson New Appointees

Jorden Backman

Lynne Barill

Nicole Campbell

Sebastian Conti

Nicholas (Nick) Cummins

Robert Gooch

Kim Jurgens

Danielle Kellstrom

Mary Knapp

Suzi Mandic

Nick Moody

Alexis Morrison

Amy New

Toni Ann Riedel

Darcy Szafnicki

Victoria Whitman

December 2018

First Impressions

www.firstimpressionsmag.com

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FI Dec 18

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FI Dec 18 Rep Corner