Articulator Volume 27, Issue 2 by Metro Denver Dental Society

ARTICULATOR MDDS

Connections for Metro Denver’s Dental Profession

4th Quarter, 2021 Volume 27, Issue 2

WE'RE BACK! Don't Get Caught Outside Looking In!

JANUARY 20-22

Creating the Easy and Efficient Temporary

NEEDLES, LUNGS & TONGUES© The Chemistry, Use and Effect of Psychoactive Substances

Evidence-Based Considerations for RDH Using Aerosol-Generating Devices

Lean-in to Marketing

Health Equity Relies on Moving from Concept to Action: It Also Relies on You!

Protect your practice. Call the Trust today.

There are a lot of differences between being a Member of the Trust and just another policy number at a large, commercial carrier. Both give you a policy the Practice Law requires, but that’s where the similarity ends.

New and Established Dentists Not Currently Trust Members:

$0.00 First Year* *some restrictions apply; subject to underwriting approval.

Convert Now!

Who do I talk to when I have a patient event, claim or question? The Trust: Local dentists who understand your practice, your business and your needs. Them: Claims call center (likely in another state). Besides a policy, what do I get when I buy coverage? The Trust: Personal risk mitigation training, educational programs and an on-call team that “speak dentist.” Them: Online support. Do I have personal input and access to the company? The Trust: Yes. You are represented by dentists from your CDA Component Society giving you direct, personal access to the Trust. Them: Yes, via their national board. How much surplus has been returned to dentists in Colorado? The Trust: Over $2.2M has been distributed back to Colorado dentists as a “return of surplus” (after all, it’s your Trust, your money). Them: $0 How long has the company been serving Colorado dentists? The Trust: We were Established by dentists in 1987. Them: It’s hard to say... they tend to come and go. Dr. H. Candace DeLapp · 303-357-2600 www.tdplt.com

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what's inside?

pg.

10 Creating the Easy and Efficient Temporary 12 NEEDLES, LUNGS & TONGUES©

. The Chemistry, Use and Effect of ..... Psychoactive Substances

16 Evidence-Based Considerations

for RDH Using Aerosol-Generating Devices

18 Lean-in to Marketing 20 Health Equity Relies on Moving from Concept to Action: It Also Relies on You!

departments 4

RMDC Chair Message

Member Spotlight

Reflections

Member Matters

Tripartite News

Non Profit News

pg.10 Advertisers Directory ADS Precise Transitions adsprecise.com................................. 11 Berkley Risk Services of Colorado colorado.berkleyrisk.com.................... 17 Carr Healthcare carrhr.com........................... Back Cover CDA cdaonline.org................................... 6-7 Copic Financial Services Group copicfsg.com..................................... 26 CTC Associates ctc-associates.com............................. 13 Dente Vita dentevita.com................................... 21

Co-Editors Amisha Singh, DDS; Allen Vean, DMD Creative Manager CT Nelson Director of Marketing & Membership & Managing Editor Cara Stan MDDS Standing Officers President Pat Prendergast, DDS President-Elect Janie Boyesen, DDS, DMSc Treasurer Karen Foster, DDS

Event Calendar

Classifieds

Secretary Susan Kutis, DDS Printing Dilley Printing The Articulator is published quarterly by the Metropolitan Denver Dental Society and distributed to MDDS members as a direct benefit of membership.

Dentists Professional Liability Trust of Colorado tdplt.com...................Inside Front Cover Denver Implant Study Club (DISC) https://disc.events.............................. 13 Meisinger USA meisingerusa.com........................ 14-15 Miller Professional Upholster e-dentalupholstery.com...................... 23

SAS Transitions sastransitions.com.............................24 University of Colorado School of Dental Medicine dental.cuanschutz.edu/saveatooth.......27

Editorial Policy All statements of opinion and of supposed factare published under the authority of the authors, including editorials, letters and book reviews. They are not to be accepted as the views and/or opinions of the MDDS. The Articulator encourages letters to the editor, but reserves the right to edit and publish under the discretion of the editor. Advertising Policy MDDS reserves the right, in its sole discretion,to accept or reject advertising in its publications for any reasons including, but not limited to, materials which are offensive, defamatory or contrary to the best interests of MDDS. Advertiser represents and warrants the advertising is original; it does not infringe the copyright, trademark, service mark or proprietary rights of any other person; it does not invade the privacy rights of any person; and it is free from any libel, libelous or defamatory material. Advertiser agrees to indemnify and hold MDDS harmless from and against any breach of this warranty as well as any damages, expenses or costs (including attorney’s fees) arising from any claims of third parties. Inquiries may be addressed to: Metropolitan Denver Dental Society 925 Lincoln Street, Unit B Denver, CO 80203 Phone: (303) 488-9700 Fax: (303) 488-0177 mddsdentist.com ©2021 Metropolitan Denver Dental Society

Member Publication

RMDC CHAIR MESSAGE

Get Ready for the New RMDC Experience! By Nicole Furuta, DDS

know we all hoped that 2020 would end and the daily challenges would improve over time. Yet 2021 has brought its own set of challenges which have been both rewarding and frustrating at times. We are hoping the 2022 RMDC this January 20-22 will help you to reconnect with colleagues, build up your teams (and maybe help add to them), provide solutions to some of those challenges and help you set new goals for the year to come.

we sought out speakers geared towards building a strong culture with effective communication and collaboration that will help your practice be the type of place new hires need to work at. And, the type of business that retains team members for years to come.

For my practice, RMDC has always felt like a time to catch our breath and get excited for the upcoming year, and as the 2022 RMDC Chair, it has been refreshing to re-connect with colleagues online and in-person to prepare for this experience. The RMDC team is excited to bring live, in-person and virtual world-class thought leaders and industry experts to the RMDC educational program beginning Thursday January 20, 2022. (Registration is open now at www.rmdconline.com)

I believe that if you want a truly remarkable team, you need to give them the tools to be remarkable. I am a huge believer in what RMDC can do for those trying to build and retain amazing teams. It’s a key part of my practice, I feel helped to prevent (or a least slow down) the inevitable turnover that we all see in our practices. It all started with two questions that date back to my first year as a new practice owner with a lot more debt than I’d ever imagined.

"I believe that if you want a truly remarkable team, you need to give them the tools to be remarkable. I am a huge believer in what RMDC can do for those trying to build and retain amazing teams."

We would like to thank you for your input over the past year and assure you that we listened to the communities’ broad range of suggestions. One thing 2020/2021 has shown us is the need for flexibility, and we believe RMDC offers exactly the right balance and spectrum of opportunities to appeal to everyone’s needs. Whether you choose to enjoy RMDC education sessions while sipping coffee in your PJ’s from home or experience RMDC in-person alongside your team and colleagues, we think your experience will be second-tonone.

A Key Focus this Year: Building and Keeping Amazing Teams! If you are looking for ways to differentiate your practice from others, what better way than committing to invest in your team and their continuing education? For 2022, we cultivated a speaker lineup with a focus on a continuing education experience that will help you train and retain team members including front office, assistants, hygienists and doctors. The RMDC Convention Arrangements Committee especially wanted to help practices stand out to prospective team members. For that,

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I hope you take the opportunity to build on the foundation of knowledge and experience we’ve put together that is hard to find collectively outside of the RMDC experience!

Me: “What if I spend all this money on RMDC educating my team and they decide to leave?” My Mentor: “What if you don’t, and they decide to stay?”

Key Speakers and Partnerships We are excited to have commentator, author and former Denver Bronco, Reggie Rivers, speaking at Opening Session. I hope he will motivate and inspire you and your team with, “What the NFL Can Teach Us About Leadership and Teamwork in Our Practices.” The Expo Hall is back with over 200 vendors ready to connect with you and your team. While you are in the Expo Hall, don’t forget to take advantage of our Summit Stage speakers who will be speaking on a variety of topics such as online presence, practice transitions, alveolar ridge preservation and airway dentistry. We have brought back many of your favorite events at RMDC including essential hands-on instruction, social hours in the Expo Hall and several alumni association events. We also have a brand-new kickoff event this year. Get those singing voices ready for the Dueling Piano Party at the Hyatt on Thursday evening at 6:00pm! Thank you for taking the time out of your busy schedules to come together with our community at the 2022 Rocky Mountain Dental Convention. Please, come prepared for some great continuing education, amazing team building and reconnecting with your colleagues. I want to thank the team at MDDS and all the committee members who contributed countless hours to make this the best RMDC yet. I am looking forward to seeing you there!

MEMBER SPOTLIGHT

MEMBER MEMBERMATTERS MATTERS

Kyle O’Donnell, DDS 2023 RMDC Chair Alpine Vista Dental Highlands Ranch, CO What influenced your decision to become a dentist?

"I am fortunate to have several family members who are dentists. Growing up, I saw the pride they have in their profession. As I chose my own road toward dentistry, I’m happy to say I now share that same pride. I love what I do!"

What is your favorite part about practicing dentistry?

"Building a smile for someone can be very rewarding. Fostering an environment where the people around you choose to smile is immeasurable. I feel blessed I have an opportunity to work with an exceptional team that likes to have fun while we take care of our patients."

With all your international travel, what made you settle in the metro Denver area and what keeps you here?

"Where else would you find a network of world class dentists, specialists and like-minded adventure seekers combined with immense cultural diversity, the breathtaking beauty of the mountains and the fun they hold? I love Denver!"

How did you become involved with MDDS?

"Our profession shines brightest when multiple dentists from diverse backgrounds participate in the development of our future. When a friend asked me to join the committee, I was happy to offer my perspective and do my small part."

As the 2023 RMDC Chair, what are you most looking forward to?

"RMDC is about people collaborating and sharing ideas. The pandemic made that more difficult. As the 2022 and 2023 RMDC approach, I look forward to reconnecting with colleagues, a handshake with our vendors and, eventually, seeing the smile that’s been hiding under so many of our masks."

What would you be doing if you were not a dentist?

"Would it be aspirational to say, 'Stay at home dog-dad'?"

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A community where

7 out of 10 dentists in Colorado are CDA members.

WE ARE YOUR COMMUNITY

The CDA Offers You: - Support and opportunities - Connection and belonging - Learning, shared experiences and resources - Influence at the local, state and national levels Renew your CDA membership today! cdaonline.org / 303-996-2841, 303-996-2842

In this community, the future is bright!

Building a Better Community & Succeeding Together

10 Reasons You Belong in CDA

cdaonline.org

Enhance Your Network

Tackle Challenges

Broaden your Knowledge

Find Support with Wellness Programs & Resources

Being a CDA member makes you part of a vast network of over 3,500 dentists across the state to have fun, get or give advice, expand your job prospects, and share knowledge.

Access the enormous amount of resources available to you with your membership: webinars, CE courses, publications, events, white papers, the new ADA Dental Experience and Research Exchange and more.

Speed Up Your Clinical Workflow

Tackle current challenges and achieve your long-term goals with the ADA Accelerator Series – your hub for financial, leadership and work/life balance tools.

Support your and your team’s wellbeing by accessing numerous wellness resources provided by the CDA and ADA.

Affordable Group Health Coverage

Using iCoreRx e-Prescribing software can save you time and protect your patients.

Provide health insurance for your family and team with Allstate Benefits through the CDA Health Plan.

Gain Awareness When it Matters Most

Guidance for Associateships & Practice Ownership

Gain awareness of the regulatory and legislative changes affecting dentistry and how you practice.

Move Toward a 401K Plan

Be ready for the Colorado Secure Savings Program and follow an easy path to compliance with the CDA Retirement Solution.

Get guidance for starting or closing a dental practice. Or acquire information about what to expect with associateships. ADA Practice Transitions can help you sell your practice, buy a practice, hire an associate or find a job.

Sustain HIPAA Compliance with Abyde

Never stress over HIPAA again when you use Abyde’s revolutionary software solutions.

REFLECTIONS

Let’s Talk About Perspective By Amisha Singh, DDS

s I type this out, I am coasting at 477 mph at a

to force my hand. But now, with my 20/20 hindsight, I see all the paths that

breathtaking 38,000 feet in my first flight since

had to align to bring me the joy I have now. Some of the paths were amazing

the pandemic started. As someone who once

(I will remember the December 1st call accepting me to my dream school for

considered Denver International Airport a second home,

the rest of my life.) But others felt like losses at the time. I remember grieving

this is a little bit like a step back into another life, complete

those losses and wondering “why?”.

with equal parts excitement and anxiety. I look out over the patchwork landscape of beautiful Colorado, my forever home, taking in a familiar sight

I type this to remind you (and myself), the why may not be evident in the

which I hope I will not take for granted again. And I think about perspective.

moment, but it shows itself eventually. So far, this has not failed. I am standing on the mountain with complete visibility so I can say that easily now. I am

I spent the weekend at a family wedding in Atlanta and there we had

joyous now. But in my sorrow, it was not always easy to trust the universe, to

numerous conversations about life over the past two years. Two years is a

trust that I would know the why behind what felt like an unmeasurable loss.

fairly long time for my large, extended, Indian family to go without seeing each other so there was plenty to catch up on. One of my cousins decided to leave a career in health care. Another is moving across state lines and leaving a newborn niece she thinks of as a daughter. As I heard about life trajectories of cousin after cousin, job changes and moves

When I mentor students and younger dentists, so often, I hear them lament

"Life turns aren’t binary- good or bad, happy or sad. They are amalgamations of a multitude of emotions, and sometimes, as humans we do not know where to place them."

over the length of their journey. They ask “why?” too. Why did I have to take that gap year? Why did I major in engineering first? Why did that practice fall through? Why did it take me so long to realize that I love public health? As I hear them, I think of all the times I asked myself these questions. It brings

and weddings and transitions, I

me right back to this plane. See, when I travel from ATL to DEN, I do not

could not help but think how unexpected are some changes. Changes like the

complain about the three hours of my day I spent on this flight. I do not see

pandemic, your favorite dental assistant quitting over lunch, family illnesses,

this as a waste of my time. I recognize that I need the time to travel the miles.

acceptance to dental school, buying a practice, changes filled with joy and

I need to spend this time on a flight, traveling the journey, to return home. In

sorrow alike, often come out of nowhere. They feel like an accost to your life,

fact, I trust a plane is flying the quickest route possible to get me home. So why

to your balance, to all the places you knew you were destined to be. They

can we not trust the same of the journey of our lives? Every path we travel,

can feel like a win wrapped up in a loss, or vice versa. They are unexpected

every turn we take, is necessary to give us an important piece of ourselves, to

and emotionally turbulent and sometimes a dichotomy. And that is okay. Life

bring us home. This path will wind and sometimes meander, but it will always

turns aren’t binary- good or bad, happy or sad. They are amalgamations of a

bring us home… to our dream jobs, to the best version of who we are, to who

multitude of emotions, and sometimes, as humans we do not know where to

we will eventually become.

place them. Humans like buckets. Buckets feel safe, reliable and predictable and we want to compartmentalize and categorize to gain access to that

So, as we start the descent to DIA, and I take in the patchwork quilt of land

stability. But changes are, by their very definition, unstable.

which lies beneath me, watching tufts of clouds cast shadows and glide past, I want to anchor this memory. I want to remember what it feels like to see all

I think about my own life path and how I had no idea that academic medicine

the whys, trust the universe, and feel like home is approaching. May we never

would be my ideal work. I think about the journey I took to get here and how

forget this feeling of coming home.

I did not always willingly cross the paths on that journey. Sometimes life had

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MEMBER MEMBERMATTERS MATTERS MDDS Annual Shred Event Benefitting the Colorado Orthodontic Foundation (COF)

MDDS volunteers worked to shred a record number of sensitive materials for member dentists while raising money for the Colorado Orthodontic Foundation (COF) at the annual Shred Event this August.

CDA & MDDS Celebration of Women in Dentistry

More than 80 women dentists from around Colorado gathered for a special luncheon; keynote address from ADA Outgoing Executive Director, Dr. Kathleen O’Loughlin; and panel discussion at the Denver Athletic Club on September 19, 2021 at this celebration of women in dentistry.

CDA & MDDS Day of Wellness

Attendees enjoyed yoga, tips for stretching and pain relief, mindfulness instruction and a clinical course on socket bone grafts at the first-ever CDA & MDDS Day of Wellness.

MDDS October New Member Welcome Event

Dentists from around the metro area enjoyed delicious pizza, great conversation, and views of the Front Range at the October New Member Welcome Event at Joy Hill.

New Members, Welcome! Dr. Sean Adams Dr. Enas Al Sharea Dr. Fawaz Aldweesh Dr. Crystal Almaraz Dr. Dalal Alnassar Dr. Mohammad Alshemali Dr. Sulaf Al-Shorji Dr. Asha Suresh Athans Dr. Manjari Badgujar Dr. Laya Bahrani Dr. Morgan Barber Dr. Rajvi Bhagat Dr. Ranu Bhandari Dr. Gagandeep Bhangu Dr. Margeaux Black Dr. Kayla Brown Dr. Nagapoornima Brown Dr. Leela Buddaraju Dr. Dallin Burk Dr. Michael Chacho Dr. Chris Chambers Dr. Chi Lok Tiffany Chan Dr. Tyler Chancellor Dr. Rita Chandki Dr. Rhiti Chatterjee Dr. Skyler Christensen Dr. Joseph Coromelas Dr. Elana Costanza Dr. Abhay Dalal Dr. Subhashish Das Dr. Timothy Daudelin Dr. Nicholas Demeo Dr. Margaret Dinkel Dr. Kathleen Fay Dr. Tabitha Fischer Dr. Matthew Fusco Dr. Jui Gaikwad Dr. Jinal Ganatra Dr. Addys Garcia Delgado Dr. Xavier Goode Dr. Olga Granados Dr. Trevor Grandgenett Dr. Danea Graves Dr. Brooke Green Dr. Lauren Gullett Dr. Chun Guo Dr. Erik Gustafson Dr. Yohannes Hadera Dr. Michael Halasa Dr. Nora Hameed Dr. Lauren Hanzlik Dr. Adam Holowecky Dr. Jason Hoop Dr. Tiffany Huynh Dr. Irene Hwang Dr. Aida Ibrahim Dr. Messay Ibrahim Dr. Olivia Jaconette Dr. Rajat Jaiswar Dr. Neha Jivan Dr. Ryan Jones Dr. Pinky Kadur Dr. Etasam Khan Dr. Rinku Khullar Dr. Conni Kim Dr. Paul Kim Dr. Elisa Kim Lee Dr. Daniel Koman Dr. Ryan Koster Dr. Mohammad Kraishan Dr. Scott Kuma Dr. Casey Lally Dr. Emma Lazaroff

Dr. William Lee Dr. Hyun Joo Lim Dr. Charles Long Dr. Allicia Lucich Dr. Lauren Lustig Dr. Chardai Lyde Dr. Dimplejit Mangat Dr. Alexandra Martella Dr. Kamini Masilamani Dr. Megan Massey Dr. Geebellue Mensah Dr. Palash Modi Dr. Daniel Mora-Plata Dr. Cori Morris Dr. Michael Mulady Dr. Kathryn Nagel Dr. Kunal Narang Dr. Natalie Newton Dr. Jason Palmer Dr. Nazia Parveen Dr. Namrata Patel Dr. Kai Pedersen Dr. Jordan Pellegrom Dr. Cara Pocano Dr. Damon Pogoncheff Dr. Derik Powell Dr. Yasmeen Qadi Dr. Pota Rakes Dr. Poornima Ramesh Dr. Japneet Randhawa Dr. James Rhee Dr. Jayson Ricks Dr. Brandon Rinker Dr. Brady Robbins Dr. Keith Rockwood Dr. Nitika Rohilla Dr. Lauren Rothwell Dr. Joseph Runco Dr. Zaid Saeed Dr. Fatima Salman Dr. Michael Sefcik Dr. Darshika Shah Dr. Aadya Sharma Dr. Bomy Shim Dr. Dipti Shinde Dr. Jaipal Singh Dr. Kulshrest Singh Dr. Ann Skradski Dr. Stanford Smith Dr. Yanairde Somarriba Dr. Cengiz Soysal Dr. Sarah Stamps Dr. Frederick M. Stark, IV Dr. Brandon Sturgell Dr. Mi Than Dr. Veronica Toca Sone Dr. Brittani Trevithick Dr. Judy Trinh Dr. Alexandria Truong Dr. Madison Turner Dr. Katherine Urie Dr. Mark Velemirovich Dr. Luke Vernon Dr. Caroline Vick Dr. Emily Waikem Dr. Joshua Way Dr. Rachael Yancey Dr. Madhulika Yemba Dr. Zackary Zayakosky Dr. Nibal Zrik Dr. Peter Zwickey

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RMDC SPEAKER

Creating the Easy and Efficient Temporary By Lori Trost, DMD

well-made temporary lends itself as the blueprint to the final dental restoration and its long-term success. Regardless if you utilize digital impression scanning or take traditional impressions, maintaining the restorative space during the temporary phase is critical for dimensional accuracy. And, given a recent ADA survey that 48% of any dental practice production directly reflects indirect procedures, temporary fabrication quickly becomes a significantly valued procedure. Often though, temporaries become an arch nemesis of the practice. They come off or break and need to be remade and then recemented. For a busy dental practice, this interruption in the schedule leads to frustration, miscommunication and appointment delays. Effectively, the inefficiency of a single unit crown procedure can manifest in many ways. Implementing a temporary fabrication protocol that can be performed predictably and efficiently has benefits not only for the patient but for the practice. Patients want their temporary to “stay on,” look good and not be sensitive. Dental professionals desire to work with a temporary material that is easy, strong and esthetic, protects the pulp, maintains the periodontal health, yet, is easy to remove. And each of these features must be respected. Whether fabricating a single or multiple unit provisional, specific material properties offer advantages that can significantly reduce the temporary-making anxiety. From the initial model or template of the tooth to be restored, to the actual provisional material and temporary cement choice, each selection should provide a benefit. Case Study A patient presented with a large MOD amalgam on tooth #29 that had recurrent decay. A crown was treatment planned to properly restore the tooth for function and support. Before the tooth was prepared, a model or template was made using a polyvinylsiloxane hybrid impression material (AlginX Ultra, Dentsply Sirona). The PVS material was syringed into an aluminum quadrant tray (TempTray,

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Clinician’s Choice) and positioned and held steady over the tooth for three minutes. (figure 1) This PVS hybrid impression material oﬀers two weeks of dimensional stability, therefore it can be stored and re-used if necessary in case the temporary needs to be remade. (figure 2)

figure 1

The crown prep and digital intraoral scan were completed. A dual cure composite-based material, shade A2 (Integrity Multicure, Dentsply Sirona) was syringed into the initial model/ template. (figure 3) The selection figure 2 of a dual cure temporary material aﬀords the clinician the benefit from a self or auto-cure mode that can be complimented and finalized by light curing to expedite the polymerization process. Not only is this a time savings feature, but also provides a fully cured temporary that can be immediately finished and polished. The syringe tip was figure 3 placed at the base or occlusal table of the model, carefully dispensing the material to fill the preparation site to 2/3 full. No swirling occurred during the dispensing. This technique minimizes voids and air bubbles that can often form during the fabrication process. The filled model was positioned over the prep and held in the patient’s mouth for 90 seconds. (figure 4) The patient was instructed not to bite down on the

tray. This could potentially “rock” the tray and cause a mis- fitting temporary. After the allotted time, the tray/model was removed from the mouth with the temporary remaining inside the template. The tray was placed on the counter with the intaglio surface of the model facing upright. A LED curing light (SmartLite Focus, Dentsply Sirona) was placed over the intaglio the intaglio surface and activated for 20 seconds to complete the polymerization of the temporary material. (figure 5) Next, care was taken to remove the newly formed temporary from its model. Notice the lack of voids or bubbles. Because this material

Regardless, a temporary cement must primarily function to soothe the tooth, work in tandem to keep the provisional seated, possess a low film thickness, and provide an easy clean-up upon initial placement and then upon provisional removal for the cementation of the final restoration. A resinbased temporary cement (TempGrip, Dentsply Sirona) was syringed into the provisional as a thin layer coating the intaglio surface. The provisional was seated over the preparation firmly using finger pressure. A cotton roll was placed over the occlusal table of the quadrant to allow the patient to close and rest for two minutes while the temporary cement set. This temporary cement oﬀers an easy peel away clean-up that the author finds very favorable and unique. The provisional was flossed and occlusion re-verified. (figure 7)

figure 4

figure 7

figure 5

And finally, the patient was given home care instructions to follow until the final restoration was delivered.

figure 6 is composite-based, if an area needs to be filled in or added to, flowable composite can be used. (figure 6) As you can see, minimal flash resulted from the fabrication process that could easily be peeled away. Also, due to the nature of the composite chemistry, a 2 x 2 dry gauze was used to wipe off the oxygen-inhibited layer. An acrylic bur was used to trim around the margin and finish the exterior surface. The temporary was tried in to verify occlusion, contacts, and marginal coverage. Few adjustments were necessary. Again, due to the composite-based material selection, flowable resin could be relied upon to fill in an area because of compatible chemistry and light cured. Prior to these materials, methacrylate-based provisional materials consisted of a powder and liquid mixture that were inconsistent, created a thermoplastic reaction that set off heat into the tooth yielding sensitivity, and ultimately resulting in shrinkage that potentially caused temporaries to “lock on” to the newly prepared tooth. A cup-shaped composite polisher (Enhance, Dentsply Sirona) with a latch grip on a slow speed hand piece was selected to polish all the surfaces of the temporary using a light touch. The polishability of the temporary is critical to create a luster that is biocompatible, smooth to the tongue, and cleansable for the patient. The provisional was ready to be temporarily cemented. Considerations for temporary cements focus on either a resin-based or eugenol based chemistry. Some temporary cements even offer antimicrobials such as chlorhexidine in their ingredient listing. Relating to the esthetics of the case, temporary cements are also available in clear or translucent options for anterior teeth as well as more opaque cements for posterior teeth.

Conclusion Ultimately, the temporary fabrication process is realized by what works best in the clinician’s hands and what materials are most helpful. By selecting materials that not only provide durability, but also eﬃciency, dental professionals can become more confident in predictable outcomes for the delivery of a much anticipated functional temporary. About the Author Dr. Lori Trost has extensive private practice experience that focuses on restorative dentistry, digital workflow solutions, business management and team building. She has been awarded the ADA’s Shils Foundation Award and named a “Top 25” Woman in Dentistry and a Leader in Continuing Education by Dentistry Today.

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RMDC SPEAKER

NEEDLES, LUNGS © & TONGUES The Chemistry, Use and Effect of Psychoactive Substances

By Amber D. Riley, MS, RDH, FAAFS, FIACME

sychoactive substances legal or not, are ubiquitous in our communities and used by the patients we treat. Use and abuse, of psychoactive compounds date back thousands of years. America’s history with psychoactive substances is a torrid one, I hope to lessen if not eliminate the stigma, secrecy and shame that still associates itself to learning about drugs. A person’s inexperience compounded with curiosity can make a dangerous drug a deadly one on the first use; and any government’s naivety to expect its constituents to abstain from drug use and abuse is just as dangerous.

reporting, intervention and diversion for dental professionals practicing under the influences of psychoactive substances is also addressed. Is this a complicated and provocative topic? Yes. Is this topic one rife with political arguments and special interest lobbyists and pharmaceutical billions in play? Yes. Is this topic one that reaches into every neighborhood and zip code regardless of wealth and privilege or poverty and disfranchisement? Yes.

The mercy of drugs and menace of pain is a great equalizer to the human animal. No one is exempt from the dangers, benefits and vulnerability to any of As of the time of this writing, forty-six states and the District of Columbia have these molecules. Anyone that has ever taken (or listened to thanks to COVID!) some form of a medicinal or compassionate cannabis use permission or have any of my programs, can be assured that we will take on this complex topic of decriminalized the possession and use of cannabis; eighteen states and D.C. substance use and abuse from the same playbook, and we will not dance around have full legalized use; and the U.S. House of Representatives has passed a bill to any elephants in the room or speak in the boring generalities that dominate federally decriminalize marijuana across all 50 states, with bi-partisan support, the educational coffers in this area of continued education. and which now sits in the Senate for a vote. In 1967, 10% We will address this subject matter with a straight-forward, of Americans favored marijuana being legal and in 1970 "America’s history with at times humorous and at times very blunt way. With a marijuana was functionally made illegal by the development of the Controlled Substances Act. States began legalizing psychoactive substances friendly approach we each effectively can meet the needs of our communities that are struggling to stop the tiptoeing that marijuana for medicinal use, with California first in 1996, is a torrid one, I hope to still goes on around these discussions and the reticent lack of and Colorado and Washington legalizing all use in 2016.The lessen if not eliminate acknowledgement of what is harming all of us in one way or social tolerance for marijuana now stands at over 90% of another. Reticence results only in a failure to be proactive and Americans being in favor of legalizing marijuana as reported the stigma, secrecy to reduce harm. by The Pew Research Center in April 2021. 1

and shame that still associates itself to learning about drugs."

One of my programs for the 2022 Rocky Mountain Dental Convention (RMDC), Needles, Lungs & Tongues, will bring actionable insights to participants who have an interest, in any depth, in the subject of drugs, more specifically drugs that are currently and historically misused and abused. We will review what are many of the most important points of use that we must understand in order to mitigate acute risks when treating patients and what long term risks will become inherent. This program should be immediately useful and relevant to dental professionals and drug prescribers. We will move through categorizations, relevant legal authorizations, and considerations for multiple common, and frequently encountered substances of use and abuse that circulate within all of our communities, patient populations, and even in our families. This discussion will meet and exceed the American Dental Association’s published recommendations for continuing education pertaining to opiate prescribing that is specific to dental practice, including alternatives for dental pain-management that are scientifically supported by peer-reviewed, replicated research and reliable data from which we may develop safe prescribing policies of schedule II medications all the way up to over the counter choices, and provide the most appropriate care and education of prescribing practices to our patients. Discretionary

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This program delivers current data, published understanding and facts about what is real, and what is myth. We draw from the wealth of research that is available from legitimate, respected institutions of higher learning in the United States and abroad, from city to federal law enforcement expertise and from my personal, family and patient experiences. In short, if you are one to clutch your pearls easily, this program is not for you. But if you are someone who finds yourself empowered and more confident when you choose to face uncomfortable topics that you deem important; you are someone who is looking for a program to fulfill mandates on opiate education, or you or someone you love are being affected by substance misuse or abuse and you are able to acknowledge the behavior is causing harm, then this program is for you! About the Author Ms. Amber Riley is a dental hygienist in San Diego, CA and a Forensic Dental Consultant for the San Diego County Office of the Medical Examiner. She is also a Forensic Dental Unit member of DMORT/NDMS and serves as an RDH Advisory Board Member to the Oral Cancer Foundation. References: 1.https://www.pewresearch.org/fact-tank/2021/04/16/americans-overwhelmingly-say-marijuana-should-be-legal-forrecreational-or-medical-use/

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4th Quarter 2021 mddsdentist.com

Evidence-Based Considerations for RDH Using Aerosol-Generating Devices By Karen Davis, RDH, BSDH

This virus appears to have stability and viability similar to but somewhat more n unexpected benefit of the SARS-CoV-2 viral significant than another virus (SARS-Cov-1) in experimental conditions2. pandemic for dentistry is the emergence of data Therefore, increased infection control considerations, pre-rinse, increased use shedding light on the safety of utilizing aerosolof High-Volume Evacuation (HVE), and increased use of Personal Protection generating devices on patients during dental hygiene care. Equipment (PPE) should be the new normal for dental professionals. HVE with Many dental hygienists resumed practicing once the shut-down an 8mm opening has been shown to reduce >95% of aerobic bacterial aerosols was lifted with uneasiness about clinician and patient safety when used with ultrasonic and air polishing devices.3 Likewise, recommendations while using aerosol-generating devices such as ultrasonics and air-polishing devices. Some states even passed rules and regulations prohibiting to use low-speed polishing opposed to air polishing with HVE are based upon usage of such equipment for many months, requiring dental assumptions one is safer than the other, yet not substantiated hygienists return to manual instrumentation. The Centers by current evidence. If you were skimping on previous OSHA for Disease Control published recommendations to avoid and CDC guidelines regarding infection control in your "As a practicing dental aerosol-generating devices whenever possible during the dental practices, COVID-19 should have been a wake-up hygienist, I for one, pandemic until mid-2021 when additional language specified call to get your office in order. Thankfully, there are ample was interested in what that the recommendation applied only when working on those resources available from the OSHA, CDC, ADA and ADHA with suspected or confirmed COVID-19.1 Today there are to guide clinicians on how to provide care once patients have the science said about been screened for COVID-19 exposures or symptoms. clinicians that still struggle with concerns over personal and the risks of disease patient safety incorporating aerosol-generating devices, and have continued increased usage of manual instrumentation Patient Preferences and Clinician Experiences transmission during over power instrumentation. the pandemic in lieu Even in a pandemic as devastating and costly as this one, clinicians should still make evidence-based decisions. of such unprecedented Dental professionals accustomed to making evidence-based Evidence-based dentistry encompasses the best available decisions noted early on the lack of scientific data related to recommendations, science and two other important components: the patient’s dental environments and the transmissibility of the SARSrules and regulations preferences and values, and the clinician’s experiences COV-2 virus. As a practicing dental hygienist, I for one, and expertise. Charles Cobb, in his review of the literature was interested in what the science said about the risks of on the profession." presented at the 2000 World Workshop on the topic of disease transmission during the pandemic in lieu of such mechanical therapy4, concluded, “The best results are probably unprecedented recommendations, rules and regulations on obtained by combining sonic/ultrasonic instrumentation the profession. with manual scaling.” This appears to be consistent with current usage of power and manual instrumentation by most clinicians today. Completely eliminating Assumptions Do Not Equate to Science power devices for dental hygiene care may have significant consequences. A study published in 20165 evaluated ultrasonic versus hand instrumentation On March 17, 2020 when the New England Journal of Medicine published data and established that hand and ultrasonic instrumentation can both achieve showing the SARS-CoV-2 virus could remain viable in aerosols for three hours comparable outcomes, but ultrasonic instrumentation reduced the time by 36.6% and on inanimate objects for much longer2, as a dental professional my knee-jerk in one referenced study and caused less soft-tissue trauma.6 Other studies show reaction caused me to immediately question the safety of ever treating patients time savings of 20-50% for thorough periodontal debridement.7,8,9 Said another again. However, at a second glance, I examined how this study was conducted to determine how applicable it is to our dental environment. Suffice it to say, a dental way, eliminating ultrasonic instrumentation could take as much as 50% longer environment already using universal precautions is a stark contrast to creating in a COVID-19 environment. In the absence of incorporating power technology, an aerosolized environment in a laboratory using a three-jet Collision nebulizer are appointments lengthened to accommodate that reality? Will patients need inside of a Goldberg drum. It is a leap to assume results of this laboratory study, to return to complete necessary debridement? Will pathogenic biofilm be where a large expression of viral aerosols was dispersed into a stainless-steel drum, inadequately debrided? These are legitimate questions worthy of consideration. equate to a dental treatment room not being a safe environment to incorporate power technology. Many patients prefer power technology when used with the lowest power and water settings possible and prefer achieving the end result in less time. While not

16 4th Quarter 2021 mddsdentist.com

RMDC SPEAKER

all published data concurs, several studies confirm increased patient comfort with ultrasonic versus hand instrumentation6,9,10 which should also impact evidence-based decision making for clinicians. New Evidence Sheds Light on Dental Aerosols

Ms. Karen Davis is founder of her own continuing education company, Cutting Edge Concepts®, and currently practices dental hygiene in Dallas, TX. Dentistry Today has consecutively recognized her as a “Leader in Continuing

An article titled, “Sources of SARS-CoV-2 and other microorganisms in dental aerosols” published by the Journal of Dental Research in 202111 confirmed something we have long known in dentistry, that hopefully will increase the urgency for dental unit water line safety in all dental practices. In this study, they analyzed the aerosolized DNA microbiota from 28 patients undergoing ultrasonic instrumentation, implant surgery, or restorative procedures and found a major source of DNA contaminant in aerosols came from the dental irrigants. In contrast, saliva did not significantly contribute to aerosolized contamination as pre-procedural rinses and HVE were utilized. Numerous other studies published since the outbreak of the pandemic have reached the same conclusion.

About the Author Ms. Karen Davis is founder of her own continuing education company, Cutting Edge Concepts®, and currently practices dental hygiene in Dallas, TX. Dentistry Today has consecutively recognized her as a “Leader in Continuing Education” since 2006.

Bottom-Line The risk of disease transmission in a dental environment never has been and never will be zero, but what is documented is miniscule. Universal precautions incorporated prior to COVID-19 have provided a high-level of safety to patients and clinicians. Additional layering of infection-control practices must be incorporated in dental practices in a COVID-19 environment, but dental hygienists should feel confident that aerosol-generating devices can be incorporated safely. For more information and evidence on this topic, attend “Aerosol-Producing Devices for the RDH” on January 20, 2022, during the Rocky Mountain Dental Conference.

Education” since 2006.

References: 1Guidance for Dental Settings. Interim Infection Prevention and Control Guidance for Dental Settings During the COVID-19 Response. https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html Accessed Nov 1, 2021. 2Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. New England Journal of Medicine, 2020: 382: 1564-1567. Doi:10.1056/NEJVc2004973. 3Harrell SK, Molinari J. Aerosols and splatter in dentistry. A brief review of the literature and infection control implications. Journal of the American Dental Association, 2004: 135: 429-437. 4Cobb CM, Non-surgical pocket therapy – Mechanical. Annals of Periodontology, 1996: 1: 443-490. 5Krishna R, DeStefano JA. Ultrasonic vs. hand instrumentation in periodontal therapy: clinical outcomes. Periodontology 2000, 2016: 71: 113-127. 6Tunkel J, Heinecke A, Flemmig TF. A systematic review of efficacy of machine-driven and manual subgingival debridement in the treatment of chronic periodontitis. Journal of Clinical Periodontology, 2002: 29: 72-81. 7Checchi L, Pelliccioni GA. Hand versus ultrasonic instrumentation in the removal of endotoxins from root surfaces in vitro. Journal of Periodontology, 1988: 59: 398-402. 8Cobb CM. Clinical significance of non-surgical periodontal therapy: an evidence-based perspective of scaling and root planing. Journal of Clinical Periodontology, 2002: 29: 6-16. 9Drisko CL. Periodontal debridement: hand versus power-driven scalers. Dental Hygiene News, 1995: 8: 18-23. 10Wennestrom JL, Tomasi C, Bertelle A, Dellasega E. Full-mouth ultrasonic debridement versus quadrant scaling and root planing as an initial approach in the treatment of chronic periodontitis. Journal of Clinical Periodontology, 2005: 32: 851-859. 11Meethil AP, Saraswat S, Chaudhary PP, Dabdoub SM, and Kumar PS. Sources of SARS-CoV-2 and other microorganisms in dental aerosols. Journal of Dental Research 2021. https://journals.sagepub.com/doi/ pdf/10.1177/00220345211015948 Accessed October 31, 2021.

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4th Quarter 2021 mddsdentist.com

RMDC SPEAKER

Lean-in to Marketing By Minal Sampat, RDH, BA

ou may be an amazing clinical dentist but if you aren’t marketing your skills and practice properly, potential patients won’t know. As a healthcare professional, marketing may not be what excites you but it’s essential to your practice success. Plus, once you learn how to do it well and see the results, you may find it more exciting than you first thought. Here are some commonly asked questions on incorporating a successful marketing strategy into your practice.

There are so many ways to market a dental practice but going from ideas to execution can be a common hurdle. How can practices overcome this? It’s true; many dentists have great marketing ideas they can’t seem to put into action. Between running the practice and treating patients, these ideas often fall between the cracks. The best way to get the ball rolling is to make it one person’s job to execute the marketing. If it’s everyone’s job, then no one really does it. Once practices designate a marketing manager, they start seeing results. That’s because it becomes someone’s responsibility to make it happen.

Social media platforms are fun but require consistent posting. How can practices keep creating content long-term? Consistent posting is important, but you don’t want to burn yourself out. To prevent that, choose just one platform and create a posting strategy for it. If you’re experienced on two social platforms, then you can stretch to two, but no more than that at first.

Four posts a week is a great goal. Once that’s a habit, you can build from there either by posting more often or cross-posting to another social media platform. As you get better at gathering content, you can then focus on leveraging each platform individually to get maximum reach.

"It’s true; many dentists have great marketing ideas they can’t seem to put into action. Between running the practice and treating patients, these ideas often fall between the cracks."

You don’t always have to hire a new team member to accomplish this. Train someone in your practice or give them a couple of hours a week to train themselves. As their knowledge and project load grow, you can expand their hours and give them more resources.

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We know that photos and videos emphasizing your practice’s culture get the best engagement. The best strategy is to keep it simple by sharing something about your day at the office. Take a photo of your morning huddle one day, and the staff pizza party another. Honor birthdays or highlight team members for being great. If you see 25 patients a week, challenge yourself to get photos of four patients who consent to being featured online. Share before and after treatment cases.

Four posts a week, got it. What type of content should practices focus on putting out? Today, 80% of content consumed online is video. These are mostly short-form videos; think TikTok or Instagram Reels.

Pay attention to this trend. Figure out how to include it not just in your social media but also your emails, text message marketing and website. Forbes published a finding that 88% of people would rather spend time on a website with a video than one without, and 64% of customers are more likely to buy a product after watching a video. Another fun fact is that Reels were just added to the Facebook platform and LinkedIn has mentioned many times that they are also adding video options to their platform. Video is hot right now; lean into it.

Okay, we’ve got consistent posting and videos down, but we’re not seeing a lot of likes and comments. What can practices do to increase social media engagement? On Instagram right now, Reels are the best way to organically reach audiences and boost engagement. You can record quick videos where you compile clips and effects to catch and keep your audience’s attention.

If you have a Facebook business page and you’re not already using Facebook Ads, it’s time to start. Their tools let you input parameters, so your ideal target audience sees the ads, making them worth the investment. You can affordably experiment with small geographic regions or shorter spans of ad time before committing to a larger campaign. The real lesson here is to get comfortable with the tools that each platform encourages you to use. That’s what they’ll prioritize in the user's feeds.

Alright, great advice. Let’s zoom out a little now. What gets in people’s way of success when it comes to marketing in general? Most commonly friction around posting photos and videos. Perhaps there’s a marketing manager, but team members and doctors are camera shy. Or they’ll get the photos, but not have time allocated to create a meaningful post to go with them. It’s really important to pick a marketing manager who enjoys marketing, social media and technology, and to give them ample time to execute on ideas. The biggest hurdle is often just getting the tasks done. Having someone who genuinely likes marketing rather than just doing it because they’ve been asked to makes a huge difference. As for getting the team on board with helping to build marketing content, try to incentivize them. Put up a raffle prize and give a ticket for every patient photo that results from a team member’s invitation to take one.

This has all been very informative. Looking ahead, where can practices look for inspiration and branch out with their methods? At RMDC 2022, we’ll be discussing strategies with dentists and their teams to help them consistently come up with marketing that’s customized to their practice. We’ll look at ad-targeting, building a marketing plan that converts, and taking action based on the patients you want to attract. The goal is to keep practices from getting overwhelmed and to simplify marketing so it can be easily implemented. Being a virtual presentation, the audience will also see examples of social platforms live on-screen so they can follow along. I’m really looking forward to meeting dental professionals and sharing strategies proven to work. About the Author Minal Sampat, RDH, BA is an International Best Selling Author a National Speaker, Marketing Strategist, Social Media Coach, Registered Dental Hygienist and an enthusiastic shoe lover. Minal grew up in St.Thomas, US Virgin Islands and now resides in Washington State with her husband. She launched her first marketing company by breaking a Guinness World Record, and last year, she launched Marketologist™ - a marketing strategy school, online. Minal has also been featured in industry and national press including Forbes.

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rmdconline.com.

RMDC SPEAKER

Health Equity Relies on Moving from Concept to Action: It Also Relies on You! By Dr. Dwinita Mosby Tyler

he U.S. (well, the whole world for that matter) has experienced dramatic change over the past year and a half and some of those changes have us wondering how much progress we have made in advancing and achieving health equity. You know the spiel…

Health equity is achieved when every person has the opportunity to “attain his or her full health potential” and no one is “disadvantaged from achieving this potential because of social position or other socially determined circumstances.” Health inequities are reflected in differences in length of life; quality of life; rates of disease, disability, death; severity of disease; and access to treatment (Centers for Disease Control and Prevention, 2021). One of the most important things we can do right now is assess what we’ve done; what we’ve advanced, up to this point. We have been at diversity, inclusion, equality, and equity work for a very long time. With that said, have we achieved health equity? Have our actions brought about the shifts we have wanted to see?

things as every other group. This is the area, in the U.S., where we have spent the most time. Everything from the Civil Rights Movement to the Women’s Movement are examples of equality. Lastly, there are times, like now, where we are focusing on equity. In this case health equity. Unlike diversity, inclusion and equality, equity calls for big commitments:

• You must commit to investigating your own systems • You must commit to dismantling systems of inequities

Health equity relies on deep equity work. Equity calls for systems and structural work. It is about creating systems where everyone gets what they need to thrive. In effect, the systems we know all too well must be challenged. Within these systems exist the inequities that keep us from achieving health equity. To achieve health equity, we venture into areas of discomfort and sometimes fear, including the need to discuss race and its implications on health equity.

The answer lies in our understanding of what we have been working on. My take? We haven’t really been working on equity as much as we might think. I often talk about The Continuum of Equity below. It is meant to illustrate the fluidity of the work. It acknowledges the fact that we move up and down this continuum, depending on what we’re working on. Sometimes our work creates a keen focus on inclusion (or belongingness) strategies. We want to make sure our staff and patients/clients/partners we serve experience the feeling of being a part of the system in an authentic way. Sometimes we are focused on diversity – the work that centers on valuing differences. All kinds of differences. We typically are working to increase or change, statistically, a demographic or identity group.

Historically (from the 1950’s to now), we have focused our organizational work on diversity, inclusion and equality. This has helped us to make substantial and important change. We have passed equality laws that provide access to those who didn’t have it, we have opened the door to the richness of diverse workplaces and systems, we have focused on creating welcoming environments. These are all important achievements and yet, we are still challenged with inequities and not achieving health equity? Why? I’m glad you asked. There are also times when we focus on equality – the intentional work of level-setting, providing access and providing one group with the same

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It is because we really haven’t been working on equity over the years. We’ve been working, almost exclusively, on diversity, inclusion, and equality.

None of these get you to the deep system interrogation investigation and change needed to actualize health equity. They change the access and infrastructure without dramatically shifting the system. In other words, we are early on in our equity work.

So…is health equity even possible?

"Health equity is achieved when every person has the opportunity to 'attain his or her full health potential' and no one is 'disadvantaged from achieving this potential because of social position or other socially determined circumstances.'"

Our collective challenge is to be extraordinary navigators in this work. We should each know where we are on The Continuum of Equity at any given time. Not everything we do is equity work, so our careful articulation of the “what” we are doing is important. This helps us to set reasonable and realistic expectations about outcomes. No need to get frustrated when your work still leaves you with a preponderance of inequities. It may be that your tactics for dealing with the inequities were not laser focused. I often see us using diversity or inclusion (D&I) tactics in hopes of achieving equity. The reality is D&I won’t bring you equity. Equity is its own systematic strategy.

Yes. It is. It will be evolutionary work with defined strategies and each of us has a role to play in advancing it. I can confidently say to you that I see equity in our sightline. This is extraordinary. I’m also a realist. It may be that I won’t see total equity and health equity in my lifetime. It reminds me of my favorite books, ‘The Cathedral Within’, by Bill Shore. The book reminds us of the great cathedral builders of the world. The builders knew the whole time they were building that they would never live to see the finished product. This fact never compromised how hard they worked and how committed they were. So…maybe it is true that health equity is the next “great cathedral.” I’m honored to be one of the builders. Aren’t you? About the Author Dr. Dwinita Mosby Tyler is the Chief Catalyst and Founder of The Equity Project and founder of The HR Shop. She is the former Senior Vice President and Chief Inclusion Officer for Children’s Hospital Colorado and former Executive Director of the Office of Human Resources for the City and County of Denver.

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4th Quarter 2021 mddsdentist.com

TRIPARTITE NEWS

Exercising Your Voice in Organized Dentistry By Greg Hill, JD, CAE, CDA Executive Director

magine a young dentist in 1968 who designed a state-

the marketplace. The board of trustees must be the driving force in how we

of-the-art dental practice, fit with the top-of-the-line

understand and react to a continuously evolving profession, the increasing

equipment, sleek mid-century design, a trendy avocado

external regulations and auditing requirements we face, and still provide the

green color and wood panels throughout the office and began

foresight that will allow the association to remain at the top of its profession

their practice with a business model designed on 1968’s best

for years to come.

dental office management practices. Now imagine that same dentist continuing to practice in 2021 with that same design, equipment and

These competencies we are talking about as a board include critical judgement

philosophy.

and decision-making skills, exemplifying integrity, leading and managing change, risk management, and strategic vision and thinking. This framework

Seems rather preposterous, right? What kind of business would be unwilling

is also called the “13 Best.” The idea that the members of the board are among

to change their business model to keep current with research, design and best

the best leaders available to serve based on the expertise they contribute. These

practices? What aspect of a business model has not changed in 53 years that

board members are sensitive to regional, special interest, and the high priority

needs to be modernized?

needs of the membership, but not seated based solely on geography. The objective is to leverage the boards’ competencies to drive

What if I were to tell you that the business I am describing is not a dental office, but instead the governance of organized dentistry? In many ways, the framework by which organized dentistry operates is built on the same “practice” philosophy of 1968 when the current structure was put into place - regionally elected trustees; component societies, each with their own corporate legal structure; a House of Delegates, which establishes all the organization’s policy, yet only meets to create policy once a year. Some of you are thinking because we want to make change means we want to take away your

"What aspect of a business model has not changed in 53 years that needs to be modernized? What if I were to tell you that the business I am describing is not a dental office, but instead the governance of organized dentistry?"

the organization's performance. Imagine a basketball team with thirteen point guards – you may be able to run a very fast and nimble offense, but you are most likely going to be a very poor rebounding team and good luck blocking shots from a seven-foot center. A board not only needs the competencies above, but also diversity in practice model, age, race, gender, unique knowledge such as dental school faculty, a background in understanding dental service organization operations plus a curiosity and understanding of the external drivers of change in the dental industry.

voice and your ability to engage in your association. That could not be further from the truth. We see inefficiencies in this design and

The Board of Trustees and your elected officers have tried to draw attention

better ways to ensure that your voice, along with every other voice, is heard.

to these challenges and to build a new, modernized practice philosophy, to allow us to be a better association, representing all dentists. The board recently

Association management research has provided a business model for non-

created a Council on Component Leaders. This council is designed to give

profit boards of directors built on what is referred to as a “competency-based

the components true representation to the board and a larger voice to the

board.” We’ve floated this idea and some of the feedback we have received

concerns of the grassroots members. This council is in place so the needs

is members don’t like the word ‘competency’ because it implies that you are

and challenges of all members can be voiced through component leadership

either competent to serve on the board or that you are incompetent. The

directly to the board or to the House of Delegates.

term doesn’t refer to the individuals who serve, but rather to the needs of the board – the competencies it needs as a body to see and understand the

Additionally, we are working to draw attention to the powers and duties of the

full scope of organizational needs that we as an association and a non-profit

House of Delegates (HOD). The HOD has a critical role to play in organized

corporation must resolve and oversee. These issues include direct dental

dentistry. It creates the policy by which the board and councils operate. It’s

practice concerns – workforce shortages, dental insurance, regulations – but

the “what position does the CDA have on?” body. Without direction from

also include understanding innovations driving changes in the operations of a

the HOD, the board is limited in what it can do. The Board of Trustees is not

dental practice from both the private sector and through dental education. It

a legislative body, it can only create organizational policy if it is necessary for

includes understanding how to protect and safeguard our intellectual property

the operations of the association. In other words, it can’t decide itself what the

and IT framework, overseeing the associations investments and identifying

association’s position is on workforce expansion, dental insurance reform or

new revenue sources, which enable us to keep your dues low. It includes

even mid-level providers. This must come from the House of Delegates, not

linking the dental practice needs of each member to business solutions in

because the board doesn’t want to take this responsibility, but because it can’t.

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TRIPARTITE NEWS The bylaws created by the House of Delegates do not give the board that power.

create an even bigger voice. However, unless you exercise that voice, it’s very difficult for the CDA to resolve your concerns. The board, more than anything

Here is our challenge: Each one of you has an idea on how you think dentistry

else, wants you to exercise your voice through your delegates serving in the

and the profession should operate: the laws that surround the profession, the

House of Delegates, so it can leverage its’ competencies to carry out these

way in which dental benefit plans intersect with patients and dentists, ideas on

wishes in the very best way possible.

how to manage the supply of dental workforce. You may want your organization to be more diverse and its leaders to better reflect the dental school graduating

This practice philosophy is what the board is looking to accomplish to drive

classes. You may believe there is a bigger role the CDA can play in special needs

this organization forward in the future.

population or have concerns about how the growing senior citizen population is going to receive and afford dental services in the future. Regardless of what your ideas are and what you are passionate about, we as a board and through the councils, can’t make those things happen on our own. Each of you belongs to a component dental society and you elect delegates who serve in that role until they are replaced. These delegates advocate for you and bring your thoughts, ideas and solutions to the CDA. If you have ideas take them to your component society. Ask they bring forward and support a resolution reflecting that policy change. Then it becomes the task of the board to carry forward the new policy. The voice for you as a member is, and has been since 1968, through the House

About the Author Greg Hill, JD, CAE has served as the Executive Director of the Colorado Dental Association since June of 2014. Prior to joining the CDA, Greg was employed by the Kansas Dental Association for 15 years and served as the Assistant Executive Director of the CDA and Executive Director of its Foundation. Mr. Hill is a 1999 graduate of the Washburn University School of Law in Topeka, KS and a 1994 graduate of Kansas State University with a Bachelor of Science in Economics. He became a Certified Association Executive (CAE) in 2016. In addition, he serves as Co-Chair and Treasurer of Oral Health Colorado; on the Board of Directors for the Colorado Dental Lifeline Network and the Colorado Mission of Mercy; and is a member of the Denver Tech Center Rotary Club. He and his wife, Gwen, are the parents of daughter, Haven, and son, Camden.

of Delegates and we’ve now added the Council on Component Leaders to

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4th Quarter 2021 mddsdentist.com

NON PROFIT NEWS

Donated Dental Services (DDS) Volunteers Give Single Father of Two More Reason to Smile Again By Dental Lifeline Network

I wish I could give back double what I received from DDS and the volunteer dentists. The positive impact of their gift will last me the rest of my life.” Please join the 724 volunteers in Colorado who volunteer with DLN’s DDS program. You too can provide relief to people with great needs right here in Colorado. By seeing just ONE patient a year, you can help provide comprehensive dental care to those who otherwise could not afford it.

apturing precious family moments through pictures preserve a lifetime of memories with loved ones. Many patients like Akiji are able to confidently smile for photos with their children and eat more comfortably again thanks to Dental Lifeline Network’s Donated Dental Services (DDS) program. Akiji, 64, lives in Aurora and is a single father of two sons. He is paraplegic, deaf, and suffers from mental illnesses. Unfortunately, due to his physical and mental health challenges Akiji is unable to work and couldn’t afford the dental care he urgently needed. He survives on a small Social Security benefit and struggles to make ends meet. Akiji has developed several digestive problems from not being able to chew well because his dentures are not fitted properly. Thankfully DDS volunteer Dr. Ken Allen, together with Front Range Dentures and Prosthodontics Laboratory donated and fitted him with a new set of upper and lower partial dentures that he’s very grateful for.

“It was a wonderful experience helping Akiji with his dental needs. I am very happy that we were able to provide teeth that allow Akiji to eat and to smile. His new smile allows the world to see the inner happiness and beauty that Akiji exudes,” said Dr. Allen, DDS volunteer. “As dentists we have skills that allow us to not only fix teeth, but to improve lives. I enjoy participating with the Donated Dental Services program through Dental Lifeline to change people’s lives for the better. Programs like DDS are important because they help people who are trying to better their lives.” Currently, people in the Denver metro area are waiting for treatment. To help ONE patient, please consider volunteering. Since inception 35 years ago, over 13,000 patients in Colorado have been treated and received nearly $38 million in donated treatment. If you would like to become a volunteer, contact Diane Johnson at 303.534.3931, visit WillYouSeeOne.org, or scan the QR code.

DDS patient, Akiji, with his care team.

“I want to express my appreciation for giving me a second chance to smile again. Donated Dental Services generously gave me the gift of life. A smile, being able to eat and enjoy food again, “ said Akiji, DDS patient These are just a few of the things I can do again and feel that a simple “Thank you” isn’t enough.

We Can Sell and Transition Your Practice Without “Selling Out” Your Legacy! Schedule your conﬁdential consultation today at www.sastransitions.com

Susan A. Spear

LICENSED BROKER / BUSINESS INTERMEDIARY

(303) 973-2147

susan@sastransitions.com www.sastransitions.com

CLASSIFIEDS Jobs Associate to Owner Opportunity: Busy 4-5 days per week, 6 OP, 2 hygienists, 950K collection, general dentistry office in rural southern Colorado community. Quaint, historic beautiful town close to skiing, hunting, fishing and hiking. Beautiful lake, largest new state park and lots of opportunity to stay busy. If your sick of the rat race, this opportunity is for you. Contact 719-440-6003 leave voice mail. Northern, Colorado General Dental Practice! Associate to Partnership Ownership! Our practice requires two dentists and continues to grow! Candidates must have at least 2 years post dental school experience or GPR/AEGD completion to join established practice with patient centered care. This isn’t a job, but an opportunity to own and work with an exceptional partner! Call Susan for more information 303-973-2147 or email administrative contact carolyn@sastransitions.com to learn more! Northwestern Mountains, Colorado GP Practice! Excellent collections and continued new growth! Own now or Associate! Serving 5500-6000 residents as the only dentist in the area! If you have ever considered real mountain living in the majestic Rockies of Colorado, then this is your dream practice! Tracking $520K 2021 3 days per week. Excellent collections and high growth potential. Owner can’t handle volume alone! Administrative contact carolyn@sastransitions.com. 303-973-2147. sastransitions.com Fort Collins, Colorado GP Practice! Associate to Partnership Ownership! Our doctor is seeking an experienced dentist who is ready to own a real piece of the pie! The practice requires two dentists and continues to grow! Candidates must have 3 years post dental school experience or GPR completion to join established practice with patient centered care. This isn’t a job, but an opportunity to own and work with an exceptional partner! Administrative contact carolyn@sastransitions.com. 303973-2147. sastransitions.com

For Sale Collecting $655K 3 days per week! Mountains, Colorado. This is a chance to own through an incredible offer from the Seller! World class location with unparalleled lifestyle. CBCT technology, fully digital and ready to move in tomorrow! 4 opts with consult room. Owner motivated to sell. Great purchase options with office rent credit! Broker: Susan Spear. Administrative contact carolyn@sastransitons.com 303-973-2147. https://www.sastransitions.com/practices-for-sale Orthodontic Dental Practice! Western Colorado with Two Locations! Excellent Patient Access! Each location well known with lots of room for growth! Owner is retiring! Established referral without marketing. Positioned well for private practitioner, group, pedo/ortho or other multiple owners. Don’t miss a look! Broker: Susan Spear. Administrative contact carolyn@sastransitons.com 303-973-2147. https://www.sastransitions.com/practices-for-sale Metro-Denver, Colorado! General Dental Practice. New Cone Beam and upgraded office space! Excellent patient referrals! Strong hygiene and Recare Program. Lots of room for growth! Broker: Susan Spear. Administrative contact carolyn@ sastransitons.com 303-973-2147. https://www.sastransitions.com/practices-for-sale Collecting 520K 2 days per week! Mountains, Colorado General Dentistry Practice! Excellent collections and high growth potential. Established long time presence in the community. Growth is simple. Just add more days! Motivated Seller. Broker: Susan Spear. Administrative contact carolyn@sastransitons.com 303-973-2147. Go to our website to learn more! https://www.sastransitions.com/practices-for-sale South Front Range, Colorado General Dental Practice and Real Estate! $750K 4 days per week! Established patient base with strong new patient numbers! Excellent staff and exceptional hygiene department! 3,000 sq ft Dental Office! 7 treatment opts plus so much more! Broker: Susan Spear. Administrative contact carolyn@ sastransitions.com. 303-973-2147. Go to our website to learn more! https://www. sastransitions.com/practices-for-sale General Dental Practice for Sale in Central Mountains CO (CO 2118) 6 Ops, approx. $1.7M in collections, two doctor practice. Doctors are relocating. For info contact jed@adsprecise.com or call 303.759.8425. For more listings visit www. adsprecise.com. Orthodontic Practice for Sale in Northwestern Denver Area, CO (Listing #CO 2116) Collections of $400K. Practice occupies 1,400 square feet and consists of 4 chairs. For information email: jed@adsprecise.com or call 303-759-8425. For more listings visit www.adsprecise.com.

General Dental Practice for Sale in Boulder, CO (listing # CO 2111) Collections of $650K. Practice occupies 1,800 square feet and consists of 3 fully equipped operatories with room to expand. Dr retiring. For information email: jed@adsprecise.com or call 303-759-8425. For more listings visit www.adsprecise.com. General Dental Practice for Sale in Denver, CO (listing # CO 2112) Collections of $350K. Practice occupies 1,410 square feet and consists of 4 fully equipped operatories. Building also being sold with practice sale. Dr retiring. For information email: jed@adsprecise.com or call 303-759-8425. www.adsprecise.com. General Dental Practice for Sale in Aurora, CO (listing # CO 2113) Collections of $320K. Practice occupies 1,400 square feet and consists of 3 fully equipped operatories. Doctor retiring. For information email: jed@adsprecise.com or call 303759-8425. For more listings visit www.adsprecise.com. General Dental Practice for Sale in Littleton, CO (Listing # CO 2114) Collections of $700K. Practice occupies 2,400 square feet and consists of 4 fully equipped operatories and possibility to have a 5th Operatory. For information email: jed@ adsprecise.com or call 303-759-8425. For more listings visit www.adsprecise.com. Established GP for Sale in Basin, Wyoming (listing # WY 2108) Collections of $572K. Practice occupies 2,432 square feet and consists of 4 fully equipped operatories. The practice also includes a reception area, business area, private doctor’s office, consultation area, lab, sterilization area, and break room. Building being sold with practice. For information email: jed@adsprecise.com or call 303-759-8425. Established GP for sale in Denver (listing # CO 2109). Great Location! 3 Ops, $450K in collections. Seller prefers a Dawson Trained Dentist. Dr. Retiring. For information email: jed@adsprecise.com or call 303-759-8425. Listing Reference Number: CO 2109. For more listings visit www.adsprecise.com. Established GP for Sale in South Metro Denver (listing # CO 2015) Collections of $1.1M. Practice occupies 1,530 square feet and consists of 5 fully equipped operatories. Dr retiring. For information email: jed@adsprecise.com or call 303-7598425. For more listings visit www.adsprecise.com. GP for sale in North Denver Metro area (listing # CO 2013). Annual Collections $400K, 3 Ops, 1,100 sqft – Dr. retiring. For more information call 303-759-8425 or email: jed@adsprecise.com. For more listings visit www.adsprecise.com. GP for Sale: Colo Springs (listing # CO 2010) Annual Revenues $319K, 3 Ops fully enclosed, 1682 sqft – Dr. Retiring. Sale price $239K. For more information call 303759-8425 or email: jed@adsprecise.com. For more listings visit www.adsprecise.com. Perio practice for Sale: North of Denver Metro area (listing # CO 1909) Annual Revenues $500K, 3 Ops, 1,323 square feet. For more information, please contact jed@adsprecise.com or call 303.759.8425. For more listings visit www.adsprecise. com GP for sale in Colo Springs (listing # CO 1908) Collections $465K, 2,043 sqft, 5 OPS. Sales price $250K. For more information, please contact jed@adsprecise.com or call 303.759.8425. For more listings visit www.adsprecise.com. GP for sale in Colorado Springs ((listing # CO 1904) 4 Fully Equipped Ops, $250K in collections, 2540 sqft, Dr Retiring. For more information, please contact us at jed@adsprecise.com or call 303.759.8425. For more listings visit www.adsprecise. com. GP and free-standing Building (sold with practice) for sale in beautiful Pikes Peak area (listing # CO 1803). Dr retiring, 5 OPS. Room for growth! Practice price $200K and Building price $495K. For more information, please contact jed@adsprecise. com or call 303.759.8425. For more listings visit www.adsprecise.com. GP for Sale: Northeastern CO (listing # CO 1735) 4 Ops, approx. $900K in collections, Stand-alone bldg. sold w/practice. Dr. retiring. For more information, please contact us at jed@adsprecise.com or call 303.759.8425. For more listings visit www.adsprecise.com. GP for Sale: Pueblo, CO (listing # CO 2006) 4 Ops, 1900 sqft office, $393K in collections. Dr. retiring. For more information, please contact us at jed@adsprecise. com or call 303.759.8425. For more listings visit www.adsprecise.com. Pediatric Practice for sale (listing # CO 2019) in beautiful resort mountain town with 7 OPS. $900K annual collections. For more information, please contact jed@ adsprecise.com or call 303.759.8425. For more listings visit www.adsprecise.com

4th Quarter 2021 mddsdentist.com

EVENT CALENDAR February 9 CPR & AED Training -CPR Choice Mountain West Dental Institute 925 Lincoln St Unit B Denver, CO 80203 6:00pm – 8:30pm February 24 MDDS Social Location TBD 6:00pm – 8:00pm April 1 Advanced Chairside Assistant's Role with Dental Implants and Surgical Assisting -Dr. Brian Butler, Dr. Dennis Waguespack, Dr. Janie Boyesen Mountain West Dental Institute 925 Lincoln St Unit B Denver, CO 80203 8:00am – 12:30pm April 12 CPR & AED Training -CPR Choice Mountain West Dental Institute 925 Lincoln St Unit B Denver, CO 80203 6:00pm – 8:30pm

April 14 MDDS Social Location TBD 6:00pm – 8:00pm April 22 Botulinum Toxins (Xeomin, Dysport, Botox) and Dermal Fillers Training, Level 1 -American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln St Unit B Denver, CO 80203 8:00am – 5:00pm April 23 Frontline TMJ & Facial Pain Therapy, Level 1 -American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln St Unit B Denver, CO 80203 8:00am – 12:00pm May 13 Oral Surgery Techniques for Predictably Great Outcomes -Dr. John Alonge Mountain West Dental Institute 925 Lincoln St Unit B Denver, CO 80203 8:00am – 3:00pm

May 20 Navigating the World of 3D Imaging - Dr. Peter Green and Dr. Michael Moroni Mountain West Dental Institute 925 Lincoln St Unit B Denver, CO 80203 8:00am – 3:00pm June 10 Nitrous Oxide/Oxygen Administration Training -Dr. Jeffrey Young Mountain West Dental Institute 925 Lincoln St Unit B Denver, CO 80203 8:00am – 4:00pm

KEEP UP-TO-DATE EVERYTHING MDDS

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Articulator Volume 27, Issue 2

Articles inside

Donated Dental Services (DDS) Volunteers Give Single Father of Two More Reason to Smile Again

Exercising Your Voice in Organized Dentistry

Health Equity Relies on Moving from Concept to Action: It Also Relies on You!

Let’s Talk About Perspective

Get Ready for the New RMDC Experience!

NEEDLES, LUNGS & TONGUES© The Chemistry, Use and Effect of Psychoactive Substances

Evidence-Based Considerations for RDH Using Aerosol-Generating Devices

Creating the Easy and Efficient Temporary

Lean-in to Marketing