ARTICULATOR MDDS
Connections for Metro Denver’s Dental Profession
Winter 2014 Volume 19, Issue 2
WINTER EDITION The Expansion of Dentistry 6 Roundtable: Be the Best You Can Be – A Seminar for Dental Assistants Only! 8 Pathology Puzzler with Dr. John Svirsky 10 Forensic Hiring: Put Applicants "Under the Microscope" and Solve the Mystery of the Revolving Door 12 Screening for Alcohol in Dental Practices 16 Sink Your Teeth Into Saving A Life 18
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B
now in
The most popular and longest running CE curriculum focused on occlusion and restorative dentistry is now available in Denver. Register today to start your journey to complete, predictable dentistry. Your life as a dentist will never be the same when you learn what it’s like to be predictable in everything you do.
Hands-On Course Schedule: Examination and Records March 5-7, 2015 Mastering the skills necessary to accurately gather complete records is one of the most important steps to practicing predictable dentistry. CR Bite records, facebow recordings, photography, muscle exams and more are all taught in this workshop. Treatment Planning Functional Esthetic Excellence June 18-20, 2015 Programmed treatment planning is a step-by-step, repeatable process for creating predictable treatment plans for every type of case, regardless of the degree
Functional Occlusion – From TMJ to Smile Design June 18-20, 2015 Discover how to successfully integrate scientifically based occlusal principles into everyday practice. Every time you place a single restoration, you will save time and frustration if you know the rules of occlusal harmony and how to achieve them. Learn how a stable occlusion is an absolute must for your cosmetic cases to achieve optimal, stable, beautiful results. Scan the QR code for additional information or to register.
All classes are held at the new Mountain West Dental Institute the hub of dental continuing education and camaraderie for the metro Denver area and the Rocky Mountain region.
866.879.1238
ARTICULATOR MDDS
Connections for Metro Denver’s Dental Profession
Volume 19, Issue 2
MDDS Articulator
Creative Manager & Managing Editor CT Nelson Director of Marketing & Communications Jason Mauterer Communications Committee Brandon Hall, DDS, Chair Maria Juliana DiPasquale, DMD Karen Franz, DDS Jeremy Kott, DDS Carrie Seabury, DDS Jennifer Thompson, DDS MDDS Executive Committee President Larry Weddle, DMD
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Winter 2014
Inside This Issue:
CONNECT! .....................................4
Screening for Alcohol In Dental Practices ..16
Member Matters ..............................5
Sink Your Teeth Into Saving A Life.......... 18
The Expansion of Dentistry ....................6
Many Thanks to the 2014 Molars Sponsors, Players and Volunteers! ......................... 23
Roundtable: Be the Best You Can Be – A Seminar for Dental Assistants Only! .....8
Event Calendar.............................. 24
Pathology Puzzler with Dr. John Svirsky ..10
How to Thrive in Social Media in 2015 .. 26
9HealthFair – Own Your Health ..........11
CMOM 2014 .................................29
Printing Dilley Printing
Forensic Hiring: Put Applicants "Under the
PPO Insurance Fees –
The Articulator is published bi-monthly by the Metropolitan Denver Dental Society and distributed to MDDS members as a direct benefit of membership.
Microscope" and Solve the Mystery of the
Strategy and Renegotiation...............33
Revolving Door ....................................12
President-Elect Ian Paisley, DDS Treasurer Sheldon Newman, DDS Secretary Nicholas Chiovitti, DDS Executive Director Elizabeth Price, MBA, CDE, CAE
Classifieds.............................................35
Editorial Policy All statements of opinion and of supposed fact are 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 ©2011 Metropolitan Denver Dental Society
Member Publication
MESSAGE TO OUR READERS:
CALL FOR ARTICLES – SUBMIT YOURS TODAY!
T
he Articulator belongs to you, our readers. Share your indepth subject knowledge, events and accomplishments with the Metro Denver dental community, By submitting articles, photos, happenings, etc. to us for consideration. Article submissions are open to members and vendors in the Dental community.
Please submit your articles, photos, etc. to CT Nelson, Managing Editor, at creative@mddsdentist.com.
MDDS NEWS
CONNECT! By Jason Mauterer, CDE, MDDS Director of Marketing & Communications
T
he air is crisp, holiday decorations are climbing the walls in every store and there’s a familiar intensity building within the normal buzz at MDDS. This can only mean one thing – the Rocky Mountain Dental Convention is around the corner. Ahhh...the Convention, the Mid-Winter, the RMDC; whatever you call it, it’s your show. Every January you get together with nearly 10,000 of your closest friends to learn, laugh and CONNECT. I like the word “connect.” Google defines it as joining together so as to provide access and communication. That is a perfect description of the RMDC. It is access to education, access to vendors and access to the dental community here in the Rocky Mountain region. It is also definitely the best annual opportunity to network with a huge group of dental professionals. The 2015 RMDC will certainly be no exception to the rule. It’ll be sporting big names like Drs. Henry and Maurice Salama, Dr. L. Steven Buchanan and Dr. John Svirsky (be sure to check out his Pathology Puzzler on page 10). There will be wide variety of hands-on courses and The Dawson Academy will have courses at both the Convention Center and the Mountain West Dental Institute. It will also be boasting nearly 300 exhibitors for you to visit and support in the Expo Hall – don’t forget how important they are to your show. Of course, there are the can’t-miss-events like the Opening Session with Mr. Paul Moya and the Expo Hall Reception with free beer, wine and sodas (Thursday at 4pm). This year’s Friday Night Party will benefit the Metro Denver Dental Foundation and feature DJ Bedz, official DJ of the Denver Broncos and Nuggets and the After-Party will turn it up a notch at Chlóe.
Information about this can be found in the RMDC’s very own app, which will be accessible on the free Wi-Fi. With all of these courses, amenities and opportunities, your 2015 Rocky Mountain Dental Convention is truly going to be THE PLACE TO CONNECT.
Dental Construction Specialists Ask us how we can save you time and money on your next office project. Phone: (303)637-0981 Web: www.bvgci.com
MDDS will also be introducing a new event this year, the MDDS Awards Gala & President’s Dinner. Dress to kill and come rub elbows at this reception, dinner and awards ceremony honoring MDDS President, Dr. Larry Weddle. Stick around after the ceremony for entertainment (dancing!) by Digital Pocket. This will be a premier annual event complimenting your convention.
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MEMBER MATTERS MDDS High Tea @ The Brown Palace (September 27, 2014) The High Tea at the Brown Palace was a huge success with over 50 attendees! Thank you to Fortune Management, Pacific Dental Services and UMB for generously sponsoring this event.
New Members, Welcome! Dr. Angela D. Bernedo Pantigozo Dr. Brian J. Fangman Dr. Kary L. Berry Dr. Kathryn S. Buss Dr. Robert Berg Dr. Stanley Samuel Dr. Vladimir R. Jovic
Drs. Elizabeth Crespi, Jean Felton, Purvi Shah, Kelsey Snavely and Debra Gander enjoying the historic High Tea at the Brown Palace.
MDDS New Member Welcome Event (October 23, 2014)
Thank you to Bank of America, Carestream Dental and Pacific Dental Services for sponsoring this event.
Dr. Maryna Goergy, Ms. Jennifer Wissel, Dr. Carrie Seabury and Dr. Diane Fuller at the New Member Welcome Event at Three Dogs Tavern.
Congratulations, Dr. Michael Burnham! Dr. Burnham is an oral and maxillofacial surgeon that has been practicing for 15 years. Originally from New Mexico, he graduated from the Loma Linda School of Dentistry in California, and obtained his medical degree from the University of Texas Southwestern Medical Center, where he also completed his residency. He moved to Colorado in 2006, where he opened his private practice and
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Drs. Betty Barr, Brian Fangman and Maryna Goergy socializing at the NMWE.
ሺ͵Ͳ͵ሻ ͵ǦͲͻͺͳ ̷ Ǥ
became the director of the 5280 Study Club. Recently, he opened his 4,606 sq ft in Thornton, CO that was built in 13 weeks. It features a waiting room, reception, fireplace, coffee bar, a custom mural, admin office, two consults, two private operatories, exam room, med/gas, nurse station, sterlization/lab, imaging, two restroom, doctor’s office, recovery room, and staff room with kitchen.
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2015 RMDC SPEAKER
THE EXPANSION OF DENTISTRY By Ms. Molly Dubois
I
n this fast paced world we sometimes take our day to day choices for granted. I recently had a patient that came into my office for a broken tooth, who told me, “Here in America we have problems, but they are good problems.” For example, if someone has a toothache they can schedule a dental appointment within 24 hours and receive treatment. In the 1400’s going to the dentist was not even a possibility. These people were experiencing horrific tooth pain and often times had to endure a very primitive and unethical method of treatment. Sit back and really contemplate this idea of modern medicine and you will gain a whole new appreciation for the day to day problems you may be facing. My five-year-old daughter Jaden recently fell off the monkey bars at school and broke her elbow. She needed a cast to set the bone exactly one week before my wedding. I took a deep breath and thought about how anything from this stressful situation could be perceived as positive. I quickly realized that my daughter and I are extremely lucky to have the ability to go to school, have a playground to play on, and most importantly, have a healthcare system in place to address emergencies and preventative care. The next time you’re faced with a problem, think of all the medical luxuries we have today in the United States. We have the ability to make informed decisions on our healthcare and oral care alike. Consider today’s technology. We have SonicCare toothbrushes, electric flossers, resin composites, Cerec CAD/CAM milled porcelain restorations, and even
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anesthetic! Yes, it may be troublesome to go to the dentist twice a year but at least we have access to one. If you were faced with a toothache 500 years ago it would have been a whole different story… Methods in the early 1400’s were crude and barbaric. Travel back in time with me for a second. Try to visualize your husband, mother or son experiencing a throbbing toothache, they are swollen and have been in agony for days. They see a poster on the side of a horse carriage that reads, “Barber Surgeon in town two days only, come and witness how he relieves pain!”
Your loved one sees a slim opportunity for relief. They come home and tell you all about the visiting Barber Surgeon. You immediately decide to attend this gathering of the town’s people to watch this man perform magical pain relieving procedures. The following day in the town square the Barber Surgeon is wearing a jester hat and brightly colored clothes, he appears to be more of an entertainer than a medical professional. However, your beloved family member is eager to be first on stage due to his excruciating toothache. You stretch your arm out in front of his chest to stop him from volunteering to be the first. A young woman who you don’t
recognize is picked from the audience instead. She is close to the stage already, and seems quite comfortable with her decision to be the first. She is placed in a chair and screams out, “Please help me Sir! I have pain in my mouth!” The Barber Surgeon hops about the stage looking as if he is performing an elaborate rain dance. He approaches the young woman and reaches for his “Pelican tool.” The crowd is rowdy and yelling so loudly at this point that it is difficult to hear what is being said on stage. The Barber Surgeon then grabs another tool that reminds you of a hammer a Blacksmith would use to hammer nails into horseshoes. The crowd is stunned into silence, the young woman seems to be comfortable and not in pain at all. The Barber Surgeon quickly grabs a rag from under his stack of tools and inches toward the woman. The woman scoots down in her chair and suddenly the Barber Surgeon withdrawals his hand from her mouth and the crowd cheers! He has pulled out her tooth! Clenched within the rag are the remnants of her bloody tooth. Your loved one is sold! For a small fee, he is now third in line to have his tooth “drawn.” Little do they both know, what they just witnessed was a complete fraud! A fake! A master mind of disguise! Certainly not a Dentist! The young woman who was chosen to go first was a part of the Barber Surgeon’s act. The tooth that was extracted from her mouth was never in her mouth at all! It was hidden carefully in the rag and under the Barber Surgeons tool’s the entire time. Animal blood and all! The victims who desperately sought out relief from their ailments by these
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Barber Surgeons were not so lucky. They often were faced with brutal methods of dentistry, and primitive tools that were often handmade. Their teeth cracked and broke off at the gumline while the Barber Surgeon charges hard earned money for his “services.� This incompetence leads to unspeakable pain. His victims were often faced with misdiagnoses, severe trauma and post-operative infections that lead to death! The technology and services we have today
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are absolutely miraculous. When you or your loved one is faced with a medical emergency in the future, remember the Barber Surgeon. You will most likely be lead into a comfortable, temperaturecontrolled, well lit room where your medical provider will give you several options to relieve your pain. My course at RMDC will take you on a guided tour through those brutal, primitive years. You will learn to appreciate all the victims who sat in labored pain on that stage to
unknowingly teach us the paramount way to practice dentistry. About the Author Ms. Molly Dubois has been a committed EDDA/Dental Assistant for more than 13 years and has been teaching for more than three years.
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2015 RMDC SPEAKER
LEARNING IN THE ROUND – A SEMINAR FOR DENTAL ASSISTANTS ONLY!
By Jen Blake, CDA, EFDA, MADAA
I
t is my pleasure to be joining the dental assistants attending the Rocky Mountain Dental Conference for a day of celebration….just for us on Friday, January 23rd.
We are going to start the day with the ever popular Learning in the Round. This program is back by popular demand and created especially for the dental assistant. Don’t miss this opportunity to learn about new products, updated techniques and share ideas with other dental assistants in this enjoyable, small group setting. It is always invigorating for me to be with dental assistants from across the country. We all have the same joys and concerns as we strive to give our patients the best care possible. You will come away energized, with new ideas for your practice and the possibility of great door prizes for yourself! In the afternoon join me in the lecture Be the Best You Can Be – A Seminar for Dental Assistants Only! This is a fun, fact filled, interactive look at dental assisting past and present. Understanding the importance of practicing evidence based dentistry and how to find the best evidence with be discussed. As our patients become savvier, it is vital that we do too. We all know our patients ask us questions they would never ask the dentist.
really is connected to overall health. As dental professionals, we owe it to our patients to help them understand the connection. We might just save a life. There is always room to sharpen our communication skills. We communicate every day on so many different levels. From professional to patient…employee to employer…and coworker to co-worker. Are we actually sending the message we are trying to convey? These programs are appropriate for the new, seasoned and every dental assistant in between. Dental assistants are the backbone of the dental practice and I can’t wait to meet you in Denver. Dental Assistants Rock! About the Author Ms. Jen Blake, CDA, EFDA, MADAA has been a chairside assistant in a private practice; taught dental students how to work with expanded duty assistants; worked as a program administrator for an ADA Accredited Dental Assisting Program; and been a guest lecturer at dental assisting continuing education programs around the country. She is a past president of the American Dental Assistants Association and is currently the ADAA Director of Education and Professional Relations.
What we have all known for a long time is finally now fact. Oral health
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WE NEED YOUR
SUPPORT
THANKS TO OUR MWDI SPONSORS!
Go to mwdi.org
to donate!
Includes cash donations and sponsorships; this does not include donated service and equipment.
Mile High Founding Members (Contributions of $5,280+) 1st Impressions Orthodontics Terry L. Brewick, DDS - Governor's Park Dental Group Brighton Smiles - Jaci Spencer, DDS Burnham Oral Surgery - Dr. Michael Burnham, DDS, MD David Chavez, DDS Charles Danna, DDS Denver Metro OMS The Doctors at Mountain Range Dentistry, Dr. Nicholas Chiovitti & Dr. Paul K. Mizoue Mark S. Ehrhardt, DDS Mitchell Friedman, DDS Louisa I. Gallegos, DDS Larry Gayeski, CPA Alan Gurman, DDS Jepson, Murphy and Associates Nestman & Eng Orthodontics Dr. Roger D. Nishimura Ohmart Orthodontics Ian Paisley, DDS Shon Peterson, DMD Rocky Mtn. Dental Partners - Aspen/Aurora/Cherry Creek Robert Rudman, DDS Michael Scheidt, DDS & Kathryn Scheidt, MSN Christopher J. Sakkaris, DDS, PC Stamm Dental, Dr. Heather Stamm & Dr. Kai Kawasugi Tennyson Pediatric Dentistry Larry Weddle, DMD, MS Dr. Mark Wheeler & Dr. Matt Johanson Cassady Wiggins, DMD Young Dentistry for Children
Benefactors (Contributions of $2,000+) 2013 MDDS Delegates to the CDA Kimberly Danzer, DMD The Dental Center Troy A. Fox, DDS Anil Idiculla, DMD Sheldon Newman, DDS & Linda Newman Sean W. Shaw, DMD, Periodontics Dental Implants Joseph K. Will, DDS
DENTAL INSTRUMENTATION
Patrons (Contributions of $500+) Alpha Omega Dental Fraternity Bank of America Jack W. Choi, DDS Colorado Society of Oral & Maxillofacial Surgeons, Inc. Karen D. Foster, DDS George G. Gatseos, DDS GHP Investment Advisors Paul Glick, DDS HJ Bosworth Company Thomas Maier, DDS Michael McKee, DDS James C. Nock, DDS Alexander Park, DDS Ridgeview Pediatric Dentistry Michael Poulos, DMD Edward F. Rosenfield, DMD, MS Eric W. VanZytveld, DDS Dr. Gregg Lewis Jacob Williams Dr. Herbert T. & Lenore Williams
The MWDI is owned and operated by the Metro Denver Dental Society
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PATHOLOGY PUZZLER
PATHOLOGYPUZZLER WITH DR. JOHN SVIRSKY
A
Figure 1: Clinically expansive radiolucent lesion of the right mandible, 4 cm by 3 cm, featuring a sclerotic border.
72 year-old white male presented to an oral surgery office for biopsy of a clinically expansive, radiolucent lesion (Figure 1) of the right mandible. There was hyperplastic tissue around tooth #31, which was mobile. The lesion appears to be a 4 cm by 3 cm well-circumscribed radiolucent lesion with a sclerotic border. The patient experienced no pain or paresthesia and the lesion rapidly developed over three months (according to the patient). The patient’s past medical history includes management of high blood pressure, muscle spasms, prostate issues secondary to prostate cancer and osteoarthritis. His medications include Caduet®, losartan, 81 mg aspirin, cyclobenzaprine, nabumetone, NSC-24 Prostate™ formula , PreserVision®, fish oil and calcium supplements.
Based on the radiographic findings which of the following could be considered in a differential diagnosis? 1. Ameloblastoma 2. Central giant cell granuloma 3. Odontogenic keratocyst 4. Odontogenic myxoma 5. Squamous cell carcinoma 6. Metastatic disease 7. Periapical pathosis Answers on pg. 31
Reprinted with permission from the Virginia Dental Journal Volume 90 Number 1
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DENVER SPOTLIGHT
By Ashley Atkinson, 9HealthFair Communication and Sponsorships Coordinator
Y
ou know that oral health plays a big role in a person’s overall health – but not everyone has that same perception. That’s why 9Health Fair is proud to work with Metro Denver Dental Society to encourage oral health awareness in Colorado. Our extensive history of working with MDDS has helped us to recruit some of the best medical professionals in Colorado, which enables us to continue to offer important oral health screenings and education to our participants. Every spring, 140 communities across Colorado host a 9Health Fair that provides high-quality, professional health screenings and important health resources to their residents. Each fair is run entirely by volunteers who have a passion for health and for helping others. 9Health Fair
has become a trusted organization that 70,000 Coloradans rely on every year for an annual check of their health. 9Health Fair depends on the 15,000 volunteers that lend us their time and expertise each year. We are always looking for committed volunteers with a desire to promote health awareness. Anyone interested in volunteer opportunities can visit our website to find the fair (or fairs!) you’d like to volunteer at and simply sign-up online! The site leaders will then contact you with more details. 9Health Fair has been helping Coloradans with their overall health for 35 years. Join us to make a difference in your community– volunteer your time and talents with 9Health Fair this spring!
Knowledge • Experience • Credentials • Trust More “Completed Transitions” and
“Years of Practice Transition Experience” of any brokerage firm in Colorado.
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• Practice Sales Since 1986 • Practice Appraisals • Partnerships
• Transition Planning • Dental Building Sales • Buy Ins/Buy Outs
Jed Esposito MBA, CVA
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RMDC booth #647!
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OFFICE MANAGEMENT
FORENSIC HIRING: PUT APPLICANTS “UNDER THE MICROSCOPE” AND SOLVE THE MYSTERY OF THE REVOLVING DOOR By Jan Keller, Practice Management Consultant
H
iring new staff members can be a daunting process, especially as the consequences of making a mistake are costly -- in time, money and stress.
It doesn’t have to be that way. There are ways to put candidates “under the microscope” to make sure you choose the right person every time, and finally put an end to the mystery of the personnel revolving door most practices are familiar with. How? By using an easy 4-step process for finding and integrating the right person for the job into your practice: 1. 2. 3. 4.
Clarify Screen Select Integrate
Step #1: Clarify Two of the most common errors dentists make when hiring new staff are 1) failure to clarify their own values; and 2): failure to ensure the candidate they choose shares those values. So the first question to ask, of course, is what are your core values? What matters most to you? Skills? Experience? Communication style? Is one more important than the other – communication style versus experience, for instance? Ask questions like these to help you form a picture in your mind of the perfect applicant – the “treasure”: • What level of experience is preferred, or required? • Should the applicant be a people person? A quick learner? Calm? Detail-oriented? • What personality style complements yours, and/or your teams? Next, clarify the job description and job qualifications. A good job description will include: • Job title
• • • • • •
Job summary Qualifications Education and experience Certificates, licenses and registrations Skills/Competencies Essential duties and responsibilities
Now you’re ready to promote the position and build your applicant pool. Step #2: Screen With your ad in place, resumes will soon follow. Questions to ask about resumes and/or applications: • How detailed is the resume? • Is the spelling and grammar up to par? • Is there enough information provided to proceed to the next step – the telephone interview? (Continued on pg. 14)
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DOES YOUR PERSONAL DISABILITY POLICY: • Cover you in your “own occupation” even if you choose to work in another after a disability? • Separately cover your student loan payments? • Cover you fully for “mental/nervous” claims? • Protect your retirement plan contributions? Be sure to know. Find out how yours compares. For Dentists and Specialists, the best value is the strongest policy. Contact David Richards, Disability Income Specialist for the dental profession since 1993 at 303.714.5875 and visit the website
www.ddsdi.com
Walt’s Fine Upholstery Specializing in Medical and Dental Furnishings
303-467-9291 We are experienced and dedicated professionals who: • Service the Front Range with 38 years of experience • Know your equipment’s upholstery needs • Give guaranteed quality results • Feature materials especially for medical applications • Minimize operatory down-time
Same Quality Service • New Address Before & After Pictures at Walt’s Fine Upholstery on Facebook 5985 Lamar St. Suite D • Arvada, Colorado 80003
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(Continued from pg. 12) The Telephone Interview Use this time-saver as a chance to get to know the applicant, provide important information about the position and weed out those who are clearly not right for the position. Assign the responsibility for telephone interviews to a staff member who will represent your practice well, and make up a telephone screening form prior to contacting applicants. Include questions that complement your core values, as defined above. Be sure to listen to the applicant’s tone of voice, diction, professional manner. If you like what you hear, proceed to the next step – the interview. The Office Interview Once applicant’s pass the telephone interview, an in-office interview should follow, in which both parties should be: punctual, prepared and professional. As the interviewer, ask open-ended questions that give the applicant a chance to provide in-depth answers. Give the applicant time to ask you questions. Know the questions you are legally permitted to ask! For the applicants who meet your criteria, however, move on to the next step, the second interview, at which time you will assess skill and communication. The assessment interview allows you to observe, evaluate and listen to the applicant while in your office. Follow these guidelines: • Allow three hours for the interview. • Evaluate: skill level for the job, self-motivation, communication skills with patients and team, professional attire, punctuality, professionalism. Finally, for those who impress at the Assessment interview, move on to the final interview step, the team luncheon. Involving the entire staff in the selection process has numerous benefits, including illustrating to the applicant that spending time to hire the right person is important; letting the applicant know that the staff’s input is valued; and giving staff members a chance to get to know the applicant better in a relaxed environment. So, you’ve made your choice and you’re now ready to make the job offer to the applicant. This brings us to the next step in our treasure-mining process.
Offer Letter – Once you have decided on whom to hire, send an Offer Letter that reiterates or verifies the following: start date, hours, salary and benefits, expectations for training. Step #4: Integrate Okay, the new employee has been hired. Now begins the process of integrating this person in to your practice. Follow these simple steps to ensure your new employee gets off to a strong start. Training plan – Commit to a training plan that is shared with the staff and allows the new employee to excel at a rapid pace. Use your job description as a guide for making a list of all tasks and responsibilities that must be learned. Schedule training sessions – determine with whom, when and where. Acknowledge and celebrate as each phase of the training plan is completed. Orientation – Start the new employee off right! Allow several hours for orientation, and provide the new employee with information on practice philosophy, personnel manual and file, training plan – including OSHA and HIPAA, employment forms, performance reviews. Be sure to block time out of the doctor’s schedule to be involved. And there you have it – a simple, 4-step process that will help you to uncover the treasure in every applicant pool, and assist them in becoming “gold” for your practice. About the Author Ms. Janice Keller has 25 plus years of experience in dentistry – clinically, and as an office manager and software trainer. Now, as a practice management consultant, she provides high-quality, customized practice development and education to clients and their teams. Jan is certified by Bent Ericksen & Associates in employee law compliance, and also certified by the Institute of Practice Management. She is a member of the prestigious Speaking/Consulting Network, and the Academy of Dental Management Consultants.
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Reference Check – Call the applicant’s reference, and ask specific questions, based on what you have learned about the applicant in the interview process. Make sure the applicant has signed a waiver allowing you to contact references. Background Check – never skip this step! Make sure the applicant has signed a waiver allowing you to run a background check, including credit and criminal history. Fees are nominal and information can be quickly obtained.
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2015 RMDC SPEAKER
SCREENING FOR ALCOHOL IN DENTAL PRACTICES By Carolyn Swenson, MSPH, MSN, FNP and Rachel Steffl, MA, LPC, LAC
A
ccording to the Centers for Disease Control and Prevention, at least 38 million Americans drink too much and most do not have an alcohol use disorder. Yet, only one in six people has ever talked with a healthcare professional about alcohol. Drinking too much includes binge drinking (more than three drinks in a sitting for women; more than four for men), weekly consumption above a moderate level, and any alcohol use under age 21 or by pregnant women. We believe that dentists can play an important role in addressing this issue since they have an ongoing relationship with individuals and some people may see a dentist more often than they see a primary healthcare professional. In addition, unhealthy alcohol intake may co-occur with other substance use that is known to affect oral health such as tobacco, marijuana and illicit drugs. According to the American Cancer Society, heavy alcohol consumption combined with tobacco use has been identified as a primary risk factor for 75 % of oral cancers in the United States. Some patients who struggle to quit smoking tobacco are more likely to be successful if they change their pattern of alcohol and tobacco use at the same time. Additionally, heavy alcohol consumption has also been linked to periodontal disease and chronic tooth decay. Oral health complications are just some of the negative consequences related to heavy alcohol consumption. Dentists who take part in SBIRT can play a vital role in the prevention and intervention of costly and deadly diseases. Screening for alcohol can be as simple as asking one question of all patients age 18 or older: “How many times have you had X or more drinks in a day?”, where X is four for women and five for men, and a response of 1 or more times is considered positive. Brief counseling can be as simple as interpreting the screening result for the patient so they are aware of what constitutes moderate drinking and giving advice to cut back or abstain. Screening and brief counseling can reduce alcohol consumption by as much as 25%. The earlier we intervene to address drinking above moderate levels, the more likely we are to prevent progression to a substance use disorder, prevent and improve other chronic health conditions, and
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prevent injuries and violence. Our experience in Colorado confirms the effectiveness of this prevention service. Since 2007, over 140,000 Coloradoans have received screening and brief counseling. Follow-up interviews conducted with a sample of patients from 2007-2011 found a 49.3% reduction in alcohol use and a 47.5% reduction in illegal drug use six months following screening. Different members of the dental team can help to carry out screening and brief counseling as part of preventive oral health counseling; for example, dental hygienists and dentists. The SBIRT Colorado program at Peer Assistance Services, Inc. offers training and technical assistance to help health professionals in Colorado implement alcohol screening and brief counseling. Contact Carolyn Swenson for more information: cswenson@ peerassist.org About the Authors Ms. Carolyn Swenson , MSPH, MSN, FNP is a family nurse practitioner with a Master of Science in Nursing from Pace University and a Master of Science in Public Health from the University of Colorado. She is the Manager of Training and Consultation for SBIRT- CO. Rachel Steffl, MA, LPC, LAC is the Program Lead for the Dental Peer Health Assistance Program at Peer Assistance Services, Inc. Ms. Steffl holds a Master’s Degree in Counseling from Colorado Christian University, and is a Licensed Professional Counselor as well as a Licensed Addition Counselor. Rachel Steffl has over 6 years of experience working with individuals with substance use and co-occurring disorders. Citations 1. CDC Vital Signs, Centers for Disease Control and Prevention. 1/7/2014. http://www.cdc.gov/vitalsigns/ pdf/2014-01-vitalsigns.pdf 2. Blot WJ, McLaughlin JK, Winn DM, et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res 1988; 48:3282-7. Cited by: Delta Dental Plans Association. (2012, April 12). You Booze, You Lose: Excessive Drinking Harms Oral Health. Retrieved October 27, 2014, from Delta Dental News Room: www. deltadental.com/Public/NewsMedia/NewsReleaseYouBoozeYouLose201204.jsp 3. Araujo MW, Dermen K, Connors G, Ciancio S. Oral and dental health among inpatients in treatment for alcohol use disorders: a pilot study. J Int Acad Periodontol. 2004 Oct;6(4):125-30. Cited by: Delta Dental Plans Association. (2012, April 12). You Booze, You Lose: Excessive Drinking Harms Oral Health. Retrieved October 27, 2014, from Delta Dental News Room: www.deltadental.com/Public/NewsMedia/ NewsReleaseYouBoozeYouLose201204.jsp
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Winter 2014
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ORAL HEALTH
SINK YOUR TEETH INTO SAVING A LIFE By Lisa Bennett, DDS
A
t the age of 33, performance artist and story teller Eva Grayzel was diagnosed with stage IV oral cancer (squamous cell carcinoma) on the left side of her tongue. Eva ate well, exercised regularly, and had none of the risk factors commonly associated with oral cancer. She was a non-drinker who had never smoked. She was also the mother of two small children, Elena and Jeremy, ages five and seven. Nearly three years earlier, Eva had noticed a sore on the left side of her tongue. She consulted an oral surgeon who removed the sore and had the tissue biopsied. He assured her that the results of the biopsy were negative and told her there was nothing to worry about. Two years passed with no more obvious symptoms. Then a new sore appeared right over the area where the first one had been removed. She visited her dentist and oral surgeon numerous times over the following nine months and, as the sore on the side of her tongue got bigger, both of them continually told her to come back if it didn’t improve. Eva says, “They were asking me to determine whether or not my condition was improving, even though, in living with it every day, the changes were very subtle.” Almost three years passed from the time she initially consulted dental professionals about the sore on her tongue before her condition was accurately diagnosed. Ultimately, she had to endure a partial tongue reconstruction, a modified radical neck dissection, and the maximum dose of radiation therapy. Following her exceptional recovery, she
became a motivational speaker, giving presentations on how to find strength from adversity and telling her remarkable story to dental professionals. Neither her dentist nor the oral surgeon ever mentioned the possibility of oral cancer. If they had, she would have been more proactive as the sore became more and more painful. Eight months after the sore on her tongue reappeared, she developed an unbearable earache and was treated for what was diagnosed as “water on the eardrum.” After 10 days on antibiotics, she was waking up throughout the nights in tears and she returned to the oral surgeon, desperate for answers. He said, “Your tongue is small and we don’t want to cut it up unless we have to, but at this point, I guess the next step would be another biopsy.” Finally, after nine months of consultations with her dentist and two different oral surgeons, she decided she needed to look elsewhere for answers. A family friend recommended that she see Dr. Mark Urken, chief of head and neck surgery at Mount Sinai Hospital in New York City. When she made the two-hour bus trip from Easton, Pennsylvania into New York City on the day of her appointment, she had no inkling that the nasty sore on her tongue could be cancer. Dr. Urken felt the enlarged lymph nodes in her neck, looked at the classic ulceration on the side of her tongue, and told her that he wanted to do a minimally invasive second biopsy. When the results came back, Dr Urken told her in a gentle voice that she had a squamous cell carcinoma. Woozy from anesthesia, she asked if it was benign or malignant. In an apologetic tone, he said: “Eva, you are in an advanced stage of oral cancer.” The (Continued on pg. 20)
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Winter 2014
ROCKY MOUNTAIN DENTAL CONVENTION IN BEAUTIFUL DENVER, CO
JAN
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(Continued from pg. 18) date was the first of April, 1998 and, as Eva says, “It was the cruelest April Fool’s joke of my life.” Surgery and Radiation Eva went into shock. Her treatment would consist of a modified radical neck dissection, a partial glossectomy (tongue reconstruction), and the maximum dose of radiation. She was given a 15 percent chance of surviving for more than five years. The surgeon removed and reconstructed one-third of her tongue. Fortunately, he left the tip of her tongue intact so that she would still be able to speak articulately. He took an artery from her left arm to feed blood to the tongue graft and transplanted tissue from her forearm to reconstruct the outside of her tongue. He used grafts from her left thigh to replace her forearm skin and rebuild the tongue’s density. He also removed all of the lymph nodes on the left side of her neck and, ultimately, the entire sternocleidomastoid (SCM) muscle. Radiation therapy began eight weeks after surgery. She found a radiation oncologist in nearby Allentown, Pennsylvania, who had an Intensive Modulation Radiation Therapy (IMRT) machine, which allowed him better control of the radiation exposure to different areas of her mouth and neck. Radiation treatments were twenty minutes long five days a week for six weeks. After two weeks of radiation, the side effects became almost unbearable. Blisters in her mouth and throat resulted in severe pain when swallowing, so eating became extremely difficult. It would take her an hour to eat three spoonfuls of food. She lost her ability to speak as her tongue and vocal chords stiffened. Her saliva became gluey and sticky, causing coughing and breathing difficulties that made it impossible to sleep. It took two weeks after radiation ended before the symptoms subsided and the sores started to heal.
Immediately following radiation treatments, her mouth was so dry that she had to practically pry her mouth open to moisten it with water. Over the years, her saliva production has increased and she can make it through some nights without drinking if she sleeps with her mouth closed. It is quite a challenge, but it is possible. Even though she only chews on her right side, the left side of her mouth gets grimier from the lack of saliva. Before she goes to bed, she brushes, flosses, stimulates, proxi-brushes, irrigates, and finishes off with Prevident, a fluoride treatment.
Importance of Early Diagnosis If Eva’s cancer had been diagnosed early, it would have been about seven days from surgery to recovery. Instead, seven months of her life passed during her initial surgery, radiation treatment, and recovery. Also, her children were traumatized by her surgery and ongoing treatment. They could barely look at her when she came home from the hospital, and shied away from her touch fearing that she was contagious. Her ordeal continues with a lifetime of dental complications, numerous doctor’s appointments and diagnostic tests, health scares, occasional ringing in her ears, sensitivity to sunlight in her eyes, and other quality-of-life compromises. During the 13 years since her diagnosis, she has had three negative biopsies and bilateral vocal chord polyps, but no recurrence of cancer. She will have to take Synthroid for the rest of her life to counteract the effects of compromised thyroid function from the radiation.
Dental Complications Six years later, she had to have a molar extracted on the only side of her mouth where she is able to chew. She saw a specialist in New York who had experience treating oral cancer patients. After the extraction, she was in pain for a month.
Now, as she tells her story professionally, she says, “It is more than a mission to educate. It’s my tribute to those who came before me and my obligation to those who will follow. By publicly sharing my journey to help others, I’m gaining back all the years of life and more that oral cancer took from me. During radiation, when I was teetering on the tightrope between life and death, I thought good and hard about how I would be remembered. I would not be remembered for taking my children to ballet and soccer, but for how I made a difference in other people’s lives. If you can save one life in your entire career by performing oral cancer screenings on everyone and detecting it early, wouldn’t it be worth it?”
Three years later, she had the adjacent lower molar extracted, after which she had difficulty chewing and started to lose weight. She explored the options. Her dentist did not recommend a bridge spanning two molars, and an oral surgeon specializing in irradiated bone, strongly discouraged using dental implants because the risk of osteoradionecrosis (ORN) was too great. However, a specialist in oncologic dentistry told her that implants might work. Bone that isn’t stimulated results in continued bone loss and leaves no chance for future implants. He was confident from the results of a cone-beam X-ray that her bone was sufficiently dense. Luckily, all three of the implants she had were successful.
Eva’s career as an interactive performance artist and master storyteller allow her to communicate her experience as a survivor in a unique and powerful way. Her passion to save lives by publicly telling her intimate and dramatic story was fueled by her experience as a featured speaker at the 2003 ADA Annual Session. Eva speaks worldwide at dental meetings, healthcare association conferences and cancer centers. A champion for early detection, Eva developed an oral cancer awareness campaign, SixStep Screening, for which she was recognized by the American Academy of Oral Medicine. She is the author of ‘You Are Not Alone: Families Touched by Cancer’ and ‘Mr. C Plays Hide & Seek.’
Dry Mouth and Oral Hygiene Unfortunately, dry mouth is a condition that is more complicated.
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Articulator
Winter 2014
NON PROFIT NEWS
MANY THANKS TO THE 2014 MOLARS SPONSORS, PLAYERS AND VOLUNTEERS! By Amy Boymel, MDDF Executive Director
O
n a perfect Colorado morning, more than 65 golfers gathered at The Ridge at Castle Pines, one of our state’s most beautiful courses, for the 9th Annual Molars Golf Tournament. Breakfast Burritos, Molars Milkshakes, an Italian buffet and plenty of sunshine all added to the fun and festivities of the day.
MDDF wants to thank Molars sponsors Mountain Oral & Maxillofacial Surgery, Care Credit, Henry Schein, Perry & Young, COPIC Financial Service Group, Allegro
He almost made the $100,000 shot…maybe next year
Orthodontics, Summit Accounting Solutions and Carr Healthcare Realty, for their generous support. And a big thank you to all of the players who participated, the volunteers who helped out on the big day and the staff at The Ridge for making this special day possible. The Molars Tournament benefits MDDF’s Smile Again Program®, which provides free restorative dental care to survivors of domestic abuse. More than $5,000 was raised this year, which will help others smile again. THANK YOU! Plans are already underway for September 2015, when Molars will celebrate its 10th anniversary – we hope you’ll join us. Check the MDDF website, mmdf.org, for details as soon as the date is set.
Oh, what a beautiful morning!
After a great round of golf, Molars participants enjoy a delicious lunch
Our generous sponsors from Henry Schein are all smiles
2014 MOLARS SPONSORS
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Be sure to check out the RMDC HANDS-ON COURSES being held at the:
MOUNTAIN WEST DENTAL INSTITUTE!
Visit MDDSdentist.com for a full schedule of other upcoming courses at the MWDI! • 140-seat Auditorium (can be divided in two) • Banquet Hall • 20-seat Executive Board Room • Hands-on Learning Lab Benches for 40 participants • Large Wet Lab • Four (4) Educational Operatories including one (1) equipped for surgery • 2D/3D Digital Imaging Suite • Planmeca PlanScan™ (mill & scanner) • Equipped to capture and stream live video • MDDS members receive a 15% discount • Multi-day & multi-room discounts • A/V always included • No catering restrictions • Free Wi-Fi • Two (2) free parking structures
MWDI.ORG Metro Denver Dental Society | 925 Lincoln St., Unit B Denver, CO 80203 | (303) 488-9700
EVENT CALENDAR NOVEMBER 2014
FEBRUARY 2015
November 21 All on Four: Live Patient Surgery and Immediate Provisionalization –Dr. Kevin Patterson – Dr. Brian Butler Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am - 4:00pm (303) 488-9700
February 13-14 Introduction to Dental Sleep Medicine – Dr. Barry Glassman Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am - 4:00pm (each day) (303) 488-9700
DECEMBER 2014 December 5-6 Nitrous Oxide/Oxygen Adminstration Training – Dr. Jerome Greene – Dr. John Forney Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 Dec. 5 8:30am - 5:00pm Dec. 6 8:00am - 12:00pm (303) 488-9700
JANUARY 2015 January 22-24 2015 Rocky Mountain Dental Convention Colorado Convention Center, 700 14th St, Denver, CO 80202 The Mountain West Dental Institute 925 Lincoln St. Unit B Denver, CO 80203 (303) 488-9700
FEBRUARY 2015
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February 10 CPR/AED Training Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm - 9:00pm (303) 488-9700
February 27 Basic Radiation Education for Unlicensed Dental Personnel – Dr. Brad Potter Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am - 12:00pm (303) 488-9700
MARCH 2015 March 7- 8 HANDS-ON Recognizing and Managing Medical Emergencies: A Seminar and Clinical Simulation -Dr. Jeffrey Young Chldren's Hospitial 13123 E. 16th Ave. Aurora, CO 80045 9:00am - 4:00pm (each day) (303) 488-9700 March 13 HANDS-ON Soft Tissue Grafting: Enhancing Restorative Results – Dr. James Kohner Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 9:00am - 4:30pm (303) 488-9700
March 14 HANDS-ON Crown Lengthening: Creating Predictable Restorations – Dr. James Kohner Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 9:00am - 4:30pm (303) 488-9700 March 19 CPR/AED Training Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm - 9:00pm (303) 488-9700 March 20 MDDS Casino Event Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:30pm - 10:00pm (303) 488-9700 March 27 Botulinum Toxin (Xeomin, Sysport, Botox) and Dermal Filler Training Level 1 -American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am - 5:00pm (303) 488-9700
March 28 American Academy of Facial Esthetics Frontline TMJ & Orofacial Pain Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am - 12:00pm (303) 488-9700
SOCIAL MEDIA
HOW TO THRIVE IN SOCIAL MEDIA IN 2015
By Ms. Rita Zamora
W
hat was your most pressing social media challenge this year? Chances are you might say it was one of the following:
1) We weren’t really sure what we were supposed to be doing. 2) We didn’t have the time to manage it. 3) We didn’t know if our efforts were working. Let’s look at each challenge, as well as solutions. Problem Number One: We weren’t sure what to do First of all, problem number one. If you aren’t sure what you are doing on Facebook or Twitter, know that you are not alone. Everyday new practices join these social media platforms and find their own way... or not. Because social media is a “free” tool to use, often practices struggle with the idea of spending marketing dollars for help with social marketing. However, remember that time is money. Investing in a course or some coaching can not only help you get ahead, it can also help to save hours of time and frustration. Solution: First and foremost consider your goals. What results would you like to see from your social marketing efforts? By answering this question, you can determine which social marketing platforms you should be working with. Note not all practices are cut out for every social media platform. For example, if you said your primary goal is to grow relationships with patients and other businesses in your community, I’d recommend you utilize Facebook. On the other hand, if you said you are at a loss for words, but love photography, maybe Instagram would be a better fit. It can be frustrating not knowing if you are doing the right thing on social media, and even more nerve wracking to learn you aren’t even using the best platform. So, begin with the end in mind. What are your goals? Once you know your goals, you will discover which social media tool, or tools, are best for you. You can then focus on those
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tools—and master using them. Problem Number Two: We didn’t have time to manage it Now that you know what your goals are, and which social tools are best for you, we can address challenge number two: finding the time to manage social marketing. Many practices are struggling to keep up with creating content for their Facebook Page, finding time to tweet on Twitter, or make video for their YouTube channel... Not to mention we now have Google Plus Pages as well. The best way to survive (and thrive) in social media management is to have a plan. Your plan may involve partial delegation of your activities or hiring someone to manage your activities internally. Either way, without a plan you are planning to fail. Solution: Put a basic strategic plan in place. You wouldn’t get into a car or hop a train without knowing where you are headed. If you don’t have a plan for your social efforts you could end up driving around in circles. No wonder so many practices find themselves lost! To help you get clear direction, and most importantly make your efforts both manageable and effective, take time to create a basic strategic plan. Consider the following: 1) Who will be responsible for your marketing efforts? Decide if you will manage these efforts internally or partially outsource the responsibilities. Notice I don’t recommend outsourcing all efforts. If you are considering totally outsourcing your social marketing so you “don’t have to see or touch it”, then social media marketing may not be a good fit. A part of your success will rely on personalization, and that’s where you or your team need to participate. 2) What is your promotional strategy? Although social media is a digital tool, much of the success of your efforts will rely on your offline marketing. Think about social media or review site business cards, scripting for verbal invitations, and other tangible support materials.
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3) What is your content strategy? Determine how you will come up with content for your Facebook Page. Consider what you will tweet about and how you will interact... Note also how often and when you will participate, such as Tuesday and Thursday mornings or when the practice is typically slower. Problem Number Three: We weren’t sure if it was working Once you have a plan and systems in place to leverage your social marketing, you are ready to address challenge number three. Do you know if your social marketing efforts are really working? Much like getting into a car without knowing where you are going, if you aren’t sure how you are going to measure social media successes, how will you ever know how you are doing? To use an analogy, how do you know when you are successful at driving your car to your practice? The answer of course is that you actually got to your practice. To know if you were successful at your social marketing efforts, you must have some specific measurable outcomes that match your overall goal in mind. Solution: Decide which metrics you will measure. As with any marketing activity, social media efforts should be measured. While there are several metrics you can use to determine how you are doing, the most important metric of all is tracking specifically where new patients have seen you. Often practices say they are seeing the number of new patients
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“from the Internet” grow. The best way to learn exactly where you were found is to ask. Wait until new patients visit your practice for their first visit—and you’ve wowed them with excellent service. Then simply say, “We are working hard to ensure we can be found easily in our community. Would you mind telling us if you happened to see our, ie: Facebook, Twitter, Google Plus or YouTube?” Keep in mind the movement of social metrics may move slowly. However the quality of new patient referrals via social media (conversational, relationship-focused) will, for most practices, be far greater than those acquired via traditional media (one-tomany, sales-oriented). If you haven’t already, make the most of the unique opportunities social marketing has to offer. Thrive in 2015 by considering your goals, putting a basic plan into place, and tracking exactly where people have seen you. Following these recommendations will put your practice on the right track for a socially successful future. About the Author Ms. Rita Zamora has been published in DentalTown, The Progressive Orthodontist & Progressive Dentist Magazines, and is a regular contributor to the Dental Tribune UK. Rita was named Honorary Vice President of the British Dental Practice Managers Association where she has provided their executive team and members with social media advice.
6 N Tejon, Suite 501 Colorado Springs, CO 80903 info@hcmws.com 719-445-5044 720-319-9419 www.hcmws.com Articulator
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Take 5 and Make Colorado Healthier! It’s our profession’s time to shine! Enroll as a Medicaid provider and Take 5 new patients or families today. For the first time, adults are now covered by Medicaid in Colorado. This means that an estimated 300,000 Colorado adults will be seeking dental treatment. They need you – and in fact their well being depends on it. Make a pledge to Take 5. Join your colleagues and make a commitment to address the needs of those served by Medicaid. On July 1, the full benefit for the Colorado Medicaid Dental Program will be available to patients and includes a $1,000 annual benefit, in addition to a full denture benefit. DentaQuest will administer the Colorado Medicaid Dental Program, and will provide regional field representatives to personally assist dentists, help with Medicaid enrollment, and educate your staff on best practices for efficient billing and patient management. DentaQuest administers dental benefits in 28 states. Visit cdaonline.org/Take5 and join the list of CDA members committed to caring for the new population of patients in Colorado. Questions? Call the CDA at 303-740-6900 or 800-343-3010. 28
NON PROFIT NEWS Congratulations to the 2014 Colorado Mission of Mercy and it’s volunteers and supporters for providing free oral healthcare services to over 1,200 adults and children who otherwise would have gone without. The 8th annual COMOM was held at Prairie View High School in Henderson on October 3 and 4. During these two days, approximately $1,100,000 in dental care was donated to patients.
This gym at Prairie View High School had 60 chairs.
Our very own MDDS Secretary, Dr. Nick Chiovitti, was the Chair of this year’s COMOM.
ARE YOUR PATIENTS FINDING YOU ONLINE? ??? IS YOUR INTERNET STRATEGY CURRENT?
???
There is no "one-size-fits-all" approach to dental marketing. We create the right web presence for your practice, with measurable results.
Call Cindy Wilson at 855-876-9545 for a free dental practice online marketing consultation. www.maitrimarketingstrategies.com
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A LAW OFFICE FOR DENTAL AND MEDICAL BUSINESS NEEDS .
Office Leases Practice Transitions Formation of Practice Entities Property Purchases Estate Planning General Business Needs
Emphasis is placed on understanding client needs and using technology, resources, and relationships with your brokers, consultants, bankers and CPAs to meet those needs in an efficient, effective and professional manner.
Law Office of Kimberley G. Taylor, LLC | www.lawofficekgt.com | 303-526-8456 or 970-926-6389 | kim@lawofficekgt.com
ALL ON FOUR: LIVE LIVE PATIENT SURGERY SURGERY AND IMMEDIATE PROVISIONALIZATION Friday, Nov. 21st, 2014 Presented by Dr. Brian Butler & Dr. Kevin Patterson SPONSORED BY:
Register Online Today mddsdentist.com 30
PATHOLOGYPUZZLER WITH DR. JOHN SVIRSKY (from pg. 10)
Based on the radiographic appearance all of the following could be considerations, although squamous cell carcinoma and metastatic disease were unlikely. A biopsy was performed and the histologic appearance was that of a tumor composed of nest and cords of a glandular malignancy completely replacing the normal tissue architecture (figure 2). It did not appear of salivary origin and the histology suggested a metastatic adenocarcinoma. With a previous history of prostate cancer, this was the primary consideration. The patient did not have symptoms of bone pain and there were no findings to suggest other lesions. Immunohistochemical stains were ordered to rule out metastatic prostate (PSA {figure 2} and PSAT) and the patient was sent for a PET (Positron Emission Tomography) to determine other lesions. Immunohistochemical stains that are positive will stain brown. In this case both prostate stains were negative (figure 3).
This interesting and unusual case was submitted by Dr. Amir Naimi, an oral surgeon practicing in Northern Virginia.
Figure 2: Hematoxylin and eosin stained slide showing a glandular malignancy replacing the normal cellular architecture.
The PET Scan revealed a large lung mass and additional stains were ordered. CK20, Napsin A and TTF were negative. However CK7 was positive (figure 4 staining brown) and this was consistent and suggestive of a metastatic lung process. The lesion was signed out: Adenocarcinoma, favor metastatic lung. The radiographic appearance suggested an ameloblastoma, odontogenic myxoma and central giant cell granuloma due to this being a lesion showing expansion. The location is characteristic for an ameloblastoma and odontogenic myxoma, but the age of the patient is much older than typical for these entities. Central giant cell granulomas (CGCG) also expand, but are more likely in the anterior regions of younger patients. CGCG associated with hyperparathyroidism typically show irregular bone loss without expansion. The cortication shown in the radiograph is suggestive of a cystic process. An odontogenic keratocyst does not normally expand and an apical lesion of this size would normally have symptoms. The radiograph had a localized appearance which would normally rule out a squamous cell carcinoma or metastatic disease. This case really surprised us, especially in a patient without any other symptoms. Typically metastatic lesions do not show up in the mandible without involving multiple other areas. This lesion also appeared well circumscribed and showed cortication. This again proves “tumors do not read text books� and the patient is a case of one.
mddsdentist.com
Figure 3: PSA (prostate specific antigen) immunohistochemical stain showing negative findings. The islands of the tumor would stain brown in a positive stain. The second prostate stain was also negative (PSAT).
Figure 4: CK7 (cytokeratin 7) was strongly positive with the tumor islands picking up the brown stain. This finding along with the lung mass suggests a metastatic lung lesion of the mandible.
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Metro Denver Dental Society’s Awards Gala and President’s Dinner
J
Ellie Caulkins Opera House Lobby Thursday, January 22, 2015 6:30pm – 10:00pm
oin MDDS President, Dr. Larry Weddle, at this premier RMDC social event. Attendees will be dressed to impress for live music, reception, dinner and society awards ceremony.
Enjoy this unique and fun event for only $72/pp.
SPONSORED BY: Benco Dental, Carr Healthcare Realty, Cornerstone Dental Solutions, Fortune Management, Summit Accounting Solutions, Topline Management, UMB
Let us help you ensure your
LEGACY Your practice is your legacy. As practice transition specialists, we guide you through the complex process of selling your practice to ensure everything goes smoothly and the legacy you have built is preserved. Larry Chatterley & Susannah Hazelrigg (303) 795-8800 • info@ctc-associates.com www.ctc-associates.com 32
CTC Associates Practice Transition Specialists
Appraisals • Practice Sales • Partnerships • Buyer Representation • Post-Transition Coaching • Start-Up Coaching • Associateships
PRACTICE MANAGEMENT PPO INSURANCE FEES – STRATEGY AND RENEGOTIATION By Ms. Sandi Hudson
T
he insurance landscape is ever-changing in dentistry but one thing is certain, PPO insurances are here to stay. Whether you participate with many PPO plans or just a few, it’s important to have game plan with how to handle them and to renegotiate the fee schedules every few years to maximize your fees and your office collections. Sandi Hudson, the founder of Unlock the PPO, a firm that helps dental practices do just that, shares some tips. 1) Many insurance companies will renegotiate their fees; however, there are some large ones such as Metlife and Delta Dental which (except in rare cases) do not. For those that do, usually you can renegotiate once every 24 months. 2) There are sometimes 4-5 different ways to contract for the same patients. Different fees can be assigned depending on if the dentist is contracted directly with the insurance company or indirectly via a third party. It’s important to make sure you are contracted appropriately with each to see if you’re maximizing your fees. Otherwise, you might be taking lower fees when you don’t have to. 3) If you decide to utilize a third-party agreement (such as Connection or DenteMax), be aware of what that means regarding in-network agreements. They can be very unclear about who (employers, networks) are contracted so it’s important to know what the implications are for your practice. 4) Typically, offices only utilize about 30 codes on a regular basis. Getting an increase on the top codes versus all of them is usually a more profitable way to negotiate. 5) Once you’ve renegotiated your plans, be sure you analyze what your annual production increase will be with each before making any contracting changes. An Excel spreadsheet with before and after percentages compared to your UCR fees can easily show you this. This comparison can help you determine ultimately which plans make sense for the practice you wish to have. 6) Delta Dental is one company in particular to keep an eye on because they are usually the number one source of production in most practices and there are some troubling trends regarding their plans. Currently, they have two fee schedules (Premier and PPO) however Delta typically pays the dentist at the lowest rate the office is participating with so how you are contracted is important. The Premier fee schedule is substantially higher than PPO but in some states, they are no longer allowing practices to have new contracts that are only Premier. Furthermore, in Arizona, in order to be contracted with Premier you can’t be a participant on any other PPO plan. The most important recommendations that we can suggest are to support your state dental association in passing two laws. The first one being the ability to charge your full fee if the procedure is a noncovered benefit. This means if the patient’s policy will not cover
mddsdentist.com
the procedure you would not be bound by the PPO rates and could instead charge for your full fees. The majority of states have now passed the law but Colorado has not. The second issue is a law stating that insurance companies cannot be allowed to withhold assignment of benefit checks for doctors who are not participating providers. As it stands now there are two major national companies who will only send benefit checks to the patient, not to the dentist, if the dentist is out of network. This is a way to strong arm dentists into participation and the patient who is paying the policy should have every right to have their benefit checks sent to their dental provider regardless of participation. There are many insurance changes on the horizon and third party administrators have made insurance participation harder to understand. Make sure you take the time to negotiate and thoroughly research the network agreements you are participating with. About the Author Ms. Sandi Hudson is co-owner of Unlock The PPO, a company that handles national PPO strategizing and negotiations on behalf of dentists. They can be found at UnlockThePPO.com.
NATIONALLY
close to KNOWN
star of the north meeting april 23-25 | saint paul rivercentre 132nd annual scientific session
Home
The 2015 Star of the North Meeting brings you the best clinicians and dental-related companies in the industry, providing the latest in cutting edge techniques and information. Choose from over 80 continuing education sessions presented by over 35 nationally recognized speakers— all conveniently located close to home. Nationally Known, Close to Home • Network with over 8,500 dental professionals from across the Midwest. Take advantage of the opportunity to learn “outside the classroom” by sharing ideas and experiences with your peers. • We discover leaders in the dental industry and bring them to YOU! Don’t miss the opportunity to learn from the best and brightest in your profession. Plus talk face-to-face with over 250 exhibitors and experience firsthand the latest advances in dental equipment and products for your practice. • We are offering 17 workshops to give you valuable one-on-one time with and experience hands-on learning. For the first time ever, we are bringing a Botox seminar and Invisalign Certification courses to the meeting! Check out the full list of educational programs for more information.
2015
For additional information or to request a copy of the Preliminary Program, visit www.starofthenorthmeeting.org or email son@mndental.org. REGISTRATION REGIST REGISTR RATION ATION OPENS O PENS JANUARY JANUA RY JANUAR Y 2, 2015
Articulator
Winter 2014
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CLASSIFIEDS Real Estate Dental Space for lease near Southglenn Mall Dental office space for lease near Southglenn Mall. Approx. 1500 SF in professional dental building. Space is fully built out including cabinetry, gas lines, plumbing and electrical for 4 ops. Landlord offering free rent and generous TI allowance. No NNNs. Responsive and caring property manager. Please call Sharon Sheppaard 303726-2093 General Practices for Sale with CTC Associates: Practice listings along the Front Range in Denver, Arvada, Lakewood, Littleton, Castle Rock, Colorado Springs, and Fort Collins. Additional opportunities available in Montrose and throughout the eastern mountains. We also have opportunities in New Mexico, Utah, Idaho, Wyoming and Hawaii. For a summary of each current practice opportunity, go to www.ctc-associates.com or call Larry Chatterley and Susannah Hazelrigg at (303)795-8800. Ortho Practice for Sale with CTC Associates: New, beautiful, high tech, spacious Orthodontic practice for sale in Colorado Springs. This practice offers private consultation room, large imaging
room, 5 operatories, digital imaging and paperless charts, with plenty of room to expand. Contact Marie Chatterley with CTC Associates at (303)249-0611 or marie@ctc-associates.com. ADS Precise practices for sale: Colorado & Wyoming including Denver, Boulder, Cheyenne, Cody, Casper, Westminster, Arvada, Englewood, Aurora, Lakewood, Littleton, Parker, Greenwood Village, Ft. Collins, Colorado Springs & South, Mountains and Western Slope. For detailed information on practices for sale visit www.adsprecise.com or call Jed Esposito MBA, CVA or Peter Mirabito DDS, FAGD at 888-886-6790. We specialize in Practice Sales, Practice Appraisals, and Partnerships. Announcements & Services Transition Services with CTC Associates: For more information on how to sell your practice or bring in an associate, or for information on buying a practice or associating before a buyin or buy-out please contact Larry Chatterley and Susannah Hazelrigg at (303)795-8800 or visit our website for practice transition information and current practice opportunities www. ctc-associates.com.
Visit mddsdentist.com/classifieds to place an ad. Casino Night
Casino Night Friday, March 20, 2015
@
Benefiting the Metro Denver Dental Foundation Register Online at MDDSDENTIST.COM
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lease and purchase negotiations:
New Offices | Expansions | Relocations | Practice Acquisitions | Lease Renewals
“My practice has
exploded and has
grown faster than i ever expected.
invaluable advice!” – paul bigus, dds rocky Mountain sMiles
WhEthER yOu ARE cONsidERiNg A RELOcAtiON OR RENEWAL, LEAsiNg OR PuRchAsiNg A NEW OfficE, OR ARE simPLy cuRiOus AbOut thE cuRRENt REAL EstAtE mARKEt, ALLOW OuR tEAm Of ExPERts tO hELP yOu cAPitALizE ON yOuR NExt OPPORtuNity.
colin caRR
dENvER mEtRO 303.817.6654
cOLiN.cARR@cARRhR.cOm
RogeR HeRnandez
cOLORAdO sPRiNgs sOuthERN cOLORAdO 719.339.9007
ROgER.hERNANdEz@cARRhR.cOm
Kevin ScHutz
bOuLdER NORthERN cOLORAdO 970.690.5869
KEviN.schutz@cARRhR.cOm
ONLy hEALthcARE. ONLy tENANts ANd buyERs.™ www.carrhr.coM