UDA Action

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UTAH D E

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MY PRACTICE

MY BUSINESS

COMESEEUSAT THEUDA CONVENTION BOOTH #316, #318

WHY PPO PLANS ARE KILLINO YOUR PROFITS

IT'S NOT WHAT YOU THINK

We often hear dental professionals express concerns like this, "I'm working harder, but taking home less," or "my team is asking for a raise, but there's just not enough money to make it happen."

In Utah, dental practices typically have a $500 hourly overhead cost. The average PPO reimbursement rate for a composite fill is $120. If you factor in the $500 hourly overhead cost, scheduling three 2-surface posterior composites within an hour would result in a loss of $140. Even if you schedule a hygiene appointment simultaneous­ ly, you're still in the red. The average PPO reimbursement rate for an all-porcelain crown and build-up is $825. But here's the catch, your overhead for this two-hour procedure is $1000. That means you are $175 in the red. While the most common advice out there is to abandon PPO plans for higher profits, the more strategic business decision is to learn more about your contracts and state regulations.

Our approach at MPMB teaches offices to leverage insurance insights and state laws. MPMB-trained offices generate an aver­ age of $210 in revenue for each 2-surface composite fill and $1425 for every all-porcelain crown, even when dealing with PPO plans. This translates to $130 and $425 profitability, respectively. You have a choice. You can stick to doing non-profitable dentistry or you can come benefit from our guaranteed training at MPMB.

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CONTENTS PRESIDENT'S MESSAGE 4

What's Next, I Wondered To Myself?

OFFICIAL PUBLICATION OF THE UTAH DENTAL ASSOCIATION

CONTRIBUTING WRITERS ADA News Dr Len Aste Dr Ken Baldwin Dr Jerald Boseman Dr Darren Chamberlain Dr Kay Christensen Dr Rich Fisher

ASSOCIATION 5

Chanage Is A Coming To The ADA

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In The Room Where It Happens

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An Open Letter To ADA Members – The Value Of A United Tripartite And The ADA

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Lights In The Fog

CONVENTION

Dr Laura Kadillak

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Dental Education Platform Schedule

Dr Val L. Radmall

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Alive or Virtually Dead: Why We Still Have Live Meetings

Dr Mark R. Taylor Dr Rob Thorup

LEGISLATIVE

Dr Bryan Trump

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COVER PHOTOS Photo Credit: visitutah.tandemvault.com/ (clockwise) Matt Morgan – Sunset at Delicate Arch, Arches National Park Bryce Canyon National Park Tom Till – Zion Overlook, Zion National Park Tom Till – Canyonlands National Park Frank Jensen – Chimney Rock, Capitol Reef National Park PUBLISHER: Mills Publishing, Inc.

GRAPHIC DESIGNERS Ken Magleby Patrick Witmer

LETTER 26

Pro Profitability: Yes, It Does Exist

MENTORING 8

Mentoring: An Opportunity For All

13

Stop By To Say Hello!

PRACTICE

PRESIDENT Dan Miller OFFICE ADMINISTRATOR Cynthia Bell Snow

UDPAC Contributions

ART DIRECTOR Jackie Medina

ADVERTISING REPRESENTATIVES Paula Bell Dan Miller

The Utah Dental Association holds itself wholly free from responsibility for the opinions, theories or criticisms herein expressed, except as otherwise declared by formal resolution adopted by the association. The UDA reserves the right to decline, withdraw or edit copy at its discretion. UDA Action is published bi-monthly. Annual subscriptions rates are complimentary to all UDA members as a direct benefit of membership. Non-members $30. Utah Dental Association, 801-261-5315 1568 500 W Ste. 102, Woods Cross, Utah 84010 uda@uda.org. UDA Action is published by Mills Publishing, Inc. 801-467-9419; 772 East 3300 South, Suite 200, Salt Lake City, Utah 84106. Inquiries concerning advertising should be directed to Mills Publishing, Inc. Copyright 2024.

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What Have I Learned

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Oral Pathology Puzzler: Do You See What I See?

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The UDA, DOPL And You

PUBLIC HEALTH 14

Utah City Defeats Ballot Measure To Remove Fluoride From Drinking Water


PRESIDENT'S MESSAGE WHAT’S NEXT, I WONDERED TO MYSELF? “What’s next?” I wondered to myself while driving home the other night. “What else will come our way that has the potential to fragment, weaken or otherwise harm the practice of dentistry and the health of the public?” Needless to say, it has been quite busy lately. What follows, I believe are the very significant issues facing our profession:

Rewrite of the Utah State Dentist and Dental Hygienist Practice Act

The passage of S.B. 237 during the 2023 legislative session opened the Utah Dentist and Dental Hygienist Practice Act. This bill was heavily promoted by the leadership of the Utah Dental Hygienist Association in order to expand their scope of practice. Now that the statute has been opened, we are currently working together with the bill writers to clarify intent and eliminate inconsistencies. This has been a major undertaking by many in the leadership of our association.

The Dentist and Dental Hygienist Compact

While the concept of a “Compact” to regulate the licensing of professions has been around for a number of years, the Dentist and Dental Hygienist Compact became an issue with us this past Spring. Ostensibly, it is being promoted as a way to facilitate licensure portability for spouses of military personnel. While the cause is worthy, the method is not. Upon a more thorough inspection of just what the Dentist and Dental Hygienist Compact is all about, it becomes very clear that adoption by our state will further complicate our lives and burden the licensing of our profession. In essence, the Compact would create a federal level of authority over dental licensure, complete with the added expenses and the bureaucracy required for its administration. Furthermore, by its very nature, it would produce a system that invites corruption. Consequently, as a UDA Board, we are opposed to any kind of a licensure compact for dentistry.

Medicare Expansion to Include Dentistry

When I first heard discussion about Medicare expanding to include dentistry a couple of years ago at the ADA House of Delegates in Houston, I reeled from the thought. Talk about losing control of our profession! In my opinion, this would prove to be the final step off into the abyss for us. Nevertheless, as I learned more, I softened a bit. Some were saying that it was already a done deal, that Senator Chuck Schumer and others were looking to buy votes, and had made the decision that Medicare was going to be expanded to include dentistry, much like was done with prescription drug coverage during the Bush, Jr. administration. They reasoned that opposing this was futile, and that by agreeing to consider options, we would at least have a seat at the table in the negotiations, and be much better off in the long run. That argument almost won me over. Then, I came to my senses the other day as I watched a docu4

mentary1 detailing the many rural hospitals across the country that are being forced out of business. Why? Because Medicare is now responsible for over 60% of their revenue, and reimbursement rates have not kept up with expenses. With Medicare, there is no negotiating. They simply tell the hospitals and doctors what they are going to pay for a given procedure, period, end of discussion. In essence, Medicare is now forcing these rural hospitals to close their doors. The only reason that larger, big city hospitals are still able to stay in business is because they are in a stronger position to negotiate with commercial insurance carriers. These insurance companies are then over-charged by as much as eight to ten-fold to compensate for the deficit caused by Medicare. The larger hospitals are also on a collision course with insolvency. Their demise is just a little further down the road. So, how do I feel now about Medicare expansion into dentistry? Just like I felt when I first heard about the dangerous idea. Organized dentistry needs to strongly oppose this. Not doing so would be suicide for our profession. Look no further than what is happening right now with rural hospitals for the answer. This notion that we need to acquiesce and roll-over because it will be better for us in the long run is nonsense. Dentistry must stand together, stand up, and just say no! We have more power than we realize, but only when we stand together. I want to be very clear that I am not necessarily opposed to programs, government sponsored or otherwise, that provide assistance to deserving individuals with health care related expenses. However, anything that is compulsory in any way, or controlling when it comes to reimbursement levels is not good for anyone involved. Dentists have a reputation for being generous and caring toward those in need. But, this is dependent upon financial health. If our own fiscal house is not in order, providing discounted or pro bono care becomes impossible.

Alternate Path to Licensure for Internationally Trained Dentists

This has been a hot topic in Utah recently, so there is little need for further discussion. Suffice it to say, any relaxation of the current standards for dental licensure in our state is a recipe for disaster. While we welcome foreign trained dentists to our state who obtain a dental license through existing, well-established pathways, we are very opposed to putting the public at risk by relaxing requirements.

So, What is Next?

Some might say that each of these are random events that are just coincidentally all arriving at our doorstep at about the same time. Others would suggest that they are part of something much more sinister, that there is a coordinated effort to purposely fragment and weaken the dental profession. I do not know the answer. But, this I do know: United we stand, divided we fall. (continued on next page) 1

Flatline: America’s Hospital Crisis, Epoch TV

January / February 2024


ASSOCIATION CHANGE IS A COMING TO THE ADA

necessary.

Recently I attended the ADA’s State President-Elect Conference at the ADA Headquarters in Chicago. I assumed the focus of the meeting would be on training new state presidents. To my surprise, the ADA leadership decided to take the opportunity to introduce a new paradigm change for the organization and why they felt it was

Dr. Ray Cohlmia, the executive Director of the ADA, outlined the five key business principles the ADA will implement to navigate trends and foster opportunities on behalf of its members. 1- Customer focus 2- Sustainability 3- Global presence 4- Innovation 5- Nimbleness

• reverse the tripartite membership decline • balance the price/value equation • elevate opportunity for engagement revenue beyond membership dues. With respect to global presence, the ADA will continue to strive to be a world leader in technology, research, innovation, patient and practice management through its publications, continuing education and advocacy platforms.

"The communications plan will assist stakeholder groups in understanding more about the membership model, ask questions, get feedback, and foster agreement across the Tripartite."

With respect to customer focus, the ADA is developing a new robust communications plan, inclusive of demos and discussion guides for state/local staff and leadership, as well as other key stakeholder groups and members. The communications plan will assist stakeholder groups in understanding more about the membership model, ask questions, get feedback, and foster agreement across the Tripartite. Also, through the communications and rollout process, dental societies will learn about early opportunities to onboard to the new model and launch with the ADA in January 2025. With respect to sustainability, the ADA has developed a Membership Model Taskforce Team for a new membership model. The new taskforce has recommended rationale for the change, including the need to: • appeal to a broader demographic of dentists

While I do not always agree with every issue championed by organized dentistry, I am a firm believer in organized dentistry. We must have a mouthpiece that speaks on behalf of our profession. And, it needs to be robust and powerful to be effective. Our membership must be broad-based, and represent dentists from communities all across our country. While I cannot look into a crystal ball to answer the question of what might be next, I have arrived at three conclusions: First, powerful interests are working hard to make fundamental changes to our profession. Second, the attacks will continue and likely intensify. And third, without each other we are simply fodder for bloated corporations intent on expanding their power,

With respect to innovation, the ADA will replace Aptify, the current Customer Relationship Management platform with Fonteva/Salesforce. Fonteva has the capabilities to modernize and support users at the state level while simultaneously providing an enhanced member experience and delivering personalized value to all ADA members.

With respect to nimbleness, as the ADA moves through each year’s fiduciary responsibilities, “the budget” or Financial Operating Plan (FOP), will be reviewed and revised (as indicated) every quarter throughout the year instead of annually. This allows for quicker reactions and responses to changes in the near forecast, recommendations from the Strategic Forecasting Committee on shifts in long term goals, respond to any emerging needs and appropriate reallocations. It is exciting and encouraging to see that the leadership of the ADA has recognized that we live in changing times and that the needs of the dental profession are changing and evolving also. In order to maintain its relevancy with its membership, it too must make a paradigm shift. As more changes occur, we at the UDA will do our best to update you and implement those changes to better our organization. Len Aste DDS UDA President-Elect

and over-zealous politicians looking to buy votes. Whether currently a member or not, we all are the beneficiaries of the efforts of organized dentistry. We are also indebted to the many who have worked hard to preserve our profession over the years. I sincerely hope we can do the same for the next generation of dentists. So, if you have let your membership in the ADA/UDA lapse, come back! We need you. We need your help to effectively fight these and similar battles. Mark R. Taylor, DDS UDA President

UDA Action

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CONVENTION

DENTAL EDUCATION PLATFORM SCHEDULE See UDA website for an updated schedule

Thursday, February 1 10:00 – 10:45 Company: Adit Ryan Vet Creating Experiences Worth Sharing- How to Simply Boost Patient Experience and Maximize Practice Growth The landscape in dentistry is drastically changing. It is more important than ever to stand out to your patients and create an experience worth sharing. In this course, attendees will explore ways to boost patient satisfaction with simple, easy-toapply customer service and marketing strategies. Additionally, attendees will explore effective communication and time management techniques for optimal patient satisfaction. With these tools, you will discover exciting ways to radically grow your patient base without breaking the bank. Thursday, February 1 11:00-11:45 am Company: Glidewell Presenter: Jinny Bender, DMD Jinny.bender@glidewell.com Incorporating Digital Dentistry In this program, attendees learn how to incorporate digital dentistry into their practice practically and profitably. Dr. Binder discusses how to embrace the digital workflow in scanning, designing, and milling in-office chairside restorations using a modern CAD/CAM system. Additional topics discussed are material selection, preparation, final finish, and cementation. Thursday, February 1 Noon -12:45 pm Company: Drill Down Solutions Presenter: Stephen Nance 6

Website: Schedule with me 5 Ways to Increase Dental Profits Learn how to make your dental practice more profitable by taking basic steps toward success. Thursday, February 1 1:00 – 1:45 pm Company: Gargle Presenter: Jake Goates Marketing Budgets - How Much to Spend, and Where to Spend it! Come and get to know one of the best marketing and branding professionals in the industry while you learn the difference between branding and marketing; How to avoid overspending on marketing services; how to hold your marketing team more accountable, and why you should invest marketing dollars into specific campaigns or avoid others. This course was designed to help you minimize the guesswork of marketing by breaking down case studies and identifying what works and what doesn’t for your market. Thursday, February 1 2:00-2:45 pm Company: Safe Sedation Training Presenter: Micah Baker Safety in Sedation How safe is your sedation practice? This course will review key elements of assessing patients along the sedation continuum and, using part task trainers, allow you to practice potential intervention techniques when your patient is not able to self-rescue. As healthcare providers, we often don’t get to practice what to do when a patient stops breathing or is not tolerating a procedure with a standard amount of sedation. This course will give you tools

to improve your patient assessment, emergency communication and safety of your sedation practice overall. Friday, February 2 9:00-9:45 am Company: Dental Intelligence Presenter: Steve Jensen Intelligent Dentistry: “Secrets of the Top 10% Highest Performing Practices” Would you be interested in learning what the top performing dental practices are doing to thrive during the ups and downs of our economy. We analyzed the data from 10,000+ dental practices and discovered a simple formula for success that elite dental practices follow. By the time we’re done, you’ll have the inside scoop on how the top practices in the U.S. are thriving and have the tools to replicate their methods for success. Friday, February 2 10:00-10:45 am Company: Weave Presenter: Branden Neish www.getweave.com Hiring Robots: Putting AI to Work in Your Office as a Full-Time Employee AI can provide more than just insights into your office; it can actively become a full-time employee at your office. From performing tedious time-consuming tasks to providing new opportunities, learn how you can start or enhance your use of AI in your office and how, when used properly, you will find hitting new office records in ROI, efficiency, and growth. Friday, February 2 11:00-11:45 am Company: Dandy Presenter: Dandy Lab Expert www.meetdandy.com January / February 2024


Inside Dandy Utah - America’s Most Advanced Digital Dental Lab Have you heard the buzz? The beehive state is now home to America’s most advanced dental laboratory! Join us for a unique journey behind the scenes at Dandy Utah. Here, the fusion

of craftsmanship and cutting-edge technology takes center stage, birthing a new standard of quality and consistency! Come visit us, as we pull the curtain back on our 30,000 square foot flagship lab Dandy now calls home.

Friday, February 2 12:00-12:45 pm Company: Dental Radiology Diagnostics Presenter: Robert J. Timothy DDS, MS CBCT Applications and Incidental Findings

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UDA Action

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MENTORING MENTORING: AN OPPORTUNITY FOR ALL As secretary of the Utah Dental Association (UDA), I have witnessed many different experiences this past year. Several times this year the American Dental Association has invited senior dental students to come and address us with their concerns as they prepare to launch into the professional world of dentistry. So, everyone knows the students that have addressed us have not been from Utah schools, although because of the similarities of their stories it is likely that our Utah students have similar concerns. They are: “ How am I going to pay back my student loans? Have I learned enough to handle the ins and outs of daily practice?” Do these concerns sound familiar? As I write this article, on how mentoring has impacted my learning with running a dental office, I reflect on my own major concerns from twenty years ago, I would have to say those two questions were probably two of the largest concerns in my own journey, outside of where am I going to practice. Once I settled on where I wanted to practice, I very much felt isolated in the day-to-day operations of dentistry. I hopped onto the hamster wheel and went to work every day trying to remember what I learned from school and trying to relearn what I may have overlooked as unimportant in school, only to now face its true importance in outcome-based dentistry. Lucky for me, I was able to reach out to several senior (anyone that may have graduated before me) dentists that I had met over the years and learn from them. A few were a part of the Great Basin Study Club that had already been in existence for twenty years and they had just started to allow new dentists to join. They operated on a school year schedule, September-May, where they met monthly to either listen to a guest lecturer or from someone in our group to discuss their passionate topics. Topics ranged from embezzlement and business management to oral sedation and sleep apnea, nothing was off the table. This included a “Show and Tell” meeting where everyone took turns discussing a high and a low experience from the year that changed how they practiced dentistry in their independent offices. This interaction taught me many important things. Two of which were, we all practice dentistry differently, while at the same time trying to do what we think is best for our patients, and that years in practice do not always equate to knowing everything. In my early years of practice this club allowed me to understand that it is up to me to determine what is most important in my office. It created an environment comfortable enough to help me go back to my office and at least know someone else was finding success or that others were challenged with some of the same things I was wondering about. How great to learn from others experiences while not having to try everything when determining what is best for my patients. 8

Photo: Image licensed by Ingram Image

Additional educational opportunities like The Pankey Institute, local Holladay Dental District educational lunches, University of Utah evening CE lectures and Spear Education have all benefitted my learning. Currently I have been following Spear Education as their focus has been on keeping the end in mind well before starting a case and the fact that they encourage interdisciplinary planning and the formation of local study clubs (8-12 dentists). This Philosophy has benefited me learning with local dentists in my community and created again a group learning experience that has helped with me rapid implementation. As we move into a new year the UDA Board has just evaluated the layout of our UDA Convention, February 1-2, 2024. We feel mentorship and networking is a vitally important issue facing all of us. We have decided this year to hold a mentoring/ networking event at the end of day one (Thursday, February 1) of the Convention to encourage interactions and learning within our communities. If you currently are a part of a study club, please reach out to Becky at our UDA office and inform her of what you are doing and if you have space for more members. We would like to create an up-to-date list of options for all Utah dentists that may be interested. Our state’s smaller dental districts maybe just the right size for interactions and learning. In larger districts it is overwhelming to try and create activities that are meant to be achieved in smaller more intimate settings. If you want to get to know others in your area please plan on attending our event. If you have the time and want to see what other study clubs are doing so you can create a club in your area we encourage you to attend. Activities like these should aid all dentists regardless of how long one has been practicing with getting to know who practices around you, create spaces where sharing is comfortable and safe, and improve patient treatment outcomes and experiences more rapidly. Please consider attending and getting involved! Rich Fisher, DMD UDA Treasurer January / February 2024



PRACTICE WHAT HAVE I LEARNED? As I look back on the several decades that I have been privileged to practice Oral and Maxillofacial surgery as a subspecialty of Dentistry I have learned several important things that may be applicable to all of us as dentists. When I graduated from my residency I thought that I knew everything there was to know about my specialty, but I learned through experience and the school of hard knocks as well as from the kindness and benevolence of mentors that there was, and still is, a tremendous amount of things to learn and to perfect. Following is a list of a few of the important things that I have learned. This is not all inclusive! 1. Stay current. Attend appropriate continuing educational opportunities. This applies to techniques, medications, medical and dental products, diagnostic products and their application, safety and patient care techniques and products etc. 2. Do your very best. We cannot ask more of ourselves than that, but we need to be diligent in providing the very best care that we can and that includes looking at completed cases and being honestly critical about the work that was done. I keep a journal in my office of various cases where things could have been done differently and perhaps would have had a better result for the patient. Be willing to learn from your successes and especially from your failures. 3. Encourage second opinions. Sometimes patients will return from a second opinion and proceed with your recommended treatment and sometimes they will find another practitioner to provide your recommended treatment, or perhaps some other treatment. Don’t fret about these cases. Maybe all that you’re missing out on is the opportunity to be in front of a lot of attorneys. 4. Use your time wisely. That is really all that we have to give to our patients. We gain expertise by investing time and money in education and time spent in daily practice. 5. Don’t be critical of others’ work. We weren’t there when that work was provided and we really have no idea what challenges they were dealing with. We all have multiple skeletons in our closet where things have not gone as well as we would have liked. I would just as soon keep all of my skeletons well hidden in the closet if possible. 6. Remember the law of entropy. Everything that is in a higher state of energy and organization naturally decays to a lower state of energy and organization. This includes surgical trays, x-ray equipment, dental chairs, handpieces, autoclaves, emergency equipment and drugs etc. To keep everything operating at the A+ level requires an input of energy and work. 7. Refer patients when it is in their best interest, because it is also in your best interest. I have had to talk many patients into going back to their regular dentist after delay of referral 10

to a specialist led to prolonged treatment and perceived inferior care. Don’t let patients talk you into doing something that you do not feel qualified and comfortable doing. 8. Remember the law of osteo economics. Patients that have plenty of bone rarely have any money for placement of implants and patients that have plenty of money rarely have any bone to support the implants. This seems to be fairly universal. 9. Be kind. Dentistry by its very nature includes some discomfort associated with its delivery, however, kindness along with profound local anesthesia goes a long way to alleviate discomfort and anxiety and ensure good relations with your patience. 10. Be fair. Provide a good service for your patients but remember that you must also provide for your family, staff, and other obligations. Remember that anything you give away for nothing is worth exactly that much. A surgeon acquaintance who provides significant charitable care in Africa always charges something for his services. It may be a chicken or a few eggs or cleaning services. When I asked him why he charges something, he stated that if he gives any services away totally free that the patients do not appreciate what was given and are more likely to discount post-operative instructions and become non-compliant thus compromising the result. 11. I prefer to work on patients that do not eat too much garlic. Then my wife wonders why I don’t like very much garlic in our food. 12. Be grateful. Remember you could have ended up in medicine. Most patients are much more attractive fully clothed. 13. Keep things simple if at all possible. Much better results almost always proceed from a more simple approach versus more complex procedures. 14. Maintain a good blood supply. We facilitate healing but we do not do the healing ourselves. We rely on good blood supply, immune response, Etc for our patients to heal well. 15. A small amount of Vaseline placed on the patient’s lips is very appreciated. Also simple to do. 16. If you choose to work on colleagues, such as physicians, dentists, nurses, or family members, remember Murphy’s Law because it will come into effect. 17. Tattoos and gauged ears do not enhance beauty or prove originality, after all 41% of American adults under age 30 have at least one tattoo. Maybe they are just trying to fit in just like the rest of us. 18. Double check everything. Just because your surgical tray was organized in a certain order last week does not mean it will be organized in that same manner this week. The 13 mm drill may be in the 10 mm slot resulting in nerve injury or January / February 2024


sinus perforation. The only people that rejoice in this type of error are trial attorneys.

PRACTICE

19. Be honest. Be honest in your communications with your patients. Don’t promise them a Mercedes outcome based on a Volkswagen cost. As dentists, we are notoriously guilty of trying to provide great service with minimal sacrifice, financially and otherwise, on the part of the patient. The very best patients are those who are willing to put in time, effort, and appropriate financial resources in order to achieve the desired result. Those who want something for nothing, or for very little, will never be satisfied regardless of the results provided.

ORAL PATHOLOGY PUZZLER: DO YOU SEE WHAT I SEE?

20. Thank heavens for organized dentistry. Only together can we pass on the great legacy that we now enjoy. To paraphrase Abraham Lincoln, he stated that America will never be destroyed from the outside, only from the inside. The same applies to dentistry. If we fail to stand together we will certainly fail individually. I am so grateful to be a part of dentistry and for all that it has taught me through the years. What a great opportunity to be of service to those around us as well as to our own families. I hope that some of my lessons learned, as outlined above, may be of service to you as well. Ken Baldwin, DDS ADA Delegate

Which of the following represents the best diagnosis for the radioraphic and clinical findings noted in the right anterior mandible (coronal aspect of teeth #’s 26 & 27)? a)

Enamel pearl

b) Turner Hypoplasia

c)

Dens invaginatus

d) Dens evaginatus (continued on page 22)

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UDA Action

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ASSOCIATION IN THE ROOM WHERE IT HAPPENS In the Broadway Musical Hamilton one of The UDA was present during the sedation reform discussion the pivotal scenes describes the Compro- saving dentists several hours of CE and other onerous restricmise of 1790 from Aaron Burr’s perspections. tive. This unprecedented compromise Teledentistry discussions were led by the UDA and the UOA between Alexander Hamilton, Thomas which restricted clear aligner therapy companies from having an Jefferson, and James Madison happened in overwhelming presence in the state, and required them to have a a closed room around a dinner table. The Utah dentist sign off on treatment. compromise resulted in the capital city of Countless dental insurance reform bills have been passed that the new nation being situated in the South on the banks of the have restricted the reach of insurance companies and empowPotomac river (Jefferson and Madison’s home region), while ered Utah dentists. Hamilton would get the support of the Democratic-Republican Party for his governmental financial plan. Aaron Burr chides Because the UDA board was at the table, COVID restrictions Hamilton for selling New York City down were lifted not only in dentistry, but in all the river with the compromise, and Hamhospitals and medical practices in Utah, ilton responds by goading Burr for not "There were a group of before any other state in the nation. standing for anything. Burr then laments pediatric dentists in the Nationally, we have seen what happens about not being in “The Room Where it room where this plan when the ADA is at the table… Happens,” and decides that the best way to was discussed and they The McCarran-Ferguson act was overrectify this is to run for political office. This benefited from being turned, putting health care providers and is the beginning of a rivalry that would end insurance companies on the same playing in the death of one of the greatest founding at that table. A lot of field. minds of this nation, and the downfall and offices that were not political exile of another. A Dental Loss Ratio was implemented in present did not get the

Massachusetts that limits the amount of monThere was a time when I was like Aaron same privileges." ey insurance companies can pocket. This is Burr and on the outside of the “room where seeing a snowball effect across other states in it happened”. In 2011 the Utah government the country. decided to privatize Dental Medicaid to two third-party administrators. One of these insurance companies decided to change The ADA is also working on insurance, Medicaid and Medicare from a fee-for-service model to a capitation plan. There were reform. We are finding solutions that are good for the general a group of pediatric dentists in the room where this plan was public as well as dentists and our practices. discussed and they benefited from being at that table. A lot of ofMoving forward, there is a lot of talk about dentistry following fices that were not present did not get the same privileges. That the “medical model.” I don’t know about you, but I personally meeting fractured the Utah Association of Pediatric Dentistry don’t know a lot of physicians that are thrilled with the current and we are still feeling the effects of that division. model in medicine. If we are going to change dentistry, we need The UDA decided that the capitation model, where a dentist is to make sure it is better than the model practiced by our medical paid a set amount of money for the number of Medicaid patients colleagues. We need to be at the table during these discussions “assigned” to their office, was not in the best interest of dentists because we will see a change in dentistry as we know it. If we or the public at large. As a result, the UDA decided to step in are going to make this change it has to provide access to care and work to repair the Medicaid model. I was privileged to be for those in need while protecting the dentist’s ability to practice present in the Health and Human Services Committee chamber, autonomously. when Senator Pete Knudsen spoke up and railed on the insurI am the first to admit that I don’t have all the solutions, but I ance company for the changes they had made. Because of his words and the testimony of several colleagues, the senators were know that there are some great minds at the helm of the UDA and the ADA who have been and will continue to be in the convinced that the capitation model for Medicaid was not best “room where it happens.” I trust them to make wise choices and suited for dentistry and reinstated the fee-for-service model that decisions on our behalf. we see today. If you don’t like something in dentistry, please get involved and Since that time, I have watched and participated with members make a difference. With a lot of hard work and perseverance, we of the UDA board as we’ve discussed and advocated for and can make our profession better for everyone. against legislation that would have changed the way we practice dentistry.

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Darren Chamberlain, DDS ADA Delegate

January / February 2024


MENTORING STOP BY TO SAY HELLO! This past year, I have assist the District President would be a great "The hope is that throughout been learning what way to help facilitate these events. If you the next year, new dentists it means to be on the or someone you know is interested, please entering the profession will UDA Board as an ADA reach out to your local District President. Alternate Delegate. I Unsure who to contact? Becky Waters can see the value in joining the have had the opporbe reached at becky@uda.org to help conUDA and connect to the great tunity to form a New nect you to your local leadership. network of dentists that we Dentist Committee, As the New Dentist Committee continues to are proud to host in Utah." focused on what the UDA can do to help meet, we would like to encourage suggesour newest members in Utah to thrive. Upon tions and feedback from all UDA memmeeting newer graduates, I am impressed with the passion and bers. We would especially like to meet Utah’s newer dentists, willingness of the newest generation of dentists to connect with typically those less than 10 years out from school, who would other members of the profession. There is a great desire for like to be involved in leadership in organized dentistry. We want networking, not only just to form connections, but also to open to hear from you! If you have any suggestions, questions, or opportunities for mentorship, study clubs, and general educasimply are looking to be involved, please contact the UDA at tion. However, this also requires a willingness from experienced 801-261-5315 or via the UDA website, www.uda.org. We hope dentists to participate in the conversation as well. One of the to see you all at the UDA Convention, and hope you stop by to impacts of the 2020 pandemic was an increase of virtual and say hello at our networking event! online connections, which increased flexibility for many people. Laura Kadillak, DDS Conversely, we also noticed a drop in physical meetings, which ADA Alternate Delegate negatively impacted the physical relationships that previously existed among many local societies. Now we are attempting to reignite those professional relationships amongst dentists in the local communities throughout the state. The hope is that throughout the next year, new dentists entering the profession will see the value in joining the UDA and connect to the great network of dentists that we are proud to host in Utah. Together we are much stronger, and with more willing members, the UDA can help enact change that will help the dental profession and the public that we serve. As a committee, we have been discussing how we can help create an increased sense of community amongst members of the UDA. We hope to put into place some new networking opportunities, starting with the UDA Convention in February. We will be inviting all members of the convention to a networking event, held prior to the Reference Committee meeting on the first day of the convention. The hope is that by holding this event prior to a leadership meeting, all members of the UDA who are interested in becoming involved can meet with their local district leadership, in addition to UDA state leaders. At this event, District Presidents can get to know their members, and anyone interested in playing a part in leadership can have an opportunity to learn about the many ways to become involved. The UDA also has the potential to help different communities form study clubs, with a database for members who are willing to participate. Another common request from new dentists is for resources on finding a mentor. Our committee would like to implement a system for suitable mentors and mentees to help connect with each other. Ideally, we would like to set up situations for these meetings to happen organically, through more district CE courses and social events. For those districts with enthusiastic members, setting up a social committee or social chair to UDA Action

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PUBLIC HEALTH UTAH CITY DEFEATS BALLOT MEASURE TO REMOVE FLUORIDE FROM DRINKING WATER ‘The coalition was a group of amazing people that made this win a reality’ It wasn’t even close. In late November, residents of the northern Utah municipality of Brigham City voted overwhelmingly to keep fluoride in their water. Proposition 3 in the special election would have removed fluoride from the drinking water in the town of 20,000 people 50 miles north of Salt Lake City, known for its annual Peach Days festival the weekend after Labor Day. “The coalition was a group of amazing people that made this win a reality,” said Johnny Johnson, Jr. D.M.D., president of the American Fluoridation Society. “The team includes professionals from academia, the Utah Dental Association and a very broad coalition of people who make up this group. The local health care professionals, citizens and the media were key in getting this across the finish line.” The ballot question in the special election was placed in the first place not because of any anti-fluoride activism, but because it was potential option of cutting costs due to financial pressures on the city, said fluoride proponent Randell M. Capener, D.M.D., a Brigham City dentist. “It was misguided attempt,” Dr. Capener said of the city’s officials. “It wasn’t done out of evil.” He said he can easily tell the difference between the oral health of patients who live in Brigham City and those who live nearby who don’t receive the dental benefits of fluoridated water. As for his advocacy, he said, “We felt that we owed it to our patients. It’s a no-brainer.” The Utah Oral Health Coalition, based in Salt Lake City, was instrumental in educating the public and calling on activists to defeat the measure.

“Matt and Johnny were very helpful,” Ms. Koci said. Letters to the editors soon started appearing in the Box Elder News Journal from concerned citizens. “I’m not sure why it is even on the ballot,” wrote Sarah Yates of Brigham City. “Fluoridation of our water costs less than $100,000 annually, a drop in the bucket — forgive the pun — in our city budget. Water is something used by almost 100% of the population. There are people who drink only bottled water, but that isn’t the case for most low-income families with young children, who don’t buy something in a plastic bottle that they can get through their kitchen faucet.” Lynette Schwinn, also of Brigham City, wrote, “At the age of 20 I lived where there was no fluoride in the water. I was told by an area dentist that by the age of 35 I would lose my teeth. I moved to Brigham City more than 50 years ago and due to fluoride in the water, I still have my teeth … So, I’m saying, keep the fluoride. I like my teeth.” One letter to the editor against fluoride in the water appeared in the paper, but it was prefaced with an editor’s note: “This letter contains information that is inaccurate, disputed by experts and/ or credible authorities, and/or commits errors of context/omission. Reader discretion is advised.” Once the measure was defeated, Ms. Koci said she felt emboldened by the swelling enthusiasm of people of the coalition. She noted that only 52% of the people in Utah receive fluoridated water — more than 20 percentage points lower than the national rate. “It’s nuts with all of the children here,” she said.

“It’s a great community,” said Lorna Koci, program director and chair of the Utah Oral Health Coalition. “We got the word spread.”

The ADA recognizes the use of fluoride and community water fluoridation as safe and effective in preventing tooth decay for both children and adults.

As soon as the ballot measure was announced earlier in the year, Ms. Koci said, the coalition plastered flyers all over the area touting the benefits of fluoridated water. Dentists like Dr. Capener called on colleagues to educate patients about the measure and the benefits of fluoridation at each and every dental visit in the months prior to the election. A steady stream of dentists showed up to council meetings to advocate for keeping fluoride in the community water, which had been in place since 1965.

Jessica Robertson, D.M.D, vice chair of the ADA Council on Advocacy for Access and Prevention, said she was excited that Brigham City and their residents will continue to have fluoride in their water.

Dr. Johnson and Matt Jacobs, communications consultant to the American Fluoridation Society who also has served as an advisor to the American Academy of Pediatrics Section on Oral 14

Health, traveled to Brigham City in late July to meet with the mayor of Brigham City and a reporter for the local newspaper, the Box Elder News Journal. The two also met with Ms. Koci and other stakeholders to teach them how to campaign successfully for fluoride based on past efforts and what to tell patients.

“This will help families from all walks of life have an opportunity to decrease their chances of getting cavities,” she said. For more information on fluoride in water, visit ADA.org/fluoride. ADA News

January / February 2024



CONVENTION ALIVE OR VIRTUALLY DEAD: WHY WE STILL HAVE LIVE MEETINGS? At the meeting you will find a lively exhibit hall where you can see and learn about products and equipment while taking advantage of convention specials. Live courses are provided for every member of the dental team to learn and meet CE requirements. Our presenters are asked to provide information that can be implemented in offices on Monday when we return to our practices; so time spent in courses should be immediately useful. One aspect of a live meeting that is difficult to pull off virtually is a live workshop where you can receive hands-on training. The UDA is working to bring more live workshops to our convention so that many more can take advantage of this type of learning opportunity. Make sure to consider the great workshops being offered this year. Register early before seats sell out.

Photo: Image licensed by Ingram Image

If we learned nothing else during the recent pandemic we learned how to present CE content in a virtual environment, avoiding person-to-person contact and adapting to an entirely new way of transmitting and receiving information. Many live dental meetings experimented with a virtual or hybrid format in order to still hold meetings during this almost 2 year pandemic. Some aspects of this “experiment” failed miserably, however. Virtual exhibit halls did not allow attendees the opportunity to have a “hands on” experience with materials and equipment and so failed to attract significant exhibitors or attendees. Most attendees noted they missed the opportunity to interact with professional peers as well as the synergy generated and felt during a live meeting. The opportunity to ask questions of speakers and engage in meaningful dialog was hampered, mostly restricted to typing questions in a “chat box” hoping that they would be noticed and addressed. The big positive was that we could fulfil CE requirements while sitting in our “jammies” at home and did not have to pay to travel long distances and stay in expensive hotels to meet those CE requirements. Many of us decided we enjoyed this convenience and continue to take advantage of virtual CE opportunities. Yet live meetings offer so much more… The Utah Dental Convention has been part of our culture and a tradition for well over 50 years that I know of. It is designed to specifically address the needs of practices in Utah and surrounding states. It is a big benefit of membership in the Utah Dental Association and welcomes members and non-members alike to attend. Those practicing on the Wasatch Front do not have to travel very far to attend with their staff; commuting from home you do not have to pay for hotel rooms unless you want to stay downtown. Those travelling in and needing a hotel will find reasonable room rates at nearby hotels negotiated by the UDA for the meeting. It is a unique opportunity to provide training for your entire staff at a fraction of the cost of travelling to another meeting out of state. 16

Please consider the myriad of opportunities available to you and your staff at the upcoming UDA Convention, held Thursday and Friday February 1-2 at the Salt Palace Convention Center. Come and be a part of the learning, networking, vendor deals, team building and synergy that make the Utah Dental Convention one of the best investments you can make in your dental practice. We look forward to seeing you there!

Wonderful Workshops Woefully Wanting…

Requests for more hands-on workshops at our annual UDA Dental Convention have been heard and we are working to bring to our meeting the workshops you request. We offer them at very reasonable prices as a benefit of membership. Please look at the workshops that will be coming to the meeting in February and get signed up before everything is booked.

Equipment Maintenance Workshop –

Hosted and taught by excellent technicians from Patterson Dental attendees in 3 hours will learn all aspects of preventive maintenance to keep your equipment running smoothly thus reducing the need to incur expensive visits for equipment repair due to lack of proper maintenance. Attendees will learn how to maintain and do basic maintenance on vacuum, compressor, amalgam separator, water shutoff, autoclave, ultrasonics, lube station, handpieces, hoses, air-water syringes. Learn how to maintain proper asepsis, prevent clogs in lines, and bio growth. Open to any member of the dental team. Every office should consider sending at least one representative to this valuable course! Two sessions will be offered on Thursday and cost is just a mere $35 to register. Sign up before all seats are sold out.

Advanced Periodontal Scaling and Ergonomics –

Learn from the person who wrote the book on this topic. Working in 2 person teams you will gain experience in advanced SRP techniques while learning to ergonomically protect hands, wrists, arms, shoulders, neck and back from injury. Feel better at the end of your hard day and prolong your professional career by learning these valuable techniques. You will also receive an actual copy of “the book” when you attend this course. One January / February 2024


session will be offered on Thursday and one on Friday. It is limited to 24 attendees/session so that everyone receives personal instruction. Cost is $100 to attend and includes a copy of Diane Millar’s book. This course is for those hygienists and dentists who are practicing and already know how to scale teeth.

Utilizing Laser Technology in a Periodontal Environment Dr Sam Low’s workshops are in big demand and sell out at dental meetings around the country, usually with fees ranging from $295-$495 per workshop. Take advantage of this unique opportunity to learn from Dr Low. Using pig jaws and dental lasers attendees will receive hands-on instruction in the use of both diode and all-tissue lasers to accomplish periodontal surgical and non-surgical procedures. Learn how to accomplish frenectomies to crown lengthening in less time, with less pain and post-op complications. This course is a tremendous value and opportunity for only $100. Attendance is limited to 30 participants; available slots will go quickly.

User-Friendly Crown Lengthening

Another excellent workshop with Dr Sam Low where he will teach straightforward crown lengthening procedures. Practicing both traditional surgical and laser surgical techniques on pig jaws you will learn how to manage esthetic tissue challenges

while maintaining essential biological width in your challenging restorative cases. Not only will you learn how to incorporate this valuable procedure into your practice, but Dr Low will share billing strategies and codes to enhance reimbursement and case acceptance. Once again it is a mere $100 for this exciting 3 hour hands-on course. Only 30 participants will be permitted.

CPR and BLS Certification

We all need this certification training every 2 years, so take advantage of the excellent instruction available at this workshop and renew your certification while attending the convention. Two sessions will be held each day; sign up for the most convenient session for you and your team so you will be certified and prepared. Cost is $40. As we plan for the future we see a need to expand the number of workshops we offer at the convention. So if there is a workshop you would like to see at a future meeting please let us know either through your response on the course surveys or contact me directly so we can arrange for the workshops you desire. Jerald Boseman DDS Convention Coordinator, bosey@aol.com

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ASSOCIATION AN OPEN LETTER TO ADA MEMBERS THE VALUE OF A UNITED TRIPARTITE AND THE ADA "The strong tripartite of organized dentistry helped to build the modern dental profession that we have today – a profession that is compassionate, inclusive, trusted, and respected." The American Society of Constituent Dental Executives (ASCDE), representing state dental association executive directors and CEOs, believes that a unified tripartite is crucial for advancing the dental profession and its values. As Executive Directors/CEOs of state dental associations, we often focus on the value of organized dentistry at the state and local levels. However, the American Dental Association is also an important, valuable partner in the tripartite structure of organized dentistry. A dentist’s membership in organized dentistry means the individual gets the benefit of the tripartite – the local dental society, the state dental association, and the ADA – all working together to support dentists and their practices, while also protecting dentistry as a profession and promoting the oral health of the public. The strong tripartite of organized dentistry helped to build the modern dental profession that we have today – a profession that is compassionate, inclusive, trusted, and respected. Many ADA programs that provide direct assistance to dentists, regardless of practice modality, are highly visible and well known. Other ADA programs are less visible but no less valuable to dentistry, the public, and the tripartite. This includes critical support services to state dental associations and local dental societies. A discussion of some of the amazing benefits provided by the ADA can be found below. Not every state dental association and local dental society uses all the support services offered by the ADA, but most have used several of these benefits at some point. Whether it is a grant to help advance a legislative issue, financial assistance with litigation, or an invitation to the ADA to weigh in on an important scientific issue, we all benefit from having access to ADA’s resources. And similarly, we all benefit every time the ADA assists one of our sister state or local dental societies as it strengthens our collective body. We know that issues that are not adequately addressed in one state can blossom into problems in other states, which is why we stay unified in support of the tripartite and the dental profession wherever issues arise. While dentistry’s challenges continue to evolve so does organized dentistry as we rise to meet those challenges together as a strong, influential, and unified profession. Organized dentistry’s engagement and membership market share are the envy of nearly all other professional associations, especially in the health care professions. The ASCDE strongly believes unity is critical 18

as we address the unique challenges and opportunities facing dentistry today and build on our strong foundation to achieve continued success into the future. We are better together.

Essential ADA Benefits: The Voice of the Dental Profession

The ADA is the public authority on all dental topics. When the national media outlets cover dental issues, they seek input from the ADA. The ADA’s team of trained spokespeople and subject matter experts speak to the collective wisdom of the profession to the media, policymakers, and the public. For state or local level inquiries, we often turn to ADA resources or messaging to add validity and heft to our own communications. The ADA communications efforts protect and promote the dental profession and oral health from a position of credibility and authority unmatched by any other organization.

A Reliable Advocate

The ADA’s federal advocacy has had a significantly positive impact on dental care, dental practices, and oral health. The ADA defends and promotes the profession and patients before Congress and federal regulatory agencies. The ADA routinely and successfully advocates to eliminate or reduce the impact of burdensome regulations on the practice of dentistry. No other organization can do that with such credibility. The recent passage of the Competitive Health Insurance Reform Act, which limits the antitrust exemption available to health and dental insurance companies under the McCarran-Ferguson Act, and the development of the dental licensure compact and other efforts that promote licensure portability, are recent examples of how the ADA’s advocacy benefits patients and the profession.

ADA Standards Program

Setting standards is one of the most crucial roles of the ADA. From the specific torque at which dental handpieces spin to the wavelength at which dental curing lights cure, the ADA Standards cover almost every aspect of dentistry. These standards promote safety, reliability, and efficacy for dentists and the public. The U.S. Food and Drug Administration encourages dental product manufacturers to use FDA-recognized ADA consensus standards in their product submissions. No entity other than the ADA has the national presence and credibility to provide this crucial and valuable service.

Maintaining Strong Ethics

The ADA maintains the “ADA Principles of Ethics and Code of Professional Conduct.” This is the universally accepted dental code of ethics in America and it serves as a publicly accessible reminder that patients come before commercial or financial interests. The ADA is the only organization that has the credibility to promote a code of ethics for the entire profession. The code is integral to ensuring dentistry remains a profession that is trusted by the public. (continued on page20) January / February 2024


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Creating Universal Codes

The ADA maintains the Code of Dental Procedures and Nomenclature (the CDT Code). The CDT code is the universally accepted standard for documenting dental treatment and ensures a level of consistency for payment of dental services. Only the ADA has the credibility that ensures these codes are universally accepted by payers, the government, and dentists. The ADA also ensures these codes are regularly reviewed and updated – keeping up with changes in technology and dental practice.

Science and Research

The ADA Science and Research Institute is crucial for advancement of dentistry through scientific research and provision of information that is practical, useful, and free from outside bias. The ADA’s research allows for development of evidence-based best practices and clinical practice guidelines that drive innovation and support the delivery of optimal oral health care. The ADA is regularly called upon by state and local dental societies to provide science and evidence-based information to regulatory bodies about dental amalgam, water fluoridation, and other dental-related issues. The ADA is the recognized preeminent resource for the science of issues related to dentistry.

Health Policy Institute

The ADA Health Policy Institute (HPI) conducts innovative studies on a wide range of topics impacting the U.S. dental economy, including access to dental care, the dental workforce, utilization and benefits, dental education, health care outcomes and more. A recent example of the importance of HPI is the COVID-19 Economic Impact on Dental Practices polling that was instrumental in providing valid data and guidance to policymakers and industry stakeholders during the pandemic.

may not be as visible as the direct benefits like advocacy and dental practice support, but they are no less vital to the success of organized dentistry and the dental profession. For example, the ADA aggregates best practices and provides toolkits for various issues, including membership recruitment and retention and in-office dental plans. The ADA also provides expert information about dental insurance reform legislation, which encompasses dental loss ratio, noncovered services, prior authorization, and virtual credit cards. All of these tools can be modified to fit specific specifications and help state dental associations save time and resources while advancing issues that benefit member dentists. Perhaps the most underpublicized aspect of the ADA’s support for the tripartite is its investment in technology to provide local dental societies and state dental associations with a shared membership management database and software that enhance our ability to meet and track member dentists’ specific needs, streamline processes, assist with governance, and aid meeting planning. The ADA’s investment in this technology saves state and local resources and enhances our effectiveness.

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ADA Credentialing Service

The ADA Credentialing Service allow dentists to avoid the repetitive, slow, and cumbersome method of submitting error-prone traditional paper applications for credentialing and re-credentialing. Through the ADA Credentialing system, dentists are able to retain ownership and control over access to their data while simultaneously reducing the administrative burden of filling out repetitive information for multiple dental plans. More than 100,000 dentists have used the ADA Credentialing Service, clearly illustrating its value.

Additional ADA Benefits and Programs

We could continue to go on about invaluable ADA programs and benefits like diversity leadership training, wellness and mental health support, and the ADA Seal of acceptance program for consumer products that helps the public make informed decisions about dental-related products. There simply isn’t enough space to list all that the ADA does to benefit the profession, the public, and oral health.

ADA Support for the Tripartite

One of the least visible aspects of the ADA is its support for state and local dental societies. Just as providing roads, electrical service, and water and sewer lines are important to our communities, the ADA provides important infrastructure that sustains and enhances the work of state dental associations and local dental societies across America. These “public works” 20

We need you and your team! Once a year Utah dentists join together to treat underserved children. Patients are screened and come to the University of Utah. Dentists volunteer time to treat children from 8am-1:30pm, and are encouraged to bring their own staff members to help treatment run smoothly. We need you and your team! Please contact us if you are interested in participating. Location: University of Utah Dental School Time: 8am-1:30pm Contact: Dr. LaRisse Skene Office: 801-207-7070 / Office email: info@mosaicperio.com Cell: 801-664-0622 / Personal Email: larisse100@yahoo.com We need dentist, hygienist, and assistant T shirt sizes

January / February 2024


ASSOCIATION LIGHTS IN THE FOG One of the things I remember from my younger years was the fog rolling in from the seashore of the beautiful Pacific Northwest. Its dense, thick blanket would cover and hide our neighborhood, and I loved how quiet and still it was. I liked to walk along the streets at night in the fog, relying on the occasional streetlight to show me the way where I was going, and to guide my way back home. I later learned more about the importance of lights used as a safe guide through the fog. Many coastal areas, or islands of the seas have lighthouses placed on high points of ground to help ships and boats to see where the land is which they are trying to reach. There are also the lower lights, placed along the shorelines. A sailor approaching an island is guided toward the land when the beacon light from the lighthouse above is spotted, but in order to safely navigate the dangers of the hidden reefs or other obstacles, the lower lights need to be burning. It is especially critical for the lights to be shining when it is dark, or when

vision is obstructed by the fog. The beacon light of the lighthouse, together with the lower lights, show the safe way to the desired destination, a task which is nearly impossible without the guiding lights. Many of us have experienced the white knuckle driving through dense fog, relying on the lights of the car in front of us, hoping and trusting that following the light will keep us safe on our journey. Sudden accidents can and do happen, as noted in recent news of tragic events associated with a super fog in Louisiana, or the recent multiple car pileup in Pocatello. The sudden dense fog blinded drivers to their surroundings and made traveling dangerous. Safe and sure traveling in foggy conditions requires slowing down and carefully following the lights that guide us. Why do I ramble on about the fog, and guiding lights? Maybe because I woke up this morning to its dense cover, and it made me think. When I graduated from dental school, it was an exciting time. Exciting to be finished with all the requirements and work, and to be starting life as a professional, as a dentist. Classmates seemed excited, too, eager and anxious to move on

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BRYAN G. TRUMP, BRYAN DDS, MSG. TRUMP, ORAL & DDS, MS

with their career, feeling like they now knew everything they needed to conquer the dental world as a new doctor. I kept thinking about how much I still needed to learn in the “practice” of dentistry. There seemed to be a lot of careful travel ahead through the fog. I am so grateful for the guiding lights I’ve had throughout my dental experiences that have helped me to safely navigate my dental career. Simply said, organized dentistry provides the best safety and guidance we can receive in our profession. Sure, one may have a great innate ability to succeed alone in dental practice, in business, in clinical matters, and so forth. But sooner or later, there will come the sudden, unexpected challenges that accompany our profession. The dense fog will come, and unless one slows down and follows the experience and wisdom of the guiding lights, accidents or disasters may come. Membership and participation in our dental associations with other colleagues is perhaps the greatest benefit available to us. It may seem to be taken for granted when thinking of other more tangible benefits, but I can’t say enough how important it is for our success in our profession to be joined with others in our experiences. Don’t try to navigate through the periods of fog alone! Follow the guiding lights of others or be the guiding light to someone else!

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Kay Christensen UDA Past President

TESTING SERVICES

Oral Pathology Puzzler (continued from page 11) Correct answer: (b) Turner Hypoplasia (Turner Tooth) Turner Hypoplasia is a pattern of enamel defect seen in permanent teeth as a result of injury (traumatic or due to a periapical inflammatory disease of the overlying deciduous tooth). The altered tooth is called a Turner tooth. The clinical and radiographic appearance can vary according to the timing and severity of the “trauma”. The enamel defects vary from focal areas of white, yellow, or brown discoloration to extensive hypoplasia, which can involve the entire crown (Neville, 5th edition). Bicuspids are affected most frequently because of their relationship to the deciduous molars and as a result of periapical inflammatory disease. Anterior teeth are involved to a lesser extent due to the fact that crown formation is usually finished prior to any apical inflammatory disease (particularly because of the relatively caries-resistant nature of the anterior deciduous dentition. In the present case, this 11 year old female had a history of periapical pathology to the overlying deciduous teeth. Works Cited Neville, Damm, Allen, Chi (2024). Oral and Maxillofacial Pathology, 5th Ed. St. Louis: Elsevier. Dr Bryan Trump

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Dermatology Laboratory Services 417 S. Wakara Way, Ste 2152 Dermatology Services Salt Lake Laboratory City, UT 84108 Phone: (801)Way, 581-7139 417 S. Wakara Ste 2152 Fax:Lake (801) 585-2700 Salt City, UT 84108 Phone: (801) 581-7139 DermatologyLaboratories@hsc.utah.edu Fax: (801) 585-2700

Hours of operation 8:00 AM-4:30PM MT DermatologyLaboratories@hsc.utah.edu Monday-Friday Hours of operation 8:00 AM-4:30PM MT Monday-Friday

January / February 2024


Recruit for Rewards

Caring • Connections • Create • Commitment You know first-hand the value you receive from your ADA membership. Through the community and resources you’ve come to count on, the ADA provides the support you need to help achieve your goals. You can help colleagues and friends thrive by inviting them to join the ADA.

For every 5 new members

For each new member

you recruit, you’ll receive a chance to win a 7-day interisland Hawaiian cruise* for you and a guest.

you recruit, you’ll be entered into a quarterly drawing for a chance to win $1,000 in prizes from ADA-endorsed providers or products from the ADA Store.

Eligibility

Program Rules

Who can recruit? Any ADA member dentist (including graduate student, resident, active licensed, active life, retired and retired life) is eligible to participate as a recruiter

• This program will run January 1 – August 31, 2024.

Who can be recruited? Any degreed dentist who was not an ADA member in 2023 (including graduate students, residents) Who is not eligible to be recruited for this program? • A renewing member (someone who was a member in 2023) • Dental students • Retired dentists

How to Participate • Newly recruited members are required to indicate the recruiter’s name and contact information as a referral on the membership application. • ADA member recruiters will receive an email notification after the dentist referred has been accepted into membership. • A raffle entry for quarterly drawings will be awarded for each new, active member recruited who pays national dues (as applicable) in the current year. Recruiters will receive a chance to win a 7-day Hawaiian cruise* for every five new recruited members who pay national dues (as applicable).

Recognition • All recruiters will be recognized at SmileCon 2024. Top recruiters will receive additional recognition. • Quarterly winners and top recruiters will be announced in ADA Morning Huddle.

• For each new, active member who joins in that timeframe, the referring member’s name will be entered into quarterly drawings for a chance to win $1,000 in prizes from ADAendorsed providers or products from the ADA Store. Referring members will also receive a chance to win a 7-day interisland Hawaiian cruise* for every five new, eligible members they recruit. • Referring members will receive a qualifying entry each time their name is listed as the “referring member” on the new member’s application (one entry for quarterly drawings for every one member recruited, one entry for the grand prize drawing for every five members recruited). There is no limit to the number of new members who can be recruited or entries in the drawing. • Referring members will automatically win a quarterly prize (up to $1,000 value) when they recruit 25 eligible new members. Quarterly prize winners are also eligible to win the grand prize should they recruit at least five new members. • The grand prize drawing will take place at SmileCon® 2024 in New Orleans. SmileCon attendance is not required to win. * The grand prize winner will receive a 7-day interisland Hawaiian cruise with a balcony room and airfare for two to be redeemed in 2025, an estimated value of $7,500. If winners do not wish to claim the Hawaiian cruise package, they are able to select another trip from AHI’s catalog at equal or lesser value, or take a cash prize option of $3,500. Learn more about the available cruises provided by ADA Member Advantage endorsed partner, AHI Travel. The ADA Member Recruitment Initiative is subject to all applicable federal, state and local laws and regulations, and is void where prohibited by law. Visit ADA.org/R4R for more details. © 2023 American Dental Association All rights reserved.

Updated: 12/11/2023


LEGISLATIVE UDPAC CONTRIBUTIONS

Congratulations to the 2024 UDA Distinguished Service Award Winners!

Dr Kel Faddis Photo: visitutah.tandemvault.com

The Utah Dental Political Committee (UDPAC) would like to acknowledge and express its appreciation to those dentists who have made generous contributions to UDPAC during the 2023 dues cycle. Dr Craig Allan Dr Kent Arbuckle Dr Len Aste Dr Ken Baldwin Dr Richard Blackhurst Dr Charles Brimhall Dr Jeff Burg Dr Brian Call Dr Jonathan Campbell Dr Randell Capener Dr Rhett Casper Dr Darren Chamberlain Dr Kay Christensen Dr David Christianson Dr Scott Cold Dr William Davis Dr Mary Draper Dr Joseph Feller Dr Jaleena Jessop Fischer Dr Richard Fisher Dr Scott Folkman Dr Jonathan Ford Dr Brandon Glenn

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Dr Bart Goldsberry Dr Debbie Graham Dr Michael Green Dr Jordan Hansen Dr Jacob Haslam Dr Trevor Hoffman Dr Brad Holmes Dr Richard Howard Dr Michael Hutchings Dr Paul Innis Dr Brad Johnson Dr Laura Kadillak Dr Kimberley Kershaw Dr Keith Lever Dr Lloyd Liu Dr Spencer Luke Dr Brian Lundberg Dr Michael Matheson Dr Scott Matson Dr John Myers Dr Scott Nord Dr David Okano Dr Barney Olsen

Dr Thomas Page Dr Sheldon Peck Dr Paul Porter Dr Adam Proctor Dr Val L. Radmall Dr Michael Richards Dr Dean Robinson Dr Larisse Skene Dr Michael Smuin Dr Bret Sorenson Dr Kip Sterling Dr Mark Taylor Dr Scott Theurer Dr Rodney Thornell Dr Rob Thorup Dr Wells Wagner Dr Jennifer Poorman Wahlen Dr Mark Webster Dr George Winder Dr Troy Winegar Dr Glenn Zeh

Dr Drew Jones

Dr Glenn Zeh

January / February 2024


UDA Convention 2024 Visit me at booth #415 Matt is presenting on Thursday, February 1 @ 3:30 in room 251 DEF Successfully connecting the dentist’s present with their future

IT ALL STARTS WITH A CONVERSATION Ready to talk? Or know someone who is? Contact me for a complimentary DENTAL PRACTICE TRANSITION ASSESSMENT Our Services:

Key questions we can talk about: • What is the current local dental practice transition marketplace like? • What are the best transition options for my practice? • What impact does the makeup of insurance have on the sale of my practice? • Any suggestions for improving my practice image and real estate? • What potential practice investments to increase value could I make or avoid? • What might present and future staffing integration look like? • What might present and future associate integration look like? • How does my new patient flow and patient turnover analysis stack up? • How is my promotion and marketing of the practice? What basic ideas should I consider? • What about my lease or transfer of the real estate?

• Practice Sales • Associate Placements • Practice Appraisals and Valuations • Partnerships & Mergers • Dental Real Estate • DSO & Private Equity Transitions • Practice Transitions & Succession Planning With 26 years of experience in the dental industry, I have worked with dentists through all stages of their careers. I know how hard you have worked to build your practice and how important it is to preserve your legacy. When the time is right…

I’m ready to help you make a Trusted Transition©.

Contact Matt Hamblin to schedule your confidential and complimentary conversation.

Matt Hamblin • 801.362.1557 • mhamblin@ddsmatch.com DDSmatch.com

UDA Action

25


LETTER PPO PROFITABILITY: YES, IT DOES EXIST I was asked to write an article on how to be profitable with PPO Plans, because that is our specialty here at My Practice My Business (MPMB). It’s honestly such a broad topic, as all of you who have been through our training here at MPMB understand, that I simply didn’t know where to start at first. However, I will be so bold in my old age as to start with this: those who tell you to dump PPO Plans, or even a part of them, have no clue what they are talking about. Put another way, those who go through our training on how to be profitable with PPO Plans, and experience “real” profitability with their own fee-for-service fees, would never drop the PPO Plans they take. After trained dental teams understand PPO contracts and state laws, they realize it’s not the fault of dental insurance companies that their practices are not profitable, it’s their own darn fault for not understanding the latitudes they have in those contracts and how state laws protect them from doing “free” dentistry when they should be getting paid for the dental services they provide to their patients. We have been honored to educate so many of you in Utah, but we see there is still work to do in correcting the misinformation propagated by so many. So many dentists “don’t know what they don’t know.” All of us need business training. Ignorance is not bliss. Years ago, I began teaching dentists how to be profitable with PPO plans as taught to me by Mary, the regional manager of a very “blue” dental insurance company in the US. I took a lot of heat in those early days challenging the status quo. But, I stayed the course (as so many of you have kindly recognized) and pushed forward teaching truths about dental insurance contracts and state laws. Now, if what I’m about to share makes you uncomfortable, it’s because you “don’t know what you don’t know.” Here are a few ways to be profitable with your PPO Plans without giving away too much of what our clients pay for in our incredibly effective business training here at MPMB:

Ensign Academy of Dentistry

1. Read, study, and understand how to apply our two wonderful Utah Laws: SB 44-the “Non-covered services” law, and HB359-the “Network leasing, down-coding, and bundling protections” law. Just like medical, you can charge your patients for: anesthetic, palliative treatment, oral facial images, gingivectomies when doing crowns, and many other items that they have forced us to write off in the past. In addition, they can down code, but they cannot have language on their EOB pushing you to write off the balance. And then there are non-covered services. They try to tell you their plan was written in another state, and therefore, does not have to concede to our SB44. However, if their state has “non-covered” services laws, they have to comply with them. Yes, you can collect your FFS fee, or at least the PPO fee, depending on the verbiage with the state law the PPO plan was written in. 2. Read the dental PPO contracts you have signed. Below is an excerpt from a PPO contract which is similar to nearly every dental contract we have studied. When you read it, think about how this statement applies to the dental procedures you perform, and your potential profitability. “The provider must present the patient with an accurate and detailed breakdown of covered and non-covered services and their financial responsibility for each service whether covered or non-covered. If there are alternative upgrades to a procedure which are not covered, but the base procedure is covered, providers must explain that a covered benefit is available to the patient and the patient must sign their consent to receive any upgraded, non-covered alternative or additional services.” 3. Stop blaming dental insurance companies for you not being profitable on procedures. They, like you, are a business. They, like you, sell products and services. Stop thinking that they should cover every procedure at high reimbursement fees that are not even close to the premiums they collect from businesses or individuals for their dental plan products. Yes, I am sticking up for them on this point. It’s

DENTISTS, DENTAL HYGIENISTS, SPOUSES AND YOUTH

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Ensign Academy

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CONFERENCE August 9–10, 2024 Ut a h Va l l ey Co n v en ti on C e n t e r

January / February 2024


simple business, and many of you waste so much energy complaining about their reimbursements, when you should be simply collecting more from the patient for your services. For heaven’s sake, many of us pay thousands of dollars a month for medical insurance, yet we still have co-pays and deductibles every time we receive medical treatment. Charge your patients for the services you perform. Learn how to be paid fairly for those services. 4. Learn what true profitability is and how to acquire it. We continually see offices take some of the pearls of profitability we teach at our intro courses and run with them. I love it! But those are not all the pearls of profitability. Mary, the regional manager from the “blue” dental insurance company taught me that dental practices are not profitable like they should be because of two reasons: (1) lack of business training and (2) fear. What Mary taught me early in my career has been priceless. The knowledge she shared with me is what every dental practice must know to be profitable in the PPO and FFS business we are in. 5. Learn business skills that are laser-focused on dentistry. That business education must come from people with reputable

business degrees from accredited schools of learning, and real-world dental experience. As important as business skills are, leadership skills hold the same level of importance. It’s our thought leadership that you should be armed with the business skills needed to run profitable dental practices so you no longer need to rely on us. What a concept! It’s time to face the facts: Your current insurance reimbursement is based on YOU providing the “least expensive professionally acceptable treatment” (LEPAT), as outlined in your contract as a dental PPO provider. This situation presents you with three choices: racing to the bottom by providing the cheapest dental care possible (resulting in financial losses), delivering high-end dentistry on a PPO budget (leading to even bigger financial losses), or a hybrid of the two (where you’re still losing money). You shouldn’t blame yourself – your education focused on dentistry, not business management. However, a more profitable option does exist: guaranteed training with MPMB. Rob Thorup, DDS President My Practice My Business, LLC

MCNA Insurance Company is pleased to administer benefits for the Utah Medicaid Dental Program. MCNA is a provider-centered organization committed to helping dentists serve Medicaid and CHIP enrollees. We provide dentists with leading-edge technology and superb customer service support to reduce missed appointments and encourage patients to seek timely dental care. For more information, visit us online at: www.mcnaUT.net VISIT US AT BOOTH #708 UDA Action

27


PRACTICE THE UDA, DOPL AND YOU In the past few years, the Utah Dental Association has been holding regular meetings with the Division of Professional Licensing (DOPL). DOPL is under the jurisdiction of the Utah State Dept of Commerce. They are the governing and licensing body for many professions and trades in our state. The Utah Dental Association has worked closely with DOPL authorities to maintain state rules in dentistry that protect the public and maintain quality within the dental profession.

and the dentists to eliminate all the “bugs” in the process. Note: Because of DOPL workload, the exemption form will not be available for an uncertain time. Therefore, the e-prescribing law will not be enforced until after the new exemption form is available. Please note: Starting January 1, 2024, all controlled substance prescriptions that are not e-prescribed, need to include a note that states, “Exempted from e-prescribing for technological issues.”

SBIRT Training

What is SBIRT Training? “SBIRT” means the Screening, Brief There have been several issues and topics recently where our Intervention, and Referral to Treatment approach used by the UDA has worked with DOPL to benefit dental team members federal Substance Abuse and Mental Health and their offices as well as keep patients safe. Services Administration, in accordance I hope to update you on several of these areas with Title 63G, Chapter 3, Utah Adminis"There have been in the next few paragraphs. trative Rulemaking Act. Simply put, since several issues and topics E-Prescribing 2014 this is a required Training for all recently where our UDA In 2020, an E-prescribing law passed in Utah healthcare professionals that prescribe has worked with DOPL (HB 177). It went into effect on Jan 1, 2022. Controlled Substances. SBIRT is a 3.5 This law designated that all Controlled Subto benefit dental team hour training that needs to be completed stance prescriptions needed to be submitted to members and their once while licensed in Utah. The deadline the pharmacy through electronic transmission to complete this training is by the end of the offices as well as keep or “E-prescribing”. There was a concern with next licensing cycle, which for dentistry in patients safe." those dentists that prescribe very few conUtah, will be by May 31st 2026. (Reference trolled substances, would be burdened with in statute: 58-37-6.5 - Continuing Education costly software or monthly fees in order to for Controlled Substance prescribers). still be able to prescribe when needed. The Utah Dental AssociSummary: Each Controlled Substance prescriber should comation has been working with DOPL on this since the beginning, plete this one-time training by May 31, 2026. A CE Certificate when an exemption for prescribers issuing very few CS, was of completion is all that will be required if audited. Keep track removed from the original bill. DOPL offered the two-year of that certificate. If you have lost your certificate or have not exemption period for e-prescribing, which will expire Dec 31, taken the course. It will be made available free to UDA mem2023. Beginning Jan 1, 2024 we needed a more permanent solubers in the Spring of 2024 at www.uda.org/member-center/ tion for those that prescribe few Controlled Substances. That course-library solution has been developed and is beginning to be applied. The drafted rule, when finalized will allow prescribers to write Internationally Trained Dentists Licensure up to twenty-five controlled substance prescriptions monthly. First, “Thank you!” to the hundreds that took action when the For those prescribing few Controlled Substance prescriptions a UDA asked you to write DOPL a letter in late October and month, there is an option to be exempt from e-prescribing. This early November, on your concerns with licensing internatione-prescribing exemption requires the dentist to do two things. ally trained dentists. We also want to acknowledge we are not These two requirements are: against adequately Internationally trained dentists from coming 1- Apply for the exemption – DOPL has an application form that to Utah. In fact, we feel there is a well proven pathway for licensure for those that did not attend a CODA accredited dental will need to be completed. This is an agreement to write fewer school. We feel that where one received their dental training than the limited number of prescriptions per month. The form is not as important as the context of that training and skill set will be available at www.dopl.utah.gov/dentistry development. Utah has done well in the dental field to provide 2- The prescriber will need to write or print on each Controlled an opportunity for any well-trained dentist to obtain licensure. Substance prescription, “Unable to submit electronically” or We are opposed to anything that provides a pathway to licensure “Exempt from E-prescribing”. This will be what tells the Pharthat does not ensure the quality level or standard of care the macist why the prescription was not sent electronically. public expects. DOPL reminds all prescribers that all controlled substance preThis issue is not over yet. There are those in the Executive scriptions must be either e-prescribed or use the above method of branch and Legislative branch of Utah government that seek submission beginning Jan 1, 2024. DOPL will use the CS database deregulation of licensure laws or removal of things perceived as to monitor and identify issues. Remember to tell your patients that “Barriers to Care.” The UDA is actively opposing these actions this system is new and it might take some time for the Pharmacy 28 January / February 2024


Utah UtahDental DentalAssociation Association Utah Dental Association

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which would surely have a negative effect on Utah healthcare standards. A “short-cut” or removal of quality standards in dental training, would surely expose patients to harm because of the patients inability to determine healthcare provider level of qualification. We are working with the Dept of Commerce heads and DOPL heads to find adequate solutions and still maintain the Standard of Care the public expects.

Mate Act

Many of you are aware of the Mate Act (Medication Access and Training Expansion Act), which was an Act passed about a year or so ago that required 8 hours of Controlled Substance Training when renewing or applying for a DEA license. What does this mean for a dentist licensed in Utah? Answer: You likely already qualify without taking any extra CE courses! Why is that?: 1- If you do not intend to apply for a DEA registration, you are not affected. 2- This is a One-time requirement of 8 hours of CE on Controlled substances 3- There is a box to check on the DEA renewal application to comply 4- There are no audits or requirements to prove having taken the CE (Unless you are being investigated for other DEA violations) 5- Utah DOPL approved CE will count for the MATE requirement 6- Dental school graduates in the past 5 years – your training counts as completed 7- Training taken is retro-active. CE from the past counts. No minimum date. 8- If you have been licensed in Utah for the past 8 years. And you have complied with Utah law for completing two hours of Controlled Substance Training each licensing renewal cycle, You have already completed the 8 hours of CS training. For those still needing or wanting CE hours on Controlled Substances. There are free CE courses available to UDA members and can be found at www.uda.org/member-center/course-library

Licensure Classifications and email addresses

Near the end of September, each licensed dentist in Utah was re-issued their existing dental license with the newly updated classification categories. Gone are the code phases of Class I, II,III, IV or Class A, B, C, D, E. Now, the classification on your dental license reflects the level of Sedation or Anesthesia you are legally qualified to use in your dental practice. These are based on the ADA Guidelines for Sedation and Anesthesia. A pdf document is available at this link: https://www.ada.org/-/media/project/ ada-organization/ada/ada-org/files/resources/research/ada_sedation_use_guidelines.pdf?rev=313932b4f5eb49e491926d4feac00a14&hash=C7C55D7182C639197569D4ED8EDCDDF6 There are a couple of items to confirm or be aware: 1- Did you get the email with your new license classification? 30

The email would have come from an address of: StateOfUtahCommerceLicensing@utah.gov arriving around Sept 26th, 2023. The reason knowing you received this license update is important, is all future license renewals and valid licenses will be sent through this email process. (If you didn’t get the email, Does DOPL have your correct email address? Will you receive your renewal application or license this Spring?) 2- Always check that your licensing classification matches how you use sedation and anesthesia in your dental practice. If you are exceeding your licensing classification while practicing, it’s likely your malpractice insurance will not cover you if ever an issue arises. With all the license classification changes over the past 5 years, it would be wise to ensure your license classification level matches what you think it should and therefore, you are not practicing beyond your licensing level.

Rules for Moderate Sedation

Many of you were in attendance last March at the 2023 UDA Convention when a Sedation update course was being taught by Mitch Duckworth, DDS. There was a discussion generated about the safety and need for two ACLS or PALS certified individuals in an operatory room when conducting treatment using Moderate Sedation. There have been no significant issues or risk to the public with only having a single ACLS or PALS certified individual. Therefore, DOPL has researched and modified the Rules to reflect the following: R156_69-302a (2) is modified to lessen the regulatory burden on the dentists who perform moderate sedation by reducing the requirements for monitoring patient oxygenation to the use of an oximeter. The rule is also changed to require one person to be in the operatory that is ACLS/PALS certified instead of two. This should help most specialists and those using Moderate Sedation in their practice, to more practically remove barriers that might have existed if additional certified personnel were required to be present in the operating room.

Summary

There are also many other topics and concerns where the UDA has worked with DOPL for the benefit of the dentist and the dental team. As well as ongoing efforts to protect the public. Our ongoing and regular collaboration with DOPL officials has benefitted all Utah Dentists and Hygienists. This alone should be enough value and benefit to the individual dentist to maintain one’s membership in the Utah Dental Association.

Note

DOPL representatives will be attending the 2024 UDA Convention on Feb 1st and 2nd at the Salt Palace in SLC. They will be there to answer your questions on the Controlled Substance database, new Rules and laws that affect dentistry, and help you with license renewal questions. DOPL representatives have been working hard to help the dental profession and work out dental issues in our state. Stop by their table at the convention and thank them for their efforts to work with the UDA to make common sense decisions regarding dentistry in Utah. Val L. Radmall DDS UDA Executive Director January / February 2024


Resto ra t i on s w it h

Just One Shade Transcend composite allows you to complete restorations with just one shade, no blocker needed. The Universal Body shade is able to blend in with tooth structure of almost any color thanks to Ultradent’s Resin Particle Match™ technology. Because the refractive indices of the resin and the filler particles are so similar, Transcend composite is able to take on the shade of surrounding dentition.1 That means you can complete almost any restoration with just one shade of composite. Plus, Transcend composite features ideal handling for manipulation and sculptability.1 If you prefer a layering technique, Transcend composite also includes four dentin shades and two enamel shades, so you can choose the best technique for every procedure.

Before

After

Deep staining from amalgam tattooing presents one of the most difficult restoration situations to clinicians. In this case only the Transcend composite Universal Body shade was used to replace the amalgam, no blocker needed. Note the excellent color blending of the preserved oblique ridge.

Visit Booth #309 to learn more.

1. Data on file. © 2024 Ultradent Products, Inc. All rights reserved.



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