UDA Action

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Utah Dental Association, 801-261-5315 1568 500 W Ste. 102, Woods Cross, Utah 84010 uda@uda.org

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Photo Credit: visitutah.tandemvault.com/ Andrew Burr, Juanita Ah Quin, Kaia & Sierra Burr Scenic Byway Highway12, UT

WE ARE NOT ALONE

The board of the Utah Dental Association recently completed the annual Leadership Conference, where we gathered together with local district dental leaders from all over the state to offer instruction, share information, and visit with one another about dentistry through Utah. The following agenda items were topics of discussion:

• District leader responsibilities

• District meetings and activities, including social and CE events

• Welcoming dentists from all practice models

• Membership growth and retention

• UDA House of Delegates

• Engaging members, especially younger dentists

• District funds and finances

• CQI topics and dates

For many, it was their first time attending. Some were a little quiet or reserved at first, but once we broke into group discussions, everyone had the opportunity to share thoughts, ideas, complaints, and potential solutions to problems. I won’t go into detail here reporting specifics of our meeting. I suspect your local leaders will share things with you when meeting together in your districts. Or you can ask them to report on what was shared and discussed. Rather, I feel impressed to share a couple of my observations and feelings about what I saw from your state and local district leaders. I noted two things which showed me the importance of belonging to and participating in our dental association.

First, when we belong to our dental association, we need never feel like we’re alone in our journey. My family has recently been watching episodes of the series, “Alone” on Hulu. In this show, people apply to be contestants in a test of their skills to see who can survive the longest when placed in a wilderness environment, relying only on their individual skills and abilities, and what few items they’re allowed to take with them. And they must do this all alone, without anyone to help, and without contact with the outside world. The contestants selected to participate have all previously proven to have the appropriate level of expertise and experience which qualify them for potential success. They all begin the experience with a confidence that they will be successful at survival because of the skills and knowledge they have acquired over the years. One by one each contestant ends up “tapping out” due to injury, lack of food, dangers around them from wild animals or weather, or from illness. But by far the most common cause I’ve seen for people ending their adventure prematurely is the mental and emotional challenge and difficult of facing the experience along. One participant who ended up being the winner in his group observed, “The greatest tool or resource for survival is the person next to you. But we don’t have that. We have to do this alone.”

As dentists, we’ve all received the appropriate training, and have acquired levels of expertise and experience which may qualify us for potential success. We may feel confident in our skills and abilities and expect to be successful in our profession. But sometimes we may feel like “tapping out” due to unforeseen reasons, or failure to thrive in facing our journey alone. Your neighbors and colleagues at the Leadership Conference proved to me that no one needs to face their challenges on their own. Our greatest tools or resources for survival are the colleagues we have in our dental association! We do have that! We don’t have to do it alone! When one asks about reasons for belonging to the dental association, one of the best reasons for belonging is belonging.

When we belong, we will naturally have a desire to do our part in contributing to the success of the whole organization. We won’t just say, “What’s in it for me?” but we will feel the peace and satisfaction, and responsibility, of doing something ourselves to help others. This brings me back to a story I’ve shared before, and the second thing that impressed me at the leadership conference.

“One Friday when my wife and I drove to town we noticed a pile of trash on the side of the road. “Ewww. Somebody should clean that up.” On Saturday, when we drove to town we noticed the same pile of trash on the side of the road – spread out a bit. “Ick. I wonder why somebody hasn’t cleaned that up!” On Sunday when we drove to town we say the same pile, spread out a lot. “Yuck! I can’t believe somebody hasn’t cleaned that up!”

And the thought came, “You are Somebody”

So on our way to work this morning, armed with rubber gloves and a couple of trash bags, we became Somebody.

Moral of the story: Next time you think or say, “Somebody really ought to do something,” remember YOU are SOMEBODY!”

I saw all those dentists at the leadership conference who had decided to step up and be Somebody! They aren’t sitting alone in their own world complaining that somebody needs to do something about Utah’s low insurance reimbursements, or spouting off on other things we all seem to moan about. They have the same complaints and challenges as the rest of the dentists in the state, but they’ve decided to try to do their part, to be somebody and contribute to efforts made to come up with solutions to problems and issues. I am grateful to all who give of themselves for the benefit of the whole body.

These are your leaders, your colleagues, and your friends who strengthen and support our association, so that we are never along, and so we can join together to be somebody and make a difference and survive and thrive together.

Dr Kay Christensen UDA President

WHY ARE YOU HERE?

Recently, me and 60 other dental and medical caregivers returned from a G3 Foundation sponsored humanitarian trip to the Dominican Republic. Our group was made up of dentists, hygienists, dental assistants, dental students, a few teenage children of participating dentists and a small medical team. I often wonder what the impact a trip like this has on the dental students clinical training and patient care. I decided to ask one of the them to share his feelings about this trip. His name is Clint Stuart, he is a third year dental student at the University of Utah School of Dentistry.

“As Padre Rogelio Cruz spoke to the medical and dental professionals, he asked, “Why are you here?” (serving the people of the Dominican Republic). The Padre has a long affiliation with the G3 Foundation and has been instrumental in coordinating the efforts to help the poorest people of the Dominican Republic for many years. The question was a poignant plea asking people to evaluate what motivates everyone present to donate their time and talents to help these people.

The G3 Foundation has been traveling to the Dominican Republic twice a year for twenty years. Over those many trips, the foundation has taken 2,200 dental students along allowing them the opportunity of providing care to the Dominican people. The main goal of each trip is to provide dental and medical services to those who would otherwise not be able to access care. One unique quality of this Foundation is the portability of the clinic and services. Often the people that need the most help live great distances from the major cities, and the Foundation has worked out a way to take a comprehensive dental clinic to the people who could not access care in any other way.

As Padre Cruz spoke to our group, he was sincerely concerned about the destitute situation many of his fellow Dominicans face daily. Having participated on the previous G3 trip six months ago, I had already witnessed extreme poverty. I also benefited from the kindest acts of pure gratitude from these people. On the first trip, a classmate and I were walking down the street during a lunch break when two elderly gentlemen signaled from their tin roof thin-walled shack and asked us to come in and sit with them. These two men, weathered from the Caribbean sun and long hours of back-breaking labor, offered their lunch to us as a thank-you for coming to help the people of their village. As we talked with them, we realized they were not looking for anything in return. They were just grateful someone cared enough to come to help their community.

This return visit caused me to pause and answer Padre’s question about why I was there. With the vast poverty, were we making a difference for these people? The G3 Foundation could set up a clinic in the Dominican and work around the clock for years and not be able to meet the dental needs we encountered. On this trip we were reminded by one of our medical colleagues that had recently returned from Ukraine that this problem is not limited to the Dominican Republic. Many of the dentists in attendance emphasized the point of vast needs and opportunities to serve within our local communities.

One of the missions of the G3 Foundation is to also provide learning experiences through hands-on mentoring. The goal is to take the basic principles we are taught in dental school and apply them with the personal guidance of a tenured dentist. This trip was an incredible opportunity for dental students. As many know, the many requirements of dental school do not allow adequate time to perfect specific techniques. Instead, we become a “Jack of all trades and the master of none. “One of the objectives of these humanitarian trips is to offer various experiences ranging from endodontics, pediatrics, oral surgery, hygiene, and restorative. The sheer volume allows for repetition, which is impossible in dental school. Many of the dental students were able to perform more root canals and stainless-steel crowns in a single four hour session, than they had in an entire year of formal education. This repetition solidifies our knowledge and accelerates our clinical skills.

I experienced exponential growth every day I was in the Dominican Republic. My confidence increased. But most importantly for me, I could look beyond the procedure and see the individual who was willing to trust me enough to get in my chair. I have extremely limited Spanish speaking ability, but I could see the patient and connect with them in a way that I did not know was possible. For example, a middle-aged gentleman had multi-surface caries on teeth #7-10. The Endodontists helped a classmate perform root canals on #7 and #10, and the patient was transferred to restorative for fillings. The patient was a pleasant man who patiently waited his turn. He sat with a calm demeanor but would only open his mouth when he was asked. When he sat in my chair, he promptly laid back and opened his mouth as wide as possible. Restorations were completed on teeth #7-10 with the help of a classmate and wonderful assistants willing to work together to meet this patient’s needs.

The connection with the patient came when the team had completed the work and he could see the result. This gentleman would not stop smiling. He had a beautiful large smile that was contagious. All could feel his joy and gratitude. We could not cure all the oral health problems for the people of the Dominican Republic, but for this one person, we helped create a lasting impact on his life. We would share stories from the day when we returned to our lodging. There was no shortage of uplifting and inspiring stories from every dental student in attendance.

Two recurring themes were found in each story. First, each student experienced profound personal and clinical growth. Second, each day we left invigorated by the joy and gratitude offered by the Dominican people we were able to serve. My personal growth as a clinician and the tender moments of appreciation from the people were the answers to Padre Cruz’s question about why I was there… To make a difference where possible.

The trip to the Dominican Republic had a profound impact on me. I feel fortunate to have met and worked alongside many talented dentists who emulate integrity and charity. The passion I have found for service early in my dental career will have a significant impact for many years to come. I am grateful for the opportunity to accelerate my clinical skills, which will help me to maximize my potential as a future dentist.”

Dr Len Aste UDA Treasurer

I took over my father’s dental practice after his unexpected passing in 2006. He had practiced dentistry for about 25 years and was well known amongst dentists for the great dentistry he provided for his patients. My dad purchased the practice from another great dentist, Dr. Frank Smith. Frank was a great dentist too from what I can tell. His patients adored him and appreciated the great work he did for them. I still see some of his work. I used to see more of it 15 years ago, but many of his patients have passed away now. I am still in awe of the quality of dentistry he could produce. Somewhere along the way my dad picked up a set of 2.5x magnification Orascoptic loupes. They were the flip up style mounted to a set of gold wire frames and at some point, he added a fiber optic head lamp to help improve the quality of dentistry he could do.

Materials have come a long way since Dr. Frank Smith and my dad practiced. Materials to do micro preventative resin restorations weren’t available and endodontic treatments and outcomes have improved significantly since that time, but magnification has sure helped improve the outcomes in dentistry.

While I was in dental school magnification was becoming standard for students and after moving to Salt Lake City after a brief couple of years serving as a dentist in the Navy, I purchased a pair of surgical microscopes. I have always liked seeing what I am doing, and my experience using a microscope in the Navy made the purchase an easy choice.

The microscopes were not cheap, but they were an investment in me and for my patients.

Loupe technology has come a long way since the first set my dad purchased. The optics and illumination have improved significantly but I’m not ready to go back. I’d miss the large viewing field and the amount of shadow free illumination the microscope provides.

There are many benefits to practicing with a microscope. Some of which are the increased ability to diagnose and treat lesions, improving restoration margins and reducing voids and defects, the ability to locate additional canals, finding fractures in teeth, finding the pdl around a fractured root tip during a difficult extraction, removing broken and damaged implant screws and abutments…the list goes on and on.

The microscope also makes my life easier. Gone are the days of slouching over a patient to see the area I am working on with a pair of heavy loupes and a headlamp strapped to my head. No more dead batteries either. The microscope forces you to sit up straight and look forward. The highly adjustable microscope does all the acrobatics for you. I don’t come home with a tired back or shoulders and my eyes don’t feel strained either.

An assistant once asked if I wanted to order a new light bulb for my handpiece. I hadn’t noticed it had gone out. I asked her how long she had noticed it was out. She replied for at least a couple of weeks. The microscope more than made up for the little illumination the fiber optic light on the handpiece.

There are great reps who would love to come demo a microscope in your office if you are interested. I opted for ceiling mounted microscopes. They tuck up and out of the way when not in use. It took a bit of engineering and reinforcement in the ceiling to support the weight of the microscope and to eliminate any drifting that may occur. Wall mounted microscopes typically require some reinforcement also, but it was worth the effort.

Many friends have stopped by the office over the years to view the microscopes and all of them have added them to their practice and have enjoyed the investment as much as I have.

I find myself working on projects at home wishing I could see the details a little better. I’m still convinced it’s not my increasing age but the fact that I know I can see it better than anyone with my microscope.

I still have a hard time believing the quality of dentistry past generations of dentist were able to accomplish without magnification but I know we can and do it better.

Dr Greg Gatrell UDA Past President

LEGISLATIVE

INSURANCE CARD UPDATE

During the last five years the Utah Dental Association has made great strides in dealing with Insurance Reform through the legislative process. These bills that have been passed unfortunately only apply to State Regulated Insurance plans. The UDA office often gets calls asking which plans are state regulated and which ones are federally regulated. With the variety of insurance plans and the many variations of each plan, we previously have not been able to determine whether a plan was state or federally regulated.

The UDA has been working with Rep Jim Dunnigan and the Insurance Commissioner’s office. As a result, effective July of 2023, the patients’ health ID card should indicate if a patients plan is a state regulated plan. Look for that designation on the Patient ID card (both sides should have the designation)

This will give dental offices the information needed to use the bills that have been previously passed without guessing if those bills would apply.

With the legislation that has been passed the past few years on dental insurance reform, we are hearing more and more reports of various insurance companies not complying with the new laws. The Insurance Commissioner’s office has asked us to collect the details and information of which companies are dodging the laws. In order to better fight back on those situations where the laws are not being followed, we need you to report to us the violations as you experience them. As we gather this information, the Insurance commissioner’s office can force the insurance companies to “play by the rules”. This will allow dental offices to use the Legislative successes to their full capabilities.

Volunteer Dentists and Hygienists Needed for Project Homeless Connect - Friday, March 24, 2023

Project Homeless Connect is a one-day event at the Salt Palace Convention Center where over 1000 unsheltered members of our community receive essential services, including medical, dental, vision, legal, recovery, and wellness care. Nearly 100 organizations and 900 volunteers attend to offer services. The dental area is one of the most popular services; In 2019 over 200 people received dental checkups, cleanings, or extractions.

www.phcslc.org

We are looking for dentists and hygienists to volunteer on Friday, March 24, 2023. If you are available, please contact nicolehandy@gmail. com for more information.

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� Dr. David Chamberlain

The 2023 Utah Dental Association is Just Around the Corner!!!

Thank You to Our 2023 Convention Sponsors

Register Now at www.uda.org

New This Year

The Dental Education Platform – Presentations will be available throughout both days of the Convention.

Dental Education Platform Presentations (Thursday)

Thursday, March 30 @ 9:00

Company: Prosites

Presenter: Keith Washington

Title: Building Patient Trust to Provide a Higher Level of Patient Care

Description: Dental Practices are at a crossroad: either adopt technology and become more efficient, or stick with traditional methods and risk financial health, team well-being and patient relationships. Becoming “tech-forward” may sound daunting but the benefits gained, from work-flow efficiency to improved patient care, are well-worth the bumps in the road. Join us as we take you on a lesson-filled client journey through a technology-forward practice.

Thursday, March 30 @ 10:00

Company: DrillDown Solutions

Presenter: Stephen Nance

Title: Navigate economic ups and downs using tax planning and mitigation.

Description: The last few years have been filled with uncertainty for the US and the world. Join Stephen Nance from DrillDown Solutions and learn how to navigate the economic ups and downs. Discover how to benefit from new tax rules. Plus, he’ll cover tax strategies dental professionals can use

including:

• Retirement plans

• Employee Retention Credit

• Small businesses & the self-employed deductions

• Evolving legislation

Thursday, March 30 @ 11:00

Company: Birdeye

Presenter: Dr Leonard Tau

Title: Raving Patients: Get Visible, Get Credible, Get More Patients

Description: In our internet age, you might think that Facebook ads, Yelp!, Google, or some other new marketing tactic would overtake word of mouth as the leading contributor to our new patient pipeline. While there’s some truth to that, the bottom line is those tactics haven’t replaced word of mouth. In fact they make word of mouth even more important. But word of mouth has evolved…

Today word of mouth includes what people say about you online in the form of online reviews.

Online reviews are now one of the biggest ranking factors in a local search and in whether people referred to you ultimately schedule an appointment. If people are referred to you, they search you before scheduling an appointment. If they don’t see recent, relevant, positive reviews when they search for you, they’ll ask another friend for a recommendation.

The Dental Education Platform is located in the back of the exhibit hall. (These presentations will be conducted by certain vendors that are exhibiting in the exhibit hall)

Thursday, March 30 @ Noon

Company: Biolase

Presenter: Steve Ross

Title: Innovations in Laser Dentistry

Description:

Erbium Lasers

• Highly Efficient Crown & Veneer Removal

• Restorations (with fewer injections)

• Minimally Invasive Perio

• Peri-Implantitis Treatment

• Single Visit Endo

• Frenectomies

• Esthetic Dentistry

• Herpetic Lesion Treatment

•

Diode Lasers

• Wavelengths

• Non-Surgical Perio

• LBR vs LAPT

• Photobiomodulation

• Laser Whitening

Thursday, March 30 @ 1:00

Company: My Practice My Business

Presenter: Dr Rob Throup

Title: The Clinical Business of Dentistry

Description: Insurance plans shrinking your profits? Working harder and taking home less? By attending this 45-minute seminar, you will be introduced to business skills that are much needed in dentistry and truths about dental insurance (as revealed by them) that will help you be profitable!

Thursday, March 30 @ 2:00

Company: Dentist Advisors

Thursday, March 30 @ 3:00

Company: Shatkin F.I.R.S.T

Presenter: Dr Todd Shatkin

Title: Mini Dental Implants for Long Term Fixed and Removable Prosthetics and Live Implant Placement

Description: In this course Dr Shatkin will be discuss and demonstrate the following topics:

Using the MDL Mini Dental Implants for lower and upper denture stabilization.

Using the MDL Mini Dental Implants for partial dentures.

Using the MDL Mini Dental Implant(s) in fixed applications for individual and multiple missing teeth.

How and when to use the bendable Mono Mini Dental Implants.

Using the MDL and/or Mono Mini Implants for full arch fixed applications.

Dental Education Platform Presentations (Friday)

Friday, March 31 @ 9:00

Company: Dental Intel

Presenter: Steve Jensen

Title: Intelligent Dentistry – Secrets of the Top 10%

Description: Dental Intelligence actively monitors the data from 10,000+ dental practices watching industry trends, shifts, and top-performing practices. We’ll walk through the most recent trends/problems and some rock-solid solutions. There’s no fluff, no messing around, just a PROVEN formula that you can follow to improve patient care, team performance, & practice profitability. By the time we’re done, you’ll have the inside scoop on how the top practices in the U.S. are thriving in a continually evolving marketplace.

Friday, March 31 @ 10:00

Company: Prosites

Presenter: Keith Washington

Title: Building Patient Trust to Provide a Higher Level of Patient Care

Description: Dental Practices are at a crossroad: either adopt technology and become more efficient, or stick with traditional methods and risk financial health, team well-being and patient relationships. Becoming “tech-forward” may sound daunting but the benefits gained, from work-flow efficiency to improved

Photo by Jon Flobrant on Unsplash

patient care, are well-worth the bumps in the road. Join us as we take you on a lesson-filled client journey through a technology-forward practice.

Friday, March 31 @ 11:00

Company: eAssist

Presenter: Natalie Rogers

Title: Three Ways to Avoid a Dental Billing Mess

Friday, March 31 @ Noon

Company: Birdeye

Presenter: Dr Leonard Tau

Title: OMG, I got a Bad review: What do I do

Description: It doesn’t matter how hard you work or how well you treat patients, it’s only a matter of time before someone leaves you a negative review. It happens to everyone. It’s only a matter of time. Unfortunately, many practice owners make one of several big mistakes when this happens… some that cause even more reputation harm… others that can even get them into legal trouble. The truth is, the perfect practice is not the one with perfect reviews; it’s the one that deals with reviews perfectly.

Friday, March 31 @ 1:00

Company: Brasseler

Presenter: Chanda Ellis, Regional Sales Manager; Carolina Solano, District Sales Manager; Alex Thatcher, District Sales Manager

Title: Procedural and Instrumentation Solutions to Grow Your Business

Description: Brasseler is an industry leader in rotary instruments such as diamonds, carbides, and polishers with a specialty focus on Endodontics and Restorative materials. The presentation will discuss our company history, core values/vision, legacy products, advances in product line within Brasseler, partnership with customer to grow business, affiliation with institutional customers/DSOs/Group Purchasing

Friday, March 31 @ 2:00

Company: Provide

Presenters: Steve Steinbrunner and Brian Carroll.

Title: A Financial Roadmap for Your Dental Practice Journey

Description: Independent dentists and physicians often begin their journey with an eagerness to provide exceptional clinical care for their patients; however, the business of healthcare can be overwhelming and complex. This course is intended to share a financial roadmap - from a leading healthcare bank - that will help the independent practice owner understand how to buy or build their first practice, expand or grow that practice later on, and finally prepare for the proper exit or practice sale at the end of their journey.

Friday, March 31 @ 3:00

Company: Lighthouse 360

Presenter: Riley Banks

Title: Keep your patients, grow your practice

Description: On average, 1 in 4 patients leave your practice

every year. Join us as we discuss why your patients are leaving and how you can lead the effort to enhance the patient experience to delight, attract, and retain more patients.

Hands On Workshops are Still Available to Register For

(These courses will require an additional fee to register)

Hands On Courses for the Dentist

Anatomy Flashback: What you NOW realize you really needed to know!

Wayne Cottam, DMD, MS

Limited to 20 participants (Thursday AM and Friday PM)

This course will review the relevant anatomy for a general community-based dentist and apply that knowledge to common procedures and therapies completed in the CHC setting. This fast-paced session will include hands on, active learning with high quality artificial skulls and interactive activities and learning. Topics will include: a review of innervation and blood supply to the oral cavity; a review of the relevant anatomy related to anesthetic injections; attachments, actions, and innervation of the muscles of mastication; basic TMJ anatomy and relevant anatomy of the floor of the mouth, tongue, palate and paranasal sinuses.

Achieving New Levels of Success in Endodontic TherapyHands

on Endo Workshop

Reid Pullen, DDS

Limited to 40 participants (Thursday PM)

From diagnosing and establishing your endo treatment plan to achieving a dense, three-dimensional fill, you’ll learn modern, step-by-step procedures for everyday use. You will also learn how to safely and efficiently maneuver around challenging curves and create and ideal glide path, when to use more complex techniques and how to avoid post-treatment disease. Take your practice to the next level with core concepts from a fresh perspective by learning how to successfully perform modern, basic techniques and why they are important.

A Mini-Residency in Pediatric Dentistry: Learning Lab

Barney Olsen, DDS, MS

Limited to 20 Participants (Friday AM and Friday PM)

This hands-on learning lab will be interactive requiring you to learn 6 important skills in Pediatric Dentistry in a lab setting: 1) Intra osseous anesthesia. 2) Hall Crown fitting and placement. 3) When and how to use SDF. 4) How to access caries risk and each patient and how that will guide your restorative therapy. 5) How and when to do minimally invasive dentistry. 6) How to fit and construct 5-minute space maintainers. We will be working on tables in groups of 5.

Hands On Course for the Hygienist

Local Anesthesia Technique Hands-On Workshop

Alberto Varela, DDS

Limited to 40 participants (Thursday PM, Friday AM, and Friday PM)

Come receive guidance and practice your local anesthetic technique at this hands-on workshop! You will be guided by licensed dentists who can help give you tips and tricks to improve your technique. In this course, you will have the opportunity to demonstrate your current technique, discuss the challenges you face in obtaining profound anesthesia, and receive guidance on methods that may enhance your success. Safety needles will be used for this course. No live needles will be present. Feel free to bring your loupes and headlight.

Hands on Courses for the Assistant

The Role of the Dental Assistant – Techniques and Technologies That Help Deliver “World Class” Dentistry –Hands On Workshop Part I

Shannon Pace Brinker, CDA

Ewa Bujalski, CDA

LaShae Steele, CDA

Ariela Myler, EFDA

Limited to 100 participants (Friday AM)

The ideal dental team must be current and knowledgeable in materials science and be proficient in the various step-by-step procedures that are now required to deliver state-of-the art dentistry to the patient. Increase your artistic skill and satisfaction by learning about materials and techniques that can help deliver to the patient the best dentistry has to offer! This is one comprehensive course that every dental assistant needs to attend!

• Infection Control: Dental assistants must thoroughly conceptualize the best means to comply with those minimum infection control requirements set forth for dental settings. Compliance is critical to adhere to state dental boards, laws, and regulations. The primary intention is to limit the threat of exposure for dental clinicians and the greater public.

• Digital Photography (Both SLR and Point and Shoot): In this digital age, effective patient and lab communication is predicated on clinical photography. This lecture will provide dental assistants with the necessary skills to shoot basic photographs for quick co-diagnosis, as well as pre-treatment, treatment, and post-treatment clinical angles required for documentation and lab communication purposes. How exquisite provisional restorations serve as an anatomic (functional) and esthetic blueprint for laboratory and lab communications.

• PVS vs Alginate. Alginate Impression Techniques: Dental impressions are essential in dental practice for obtaining accurate representations of hard and soft oral tissues. As scientific advancements continue to enhance impression materials and techniques, progress will continue to be made to simplify the impression taking process and ensure greater accuracy and material stability. Although a variety of materials are available that represent long-lasting alginate impression material that can withstand longer storage periods and times-before-pouring without losing its accuracy.

• Anterior Provisional Restorations: This session will present a philosophy of esthetics centered on the concept of natural beauty created from research in the fields of both art and science. Esthetic success depends not only on the creation of a beautiful smile but ensuring optimal function and health.

The Role of the Dental Assistant – Techniques and Technologies That Help Deliver “World Class” Dentistry –Hands On Workshop Part II

Shannon Pace Brinker, CDA

Ewa Bujalski, CDA

LaShae Steele, CDA

Ariela Myler, EFDA

Limited to 100 participants (Friday PM)

The ideal dental team must be current and knowledgeable in materials science and be proficient in the various step-by-step procedures that are now required to deliver state-of-the art dentistry to the patient. Increase your artistic skill and satisfaction by learning about materials and techniques that can help deliver to the patient the best dentistry has to offer! This is one comprehensive course that every dental assistant needs to attend!

Learning Objectives:

• Isolation Techniques from Retractors to Rubber Dam Placement: With today’s heightened awareness of infection control, patient safety, and technique-sensitive

dental materials, meticulous operative field isolation is mandatory. Today the rubber dam is the standard of care for isolation during restorative procedures and should be employed whenever possible. Once the teeth are isolated for any proper restoration, we also must not forget about tissue management. This management begins with rapid profound knowledge of hemostasis. For every restoration— direct or indirect—controlling hemostasis is necessary.

• Fluoride, Coronal Polishing, and Sealant Placement: Mouth rinses, fluoride varnishes, and dental sealants provide excellent resources for preventative care and maintenance of good oral hygiene. Mouth rinses combat periodontal diseases, dry mouth, and bad breath. Fluoride varnishes and sealants both work toward specifically preventing dental caries. Fluoride varnish, well accepted by children, provides an ideal fluoride treatment. Similarly, the improvements in sealants over the past 40 years make them a cost-effective and reliable preventative measure.

• Posterior Provisional Restorations: Provisional restoration is a critical phase in the treatment of the dental patient. The design for the provisional restoration begins with a gathering of diagnostic information, which includes the desires of the patient and dental team. The hardest part of the fabrication process is not the trimming or the finishing, but the carving of the anatomy and the occlusion.

• Whiter, Brighter, Healthier Teeth: The course will cover practical techniques for in-office and take-home whitening. Fulfilling the desire and demand to have a bright and white smile is the goal of every dental practice. A bright smile not only presents a healthy and beautiful impression but also increases one’s interest in oral hygiene, allowing the patient to have higher self-confidence. Before the patient can go through the whitening process, we must have a proper consultation to understand the patient and their desires—and determine which of the various product options to recommend.

Team Luncheon

Thursday, March 30

Noon–1:45 pm

Marriott City Creek Hotel

75 S West Temple

Admission by ticket only

Cost $25 per person, must pre–register at www.uda.org

Oh That’s Bad… NO, That’s Good!

John Bytheway, BS, MA

Life is never easy. But some of the hardest situations in life can bring positive results when approached with the right attitude. We’ll talk about a three–word formula for creating perspective, and how to deal with others on your team with respect and optimism to bring out the best they have to offer. Expect to laugh. Outloud! A lot. And to learn a thing or two along the way.

Seating for the team luncheon is assigned when you register. Group tickets must be purchased together so you can be seated in the same area. There are 10 seats per table. Tickets with table numbers will be mailed to you with your name badges. There are no refunds or changing of tables after tickets are mailed from UDA.

CONVENTION EXHIBITORS

Company

A-dec

AB Creative

Abundant Dental Care

Accelerate Dental

ADIT

Aetna

America First Credit Union

American Diamond Instruments

Arrowhead dental Laboratory

Artcraft Dental

Aseptico

Bank of America Practice Solutions

Bank of the West

Bear Bones IT

Wonderpax

BioGaia

Biolase

Birdeye

BISCO

Brasseler USA

CAO Group

CariFree (Oral BioTech)

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HALF OF DENTISTS SAY PATIENTS ARE HIGH AT DENTAL APPOINTMENTS

MARIJUANA USE MAY AFFECT ORAL HEALTH AND TREATMENT

As personal and medical marijuana use increases nationwide, the American Dental Association (ADA) suggests patients refrain from using marijuana before dental visits after a new survey finds more than half of dentists (52%) reported patients arriving for appointments high on marijuana or another drug.

Currently, recreational marijuana a use is legal in 19 states and the District of Columbia, with five more states voting on ballot measures Nov. 8. Medicinal use is legal in 37 states and the District of Columbia.

“When talking through health histories, more patients tell me they use marijuana regularly because it is now legal,” says ADA spokesperson Dr. Tricia Quartey, a dentist in New York. “Unfortunately, sometimes having marijuana in your system results in needing an additional visit.”

That’s because being high at the dentist can limit the care that can be delivered. The survey of dentists found 56% reported limiting treatment to patients who were high. Because of how marijuana and anesthesia impact the central nervous system, 46% of surveyed dentists reported sometimes needing to increase anesthesia to treat patients who needed care.

Findings were uncovered in two online surveys earlier this year – one of 557 dentists and a second nationally representative survey of 1,006 consumers – conducted as part of trend research by the ADA.

“Marijuana can lead to increased anxiety, paranoia and hyperactivity, which could make the visit more stressful. It can also increase heart rate and has unwanted respiratory side effects, which increases the risk of using local anesthetics for pain control,” Dr. Quartey said. “Plus, the best treatment options are always ones a dentist and patient decide on together. A clear head is essential for that.”

Studies have also shown regular marijuana users are more likely to have significantly more cavities than non-users.

“The active ingredient in marijuana, THC, makes you hungry, and people don’t always make healthy food choices under its influence,” Dr. Quartey said. “Medically speaking, munchies are real.”

The science behind oral health and marijuana is beginning to emerge, particularly when it comes to edible or topical forms. Still, there are strong indications that smoking marijuana is harmful to oral and overall health. The ADA surveyed 1,006

consumers in a second poll around marijuana and vaping use. The results of the representative sample found nearly 4 in 10 (39%) patients reported using marijuana, with smoking the most common form of use. Separately, 25% of respondents said they vaped, and of those respondents, 51% vaped marijuana.

“Smoking marijuana is associated with gum disease and dry mouth, which can lead to many oral health issues,” Dr. Quartey said. “It also puts smokers at an increased risk of mouth and neck cancers.”

The ADA has called for additional research around marijuana and oral health and will continue to monitor the science to provide clinical recommendations for dentists and patients.

In the meantime, survey results show 67% of patients say they are comfortable talking to their dentist about marijuana. The ADA recommends dentists discuss marijuana use while reviewing health history during dental visits.

“If we ask, it’s because we’re here to keep you in the best health we can,” Dr. Quartey says. “If you use it medicinally, we can work with your prescribing physician as part of your personal healthcare team.”

In the meantime, patients who use marijuana can stay on top of their oral health with a strong daily hygiene routine of brushing twice a day with fluoride toothpaste, cleaning between teeth daily and visiting the dentist regularly and making healthy snack choices.

For more information on the oral health effects of marijuana, visit ADA.org.

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TEN FINANCIAL STRATEGIES TO SUCCEED IN DENTISTRY

As dentists we are blessed with having a great profession. There is no other career I know of where you can be your own boss, work in the manner that you choose and create a great life for your family.

Dentists also have an opportunity to earn a tremendous amount of money by working as hard as they choose. Over the course of an average 35-year career, a dentist can easily collect over $30,000,000 in his or her office. Many dentists will do far more than this.

A dentist can also easily average $250,000 - $350,000 in take home pay yearly. Why is it then that only about 10% of dentists can afford to retire and stay at the same standard of living? It’s not that we don’t make enough money. As the saying goes, we don’t plan to fail. We just fail to plan.

In this article, I will share 10 financial strategies to help dentists reach their goals. By using these proven, highly effective strategies, we can move confidently towards becoming financially independent.

1. Develop a Written Financial Action Plan. Create this plan as early as possible and don’t stop. Having a written plan that spells out exactly what you will accomplish and how you will do it, greatly increases the chances of success. Keep the plan in various places where you can easily see it every day. By constantly reminding yourself of your objectives, success comes more easily. If you need help in creating a plan, work with a financial professional. It will be money well spent.

2. Live Below Your Means

Human nature causes us to try to live at or above our means. When we first start our careers, we have to be more frugal with our spending. We typically aren’t making as much money, so we don’t get into as much trouble. As we earn more, we justify the increased spending by saying we deserve it. There is always a tug of war between our current desires and our future needs. Most of the time, the current desires win. One way to help prevent this is to visualize your future self. What will your financial situation be like in 15-20 years, if you keep doing what you are now? In the fourth strategy, I will show how dentists can provide for their future without sacrificing the present.

3. Maximize the Collections in Your Dental Practice

By working at an increased level, you create more production and collections. Most dentists are working close to half their possible capacity. The problem is we don’t usually know how to fix our issues. Some type of change is needed. This change could be in your facility, your staff, your skills, or even in yourself. Many times, in a dentist’s career, they will reach a point where the practice hits a plateau. The dentist feels like they are working as hard has they can, in their current office, with the staff they have and the systems in place.

It feels like they have hit a wall. Usually, a fundamental change is needed. Typically, the dentist will need help making these changes. Consultants that help with practice management issues are not inexpensive. They are however, worth every penny if they can facilitate the needed change.

4. Invest Automatically

This is a key to becoming wealthy. Your financial life should run on systems, just like you dental practice. By scheduling saving and investing to occur automatically every month, you are accomplishing many great objectives. First, the money goes directly from your business account to your investments. It doesn’t get sent home where it will be spent. The prescribed funds go automatically into the investments every month. By doing this, you are dollar cost averaging into the market. When the market is down, you are buying in more shares with the money. When the market is up, you are buying less shares with the same amount of money. By using this principle, you are being smart without having to try. By saving and investing automatically over the years, you will create wealth. The money will arrive exactly where it should be, and you won’t ever miss it.

5. Always Have Your Money Working

As dentists, we work hard for our money. It should work as hard for us. No one can effectively time the market. In order to do so, one must be right twice. Once when you take the money out of the market and then again when you put the money back in. This is impossible. However, by developing a sound investment strategy and a good long term plan, and by keeping your money invested, you can benefit from good markets and rebounds in bad markets. Studies show us that the best days in the market usually occur right after the worst days. By keeping your money invested, you won’t be tempted to pull the funds out at the worst time. Most dentists tend to hoard cash in their business accounts, all the while earning next to nothing from their bank. While it is prudent to keep an emergency amount of cash on hand to take care of any unforeseen events, most dentists have way too much cash on hand. They never realize the lost opportunity of having that money working for them. With inflation running high, money in the bank could be losing up to 8-9% in spending power.

6. Rebalance Your Portfolio Quarterly or Yearly

This is how the principle works. For example, initially your investment portfolio is created with 60% stocks and 40% bonds asset mix, based on your particular risk tolerance. Then, over the course of a year, if the stocks do well, but the end of the year your portfolio would look like 70% stocks and 30% bonds. In order to rebalance to your original asset allocation model, you would sell some stocks that have appreciated and buy some bonds that are lower. By doing this, you are returning to your original 60/40 model. More importantly, you are selling high

and buying low which is the smart way to invest. Having your portfolio rebalanced automatically ensures it will happen.

7. Reduce Your Taxes Constantly

The effect that taxes have on the ability to build wealth is enormous. By regulating participating in pretax retirement plans in your dental practice one can save a tremendous amount on taxes. Money is saved pre-tax and grows tax deferred within the plan. Retirement plans come in many types and sizes. Examples can include 401K plans, SIMPLE plans, and SEPs. Consult with a financial professional to help evaluate which plan is right for your dental practice. Also, knowing which type of investments to hold in various types of accounts is important. For example, in non-qualified accounts where you are taxed yearly on any gains it is vital to hold appropriate investments. Possibilities could include municipal bonds that give fed tax free income, growth stocks that you want to hold for a long time and dividend producing stocks. Furthermore, working with a dental specific Certified Public Accountant (CPA) is very important. The CPA can help you save on taxes every year. One of the biggest tax issues that can occur is when a dental practice is sold. It is extremely important to structure the sale properly. This is very complicated topic which should be dealt with in another article.

8. Working with A Financial Professional to Help You Optimize Your Outcome

Studies show that people who work with a financial advisor can potentially improve up to 2-3% better annually in investment performance over those who don’t. Sometimes getting advice when facing various financial and business issues can help dentist avoid mistakes. Find an advisor who has knowledge and experience with dental practices. By sharing ideas and befitting from experience, you can shorten the learning curve significantly.

9. Reverts to Strategy 1, Review and Adjust Your Financial Action Plan Periodically

Even a well thought out plan need evaluation and adjustments occasionally. Time, changing issues in dental practices and circumstances of life will dictate periodic adjustments. As the saying goes, most plans don’t survive first boots on the ground. Communication and flexibility help you to continue to benefit from the plan and move towards the ultimate goal of financial independence.

10. Maintain Your Focus on Your Long-Range Goals

We are bombarded everyday with news, noise in the media and meaningless babble. Markets will go up and down, but the prudent dentist knows to filter out most of the daily noise. Over time, a well thought out and followed plan increases the chances of success. The daily rantings and raving of media announcers and daily market moves don’t mean much in the long term.

Keep your focus on what’s important in your life. Your family, faith, long term goals and your dental practice should be the focus. By maintaining this focus, you move confidently in the direction of your dreams.

Dr James Pitt II

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LEADERSHIP CAN TAKE ON MANY FORMS

Leadership in the dental field takes on many forms. From leading our own team members in the office every day to our involvement in organized dentistry and in our communities, we find ourselves called to be leaders more often than we realize. Effective leaders are passionate, committed, inquisitive, solicitous and available. They lead with integrity, handle conflict fairly and maintain confidentiality where required. While some of these qualities are inherent to the individual’s personality, many of these traits and abilities can be improved through learning opportunities and practice.

Leadership within a dental practice is frequently combined with management, and the lines are commonly blurred between the two. Leaders formulate ideas and motivate their teams to understand the vision they have set forth. Managers focus on the day-to-day activities, setting measurable goals to report success. In small businesses, these two roles often are combined and frequently overlap. My partner, Dr Ryan Caudill, and I own and manage our office, and we work hard to be as organized and clear as possible to our 18 team members. We spend time training them, outlining expectations and cultivating problem-solving skills to improve self-awareness. Our morning huddles, monthly team meetings, and yearly staff reviews keep everyone focused on common goals and ensure processes are consistently followed. We also take each team member to lunch one a year on their own with the doctors to get to know each other better. Our yearly patient appreciation parties and team-building days outside the office setting are some of our favorite memories together and help strengthen these relationships. I am a more effective leader when I better understand the person I am leading.

Leadership outside the office in our communities and professional organizations can be a challenge with varying personalities and leadership styles. Staying positive and focusing on the task at hand are helpful in achieving a favorable result that benefits everyone. At Dentists’ Day on the Hill each year, I am reminded that community leaders are looking to us for guidance on critical issues, and actively listening to understand others is the first step.

I’ve found that the most important piece of leadership is cultivating personal relationships. Becoming genuinely interested in others and getting to know them on a personal level builds trust and rapport. I aim to bring others into the conversation as much as possible, creating a safe space to voice opinions while encouraging others to listen and reflect attentively. This is especially important in our virtual (Zoom) meeting spaces, where having your camera on, being engaged and calling on those who may be more reserved is essential for ensuring everyone’s perspectives are heard and team decisions are made. As a leader, I also strive to be as available and responsive as possible, ensuring fellow colleagues and community members have my cell-phone number so they can really reach me at any time. Responding to emails, texts, phone calls and social media messages in a timely manner (aka as quickly as possible) is a vital sign of respect.

I strive every day to improve my own leadership skills through building relationships, communicating clearly and showing integrity. Reflecting on your leadership strengths as well as areas that need improvement will help you become the best leader you can for your team, your colleagues and your community.

Dr Angie McNeight Today’s FDA

PRACTICE

I FOUND A LUMP, IS THIS NORMAL?

A MODERN APPROACH TO CLINICAL ORAL PATHOLOGY

We’ve learned so much about ourselves and our healthcare system over the past two years and one thing is clear: Dental practitioners are essential and adaptable.

I treated a patient from out of state for oropharyngeal cancer – a tonsillar squamous cell carcinoma. He, like many people, fell victim to the fallout of the COVID-19 pandemic. His diagnosis and treatment were delayed for months as he couldn’t get in to see his primary care physician. Fortunately, his dental hygienist noted a tonsillar abnormality and made an expeditious referral for a biopsy.

This patient was planned for concurrent chemoradiation therapy to treat his tonsil cancer – a viable but “shotgun” approach to many throat cancers. At age 48, he was wary of the long-term effects of cancer therapy as they relate to xerostomia, osteonecrosis, trismus, fibrosis, and renal failure. Of course, treating his cancer was paramount, but so was maintaining long-term quality of life. Like many patients, he educated himself and found some of our publications on robotic surgery and de-escalated therapy to treat his cancer with excellent outcomes and minimal side effects. He wondered if he would qualify for this.

Through a streamlined process of virtual visits, we were able to complete his workup from a distance and collaborate with his referring dentist to coordinate in-person needs. He was an excellent candidate for TransOral Robotic Surgery (TORS) to remove his throat cancer without the need for major open surgery, radiation, or chemotherapy. This was not available in his home state.

He underwent surgery with me in Portland. We were able to clear his cancer in a single operation just two weeks after we met via Zoom. He returned to his home state one week after surgery and has remained cancer free without radiation or chemotherapy. His general dentist, primary care physician and I coordinate telehealth and in-person visits so he doesn’t have to travel to Portland for follow-up care. Prior to 2020, this sort of collaboration and coordination was cumbersome

and generally avoided. Out of necessity, it has been efficient, effective and safe.

Despite these advances oral pathologic conditions can still create anxiety for patients and dental practitioners. Oftentimes, incidentally discovered oral lesions alter the timeline of comprehensive dental treatment due to the time required for diagnostic workup and inability to access the oral cavity secondary to pain and irritation. In an era where we are limiting in-person visits and personal protective equipment may be scarce, developing a decision tree for which patients should be seen and treated urgently is paramount.

“Oral pathology” is an umbrella term for the diagnosis and study of diseases affecting the mouth and surrounding structures, but colloquially has become synonymous with oral lesions not directly related to teeth. This broad discipline of dentistry encompasses hundreds of conditions ranging from common variants of normal such as Fordyce granules to rare malignancies of jaws including odontogenic sarcoma. As dental practitioners, we see conditions within this range on a daily basis. Fibromas, mucoceles, and papillomas are common and can be diagnosed via clinical exam with reasonable accuracy. The problem lies in conditions such as leukoplakia or erythroplakia, where clinical evaluation often doesn’t reflect what is happening at a microscopic level. There are four essential goals for dental

practitioners to consider when they encounter oral lesions:

1. Accurately clinical characterize oral hard and soft tissue lesions to develop a differential diagnosis.

2. Use our clinical skill set to risk stratify lesions.

3. Develop a treatment plan and timeline for treatment based on the above criteria.

4. Know when to refer to a specialist for further management. As dentists, we are proceduralists and often live by the adage, “A chance to cut is a chance to cure.” Even in oral pathology, many roads lead toward a procedure or surgical intervention to diagnose and treat disease. The often-challenging component is creating a surgical prescription based on our history, physical exam, and diagnostic imaging. There are many branches in a clinical decision tree, which can be overwhelming to both patients and providers, particularly when decisional fatigue sets in. Harnessing our knowledge of the oral cavity, local and systemic diseases, and pathologic conditions allows us to use our skill set and expertise in diagnosis and treatment planning to make the right decisions for our patients.

Dr Ashish Patel Oregon Dental Association

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WHAT ARE THE ETHICAL CONSIDERATIONS OF USING VIDEO SOCIAL MEDIA PLATFORMS SUCH AS TIKTOK IN YOUR DENTAL PRACTICE?

society that its members will adhere to high ethical standards of conduct.” Furthermore, the Preamble to the ADA Code states that “dentists should possess. traits of character that foster adherence to ethical principles. Qualities of honesty, compassion, kindness, integrity, fairness. help to define the true professional.” Although these sections were developed long before the advent of TikTok and other social media applications, the message they convey is still applicable and relevant.

Question: Some of my colleagues are using social media platforms like TikTok to create short videos to appeal to a larger patient population, to build their practice bases, and to educate patients. Some of these videos can be shared in the form of duets whereby other dentists can opine on the post. So, if 1 dentist posts a video of their treatments, a second dentist can repost the video and comment if this feature is enabled by the content creator, giving their “professional” opinion, without the full knowledge of the patient’s dental history, consent, or specific case details. These “TikTok Dentists” are providing generalized treatment recommendations and have no specifics of the patient in question. I do not want to be left behind, but I wonder what the ethical considerations of this social media platform are in the world of modern dentistry.

Answer: Social media video applications offer free and potentially viral forms of communication that appeal to everyone, from Generation Z to baby boomers. In addition to reaching new audiences with generalized and viral video content, this form of communication also allows users to duet other content creators’ videos and share their own opinions or advice on the topic. When videos on platforms like TikTok are liked or viewed, the platform’s algorithm fills the user’s feed with similar videos based on the topics with which they have interacted.1 For example, if you are an avid reader and watch videos about book reviews, you will be targeted with content created by creators who also love books. Some users dub these genres as BookTok, DentalTok, and so on, depending on the topic of videos viewed regularly.

Social media is used widely among both patients and providers. TikTok, in particular, seems to be gaining momentum and, like other forms of social media use, presents both risks and opportunities. In recognition of that, consideration of some of the ethical parameters of dentists using TikTok are worthy of consideration. The Introduction to the American Dental Association Principles of Ethics and Code of Professional Conduct (ADA Code) states that “the profession makes a commitment to

The ADA Code Section 1 addresses Patient Autonomy (“self-governance”), including the patient’s privacy and confidentiality of their information. “The dentist has a duty to respect the patient’s rights to self-determination and confidentiality.” Dental care professionals who post videos that are meant to influence and educate patients about particular treatments without knowing the patient’s history or specific information about the patient may be unduly influencing patients in their decision making and therefore interfering with true self-determination. Care also must be taken to protect the confidentiality of patients when using a case history or patient’s images in these videos. In fact, in sharing this information, the dentist must be aware of not only potential ethical implications but legal implications as well, including applicability of the Health Insurance Portability and Accountability Act 3 and any relevant state laws regarding patient privacy.

Furthermore, Section 2 of the ADA Code, Nonmaleficence (“do no harm”), states, “The dentist has a duty to refrain from harming the patient.” 2 Specifically, Section 2.G., Personal Relationships With Patients, may apply when a dentist posts a video that includes a particular patient. This may “risk the possibility of exploiting the confidence placed in them by a patient” if the dental care professional posts videos in instances that could be considered unprofessional or questionable or that might portray the patient in an unfavorable light.2 Again, the dentist, if using a video regarding a specific patient, must be sure that the patient has provided their informed consent in adherence with the principle of Patient Autonomy. The dentist also must be mindful of not potentially harming other patients. When the information in the video is used in a generalizable way, without sufficient acknowledgment that each patient’s circumstances may differ, it is potentially harmful to other patients. The dentist viewing the TikTok should be mindful that although the material may have some educational benefit to how they might manage a similar situation, what is presented on TikTok is general and should not replace sound professional judgment.

Section 3, Beneficence (“do good”), is also applicable. “The dentist has a duty to promote the patient’s welfare.” This directive may support use of social media platforms if the information is educational. These types of social media platforms could be used to provide a community service such as encouraging dental health, dental education, or overall community service.

Photo: Image licensed by Ingram Image

The ADA Code obligates dentists to “use their skills, knowledge and experience for the improvement of the dental health of the public.” However, we must always keep in mind that “dentists in such service shall conduct themselves in such a manner as to maintain or elevate the esteem of the profession.” So, when using a platform like TikTok, the dentist should be careful to be accurate, truthful, and protective of individualized patient information.

The principle of Justice (“fairness”) obligates dentists “to treat people fairly.” This obligation of dentists is not only toward patients but peers and the dental team as well. Section 4.C., Justifiable Criticism, might be applicable in the context of dueting. Any dentist commenting on or responding to the recommendations and work of another dentist should be careful to not disparage another dentist publicly. “Dentists issuing a public statement with respect to the profession shall have a reasonable basis to believe that the comments made are true.” If critical of the work of another dentist, airing that criticism in a public forum such as TikTok may not be appropriate without first addressing the concern with the dentist in question or, if necessary, discussing with one’s constituent or component society

Finally, Section 5, Veracity, addresses issues related to “truthfulness”: “The dentist has a duty to communicate truthfully.” Specifically, dentists are responsible for “communicating truth-

fully and without deception, and maintaining intellectual integrity.” For example, making unsubstantiated recommendations would be considered unethical as would any type of advertising or marketing that is false or misleading.

Social media platforms are here to stay. They are an effective method of communication for existing and prospective patient engagement. A 2021 article by Zenone and colleagues4 acknowledges that “public health is served by paying urgent attention to the potential health-related implications and opportunities of TikTok” and suggests “a research agenda to inform decision-makers, health providers, researchers and the public.” Dentists should be mindful of these questions. The ethical dentist and, by extension, auxiliary dental staff members must take measures to ensure adherence to the ADA Code in day-to-day practice as well as when engaging in social media in their professional capacity. Although giving generalized oral health care tips may be beneficial to social media users, specific treatment recommendations should be made only once a dentist-patient relationship has been established. In addition, dentists engaging with the social media of another dentist must be sure to avoid unjustifiable criticism of peers, protect patient privacy, and maintain the integrity of the profession as a whole.

Kathleen Nichols, DDS JADA

10 TIPS FOR DEVELOPING A DENTAL OFFICE EMERGENCY PLAN

Unfortunately, natural disaster and manmade threats, including active shooters, are occurring more frequently throughout the nation. Most people don’t want to entertain the thought of the unthinkable happening; however, threats and responses should be discussed and practiced with dental teams just as they are at schools, places of worship and shopping malls. A frustrated employee or patient could make your office and staff victims of preventable violence or other attacks. Office staff should be informed and prepared with a plan that can be performed faultlessly in the unfortunate event that a nightmare scenario becomes reality.

Following are 10 tips to best protect your staff and your practice during a threat or disaster.

Tips for General Threats

1. Set an emergency action plan (EAP) for your dental office to employ in the case of a threat. Make sure that all staff members are aware of – and fully trained for – the procedures of your office plan. It may be a bit uncomfortable to have these discussions with staff, but not having a plan is no longer a responsible option.

2. Always be aware of your office’s exit locations. Evacuation is the best option in most threat scenarios. Once safe, call 911, and provide as much information as possible including the location, a physical description of the threatening person or people, any weapons involved, the number of potential threats and the number of potential victims at the scene.

3. Help yourself first. Whether or not other decide to follow your offices emergency plan, follow it yourself. Help others, if possible, but secure your safety first.

4. If evacuation is not an option, find a hiding place and put obstacles between yourself and the threat, such as a locked door. Barricade doors with upturned furniture or whatever you can find to add to the obstacles between you and the threat. Try to have an escape route from your hiding place in case it’s needed and remain as quiet as possible.

5. If you are confronted by the threat and feel as though your life is in danger, attempt to disrupt or incapacitate the attacker. Be aggressive, throw any items within reach and use any type of improvised deflector that you can. Commit to your actions and don’t stop until the threat has been immobilized.

Tips for if the Threat is a Patient

6. Try to move the patient away from public space. Ask the patient to move into a consult room or private office.

7. When the patient is speaking to you, do not speak until he

or she is finished. Be sure to allow the person the time and space needed to feel heard, do not interrupt; and only speak when you’re absolutely sure the patient is finished or asks a question for you to answer.

8. When it is your time to speak, focus on empathy. Connect with the patient and try to understand the person’s frustration in order to see the issue from their perspective. Do not shout the person down or try to rationalize with them, simply make him or her feel heard.

9. Make notes about all the information the person tells you. Not only will this give you a chance to document the scenario but it also assures the patient that you’re taking his or her concerns seriously. Show the patient the notes you took and ask if anything should be added. Explain to the patient that you will investigate the problem and respond as soon as you’re able. Review all of the facts of the situation from an objective point of view and then follow up with the patient in the timely fashion.

10. If all of the above tips do not help to diffuse the angry patient and the person threatens or becomes violent, contact local law enforcement immediately and follow through with your emergency plan.

Threat situations can be chaotic and unpredictable, which is why it’s important to have a plan in place. In some instances, law enforcement will need to be immediately dispatched so they’re able to quickly get control of the situation.

Ensure all building exits are marked and have an evacuation plan in place with a central meeting location to account for all staff member. Implement an emergency notification system so all staff members are on the same page during a disaster and use code words during emergencies to prevent patients from panicking. Ultimately, being prepared is the first step to protecting your staff and your practice from threat and disasters. If the unthinkable happens, you and your team will be ready.

An EAP (Emergency Action Plan) will help your staff respond efficiently to unplanned events ranging from violent threats to fires and other natural disasters. Learn more about creating an EAP for your practice through the U.S. Department of Labor at dol.gov or the Occupation Health and Safety Administration at osha.gov. Ready.gov has information about how plans for disasters and emergencies ranging from severe weather to chemical emergencies and more. Also, find the Federal Bureau of investigation’s guide to active shooter planning and response for a health care setting at bit.ly/2QSIP7R.

Shey Loman Today’s FDA

ARE CREDIT CARD FEES AFFECTING YOUR BOTTOM LINE?

EXPERT OFFERS TIP FOR MINIMIZING FEES

ARE CREDIT CARD FEES AFFECTING YOUR BOTTOM LINE? EXPERT OFFERS TIP FOR MINIMIZING FEES

It’s no surprise to small business owners that more and more consumers are paying for goods and services with debit and credit cards rather than cash.

And data from the Federal Reserve show that cash payments in 2020 declined sharply among consumers in every age group, and especially in two groups that consistently made the highest share of cash payments — those aged 18-24 and those age 65 and older — due in part to making fewer in-person purchases during the height of the pandemic.

It's no surprise to small business owners that more and more consumers are paying for goods and services with debit and credit cards rather than cash.

and 3- to 4-digit card security code whenever possible. This is an anti-fraud check and if it passes you get a lower rate than if you don’t put in info or have the wrong info for the cardholder.

And data from the Federal Reserve show that cash payments in 2020 declined sharply among consumers in every age group, and especially in two groups that consistently made the highest share of cash payments — those aged 18-24 and those age 65 and older — due in part to making fewer in-person purchases during the height of the pandemic.

Dental offices have long accepted card payments to boost sales, improve cash flow and offer convenience to patients. But, without a vigilant management strategy, credit card processing fees can add up and affect your bottom line.

Dental offices have long accepted card payments to boost sales, improve cash flow and offer convenience to patients. But, without a vigilant management strategy, credit card processing fees can add up and affect your bottom line.

3. Encourage patients to use a debit card instead of a credit card and avoid insurance payments made on credit cards. Since different cards run at different rates, any patient payments made with a debit card (no PIN required) should result in substantially lower fees than credit cards. On the other end of the spectrum, insurance payments made by credit card tend to be the most expensive types of cards.

“The first thing every practice should do is calculate its effective rate,” said Phil Nieto, president of Best Card, a company that provides credit card processing solutions to thousands of dental offices and is endorsed by ADA Member Advantage.

“The first thing every practice should do is calculate its effective rate," said Phil Nieto, president of Best Card, a company that provides credit card processing solutions to thousands of dental offices and is endorsed by ADA Member Advantage.

“Your effective rate tells you your total average cost to run cards,” said Mr. Nieto. “It’s easy to calculate. Grab your latest monthly statement and divide the dollar amount of processing fees you were charged by the total amount of monthly sales. Based on our 2022 comparisons, the average rate dental offices pay is 3.38%, but you should be shooting for a rate closer to 2.12.2%.” For example, if your office paid $1,027.45 to run $37,355.25 in card sales, your calculation would look like this: $1,027.45 ÷ $37,355.25 = 2.75%.

“Your effective rate tells you your total average cost to run cards,” said Mr. Nieto. “It’s easy to calculate. Grab your latest monthly statement and divide the dollar amount of processing fees you were charged by the total amount of monthly sales. Based on our 2022 comparisons, the average rate dental offices pay is 3.38%, but you should be shooting for a rate closer to 2.1-2.2%.” For example, if your office paid $1,027.45 to run $37,355.25 in card sales, your calculation would look like this: $1,027.45 ÷ $37,355.25 = 2.75%.

Credit card processing fees can be complicated and confusing, which is why Best Card offers a free savings analysis to help explain your current fees and potential savings. Just email a recent credit card processing statement to compare@bestcardteam. com or fax to 1-866-717-7247. In 2022, Best Card helped 96% of practices pay less than their previous fees and the average savings per practice was more than $5,500.

“We switched to Best Card in May of 2020, after learning of the ADA endorsement,” said Prabu Raman, D.D.S., a general dentist in Kansas City, Missouri. “The transition was so easy and painless, and we are saving over 50% on our credit card processing fees each month. Saving is one thing; their customer service is beyond my expectation … We highly recommend that you see what Best Card can do for your practice.”

Is your effective rate too high? There are a lot of different factors that affect how much you might be paying in fees, and processors can add or raise fees anytime if they provide you with a 30-day notice in small print at the bottom of your monthly statement.

Is your effective rate too high? There are a lot of different factors that affect how much you might be paying in fees, and processors can add or raise fees anytime if they provide you with a 30-day notice in small print at the bottom of your monthly statement.

“Changing providers or renegotiating can be ways to save a lot, but once you have a great deal, there are also some steps you and your staff can take to bring your costs down," Mr. Nieto said.

“Best Card is hands down the best service for the best price of any credit card processing company I’ve dealt with in the last 20 years,” said Shaun Christensen, D.M.D., a general dentist in Nampa, Idaho. “My credit card fees are half of what they used to be. What really sold me was that their software works directly with my dental software ... easy for my staff and easy on my wallet. Win-Win.”

“Changing providers or renegotiating can be ways to save a lot, but once you have a great deal, there are also some steps you and your staff can take to bring your costs down,” Mr. Nieto said.

1. Accept payment directly from the patient in person via chip, contactless, or swipe whenever possible to get a lower rate than when keying in those same cards. Because there is less risk of fraud with the patient and card present, lower fees are charged.

2. If you are going to manually enter a card number or have a patient pay online, make sure to include the 5-digit ZIP code

“Switching to Best Card was one of the best things I have done in a long time,” said Ron Lee, D.D.S., a general dentist in Colleyville, Texas. “I’m saving thousands of dollars every year, and as my father-in-law once told me, ‘It’s not how much you make, but how much you keep.’ So, thank you Best Card for helping keep more of my money, while providing amazing customer service.”

For more information, visit www.bestcardteam.com/ada-member-advantage

While no one likes to think about it, things do happen and it’s always important to be prepared.

Knowing your practice’s value can make the difference between selling your practice or having it become unsellable. That is why practice owners should have an up-to-date practice valuation.

Whether you are anticipating selling your practice and planning for retirement, recruiting a new associate who potentially may become a partner, or preparing for the unexpected, there are many reasons to have a current practice valuation.

A Henry Schein Dental P r actice Transitions valuation considers both tangible and intangible assets of the practice and can provide the many key factors which infl u ence the practice’s value.

To get started on your practice valuation or schedule a complimentary, confidential consultation, contact me or scan the QR code!

Jeff Harmon Transitions Sales Consultant 801-319-4161

Jeff.Harmon@henryschein.com

n PRACTICE TRANSITION PLANNING

n SALES & VALUATIONS

n BUYER REPRESENTATION

HOW DOES HIPAA AFFECT THE WAY I MANAGE PATIENT INFORMATION?

If a dental practice meets the HIPAA definition of a “covered entity” or “business associate,” the dental practice must be in compliance with the four HIPAA rules or it risks substantial penalties. There is also a risk of reputational harm, since the federal government makes public certain data breaches and violations through online postings and media releases. A dental practice that has agreed contractually to comply with HIPAA (for example, in a participating provider agreement) risks liability under the contract for failure to comply.

The Four HIPAA Rules

Dental practices that are covered by HIPAA must comply with the HIPAA Privacy Rule, Security Rule, Breach Notification Rule, and Enforcement Rule, and also with applicable states laws that are more stringent than HIPAA. Some of the requirements of the various HIPAA Rules overlap. For example, the Privacy and Security Rules both require a covered dental practice to designate personnel to be responsible for certain HIPAA-related tasks, to have written policies and procedures in place, to train workforce members and document the training, and to apply appropriate sanctions if a workforce member fails to comply. Both the Privacy and Security Rules require compliant written agreements with “business associates,” which are generally defined as outside entities and individuals who create, receive, maintain, or transmit patient information and when doing something for or on behalf of the dental practice.

Here are examples of requirements in each of the HIPAA rules: The Privacy Rule applies to patient information in any format, such as electronic, hard copy, (e.g. paper, films, and other physical items), and spoken. It also:

• Gives patients certain rights over their information, such as the right to see information and obtain a copy, the right to an accounting of disclosures of their information, and the right to ask for changes to the information. Each of these rights has certain limitations.

• Tells a covered dental practice when HIPAA permits patient information to be used or disclosed without getting the patient’s written authorization.

• Includes certain other standards and requirements to protect patient privacy, such as the “minimum necessary rule,” which, with limited exceptions, require (1) using, disclosing and requesting the minimum amount of patient information necessary for the purpose of the use, disclosure or request, and (2) identifying which workforce members (or categories of workforce members) require access to which categories of patient information, and making reasonable efforts to limit access accordingly.

The Security Rule applies only to electronic patient information. The Security Rule requires covered dental practices to

assess the risks to the confidentiality, integrity, and availability of patient information and document the risk assessment, and to update the risk assessment as appropriate (for example, when the dental practice buys new technology or learns of a new risk.) The dental practice must implement risk management to bring the identified risks to an acceptable level. The Security Rule also requires covered dental practices to have certain specific safeguards in place to protect electronic patient information. The safeguards are not technology-specific, and are flexible and scalable to a certain extent.

The Breach Notification Rule requires covered dental practices to notify affected individuals, the federal government, and in some cases the media, of a breach of unsecured patient information, unless the dental practice can demonstrate that there is a low probability that the information is compromised by performing a written analysis of all relevant factors, included four required factors:

i. The nature and extent of the protected health information involved, including the types of identifiers and the likelihood of reidentification

ii. The unauthorized person who used the protected health information or to whom the disclosure was made

iii. Whether the protected health information was actually acquired or viewed; and

iv. The extent to which the risk to the protected health information has been mitigated.

Many states have adopted breach notification laws that may impose obligations on dental practices whether or not the dental practice is covered by HIPAA, and whether or not the breached information is patient information. For example, a state breach notification law may apply to a breach of a name and Social Security number that a dental practice has collected from an employee. Some breaches may require notification under both HIPAA and state law.

The Enforcement Rule contains provision relating to government investigations, penalties for HIPAA violations and procedures for hearings. For example, the Enforcement Rule requires covered dental practices to cooperate with investigations and compliance reviews, and to permit the U.S. Department of Health and Human Services (HHS) to access to the dental practices facilities, books, records, accounts, and other sources of information, including patient information, that are pertinent to ascertaining compliance with HIPAA.

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WHAT ARE THE PENALTIES FOR VIOLATING HIPAA?

HIPAA violations can result in civil penalties and in some cases, criminal penalties. There are four tiered ranges of civil penalties. The lowest tier is for violations where the dental practice did not know, and by exercising reasonable diligence would not have known, that the dental practice was in violation of HIPAA. Penalties in this tier range from $100 to $50,000. The highest tier involves willful neglect that is not corrected within 30 days. Penalties in this tier can start at $50,000. There is a maximum penalty of $1.5 million for all violations of an identical provision during a calendar year.

In most cases, the maximum penalty amount will not be imposed. Instead, the government will determine the amount of a penalty on a case-by-case basis, depending on the nature and extent of the violation and resulting harm, as well as other aggravating and mitigating factors, which are listed in the HIPAA regulations at 45 CFR 160.408, available online (see ECFR in Related References and Resources).

Examples of the factors include the number of individuals affected, the harm caused to the affected individuals, and the size of the dental practice.

A HIPAA violation can also result in criminal penalties.

According to the U.S. Department of Health and Human Services Office for Civil Rights (OCR):

A person who knowingly obtains or discloses individually identifiable health information in violation of the Privacy Rule may face a criminal penalty of up to $50,000 and up to one-year imprisonment. The criminal penalties increase to $100,000 and up to five years imprisonment if the wrongful conduct involves false pretenses, and to $250,000 and up to 10 years imprisonment if the wrongful conduct involves the intent to sell, transfer, or use identifiable health information for commercial advantage, personal gain or malicious harm. The Department of Justice is responsible for criminal prosecutions under the Privacy Rule.

A Dentist’s Guide to the Law: 246 Things Every Dentist Should Know

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2023-2024

Upcoming University of Utah, School of Dentistry

Continuing Education Lectures:

September 8, 2023 all-day event 8:30 am- 4:00 pm; The 5th Annual Lynn Powell Lecture Series: Hit Me With Your Best Shot and Is The ‘Mandibular Block’ Passe?

Featuring: Stanley F Malamed, DDS

October 19, 2023 6:30 pm – 9:00 pm: Implants (Part I) Site Preparation and Placement

Featuring: Chanook David Ahn, DMD

November 16, 2023 6:30 pm – 9:00 pm: Implant (Part II) Restoring Implants

Featuring: Jonathan M. Rasmussen, DDS, MS

January 18, 2024 6:30 pm – 9:00 pm: Oral Medicine

Featuring: Audrey L. Boros MSc., DDS

February 15, 2024 6:30 pm – 9:00 pm: Oral Cancer, DX, TX, and Maintenance

Featuring: Michael Gladwell, MD, DMD, FACS, and Rhet Tucker, DMD, FACP

March 21, 2024 6:30 pm – 9:00 pm: Geriatrics

Featuring: Bonnie Lederman, DDS, BS

April 19, 2024 ½ day morning 8:00 am -12:30 pm: Dental Sleep Medicine

Featuring: Jamison Spencer, DMD, MS

Questions:

Karin Mishler, Karin.mishler@hsc.utah.edu 801-587-2023

Jerald Boseman, Jerald.Boseman@hsc.utah.edu 801-587-2246

WHAT DO I HAVE TO DO IN ORDER TO COMPLY WITH HIPAA’S PRIVACY RULE?

Some of the key requirements of the Privacy Rule are:

• Designate a “privacy official” for your dental practice.

• Develop and implement appropriate written privacy policies and procedures.

• Have in place appropriate administrative, technical and physical safeguards to protect the privacy of patient information in all formats (e.g. electronic, paper, and oral).

• Develop the necessary documents, such as the Notice of Privacy Practices (NPP) and business associate agreements.

• Provide you NPP to patients on their first visit, and prominently display your NPP in you office and make copies available to patients upon request. Make the NPP available through your dental practice website if you have one.

• Obtain written patient authorization in the required format prior to any use or disclosure not permitted by HIPAA.

• Respond appropriately if a patient exercises his or her right under HIPAA; for example, by requesting an accounting of disclosure, access to records, an amendment to records, confidential communications, or restricted disclosure. Each of these patient rights has certain limitations and requirements.

• Adhere to HIPAA’s “minimum necessary” rule. When patient information must be used, disclosed or requested, limit the information to the minimum necessary for the purpose of the use, disclosure or request (the minimum necessary rule does not apply to disclosures for treatment purposes.) Identify workforce members, or categories of workforce members, and the patient information it is appropriate for them to access, and make reasonable efforts to limit access accordingly.

• Implement reasonable safeguards to limit incidental uses or disclosures of patient information that result from any use or disclosure permitted under the Privacy Rule. An example of an incidental exposure is a visitor hearing a treatment-related conversation between dentist and patient.

• Train your staff about your office’s privacy policies and procedures, and document the training. Apply appropriate sanctions for violations of your policies and procedures, and document any sanctions applied.

• Enter into a compliant business association agreement with each of your dental practice’s business associates.

• Maintain documentation of HIPAA compliance for the time period required under HIPAA. Each document must be retained for at least six years from the date the document’s creation, or at least six years from the date when it is no longer in effect, whichever is later.

NOTE: Keep in mind that HIPAA’s privacy rule covers more than just the traditional written patient record. It extends protection to information about the patient, including demographic information, that identifies (of that could be used to identify) the patient and that pertains to the patient’s past, present, or future:

• Physical or mental health

• Health care

• Payment for health care

This can include records such as patient charts and billing records and includes information in any format, such as paper, photos and films, oral information and electronic information.

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