UDA Action

Ryan Dulde, DDS Paul R. Ehrlich Dr Sandra Kahn Dr Brett Kessler Dr Craige Olson

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WOVEN TOGETHER – A REPORT OF THE ADA HOUSE OF DELEGATES

As the current president of the Utah Dental Association, my opportunities for service include meeting with other colleagues from around the state and country who share similar responsibilities. We learn together, counsel together, and share thoughts and ideas in a common vision of supporting and improving our profession and its supporting organizations. We recently had the opportunity to meet together in Houston, Texas at the annual House of Delegates meetings of the American Dental Association, where important business was conducted relating to the governance, well-being, and continued strength of the association. I now feel the responsibility to share what took place and what I learned.

Reports of the 2022 ADA House of Delegates. . . Through my eyes: My wife, Christine, accompanied me on this trip, and we arrived in Houston a couple of days prior to the start of the HOD meetings. We came early because we knew that I had close relatives who had come to Texas to work and to live, and we hoped to find where they had lived, married, raised families, and died. I must give the credit to Chris for researching these things and encouraging me to connect with my family.

My grandmother, Lattie, was born in North Carolina, and moved as a child with her family to the Hillsboro area of Texas, and her parents are buried in Crockett, Texas. Her family, along with many more of my ancestors from the Southern states were greatly impacted by the effects and aftereffects of the Civil War. I imagine that they moved to Texas, along with others,

to seek out new opportunities to better their lives and improve their circumstances. They were farmers, most likely of cotton, but also worked in the cotton mills as weavers. We visited the courthouse in Hillsboro where Lattie received the marriage license to marry her first husband, who died a short time later in 1918 at the age of 22. Grandma was now a young widow with a little baby when she met and married my grandfather, Jeffie, again in that same area. Lattie and Jeffie eventually made their way back to Columbus, Georgia, where my mother and her three brothers were born. This is where I had always remembered Grandma. She is the only grandparent that I was able to have known. Lattie and Jeffie again worked as weavers in the cotton mill. Grandpa had a stroke and died when he was in his forties, leaving Grandma a widow once again, 35 years old, her older step-brother, and three younger brothers, the youngest being three months old. Grandma continue to work to support her young family, and never did marry again. She taught her children well to be faithful, to overcome obstacles, to meet challenges, and to be successful in life. She was a weaver.

A weaver works with their hands to weave threads and strands together to create textiles that are used as fabrics for blankets, towels and bedding, clothing and so forth. The individual strand may sometimes be varied in color or size, and may not be very strong on their own, but when woven together, they become the beautiful textile, ready and able to provide clothing, cover, strength, warmth, or protection. Our family have been recipients of blankets or sheets that my grandmother or others have woven at the mill. I feel honored and grateful that my grandparents worked with their hands and were weavers and good examples to their posterity.

So, what do these family history experiences have to do with the business I observed at the Hour of Delegates at the ADA? The House is composed of dentists from all across the country. Dentists who work with their hands every day in providing essential care to members of their communities. Though these dentists may not have great influence on their own, all come from various backgrounds, political stances, geographic areas, practice modalities, and economic backgrounds and situations, and all have the same desires to be woven together in our desires and efforts to provide the best oral health care in the best ways possible.

The House of Delegates was an opportunity for me to see the weaving together of ideas and values that will strengthen, benefit and protect our profession, and provide the means to clothe it with success. I would encourage every one of you to be a weaver! There truly is strength when we are woven together in our lives!

Dr Kay Christensen UDA President

HOW THE DECISION TO CHOOSE YOUR DENTAL PATH IS CHANGING, AND WHAT WE CAN DO ABOUT IT

Years ago, in my dental school interviews I was asked why I wanted to be a dentist. Back then the idea of being a dentist brought with it many possibilities. I wanted to be a dentist because of the freedoms the profession would allow me, to be my own boss, to treat patients how I would want to be treated, to help people be more healthy and confident, to be financially able to help those in need, and to serve others in my profession. So, when I saw the article in last month’s ADA news about dental students being asked why they want to be a dentist in todays world, I was interested in what they had to say. Their responses are as follows.

“With my massive sweet tooth, I grew up at the dentist and trusted them. I want to create that relationship with my patients while educating them about prevention and oral health.” — Jenna Chun, Virginia Commonwealth University School of Dentistry, Class of 2024.

“As I continued through high school and began college, while considering my future career, I realized that what my dad did as a dentist was very similar to what I loved about building model airplanes. He used his hands and tools to precisely turn broken, deficient teeth into a perfect recreation of what was originally there, all while giving people a reason to smile.” — Jackson Downey, University of Nevada, Las Vegas School of Dental Medicine, Class of 2025.

“I want to be a dentist because it provides me with the privilege to serve others in the health care field while enhancing one of the most noticeable aspects of an individual — one’s smile. Growing up in a household that valued maintaining good dental hygiene, becoming a dentist allows me to promote the importance of oral health in my community and play a part in bridging the gap in oral health disparities.” — Kynnedy Kelly, Indiana University School of Dentistry, Class of 2023.

“I want to become a dentist to help people improve their health and restore their confidence in themselves. After all, the most powerful social tool we have is our smile. Also, I chose dentistry because it is one of the few fields that combines creativity, science, entrepreneurship and patient interaction.” — Rayna Means, University of Alabama at Birmingham School of Dentistry, Class of 2025.

“My decision to pursue a career in dentistry has been influenced by so many of my life experiences. I want to become a dentist because I am passionate about the health sciences — specifically, the intersection of medicine and dentistry. I care deeply about providing care to those in need and improving

access to care, and I receive incredible joy and fulfillment from developing meaningful relationships with my patients, colleagues and mentors.” — John Pelton, New York University College of Dentistry, Class of 2023.

“I have always wanted to be a dentist because I love working with my hands and am very detail oriented. The idea of treating patients and assisting them in protecting their oral health is a privilege to experience.” — Danielle Silver, University of Pennsylvania School of Dental Medicine, Class of 2023.

Are dreams and goals different now?

I see such desire in these answers of students who want to serve future patients and better the profession. But what surprised me, is that not one of them answered anything about being their own boss! Back in the day that was one of the main reasons that I wanted to be a dentist and I wasn’t alone in my desire. I remember many other of my fellow dental students also wanted (continued on next page)

SO, WHY DID YOU WANT TO BE A DENTIST?

to own their own practice. We recognized that freedom and money comes along with ownership. Why in such a relatively short time has the desire to own a practice faded?

I feel for these young dentists with their unprecedented student debt. Because of their huge financial burden, many of them are less likely to choose the owner-doctor practice style. This debt alters their vision and dreams of the future.

I feel that dental school education debt has gotten way out of hand over the last decade. Many other people at the ADA feel this way as well and have desires to help fix this, but no substantial resolutions have yet been passed to help with this situation. As a result, I see more dental students making their practicing decisions based on student loan debts rather than job satisfaction or future goals. We need to do something about it, but we need more of you involved to help us with it.

Currently in Utah, the majority of dental practices are solopractitioner owner-dentist offices. My friends and colleagues from other states are calling this style of practice “cottage style” and don’t feel that it is a viable business model any more. I, however, do not feel that way. I love the the variety of practices that can exist in the dental field and I feel that it is important to fight for every dentist and to let each dentist decide what type of practice is right for them.

I don’t have an issue with dentists working for DSO’s or other large group practices, but I do have a problem with the fact that most new dentists are choosing this form of practice mostly because their student debt forces them to.

How

we can fix the profession

together

That, as well as many other problems we are facing as dentists, is why organized dentistry is so important for all of us. It would be easy to just sit and let others continue to fight these battles for us, but your ideas and effort are needed to help solve situations like this one.

The UDA Board has the best interests of the dentists of Utah in mind. However, they can not do it alone. We need your help. We need you to get more involved. We need you to share your opinions on what needs you have and how we can help you with those needs.

I’m asking for your help to run for leadership positions at the local and state level. We need you to be willing to fight for what you feel dentistry should be for your family, your patients, your dental team and you (the old you from before dental school who had dreams of making the world a better place). As Jack London stated “The proper function of man is to live, not to exist. I shall not waste my days in trying to prolong them. I shall use my time.” Let us not waste our time.

Thank you for all that you do for our profession. Thank you for deciding to join this great profession. I invite you to continue your ADA membership. I encourage you to become more active with your local chapters and I encourage you to get involved with local and state leadership. It is what is needed to continue to help Utah remain a great place to practice.

Dr Rodney Thornell UDA Secretary

PRACTICE

ORAL PATHOLOGY PUZZLER: DO YOU SEE WHAT I SEE?

Case History: A patient presents to her dentists office for restorative treatment when the lesion was noted by the clinician. Asymptomatic. 4mm x 4mm yellow, non-uclerated papule or left tonsillar pillar region.

Which of the following represents the best diagnosis for the clinic findings:

a) Lipoma

b) Oral Lymphoepithelial Cyst

c) Abscess d) Tonsillolith

PERCEPTION VS REALITY

We live in an age where perception may become totally disconnected from reality. We see this every day in our dental offices. We may pride ourselves on being the best and most caring general dentist, periodontist, endodontist, orthodontist, or other dental specialist and yet our patients may believe that the care that was given to be less than ideal based on perceptions unrelated to the actual delivery of care. Our websites universally show a happy staff, all smiling, with their arms around each other, and a very happy doctor in the middle. They portray an up to date and modern practice with only the very best of equipment, staff, supplies training, and using only the latest technologies in order to provide the very best of care. Your patient sees this and this is what they expect when they come to the office. What they may find when they enter, is that the parking lot is too crowded, because tenants from the new apartment building next door are now occupying too many spaces, the carpet in the reception area has a new coffee stain compliments of yesterday’s patient, the receptionist just found out that her husband has cancer and is justifiably inattentive, and the necessary paperwork and check-in process is onerous. You are also running behind schedule and they have to wait an extra 45 minutes to be seen. To top that off they find out that they have already used most of their insurance benefits for the year but they still need additional restorative and endodontic treatments to relieve their pain and correct functional and esthetic concerns. The patient is still seen of course and appropriate and attentive treatment was given. The reality is that the quality of care was not affected by any of the above factors and yet the patient may leave the office with the perception that because the parking lot was too full, you were too busy to give them the appropriate amount of time and this was of course confirmed by the fact that they had to wait an additional 45 minutes to be seen. The coffee stain on the waiting room carpet confirms to their mind that appropriate cleanliness and sterility of the office is now in question and they’re wondering if you even have an autoclave. The discourteous reception confirms to your patient that your office staff only cares about themselves and not the patients. Now they have to go fill a prescription for an antibiotic but no prescription for pain medicine was given and they’re worried that they may have to endure significant pain and discomfort as well. Again the reality is that the care that was given to the patient by the doctor was excellent and no prescription for pain medication was indicated but the perception is entirely different.

We see this on many other issues as well. Several years ago I saw many patients for extractions of teeth with irreversible pulpitis. This all began because they wanted all of the “poisonous” mercury fillings removed and replaced with

composite restorations. There is no scientific evidence to support this practice. Yet these patients insisted on the removal of the amalgam restorations which ultimately resulted in the loss of the tooth.

Community water fluoridation is another perception versus reality issue. In spite of the American Dental Association’s support for appropriate community water fluoridation and a long proven benefit, there is the perception by many in the community that fluoridation of the water is poisonous and provides no benefits.

Vaccination use is another area where perception versus reality clashes. (I will not go into Covid vaccinations at this point.) One of my neighbors refused to vaccinate his own children against common childhood and adult diseases and yet provided vaccination for his dog (Dogs don’t get autism). As expected his children came down with pertussis, and although treated successfully with antibiotics, this was totally unnecessary. There is the perception that childhood vaccinations are related to autism and autoimmune disorders when there is no scientific evidence to support this. The truth is that the recent outbreak of measles, a potentially deadly disease, at Disneyland could have been avoided by simple vaccination that is readily available.

We live in a world where perception is just as important as reality. Many of our patients make decisions based on their perception of what reality is and not based on what is actually true. Professor Thomas Sowell, an economist at Stanford University stated, “Truth is often not complicated. What gets complicated is evading the truth.”

Truth and reality always prevail in the end but it is our duty as healthcare providers to try and to keep the cost that is paid by society and individuals to a minimum by always upholding what is true versus what is the perceived reality. The cost that is counted not just in dollars but in sorrow, pain, lost opportunity, illness, disease, and even loss of life that easily could have been avoided by making decisions based on truth and not just perception. We do this by educating our patients and letting them know what is in their best interest is in fact in our best interest as well.

Dr Ken Baldwin ADA Delegate

THE STORY OF STUDENT A

Addiction to alcohol and drugs remains among the most misunderstood phenom ena in medicine. Though the American Medical Association classified alcoholism as a disease in 1956, many people, inside and outside of health care, continue to look at it as a moral issue or the result of a lack of willpower.

Alcoholism and addiction know no prejudice. They affect the entire spectrum of the population, at an estimated range of 6% to 10%. Some surveys report that the dentists’ easy access to drugs such as Vicodin, Valium and nitrous oxide makes our profession more susceptible.

My story started in dental school. It was much harder than I expected. I always pulled good grades in undergrad. My classmates were really smart and good with their hands. I was struggling. I questioned why I decided to go to dental school. I started drinking at night just to unwind. I was soon drinking an entire bottle of wine every night. All the effort in studying was totally negated the next day. I had no recollection of any of the information I had spent all that time trying to learn.

At first, it was innocent. I needed a drink to fall asleep. One became several and I still couldn’t sleep. I was so anxious! I went to a doctor who prescribed me sleeping pills. Now I could fall asleep, but the combination of the wine and the sleeping pills made it impossible to wake up in the morning. Things quickly started to spiral out of control. My grades were low, my self-esteem was low, I didn’t know what was happening. I never failed at anything. My addiction snuck up on me and took over fast. I was self-destructing and within six months, things got really bad.

Some of my classmates asked me what was wrong. They knew I was struggling, but I could not show any signs of weakness. I brushed them off. Alcohol was not my problem, it was the stress of school that was my problem. Alcohol was my solution. I isolated from my classmates. God forbid they see my shortcomings.

Alcoholism and addiction are diseases of denial and perception. It is difficult to differentiate the true from the false. It is also a disease of isolation. The end result of untreated addiction is death, jail, or hospitalization.

Then came my DUI. I didn’t think I was drunk. Unfortunately, the police officer though differently as he arrested me. I spent the night in jail. When I awoke, I knew things needed to change, but I didn’t know how. I worked so hard to get into dental school. I thought about quitting. Dentistry wasn’t for me. It was too hard. If I quit, life wouldn’t be so difficult and I wouldn’t drink anymore. That was the answer.

I went to the dean at school to let him know of my plans to quit. I made a mistake applying. It was just too hard. He listened

to me in a very empathetic manner. I trusted him. Before I knew it, I told him of my recent DUI. He smiled and gave me a phone number to a local dentist that he thought could help.

Most state dental associations have Well Being programs. The Indiana Dental Association’s Well Being Program is run by a licensed clinical social worker and is overseen by a committee of IDA members who want to help fellow dentists who are struggling with substance abuse disorders. Their hope is to help the dentist get the help he/she needs before trouble arises or someone gets hurt. All inquires remain anonymous. Dental students are just as susceptible to addiction. Help is available through the leadership at the dental school.

I made the call. I was scared, like anyone would be, but deep down I felt a sense of relief. My life was taking me in directions that could only in my mind, lead to devastation. The dentist agreed to meet with me at once. We spoke for hours. He got me into a program to help with my stress and my drinking. That was several years ago. Now I am a practicing dentist in a job that I love. How dark is was before the dawn! Thank you Well Being Committee. You saved my life and gave me the help and hope that I needed.

Professional diversion programs allow for dentists to get help and create opportunities to continue to practice. They have a success rate upwards of 85 percent, far higher than the general population. It should also be noted that alcoholics and addicts who try to get better on their own without formal treatment have about a 6% success rate.

The ADA Code of Ethics states, “It is unethical for a dentist to practice while abusing controlled substances, alcohol, or other chemical agents, which impair the ability to practice. All dentists have an ethical obligation to urge chemically impaired colleagues to seek treatment. Dentists with firsthand knowl edge that a colleague is practicing dentistry when so impaired have an ethical responsibility to report such evidence to the professional assistance committee of a dental society.”

Reporting a colleague/fellow student is not only an ethical mandate, but it could also save a life.

Dr Brett Kessler

ADA 14th District Trustee (Reprinted with permission of Dr Kessler)

Utah Professional Health Program (UPHP) is available to health care professionals with substance use disorders, and offer a confidential, non-punitive approach while assisting the health care professionals on their road to recovery. UPHP serves to promote the health and well being of licensed healthcare professionals through coordination of assessment, treatment placement and long term aftercare monitoring.

For more information, contact Kelli Jacobsen, MSW, LCSW Program Manager | 801-530-6291

ORAL PATHOLOGY PUZZLER: DO YOU SEE

WHAT I SEE? (continued from page 6)

Correct answer: (b) Oral Lymphoepithelial Cyst.

An oral lymphoepithelial cyst is an uncommon lesion that occurs in the oral cavity and typically presents as a non-ulcer ated papule (soft tissue mass less than 1cm in size). When they occur, they are found within oral lymphoid tissue. Lymphoid tissue is located all around the oral cavity (Waldeyer ring). Palatine tonsils, lingual tonsils, pharyngeal adenoids are more common locations. However, accessory oral tonsillar tissue or lymphoid tissue can be found on the ventral tongue, floor of mouth and other soft palate.

This oral lymphoid tissue is located just beneath the mucosal surface. The epithelium invaginates into the tonsillar tissue, resulting in “pouches” or “crypts” that can fill up with keratina ceous debris or the crypts can become closed off or obstructed, resulting in a keratin filled cyst within the lymphoid tissue just below the mucosal surface. The typical color is white or yellow (see clinical image) but can clinically appears as pink or red, depending on its proximity to the surface. While usually asymptomatic, patients occasionally complain or drainage or swelling. Pain is rare but may result due to trauma of the lesion. Oral lymphoepithelial cysts may develop in people of any age, but are most common in young adults. They are most fre quently located on the floor of mouth, ventral tongue, posterior

lateral border of the tongue, palatine tonsil and soft palate (areas where lymphoid tissue is normally found). Microscopic examination (see histology image) demonstrates a cystic cavity (white area in the middle of the image) that is lined by stratified squamous parakeratinized epithelium without rete ridges. Des quamated epithelial cells fill the cyst lumen. Lymphoid tissue is noted surrounding the cystic space with germinal centers often being present, but not always.

Surgical excision is the treatment of choice. Recurrence is rare. The differential, based on the yellow color, typi cally includes a lipoma (tend to be larger), abscess (drainage usu ally noted), tonsillolith (not usually covered by epithelium).

Cited

Neville, Damm, Allen, Chi (2016). Oral and Maxillofacial Pathology, 4th Ed. St. Louis: Elsevier. Dr Bryan Trump University of Utah School of Dentistry

INFANT DENTAL EXAMS

find primary teeth eruption charts on the internet, but I like to use the three month rule. On average, starting around six months old, new teeth generally emerge every three months …

6 month old - Mandibular Central Incisors

9 month old - Maxillary Central Incisors/Mandibular Lateral Incisors

12 month old - Maxillary Lateral Incisors

15 month old - First Primary Molars

18 month old - Canines

24 month old - Second Primary Molars (the exception to the three month rule)

Obviously there are exceptions to these rules (natal/neonatal teeth and late erupters - after 1 year old), but this works as a good rule of thumb.

Things to look for in infants/newborns-

Riga-Fede - caused by natal or neonatal teeth. Abrasions to the ventral surface of the tongue.

Bohn Nodules - small developmental anomalies located along the buccal and lingual aspects of the mandibular and maxillary ridges and in the hard palate. Remnants of mucous gland tissue. No treatment necessary.

The AAPD handbook states; “The dental home should be established no later than 12 months of age to help children and their families institute a lifetime of good oral health. A dental home addresses anticipatory guidance and preventive, acute, and comprehensive oral health care.”

As a pediatric dentist, I’ve heard “you’re kidding, right?” from my general dentist colleagues when the subject of the first dental exam before 12 months old comes up in conversation. I explain to them that it isn’t as daunting as it may seem. Yes, infants and toddlers cry; yes they have a hard time staying still; yes they are scared of you; and yes they may even bite, but establishing a dental home at this early age is worth the time and effort. It can be a great way to gain confidence with the entire family.

Let’s start with the basics…

The Exam - The easiest way to perform an infant exam is a knee to knee exam. Have the parent hug the child with one leg on either side of them (straddling the parent). The parent holds the child’s hands. The dentist places their knees against the parent’s knees. And the parent lays the child’s head on the dentist’s knees. This allows the dentist and the parent a way to calm a squirming tike. It is normal for a child to cry at this point, most of them do. This is great!! It means that their mouth is wide open and you can get a good look inside.

Eruption Sequence - When you look in an infant’s mouth you should see teeth, if they are close to one year of age. You can

Dental Lamina Cysts - found along the crest of the mand. and max. ridges. Epithelial remnants of the dental lamina. No treatment necessary.

Epstein Pearls - keratin-filled cysts found in the mid-palatal raphe and the junction of the hard and soft palates. No treatment necessary.

Fordyce Granules - common aberrant yellow-white sebaceous glands most commonly on the buccal mucosa or lips. No treatment necessary.

Ankyloglossia - abnormally short lingual frenum that can hinder tongue movement. The frenum might spontaneously lengthen as the child gets older. Surgical correction may be indicated.

Oropharyngeal candidiasis - white plaques covering the oropharyngeal mucosa which, if removed, leaves an inflamed underlying surface. Usually self limiting in healthy newborn infants, but topical application of nystatin may have benefits.

Primary Herpetic Gingivostomatitis - erythematous gingiva, mucosal hemorrhages, and clusters of small vesicles throughout the mouth. Accompanied by fever, malaise, lymphadenopathy, and difficulty eating and drinking. Encourage fluids to prevent dehydration. Analgesics and oral acyclovir may be beneficial.

Check Occlusion -

Posterior Crossbite - discuss the need for palatal expansion in the future

Anterior Crossbite - discuss the need for possible interceptive orthodontics in the future.

Open Bite - discuss non-nutritive suckling. Usually caused

Photo: Image licensed by Ingram Image

by pacifier, thumb, or finger sucking. Our office encourages parents to take away pacifiers after the eruption of primary first molars. Thumb and finger sucking is usually addressed after the child starts school, when it becomes a socially unacceptable habit. Positive reinforcement works best.

Early Childhood Caries -

One or more decayed teeth in children 5 years or younger. This is the most common childhood disease. Begins with white-spot lesions; progresses until the complete destruction of the crown of the tooth. Major contributing factors include improper feeding practices, familial socioeconomic background, lack of parental education, and lack of access to dental care. Many treatment options are available. Treatments may be performed in a normal dental setting with a cooperative child. For the uncooperative child, nitrous oxide or sedation is a viable option.

There are many other things that happen in an infant exam, but these are the basics. This is also a great time to talk with parents about hygiene, fluoride, and limiting carbohydrate intake (especially at bedtime). Taking the time to look into a young child’s mouth shows their parents that you are willing to earn that child’s trust. Along the way, you will earn the parent’s trust and establish a life-long relationship.

As a pediatric dentist, I am thrilled when general dentists perform good quality care for children in their offices. Establishing a tranquil dental home isn’t always the easiest thing to achieve with this population, but it is very rewarding. The pediatric dentists in the state are doing everything in our power to establish a generation of children that will turn into adults without dental phobias. We are glad that the vast majority of general dentists are doing the same. If things become challenging with young patients, remember that help is just a referral away.

Dr Darren Chamberlain ADA Committee Member

1 American Academy of Pediatric Dentistry. Definition of dental home. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2021:15.

2 American Academy of Pediatric Dentistry. Perina tal and infant oral health care. The Reference Man ual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2021:262-6.

ASSOCIATION

THE ADA MEMBER APP: A NEW WAY TO TAP INTO MEMBERSHIP

Members can tap into resources, support and community, all in the palm of their hands with the re-imagined ADA Member App.

This app isn’t just made for dentists, it’s made with them. When designing the app, ADA team members worked directly with dentists from different practice modalities, including dental students.

“The sky was the limit with this group— there were great ideas flying in all directions,” said Colton Cannon, a fourth-year dental student at the University of Minnesota School of Dentistry and immediate past president of the American Student Dental Association. “It was really crucial to me and all the dentists working on this that the app be done right and making sure it had all the great ADA resources and tools and combining them with the usability and accessibility that new generations of dentists are used to. Working to do that is what I’m most proud of.”

The result of this collaboration is evident throughout the re-imagined ADA Member App.

ADA Member App features include: Chat: Tap into the ADA dental community by creating private one-toone and group chats.

Dental Sound Bites™: Stream real talk on dentistry’s daily wins and sticky situations. Tune in to “Dental Sound Bites” on the ADA Member App for exclusive content.

Digital Wallet: Store and easily access important documents like CE, licensing, credentialing and more.

Custom Newsfeed: Choose topics to follow and read what matters most to you.

Career Pathways: Get real-life insights from dentists in different settings.

“This app is really a collaboration from the ADA and its members,” said Kirthi Tata, D.D.S., a new dentist working in a private dental practice in St. Louis, Missouri. “The ADA really focused on the various resources dentists look for in all the various aspects of their career and, more importantly, how all those resources can be accessible in one place.”

The revamped app is a key new benefit to members and will continue to evolve with new offerings and features.

“As technology continues to advance the profession, the ADA needs to be able to learn and adapt and evolve with it,” said Raymond Cohlmia, D.D.S., ADA Executive Director. “This app is an important part of helping the ADA reach its member dentists so we can be there for them when they need us. I can’t wait for every dentist to download the app and see what we have to offer them.”

Learn more at ADA.org/App or search “ADA Member App” in the App Store or Google Play to download now.

CONVENTION

I APOLOGIZE TO THE UDA

I have always thought we were pretty small time because we don’t charge much to register for our meeting and don’t charge anything for individual classes. Nobody else does that. The UDA doesn’t even require a code (given out only at the end of the class) to be able to claim C.E. credit. I can even move to a different class if the one I planned on attending turns out to be a disappointment.

I have always thought we were pretty small time because we aren’t able to attract big name speakers. To my surprise, we have attracted many of the big name guys. With the exception of a couple who never leave the East coast, many like to ski or visit the national parks.

Turns out our work shops have been copied by others and most have been very practical and actually useful for your practice tomorrow.

I guess I suffer a little bit from thinking: because I don’t live in the middle of a zillion people that all the smart guys live where every body else lives.

So, I apologize for thinking the UDA Convention being small can’t attract great and useful speakers. At the 2023 Utah Dental Associa tion Convention we will have a course by the associate dean of The Arizona School of Dentistry and Oral Health who just happens to be from Utah. He was widely recognized as the best head and neck anatomy instructor at the University of Utah School of Medicine as he was preparing to go to dental school. His presentation is done in a hands on - workshop style that is practical and useful. If you are looking for boring or impractical don’t sign up. Seating is limited and there will be a $25 charge.

At the UDA Convention there will also be a workshop on practical pedo treatments for the general practitioner. Dr. Barney Olson has been volunteering his extensive knowledge of the “latest and great est” pedo and ortho techniques for the residents at Primary Chil dren’s Hospital More recently he has included the general practice residents at the University of Utah GPR program. His effort is to make treatment easier, more effective, more practical and with the newest products. If you are looking for esoteric and a good way to waste time, don’t sign up. Seating is also limited and there will be a $25 charge. This covers the supplies you get to take home.

So I apologize for thinking a small meeting isn’t as good as a big one. I apologize for thinking folks in Utah just aren’t as talented or as smart as the multitude of folks on either coast. I have been hang ing around with you in Utah long enough to know that home grown is every bit as talented and great as people from a long way away.

Dr Craige Olson UDA Convention Committee

PRACTICE

IF YOUR DENTAL CHAIR COULD TALK: HOW

RECRUITMENT AND RETENTION

What does your dental practice say about you? If a patient or staff member walks into your reception area or sits in a treatment room, what would they say about your practice? When was the last time you pretended you were a new patient and looked at everything with a fresh perspective?

What would your staff say about their day-to-day routine working in your clinic? Are they in a clean, comfortable, quiet environment with equipment that functions well, and helps them do their job? Or, are things getting dated, continually “on the fritz,” downright scary or impossible to keep clean?

Having serviced equipment for over 27 years, we’ve had the privilege of servicing dentists all over Wisconsin and have been in hundreds of clinics servicing and maintaining equipment that varies in condition with an age range span ning the last 50 years.

Just when we think we’ve “seen it all,” we still get some surprises. The one thing that has remained constant is feedback from office staff regarding the desire to have equipment that functions as it should and present itself well to patients. Staff who are reticent to complain to you, the boss, often express their frustration with us about how difficult or embarrassing it is to try and do their job with equipment that is continually broken or not maintained. Some have shared they are often asked to do repairs on equipment they know little about!

This doesn’t mean you have to purchase the latest and greatest in dental chairs, but everything – including all con trols and features – should work. Scotch tape and duct tape are NOT long-term repair solutions.

In a market of staff shortages and a difficult hiring environ ment, perspective employees have more options and job of fers than ever. They are interviewing you and your practice as much as you are interviewing them. What do they see?

Take a walk through your practice and look at it through the eyes of your patients and staff. Talk to your staff about equipment issues that need attention and try to address things that affect their daily tasks or visibly leave a poor impression on patients.

Richard Wilde WDAJ

YOUR EQUIPMENT PLAYS A ROLE IN STAFF

ASSOCIATION

ADA REINSTATES THIRD PARTY PAYER CONCIERGE SERVICE

The ADA has reinstated its Third Party Payer Concierge service, which assists dentists with insurance questions and concerns with third party payers. The free service is for member dentists only and can be accessed by calling 1-800-621-8099.

The program, which had been on hiatus for a year; will be evaluated after a five-year period, according to Resolution 88H-2021, passed by the 2021 House of Delegates.

“Many dentists cite dental insurance as the source of one of their greatest frustrations and I am happy that the ADA Third Party Payer Concierge service will be back in January 2022,” Dr Mark Johnston, chair of the ADA Council on Dental Benefits Programs’ Dental Benefit Information Subcommittee, told the ADA News after the House vote. “This service provides much-needed assistance for dentists with insurance-related questions and concerns that they cannot find elsewhere. Even though many dentists’ issues come down to contractual obligations, the ADA can provide education on the nuances of doing business with dental insurance companies and how to empower themselves to make decisions that are best for their patients and their practices.

“Coordination of benefits is a constant source of confusion for many dental offices, and the Concierge will be able to help answer questions and address concerns regarding COB,” he added. “Another common concern from dental offices involves claim denials. While the Concierge may not be able to get a claim paid for you, it can provide assistance with the appeals process. Lastly, dentists have reported concerns with poorly written explanation of benefits statements and the Concierge can also help dentists with EOB language questions as well.

Learn more at ADA.org/dentalinsurance

PRACTICE

4 HIPAA DATA SECURITY BEST PRACTICES YOU NEED TO KNOW

While the general public may not fully understand what HIPAA does and doesn’t do, you must understand your responsibilities under this federal law and the severe consequences for failing to meet them if you’re a healthcare provider or a business that supports them.

Case in point: in August 2022, A Massachusetts dermatology practice agreed to pay more than $300,000 to settle an alleged HIPAA violation because they tossed specimen bottles with patients’ protected health information into unsecured dumpsters on their property.

Here are four HIPAA data security best practices that will help you keep from being the next example of what not to do.

HIPAA Data Security Best Practice #1 – Where’s the PHI?

If the healthcare industry were like a pirate movie, PHI would be the treasure. Think about it–the pirates (cybercriminals) are trying to steal it because it is so valuable, and PHI earns hackers as much as 50 times more than financial records.

The first step in protecting the PHI in your care is knowing where all of it is. Are there paper files in cabinets or longterm storage? Where is your electronic PHI stored? How do you handle paper and electronic files when they are no longer needed? Is there any PHI in places we’ve overlooked (like on specimen bottles)?

These are just some of the questions you need to consider. Creating a complete inventory of all PHI in all its form is crucial to developing an effective strategy for HIPAA compliance and data security. After all, one of the primary purposes of the HIPAA law is to protect PHI.

HIPAA Data Security Best Practice #2 – How’s My HIPAA Data Security?

Once you know where PHI is stored, you need to examine how secure it is. Start with your HIPAA policies and procedures and evaluate if they are adequate to your needs. Then determine if those policies are being followed correctly.

Part of achieving and maintaining HIPAA compliance is conducting an annual HIPAA Security Risk Assessment as required by law. If done thoroughly, this yearly activity will help you identify any technical or non-technical gaps in your compliance with the HIPAA Security and Privacy Rules.

HIPAA Data Security Best Practice #3 – Am I Mitigating My Risk

Any gaps identified in the security risk assessment must be addressed through remediation. Now is when you fix all non-technical holes like updates to your HIPAA policy and procedures, administrative safeguards, and workstation security. Then you need to close the technical gaps like user authentication, encryption, and access and audit controls for access to PHI.

Notice that we started with the non-technical side of things. So many people think that security and compliance are all on the technical side. The truth is that HIPAA compliance is following the requirements of the law and being able to prove it. The non-technical aspects of your compliance plan, like policies, are just as crucial to HIPAA investigators as how your files are encrypted.

HIPAA Data Security Best Practice #4 – Do I Have an Incident Response Plan (and is it current)?

Believe it or not, HIPAA regulators don’t expect you to be perfect. What they do expect is that you will be realistic. Breaches are going to happen.

Whether the cause is an accident, negligence, or criminal activity, HIPAA investigators will want to know if you had an Incident Response Plan (IRP) and if you followed it.

A comprehensive IRP clearly defines who is responsible for incident response and what actions they should take, including notifying affected individuals and government agencies as required under the HIPAA Breach Notification Rule.

We’ve listed four HIPAA data security best practices, but the ultimate goal should be achieving HIPAA compliance in a way that works for your organization. Our experts at Compliancy Group are willing to help you meet all the required standards and get the peace of mind from knowing you are fully compliant.

Compliancy Group

The COVID-19 pandemic has brought infection control front and center in dental practice. Most attention has been with viral transmission through contact and aerosol in our dental world; but in the public sector the longevity of virus contamination on various surfaces has been a concern, and hand and surface cleansing have partnered with social distancing in efforts to control spread. In dental practice, surface disinfection is a standard protocol, but an area that has gained less attention has been dental material packaging, distribution, and handling. This brief article talks about how we use, disinfect and minimize cross-contamination of dental materials.

Some dentists continue to use materials dispensed from bulk stores. The obvious benefit is cost-savings. Use of bulk materials is on an as-needed basis at point of use, or in increments prepared ahead of time and packaged by staff for use when needed. Hopefully, the practice replacing dispensed, but unused, bulk materials is not common, if done at all, due to the risk of wider contamination. Yet, bulk use can still have contamination risks all along of the use chain. The first risk is with the material container itself. We may naively believe that suppliers clean and sterilize containers and packaging, but that is not always true. In a small study, I did several years ago, almost half of bulk packaging yielded pathogens. As we have learned from COVID-19 the supply chain offers ample opportunity to add contamination even if supplies leave the manufacturer in a clean state. Dispensing in the office requires strict attention to surfaces, instruments, personnel barriers, sterile receptacles, and storage. Expiration of self-packaged materials, and insurance of packaging barrier effectiveness add to the challenges. Unless a practice can assure all of these, there is the assumption of contamination and possible transmission of infectious agents.

Unit dosing is growing in acceptance in routine dental care, for obvious reasons of convenience and greater assurance of contamination control. The downsides are cost and waste, and, if you are environmentally conscious, addition of still more plastic to our environment. Even unit dosing has its risks if not done properly. Some unit dosing is not really “unitized” and is really just packaging for easy dosing still requires decontamination prior to use. Don’t assume that a dispenser in a plastic container is sterile, unless so stated. Unit dosing often also has expiration dates, which need to be accounted for in storage and utilization. Cleaning and disinfecting can be challenging; by definition, unit dosing means “one-and-done,” and most are not meant for reuse. Dentists may want to salvage remaining material and use what’s left for another patient, but in an absolute sense, that isn’t intended. The recent furor over aerosol in the COVID-19 crisis suggests that if material is to be saved for later use, rigorous decontamination and preferably separation from the active treatment area be in place, which may not be possible for all materials. A best practice has to be

to “choose and use” only single-use, single-patient materials. While manufacturers may claim that post-treatment disinfection is possible, it is technique-sensitive, and effectiveness can’t be assured.

As a result of the pandemic, we may be required to adhere in the future to a medical-surgical standard for cleanliness that includes mandated one-use products, and the era of bulkdispensing may end. My advice to dentists reading this is to begin a thoughtful process of introducing unit-does materials into your practice and analyzing what it means from a safety, efficiency and cost standpoint. The question of tighter control over potential transmission of minor and major infectious diseases inadvertently via vectors known to be controllable, is one of when not if, as a result of the COVID-19 pandemic.

Dr Paul Casamassimo

PRACTICE

IS DIVERSITY REALLY IMPORTANT?

Everyone is familiar with labels of the generation gaps, baby boomers, Generation X, millennials. Baby boomers are ages 57-75, Gen Xers are 41-56, and millennials are 25-40 years of age. While boomers made up the largest segment of population in America for many years, they’ve been overtaken by millennials as America’s largest living adult generation. Make no mistake – boomers still wield a strong force in the world, but they are an aging group and are on their way out of the workforce, while Gen Xers and millennials are its future.

You’re probably wondering what all this has to do with the topic of this article. While baby boomers continue to have a significant impact in the medical area as patients, the future of a practice, its employees and its patient rests on the shoulders of the millennial generation.

Benefits

While all generations have may significant things in common, there is a real divide in some thought processes among the generations. In contrast to earlier generations the members of the millennial generation are generally very socially and globally focused. Millennials seem to be more attuned to what would be termed “soft skills” particularly when selecting employment and service providers. They view soft skills, like the ability to empathize with and collaborate with people who are different from them, as an important indication of the type of work culture or treatment culture they can expect from an employer or a practice. For millennials, a practices’ soft skills often will overshadow its hard or technical skills. One litmus test used by millennials in evaluating a practice’s soft skills is whether there is diversity in the practice’s staff and patients. Some see a lack of diversity as a negative indicator of whether the practice will be able to understand them or empathize with their concerns and needs.

In addition to acknowledging that diversity is important for a practice to remain competitive in employee and patient recruitment and maintenance in a culture populated by millennials, society in general is a much more diverse and mobile place. Having a diverse workforce can put a practice in the position to have broader patient appeal across the community. Workforce diversity will allow the practice to better understand the needs and concerns of a diverse patient population.

Aside from the practical benefits provided by a diverse work place discussed above, there are other, less obvious benefits. In many instances, diversity drives innovation and creativity by bringing new ways to look at problems or practices. Having a substantial diversity and inclusion strategy can help organizations attract top talent, decrease employee turnover and increase employee engagements and retentions – all resulting in positives outcomes.

Potential Downsides and Legal Considerations

With a diverse workplace, however, come cultural and other differences that can sometimes lead to misunderstandings among employees. Failing to handle misunderstandings quickly and effectively, as well as tolerating racist, xenophobic, or insensitive comments about employees’ color or religion, can lead to litigation and potential liability. For practices with 15 or more employees, both Title VII and the Florida Civil Rights Act protect employees from discrimination based on race, color, national origin and religion. In addition to gender. Though smaller practices are not covered by these anti-discrimination laws, unhappy employees or employees who feel or believe they have been mistreated often find other avenues to express their displeasure, perhaps in the form of overtime or whistleblower claims.

Steps to Take

A written anti-harassment policy, even for small practices is a crucial step in preventing litigation. The policy should state that harassment of any type will not be tolerated. It should provide a clear process for employees who believe they have been subjected to harassment to report it. All reports of harassment should be investigated, and a resolution should be reached with the parties.

Just as important as having a clear antiharassment policy is setting an example for staff by fostering an atmosphere of inclusion in the office. This can be done be allowing employees to honor cultural and other celebratory events that are a part of their heritage, and by encouraging such activities.

Finally, discourage employees from perpetuating or fostering stereotypes about other nationalities or cultures. This is not a matter of political correctness but is a simple matter of respect for others. In my practice, I have seen instances where comments perceived as offensive were made with no intention of being derogatory or harassing – the individual was, unfortunately, simply repeating misinformation/stereotypes they’d heard.

Maintaining an open-door policy encouraging all employees to report any issues or concerns, and treating all employees and any concerns in an equitable and fair manner will go a long way toward promoting diversity, equity and inclusion in the workplace. And yes, diversity really is that important.

FDA

PRACTICE

RESPONDING TO INTERNET CRITICISM AND HIPAA CONSIDERATIONS

Question: I was alerted to a patient complaint about me that was posted online. This posting contained false and misleading information regarding my diagnosis and treatment and contained insulting statements about me and my staff. It described me as uncaring, and my staff as rude and unprofessional, saying that we do not care about the comfort of our patients. Based on the details given in the posting and its timing, I can tell exactly who this patient is. The fact of the matter is that the services she wanted were cosmetic and I insisted that she pay her prior balance before I would undertake any future dental work (she has no dental insurance). In the past she needed an extraction and other critical services that I provided as a result of her very poor dental hygiene and certain lifestyle choices. I would like to respond to her online posting by setting the record straight. Is this problematic?

Answer: The internet has certainly made it easy for patients to publicly broadcast their criticisms. This is especially true in the case of health care professionals, where a number of websites facilitate the posting of patient “ratings” and the publishing of patient comments regarding diagnosis and treatment received.

Unfortunately, for dentists and other health care professionals, the playing field is not level. Patients are free to provide whatever information they wish about either themselves or their dentist. They can post commentary - whether informed or uninformed – unrestrained by any privilege or other confidently restrictions. But such freedom is not the case for dentists and other health care professionals.

Generally, HIPAA allows the use of patient information only for treatment, payment, and health care operations purposes, unless you have obtained an authorization from the patient allowing your use of information for some other purpose. Since it is doubtful in the situation you describe that the patient is going to provide you with a written authorization to use information in her patient record to refute what she has posted online, under HIPAA you would be prohibited from doing so.

Making matters worse, legal recourse in these situations generally is not possible. First, you would have to prove

who posted the information, which would be difficult since most online posting are anonymous. Second, even in your case, where you are sure who posted the information, it is often difficult proving whether the statements are factual or statements of opinion. Factual statements are legally actionable, whereas statement of opinion are not. Finally, even if you could prove the identity of the poster and that the statements were factual, you would still have to prove how you have been economically damaged by the posting. Tying the posting to a specific loss of patients would be very difficult.

This is a frustrating situation to be in, with no satisfactory way to defend yourselves using patient records. The best advice is not to respond to negative postings like this and instead mange your online reputation through your own internet advertising, your practice website, etc. Consider asking satisfied patients to provide online testimonials praising you for the care you provided. Most consumers will believe the majority of the opinions that they read, and they will see a single negative posting for what it is.

The good news is, if this negative posting stands alone among several (or many) favorable patient testimonials. It will likely be disregarded.

Dan Schulte, JD MDA

Photo: Image licensed by Ingram Image

PRACTICE

WHY CAVEMEN “NEEDED NO” BRACES

abandoned Norwegian graveyards with modern skulls indicated a trend toward bad bite in our more recent forebears. The skulls of people scored as being in “great” or “obvious” need of orthodontic treatment made up 36% of the medieval sample and 65% of the modern samples. And evidence of malocclusion in still earlier human fossils is vanishingly rare. The jaws of hunter-gatherers nearly uniformly reveal roomy, perfect arches of well-aligned teeth, with no impacted wisdom teeth – a movie star’s dream smile, 15,000 years before the movies!

So, what’s happening in our mouths? Why do we today face an epidemic of crowded unruly, crooked teeth? The answer, as it turns out, has been lying right under our noses the whole time: The problem is our jaws.

Modern industrialized societies are plagued by crowded, ill-alligned teeth, a condition that the dental profession refers to as “malocclusion” – which translates literal to “bad bite.” Survey data from 1998 suggests that as much as a fifth of the U.S. population has significant malocclusion, more than half of which require at least some degree of orthodontic intervention. Braces, tooth extractions, and retainers are the bread and butter for all the dentists and orthodontists tasked with setting straight our dental deviations. Having braces as a child has become so common in the Western world that it can seem a rite of passage – today, an estimated 50% to 70% of U. S. children will wear braces before adulthood. But what did humans do to fix teeth before modern dentistry, before Novacain, gauze, and rubber spacers?

As it turns out, our ancestors did not suffer from crooked teeth to the same extent that we do today. Our species’ fossil record reveals a telling story: The epidemic of crooked teeth developed in humans over time. Evolutionary biologist, Daniel Lieberman, notes the pattern in his book, “The Story of the Human Body”:

The museum I work in has thousands of ancient skulls from all over the world. Most of the skulls from the last few hundred years are a dentist’s nightmare. They are filled with cavities and infections; the teeth are crowded into the jaw and about one quarter of them have impacted teeth. The skulls of preindustrial farmers also are riddled with cavities and painful-looking abscesses, but less than 5% of them have impacted wisdom teeth. In contrast, most of the hunter-gatherers had nearly perfect dental health. Apparently, orthodontists and dentists were rarely necessary in the Stone Age.

Ample evidence abounds in support of Lieberman’s observations. A comparison of 146 medieval skulls from

A key precipitating factor for malocclusion relates to the size of our jaws. For healthy development, jaws must be able to provide sufficient room for all 32 teeth that grow in the mouth. Over time, our teeth have grown crooked because our jaws have grown smaller. Why? The epidemic’s roots lie in cultural shifts in important daily actions we seldom think about; things like chewing, breathing, or the position of our jaws at rest, and these changes have in turn been brought about by much bigger sociohistorical developments – namely, industrialization.

Our upper jaw, which is technically known as our maxilla, seems as if it is just the base of our skull, but it is actually formed by two bones, one on each side, fused together. Our lower jaw, technically the mandible, is likewise made by the fusion of two bones. If the jaws develop correctly they have ample room for all for the teeth, and the teeth fit together well. Both upper and lower jaws can move and change in the process of development. But that process has been gradually altered ever since our ancestors began to use tools, cook, cease their mobile hunting-gathering lives and settled down to practice agriculture some 10,000 years ago.

Anthropologists have reported that the size of the human mouth has long been shrinking. Because human beings have been using stone tools for at least 3.3 million years, that may represent the time during which the shrinkage has occurred. Stone tools permitted a greater shift to a carnivorous diet because the ability to cut meat into small pieces reduced the amount of chewing required to extract nourishment. Less chewing reduced the need for large, powerful jaws. The advent of agriculture accelerate this treatment. As anthropologist Clark Larsen noted, “There has been a dramatic reduction in the size of the face and jaws wherever humans have made the transition from foraging to farming.” The superficial result, as we have seen, malocclusion.

Crooked teeth are a modern phenomenon and a telltale sign of on underlying epidemic.

Photo: Image licensed by Ingram Image

At this root, the problems we face is that we have entered a space age world with Stone Age genes – genes that evolved to produce jaws adapted to a hunter-gather diet. Today’s jaws epidemic is concealed behind the commonplace. Its most obvious symptoms are oral and facial, crooked teeth (and the accompanying very common use of braces), receding jaws, a smile that shows a lot of gums, mouth breathing and interrupted breathing, during sleep. A bother, but hardly an “epidemic” – at least until one recognizes the relationship between malocclusion and a veritable host of downstream health consequences.

If the jaws fail to develop properly, the receding mandible can put stress on the airway. The problems associated with modern jaw-facial-airway development are only now beginning to be uncovered, largely through the work of a series of dedicated scientists and practitioners who have observed dramatic changes in facial structure that correlate with higher incidence of chronic disease. Reducing the size of the airway, can for instance, eventually lead to breathing problems, such as sleep apnea, which itself has become a significant factor in public health. Some 20% of American adults are afflicted, and about 3% have a sufficiently serious case to cause daytime sleepiness. But sleepiness is the least of it. As many as half of all cardiac patients suffer from the disease. Sleep apnea also appears to generate mental problems, including lowered IQ, shortened attention span and difficulties with memory.

That the disease just noted are related to modern civilization is strongly indicated by the near absence of their symptoms in the evolutionary and historical records. Our hunter-gatherer ancestors had spacious jaws, with a continuous smoothly curved arch of teeth in each jaw, including third molars at the back ends of the arches. Today, the failure of these last molars to erupt – for our wisdom teeth to emerge healthfully from the gums – has become an all too common phenomenon that often leads to dental extraction and the attendant burdens of pain, swelling, bruising, infection and general discomfort. But with proper attention to diet, eating habits, breathing patterns, and overall oral posture (how we hold our jaw together at rest), many aspects of this epidemic, like molar impaction, could be ameliorated or avoided entirely. Jaws could return to their hunter-gatherers patterns of growth.

The bottom line is that our health and happiness (and that of our children) many be at risk due to habits which most of us never give a second thought. But how we eat can be just as important as what we eat; how we beath can be just as important as what’s in the air we breathe: how we sleep can be just as important as how long we sleep. These are all key aspects of the jaw epidemic and part and parcel of overall oral-facial health. It’s often said that the face is the window to the soul, but is also a window on the health status of the person behind the face. Gummy smiles, crooked teeth, and agape mouths are all visible signals that belie potentially much more serious underlying health problems. To address these problems our focus must be on the health development of our jaws.

Dr Sandra Kahn Paul R. Ehrlich

Continuing Education Courses

Thursday, March 30, 2023

Thank You to Our 2023 Convention Sponsors

It’s (Medically) Complicated! Essential Pharmacology for Treating Medically Complex Dental Patients.

- Tom Viola, RPh, CCP, CDE, CPMF

Esthetic and Functional Periodontal Plastic Surgery for Masterpiece Implant Restorations & Restorative Dentistry: Understanding the Fundamentals and Beyond - Jim Grisdale, DDS

How To Start Using Digital Dentures In Your Practice - Rhett Tucker, DMD

Incorporating Digital Dentistry - Jinny Bender, DMD

A Mini-Residency in Pediatric Dentistry: An Update - Barney Olsen, DDS, MDS

Optimizing Patient and Doctor Outcomes in Implant Dentistry - Nick Egbert, DDS, MDS

Local Anesthesia and Nitrous Oxide: Foundations of Pain Management in Dentistry - Enrique Varela, DDS

What Lies Beneath: Treating Periodontal Disease Systemically - Amber Auger, RDH, MPH

Banish Broken Appointments: Eliminate Cancellations and Last-Minute Changes - Larry Guzzardo, BSBA

Local Speaker Series - Does Your Membership Plan Suck? - Paul Lowry, BA, MBA

Hurts So…Swell! Management of Dental Pain and Appropriate Opioid Prescribing Practices.

- Tom Viola, RPh, CCP, CDE, CPMF

How Do I Choose the Most Effective Periodontal and Peri-implant Treatment for My Patients? Maintenance, Repair or Regeneration? How, When and Why? - Jim Grisdale, DDS

Let’s call it what it is.. Erosion or Bruxism? - Rhett Tucker, DMD

Current Trends in the Management of the Vital Pulp and Immature Tooth - Danielle Wingrove, DDS

Bitcoin, What Is It and Why Is It Important? - Grant Matsuura, BS, DDS

(continued on next page)

The RDH Toolkit: Chairside and Home Care Innovations for Improved Patient Outcomes - Amber Auger, RDH, MPH

The TRUTH About Insurance Companies and How to be PROFITABLE With Them - Tracy Thorup, MBA

Surround Yourself with Greatness - John Bytheway

Local Speaker Series - Latest Trends in Practice Transitions - Randon Jensen BA, CBI

Continuing Education Courses

Friday, March 31, 2023

Workflows for Digitally Produced All on X Hybrids, Overdentures, and Screw-Retained Implant Prosthetics

- Sam Strong, DDS

Dental Caries: Go Upstream! - V. Kim Kutsch, DMD

Trump’s Tweet: Keeping Oral Pathology Great! - Bryan Trump DDS, MS

Claims Submission and Payment Why Are My Claims Getting Denied? - Steve Canfield, DDS, CDC

Progressive Periodontal Therapy - Amber Auger, RDH, MPH

The Future of Whitening: Targeting a New Generation - Marti Santizo, RDH, MBA

The Age of I - Pam Kovar, RDA, EFDA

Get the Phone! Never Dread conversations In Person or On the Phone - Larry Guzzardo, BSBA

Local Speaker Series - How to Get A “YES!” for Funding From Your Bank - David Kirby

Local Speaker Series - The National Diabetes Prevention Program and Dental Health - Pamela Chapman, RD, CDCES

Anesthesia and Sedation in Dentistry - Mitch Duckworth, DDS

Workflows for Digitally Produced All on X Hybrids, Overdentures, and Screw-Retained Implant Prosthetics

- Sam Strong, DDS

Wellness Coaching for Dental Caries - V. Kim Kutsch DMD

Trump’s Tweet: Not Everything is Black & White, But Some Things Are - Bryan Trump, DDS, MS

The Dental Hygiene Detective - Amber Auger, RDH, MPH

Prevention & Treatment for the Wear & Tear on Oral Tissues - Marti Santizo, RDH, MBA

Who am I? - Pam Kovar

The TRUTH About Insurance Companies and How to be PROFITABLE With Them - Tracy Thorup, MBA