UDA Action

Dr

Dr Suzanne Ebert

Janiece C. Ervin

Bracken Killpack

Deborah Kotz

Dr Paul Palo

Dr Stacey Swilling

Dr Mark R. Taylor

Dr Rodney Thornell

Dr Bryan Trump

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SERVING TO MAKE A DIFFERENCE

Dear Colleagues and Friends:

I recently returned from the Western States President’s Conference sponsored by the Nevada Dental Association and held in the beautiful Lake Tahoe area. Along with Dr. Val Radmall and Dr. Len Aste, I was able to spend two days there with similar leadership from twelve other western states, including Alaska and Hawaii. The agenda focused on contemporary issues that we are all dealing with as a profession. The discussion was lively and informative. I came away from the meeting with a renewed awareness that we really do have a good thing going here in Utah. While not perfect, our Utah Dental Association is focused on the relevant issues, is well connected with other groups and organizations that interface with dentistry, and is very responsive to member needs. The UDA is also doing a good job at running interference with predatory groups that work hard to take unfair advantage of dentists and our patients. All this is being done with comparatively limited financial resources. Our dues structure is currently the lowest in the nation. In other words, the UDA is a lean, mean fighting machine.

This is made possible for a variety of reasons, not the least of which is a generous attitude towards volunteerism. We serve because we care and because we want to make a difference. Allow me to share a few examples:

1. Our 2023 House of Delegates approved the creation of the Sugar, Soda and Nutritional Awareness Task Force. This group of volunteer dentists is looking to partner with like-minded organizations, to explore ways to increase awareness regarding this important public health issue. To this end, a one-time $5,000 matching fund was appropriated, to be used only when combined with a like amount from other entities. This task force is reaching out to news organizations and other groups with a platform and audience for assistance in delivering this message. A special thanks to Dr. Jake Haslam, Dr. Scott Updyke, Dr. Ben Russell, Dr. Jessica Ash and Dr. Jamison Wagner for their time and energy, and their generous efforts in this regard!

2. Volunteer dental clinics in our state are staffed and supported by many of you and your dental teams. Thank you! In fact, a dentist who retires and moves to Utah can now apply to DOPL for a Volunteer License which allows them to render care at any one of the following volunteer clinics:

• Davis Donated Dental Services

550 E. 300 S., Kaysville, UT Tel. 801-631-3218

• Doctors’ Volunteer Clinic of St. George 1036 E. Riverside Dr., St. George, UT Tel. 435-656-0022

• Salt Lake Donated Dental Services

1383 S. 900 W. #128, SLC, UT Tel. 801-349-5177

• For more information about volunteer clinics in your area, please visit the Humanitarian Opportunities tab under Classifieds at uda.org

3. As you well know, Give Kids a Smile is an event in our state which annually provides hundreds of thousands of dollars of dental care for young children. Dr. LaRisse Skeen, Dr. Rodney Thornell, Dr. Jim Williamson and a host of others have diligently worked to make this annual event so successful.

I could go on. Many of you, quietly and without fanfare, in your own dental office, provide valuable and much needed care to individuals who just need a little extra help. Each of you are making a difference and serving in your own way. Your exemplary actions in stepping up to lift where you stand are inspirational.

In addition to all this giving, our UDA office is effective and efficient. Dr. Val Radmall, along with Dotty Tanner and Becky Waters, run a tight ship. They are prudent with expenditures and wise with resources. Our assets are well managed. Yes, when all the western states are on stage and showcased together, it is readily apparent just what a good thing we have going in Utah. It was a pleasure to be part of the team that represented Utah at the conference. It made me proud to be a part of the Utah Dental Association.

Thank you for allowing me to serve as your president!

Sincerely,

Mark R. Taylor, DDS

The biggest factor that determines how well you age is not your genes but how you live. Not convinced? A February study of 20,000 British folks published in the British Medical Journal show that you can cut your risk of having a stroke in half by doing just a few things, being active for 30 minutes a day, eating five daily servings of fruit and vegetables, and avoiding cigarettes and excessive alcohol.

Although those are some of the obvious steps you can take to age well, researchers have discovered that centenarians tend to share certain traits in how they eat, move about, and deal with stress – the sorts of thing we can emulate to improve our own aging process. Of course, getting to the age of 100 is enormously more likely if your parents did. Still Thomas Perks, who studies the century-plus set at Boston University School of Medicine believes that – assuming that you’ve sidestepped genes for fatal diseases like Huntington’s – “there’s nothing stopping you from living independently well into your 90’s.” Heck, if you parents and grandparents were heavy smokers, they might have

died prematurely without ever reaching their true potential life span. So go ahead, and shoot for those triple digits.

1. Don’t Retire: “Evidence shows that in societies where people stop working abruptly, the incidence of obesity and chronic disease skyrockets after retirement,” says Lugu Ferrucci, director of the Baltimore Longitudinal Study of Aging. The Chianti region of Italy, which has a high percentage of centenarians, has a different take on leisure time. “After people retire from their jobs, they spend most of the day working on their little farm, cultivating grapes or vegetables,” he says. “They’re never really inactive.” Farming isn’t for you? Volunteer as a docent at your local art museum or join the Experience Corps, a program offered in 19 cities that places senior volunteers in urban public elementary schools for about 15 hour a week.

2. Floss Every Day: That may help keep your arteries healthy. A 2008 New York University study showed that

daily flossing reduced the amount of gum disease-causing bacteria in the mouth. These bacteria are thought to enter the bloodstream and trigger inflammation in the arteries, a major risk factor for heart disease.

3. Move Around: “Exercise is the only real fountain of youth that exists,” says Jay Olshansky, a professor of medicine and a researcher in the field of aging at the University of Illinois-Chicago. “It’s like the oil and lube job for your care. You don’t have to do it, but your car will definitely run better.” Study after study shows that exercise improves your mood, mental activity, balance, muscle mass and bones. “And the benefits kick in immediately after your first workout,” Olshansky adds.

4. Eat A Fiber Rich Cereal For Breakfast: Getting a serving of whole grains-especially in the morning appears to help older folks maintain stable blood sugar levels throughout the day, according to a recent study conducted by Ferrucci and his colleagues. “Those who do this have a lower incidence of diabetes, a known accelerator of ageing,” he says.

5. Get At Least Six Hours Of Shut-Eye: Instead of skimping on your sleep to add more hours to your day, get more to add years to your life. “Sleep is one of the most important body uses to regulate and heal cells,” says Ferrucci. “We’ve calculated that the minimum amount of sleep that older people need to get those healing REM phases is about six

hours.” Those who reach the century mark make sleep a top priority.

6. Consume Whole Foods, Not Supplements: Strong evidence suggests that people who have high blood levels of certain nutrients-selenium beta, carotene, vitamins C and E-age much better and have a slower rate of cognitive decline. Unfortunately, there’s no evidence that taking pills that contain these nutrients provides anti aging benefits. Avoid nutrient lacking white foods (breads, flour, sugar) and go for all those colorful fruits and vegetables and dark whole grain breads and cereals with their host of hidden nutrients.

7. Be Less Neurotic: It may work for Woody Allen, who infuses his worries with a healthy dose of humor, but the rest of us neurotics may want to find new ways to deal with stress. “We have a new study that shows that centenarians tend not to internalize things or dwell on their troubles,” says Perls. “They are great at rolling with the punches.”

8. Be A Creature of Habit: Centenarians tend to live by strict routines, says Olshansky, eating the same kind of diet and doing the same kind of activities their whole lives. Going to bed and waking up at the same time each day is a good habit to keep your body in a steady equilibrium, which could be easily disrupted as you age. “Your physiology becomes frailer as you become older,” explains Ferricci, “and its harder for your body to bounce back if you, say, miss a few hours of sleep on night or drink too much alcohol.” This can weaken immune defenses, leaving you more susceptible to circulating flu viruses or bacterial infections.

9. Live Like A Seventh-Day Adventist: Members of the denomination have an average life expectancy of 89 about a decade longer than the average American. One of the basic tenets of the religion is that it’s important to cherish the body that’s on loan from God, which means no smoking, alcohol, or overindulging in sweets. Followers typically stick to a vegetarian diet based on fruits, vegetables, beans and nuts and get plenty of exercise. They’re also very focused on family and community.

10. Stay Connected: Have regular social contact with friends and loved ones is key to avoiding depression, which can lead to premature death, something that’s particularly prevalent in elderly widows and widowers. Some psychologists even think that one of the biggest benefits elderly folks get from exercise is the strong social interactions that come from walking with a buddy or taking a group exercise class. Having a daily connection with a close friend or family member gives older folks the added benefit of having someone watch their backs. Another benefit to close connections: “They’ll tell you if they think your memory is going or if you seem more withdrawn,” says Perls, “and they might push you to see a doctor before you recognize that you need to see one yourself.”

Deborah Kotz

TAKE INTERVIEWS BEYOND SKILLS TO FIND THE RIGHT ASSOCIATE FOR YOUR PRACTICE

“While experience is important, skills can ultimately be trained. Underlying personality traits cannot. Take the time to find someone who has the right attitude, approach, and personality for your practice…”

You’ve built your practice’s reputation on a certain style of care and may have known your patients for decades. That’s why hiring an associate or finding a successor can be so difficult: You want confidence that Mrs. Smith will get the same care quality she expects.

At ADA Practice Transitions (ADAPT), we speak with owners looking to hire an associate or sell their practice. We strive to connect doctors who can work well together and respect each other’s professional decision-making.

While experience is important, skills can ultimately be trained. Underlying personality traits cannot. Take the time to find someone who has the right attitude, approach and personality for your practice, then help them gain experience under your mentorship.

So how can you make sure an associate or successor is “right” for your practice and patients?

Ask — and answer — questions

Interviewing should be a two-way street. Listen closely and ask follow-up questions. But also allow enough time and space for the candidate to ask their own questions. It’s just as important that they feel confident about the fit.

PRACTICE

ORAL

Which of the following represents the best diagnosis for the radioraphic finding of a unilocular radiolucency surrounding the crown of impacted tooth #32:

Review a few charts together

While there can be many paths to a great outcome, you need to respect the other doctor’s thought process and methods. More importantly, chart review will demonstrate how the two of you communicate. Look for open dialogue and respectful exchange of differing opinions.

Involve your staff

Some doctors think they must keep the search process confidential, especially while looking for a successor. The truth is, you are more likely to hire the right person for your practice if you involve your trusted staff members. After all, they built the practice to continue to care for “their” patients even after you are gone.

Consider having your staff spend 15-30 minutes with strong candidates to assess how well they will work together.

Shadow at least three times

Everyone is on their best behavior during a first encounter. True personalities emerge with subsequent meetings. That’s why I recommend potential candidates shadow you in the office, with patients, at least three times.

This lets you and your staff assess how well the candidate will fit into your practice, while the candidate can determine whether they will be satisfied.

Dr Suzanne Ebert American Dental Association

A) Odontogenic cyst

B) Ameloblastoma

C) Odontogenic keratocyst

(continued on page 20)

FROM THE OFFICE OF THE STATE DENTAL DIRECTOR

As I’m nearing the end of my first year as State Dental Director, I want to share some updates from the Utah Oral Health Program (OHP).

As mentioned in a previous UDA Action article, DHHS was awarded a HRSA grant for an Oral Health Innovation Project in rural Utah, specifically the Uintah Basin area. Partnering with DHHS’s Oral Health Program are Mountainlands Community Health Center (MCHC), Ashley Regional and Uintah Basin Medical Centers, the University of Utah School of Dentistry, and Fort Duchesne Indian Health Service for the Emergency Department Diversion Project. Per project objectives, a training program about oral health issues for emergency department personnel in the participating hospitals has been developed and implemented. Capacity for dental services at MCHC has increased. A referral system has been developed that closes the loop and connects individuals seen in emergency departments with dental services and is to be implemented soon. The goal is to use what is learned during this pilot project in other areas of the state, ultimately fulfilling the OHP mission “to advance the general health and well-being of all Utahns by promoting oral health and preventing oral disease.”

With the HRSA funding, Kara Taylor, RDH, was added to the team as the Oral Health Program Coordinator. Kara has been a great asset. Originally from Minersville, she completed her dental hygiene studies at Southern Utah University and Utah Valley University. Prior to beginning the public health portion of her career, she worked in private practice for over 10 years. Prior to becoming a part of the OHP, Kara worked for the Southwest Utah Public Health Department and the DHHS Disability and Health Program.

Lauren Neufeld, RDH, has continued with the Department as the Oral Hygiene Educator. She regularly collaborates with other DHHS agencies, including the Office of Home Visiting, the Women, Infants, and Children (WIC) Program, and Head Start Programs. She manages the Educational Intervention Program for Adolescents and has been involved in the Opioid Toolkit development and dissemination.

Starting in September 2023, the State Dental Director will once again become funded as a full-time position. This has been a call to action for many oral health advocates across the state for quite some time, and it is finally coming to fruition.

Looking ahead:

· Basic Screening Survey (BSS) of 3rd graders in Utah: The last time this was done in Utah was in 2015-16. Gathering this information will give insight into the oral health status of the children of Utah. The OHP plans to launch the BSS of 3rd graders in Utah in 2024.

· State Oral Health Improvement Plan (SOHIP): One of the OHP’s biggest undertakings in the coming year is to develop

a State Oral Health Improvement Plan in partnership with Sri Koduri of SiriS Consulting LLC. The improvement plan will be developed using a survey of stakeholders. Follow-up focus groups and patient needs’ assessment will be conducted based on survey results.

Call for help and partnership:

I ask for your help in developing the State Oral Health Improvement Plan – please take 15 minutes of your precious time to complete our stakeholder survey. You can also access it with the QR code below. We would like input from a variety of voices… please share this survey with your dentists, dental hygienists, dental assistants, office managers, organizational administrators, and staff (including front office personnel). We want to hear from all. If you would like to participate in a focus group or in conducting a patient needs assessment, please let us know via the survey.

I’ve enjoyed meeting many new people across the state over the course of the last year. As always, I encourage you to reach out to me to share your concerns, ideas, and thoughts related to the Utah OHP. My email is sswilling@utah.gov, and I look forward to getting to know more of the Utah dental community soon.

https://www.surveymonkey.com/r/UtahOralHealth

Stacey Swilling, DDS Utah State Dental Director

a) House of Delegates - Governance

b) UDA Action Committee - Publications

c) UDPAC Committee – Legislation

d) I know my legislators – Name them & connection

e) I’d be willing to be a Collaborative Dentist

PROTECT THE VALUE of Your Practice

Besides helping you set a listing price when you are ready to sell your practice, Practice Valuations are needed to:

HIPAA & OSHA: SAFEGUARDING PATIENTS AND STAFF IN DENTAL PRACTICES

In the fast-paced world of dental practices, it is crucial to prioritize patient privacy and ensure a safe working environment for staff members. This can be achieved by effectively managing hazards through compliance with HIPAA (Health Insurance Portability and Accountability Act) and OSHA (Occupational Safety and Health Act) guidelines.

HIPAA was enacted to ensure that patients’ protected health information (PHI) remains confidential and secure. As a dental professional, understanding HIPAA regulations is essential to maintaining compliance and building trust with patients. In addition to protecting patient privacy, dental practices must prioritize the safety of their staff members. OSHA establishes guidelines and regulations to minimize workplace hazards and prevent occupational injuries.

The Basics of HIPAA Compliance: Setting the Standard HIPAA sets forth guidelines for healthcare providers to safeguard PHI. This includes any individually identifiable health data transmitted or maintained in any form, including:

• Electronic Records

• Paper Files

• Oral Communications

• Images

For dental practices, this encompasses:

• Patient records

• X-rays

• Treatment Plans

• Billing Details

• Insurance Claims

To achieve HIPAA compliance, dental practices must implement a series of safeguards. These include:

• Administrative Safeguards (developing policies and procedures)

• Physical Safeguards (securing access to areas where PHI is stored)

• Technical Safeguards (using encryption methods to protect electronic PHI)

Safeguarding Electronic Health Records: Protecting PHI At All Costs

With the widespread adoption of electronic health records (EHR) systems in dental practices, it is crucial to take measure to protect these digital records. Dentists must implement robust cybersecurity protocols to prevent unauthorized access or breaches.

Encryption is an effective method for securing EHR. Encrypting PHI ensures that even if data is intercepted or stolen, it cannot be accessed without an encryption key. Dental practices should also regularly back up their EHR and maintain a disaster

recovery plan to restore any lost or compromised data swiftly.

Training and Education in HIPAA Compliance

One critical component of HIPAA compliance is ensuring that all staff members are adequately trained on privacy rules and regulations. Dental practices should conduct regular training sessions to educate employees about their roles and responsibilities regarding patient privacy.

This includes teaching them how to:

• Handle PHI properly

• Securely dispose of documents containing PHI

• Report any suspected breaches or violations

Furthermore, dentists should keep up to date with changes in HIPAA regulations by attending conferences or workshops focused on healthcare law. Staying informed about evolving guidelines will help you adapt your practice’s policies accordingly.

The Basics of OSHA Compliance: Understanding the Importance of Employee Safety

The basics of OSHA compliance involves employers implementing safely measures, training programs and policies in accordance with OSHA standards.

This includes:

• Personal Protective Equipment (PPE)

• Conducting Regular Inspections

• Maintaining Accurate Records of Injuries and Illnesses

• Addressing Hazards or Violations Promptly

Employers must also provide employees with information about their rights under OSHA, such as the right to report unsafe conditions without fear of retaliation. Overall, OSHA compliance is essential for promoting workplace safety and preventing accidents or injuries on the job.

OSHA in Dental Practices: Looking Behind the Staff Training

There are multiple training programs employers must implement to ensure a clean and safe environment.

1. Infection Control Measures

Dental practitioners are exposed to various infectious materials daily, such as blood and saliva. To ensure the safety of both patients and staff, dental practices must adhere to strict infection control measures outlined by OSHA. These measures include:

• Sterilizing Instruments Between Patients

• Using PPE (gloves, masks, eyewear, etc)

• Practicing Proper Hand Hygiene Techniques

• Maintaining Clean Treatment Areas

Regular training on infection control procedures should be conducted for all employees to reinforce compliance with OSHA guidelines.

2. Chemical Hazard Management

Dental offices often use a wide range of chemicals for disinfection purposes or during certain dental procedures. It is crucial to handle these substances safely to protect staff members from potential harm.

OSHA requires dental practices to have a Hazard Communication Program in place.

This program includes:

• Labeling Hazardous Chemical Appropriately

• Providing Material Safety Data Sheets (MSDS) for Each Chemical Used

• Training Employees on Safe Handling Procedures

• Ensuring the Proper Storage and Disposal Methods

3. Ergonomics & Musculoskeletal Health

Dentistry involves prolonged periods of sitting or standing while leaning over patients. These repetitive motions can lead to musculoskeletal disorders (MSDs) such as back pain or carpal tunnel syndrome among dental professionals.

To mitigate these risks, dental practices should focus on ergonomics in the workplace. Providing adjustable chairs, proper lighting, and ergonomic instruments can help reduce strain on the body. Dentists should also encourage their staff to take regular breaks and stretch to prevent long-term health issues.

Maintaining Compliance with HIPAA and OSHA Within the Dental Field

Complying with HIPAA and OSHA regulations may seem daunting, but it is necessary for dental practices to ensure patient privacy and employee safety.

Here are some key steps to maintain compliance.

1. Conduct Regular Risk Assessments

Identify potential vulnerabilities in your practice that could lead to breaches or PHI workplace hazards.

2. Develop Comprehensive Policies and Procedures

Create written guidelines covering all aspects of HIPAA compliance, including data breach response plans, and incident reporting procedures. Similarly, establish protocols for infection control, chemical hazard management, and ergonomic practices as per OSHA guidelines.

3. Train Employees

Provide thorough training programs for all staff members on HIPAA privacy rules, infection control measures, chemical handling protocols and ergonomics. Regularly, update training materials to reflect changes in regulations.

4. Continuously Monitor and Review Compliance

Regularly assess your practice’s adherence to HIPAA and OSHA regulations through internal audits or third-party assessments. Make necessary improvements based on findings to stay compliant.

All in all, by prioritizing patient privacy under HIPAA guidelines and ensuring a safe working environment following OSHA regulations, dental practices can provide excellent care while protecting both patients and staff members alike.

Contributed by Compliancy Group

Compliancy Group’s simplified software solution and Customer Success Team guide dentists to achieve HIPAA compliance. As the only HIPAA solution endorsed by the American Dental Association, dentists can be confident in their compliance program.

PRACTICE

CLARIFYING THE CONTROLLED SUBSTANCE EDUCATION REQUIREMENT FOR DEA REGISTRATION

Section 1263 of the spending bill Congress passed in December 2022 requires controlled substance prescribers to complete eight hours of one-time training on safe controlled substance prescribing as a condition of receiving or renewing a DEA registration. The statutory language was taken from a separate bill, title the Medication Access and Training Expansion Act (or MATE Act).

What does the MATE Act require me to do?

If you are not submitting a DEA registration or renewal, this requirement does not apply to you and you do not have to do anything. Otherwise, at the time of your next schedule DEA registration submission registrants must:

• Have completed eight hours of qualified training on safe controlled substance prescribing, with certificates of completion. You do not need to submit the certificates to the DEA, but you should have them on file.

• Check a box on their registration submission affirming they have completed the training.

• Retain copies of all certificates of completion.

These requirements apply regardless of whether a registrant is completing their initial registration application or renewing their registration. It also applies to all drug schedules (Schedules II, III, IV, and V).

In Utah, the past licensing cycle requirements required a licensee to complete 2 hours of controlled substance training. If a dentist completed this Utah renewal requirement for the past 4 licensing cycles – they have already completed the DEA (MATE Act) 8 hour requirement.

ASSOCIATION

THE VALUE OF THE AMERICAN DENTAL ASSOCIATION –ORGANIZED DENTISTRY’S PUBLIC WORKS

“While there are many reasons why the American Dental Association is valuable to our nation’s dentists, I believe it is important to point out some of the less obvious values. Like road, electrical, water, and sewage systems help ensure stable communities, the ADA provides important infrastructure that sustains and enhances the work of state dental associations, local dental societies, and your practice.”

The dawn of a new year brings many tasks: gathering tax documents, updating calendars, and working on well-intentioned resolutions…

A question I regularly hear from members is, “What’s the value of being a member of the ADA?” Some see more tangible value of membership in local and state organizations than in the national organization.

While there are many reasons why the American Dental Association is valuable to our nation’s dentists, I believe it is important to point out some of the less obvious values. Like road, electrical, water, and sewage systems help ensure stable communities, the ADA provides important infrastructure that sustains and enhances the work of state dental associations, local dental societies, and your practice.

Here are a few examples:

• The ADA fully funds the cost of Association Management Software (AMS) for the entire Tripartite. AMS is the lifeblood of any membership organization, reducing the time and expense of creating and maintaining data for membership, accounting, governance, and events. The fact that almost every state dental association and local dental society uses the same AMS enables better collaboration. By covering the costs of a consistent AMS for the entire Tripartite, the ADA saves dental organizations hundreds of thousands of dollars collectively annually, savings we pass on to our members.

• The ADA significantly reduces the cost of knowing what activities are occurring in locations outside of your own jurisdiction. For example, take the case of a local dental society working with a rural city to install the new water fluoridation tablet feeder system (developed with funding from the CDC and worth a deep dive in a later issue) and needing to quickly get technical guidance from a location that has already implemented the system. Thankfully, the ADA’s Council on Advocacy for Access and Prevention is able to quickly connect a component with needed resources because they constantly monitor water fluoridation activities across the country. State Associations and other Tripartite members routinely access ADA resources because

it’s cheaper and less time-consuming than building and maintaining that knowledge in-house.

• The ADA invests in being a respected thought leader that furthers the practice of dentistry and makes our society healthier. Two ADA entities that everyone should know about are the Health Policy Institute (HPI) and the ADA Science & Research Institute (ADASRI). These organizations provide valuable data that can help us be better advocates and drive innovation in dental materials and other areas. Just as basic scientific research enables future business ventures, HPI and ADASRI help shape the future practice of dentistry and innovative public policy that aids in delivering optimal care.

• The ADA is also a great aggregator of best practices and distributor of useful toolkits across organized dentistry. Within the last few months alone, State Associations have used ADA toolkits on membership recruitment and retention, in-office dental plans, and minimum loss ratio legislation. These are valuable resources that help all of us avoid reinventing the wheel.

Think about how the quality of life in your hometown would deteriorate if everyone had to build and maintain their own roads, utilities, water and sewage systems. That’s the type of collective value the ADA provides for the entire Tripartite. Providing these infrastructure services is often thankless and only becomes front of mind when these systems are not working properly.

In early January, I participated in a meeting with my counterparts from across the country at the ADA’s Chicago headquarters. We discussed the ADA-maintained organizational infrastructure and improvements that we can make collectively. I am thoroughly impressed by the work of ADA staff under the leadership of former ADA Executive Director Kathy O’Loughlin and current Executive Director Raymond Cohlmia, especially in comparison to the state of our collective infrastructure in 2006, my first year at WSDA.

The ADA is a valuable partner to you and your dental practice. As we work together for the good of our patients and profession, it’s important to remember that the ADA makes this work much more feasible.

Bracken Killpack WSDA Executive Director

ETHICAL OBLIGATIONS TREATING A PATIENT WITH QUESTIONABLE DECISION-MAKING CAPACITY

These patients are at high risk of drug interactions or adverse effects. These interactions, as they pertain to mental acuity, are not well documented. As with any medical concern, it is always prudent to consult with the patient’s physician on not just their physical condition but also their mental or cognitive condition. This should also take into account that their cognitive state may be reversible. To move forward with any treatment at this point would be akin to withholding important information from the patient. This can be viewed as being in direct conflict with the principle of Nonmaleficence.

Q: Agnes is a patient of many years who has a chief symptom of lost partial dentures. She is 85 years old, and I have noticed that she has become confused recently and at times disoriented. She asked that I replace her partials with permanent bridges so that she would not lose them. Her oral hygiene is marginal at best and the supporting teeth are questionable as bridge abutments. I feel uncomfortable proposing such extensive and potentially expensive treatment to her if she is becoming mentally unsound. When I ask whether there is a friend or family member who could help her with this decision, she quickly dismisses this and insists that she is solely responsible for her care. What are my ethical obligations of following through with her wishes?

A: Your question centers around an aging patient with potential diminished mental capacity being able to make cogent decisions about their dental health. Dental treatment plans are often complex and difficult to comprehend for even the most competent patients. Add to this any barrier, such as language or mental capacity, and the problem becomes almost insurmountable. This would encompass the following 2 principles of ethics as they relate to decision making: Nonmaleficence (“do no harm”) and Patient Autonomy (“selfgovernance”).

Let us look at the facts that you presented as they relate to the American Dental Association’s Principles of Ethics and Code of Professional Conduct First is the principle of Nonmaleficence. There are numerous reasons why a patient may be exhibiting confusion besides dementia, for example, diet insufficiency or improper pharmacologic regimen. Most older adult patients are on a variety of drug therapies for various physical problems.

Second is the ethical principle of Patient Autonomy. The American Dental Association Principles of Ethics and Code of Professional Conduct states in Section 1, Patient Autonomy, that “The dentist has a duty to respect the patient’s rights to self-determination and confidentiality.” Furthermore, it says that “…professionals have a duty to treat the patient according to the patient’s desires, within the bounds of accepted treatment….” We can presume that this principle applies to patients with conventional mental statuses, not necessarily to the patients with altered mental capacities. As the population of aging patients expands, understanding their complex medical histories, which also include their mental statuses, can become difficult. An estimated 6.5 million older Americans now have dementia, including approximately 11% of the population 65 years and older and more than 32% of the population 85 years and older. Taking into account that patients who are possibly in the early stages of dementia may still be capable of making their own treatment decisions, it would be prudent to first seek consultation with the patient’s treating physician in regard to their mental state.

To take this issue from the academic to the practical arena, we have a patient who is asking for a specific course of treatment that is potentially extensive and expensive, with an uncertain outcome. Based on the patient’s mental condition, the dentist’s ethical obligation would be to defer any treatment recommendations until a sound mental diagnosis is in hand. This will satisfy the ethical principles of both Nonmaleficence and Patient Autonomy.

It is clear that no treatment recommendations should be made or followed through without referral to the patient’s physician for a thorough mental evaluation and diagnosis. Once this diagnosis is made, you and your patient will have a clearer view of how to move forward with treatment. This may also include inviting a family member or caregiver to aid in the final treatment decision.

Paul Palo, DMD, FAGD, ACD Journal of the American Dental Association June 2023

Photo: Image licensed by Ingram Image

ASSOCIATION

STRONGER TOGETHER

After dedicating 30 years to his company, my brother was let go from his job. It wasn’t a surprise since the company, previously a small locally-owned shop, had been acquired by a larger more corporate-minded group. They aimed to implement changes that my brother felt uncomfortable with, and eventually after facing his resistance, they decided to part ways.

I can only attempt to comprehend the emotions he must have experienced – devoting a lifetime to something, only to have his loyalty and dedication swiftly pushed aside and forgotten. In today’s world, dominated by corporate earnings and production targets, such situations should hardly catch us off guard. The phenomenon of “Amazonation” has been gradually engulfing our local businesses, and it’s plausible that soon only a handful of colossal corporations will reign over most industries.

A parallel trend is evident in our own industry. Dentists are increasingly selling their practices to larger corporate offices at an unprecedented rate. Over the years, numerous specialists to whom I’ve referred patients have succumbed to corporate ownership. While I can’t blame them, considering the staggering sums they receive for selling their practices, I am concerned about the ramifications for the future of our profession.

A prevailing sentiment suggests that the younger generation of dentists is more inclined towards being employees rather than business owners. This shift towards a corporate-employed dentist/specialist model is touted as necessary for the future of our profession. However, I find myself unconvinced by this argument. While it may hold merit in the short term, given the current cultural biases, I’m skeptical about its long-term implications.

In my fervent opinion, this is not the optimal decision for everyone in dentistry. While the corporate-employed dentist model certainly has its place, most dentists I know are better suited to serve their patients as owner-dentists.

Regardless of where you stand on this debate, take solace in knowing that the ADA has your best interests at heart. Those who share my perspective can find reassurance in the fact that some of us within the ADA are championing the cause of the “underdog.” Similarly, for those advocating the corporate-employed dentist model, numerous ADA dentists are advocating for your interests as well. Despite our differing views on the ideal practice model, we, as dentists, are stronger together.

The fall season brings with it the ADA House of Delegates meeting and our local “CQI” gatherings. These events provide a platform for us to collaborate and enhance our profession collectively. If there are specific areas you believe need improvement, please reach out to us at the UDA/ADA, and let us work together to make a difference. Dentists have an unparalleled ability to support one another, surpassing any other group or business. It is imperative that we stand united and collaborate to ensure a promising future.

I sincerely hope that each of you, after dedicating three decades of hard work and commitment to your patients and our profession, will find your sacrifices validated and not overlooked. I encourage you to engage with your local dental district and join forces with us at the UDA to assist fellow dentists, like yourself, in navigating our wonderful field more effectively

Rodney Thornell, DMD UDA Treasurer

PRACTICE TRUST IN NEW TECHNOLOGY

During my undergraduate years at the University of Utah I lived in the Avenues of Salt Lake City. Across the street from my apartment was the home of a sweet 90 year old couple named Berni and Hilda Barnes. Almost like clock work, during good weather Berni would sit on his front porch and watch traffic go by. I would regularly take breaks from my studies to sit and talk with Berni about all things old and new. One day while we were sitting there chatting Hilda came out with a handful of envelopes. One was labeled electric bill, another phone bill and the last a gas bill. Inside of each envelope was the billing statement and some cash. Hilda said to Berni “It’s time to pay the monthly utility bills” and then she handed him the envelopes. I said to Berni “Why don’t you just mail a check to the utility companies, it will save you time and money not having to go down to each one individually.” Berni replied in a loud voice, “I don’t trust those checks, they are just a piece of paper and they have my bank account number on them and anyone could get into my account take my money or just change the amount written on the check if they wanted to.” I was surprised at Berni’s distrust in new technology.

Fast forward 30 years when I was sitting on my patio with one of my sons talking about how and when he planned on repaying me for some money I had loaned him. He said “Let me just Venmo you a payment each month, it will be the easiest and most convenient way.” I asked, “What is Venmo?”

He began to tell me that it is an online banking app that allows you to transfer money from one person’s bank account to another account. All you have to do is download the app, give them your banking information and it’s done. My response was, “I don’t trust that online banking stuff. Anyone could get into your account and steal your money if they wanted to.”

My how technology has changed and improved our lives over the years. But it has taken us time to adapt to it and trust that it is safe to utilize. For example, artificial intelligence (AI) seems to have appeared out of nowhere and now all of a sudden it is all over the news. Too many of us it seems like new technology, but I’m certain that in those huge secret buildings that Google, Microsoft and Apple have built, AI research has been going on for years. AI applications for dentistry are transformational.

It has improved our imagining and diagnosis abilities. AI based software has improved treatment planning by analyzing data, case histories and treatment outcomes. It enhances virtual reality in patient education and treatment visualizations. AI can handle appointment scheduling, patient communications and billing processes. All of which reduces administrative burdens and enhances overall practice efficiency.

Currently another technology is being developed that many people know little about. But it could have as big an impact on our lives and dentistry that AI is having. It is called In Vitro Gametogenesis (IVG). IVG involves the creation of human gametes (sperm and eggs) from pluripotent stem cells in a laboratory setting, bypassing the need for traditional methods of gamete production within the human body. Pluripotent stem cells, which have the capability to differentiate into various cell types, are collected from sources such as embryos, adult tissues, or induced pluripotent stem cells. Through a series of carefully controlled steps, the pluripotent stem cells are guided to develop into either sperm or egg precursor cells, resembling natural gamete development.

The precursor cells are then nurtured in a controlled environment to encourage their maturation into functional sperm or eggs. Once mature, the laboratory-created gametes can be used for fertilization through in vitro fertilization (IVF) or

other assisted reproduction techniques. IVG embryos combined with new gene-editing techniques could eradicate genetic diseases and also enable the development of designer babies.

The ability to genetically modify future generations to produce the perfect baby are closer than most people realize. The applications of this technology for dentistry are real and not science fiction. Imagine designing an embryo with genes for a perfect oral anatomy. A jaw that is capable of providing space for all 32 teeth without crowding. Supporting tissue that are resistant to periodontal disease and bone that is recession proof. Teeth that are hard, resistant to decay and are perfectly shaped and colored. If a tooth is lost and needs to be replaced instead of surgically placing a titanium implant a genetically identical tooth embryo will be implanted in its place.

It will take more time and research to fully develop these technologies but the research is going on now. New innovations and the evolution of science can sometimes be hard to understand and trust. Just like Berni and I had a hard time with new innovative banking technologies, some may have difficulty with technologies of the future, but if they are based in true science, they will be come the standard of the care.

Len Aste D.D.S. UDA President-elect

For any of your practice transition needs—whether you are seeking an associate opportunity (they helped me with this), purchasing a practice, merging practices (they helped me with this), or selling your practice (they helped me with this)—there is no one better and no one I would recommend other than Randon Jensen and CTC Associates.

� Dr. David Chamberlain

THE SMALL AND MIGHTY THYROID GLAND

If you cut a small plum in half, that’s about the size of each of the lobes of the thyroid gland that lie on either side of the windpipe. These lobes are bridged together by tissue called the isthmus. The thyroid gland is situated in the front of the neck just below the Adam’s apple. This small but mighty gland regulates the entire body. The hormones secreted by the thyroid regulate the speed with which the body’s cells work. These thyroid hormones control the body’s metabolism, which affects heartbeat, energy levels, digestion, temperature, and thoughts and feelings. According to the American Thyroid Association, 12% of the U.S. population will develop a thyroid condition in their lifetime, 60% of those with thyroid disease are unaware of their condition, and 1 in 8 women will develop thyroid disease in their lifetime.

Symptoms of the two most common thyroid diseases – hypothyroidism and hyperthyroidism – are sometimes dismissed or confused with other ailments because of the wide range of symptoms that can be experienced. Signs of thyroid disease are as follows:

Symptoms of Hypothyroidism

• Tiredness

• Weight gain

• Feeling cold

• Constipation

• Dry or thinning hair

• Muscle weakness or aches

• Hoarse voice

• Pins and needles in the hands

• Slow speech, movement, and thought

• Low mood/anxiety

• Memory problems

• Concentration problems

Symptoms of Hyperthyroidism

• Racing heartbeat

• Weight loss

• Feeling sweaty and shaky

• Feeling uncomfortably hot

• Diarrhea

• Thirst

• Itchiness

• Mood swings

• Feeling anxious and irritable

• Concentration problems and restlessness

Thyroid disease is diagnosed via blood screenings, ultrasound, neck examination and a review of the patient’s symptoms. The neck examination is a responsibility that dental professionals are required to perform as part of the intraoral and extraoral examinations of each patient. However, finding the thyroid on a patient can be difficult if you are not clear on where in the neck it is located. It is therefore important for dental professionals

to familiarize themselves with the best practices of thyroid examinations.

When palpating the thyroid gland, clinicians should be looking for size, symmetry, consistency and masses. Ask yourself: Does the thyroid feel enlarged? Is there asymmetry between the lobes? Are there any irregularities of the thyroid tissue? If a mass is found, note the position, shape and consistency and mobility of it.

Stanford Medicine provides an easy-to-follow written explanation on how to find the thyroid and complete an exam on either yourself or your patient. Finding the thyroid is best accomplished using the following step-by-step examination, which is shared here verbatim from the Stanford Medicine website:

Palpation of the Thyroid

1. Put your finger on tip of the chin (mentalis).

2. Slide your finger down the midline, and the first hard structure you hit is the top of the thyroid cartilage. (Surprisingly, one does not feel the hyoid bone in the midline, although sometimes its lateral end is misidentified as a hard lymph node.)

3. Run your finger down the prow or the free edge of the thyroid cartilage (Adam’s apple)

4. The next thing you hit is the cricoid cartilage – that is the cricothyroid membrane which is where trans-tracheal aspirations for pneumonia can be performed).

5. Below the cricoid ring are the first two rings of the trachea, and the isthmus of the thyroid overlies those two rings.

6. Ask the patient to flex the neck slightly forward and relax.

7. Go through the landmarks as above.

8. Place the first two digits of both hands just below the cricoid cartilage so that the left and right fingers meet on the patient’s midline. Place thumbs posterior to the patient’s neck and flatten all fingers against the neck.

• Use finger pads, not tips, to palpate.

• Identify the isthmus.

9. Gently draw fingers laterally 1 cm to 2 cm.

• Gently palate lateral lobes.

10. Now ask the patient to swallow.

• Assess for asymmetrical elevation of lobes (suggests nodularity).

11. When you are done with the above, move to the next phase, which is displacing the soft tissues on one side to the midline while assessing for size with the other hand. Repeat in opposite directions.

Reviewing the procedures of the thyroid examination as well as the symptoms of common thyroid diseases will allow dental professionals to perform neck examinations to a higher standard and provide patients with better, more thorough preventive care in the dental office.

Janiece C. Ervin, RDH, BSDH

The Utah Dental Association, along with the Utah Dental Hygienist Association and the Utah Oral Health Coalition, is working to keep fluoride in the water in Brigham City. If you would like to be involved with this, please contact the UDA Office.

CQI MEETINGS

Please Plan to Attend the Annual CQI Meetings with UDA Leadership

South Davis - Tuesday, September 19 - Noon

Joy Luck Restaurant, 566 W. 1350 S. Bountiful

Central - Tuesday, September 19 - 6:30 PM

Steve’s Steakhouse, 1170 S. College Ave, Richfield

Cedar Breaks - Thursday, September 21 - Noon

Rusty’s Ranch House, 2275 E. Highway 14, Cedar City

The Utah Dental Associa0on, along with the Utah Dental Hygienist Associa0on and the Utah Oral Health Coali0on, is working to keep fluoride in the water in Brigham City.

Dixie - Thursday, September 21 - 6:30 PM

Courtyard By Marriott, 185 S. 1470 E. St George

If you would like to be involved with this, please contact the UDA Office.

North Davis - Tuesday, September 26 - 6:30 PM

Prairie Schooner, 445 Park Blvd, Ogden

Canyonlands - Thursday, October 12 - 6:30 PM

Zions Bank Board Room, 330 S. Main Street, Moab

Provo - Tuesday, October 17 @ 6:30 PM

Chillion Center, 710 E. Center St, Spanish Fork

Wasatch Back - Tuesday, October 19 - 6:30 PM

Hailstone Events Center (Jordanelle State Park), 515 SR-319, Heber

Salt Lake North, South & Tooele -Thursday, November 9 - 6:30

SLCC - Miller Campus, 9750 S. 300 W. Sandy

DENTAL CHARITY

Dentists provide an extraordinary amount of charity in the form of free dental care, donations to organizations that help compensate providers and provide discounted care, and donations of time to various state or voluntary organizations that provide care at a discounted rate or free. I do not know a single dentist with whom I am acquainted who does not literally give away thousands of dollars of care every year for which they are not compensated. Many times this runs into tens of thousands of dollars. Of course, not all free care was initially intended to be donated.

When I was in dental school one of my removable prosthodontics professors strayed during a lecture and mused about a recent patient that he had treated. He related how the patient had implored him to give him a “break” on the cost of the professional services that were being provided. The services provided were complex in nature requiring multiple appointments and a significant investment in time and resources. In the end the patient was given a “screaming deal” and then drove away in a very expensive motorhome. The professor then stated that he did not own a motorhome, let alone an expensive one, but would like one someday and was somewhat chagrined. He felt he had been taken advantage of. I think we have all had similar experiences. We have all personally treated patients that fit into the same scenario and category as experienced by the prosthetic professor.

Why does this happen? I believe firmly that dentists and physicians by and large are big-hearted. We are in a service oriented industry. We have very specialized skills that require years of training and significant investment. Investment in education as well as physical facilities and supplies. We know that we can help other people by relieving pain and dysfunction. We can treat serious infections. We can boost their morale, and literally change their lives (I recall one patient who had orthognathic surgery and a rhinoplasty and then went out and got a “better” husband!) Who wouldn’t want to be able to provide this kind of service? There is so much gratification and satisfaction in providing care that can literally change people’s lives. We want to be generous. We want to help.

How can we be generous and be smart at the same time? Of course we must pay our bills. We must remain solvent or no further care could be given. We have obligations to our families, as well as our communities. As I have considered how we give treatment away. I think there are several guidelines that we may consider in our practices.

First of all there are many organizations for which we can purposefully donate care and time. This may include local clinics that provide care for the indigent, programs such as Give Kids a Smile, and donated or discounting services provide to members of various religious organizations. They have essentially done

the background work ensuring that any care given is received by those who are truly needy.

Secondly, I have found that it is much more gratifying on a personal level to donate or discount professional services to those who are grateful. That of course is a judgement call on patient assessment. Some people expect decreased fees simply because “you can afford it” and they somehow deserve it.

The third thought that comes to mind is that unfortunately, a significant portion of our discounted fees benefit insurance companies and not necessarily the patient. This can even hurt patients that are uninsured and are faced with paying the full fee for service without a discounted rate contracted by an insurance company. We may consider in some instances discounting the rate we charge our uninsured patients to compensate with the average reimbursement that we would be provided were they an insured patient. After all, when we sign a contract with the insurance company, we are essentially stating that we are willing to take that discounted rate. Should our uninsured patient be punished simply because they don’t have insurance.

The fourth area of donated care is of course instances where a service has been provided for which you never get paid. Unfortunately, we all experience this as well. The best option here is to realize that postage is now very expensive and collections letters generally yield very little if anything. Don’t add insult to injury and quit stuffing money down that rat hole.

None of this is intended to provide legal or managerial advice on how to run a practice. I think we as a profession have been able to provide great amounts of donated care and still remain willing to give more. We are so blessed to be able to serve our patients, ourselves and society all at the same time. What a great profession!

Ken Baldwin, DDS ADA Delegate

Photo: Image licensed by Ingram Image

ASSOCIATION

DENTISTRY RISES TO TOP 10 IN BEST JOBS LIST

Previous U.S. News and World Report list ranked profession as No. 47

Dentistry jumped back into the top 10 of U.S. News and World Report’s 2023 Best Jobs list after ranking No. 47 in the news publication’s 2022 report.

This year’s cold and flu season and continuing COVID-19 pandemic continue to emphasize the importance of a strong health care workforce, with jobs from that sector dominating the list, with health care or health care support positions taking four of the top 10 of the 100 best jobs, according to the publication.

“[Dentistry] rose 37 spots from No. 47 to No. 10 due to its high median salary and work-life balance scores, and an increased employment rate score,” Janica Ingram, careers expert and staff writer for U.S. News and World Report, told ADA News. “The health care and social assistance industry is also the second-fastest growing industry for projected 10-year job growth.”

Dentistry was No. 10. It ranked No. 2 in 2020 and was No. 1 in 2017.

Thirteen of the 20 careers with the highest job security were health care occupations.

Software developer topped the overall list, followed by nurse practitioner at No 2.

To calculate the rankings, U.S. News draws data from the U.S. Bureau of Labor Statistics to identify jobs with the greatest hiring demand. Jobs are then scored using seven component measures: 10-year growth volume, 10-year growth percentage, median salary, employment rate, future job prospects, stress level and work-life balance.

According to the reporting, dentistry has an unemployment rate of 0.5% and ranked No. 11 in the list of best-paying jobs.

The entire list can be accessed at: money.usnews.com/careers/ best-jobs/rankings

ADA News

January 2023

Correct answer: (d) dentigerous cyst.

A dentigerous (also known as a follicular cyst) and is defined as a cyst that originates by the separation of the follicle from around the crown of an unerupted tooth. It represents the most common developmental odontogenic cyst, accounting for approximately 20% of all epithlium-lined cysts of the jaws (Neville, 2016). It usually attaches to the tooth at the cementoenamel junction and is thought

to be the result of fluid accumulation between the crown and reduced enamel epithelium. Although dentigerous cysts may occur in association with any unerupted (impacted) tooth, they most frequently involve mandibular third molars. While usually unilocular, they can be multilocular. Diagnosis to rule out other odontogenic cysts and tumors is essential. See clinical and surgical images.

Odontogenic cysts are cysts that are lined by odontogenic epithelium and are subclassified as developmental or inflammatory in origin. An ameloblastoma is a slow growing, locally invasive odontogenic tumor that usually presents as a multilocular radiolucency involving the posterior mandible, most often in the molar-ascending ramus area (Neville, 2016). A painless swelling or expansion or the jaw the usual clinical presentation. An odontogenic keratocyst is a distinctive form of developmental odontogenic cyst. These lesions are significant for three reasons: a greater growth potential than most other odontogenic cysts, a higher recurrence rate (approximately 30%), and has a possible association with the nevoid basal cell carcinoma syndrome (Neville, 2016).

Works Cited

Neville, Damm, Allen, Chi (2016). Oral and Maxillofacial Pathology, 4th Ed. St. Louis: Elsevier.

Bryan Trump, DDS, MS

Larry Sangrik, DDS

Karl Koerner, DDS, MS

Randy Huffines, DDS, FRCSEd

RECRUITING HYGIENISTS, ASSISTANTS STILL CHALLENGING FOR PRACTICE OWNERS

of 4-6% (34.6%); 14.8% reported giving wage increases of 7-9% and 22.8% reported a wage increase of 10% or more, while 27.7% reported a wage increase in the 1-3 % range. For dental assistants, 41.3% of owner dentists gave wage increases of 4-6%; 15.7% reported giving wage increases of 7-9% and 21.4% reported raising wages for assistants 10% or more, while 21.6% offered a raise between 1-3%.

One in five respondents reported offering paid leave to hygienists and assistants. And the top three benefits they provided to their hygienists and assistants were dental benefits (92.6%), paid vacation (91.5%) and paid holidays (88.8%).

Other poll results found that:

Most hygienists and assistants received wage increases in the past year.

Dentists still face challenges in recruiting dental hygienists and dental assistants, despite the majority of responding owner dentists reporting that they have given hygienists and assistants a pay raise in the past year, according to the latest ADA Health Policy Institute emerging issues poll.

The poll of some 1,100 dentists conducted June 13-19 found that, among the approximately 1 in 3 dentists who have recently or are currently recruiting, 94.5% of respondents reported that recruiting dental hygienists remains very challenging or extremely challenging. Filling dental assistant positions also remains a challenge, with 83.7% reporting that they found it very challenging or extremely challenging to recruit dental assistants – about the same level as reported in last year’s polling.

About 4 in 5 responding owner dentists reported giving their dental hygienists and dental assistants a wage increase in the last year. When owner dentists were asked about the last wage increase offered to staff, the majority of wage increases for dental hygienists were in the range

• Dentists’ confidence in their practice, the dental care sector and the U.S. economy rose slightly.

• Appointment schedules were 88% full in June 2023- the highest point since March 2022.

• Patient no-shows and late cancellations remain the most common factor for unfilled practice schedules.

To join the panel and read the full monthly reports, visit ADA. org/HPIpoll.

THINKING ABOUT SELLING YOUR PRACTICE?

Not sure where to start? Here are 11 things to do before you sell your practice.

- Matt Hamblin

If you do these things now, you can improve your practice value. To enroll to receive our monthly email newsletter with more articles and information, send me an email or text me your name and email address.

1. GET YOUR CALENDAR OUT

On average, it takes 6-18 months to sell a dental practice, depending on the practice and the practice location. To get the best possible match, a broker needs time to get to know you and to market the practice to the right people. Continue to maintain your current production levels through the process. A declining practice is declining in value.

2. ACCOUNTS RECEIVABLES: WRITE OFF OR SEND OFF

You assess your account receivables on a regular basis, but when contemplating the future sale of your practice, it’s the perfect time to take a close, hard look. Make the call regarding which receivables should be written off or sent off to collections. A high AR balance could affect the negotiation process when selling your practice and even reduce its value to a potential buyer.

3. SEE WHERE YOUR FEE SCHEDULE STACKS UP:

Are your fees comparable to others in the area? When was the last time you raised your fees? Investigate, analyze, and act. If your fees are below average, consider raising them now. It will increase your practice income now, while making your practice more attractive to a buyer who won’t want to increase fees right after buying your practice. There are also organizations that specialize in increasing your reimbursement rates. Cash flow and profitability are two of the largest influencers on the value of your practice.

4. REVIVE YOUR RECALL SYSTEM:

Sometimes established practices become a little lax with patient recall. Determine how to strengthen your recall system and you will see increases in patient numbers and production. A full schedule of patients is deemed favorable by potential matches, making your practice more attractive to buyers.

5. POLISH UP YOUR OFFICE

Increase the “curb appeal” by polishing up your physical office space. In the back office, make sure your equipment is in good working order and items are stored in an organized fashion. Assess the lobby--is it inviting? A few updates like plants, a fresh coat of paint, a change of artwork, new upholstery or new carpet can go a long way in making a good impression and they don’t cost a lot of money.

6. TAKE STOCK: YOUR FINANCIAL & TAX ADVISORS

Can you afford to sell right now? Is it in your best interest? What are the tax ramifications? Now is the perfect time to meet with your financial & tax advisors to sort out the answers to those questions. They will be able to determine scenarios that will work for you and help you plan for a favorable purchase price allocation.

Contact Matt and he will send you the full article or visit DDSmatch.com where it is part of our blog

If you have questions, contact me for a complimentary and confidential consultation about your specific situation. You’ll be glad we spoke.

If you have more questions about selling your practice, please contact Matt Hamblin at 801-362-1557 or MHamblin@DDSmatch.com DDSmatch.com