Dentistry North Texas
VOLUME 3
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ISSUE 1
a business and lifestyle magazine for north texas dentists
Smiles in the Spotlight
Greg Greenberg, DDS & Benito Benitez, DDS A Multidisciplinary Success Story
Mission Dentistry
Medical Ministry International
Money Matters The Good, the Bad and the Ugly
Helping Children Smile Save a Smile, led by Cook Children’s
YOUR 1ST CHOICE WHEN KIDS REQUIRE
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Dentistry North Texas
Helping Children Smile
ON THE COVER
Save a Smile, led by Cook Children’s
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ON THE COVER: Save a Smile is helping to put bright smiles on the faces of area children. Volunteer dentists are the heartbeat of this vital program, led by Cook Children’s.
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BAYLOR COLLEGE OF DENTISTRY
50 Years Later The Class of 1963 returns to campus to see what has changed
COMMUNITY NEWS
Southwest Dental Conference In Review Great photos of a successful convention
MONEY MATTERS
The Good, the Bad, and the Ugly A review of the Patient Protection Affordable Care Act
SMILES IN THE SPOTLIGHT
Dr. Greg Greenberg & Dr. Benito Benitez Dental, Skeletal and Facial Imbalance: a Multidisciplinary Success Story
LABORATORY NEWS
Excellence in Ceramic Restorations A guide to material selection for anterior restorations
NEWS & NOTES
What’s up in the North Texas dental community Celebrate National Children’s Dental Health Month
MISSION DENTISTRY
A Conversation with the CEO of Medical Ministry International MMI launches a new dental care initiative
PRACTICE MARKETING
Desktop Marketing / Mobile Marketing Do dentists need both?
CONSTRUCTION NEWS
2013 Offers Doctors Tax Saving Opportunities Now is the time to update your office equipment and technology www.northtexasdentistry.com
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from the publisher
Dentistry North Texas
Publisher | LuLu Stavinoha Photographer | Ray Bryant, Bryant Studios Contributing Writers | Dr. Benito Benitez, Brian Berry, Jennifer Eure Fuentes, Dr. Greg Greenberg, Bob Michaels, Neil Rudoff, Gilbert Young
In honor of National Children’s Dental Health month North Texas Dentistry is pleased to feature the outstanding program, Save a Smile, led by Cook Children’s as this issues cover story. We have worked with Dr. Tonya Fuqua, program manager for Save a Smile and her outstanding team numerous times in the past and it is always a pleasure. Watching this program grow and the increase in the number of children served has been amazing and all participants that contribute to its success should be proud of their efforts.
The Southwest Dental Conference was once again a great success! It was good to see many old friends and make new ones. I appreciate your kind words and feedback on North Texas Dentistry. I hope you had the opportunity to complete your CE requirements for 2013 and benefited from the wealth of information presented at the conference. Be sure to check out the collage of photos by North Texas Dentistry’s talented photographer, Ray Bryant.
Smiles in the Spotlight presents a dramatic case of Dr. Greg Greenberg and Dr. Benito Benitez. This multi-disciplinary success story exhibits the skeletal and facial transformation of a radiant young lady’s face and smile.
Also in this issue, Baylor College of Dentistry celebrates the 50th Reunion of the Class of 1963 which included a tour of the dental school highlighting the many advances in equipment and technology. Money Matters discusses The Patient Protection Affordable Care Act (Obamacare) and the ways it will affect your dental practice. Mission Dentistry provides insight into a new dental care initiative provided by Medical Ministry International. Enjoy these articles and much, much more!
Ray Bryant
PHOTOGRAPHY
Tina Cauller
WRITING / DESIGN
North Texas Dentistry is working on its line-up for 2013 and is looking for recommendations for cover stories, profiles, Smiles in the Spotlight cases, engaging editorial and information for inclusion in News & Notes. For more information or to make a recommendation call (214) 629-7110 or email: info@northtexasdentistry.com. Thanks to all of you who support North Texas Dentistry and make this publication possible! Keep smiling and have a great day!
LuLu Stavinoha, RDH Publisher
Remember to “Like” us on Facebook at: http://www.facebook.com/NorthTexasDentistry
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Although every effort is made to ensure the accuracy of editorial material published in North Texas Dentistry, articles may contain statements, opinions, and other information subject to interpretation. Accordingly, the publisher, editors and authors and their respective employees are not responsible or liable for inaccurate or misleading data, opinion or other information in material supplied by contributing authors. Copyright 2012. All rights reserved. Reproduction in part or in whole without written permission is prohibited.
Advertise in North Texas Dentistry For more information on advertising in North Texas Dentistry, call LuLu Stavinoha at (214) 629-7110 or email lulu@northtexasdentistry.com. Send written correspondence to: North Texas Dentistry P.O. Box 12623 Dallas, TX 75225
50 YEARS LATER
The Class of 1963 returns to campus to get a firsthand look at what’s changed at TAMBCD. Has anything stayed the same? Dr. Zoel Allen and members of the Class of 1963 observe a demonstration of the college’s digital technology now used in dental anatomy and histology courses
By Jennifer Eure Fuentes If the Class of 1963 could agree on one thing, it’s that there are no more “Jack Rabbits” to be found at Texas A&M University Baylor College of Dentistry.
Dr. George Richards organized the 50-year reunion and describes with fondness the belt-driven drill.
“We used to have a handpiece attached to a belt that went up and around to an engine. We had a foot pedal to drive it,” he says. “The further we pushed, the faster the engine would drive to turn the handpiece. We didn’t sit down. We stood up.”
That’s not to say that change wasn’t on the horizon. Richards did use a high speed handpiece before he graduated dental school — once, his senior year.
In some ways, the Class of 1963 picked the perfect day to tour the dental school. On Jan. 18, the clinics were closed so students and faculty could attend the Southwest Dental Conference. This meant that the 20 alumni and spouses got to take an unhurried, in-depth tour of campus, seeing much of the dental school that has so changed over the years.
They visited the Dental Simulation Laboratory, Lab 30, Lecture Hall 6, Oral Diagnosis, Oral and Maxillofacial Imaging Center, central sterilization area, a practical laboratory, the Third Floor Clinic and Advanced Technology Clinic along with a few impromptu detours.
Dr. Jim Lowe returned to the college from Oklahoma City for the first time in 30 years and admits that while the Hall Street entrance location is still in the same spot, its appearance is completely different from what he remembers. “It just blows your mind,” Lowe says.
Another notable change: the basement atrium. “They didn’t give us any chairs or water,” he jokes. “The only water was in the men’s room.”
The building isn’t the only thing that has transformed. So, too, have student instruments and technology.
Like the toolboxes dental students would carry to and from campus each day. Seems there was a love-hate relationship with those familiar black cases, especially for Dr. Nick Baziotes, who went on to graduate from the college’s orthodontic program in 1967.
“We had to call our own patients,” Baziotes says. “If they didn’t show up, then we had to carry our 20-pound black case back to the lab and do something else.”
Back then, the instruments in those cases underwent cold sterilization — a far cry from the substantial autoclaves and stringent sterilization processes used today. Gloves and masks were not required, patient records were written with pencil and paper instead of stored in an electronic system, and discussion of digital x-rays was not even on the horizon. Luckily, before the alumni left for the day, there was one familiarity to be spotted: “They still have the same Buffalo Knives we used,” exclaimed Lowe as the group left the Sim Lab.
According to Dean Lawrence Wolinsky, there are some other assets that remain constant throughout the decades.
“You spent most of your time doing what you do best: hands-on, restorative dentistry,” Wolinsky told the group. “It comes back to the basics of dentistry. It all comes down to your hands, your mind and the instruments.” Betty Springer served as one of the tour guides and says getting to speak with the 1963 alumni as her own graduation approaches helped put her career in perspective.
“I loved seeing dentists that graduated so long ago who are still so passionate and enjoy what they do,” Springer says. “It makes me look forward to beginning my career in dentistry.” n
Jennifer Eure Fuentes is a communications specialist at Texas A&M University Baylor College of Dentistry. A 2006 graduate of Texas Christian University, she has worked in the communications and editorial field for five years. www.northtexasdentistry.com
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cover feature
Helping Children Smile
Save A a Smile
SAVE A SMILE, FOUNDED IN JUNE 2003 BY COOK CHILDREN’S AND THE CHILDREN’S ORAL HEALTH COALITION IN TARRANT
COUNTY, PROVIDES LOW-INCOME CHILDREN IN THE COMMUNITY AN INNOVATIVE, NATIONALLY RECOGNIZED, COLLABORA-
TIVE PROGRAM DEDICATED TO PROVIDING RESTORATIVE AND PREVENTIVE DENTAL CARE ALL THROUGH THE WORK OF
VOLUNTEER DENTISTS. CHILDREN ELIGIBLE FOR THE PROGRAM ARE PRE-KINDERGARTEN THROUGH THIRD GRADE WHO ARE AT HIGH RISK FOR DENTAL DISEASE FROM SCHOOLS PRE-SELECTED BY THE SAVE A SMILE PROGRAM.
The problem:
Untreated dental disease can adversely affect learning, communication, nutrition and other activities necessary for normal growth and development.
n Children from low income families suffer twice as much tooth decay as their more affluent peers and their disease is more likely untreated.i
n According to parents, almost 43,000 children ages 0-8 years old do not receive all the necessary dental care.ii
n Sixty-seven percent of school nurse administrators in Tarrant County report inadequate community resources for referring low-income children for dental treatment.iii
U.S. Department of Health and Human Services (2000). Oral Health America: A Report of the Surgeon General i
ii Community-wide Children’s Health Assessment & Planning Survey (CCHAPS) 2012 iii
Children’s Oral Health Coalition, 2011
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Program overview
Dental screenings (limited oral evaluations) are conducted annually by licensed volunteer dentists in the participating schools to identify children with current or potential dental problems. Depending on the severity of the dental problem, age of the child, translation requirements and financial/insurance status, a referral is made to the appropriate volunteer dental provider participating in Save a Smile.
Volunteer dentists are matched with qualifying patients and dental care is given in the dentists’ private offices, free of charge to the families. Children with CHIP or Medicaid are connected with a provider selected through their coverage.
Save a Smile partners with Communities In School (CIS) of Greater Tarrant County, a non-profit organization providing health and social service resources to students at high risk for dropping out of school. CIS employs a Licensed Master Level Social Worker who is dedicated to the Save a Smile program. The social worker manages multiple Community Health Workers and Case Aides who work directly in the schools with
he explains. “One of my favorite aspects of the program is that these children are treated just like any of our paying patients. They receive first class treatment in our offices and our entire staff gets to be involved.” Dr. Williams believes that volunteering his services for Save a Smile is more rewarding than any paycheck. After seeing the look on the faces of the children that he treats, you would have to agree.
Giving back - Tarrant County College Dental Hygiene program
Two times a year, the dental hygiene students at Tarrant County College (TCC) participate in a Save a Smile event that gives them pediatric dental experience and gives young patients a chance for much-needed preventive dental care.
Dental screenings (limited oral evaluations) are conducted annually by licensed volunteer dentists. students and their families to determine additional needs they might have. Often these needs are uncovered after the preliminary dental screening at the school when the Community Health Workers/Case Aides are following up with the families to pursue a course of treatment.
While the children receive exams, x-rays, cleanings, fluoride treatments, oral hygiene instructions, dental health kits and sealants when necessary, the Community Health Workers/Case Aides work closely with families to determine and assist with any social services needs they might have in addition to their dental issues (emergency assistance, school supplies, transportation, translations, etc). Volunteer dentists oversee the treatment plans that are developed.
IMPACT:
Since the inception of the program:
n An average of 90 percent of eligible children have been screened and classified.i
n 51-73 percent of Class 1 children* have received dental treatment.i
n 1,598 children who completed comprehensive dental treatment are cavity/disease-free.i *Most severe cases
Results from a program analysis of Save a Smile, led by the System Planning department of Cook Children’s.
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Volunteering… good for the soul
Renan Williams, D.D.S., P.A., has been involved with Save a Smile since the very beginning. He learned about the program through the Fort Worth District Dental Society. Dr. Williams is, by nature, a giving individual.
“I’m happier donating my services than I am making a living,”
Dr. Renan Williams enjoys seeing the smiles on children’s faces after they are no longer in pain. www.northtexasdentistry.com
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According to Cindy O’Neal, RDH, MS, Coordinator, Dental Hygiene Program, the Save a Smile program offers TCC students a great opportunity to be involved in a community project. TCC has been involved with Save a Smile since 2005. Participating in the program allows the dental hygiene students to see a wide variety of diagnoses and exposes them to things that they usually do not see or experience.
“Most of the patients seen by the students are healthy, so often times the disease they see in these children blows the students away,” explains O’Neal. “Getting the opportunity to treat these children provides an entirely different and eye-opening perspective from the ‘typical’ patients they usually see.”
The students also like the fact that by meeting and treating these children, they get the opportunity to observe other health concerns outside of oral health issues. The Save a Smile program recognizes that oral health problems can impact a child’s overall health.
“Some of the kids will come in crying because they are scared to see a dentist,” says O’Neal. “When we see them leave with a smile, it is so rewarding.”
It’s not just about teeth
A unique aspect of the Save a Smile program is the holistic approach used to help the children and their families. Each family’s scenario is assessed on an individual basis by the social
Dental hygiene students at Tarrant County College participate in Save a Smile events that give them pediatric dental experience and gives young patients a chance for much-needed dental care.
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worker and the Community Health Workers/Case Aides. In addition to making sure the dental needs of the children are met, families may receive help filling out an application for Medicaid or CHIP, gaining access to the food bank, assistance with medical/eye exams or getting help with school supplies or clothing.
Children with dental needs are referred to a dentist free of charge. If a child has no way to get to the appointment, Save a Smile provides transportation to and from the dentist’s office.
Leah Brown is the licensed clinical social worker with CIS dedicated to the Save a Smile program. She manages the Community Health Workers and Case Aides who work directly in the schools with students and their families.
One of the most rewarding parts of this program for Brown is seeing the relief on a child’s face after he or she has received treatment for something that was hurting. She loves being a part of a program that helps so many families who never knew this kind of support existed.
“Before coming to work with Save a Smile, I had never seen a program like this. Often times, I think we just assume that everyone has access to dental care,” Brown says. “Being involved in this program has really opened my eyes to the fact that dental care often isn’t a priority with these families. The families we treat have to focus on where their next meal is going to come from and things like dental care often get overlooked.”
One of the greatest aspects of the Save a Smile program is that it provides more than just dental care. CHWs/Case Aides often provide transportation so the children are able to get to their dentist appointments.
Helping the fear fade away – Andrea’s story
Andrea, five years old, couldn’t sleep at night because she was in so much dental pain. She complained of pain when she ate and had started limiting her diet to foods that were easier to chew.
During a screening at her elementary school, a volunteer dentist for Save a Smile found serious dental disease in Andrea’s mouth. She suffered from large cavities and the potential for things to worsen if she did not receive help soon.
Andrea was referred to David Hunter, D.D.S., an oral surgeon, to have six teeth removed due to the severity of dental disease. Andrea was then referred to Janell Plocheck, D.D.S., a pediatric dentist, for needed restorative treatment on many other teeth.
Despite her fear, Andrea has remained very brave in all of her visits to the doctors’ offices. She tells her mom that visiting the dentist is still a little scary but when her mom reminds her about how much better she feels when she leaves, Andrea’s fear soon fades away. Today, Andrea is a lively first grader with a smile that can melt your heart. Her mother is very grateful for the care provided by Save a Smile, Dr. Hunter and Dr. Plocheck.
Employees from the local Kohl’s department stores volunteer their time each year for the annual assembly of the Save a Smile dental hygiene kits for children participating in the program. www.northtexasdentistry.com
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While Lauren was in dental school, she would share her experiences with older sister Dakota who was trying to figure out what her career path would be. “After listening to Lauren and talking to my dad, I decided that following in their footsteps was what I was meant to do,” explains Dakota.
When she began dental school, Dakota’s decision was confirmed. “From the very beginning of dental school, I thought it was so cool,” Dakota said. “I felt I had an aptitude for it.”
“I like what I do. I like coming to work and talking to patients,” Dakota said. “It’s fun for me to talk to these patients and help them with these services. Your oral health has an effect on your overall health, so if they come to me and are afraid of other doctors, maybe I can help them to not be.”
The entire Davis family donates their time to Save a Smile. Pictured from left: Dr. Dakota Davis, Demmie, Dr. Lauren Drennan and Dr. Paul Davis.
Save a Smile - a family tradition
With the entire family involved in the Davis Family Dental Care office, it’s easy to see that taking care of others runs through their genes. Daughters Dakota and Lauren followed in their father Paul’s footsteps as dentists, while mom Demmie runs the office. Lauren even married a dentist.
Practicing dentistry is more than just a career for the Davis family, caring for others is part of who they are. Paul calls his choice to become a dentist, “extremely rewarding.”
Paul became familiar with Save a Smile while serving as president of the Fort Worth District Dental Society. “I like the Save a Smile concept because of the consistency for the children. They get to see the same doctor the whole time. When you volunteer with other organizations, the children never get to see the same doctor.”
Lauren knew early on that she would join her father as a dentist. She was always at her parents’ office and liked the atmosphere. “Watching how they treated the patients, I could see the impact they were having on these people’s lives and it seemed extremely fulfilling,” says Lauren.
When she joined her parents’ office, she was still establishing her own practice. She used that time to see Save a Smile kids. Thanks, of course, to her mom’s encouragement… and scheduling as many as possible.
“Kids come in and they’re terrified,” Lauren said. “We tell them everything will be OK, and when it does turn out OK, to see those kids… it’s just awesome.” 10 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
Becoming involved in Save a Smile was natural for Dakota. “I had been to an event or two before I even graduated from dental school,” Dakota said. “As soon as I got out of school, one of the first things I was doing was going to elementary schools and seeing kids. I went to three screenings the first year because I had time, while building my practice. It was fun. The kids would love you and hug you.”
Paul sits back and listens as his daughters talk about the importance of Save a Smile. It’s an organization that means so much to him and he knows that the future is in good hands.
“It’s great to have Cook Children’s leading the way, but it’s the volunteer dentists that are the heart of this program. Without them, the program wouldn’t exist,” Paul said. “We are doing a lot of good for the community. Statistics show we’ve had a tremendous impact and that is a wonderful thing.”
“I obviously want to hand this practice over to my daughters and I have all the confidence in the world in them. They have similar values as their mother and me. I don’t have to question if my patients will be taken care of. I don’t have to question if Save a Smile is important to them. Seeing the smiles on the kids’ faces and seeing how happy the parents are, knowing their children don’t have to suffer anymore.”
As Paul speaks of his family with pride, you see this parent smile. His daughters soon follow with grins of their own. After all, it’s in the genes. n For more information on Save a Smile, contact Tonya K. Fuqua, D.D.S., program manager of Save a Smile, at 682-885-6731 or by email at tonya.fuqua@cookchildrens.org.
FOCUS PHOTOGRAPHY WITH A
ON DENTISTRY
creating compelling professional images that speak for your practice
214.369.1850 817.966.2631 www.Bryant Studios.com raybryant@me.com
The 2013 Southwest Dental Conference was another great success. It was fun to see old friends and make new ones!
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Photos by Ray Bryant, Bryant Studios
community news
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money matters
The Good, the Bad, and the Ugly The Patient Protection Affordable Care Act by Bob Michaels, CLU - TDA Financial Services Insurance Program
T
he Patient Protection Affordable Care Act (PPACA) is now the law of the land. With a slim majority of the popular vote and a significant victory in the electoral college, the reelection of President Barack Obama ended many months of speculation from states and businesses on health care reform and whether all of the PPACA’s provisions should be considered or implemented. Regardless of your political persuasion, PPACA is the law. As a dentist, employer, and business person running a dental practice in Texas, you need to understand the law and start planning for its impact on your practice.
Having this issue settled so you can move forward and start planning for the future is a positive. Of course, that does not mean there will not be challenges. Some of the first things to expect will be regulations spelling out how to implement mandated changes. There are significant provisions and regulations that must be implemented and they need to be detailed. These include the exchanges, the types of policies that will be available, the benefits, the premiums, the individual mandate, the employer requirements and more. Many have said that a “flood” of regulations will be coming from the government as we move forward with the law. As most of us know, floods are not typically associated as good events so you should expect a fair amount of confusion and frustration which only the Federal government will be able to resolve by providing the specific details for all of these items.
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Understanding and getting more information is a good place to start. Consequently, the following is a brief summary of the PPACA that you should consider.
The Good
PPACA is the law of the land and all the uncertainties about whether or not all or part would be implemented are largely gone. This is good because for the first time in a couple of years, regardless of who you wanted in the White House, you can move forward knowing the law isn’t going to be repealed or changed significantly.
Beginning January 1, 2014, health insurance exchanges will commence operation in each state, offering a marketplace where individuals and small businesses can compare policies and premiums, and buy insurance (with a government subsidy if eligible). If the state does not elect to set up a state exchange, the federal government will provide one. n Health insurance companies will be required to issue policies regardless of any medical condition, referred to as “guaranteed issue”. The same premium must be charged for all applicants of the same age and geographical location without regard to gender or most pre-existing conditions (excluding tobacco use). n
Minimum standards for health insurance policies are to be
established and annual and lifetime coverage caps will be banned.
n Firms employing 50 or more people but not offering health insurance will also pay a shared responsibility requirement if the government has had to subsidize an employee’s health care.
n Small businesses, including most dental practices, will be eligible for subsidies if they purchase insurance through an exchange (subject to guidelines). n Copayments, coinsurance, and deductibles are to be eliminated for select health care insurance benefits considered to be part of an “essential benefits package” for Level A or Level B preventive care.
that deadline. These exchanges are supposed be ready for enrollment by October 2013. As of this writing, Texas is one of the states that have elected not to set up a state exchange, which means the government is supposed to provide a Federal Exchange.
A shared responsibility requirement, commonly called an individual mandate, requires that all individuals not covered by an employer sponsored health plan, Medicaid, Medicare, or other public insurance programs purchase and comply with
an approved private insurance policy or pay a penalty or tax. Exceptions are made for individuals who are members of a recognized religious sect exempted by the Internal Revenue Service, and in cases of financial hardship. Employers will have new and additional regulations to comply with, including new information for W2 forms and changes to health care Flexible Spending Accounts.
(continued on page 25 4)
n Low income individuals and families above 100% and up to 400% of the federal poverty level will receive federal subsidies on a sliding scale if they choose to purchase insurance via an exchange.
n Rate increases above 9.9% are reviewable by the state department of insurance or Federal Government if it is deemed the state department is not adequately equipped to review the increases.
n Health plans must provide rebates to enrollees if their medical loss ratio – the percentage of premiums spent on reimbursement for clinical services and activities that improve health care quality – does not meet the minimum standards for a given plan year. For large group insurers this is 85 percent; individual and small group insurers must spend at least 80 percent of premium dollars.
Policies issued before the PPACA provisions take effect are grandfathered from many of these provisions; however a material change cannot be made to these policies so insureds are “frozen” in that they cannot increase deductibles, coinsurance or copayments to offset rate increases.
The Bad
Perhaps as many as 35 or 40 million Americans are expected to go online for health care needs in 2014. This means both federal and state health insurance exchanges will continue working to meet
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SMILES SPOTLIGHT in the
LEADERS IN NORTH TEXAS DENTISTRY CREATING UNFORGETTABLE SMILES
Initial Presentation
Whitney presented to our office with a chief concern of “I have a large overbite.” Extraoral examination revealed a convex profile with mandibular retrognathia and a short lower anterior face height. Upon smile, there was 100% incisor display with narrow buccal corridors. Intraoral examination revealed a full Class II malocclusion with excessive overjet, deep overbite, moderate crowding in the maxillary and mandibular arches, and bilateral buccal crossbites on the maxillary 1st premolars. Tooth #25 showed gingival recession as well. She had no previous orthodontic treatment done as a teenager. Dr. O’Dell Marshall examined Whitney as well and diagnosed her with: obstructive sleep apnea, maxillary transverse hypoplasia, mandibular retrognathism, traumatic palatal occlusion and gingival inflammation, and decreased nasal airway. 16 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
Treatment Plan
After discussing the various options with Whitney, we agreed on full upper and lower braces with orthognathic surgery to correct her skeletal and facial imbalance. We decided to address the recession on #25 after the treatment and orthognathic surgery was completed. As with all orthognathic surgery cases, the third molars needed to be removed at least six months prior to surgery, which was done by Dr. Marshall.
Procedure
GAC Inovation Clear brackets were used from canine to canine and metal Inovation brackets/bands were used for the posterior segments. Alignment of teeth begins with a small flexible round NiTi wire and progresses slowly up to a stiffer and more rectangular stainless steel wire for the surgery. Steel wire ties were placed on all brackets to allow Dr. Marshall to utilize any pattern of rubber band wear needed after the surgery. The surgery consisted of a segmental three-piece LeFort I maxillary osteotomy with bone graft, a bilateral sagittal split ramus osteotomy mandibular advancement, and an anterior mandibular body osteotomy (sliding genioplasty) to augment the chin projection.
Greg Greenberg, DDS Benito Benitez, DDS
Dr. Greenberg began practicing orthodontics in 1988 in his Lake Highlands office and is pleased to have been able to serve the same community for his entire career. He has met wonderful people and seen many children grow up to be successful adults who are confident enough in him to bring in their children as well. In 2008, he opened his Frisco office to serve the surrounding communities as well.
Results
Dr. Benitez recently joined the practice of Dr. Greenberg in March of 2012 and has been enjoying working with such dedicated people who love to see people smile. Dr. Benitez is a native of the Dallas-Fort Worth area and attended TCU and Baylor College of Dentistry. He recently moved to the Lake Highlands area and is proud to be part of such a great community.
Whitney returned to our office from surgery three weeks later and rubber bands were used to hold the Class II correction. Her braces were removed seven months after surgery and minor detailing of the occlusion and final space closure was completed. She will be retained with a clear maxillary retainer and a mandibular Hawley retainer. Whitney was thrilled with the final result and as of writing this article, she was planning her wedding in the upcoming weeks.
Dallas: 8510 Abrams Rd. Suite 508 Dallas, TX 75243 (214) 503-0060 Frisco: 6801 Warren Pkwy. Suite 121 Frisco, TX 75034 (972) 335-1300
www.rxsmile.com
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Excellence in Dental Ceramic Restorations
Material Selection for Anterior Restorations It is often said that a beautiful smile is magic; creating one is not. In today’s appearance driven society, selecting the ideal restorative material can be a challenging act, a juggling act and a game of Russian roulette, sometimes all at the same time.
Today more than ever, the use of dental ceramic materials for esthetic anterior restorations aim at avoiding the use of traditional metal-ceramics while providing not only better esthetics, but comparable strength when bonded to tooth structure.
Although the materials and techniques available today for esthetic anterior restorations are many, the criteria for the selection of the appropriate restoration can be confusing. For adequate material selection, the practitioner must take into consideration several important factors.
All-ceramic anterior restorations can be divided in two main categories based on the cementation technique: Adhesive retained restorations and conventional cemented restorations. There is still a reasonable number of practitioners that prefer the traditional cement retained techniques for full coverage restorations with a zirconia or alumina reinforced core. These restorations can also be bonded as per the techniques and studies described by Blatz, et al (1-3).
The criteria for selecting anterior restorations can be based on whether the restoration is a conservative, minimally prepared tooth or teeth or a full coverage restoration. Porcelain laminates, 3/4 veneer crowns or any restoration that restores a small portion of the coronal part of the tooth is considered an adhesively retained restoration. In general, an all-ceramic restoration can be selected based on:
n Color control (management of the color of the underlying tooth structure) n Thickness of the restoration
laboratory news by Gilbert Young, CDT
n Track record (long term performance over 5 years) n Ease of fabrication
It would be a disadvantage to utilize a monochromatic, non-layered, ceramic material for this type of preparation.
n Dental ceramist’s individual preference
Factors that can affect the color of the final all-ceramic restorations:
n
Non-discolored vital tooth
n
Post and cores of various materials
n
Discolored, non vital tooth
When matching existing natural dentition or masking undesirable tooth color, careful consideration must be given to the above mentioned factors. While a full coverage allceramic core supported restoration can yield adequate masking, a very conservative restoration will require the expertise of the dental ceramist and an intimate knowledge of ceramic layering materials to properly transition the color of the restoration to the underlying natural tooth, so a natural and realistic result can be achieved. Proper photographic documentation is key in the communication with the dental ceramist.
3/4 veneer preparation for a vital tooth.
Notice the warm color of the gingival area and the translucent quality of the incisal area. This will require layering of specific ceramic powders during the fabrication process so the harmonizing colors of the natural tooth can transition into the restoration.
18 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
It is necessary to incorporate the use of special ceramic materials that contain fluorescence and various degrees of translucency so the color of the underlying tooth structure can blend with the restoration.
dictably when treating the anterior dentition while greatly improving the esthetic quality of the treatment; from ultra-conservative restorations to full coverage crowns. However, it is necessary to understand how to manage the color of the underlying tooth structure so adequate materials can be chosen. The more conservative the preparation, the more critical this becomes. It is important that both the dentist and dental ceramist understand what each other needs in order to achieve the best results for their patients.
Final restoration fabricated using several color transition layers of ceramic to achieve a natural appearance.
This patient needs esthetic anterior restorations to replace deficient porcelain fused to metal restorations done in the past. Additionally, the problem is further complicated with inadequate gingival levels of the lateral incisors. A crown lengthening procedure will allow for the fabrication of esthetically acceptable all-ceramic restorations.
Non-vital discolored preparations can negatively affect the appearance of the final restorations. This patient can benefit from all-ceramic layered restorations with a Zirconia-reinforced core. A color dot in the corresponding area of the fabrication die is a simple technique to gauge the relative opacity of the Zirconia-reinforced substructure. The color dot in not visible under the substructure.
The author thanks Dr. William Bruce and Dr. Stephen Dallal for their clinical expertise, embracing the art and science of all-ceramic bonded restorations and for faithfully documenting the final results of the two cases shown in this article. n Post-treatment final Zirconia-reinforced restorations.
Conclusion
Bonding techniques allow a wider modality of all-ceramic restorations to be used pre-
REFERENCES
Blatz MB, Sadan A, Kern M. Resin-ceramic bonding – A review of the literature. J Prosthet Dent
2003;89(3):268-274.
Blatz MB, Oppes S, Chiche GJ, Holst S, Sadan A.
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Influence of cementation technique on fracture
strength and leakage of alumina all-ceramic
Protection is our Business
crowns after cyclic loading. Quintessence Int
Our only business is working with TDA Members and their staffs. We are committed exclusively to servicing TDA membership’s needs.
2008;39:23-32.
Blatz MB, Richter C, Sadan A, Chiche G, Swift EJ.
Resin bond to dental ceramics, part II: high
strength ceramics. J Esthet Restor Dent
www.tdamemberinsure.com 1-800-677-8644
2004;16(5):324-8.
Bob Michaels, CLU Local Associate 214-696-5103
Disability Life Health Long Term Care Malpractice
Gilbert Young, CDT is a master ceramist and owner of GNS Dental Studio, Inc. in Plano, Texas. He also lectures and teaches nationally and internationally on the subject of dental ceramics, restorative designs and esthetics and is an accredited member of the American Academy of Cosmetic Dentistry since 1997. For questions or comments, please email Gilbert Young, CDT at gnsdentalstudio@sbcglobal.net or call (972) 473-9366.
Restorations in this article fabricated by Gilbert Young, CDT c/o GNS Dental Studio, Inc. All images used in this article are copyrighted and all rights reserved.
20 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
Irving pediatric dentist donates more than 3,000 toothbrushes in celebration of National Children’s Dental Health Month
Dental-related illnesses cause children to miss 51 million school hours a year according to Oral Health in America: A Report of the Surgeon General. To help reduce cavities and other oral illnesses among children in our local community, Children’s Dental Centre of Irving will donate, for the second consecutive year, more than 3,000 toothbrushes in celebration of National Children’s Dental Health Month in February.
Dr. Reena Kuba, DDS, MS, the Centre’s board certified pediatric dentist, is committed to working with the community and parents to create a positive, educational atmosphere to get children on the right path to a lifetime of optimal oral health. The toothbrushes will be donated to pre-K and/or kinder students at 12 local schools.
“Proper diet and brushing habits are essential in preventing dental problems. We are pleased to be able to do our part to help the children in our community,” said Dr. Kuba.
Along with toothbrushes, the staff of Children’s Dental Centre of Irving will provide free dental health presentations to many of the schools.
Children’s Dental Centre of Irving provides comprehensive dental care for children ages six months to 18 years of age.
NEWS
Drive for a Smile
children’s toothbrush drive Feb. 1 - March 1
In support of National Children’s Dental Health Month, the Children’s Oral Health Coalition, led by Cook Children’s, is collecting soft, individually wrapped children’s toothbrushes for atrisk children. For more information, please visit www.cookchildrens.org/toothbrushdrive.
Here’s how you can help:
n Sign up to become a toothbrush collection site.
n Encourage employees and customers to donate! Any business or organization can take part.
To register, call (682) 885-4162 or visit www.cookchildrens.org/toothbrushdrive.
n Donate at www.cookchildrens.org/toothbrushdrive. Your monetary donation will be used to buy toothpaste and toothbrushes at a discounted rate. n Collect new, SOFT, individually wrapped children’s toothbrushes.
& notes ONE-DAY DROP-OFF EVENT on March 1 at:
Cook Children’s South Rehabilitation Clinic 1919 8th Avenue, Fort Worth, TX 76110 10 a.m. to 2 p.m. Friday, March 1, 2013
Spina Bifida Association of North Texas 40th Anniversary Gala Celebration Saturday, April 6
Dinner, Music & Casino Fun! 7:00 to 11:00 Orion Ballroom 400 S. Zang Boulevard Tickets $75.00
During February, drop them off at:
Tarrant County College Dental Hygiene School Northeast Campus: Health Sciences Building 828 Harwood Road, Hurst, TX 76054 (817) 515-6325 Drop-off times:
8am-5pm, Mon-Thu or 8 a.m.-noon, Friday
Dental Health Arlington 201 N. East Street , Arlington, TX 76011 (817) 277-1165
Drop-off times:
Celebrate 40 years of service to the Spina Bifida community in North Texas and honor those who have supported these efforts! Visit spinabifidant.org for details and ticket sales.
8am-5pm, Mon-Thu or 8 am-1pm, Friday
Tell the North Texas Dental community your news! Submit your news to info@northtexasdentistry.com www.northtexasdentistry.com
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mission dentistry
A Conversation
with the CEO of Medical Ministry International Medical Ministry International is a non-profit organization comprised of volunteers and staff members focused on providing compassion and healthcare to the poor in 22 countries around the world. MMI’s international office is based in Allen, Texas. Sam Smith, C.E.O. of MMI, recently visited with us about the work of Medical Ministry International and the launch of a new dental care initiative aimed at providing more restorative and preventative care to the world’s poor. What is unique about Medical Ministry International as a volunteer organization?
We seek to be people of excellence in all we say and do. Medical Ministry International is not about going on a quick trip, doing good work, and then leaving. We plan and execute strategies that result in lasting change for communities around the globe. MMl is ultimately about trying to give people the ability to support themselves and live normal lives. We have staff on the ground year round and thus can assess the needs and prepare to host those with the skills that can help to address the issues that are found. This staff provides for the execution and also the follow-up and assessment of the projects once the team has left. One of the important aspects about serving the poor is to have a team in place that can provide the follow up care and support needed. This staff ensures that each project team builds upon the previous teams’ work. Our Health Centers give us the chance to make the services a yearround effort in the community.
22 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
What do you say to those who ask why you work in these faraway places when there is so much need right here in the United States?
The truth is the poor in the United States have it a lot better than in the places our teams serve. For example, a man has an abscess under his tooth. This would be no big deal in the western world. In the areas we serve there is little to no dental care available and if left untreated, it can result in serious medical problems that could ultimately lead to death. Our Health Centers and Project Teams seek out these areas of need and provide a level of care that changes lives. Specifically, how does MMI address the dental needs of a region?
We provide the poor a variety of services like fluoride treatments, routine dental cleanings, extractions, and restorative procedures on most of our projects. We all know that tooth decay doesn’t happen overnight and MMI believes the loss of teeth is just as preventable in developing countries as it is for the rest of the world. With the recent additions of portable dental suites for our Project Teams, we expect to double the amount of restorative care we provided in 2012 and over time we expect to see the number of tooth extractions to decrease.
2013 is an exciting time for our Dental Program! We expect it to be one of the biggest areas of growth for the Ministry in the next 5 years and hope to more than triple the impact that our current teams are achieving. Who can go on one of MMI’s project teams?
Anyone with a servant’s heart — our teams are usually multiple specialties. We may have, for example, primary care, dental, vision and integrated health (preventative, spiritual, and wellness care) all happening at one time. We have a triage area where we determine the specific issues that need to be addressed, and then the patients are escorted to the various program specialties for care. Our volunteers are both medical and non-medical. Each has a very important role to play in the process. If you have a skill, we usually can find a place for you. This also helps couples and sometimes even families, to join our Teams as there will be a role for each person to fill. Many find that they go to serve the poor and in return they end up getting more from the trip than they ever expected. Lives are literally changed before your eyes.
person cannot see, then he cannot support or help his family. A 15-minute eye surgery can totally change his life! Without teeth, we cannot eat; people who cannot smile have a tendency to close up and not interact with others. People born with correctable defects are considered cursed in many areas we serve, and they tend to hide from society. We give them a chance to come out from hiding and live.
MMI Programs utilize Project Teams to address need and build a support infrastructure. Health Centers are built to provide year round attention and are supported by our Project Teams. We also are building capacity by training others through our Residency Training Program. Local physicians and support staff are provided
MMI volunteers describe people with common medical issues, such as vision problems or decaying teeth, whose lives are changed dramatically after they are helped. What is the long-term impact on a culture that receives basic medical care?
This is a big question, but I will try to give a concise answer. Basic care is the basis for life. You need clean water to live and quality food to sustain a healthy life. This is why we have water, sanitation, and agricultural programs as a part of our medical services. If a
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training to increase their skill sets and then go back to their communities. It’s all encompassing as you can’t just train doctors and not train the team around them. At the end of the day, we seek to build medical capacity while trying to eliminate the issues that caused the illness in the first place. It’s an amazing thing to see in action and we invite those that want to make a difference to join us and change lives! n Visit www.mmint.org for more information and follow us at www.facebook.com/medicalministry or on Twitter @medministryintl
24 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
(continued from page 15)
Flexible Spending Accounts will be limited to $2,500 per year. This could potentially impact your practice indirectly because patients may delay or decide against having elective or cosmetic procedures if they cannot prefund these on a tax preferred basis.
The Ugly
PPACA’s provisions are intended to be funded by a variety of taxes and offsets. Major sources of new revenue include a much broadened Medicare tax on incomes over $200,000 and $250,000 for individual and joint filers respectively, an annual fee on insurance providers, and a 40% excise tax on “Cadillac” insurance policies. The income levels are not adjusted for inflation, leaving the possibility of increased taxes on incomes over $250,000 inflation-adjusted dollars after more than two decades without indexing through bracket creep. Unfortunately, dentists as a group will be targeted and can expect to have more of their income and savings taxed at significantly higher rates. Insurance companies that do not have significant health insurance business will exit the market by terminating the agreements or by selling their business to another provider. This will mean fewer options in selecting policies and companies.
The range of plans and benefits offered in the Exchange will be determined by the Federal government and you will probably have less choice in picking the type of policy for your situation – for instance a higher deductible, an HSA type plan, or a plan with or without maternity coverage.
Grandfathered plans will eventually go away as the premiums will force insureds to the Exchanges.
Healthcare facilities and providers will continue to consolidate into bigger and bigger groups who will be less flexible in negotiating with insurance companies for discounting fees. The trend will be back towards the HMO model rather than the open PPO model of the past 15 or so years.
There are also taxes on pharmaceuticals, high-cost diagnostic equipment, and a 10% federal sales tax on indoor tanning services. Offsets are from intended cost savings such as changes in the Medicare Advantage program relative to traditional Medicare. A summary of these tax increases is below:
n Increase Medicare tax rate by 0.9% and impose added tax of 3.8% on unearned income for high-income taxpayers
n Charge an annual fee on health insurance providers
n Impose a 40% excise tax on health insurance annual premiums in excess of $10,200 for an individual or $27,500 for a family n Impose an annual fee on manufacturers and importers of branded drugs
n Impose a 2.3% excise tax on manufacturers and importers of certain medical devices
n Raise the 7.5% Adjusted Gross Income floor on medical expenses deduction to 10%
n Limit annual contributions to flexible spending arrangements in cafeteria plans to $2,500
A law as significant as the Patient Protection Affordable Care Act (PPACA) will never be without its many critics or advocates. There will be many unintended consequences both positive and negative. No one really knows which is probably the most concerning aspect. However, the PPACA is law and you must move forward and do your best to understand its many provisions as a Texas dentist, employer and insured.
If you would like to receive more information, or would like to discuss the insurance options available, please feel free to contact us at (800) 677-8644 or visit our website, tdamemberinsure.com. For information regarding other TDA Financial Services endorsed programs, please visit www.tdafsi.com, or call (512) 443-3675. n
Bob Michaels, CLU has been in the insurance business in Dallas, Texas for over 40 years. He has been an Associate with the TDA Financial Services Insurance Program for the last eight years. Bob’s scope of operation in the TDA Insurance Program includes life, health, disability income, employee benefits, long term care, and malpractice insurance.
For more information, visit www.TDAmemberinsure.com. You can contact Bob at bmichaels@TDAmemberinsure.com or call (214) 696-5103.
www.jhouserconstruction.com
817.988.7842 “We specialize in customer satisfaction..” jhouser@jhouserconstruction.com PO Box 325
Canton, TX 75103
www.northtexasdentistry.com
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practice marketing
Desktop Marketing.
Mobile Marketing.
Do dentists need both?
T
by Neil Rudoff hey’re everywhere you go. People have them in line at the grocery store, you see them while waiting for a doctor’s appointment, moms picking up their kids in the carpool lane usually have them and yes, you probably did just see a 10-year old with one. That’s right; we’re talking about the seemingly everpresent smart phone. Whether it’s an iPhone, Android, tablet or any of the lesser known variety, the truth is that everyone not only seems to have one, but we are using them all the time. So much so, that Smart Insights recently reported that mobile internet use is set to overtake desktop internet use by 2014. Yes, you read that right. In approximately one year, more people will access the internet (and subsequently your website) from a smart phone or tablet than their desktop or laptop computer.
So, just what are we actually doing on our smart phones? Email? Searching the web? Angry Birds? The answer is yes, yes and yes, we are doing everything that we normally do on desktop computers and then some. Surprisingly, it’s not just teenagers and early adopters who are embracing this new technology. According to Smart Insights, women aged 35-54 are currently considered the most active group in mobile socialization. Additionally, 62% of America’s moms (who tend to make a majority of the decisions regarding healthcare for their families), are using their smart phones to search for (and choose) products and services. Since search engine optimization is one of the many services we provide for our clients, we are highly interested in how increased mobile use affects the way that potential patients find dentists online. It turns out, the effects are pretty significant. Google’s
26 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
research says that 40% of all mobile searches are for local information. That means that when people are making a purchasing decision, nearly half the time they are on their mobile devices. This can include anything from what the best nearby lunch spot is or what time your local dry cleaner closes to which dentist you should schedule a six-month cleaning with. It’s clear that the product and services searching we once did with the yellow pages or on our desktop computer is now being done digitally in the palms of our hands.
And isn’t that just like technology to change so rapidly? Just as you were beginning to gain traction on your desktop marketing strategies, marketing researchers are now saying that you need a separate strategy for mobile users. Well, yes, but for business owners (including dentists and oral surgeons), this news is great. Fantastic, actually, because all of this mobile searching usually leads to one thing… the ability to easily call or book an appointment with you straight from their smart phone, more so than on a desktop or laptop. In fact, 90% of smart phone searches result in an action, with 77% contacting the local business and 61% immediately calling the business. Our clients are seeing anywhere from 20% to 25% of their visitors coming from mobile devices.
While you definitely shouldn’t ignore or discontinue your desktop marketing strategies, these statistics have confirmed what we’ve suspected for a while; dentists need a desktop marketing and a mobile marketing strategy that works together and optimizes for each unique platform. While there are several differences that separate the two, there are specific and simple strategies you can fol-
low that will ensure potential patients can both find you and easily book an appointment on a desktop computer or mobile device.
What’s the Big Deal with Website Design?
Your website may be beautiful. It’s probably modern, sleek and easy to navigate. So, if it works great on a desktop computer it should come up on a mobile browser just fine, right? Not necessarily. It’s a risky decision to build a website that is made only for a desktop computer and “hope” that it comes up correctly on an iPad, Google Nexxus, iPhone or Android, because if it doesn’t and people can’t easily read the information or book an appointment, they’ll take no time in moving on to the next dentist.
When you are planning your website development and design, mobile friendly considerations should be at the very forefront of your marketing strategy. However, this absolutely does not mean that you have to build two (or three) separate websites that look good and work correctly on a desktop computer, tablet and mobile device. All you have to do is make sure your website is responsive. According to Google research:
“Responsive websites use a flexible grid framework that “responds” to screen resolution so that the grid (or blocks of content) is positioned respective to the user’s device. Responsive sites automatically change and realign themselves so that they are optimized for legibility, navigation and fast display on mobile phones, tablets, laptops, or desktops.”
Need visualization? Here is a sample of exactly how a responsive website alters itself to fit any device:
Looks pretty good, right? Responsive websites are very versatile and can be used on all devices, including smart TVs. The beauty of choosing this type of design is you only have to market, update and manage one website. It’s a simple solution that ensures any audience looking at your website on any device will like what they see. It’s important for dental professionals to adopt a responsive website design strategy. Keep it Simple. This means avoiding “clutter,” wide (horizontal) menus and scrolling. Your address and phone number should be prominent.
Make it Fast. This means eliminating unnecessary images and optimizing your site for lightning-fast downloads. Experts recommend that webpages should load in 4 seconds.
Don’t use Flash. For now Flash cannot be used on many smart phones. But don’t worry, with HTML 5 and javascript technology, Flash interactivity is easily replaced. It’s All About Contact. Use the native OS features including click-to-call and Google Maps. People searching for a dentist on their mobile devices usually results in a booked appointment, so make it easy for them.
Optimize. Optimize. Optimize.
Google advises that a responsive website design is the best choice for businesses who want their website to not only be easily viewed on multiple devices, but also for those who want their website to be optimized for search engines. So, what does that mean for you? If you want your patients to see your website on their phone or laptop and make sure you come up on the first page of Google on both devices, you need to make sure you are optimized for each. Given that YP.com says medical services was the 5th highest growing search category in 2012 with an 83% increase, it’s a marketing choice you really shouldn’t ignore.
Mobile SEO is very comparable to the SEO on your main website, but there are a few differences. The most important being mobile searches tend to yield more local results than what would normally come up on a desktop search. Making sure you have an accurate Google+ Local listing will help you show up near the top of a search if someone is using their smart phone to look for a dentist in your city.
Partner with an expert who can help you optimize your mobile site so that it looks and functions similarly to the main website, but will come up higher in rankings for people doing a search from their smartphones and tablets. Additionally, you should track the number of visitors to your mobile website so determining value is simple. www.northtexasdentistry.com
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What about Advertising?
Pay-per-click (PPC) advertising campaigns can be very effective for dentists, especially if used in conjunction with a good SEO strategy. In fact, Google’s researchers recently studied organic click volume when search PPC ads were live and when they were turned off. They were interested in seeing if a PPC ad interfered with organic (ie. – free) clicks and answer the question; “Can you get the same number of website visits by being on the first page of Google organically for (dentist my city) without paying for PPC ads?� The answer was a very loud and definitive no. They concluded that the 89% increase in clicks from paid ads was in addition to the free organic clicks, not taking away from them. In other words, a great PPC campaign only augments a great SEO strategy because it results in additional clicks that would not have happened if the ads weren’t running.
So, if PPC ads can help on your main website, what can they do for the mobile version? Currently, the current mobile PPC landscape is full of potential. In fact, if you want to ease into the PPC market, mobile would be a great place to start. Google and Bing now offer mobile-only campaigns and since there isn’t as much competition for keywords in mobile PPC, the average cost-per-click (CPC) is significantly lower than for the regular search networks in desktop marketing.
The convergence of desktop marketing and mobile marketing was inevitable. While it can be daunting to keep up with technological advances and their marketing effects, the emergence of mobile marketing is a great opportunity for dentists to find more of their ideal patients via people searching on their smartphones. However, it’s clear that a combination of desktop and mobile marketing will ensure that when people in your area are searching for a dentist on any type of device, they find you first.
Responsive website design, SEO and PPC advertising are just a few components in a much larger blueprint to getting patients to choose you when they search for a dentist online. With expert help, you should be able to build a complete plan to leverage the internet to get high value dental patients; including Website Optimization, Pay-Per-Click Online Advertising, Website Design, Dental Microsites and Social Media. If patients are searching for dentists in your area and finding your competition instead of you, give us a call. We can help. n Neil Rudoff is the Senior Account Executive at Bullseye Media in McKinney, TX. He received his BA from Tufts University in 1989 and his MBA from UT Austin in 1993, and has been an online marketing and web design consultant since 2003. He can be reached at (214) 491-6166 or neil@bullseyemediallc.com BullseyeMedia, LLC is a McKinney, Texas based full-service digital marketing agency that specializes in helping dentist leverage the internet to grow their practices. For more information, visit www.onlinedentalmarketing.com. 28 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
& !#% T O & !#% BY $R * OEL # 3MAL L
) NS PI R I NG #UL T UR E S OF %XC E L L E NC E h &I NDI NG OUR VOI C E AND L E AR NI NG T O BR I NG WHO WE AR E T O WHAT WE DO WI L L F OR E VE R C HANG E T HE WAY WE L E ADv $R * OE L # 3MAL L
$R 3MAL L I S A NAT I O NAL L Y R ECOGNI Z ED AU T HOR AND S PEAK E R WHO L ECT UR ES AN D WR I T E S ON T HE F OL L OWI NG T OPI CS "E C O MI N G T H E L E A D E R Y O U WE R E s ME A N T T O B E "E C O MI N G A N E X C E P T I O N A L s C O MMU N I C A T O R "E I N G A R O L E MO D E L WO R T H s F O L L O WI N G "E L I E V I N G I N A B U N D A N C E s +N O WI N G T H E P O WE R O F B E I N G s V U L N E R A B L E & A C I N G C H A N G E WH E N C H A N G E s I S N E E D E D ) N F L U E N C I N G Y O U R B U S I N E S S s C U L T U R E F O R T H E B E T T E R
construction news
OFFERS DOCTORS
Equipment & Technology Tax Savings
OPPORTUNITY
by Brian Berry, CEO/President, Med-Tech Construction
If you’ve been thinking about updating or expanding your office equipment and technology, 2013 is the year to take action. Why?
You can use Section 179 of the IRS Tax Code to acquire and possibly deduct up to $500,000 in capital equipment this year. Section 179 was scheduled to be reduced from the $139,000 limit in 2012, to $25,000 in 2013. But part of the Fiscal Cliff Bill passed January 1 includes a temporary increase to $500,000. The depreciation will be reduced to $25,000 in 2014 unless extended.
If you’re not familiar with Section 179, this is the part of the IRS Tax Code that encourages small-business owners to invest in equipment or technology by allowing deductions for capital equipment expenditures.
What Can You Deduct?
New machinery, furniture, fixtures and offthe-shelf software have been standard Section 179 deductions. However, the def-
“qualified leasehold improvement property” [LHI]. This amount for LHI property is capped at $250,000 as it is a part of the $500,000. The property must be used in the taxpayer’s trade or business and cannot be used for lodging nor air conditioning or heating units.
inition of property qualifying for Section 179 was also temporarily expanded to include certain real property, specifically
The Science and Art of Dental Restorations...
transformed into beautiful and convincing smiles. GNS dental studio,Inc.
by Gilbert Young, CDT 972 - 473 - 9366
www.gnsdentalstudioonline.com
ceramo-metal restorations all-ceramic restorations implant supported restorations case planning and design continuing education provider n
n
n
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NORTH TEXAS DENTISTRY
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A Bonus Deduction!
Purchases over $500,000 qualify for 50 percent bonus depreciation. Standard first-year MACRS (Modified Accelerated Cost Recovery System) deduction applies to the remaining amount up to $2,000,000. As always, Section 179 expense cannot create or increase a loss in the year it relates to, but it can be carried over.
Disclaimer: You will want to consult
with your own tax advisor based on your
own individual circumstances. This
information is offered to provide general
guidance in applying tax credits and tax deductions that may be beneficial to
your growth plans, and should not be construed as providing financial advice,
tax advice and/or rendering advice on
tax return preparation.
Brian Berry is President / CEO of Med-Tech Construction. Specializing in healthcare construction, the national firm has been named one of the Top 100 Aggie owned companies in the world by the Mays Business School at Texas A&M University. Med-Tech also received the Dallas Top 100 Award as one of the fastest growing Dallas-based companies from the SMU Cox School of Business two consecutive years. Learn more at medtechconstruction.com.
ADVERTISER’S INDEX
AFTCO.................. Inside Back Cover Bob Michaels, CLU .........................20
Bryant Studios .................................11 Bullseye Media............................... 24
Children 1st Dental & Surgery Center.. Inside Front Cover Dr. Joel Small ................................. 28
GNS Dental Studio......................... 29
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Structures and Interiors.................. 20 Tina Cauller .................................... 19
UT School of Dentistry at Houston . 28
Call 800.232.3826 or visit us online at www.AFTCO.net for a free practice appraisal, a $2,500 value! AFTCO is the oldest and largest dental practice transition consulting firm in the United States. AFTCO assists dentists with associateships, purchasing and selling of practices, and retirement plans. We are there to serve you through all stages of your career.
Beverly D. Deacon, D.D.S. (UT - San Antonio 1988)
has acquired the practice of
Joshua E. Foreman, D.D.S. (UT - San Antonio 2008)
Duncanville, Texas AFTCO is pleased to have represented both parties in this transaction.
AFTCO is the only company that has sold dental practices with a cumulative value of over $1,500,000,000
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