ODA Journal May/June 2023

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Inside Back Cover

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OkMOM Legacy Fund

Choctaw Nation Health Services

DentaQuest

Edmonds Dental Prosthetics

Endodontic Associates

Endodontic Practice Associates

Lewis Health Profession Services

Liberty Dental Plan

MCNA

MedPro Group

Suction Solutions

University of Oklahoma College of Dentistry

Highlights

THE OKLAHOMA DENTAL ASSOCIATION

JOURNAL (ISSN 0164-9442) is the official publication of the Oklahoma Dental Association and is published bimonthly by the Oklahoma Dental Association, 317 NE 13th Street, Oklahoma City, OK 73104, Phone: (405) 848-8873; (800) 876-8890. Fax: (405) 848-8875. Email: information@ okda.org. Annual subscription rate of $39 for ODA members is included in their annual membership dues.

POSTMASTER: Send address changes to OKLAHOMA DENTAL ASSOCIATION

JOURNAL, 317 NE 13th Street, Oklahoma City, OK 73104.

Periodical postage paid at Oklahoma City, OK and additional mailing offices.

Subscriptions: Rates for non-members are $56. Single copy rate is $18, payable in advance.

Reprints: of the Journal are available by contacting the ODA at (405) 848-8873, (800) 876-8890, editor@okda.org.

Opinions and statements expressed in the OKLAHOMA DENTAL ASSOCIATION

JOURNAL are those of the author and are not necessarily those of the Oklahoma Dental Association. Neither the Editors nor the Oklahoma Dental Association are in any way responsible for the articles or views published in the OKLAHOMA DENTAL ASSOCIATION JOURNAL.

Copyright © 2022 Oklahoma Dental Association.

Practice Management: MyHealth Access Network

This presentation reviews the details of recent legislation regarding participation in Oklahoma’s State Designated Health Information Exchange and reviews the capabilities and benefits of utilizing the HIE to provide care and services This presentation also summarizes the process for joining and getting connected to the Health Information Exchange (HIE our smartphone to register for one of the presentations

REMINDER: The Oklahoma Board Of Dentistry's Continuing Education reporting period ends June 30, 2023.

Message from ODA President

Good Shepherd Merges with Crossings Community Clinic

ODA JOURNAL STAFF EDITOR

Mary Hamburg, DDS, MS

ASSOCIATE EDITOR

Roberta A. Wright, DMD, MDSc, FACP

EDITORIAL BOARD MEMBERS

M. Edmund Braly, DDS, FACS, FAACS

Daryn Lu, DDS

Phoebe Vaughan, DDS

Meredith Turbeville, DDS

Divesh Sardana, BDS, MDS, MBA, MPH, PhD

EXECUTIVE DIRECTOR

F. Lynn Means

DIRECTOR OF COMMUNICATIONS & EDUCATION

Stacy Yates

OFFICERS 2023-2024

PRESIDENT

Paul Wood, DDS president@okda.org

PRESIDENT-ELECT

Daryn Lu, DDS presidentelect@okda.org

VICE PRESIDENT

Twana Duncan, DDS vicepresident@okda.org

SECRETARY/TREASURER

Nicole Nellis, DDS treasurer@okda.org

SPEAKER OF THE HOUSE

Mitch Kramer, DDS speaker@okda.org

IMMEDIATE PAST PRESIDENT

Robert Herman, DDS,MS pastpresident@okda.org

ADMINISTRATIVE STAFF

EXECUTIVE DIRECTOR

F. Lynn Means

DIRECTOR OF GOVERNANCE & FINANCE

Shelly Frantz

DIRECTOR OF COMMUNICATIONS & EDUCATION

Stacy Yates

DIRECTOR OF MEMBERSHIP

Kylie Faherty

SPECIAL PROJECTS & COMMUNICATIONS MANAGER

Apryl Awbrey

MEMBERSHIP ENGAGEMENT MANAGER

Ansley Jinkins

PARTNER RELATIONS MANAGER

Anna Kernes

Stay connected with the ODA!

CALENDAR OF EVENTS

Visit the ODA’s online calendar at OKDA.ORG/CALENDAR for all upcoming meetings and events.

May 29

ODA Closed

June 2

Tulsa Dental Society Golf Tournament

12:30 p.m.

Forest Ridge Country Club

June 9

Council on Governmental Affairs

9:00 a.m.

ODA Building & Zoom

June 16

Rewards Partners

9:30 a.m.

ODA Building & Zoom

Membership & Membership Services

11:00 a.m.

ODA Building & Zoom

Annual Meeting Planning Committee

1:00 a.m.

ODA Building & Zoom

July 3 & 4

ODA Closed

Is Your Contact Information Correct?

Help the ODA keep you informed about legislative actions, CE opportunities, events and other important member-only news.

Contact Kylie Faherty, ODA Membership Director, at kfaherty@okda.org or 800.876.8890 to provide the ODA with all of your current contact information.

The ODA Journal Editorial Board is interested in your ideas and original articles. Do you have a unique case study you wish to share with your colleagues? Do you have a concern or particular interest in dentistry that you want to know more about?

FROM THE ODA PRESIDENT DR. PAUL WOOD

We completed another great ODA meeting. The CE lineup was excellent, and Dr. Robie Herman and Dr. Nicole Nellis did a great job with the meeting. No ODA event is possible without the tireless hard work of Lynn Means and the staff at the ODA. We viewed an inspirational video presentation by ADA President Dr. George Shipley. He outlined the need to move forward with the new Strategic Forecasting Committee (SFC). It will define a bright future for our organization, and I am looking forward to all the great things in the future of the ADA. If you have not tried the mobile app you need to! It really turned out to be fantastic.

There was also a great update from our 12th District Trustee, Dr. Terry Fiddler. Thank you to Dr. Fiddler for his years of service as a Trustee. We will have a new Trustee for the 12th District moving forward and expect excellent representation from the individual from the Kansas delegation who is selected He outlined a bright future for the SFC. Congratulations to all of the award winners at the House of Delegates. A special thank you to Dr. Doug Auld for his many years of service.

The social events at the meeting were well attended, and we had a great time visiting with our fellow dental professionals. The Opening Session was inspirational, and

along with the morning mixer, was a great start to the meeting. The Exhibit Hall was a happening place, with many interesting exhibitors offering innovative solutions. It was great to see the tribal health system representatives who are making positive strides in providing comprehensive care to their tribal members. I met with DentaQuest representatives, and they are making steady progress in establishing all the contractual perimeters for their portion of SoonerCare. Liberty Dental was there and very positive about the future. Ronnie Shaw, the Chickasaw Dental recruiter, and I took a picture with the Mr. Liberty cardboard character. It was also great to see my old friends, Phil Hodabeck and Joel Richie, from Midwest Dental.

The ODA Party was a great success and a real tribute to all the planning that the ODA staff, Dr. Nellis, and Dr. Herman put into it. Dr. Herman did a fantastic job as your ODA president, and I hope to live up to the high standard he set.

Now is a great time to be part of organized dentistry. The profession is shifting practice modalities, and it is amazing to see all those practice settings represented at our meeting. The ODA represents more than 80% of all practicing dentists in Oklahoma, and it is our mission to provide the best care we can to the citizens of our great state. The public trust in dentistry has never been higher and we as an organization will continue that. This coming year we hope to again pursue legislation that would make medical loss ratio for dental insurance in Oklahoma a reality. Our Governmental Affairs Council and lobbyists will continue to work hard to ensure that our concerns are heard by the Oklahoma Legislature. As dentists, we have always placed the needs of the patient first, and we need to get our lawmakers to understand that we are the people who care most about the oral health of the patient.

The coming year should be amazing. Our profession is stronger than ever, and the future is bright. OkMOM 2024 will be in Lawton, and preparations are well underway, with multiple planning meetings having taken place. The planning committee consisting of Dr. Shannon

Griffin, Dr. Juan Lopez, and Dr. Todd Bridges, has been working hard to make OkMOM Lawton one to remember. Dr. Sara Spurlock and Dr. Jennifer Jinkins have really charged forward with the planning for the 2024 Annual Meeting in Oklahoma City at the Omni Hotel.Thank you for trusting me to be your President for 2023-2024. I will not let you down.

Dr. Wood being sworn into the presidency by Dr. Terry Fiddler, American Dental Association Twelfth District Trustee.

2022–2023 ODA PRESIDENT, DR. ROBIE HERMAN, PASSING ON THE ODA PRESIDENT'S PIN TO DR. PAUL WOOD DURING THE ODA'S HOUSE OF DELEGATES MEETING.

2023–2024 ODA PRESIDENT, DR. PAUL WOOD, GIVING HIS FIRST ADDRESS AT THE ODA'S HOUSE OF DELEGATES MEETING.

2023-2024 ODA EXECUTIVE COMMITTEE

President-elect

2023-2024 ODA BOARD OF TRUSTEES

Dr. Paul Wood, President and ADA Delegate

Dr. Daryn Lu, President-elect

Dr. Twana Duncan, Vice President

Dr. Nicole Nellis, Secretary/Treasurer

Dr. Mitch Kramer, Speaker of the House

Dr. Robie Herman, Immediate Past President

Dr. Tamara Berg, ADA Delegate

Dr. Matthew Cohlmia, ADA Delegate

Dr. Tim Fagan, ADA Delegate

Dr. Lindsay Smith, ADA Delegate & Tulsa County Component Trustee

Dr. Mary Temple-Goins, New Dentist Trustee

Dr. Sara Spurlock, Central Component Trustee

Dr. Douglas Auld, Eastern Component Trustee

Dr. Jandra Korb, Northern Component Trustee

Dr. Colin Eliot, Northwest Component Trustee

Dr. Edward Harroz III, OK County Component Trustee

Dr. Matthew Bridges, Southwest Component Trustee

Dr. Paul Mullasseril, OUCOD Dean

President Dr. Paul Wood

Dr. Daryn Lu

Vice President Dr. Twana Duncan

Secretary/Treasurer

Dr. Nicole Nellis

Immediate Past President Dr. Robie Herman

Speaker of the House Dr. Mitch Kramer

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H o w w e P o w e r F l u s h y o u r s y s t e m :

1 . O u r s e l f c o n t a i n e d p a t e n t e d - p e n d i n g P o w e r F l u s h S y s t e m i s c o n n e c t e d t o i n s t a l l e d C a m - L o c k f i t t i n g s .

2 . U n d e r g r o u n d s u c t i o n l i n e s a r e f l o o d e d w i t h o u r h o s p i t a l g r a d e Q u a t s a n i t i z i n g s o l u t i o n .

3 . T h e s o l u t i o n i s c i r c u l a t e d t h r o u g h t h e l i n e s u s i n g o u r c l o s e d c i r c u i t s y s t e m .

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4 . T h e l i n e s a r e e v a c u a t e d a n d d r i e d .

5 . T h e c i r c u l a t e d s o l u t i o n i s f i l t e r e d t o 2 0 m i c r o n s t o r e m o v e s e d i m e n t .

6 . T h e s a n i t i z e d l i q u i d i s d i s p o s e d o f o n - s i t e a f t e r s o l i d s / s e d i m e n t s a r e r e m o v e d f o r r e c y c l i n g v i a f e d e r a l a m a l g a m w a s t e s t a n d a r d s .

The House of Delegates establishes all ODA policies not otherwise provided for in the Bylaws, elects the Speaker of the House and council members, confirms the appointments of the Secretary/Treasurer and the council chairs, adopts an annual budget and sets the membership dues. The House of Delegates meets annually and is comprised of the Board of Trustees, four officers from each Component, one delegate per fifteen members from each Component and four OUCOD dental students.

The House of Delegates met on April 27, 2023 at the ODA Annual Meeting in Tulsa. The House ratified a $1,152,830 budget, which includes a dues increase of $31. The House amended the Bylaws to add the Dean of the OU College of Dentistry to the Board of Trustees and voted down a motion to add a large group practice trustee to the Board. The House approved editorial amendments to the Guide for Disciplinary Hearing and voted to amend the Annual Session policy by striking ribbons recognition.

The House voted down a resolution to remove the names of member dentists from the following awards: Dan E. Brannin for Professionalism and Ethics, Robert K. Wynne for Public Education and Public Information, Shobe Memorial Tablet, and Richard T. Oliver for Legislative Leadership. The names of these ODA awards will remain the same. The ODA will purchase an updated Shobe Memorial Tablet and transfer the names of the prior recipients to the new Tablet to be displayed at the ODA building. The ODA will print a series of articles in the ODA Journal about all the awards to make members aware of the purpose and history of each award and its namesake.

The House adopted a policy on diversity, equity and inclusion: In principle and in practice, the ODA values and seeks diverse and inclusive participation within the dental profession. The ODA promotes involvement and expanded access to leadership opportunities regardless of race, ethnicity, gender, religion, age, sexual orientation, nationality, disability or type of practice. The organization provides leadership and commits time and resources to accomplish this objective while serving as a model for diversity to all associations.

The House adopted a the following statement in opposition to the Health Information Exchange: The Oklahoma Dental Association opposes the requirement of electronic health information exchange throughout Oklahoma for healthcare providers for SB1369/SB574.

The House elected the following members into State Life Membership: Dr. Chris Bussman, Dr. Leon Conkling, Dr. Walter Davis, Dr. Robert Dew, Dr. Nicholas Hunter, Dr. Larry Kiner, Dr. James Lowe, Dr. Don Morton, Dr. Steve Pracht, and Dr. David Simon.

The House elected the following members into leadership:

Dr. Twana Duncan, Vice President

Dr. Lindsay Smith, ADA Delegate

Dr. Chris Fagan, ADA Alternate Delegate

The House confirmed the presidential appointments for Secretary/ Treasurer and Council Chairs:

Dr. Nicole Nellis, Secretary/Treasurer

Dr. Twana Duncan, Council on Budget and Finance

Dr. Matthew Bridges, Council on Bylaws, Policy and Ethics

Dr. Brian Molloy, Council on Dental Care

Dr. David Wong, Council on Dental Education and Public Information

Dr. Lindsay Smith, Council on Governmental Affairs

Dr. Nicole Nellis, Council on Membership and Membership Services

The House recognized the 2023 award winners:

Dr. Scott Hubbard, Thomas Jefferson Citizenship Award

Dr. Paul Mullasseril, Dan E. Brannin Award for Professionalism and Ethics

Dr. Jeannie Bath, Robert K. Wynn Award for Dental Education and Public Information

Dr. Forrest Bath, Dr. Eric Winegardner and Eric’s Pharmacy, Presidential Citations

Mrs. Lynn Means, Richard T. Oliver Legislative Award

Representative Marcus McEntire, Oklahoma Legislator of the Year

Dr. Tim and Pamela Fagan, President’s Leadership Award

Dr. Matthew Bridges, Young Dentist of the Year

Dr. Lindsay Smith, Richard Haught Dentist of the Year Award

Dr. Doug Auld, James A. Saddoris Lifetime of Leadership Award

The following members were recognized for fifty-years of membership in the ODA:

Dr. Thomas Gilbert

Dr. Stanley Groom

Dr. James Hackler

Dr. Jay Hodges

Dr. Richard Homsey

Dr. Nicholas Hunter

Dr. Richard James

Dr. William Johnson

Dr. Robert Livingston

Dr. Claud McKee

Dr. James Nicholson

Dr. James Osgood

Dr. James Roane

Dr. Gregory Watkins

Dr. Scott Waugh

Dr. Gary Youree

If you are interested in serving on the ODA House of Delegates, contact your component president or the ODA office at 405-848-8873

The next meeting of the ODA House of Delegates is scheduled forApril 11, 2024 at 1:00 p.m. in Oklahoma City.

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Dr. Spencer Hinckley and Dr. Percy Bolen

Social Events

WELCOME RECEPTION

THE MAYO HOTEL

MORNING MIXER

SPONSORS:

HAPPY HOUR & BINGO

SPONSOR:

Oklahoma Dental Association Party

A CELEBRATION IN HONOR OF OKLAHOMA DENTISTRY AND 2022/2023 ODA PRESIDENT, DR. ROBIE HERMAN

ENTERTAINMENT SPONSOR

DRINK SPONSOR

Continuing Education

AWARD WINNERS

CONGRATULATIONS TO THE 2023 ODA AWARD WINNERS!

Dr. Jeannie Bath

ROBERT K. WYNN FOR DENTAL EDUCATION & PUBLIC INFORMATION

Dr. Paul Mullasseril

DAN E. BRANNIN FOR ETHICS & PROFESSIONALISM

Dr. Scott Hubbard

THOMAS JEFFERSON FOR CITIZENSHIP

Dr. Tim & Pamela Fagan PRESIDENT’S LEADERSHIP

Dr. Matt Bridges YOUNG DENTIST OF THE YEAR

Lynn Means RICHARD T. OLIVER AWARD FOR LEGISLATIVE LEADERSHIP

PRESIDENT'S CITATION

2022 / 2023 EXECUTIVE COMMITTEE

President:

President-elect:

Secretary/Treasurer:

Dr. Douglas Auld DISTINGUISHED DENTAL SERVICE

Dr. Paul Wood

Dr. Daryn Lu

Dr. Nicole Nellis

Vice President: Dr. Twana Duncan Speaker of the House: Dr. Mitch Kramer

Dr. Robert Herman pinning Dr. Paul Wood with the traditional ODA president’s pin.

Dr. Lindsay Smith RICHARD HAUGHT DENTIST OF THE YEAR

Rep. Marcus McEntire LEGISLATOR OF THE YEAR

Dr. Forrest Bath | Dr. Eric Winegardner | Eric’s Pharmacy

HOUSE OF DELEGATES

ODA MEMBERS RECOGNIZED FOR 50 CONTINUOUS YEARS OF MEMBERSHIP

Dr. Thomas Gilbert

50 YEARS OF MEMBERSHIP

Dr. Stanley Groom

Dr. James Hackler

Dr. Jay Hodges

Dr. Richard Homsey

Dr. Nicholas Hunter

Dr. Richard James

Dr. William Johnson

Dr. Robert Livingston

Dr. Claud McKee

Dr. James Nicholson

Dr. James Osgood

Dr. James Roane

Dr. Gregory Watkins

Dr. W. Scott Waugh

Dr. Gary Youree

ODA past president, Dr. Chris Fagan, pinning Dr. Robert Herman with the past president’s pin.

Dr. Tabitha Arias accepts the Cohlmia Cup, presented by Dr. Nicole Nellis, on behalf of the Oklahoma County Dental Society. This is awarded to the Component with the highest percentage of new members.

Dr. Colin Eliot accepts the Charles M. Kouri Cup, presented by DENPAC Chair Dr. Chris Fagan, on behalf of the Northwest District.

ODA Executive Director Lynn Means addressing the House.

Representatives from the ADA present on the importance of Diversity, Equity, and Inclusion.

Dr. Jeannie Bath accepts the President’s Citation on behalf of Dr. Forrest Bath, Dr. Eric Winegardner, and Eric’s Pharmacy.

HAVE YOU JOINED THE LEGACY?

During the House of Delegates at the 2023 Oklahoma Dental Association Annual Meeting, those in attendance came together to raise

$18,369 toward the Oklahoma Mission of Mercy Legacy Fund. Thank you!

This campaign was created by the incredibly generous gift by Dr. Tim and Pamela Fagan of $448,000 that will be matched dollar-for-dollar until the deadline on June 30, 2023. The money made through this matching gift campaign will be the sole funding source for the Oklahoma Mission of Mercy through 2025 and beyond.

We ask you to join the Legacy now by making your tax-deductible monthly, quarterly, annual, or one-time gift. Please help ensure essential dental care continues to be provided each year during the Oklahoma Mission of Mercy!

JOIN THE LEGACY & DONATE NOW

If you are paying by check, please make the check payable to Oklahoma Mission of Mercy Legacy Fund and mail to: Oklahoma Dental Association

Attn: OkMOM Legacy Fund 317 NE 13th St. | Oklahoma City, OK 73104

THESE ODA MEMBERS CONTRIBUTED ABOVE AND BEYOND THEIR

ANNUAL MEMBERSHIP DUES TO JOIN THE LEGACY

MARILYN HIEBERT

MYRON HILTON

RICHARD HOMSEY

JAMES HOOPER

BRAD HOOPES

MITCHELL HOOPES

JACK MCKINNIS

GLENN MEAD

JOSEPH MEADOR

JAMIE MEANS

DAVID MERRELL

ANDREA MONTGOMERY

CROSSLEY

G. FRANS CURRIER

RUSSELL DANNER

DARRELL DAUGHERTY

DAVID DEASON

STEVEN DEATON

WILLIAM DEPRATER

BRYCE DORROUGH

ANA DOTSON

BRIAN DREW

DAVID DRUMMOND

KEVIN DUFFY

TWANA DUNCAN

BENJAMIN EDWARDS

RENALLA ELLIS

HEATH EVANS

BARRY FARMER

CASEY FISHBURN

JOHN FOLKS

RICHARD FREEMAN

EMILY FRYE

CHAD GARRISON

LAMONT GEE

MARK GOODMAN

SANDRA GRACE

BARRY GREENLEY

JERRY GREER

THOMAS GRIFFIN

ANDREW GUTHRIE

JACOB HAGER

MICHAEL HANSEN

AARON HARMAN

EDWARD HARROZ

DARRELL HAZLE

ROBERT HERMAN

JEFFREY HERMEN

WILLIAM HIATT

ERIC HOPKINS

JAMES HULSEY

BENJAMIN HUMPHREY

W. ROBERT HUNTER

JENNIFER JENKINS

DONALD JOHNSON

EUGENIA JOHNSON

RICHARD JOHNSON

WILLIAM JOHNSON

JANET JULIAN

MOHAMMAD KARAMI

CHARLES KEITHLINE

CAROLYN KEYES

MICHAEL KIRK

JENNIFER KOONCE

GENE KOOP

JANDRA KORB

MICHAEL KUBELKA

ASHLEY LANMAN

GARY LAWHON

GRADY LEMBKE

ROBERT LIVINGSTON

BRANDON LOESER

ERIC LOPER

ERIC LOPEZ

GARY LOTT

KAREY LOW

PAMELA LOW

STEVE LUSK

JAMES MABRY

DAVID MADDOX

DAVID MARKS

STEPHEN MARTIN

JOSEPH MASSAD

ALAN MAULDIN

TRACY MCINTIRE

JANNA MCINTOSH

JACK MORRISON

TIM MOUNT

ANAITA MULLASSERIL

JAMES MURTAUGH

CARSON

2023 Spring ODA Membership Events

Women In Dentistry 2023

The annual ODA Women in Dentistry CE Brunch was held on February 17, 2023 at the Ambassador Hotel in downtown Oklahoma City. Attendees enjoyed a brunch buffet from Café Cuveé, coffee, and mimosa bar while earning 2 hours of CE from Tracy Butler, CRDH, MFT, who presented the course, Heart of Practice Growth with a Systemic Approach. Thank you to our sponsors, Straumann and First Liberty Bank. Look for more information on the next Women in Dentistry event next spring!

Thunder Up with the ODA!

On March 3, 2023, the ODA hosted new dentists and dentists who work in large group practices at an Oklahoma City Thunder Game versus the Utah Jazz. Members and non-members were invited to enjoy snacks, refreshments and a Thunder win at the Paycom Center! There were 19 attendees including ODA President Dr. Robert Herman and ODA New Dentist Trustee Dr. Mary Temple-Goins.

Match@ODA

The ODA’s annual Match@ODA event was held on April 20, 2023, at PARLOR OKC in downtown Oklahoma City. At this casual networking event potential employees and potential employers met and discussed similar interests, and future professional endeavors. We would like to thank our sponsors First Liberty Healthcare Banking, Henry Schein Dental Practice Transitions, Lewis Health Profession Services, Mariner Wealth Advisors, Positive Impact Dental Alliance, and Specialty1 Partners for helping make this a successful event for all! We can’t wait to host this event again next year.

Interested in attending future ODA Membership events? Check your email, ODA social media, and okda.org for upcoming events!

ODA MEMBER BENEFIT CORNER

Why is a membership with the ODA/ADA so valuable?

The ODA/ADA supports all members at the national, state, and local levels. From helping you manage your practice more efficiently and advocating on your behalf to offering you tools and resources that help you find the answers for you’re looking for, we’re there every step of the way.

HIPAA Compliance and Online Reviews

Many prospective patients turn to online reviews to help them evaluate potential dentists. In fact, 84% of the public trust online reviews to help them make decisions. With a majority of people turning to the internet to find a dentist, it is more important than ever for dental practices to maintain and respond to online reviews professionally and promptly – while ensuring they maintain HIPAA compliance.

Data revealed that 88% of dentists reported receiving online patient reviews, yet 39% of them felt they were unable to respond to reviews due to HIPAA regulations, according to a December 2022 survey by the ADA Health Policy Institute. While dental practices can be fined thousands of dollars for responding to online reviews with sensitive information, such as a patient’s name, insurance information, treatment plan, and/or cost information, they might also violate HIPAA for simply acknowledging a patient was at their practice.

Remember this: Just because a patient identifies themselves in a review, they have NOT waived their HIPAA protection—patient confidentiality must always be maintained!

Dental practices should consistently monitor their presences on major review sites to be aware of what’s been posted, whether positive or negative. To equip dentists with resources to help manage comments left on their social media accounts, review sites, or other platforms, the ADA has created a toolkit with information about navigating online reputation in a digital age.

This new resource discusses critical questions for dental practices, including:

• How should I monitor my online reputation?

• How does HIPAA apply to online reviews?

• How should I respond to negative reviews?

To learn more about online reputation management and see sample responses to positive and negative reviews, visit ADA.org/socialtoolkit. copyright © 2023 American Dental Association. All rights reserved. Reprinted by permission.

KNOWLEDGE CONNECTS

8 CE credits while learning the essentials of anatomic impressions, functional impressions, pre-bite registrations and the determination of the definitive jaw relations.

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Oklahomans know all too well that you can never be too prepared for severe weather, but where do you turn when you need immediate relief in the aftermath of a devastating storm?

Oklahomans know all too well that you can never be too prepared for severe weather, but where do you turn when you need immediate relief in the aftermath of a devastating storm?

Help is available! The Oklahoma Dental Relief and Disaster Grant Program (RDGP) is a charitable trust established to provide aid to dental professionals affected by natural disasters, physical disability, chemical dependence, or other hindering conditions. Aid is provided confidentially and without remuneration. Whether you are affected at home or office, contact the RDGP to apply for immediate assistance 800876-8890.

The RDGP accepts tax-deductible donations from individuals and dental organizations from around the country to provide aid after devastating destruction caused by tornadoes and other natural disasters across the state. Funds are awarded to dental professionals who are victimized by the storms. Additionally, the funds are used for programs like the Oklahoma Dental Foundation MobileSmiles Program to aid in relief efforts in several Oklahoma communities.

Help is available! The Oklahoma Dental Relief and Disaster Grant Program (RDGP) is a charitable trust established to provide aid to dental professionals affected by natural disasters, physical disability, chemical dependence, or other hindering conditions. Over the last three years, the RDGP awarded $28,000 in disaster assistance to individuals and dental organizations affected by severe weather. Aid is provided confidentially and without remuneration. Whether you are affected at home or office, contact the RDGP to apply for immediate assistance 800-876-8890.

The RDGP accepts tax-deductible donations from individuals and dental organizations from around the country to provide aid after devastating destruction caused by tornadoes and other natural disasters across the state. Funds are awarded to dental professionals who are victimized by the storms. Additionally, the funds are used for programs like the Oklahoma Dental Foundation MobileSmiles Program to aid in relief efforts in several Oklahoma communities.

The RDGP relies solely on contributions from individuals and dental foundations. The donations received help prepare & provide for those Oklahoma dentists and dental foundations in need of resources after destructive storms.

The RDGP relies solely on contributions from individuals and dental foundations . The donations received help prepare & provide for those Oklahoma dentists and dental foundations in need of resources after destructive storms.

DO YOU OR SOMEONE YOU KNOW STRUGGLE WITH SUBSTANCE ABUSE?

DO YOU OR SOMEONE YOU KNOW STRUGGLE WITH SUBSTANCE ABUSE?

The RDGP also contributes to the Oklahoma Health Professionals Program which is an outreach program designed to support and monitor medical and allied health professionals throughout Oklahoma who are experiencing difficulty with substance abuse. The services provided by the OHPP are confidential and at no cost. Services include expert consultation and intervention designed to encourage healthcare professionals to seek help for substance abuse and behavioral concerns. If you or someone you know needs help, please call the 24-hour confidential direct line (405-601-2536). The RDGP voluntary section on the ODA dues statement funds the ODA’s contribution to the Health Professionals Program.

The RDGP also contributes to the Oklahoma Health Professionals Program which is an outreach program designed to support and monitor medical and allied health professionals throughout Oklahoma who are experiencing difficulty with substance abuse. The services provided by the OHPP are confidential and at no cost. Services include expert consultation and intervention designed to encourage healthcare professionals to seek help for substance abuse and behavioral concerns. If you or someone you know needs help, please call the 24-hour confidential direct line (405-601-2536). The RDGP voluntary section on the ODA dues statement funds the ODA’s contribution to the Health Professionals Program.

Whether you need help or want to provide help, don’t wait! Contact the RDGP manager today at sfrantz@okda.org or call 800-876-8890

Whether you need help or want to provide help, don’t wait! Contact the RDGP manager today at sfrantz@okda.org or call 800-876-8890

Tax-deductible donations to the program can be mailed to: OK Dental Relief and Disaster Grant Program 317 NE 13th Street Oklahoma City, OK 73104

Tax-deductible donations to the program can be mailed to: OK Dental Relief and Disaster Grant Program 317 NE 13th Street Oklahoma City, OK 73104

For grant application and program guidelines, visit okda.org/programs/member-support

For grant application and program guidelines, visit okda.org/programs/member-support/

LEARN MORE, BUILD YOUR SCHEDULE AND REGISTER AT SMILECON.ORG

JOIN US AT CNHSA

POSITION 1: GENERAL DENTIST

Location | Durant Regional Medical Clinic 1801 Chukka Hina Durant, OK 74701

POSITION 2: GENERAL DENTIST

Location: Rubin White Health Clinic 109 Kerr Ave Poteau, OK 74953

• SALARY: $175,000/ Year

• BENEFITS: Generous Full Benefits Package

• DUTIES: Dental Procedures at CNHSA

Procedures are restorations, amalgam and composite. Extractions are simple and surgical, based on the comfort level of the dentist. Exams and digital x rays are offered. For complex extractions and molar endo we have both an endodontist (in Durant, OK) and the ability to refer out root canals to outside providers. This also applies to oral surgery for complex cases, third molars, full mouth extractions or complex extractions where anatomical considerations may impact the case. Also, we do have one pediatric dentist (in Durant, OK). Dentures and partials are handled by outside providers, and the patient is given contact instructions.

SEND CV TO JASON HILL, D.O.

CHIEF MEDICAL OFFICER

JLHILL@CNHSA.COM

ONE

SmileCon®, the ADA’s reimagined dental meeting, delivers endless opportunities for every career stage and specialty.

THREE GREAT PASS OPTIONS

Build Your Practice

A Dental Home is a relationship between a dentist and a patient where the patient chooses a dental office for the care of themselves and their loved ones. LIBERTY Dental Plan helps our members establish a Dental Home to support the patient-provider relationship and build trust.

The LIBERTY Advantage

LIBERTY helps our Providers by encouraging members to keep the dental home they choose. We also help Providers advertise their other office locations and offer benefits such as:

• Lowering your administrative burdens

• Giving incentives for preventive care

• Office trainings and resources to achieve improved patient outcomes

• Encouraging preventive visits every 6 months

• Providing incentives to patients to recieve preventive services

What We Won

On Tuesday, April 11th, we sent an update in our e-newsletter informing you that HB 1694, the Insurance Transparency Act, did not advance out of the Senate’s Retirement and Insurance Committee. Though disappointing for all of us, I wanted to make sure you knew how much the ODA – and especially you as a member dentist – accomplished in this campaign.

WE NEED YOUR HELP TO CONTINUE TO BE SUCCESSFUL AT THE CAPITOL IN 2024!

The Insurance Transparency Act was a brand-new piece of legislation this year. Often, new legislation does not even get a hearing the first time it is filed. This bill not only got a hearing. It was passed by the House committee, then by the full House - both unanimously. In the Senate committee, we were only one vote short. There is so much potential to advance the bill even further next year. None of this would have happened without you. Your outreach to lawmakers propelled this effort and laid the groundwork for us to build on what we achieved next year.

Even if you couldn’t actively participate in the campaign this season, you helped just by being a member of the ODA. Your membership gives us the resources and the standing to advocate for common sense laws that help you serve more patients and enhance the oral health of our communities.

We are not finished fighting for the Insurance Transparency Act and other policies that protect dentists and dental patients. In fact, we’re just getting started. Next year, we’ll begin this campaign with more allies, bettereducated lawmakers and the momentum from an incredible effort this year – all thanks to you. I won’t give up until we win, and I know you won’t either.

Thank you for all you do!

Sincerely,

WHY JOIN DENPAC

DENPAC is the political action committee of your Oklahoma Dental Association. DENPAC works hard to make political contributions to dentistry-friendly, state-level legislators. $50 of your DENPAC dues also goes towards ADPAC to support national campaigns. Currently, 20% of the ODA membership funds 99% of the ODA’s legislative and advocacy efforts.

Lynn Means ODA Executive Director

HOW TO JOIN DENPAC

CAPITOL CLUB

Dr. Jeffrey Ahlert

Dr. Clay Anderson

Dr. Tabitha Arias

Dr. Glenn Ashmore

Dr. Douglas Auld

Dr. Justin Beasley

Dr. William Beasley

Dr. Tamara Berg

Dr. David Birdwell

Dr. Elizabeth Bohanon

Dr. Blaire Bowers- Ersteniuk

Dr. Ed Braly

Dr. Todd Bridges

Dr. Matthew Bridges

Dr. Trace Bridges

Dr. S. Kelly Brown

Dr. Tricia Cannon

Dr. Wuse Cara

Dr. John Carletti

Dr. Bobby Carmen

WE DON’T FUNDRAISE. WE FRIENDRAISE!

THANK YOU TO THESE 2023 DENPAC CAPITOL CLUB MEMBERS!

Dr. Tennille Cheek-Covey

Dr. Raymond Cohlmia

Dr. Matthew Cohlmia

Dr. Susan Davis

Dr. Ana Dotson

Dr. Brian Drew

Dr. Twana Duncan

Dr. Heath Evans

Dr. Christopher Fagan

Dr. Barry Farmer

Dr. John Folks

Dr. Richard Freeman

Dr. Chad Garrison

Dr. Sandra Grace

Dr. Shannon Griffin

Dr. Michael Hansen

Dr. Kevin Haney

Dr. Aaron Harman

Dr. Edward Harroz

Dr. Richard Haught

Dr. Haley Harrington

Dr. Robert Herman

Dr. Jeffrey Hermen

Dr. Mathew Hookom

Dr. James Hooper

Dr. Brad Hoopes

Dr. Scott Hubbard

Dr. Karl Jobst

Dr. Donald Johnson

Dr. Eugenia Johnson

Dr. Krista Jones

Dr. Michael Kirk

Dr. Jandra Korb

Dr. Marti Levinson

Dr. Juan Lopez

Dr. David Marks

Dr. Stephen Martin

Dr. Stephen Mayer

Dr. Tracy McIntire

Dr. Janna McIntosh

Dr. Glenn Mead

Dr. Kenner Misner

Dr. Mohsen Moosavi

Dr. Paul Mullasseril

Dr. Nicole Nellis

Dr. Samuel Owens

Dr. Ronald Plant

Dr. Dana Price

Dr. Christopher Ray

Dr. Karen Reed

Dr. Ryan Roberts

Dr. Brant Rouse

Dr. Troy Schmitz

Dr. Brandon Schultz

Dr. Steffan Sigler

Dr. Floyd Simon

Dr. Chad Spiva

Dr. Braden Stoltenberg

Dr. Julie Storm

Dr. Carla Sullivan

Dr. Marc Susman

Dr. Jim Taylor

Dr. Stephen Taylor

Dr. Ryan Theobald

Dr. Kara Tims

Dr. Jonah Vandiver

Dr. Nathan Villines

Dr. Carlie Wager

Dr. Robert Webb

Dr. Mark Weems

Dr. Robert Wells

Dr. James Wendelken

Dr. W. Scott White

Dr. Dan Wilguess

Dr. Brian Wilson

Dr. Ronald Winder

Dr. Rieger Wood

Dr. Paul Wood

OKCapitol Club is for that “ABC” group of DENPAC members; or those who want to be “ABOVE AND BEYOND CONTRIBUTORS.”

OKCapitol Club members truly understand the importance of the ODA’s participation in the political process and want to support candidates who are committed to the state’s oral health and the issues that affect your practice. OKCapitol Club members support those efforts even more by contributing an additional $300 to DENPAC ($470 total) per year. For more information about Capitol Club, contact Lynn Means at 800-876-8890 or lmeans@okda.org.

DENPAC Grand Level

DENPAC funds our voice. Without our input, legislators are merely making decisions based on what sounds good, what makes the fewest people angry, or what is easiest for them. Whether you like it or not, the campaign contributions we make to dentistry-friendly candidates are what opens those lines of communication. It’s what reminds legislators once they’re in office to go directly to the ODA for information, and not somewhere else.

For more information about DENPAC, contact Lynn Means at 800-876-8890 or lmeans@okda.org.

THANK YOU TO THESE 2023 DENPAC GRAND ($1,000) LEVEL MEMBERS!

Dr. Douglas Auld

Dr. Ed Braly

Dr. Matthew Bridges

Dr. Matthew Cohlmia

Dr. Twana Duncan

Dr. Shannon Griffin

Dr. Richard Haught

Dr. Haley Harrington

Dr. Robert Herman

Dr. Krista Jones

Dr. Juan Lopez

Dr. Paul Mullasseril

Dr. Steffan Sigler

Dr. Dan Wilguess

Dr. Rieger Wood

Dr. Paul Wood

ADA Supports Legislation to Reduce Medicaid Administrative Barriers

The ADA led 14 other dental organizations in thanking Rep. Mike Simpson, DMD, R-Idaho, for introducing legislation that would reduce administrative barriers for dentists who participate in Medicaid.

H.R. 1422, the Strengthening Medicaid Incentives for Licensees Enrolled in Dental Act, would reduce administrative barriers by simplifying the credentialing process so that dentists do not have long wait times to become Medicaid providers. This bill would encourage states to use an integrated system such as CAQH to minimize paperwork and complete the credentialing process within 90 days.

“In order to help ensure access to care, a strong network of dentists is needed to see the patients served by Medicaid,” wrote ADA President George R. Shepley, DDS, and Executive Director Raymond A. Cohlmia, DDS, in a separate letter sent by the ADA. “Unfortunately, however, administrative requirements often discourage dentists from signing up for, or staying in the Medicaid program. Additionally, the SMILED Act would ensure fair Medicaid audits by requiring that they be performed by a dentist from the same specialty and be based on clinical practice guidelines from the ADA and other dental organizations. Follow all of the ADA’s advocacy efforts at ADA.org/advocacy.

ADA Answers Your Questions on New DEA Registration Requirement Effective June 27

In December 2022, the U.S. Congress passed an omnibus spending bill that included the Medication Access and Training Expansion (MATE) Act. This new law requires prescribers of controlled substances, including dentists, to complete eight hours of one-time training on safely prescribing controlled substances (Schedules II, III, IV, and/or V) in order to receive or renew their registration with the U.S. Drug Enforcement Administration (DEA).

It’s likely that you received an email from the DEA last week notifying you of this new requirement, which goes into effect on June 27, 2023. To help dentists comply, the ADA has created a Frequently Asked Questions document addressing common questions we have heard from members, including:

• Does this new federal training requirement affect me?

• What am I required to do?

• How much time do I have to satisfy the new training requirement?

• Do I need to maintain records showing I have completed the training?

• How will I know what courses will satisfy the requirement?

• Will training hours completed prior to the law’s passage count toward the new requirement?

• Will I have to complete the 8 hours of federally required CE on a cyclical basis?

• Will CE credits that are accepted for state licensure count toward the new federal requirement?

• Can my state impose additional CE requirements?

• Am I required to complete training on topics that are outside of my scope of practice?

• Do I have to use a specific CE provider? Will ADA CERP credits count?

• Does the ADA offer CE on safe controlled substance prescribing?

The ADA will update the FAQ regularly to answer new questions and share additional information. Currently, our team is working to address questions about how the DEA will enforce the requirement, how the rule will affect prescribers with multiple DEA registrations, and other topics.

If you have further questions, the ADA’s Member Service Center is here to help. Contact the MSC via e-mail at msc@ada.org or call 312440-2500. Staff are available Monday through Friday from 8 a.m. - 5 p.m. central time.

In the meantime, I encourage you to visit the DEA Diversion Control Division’s website for more updates at deadiversion.usdoj.gov. Additional information may be found at ADA.org.

George R. Shepley, D.D.S. ADA President

START THE NEW YEAR OFF RIGHT

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Why DentaQuest?

• 33M+ dental and vision members across more than 30 states.

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We are honored to partner with the Oklahoma Dental Association and its members to increase oral health access and improve oral health in the state of Oklahoma.

dentaquest.com/dentists

DIFFERENTIAL DIAGNOSIS: The Umbilicated Lesion

By: Glen D. Houston, DDS, MSD (gdhdds@heartlandpath.com)

HISTORY

A 68-year-old man presents to your office as a referral from his primary care provider. During your examination, an umbilicated lesion involving the right lower lip is observed. The patient states that the lesion has been present "for a few days and is painful to the touch." He also has a long history of alcohol use, smoking (tobacco and marijuana), and recently, vaping.

QUESTION #1

An appropriate differential diagnosis for this lesion might include:

a. Keratoacanthoma

b. Squamous cell carcinoma

c. Basal cell carcinoma

d. Ulcerated fibroma

e. Erythema multiforme

ANSWER #1

An appropriate differential diagnosis should include:

a. Keratoacanthoma

b. Squamous cell carcinoma

c. Basal cell carcinoma

All three of these entities may present as an umbilicated lesion with a raised, rolled border involving the lower lip.

A keratoacanthoma (a) is typically observed on actinically damaged skin, particularly the face, including the lower lip. This benign lesion has a clinical presentation and histologic characteristics similar to squamous cell carcinoma. This entity exhibits rapid growth and is typically observed in adult men.

Squamous cell carcinoma (b) of the lower lip typically presents as an oozing, crusty, symptomatic, ulcerated area. Eventually, this non-healing ulcer develops a raised, rolled border that is indurated. This lesion is much more common on the lower lip than the upper lip and is usually observed in adult men. Most squamous cell carcinomas arising

on the lower lip are associated with a lengthy history of sun exposure.

Basal cell carcinoma (c) is also typically observed on sun-damaged skin, particularly the upper face, with more than 85% of the cases found in the head and neck region. Basal cell carcinoma is the most common form of skin cancer and is more common in men than in women. This neoplasm usually presents as a firm, painless papule that slowly enlarges and gradually develops a central depression with an umbilicated appearance.

Fibroma (d) is the most common "tumor" of the oral cavity. Although it can appear anywhere in and around the oral cavity, the buccal mucosa is the most common anatomic site. Fibroma would not be included in the differential diagnosis in this case because it typically presents as a smooth surfaced, dome-shaped nodule with a broad, sessile base that is asymptomatic and not ulcerated.

Although erythema multiforme (e) may present with a wide spectrum of clinical diseases, oral lesions typically begin as multiple erythematous patches that undergo epithelial necrosis and evolve into large, shallow erosions and ulcerations with irregular borders. Patients are usually men in the20- to 30-year-old age group. This condition is not considered in the present clinical differential diagnosis.

QUESTION #2

Which of the following procedures should be performed?

a. No surgical intervention and follow closely for 3–4months

b. Consultation with a specialist

c. Biopsy

d. Exfoliative cytology

ANSWER #2

Following a biopsy, the following procedures are indicated in this case:

(b) Consultation with a specialist

(c) Biopsy

Consultation with a specialist (b) to determine optimal treatment and management of the patient is necessary. Additionally, biopsy (c) of the lesion in order to establish a definitive treatment format is essential.

The choices no surgical intervention, follow closely for 3–4 months (a) and exfoliative cytology (d) would be of no benefit in the management of this umbilicated lesion.

QUESTION #3

Following a biopsy and submission of the specimen for histologic examination, the following microscopic features are noted for this lesion: a flask-shaped, central zone of keratin; the surrounding surface epithelium forms a "lip" or "buttress" over the sides of the central zone, producing a raised, rolled border; at the deep, leading edge of the lesion, islands of squamous cells are noted; and cytologic atypia of the squamous cells is not prominent. The correct diagnosis is:

a. Squamous cell carcinoma

b. Keratoacanthoma

c. Basal cell carcinoma

d. Necrotizing sialometaplasia

ANSWER #3

The correct answer is keratoacanthoma (b). See Discussion section.

The other possibilities are not considered for the present case. Squamous cell carcinoma (a) arises from dysplastic surface epithelium and is characterized by invasive islands, ribbons, and cords of malignant squamous epithelial cells. Varying degrees of cellular and nuclear pleomorphism would be observed. Basal cell carcinoma (c) is composed of cells that are arranged into- well demarcated islands and strands that arise from the basal cell layer of the overlying surface epithelium and invade the underlying connective tissue. Epithelial islands typically demonstrate palisading of the peripheral layer of cells with a zone of "retraction" between the epithelial islands and the adjacent connective tissue. Necrotizing sialometaplasia (d) is a salivary gland lesion characterized by necrosis of salivary gland acini with an associated squamous metaplasia of the salivary gland ducts. The histologic features noted for squamous cell carcinoma, basal cell carcinoma, and necrotizing sialometaplasia are distinctive for these three entities. These histologic features are not observed in the present case.

DISCUSSION

Only since 1950, after the publication of papers by Rook and Whimster and Musso and Gordon, has this fairly common lesion been accepted as a distinct clinical entity. The keratoacanthoma is a benign lesion that occurs on sun-exposed skin. The etiology is

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unknown, although genetic and viral factors have been considered.

From a clinical standpoint, keratoacanthoma is most frequently observed in men between the ages of 50 and 70 years of age. Approximately 90% of the lesions have occurred on sun-exposed skin, with the cheeks, nose, and dorsum of the hands most often involved. The lesion occurs on the lips in roughly 10% of cases. Keratoacanthoma presents as an elevated, umbilicated or crateriform area with rapid enlargement and a depressed central plug or core. Because of this clinical presentation, the keratoacanthoma may resemble both squamous cell as well as basal cell carcinoma; however, the microscopic features are characteristic and, if untreated, the lesion will spontaneously regress within 6-24 months.

Microscopic features of the keratoacanthoma are characterized by an abrupt marginal change with marked hyperkeratosis. The lesion has a flaskshaped crateriform configuration (keratin plug) with superficial collarette (buttress) and a bulbous, expanded base composed of surface epithelium. Well-formed keratin islands are observed "dropping off" into the underlying connective tissue. Cytologic atypia of the squamous cells in these islands is not prominent.

Surgical excision is the treatment of choice. Waiting for spontaneous involution is not advisable for two reasons: (1) One cannot be assured clinically that the lesion is a

keratoacanthoma rather than a malignant neoplasm, and (2) the scar created by surgery is often more cosmetically acceptable than that which develops from spontaneous regression. After excision, approximately 2% to 8% of treated patients experience recurrent, persistent disease.

About the Author:

Dr. Houston works at Heartland Pathology Consultants, PC in Edmond, OK. He can be contacted with questions at gdhdds@ heartlandpath.com

REFERENCES

Eversole LR, Leider AS, Alexander G: Intraoral and labial keratoacanthoma. Oral Surg Oral Med Oral Pathol. 1982; 54:663-667.

Janette A, Pecaro B, Longergan M, et al: Solitary intraoral keratoacanthoma: report of a case. J Oral Maxillofac Surg. 1996; 54:1026-1030.

Mandrell JC, Santa Cruz DJ: Keratoacanthoma: hyperplasia, benign neoplasm or a type of squamous cell carcinoma? Semin Diagn Pathol. 2009; 26:150-163.

Musso L, Gordon H: Spontaneous resolution of a molluscum sebaceum. Proc R Soc Med. 1950; Nov;43(11):838-839.

Rook A, Whimster I: Kerato-acanthoma. Arch Belg Dermatol Syphiligr. 1950; Sep;6(3):137-146.

Rook A, Whimster I: Keratoacanthoma—a thirty year retrospect. Br J Dermatol. 1979; Jan;100(1):41-47.

Schwartz RA: Keratoacanthoma: a clinic pathologic enigma. Dermatol Surg. 2004; 30:326-333.

Oklahoma Dental Association

Speaker’s bureau

The ODA is building a speaker’s bureau of member dentists who are qualified and who desire to speak at various events. okda.org/oda-speakers-bureau

A full-mouth rehabilitation with FP1 prosthesis using advanced prosthodontics and periodontics approach: A case report (Part 2 of 2)

By: Jaewon Kim1, DDS, MSD, PhD, Jekita Kaenploy2, DDS, MS 1Division of Periodontics, University of Oklahoma, College of Dentistry, OK 2Department of Restorative Dentistry, University at Buffalo, NY

DISCUSSION

Prosthodontic perspective

Full-mouth reconstruction requires thorough data acquisition and treatment planning. A diagnostic work-up will guide clinicians to successful treatment outcomes by formulating a prosthetically-driven plan. In this case, the patient presented with chronic infection and pain. The initial treatment aimed to treat the infection. Regarding the decision to endodontically re-treat tooth #9, the overall success rate for secondarily endodontically treated teeth is 77%. However, higher success rates in maxillary teeth have been noted in the literature (1). Therefore, a referral to an endodontist was made for re-treatment of tooth #9. There was also an extensive chronic periapical abscess from teeth #27-29 which were deemed non-restorable, and teeth #19, 21, and 26 were present with minimal tooth structure remaining. The decision was made to extract all lower teeth except the molars based on long-term prognosis and the patient’s desire for fixed prostheses. Other potential treatment options included a partial denture on the lower arch in combination with surveyed crowns or implants. However, teeth #21, 22, and 26 had questionable restorative prognosis due to extensive loss of tooth structure. Consequently, they would not be suitable abutments for a removable partial denture. An implantsupported removable partial denture was another alternative, but the long-term prognosis and esthetic outcomes would be deficient in meeting the patient’s expectations.

The virtual implant planning was performed with immediate placement and loading concepts. According to Gallucci et al (2), immediate loading in extended partially edentulous sites is predictable and there is high evidence of success when the implants are splinted during the interim phase. The ITI consensus statements from 2013 stated that implants to be placed immediately require correct 3D position of the implant and there is a minimum of 2 mm distance from the buccal wall of the socket to the surface of the implant (3). In this case, all the planned implant positions met these requirements, so immediate placement could be performed.

The intaglio surface contours of the interim prosthesis is crucial for the emergence profile of the final prostheses and oral hygiene maintenance (4). Care was taken to ensure that the intaglio surface of the pontic areas were convex and exhibited slight pressure to the tissue to create proper emergence profile (5).

The mandibular arch was restored with implant-supported zirconia crowns and bridge. Zirconia has high strength and desirable mechanical properties which made the material a great choice to support a bridge in this case. The natural dentition on the maxilla was

restored with lithium disilicate crowns for superior bonding to the tooth structure and better esthetics compared to zirconia. Conversely, zirconia exhibits better biocompatibility and lower plaque retention than glass ceramics (6). Hence, it is a great material to be used to fabricate implant-supported restorations with the emergence profile intimately adapted to the soft tissue.

Periodontal perspective

For diagnosis, this case was classified as stage III as the patient was not aware of the reason for tooth loss. According to the 2018 AAP classification, interdental clinical attachment loss should be detectable at ≥2 non-adjacent teeth, and buccal or oral clinical attachment loss ≥3mm with pocketing of >3mm as detectable at ≥2 teeth. However, according to Kornman et al (7), if a single tooth shows enough evidence of periodontitis, then it will be classified as it is. A history of periodontitis in this patient was a strong concern as previous literature has shown a negative relationship to implant survival. According to Schwartz, previous history of periodontitis, poor plaque control, and no regular maintenance is a risk factor for peri-implantitis (8). The patient came regularly for supportive peri-implant maintenance therapy to monitor implant status after completion of treatment. According to Monje’s systematic review, a minimum of 5-6 months of maintenance is effective (9).

Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have been extensively studied in the field of wound healing. PRP was first studied in the 1990s and is composed mainly of platelets, which secrete growth factors for initial wound healing. PRF, which is the complex fibrin matrix of autologous platelets and leukocytes, holds growth factors and cytokines that are valuable for wound healing. In Miron’s systematic review, PRF combined with an open flap approach to treatment, statistically noticeable benefit to healing was observed (10). The author used PRP to mix with bone graft, while using PRF on top of the membrane to have favorable wound healing when submerged under the flap.

Socket grafting was utilized to preserve the volume of the alveolar ridge after extraction. However, throughout the healing process the bone resorbed both vertically and horizontally. According to a systematic review by Avia-Ortiz, the clinical magnitude of alveolar ridge preservation compared with extraction sites without any graft was 2mm horizontal/mid buccal, 1mm vertical/midlingual, 0.5mm mesial and 0.2mm distal height changes (11).

When multiple implants are placed, it is important to note that the bone densities will be different at each location of osteotomy

preparation. This be evaluated preliminarily via radiograph or CBCT, and the tactile feedback during osteotomy preparation. In this case, one implant lost stability and spun upon removal of the temporary cylinder. This potentially could have been prevented with gentle screw-tightening. Moreover, a study found that lower insertional torque values show inferior outcomes (12). Thus, in this case, the decision was made to keep the implant submerged and wait for a healing period of 4 months. Ultimately, the implant osseointegrated and functioned well.

For the conscious intravenous moderate sedation, dexmedetomidine was used. Dexmedetomidine (Precedex, Pfizer) is a highly selective alpha-2 adrenergic receptor agonist. It creates sedative and analgesic action via the central nervous system. Moreover, it may also result in bradycardia, which is a common side effect. It is recommended to dilute to 4mcg/ml prior to administration; combination with midazolam or fentanyl is also a possible protocol. Previous cohort studies have shown that dexmedetomidine can be a good alternative to midazolam and fentanyl (13). In this case, even though the patient was ASA III, there was no issue with sedation with Richmond Agitation Sedation Scale (RASS) score being evenly maintained with -3 throughout the procedure.

CONCLUSION

This case was successfully managed with advanced digital prosthodontic and periodontal surgical techniques. Cooperation between both departments was a key factor. Clear and open communication between the patient and treatment team is essential to predictable outcomes. The digital workflow used for surgical planning and immediate load prosthesis CAD design illustrates the capacity to generate true-to-design accuracy for implant placement through the use of surgical guide and prosthesis stabilization utilizing existing teeth prior to their extraction. However, the use of the On1™ concept in this case has its limitations in terms of clinical applications and digital workflow. Proper diagnosis, along with the thorough treatment planning and execution of therapy will ultimately achieve better outcomes for the patient and clinician.

The figures and tables are on pages 40-42. Part 1 was printed in the March/April Journal .

References

1. Ng YL, Mann V, Gulabivala K. Outcome of secondary root canal treatment: a systematic review of the literature. Int Endod J. 2008;41(12):1026-46.

2.Gallucci GO, Benic GI, Eckert SE, Papaspyridakos P, Schimmel M, Schrott A, et al. Consensus statements and clinical recommendations for implant loading protocols. The International journal of oral & maxillofacial implants. 2014;29:287-90.

3. Morton D, Chen ST, Martin WC, Levine RA, Buser D. Consensus statements and recommended clinical procedures regarding optimizing esthetic outcomes in implant dentistry. International journal of oral & maxillofacial implants. 2014;29(Suppl):216-20.

4. Able FB, Campanha NH, Younes IA, Sartori IAdM. Evaluation of the intaglio surface shape of implant-supported complete-arch maxillary prostheses and its association with biological complications: An analytical cross-sectional study. The Journal of Prosthetic Dentistry. 2022;128(2):174-80.

5. Pozzi A, Tallarico M, Moy PK. The Implant Biologic Pontic Designed Interface: Description of the Technique and Cone-Beam Computed Tomography Evaluation. Clin Implant Dent Relat Res. 2015;17 Suppl 2:e711-20.

6. Zarone F, Di Mauro MI, Ausiello P, Ruggiero G, Sorrentino R. Current status on lithium disilicate and zirconia: a narrative review. BMC Oral Health. 2019;19(1):134.

7. Kornman KS, Papapanou PN. Clinical application of the new classification of periodontal diseases: Ground rules, clarifications and "gray zones". J Periodontol. 2020;91(3):352-60.

8. Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Periodontol. 2018;89 Suppl 1:S267-S90.

9. Monje A, Aranda L, Diaz KT, Alarcon MA, Bagramian RA, Wang HL, et al. Impact of Maintenance Therapy for the Prevention of Peri-implant Diseases: A Systematic Review and Meta-analysis. J Dent Res. 2016;95(4):372-9.

10. Miron RJ, Zucchelli G, Pikos MA, Salama M, Lee S, Guillemette V, et al. Use of platelet-rich fibrin in regenerative dentistry: a systematic review. Clin Oral Investig. 2017;21(6):1913-27.

11. Avila-Ortiz G, Elangovan S, Kramer KW, Blanchette D, Dawson DV. Effect of alveolar ridge preservation after tooth extraction: a systematic review and metaanalysis. J Dent Res. 2014;93(10):950-8.

12. Walker LR, Morris GA, Novotny PJ. Implant insertional torque values predict outcomes. J Oral Maxillofac Surg. 2011;69(5):1344-9.

13. Zhang Y, Li C, Shi J, Gong Y, Zeng T, Lin M, et al. Comparison of dexmedetomidine with midazolam for dental surgery: A systematic review and metaanalysis. Medicine (Baltimore). 2020;99(43):e22288.study. The Journal of Prosthetic Dentistry. 2022;128(2):174-80.

5. Pozzi A, Tallarico M, Moy PK. The Implant Biologic Pontic Designed Interface: Description of the Technique and Cone-Beam Computed Tomography Evaluation. Clin Implant Dent Relat Res. 2015;17 Suppl 2:e711-20.

6. Zarone F, Di Mauro MI, Ausiello P, Ruggiero G, Sorrentino R. Current

FIGURE

FIGURE 3

FIGURE 4

FIGURE 5

FIGURE 6

FIGURE

FIGURE LEGEND

FIGURE 1: Preoperative intraoral photographs. (a) Right lateral, (b) Front, (c) Left lateral, (d) Maxillary occlusal, (e) Mandibular occlusal view, (f) Fullmouth series radiographs.

FIGURE 2: The digital workflow and fabrication of the immediate provisional restoration. (a) Front, (b) Occlusal.

FIGURE 3: (a) After extractions, teeth #24 and 25 remained to seat the surgical guide with tripod support. (b) #29 had bone loss in the apical area communicating through the buccal cortex (blue arrow). (c) Implant surgical guide seated. (d) Implants #22, 27, and 29 were placed immediately. Then the remaining teeth were extracted (e) Nobel Active Ti Ultra fixture. (f) Bone reduction guide. (g) After all implants were placed, the fenestration was grafted with a PRP-infused bone graft. (h) Bio-Gide membrane placed on top of the grafted sites. (i) PRF membrane was placed on top of the Bio-Gide membrane before flap closure. (j) After the healing abutment placement and bone graft, sutures were placed.

FIGURE 4: The digital workflow and fabrication of the second set of provisional restorations. (a) Front, (b) Occlusal.

FIGURE 5: The fabrication of the final restorations. (a) Jaw relation recorded in centric relation, (b) The provisional restorations used as a blueprint for the final restorations, (c) Final restorations designed using 3Shape software, (d) Milled and finished final restorations.

FIGURE 6: Comparison between initial presentation (a, b), temporary restorations (c), and final results (d,e).

FIGURE 7: Comparison between initial (a) and one-year postoperative full mouth series radiographs (b).

FIGURE 8: One-year postoperative periodontal charting.

FIGURE

TABLE LEGENDS

TABLE 1: Medication list.

TABLE 2: Problem list.

TABLE 3: Diagnosis and treatment plan.

A Provider Friendly Program

For over 30 years, MCNA has been a leading dental benefits administrator with a focus on providing exceptional service for Medicaid and CHIP members. Founded by dentists, MCNA serves over 5 million children and adults nationwide.

We are the largest dental insurer of Medicaid and CHIP programs in the country via direct contracts with state agencies. MCNA’s eight state partners include: Texas, Louisiana, Florida, Iowa, Idaho, Nebraska, Arkansas, and Utah. Our approach emphasizes prevention and compassionate care through our robust provider networks.

MCNA’s mission to care includes:

• Preventive dental care in a dental home setting.

• Positive engagement with members beginning at a very young age.

• Innovative member outreach via our member advocate team.

• Dedicated support for our network providers via our in-state provider relations team.

• Clinical decisions made by licensed dentists and guided by leadership with extensive clinical and administrative experience serving Medicaid programs.

MCNA is an active and effective partner to our network providers in the delivery of oral health care and services. We invite you to learn more about us and our mission to care by visiting us online at www.mcna.net

PRACTICE MANAGEMENT

Health Information Exchange

ODA STATEMENT

During the ODA House of Delegates meeting last Thursday, the following Resolution was passed unanimously: Resolved, that the Oklahoma Dental Association opposes the requirement of electronic health information exchange (HIE) throughout Oklahoma for healthcare providers for SB1369/SB574.

Although opposed to the mandate, in order to be in compliance with SB1369/SB574, the bill passed at the end of session last year that mandates that ALL healthcare providers connect to the HIE, please file an exemption.

DO NOT SEND ANY MONEY TO OKSHINE AND DO NOT START THE PROCESS TO CONNECT TO THE SYSTEM.

Complete the exemption form before July 1, 2023, and you will be in compliance with the law. Complete your exemption by visiting surveymonkey.com/r/OKSHINEExemption

Health Information Exchange Fact Sheet

FACT SHEET (PROVIDED BY OKSHINE)

SB 574 (2021)

• Created the Oklahoma State Health Information Network Exchange (OKSHINE)

SB 1369 (2022)

• Created the O Office of the State Coordinator for Health Information ExchangeOHCA

• Created concept of a S State Designated Entity for HIE Operations overseen by the office – OHCA has contracted with M MyHealth Access Network as the SDE

• Requires that “all providers” participate in the statewide HIE by July 1, 2023.

o Establish a direct secure connection to the SDE and transmit active patient data.

o Actively utilize HIE services to securely access records during and/or in support of patient care.

• Coordinator may grant e exemptions (financial hardship or technological capability).

H Health Information Exchange

Health information exchanges (HIEs) are connecting nationwide to seamlessly deliver patient health information across health systems, improving the patient experience by making their health information available whenever and wherever their care occurs

With the statewide HIE, the state can vastly improve public health, c care coordination, records exchange, and a address care fragmentation and care gaps for providers.

• 70% of Oklahomans have records in more than one health care delivery system.

• The HIE currently covers more than 1400 locations serving more than 110,000 patients daily.

• MyHealth is a non-profit organization and is the State Designated Entity for HIE operations

• There will be a one-time connection fee charged to establish interoperability.

P Patient privacy: All patient data is only accessible in secure, approved ways, compliant with HIPAA, MyHealth Terms & Conditions and Network Policies. The HIE is set up to monitor access of all health care information it receives to ensure patient privacy.

Misuse of the system is a crime and is subject to all penalties associated with a HIPAA violation. More information on patient privacy can be found at

https://myhealthaccess.net/who-we-are/faq/ . Psychotherapy notes are excluded from transmission to the HIE as well as any Mental/Behavioral health data covered by 42 CFR part 2.

FAQs

Why do healthcare providers need to share patient information?

If you have ever had to recall all of your medications or test results from memory to a new provider, or carry around printed medical records from one provider to the next on behalf of yourself or a loved one, you’ve experienced the need for information sharing between doctors. Because patients may see several different physicians besides their primary care provider, different sets of medical records for the same patient can be found in different offices. This creates burdensome paperwork for the patient, but also creates a very real risk that the patient could be prescribed a medication they are allergic to, or are already taking, or that the same tests already undergone (and paid for) are re-ordered.

A statewide HIE supports:

o Reduced health care costs associated with redundant testing, hospital readmissions and unnecessary emergency department visits.

o Improving care coordination during trans itions between health care settings, reduce adverse drug events and missed preventive care.

o Improved patient experience and provider performance on quality measures

H How can a statewide HIE improve health care?

• One prominent study indicates that in 85% of families’ visits to the doctor, critical health information is missing that could have changed the treatment plan. An HIE ensures that the relevant information is available for every doctor to consider

• Eliminates the delays created when a doctor needs more information from other providers involved in a patient’s care and would otherwise have to wait on the mail, a fax or a returned phone call.

• Enables your doctors to communicate directly and securely with one another to ensure care is coordinated appropriately.

• Helps to avoid additional costs and health risks created by duplicated medical tests (such as increased radiation), or complications caused by missing information (like medication reactions or missed preventive care).

W What health information is stored in the HIE?

Only high priority health information will be included in the HIE as required by Federal regulations (See the United States Core Data for Interoperability). Medical professionals have determined that information such as the following is needed to effectively coordinate your health care:

1. Names of the doctors and other health professionals who provide your care

2. Diagnoses

3. Current medications prescribed to you

4. Lab and x-ray results

5. Past procedures

6. Known allergies

7. Immunization records

8. Hospital discharge records

9. Basic personal information (your name, address, family phone contacts, etc.)

W Who will have access to medical records?

Only the health care professionals who are involved in a patient’s care is authorized to view their records. These healthcare providers include doctors, nurses, hospital clinicians, diagnostic technicians and pharmacists the same individuals who maintain health records in separate systems today.

Access to data is guarded closely. MyHealth Access Network will rely on the same authorization procedures doctor’s offices uses today to determine which health providers are eligible to have access to a patient’s medical records. Access to clinical data elements is restricted to appropriate users such as a patient’s doctor and other doctors that are involved in care, and the system keeps track of every person who views medical records so that privacy will be protecte d through regular auditing of usage logs.

C Can an individual restrict the sharing of my medical records?

Yes. Any patient may decide to prevent access to their medical records by signing and submitting an “opt out” form available from any participating health professional, or at Myhealthaccess.net/opt-out. Note that providers will continue to use and maintain information in their own systems but opting out will remove the ability for that

information to be accessed through the HIE, except in unique situations like medical emergencies

C Can a medical provider see notes from therapy sessions? How is sensitive behavioral health information handled?

As has always been the case, Providers are in control of what data they share. Sensitive information of any type (behavioral or otherwise) is withheld by providers who mark a chart or note as sensitive.

The system conforms to all HIPAA regulations and is regularly audited to ensure compliance. Additionally, any care or services covered under 42 CFR Part 2 are excluded from data transmission, as well as psychotherapy notes from any provider are marked as sensitive and excluded from transmission to the HIE. Progress notes may additionally be marked as sensitive and exclud ed from transmission.

W What is the cost?

The estimated cost to establish connection is $5,000 for a typical clinic to establish EHR system interoperability. The cost covers the time and effort for the State Designated Entity (MyHealth) to meet with the providers’ EMR vendor or IT team, review the standards, setup the secure connection, and test the data flow to ensure data elements are categorized appropriately within the patient’s chart. A subscription fee is also required to access the network and is based on organization/provider types, and size.

If a provider finds that they will not be able to meet the mandate due to technological or financial burden, they may request a hardship exemption by submitting a request to the Office of the State Coordinator for HIE through the application describing in detail their situation as to why they are not currently able to meet the mandate. Form available at okshine.oklahoma.gov.

W Where can I find more information about MyHealth?

MyHealth is an Oklahoma based 501c(3) non -profit organization whose board of directors is composed of medical associations, related disciplines (optometry, dentistry, first responders), community health organizations, insurance companies, medical universities, tribes, employers, public health, and patients

https://myhealthaccess.net/

Good Shepherd Merges with Crossings Community Clinic

By: Jeanie Bath, DDS

In August 2022, Good Shepherd formally merged with Crossings Community Clinic and became Crossings Midtown Clinic. Crossings Midtown continues to provide high-quality, dignity-affirming patient care to people who are uninsured, now with a new name.

Many ODA member dentists cared for patients at Good Shepherd, or as we called it in the late 1990s, “The Mission.” Although Good Shepherd’s 1977 origins in Chris’ Bar sound like the start of a questionable joke (some med students, homeless dudes, and a pastor walk into a bar) the mission continues more than 45 years later.

• You may have volunteered here as a dentist.

• Statistically speaking, you most likely started volunteering as a student in the student-led Extraction Clinic, serving your neighbors as soon as you had dental skills to share, carefully extracting infected teeth on Monday nights, when you could have been studying.

• Perhaps the Kids Clinic, added in 2003, is where you served.

• After 2014, you may have volunteered at the updated clinic, as we became a dental home for the adults of our medical clinic.

• Extraction Clinic, Kids Clinic, Unity Clinic, externships, partnerships with residency programs, D-DENT Community Dental Days, and Fun Fridays all continue at Crossings Midtown today.

The perfect alignment of Good Shepherd’s and Crossings Community Clinic’s missions made this merger possible. We are excited about the clinic’s future and the positive impact we will continue to have on the community, as a ministry of Crossings Community Church. Because of Good Shepherd’s rich history of service to the community combined with Crossings Community Church’s mission, we will continue to live by faith, be a voice of hope, and be known by love.

Thank you for your support and service for nearly half a century. We look forward to what God has in store in this continued partnership with Oklahoma dentists!

UCO Pre-Dental Society’s Bring Your Own Dentist Day: Students invited dentists to mentor them as they volunteered together to care for their neighbors!

The days of “dip-dipping” x-rays and spitting into a cup are long gone, but the humble service continues (2003).

Dr. Jeannie Bath graduated from OU College of Dentistry in 2000 and completed her GPR at the OKC VA Hospital. She has volunteered with many charitable dental organizations and currently serves OkMOM as Pharmacy Lead. As the Dental Director for Good Shepherd Ministries in OKC, she shows God’s love by offering dental care to vulnerable members of our community and by mentoring pre-dental and dental students to do the same.

Hoping to prevent the mouth diseases she sees in adults, Dr. Bath’s alter ego, the Tooth Fairy, began teaching kids to care for their teeth by telling the story of The Three Little Teeth She presented to thousands of children in dozens of schools in four states. Unable to present for all schools, she collaborated with her brother to self-publish The Three Little Teeth as a children’s book to empower anyone (parents, teachers, and more) to educate children on mouth health.

Since 1981, students have led the Extraction Clinic at 5 p.m. every Monday during the school year. Now, during school breaks when students are unavailable, dentists can also volunteer to treat patients.

After many challenges in life, both in Burma and Oklahoma, Mr. B came to Crossings Midtown functionally edentulous, with a mouth full of root tips. Now that he’s healed and smiling, he says, “I feel like a little boy again!”

Students teach students the tradition of service. Here in 2018, they were preparing to volunteer at Kids Clinic. Several students from this class continue to volunteer as dentists at Crossings Midtown!

The mission of Crossings Community Clinic is to humbly proclaim the message of Jesus by serving the physical, emotional, and spiritual needs of the uninsured.

Office Showcase

Melanie Emerson, DDS (Oklahoma City)

By: Melanie Emerson, DDS

Fifteen years into a lease and outgrowing my current space, I started looking into building an office that would reenergize my desire to go to work. I was hearing from others that one way to get out of the burnout doldrums was to change my professional space. In the early phases of planning, my main goal was to expand enough to take on an associate, which would give me more flexibility in my schedule and the ability to incorporate and utilize technological advances in dentistry. Once I decided to build within 5 years, I started looking for land to purchase. I practice in Midwest City, Oklahoma, and many of my patients live all over the city but work at Tinker Air Force Base. I live in Choctaw and treat many friends and family members. Therefore, my goal was to stay east of the OKC metro area and as close to my current office as possible. I consulted my dental reps, who put me in touch with a broker. As I started looking for land, I was shocked by the price of commercial land. It was doable, but much of the land near me that I was interested in required specific things such as the addition of city water. Then, a family friend and local realtor suggested that I try to rezone a residential property not even a mile from my current office. I took a risk, purchased the property, and went through the rezoning process. The risk paid off, and I now owned land. As I toured dental offices, I made notes on what was important to me and listened intently to team members and colleagues, and experienced reps who are part of the dental family and the best resources. The first stage was the architect. Architects are like magicians; they can make things that you dream appear. They have smart boards and Google Earth, and the ability to draw your thoughts, and it didn’t take much to impress a middle-aged Gen Xer like me. It truly was a fun process. Do not be afraid to dream big, and scale back if you have to. You will not know what is possible until you ask. I ended up with an upstairs bonus room, a garage, and a saltwater fish tank built into the wall, because I asked.

As I think back on my biggest struggle during the expansion phase, and I would have to say it was my own anxiety. I worried about taking on debt and closing or an interruption in the ability to see patients. You cannot be expected to shut down your dental office for extended periods of time or to go for prolonged periods without vital elements such as operatories, sterilization, or mechanical equipment. Therefore, communicating with your contractor, dental equipment team, and current lease situation is key. Choosing the right equipment, cabinets/hardware, and a designer can be a challenge. You need to trust that the sales team is looking after you and not just trying to get the most productive sell. You need to ask a lot of questions and explore options. They will take you on tours. I chose Adec equipment because I was so impressed with the facility and the amount of testing that went into their equipment. I haven’t been disappointed! I was fortunate to have a friend and colleague with design and dental profession experiencehelp me choose furniture, fixtures, paint, and art! I am forever grateful for Oklahoma orthodontist, Dr. Terry Cotterell who had the vision for my office design. Just a reminder to Oklahoma Dental Association readers that our profession has talented hobbyists in all sorts of fields!

We have been at our new location for three years, and I have achieved my goal of being busy enough to work with an associate. I love my space, utilize digital dentistry advances, and continue to grow as a practitioner by providing more services. I no longer feel the need to work extra days or stop taking new patients because I was feeling too busy and trapped in a space I had outgrown. Our new patient numbers are steadily increasing. I will never forget the emotion and excitement I felt when I saw my completed building for the first time. If you are thinking about building your dream office, start planning. It can certainly have a huge impact on your practice and mindset.

Melanie Emerson, DDS was raised in Houston, Texas.She graduated in 1995 with a Bachelor of Science from Southern Nazarene University in Bethany, Ok. She worked two years as a research scientist at Oklahoma Medical Research Foundation and went on to graduate from University of Oklahoma College of Dentistry in 2001. She started her dental practice from the ground up in 2001. They opened at their new location in February of 2019. Dr. Emerson has 3 kids, and 2 grandsons. Her youngest daughter hopes to follow her mom into dentistry and own this dental practice one day. She is a recent published author of a small book which showcases her hobby of photography called Waxing and Waning which you can find on Amazon.

Currently, Dr. Meredith Turbeville, is an associate in the practice, and has brought cutting edge dentistry techniques to the practice after graduating from University of Texas San Antonio Dental School and completing the AEGD residency at University of Oklahoma.

HYGIENE HOTSPOT What It Takes to Be a Laser Hygienist

By: Angie Wallace, RDH

With all of the technological advancements in our world of dental hygiene, lasers are here to stay; they are truly changing the way dental professionals practice. We now see patients seeking out what lasers can do for them, as well as researchers and clinicians who continue to place the highest value on their capabilities. In addition, more and more “everyday” clinicians are looking to see how lasers can increase their practice efficiency and profitability.

To get the most out of what lasers can do for your practice as a hygienist, the best place to start is education. Hygienists interested in laser technology should start by doing their homework. Familiarize yourself by reading industry publications about lasers, take a few online classes, and attend some classes. Compare laser manufacturers and their offerings to discover which laser will work best for you. When you are ready, take the next step and consider attending a Laser Certification course offered by a laser educator. Consider the one offered by The Academy of Laser Dentistry (www. laserdentistry.org). ALD is the only unbiased laser organization, which means that they work with all levels of laser users on all different lasers. ALD laser educators provide laser courses throughout the United States and internationally, and a few of the educators can even provide laser education right in your office.

There are things you should carefully consider before using a laser on your patients: What do I want to use it for? Which laser should I use? What training or certification should I have before I use a laser?

Let us examine these questions: As curettage is no longer an accepted procedure with the American Academy of Periodontology, lasers cannot be used by hygienists to cut tissue, just like we cannot use any other dental tool to cut tissue.

Depending on your state, common procedures that can be performed with lasers by hygienists are bacterial reduction, sulcular debridement, and bacterial decontamination. When performed with lasers, these procedures allow the tissue a chance to heal and new attachments to form, making the pocket easier to maintain. Moreover, laser therapy in general is antimicrobial and decreases virulent red-complex bacteria, which can invade soft tissue and enter blood vessels, affecting overall health.

Other hygiene uses for the laser include the treatment of herpetic lesions or aphthous ulcers. These procedures are great practice builders, as patients are typically very pleased with results. As there are few over-the-counter treatments for herpetic lesions, lasers allow us to eliminate the pain from lesions, healing is significantly faster, and using a laser decreases the odds of lesions reoccurring in the same area. Lasers can provide superior results in the following procedures:

1) Laser Bacterial Reduction (LBR): We can eliminate bacteria at any hygiene appointment before completing hygiene procedures. LBR is the practice of administering low-power laser energy within the sulcus throughout the entire dentition. This helps reduce bacteremia, cross-contamination, and bacterial load which in turn, helps prevent attachment loss.

2) Laser Assisted Periodontal Therapy (LAPT): Used for active periodontal therapy (SRP with laser decontamination) and in conjunction with traditional deep scaling appointments, LAPT is the practice of administering laser energy within the periodontal pocket for profound decontamination. LAPT also results in increased tissue interaction by removing inflammatory factors, significantly reducing bacteria within the pocket, and consequently promoting growth factors for healing with the ultimate goal of tissue rehabilitation.

3) Desensitizing of tooth structure: Laser energy can be used to eliminate sensitivity on the tooth structure.

4) Laser whitening: Laser technology is applied to activate bleaching solution to whiten teeth.

5) Photobiomodulation (PBM): Lasers are used for wound healing and pain management.

Once you determine what your clinical goals are in using a laser in practice, there are many lasers to choose from. Much like when you purchase a vehicle, it can be one that just gets you from point A to point B, or it can have all the bells and whistles that everyone loves. Look for one that fits what you actually want to do in order to benefit your practice and patients.

The types of lasers include Er:YAG and Er:CrYSGG, Diodes, Nd:YAG, and CO₂. Each has unique characteristics, and there are several manufacturers that specialize in each type.

I hope that I have sparked an interest for in lasers. Please do not hesitate to contact me at Angie@Laserrdh.com if you have questions about the role that lasers can play in your practice.

ABOUT THE AUTHOR:

Angie Wallace, RDH has been a clinical hygienist for over 35 years. She is a member of the Academy of Laser Dentistry (ALD), where she obtained her Advanced level proficiency, her Educator Status, and received her ALD Recognized Course Provider 2007 and her Mastership with ALD in 2008. Angie currently serves as Chair for Education for the ALD Board of Directors and serves on the Auxiliary committee. She was the recipient of the 2014 John G. Sulewski, Distinguished Service Award from the Academy of Laser Dentistry and has been recognized as a worldwide speaker as a Laser Consultant for Dental and Dental Hygiene Schools, Laser Manufacturers and Private Offices. She can be reached at Angie@Laserrdh. comprogram.

Upcoming Continuing Education Opportunities

DO NO HARM DENTAL, PUTTING SAFER PAIN MANAGEMENT INTO PRACTICE

PRESENTED BY:

EDMUND BRALY, DDS, ACD, FAACS, AND STEVEN CRAWFORD, MD

CREDITS: 2 HOURS

ORAL PATHOLOGY: A REVIEW OF ULCERATIVE LESIONS, LICHEN PLANUS, BURNING MOUTH AND TONGUE, THE HEAD & NECK & COMMON RADIOGRAPHIC CONSULTS

PRESENTED BY: RONNIE FARAM, DDS, AND KATHLEEN HIGGINS, DDS, MS

MAY 19, 2023

CREDITS: 6 HOURS

LASERS, PBM AND NEW PROCEDURES.

IMPROVING PATIENT COMFORT AND OUTCOMES

PRESENTED BY:

STEVEN FOOSHEE, DDS

JUNE 2, 2023

CREDITS: 6 HOURS

OPIOID, ETHICS, CPR OSHA AND INFECTION CONTROL REFRESHER

PRESENTED BY: DUNN CUMBY, DDS, KIM GRAZIANO, RDH, MPH, MARY HAMBURG, DDS, MS, AND CPR FOR LIFE

JUNE 16, 2023

CREDITS: 7 HOURS

This comprehensive four-module program was created specifically to satisfy the educational requirements for Oklahoma dental licensure.

For more information or to register online, visit:

CLASSIFIEDS

PRACTICE FOR SALE

Rural OK Practice For Sale - Grady County : General dental practice with 2 doc chairs and 1 hygiene room (with room for 4th chair), run as satellite office 1 day per week for 40 years. Mix of PPO and FFS. Loyal patient base and significant untapped potential in Minco/Union City area to be open more than once per week. All equipment included, Carestream Softdent and Dexis software. Implant drill and diode laser. Staff not included. Low overhead. Equipment is old but fully functional. Asking $115k, open to negotiation. Email contact preferred: elizabethksilver@gmail.com

Practice for Sale/Lease: Western Oklahoma rural active practice with 1800 plus patients for sale owner willing to stay for transition. 3700 sq ft brick building on busy intersection. Computerized digital Xray and intraoral scanner. For more info contact the owner at drj2thfxr@icloud.com

Greater Tulsa, OK Dental Practice for Sale: Looking for an excellent opportunity to own a general dental practice in the Greater Tulsa, OK area? Look no further than this highly-regarded practice, which is now available for sale. Currently open four days per week, there is significant potential for growth if interested in expanding the practice hours. With limited advertising efforts, the practice consistently bring in 15-20 new patients each month, creating even more opportunities for growth and increased revenue. The current doctor is interested in continuing to practice and partnering with a group. Don’t miss your chance to own a thriving dental practice in the Greater Tulsa, OK area. FOR AN OVERVIEW OF THIS GENERAL DENTAL PRACTICE IN THE GREATER TULSA AREA: 7 operatories, Collections of $1.328 million, EBITDA $245,000, 3500 active patients, 15-20 new patients/month, Growth potential. To learn more and review the prospectus for this Tulsa, OK area dental practice contact Professional Transition Strategies. Email Bailey Jones: BAILEY@PROFESSIONALTRANSITION.COM or call: 719.694.8320. REFERENCE #OK21523. We look forward to speaking with you!

DEER CREEK/WEST EDMOND DENTAL OFFICE FOR LEASE: High Traffic Intersection in Deer Creek/West Edmond. Office is ready to move in. 3 Operatories, Waiting Room and Reception Area. 1500 new homes under construction within 2 miles. Perfect Location. Office Space is for Lease and available now. Contact: Sam Coury | (405) 850-0532 | ascoury@gmail.com

Placing an ad with the ODA allows you to target your ad to a specific audience. Unlike other classified ad sources (local newspaper, other online classified sites, etc.), a listing with the ODA gives you exposure to the people who would be most interested in your ad. The online version of the ODA Journal contains active hyperlinks within the advertisement, ensuring you get maximum exposure for your ad.

Submitting a classified ad is easy with our online form. Find the form and more information at www.okda.org/classifieds

PRICING

ODA Members

Online: Free

ODA Journal: $40 for first 50 words

(additional words $0.15 each)

QUESTIONS?

Non-ODA Members

Online or ODA Journal: $83 (>50 words)

(additional words $0.32 each)

Bundle (online & Journal)

$149 (>50 words)

(additional words $0.32 each)

Email: advertising@okda.org Call: 800.876.8890

Visit: okda.org/classifieds

Looking to fill an open position in your office, need to sell dental equipment or a practice? Check out the latest listings below and visit okda.org/classifieds for additional listings.