• 50% employer contribution to employee portion of premium.
The Benefits of a Group Plan gives you more options. In Oklahoma,there are more carriers, networks, and plan options available to employer groups. You'll receive more enrollment flexibility & your employer paid premiums are tax deductible as an employee benefit. Group Plans also offer lower premiums in comparison to individual coverage.
Minimum Requirements for Starting a Group Health Plan: Contact Joe, Cooper, or Lydia for
ADVERTISERS
Thank you to the following businesses who support the Oklahoma Dental Association by advertising in the Journal:
Alliant Insurance Services
Best Card
Endodontic Associates
Endodontic Practice Associates
Hopkins Dental Implant Institute
iCore Connect
Mobile Smiles Oklahoma
ODA Rewards Partners
Oklahoma Health Professionals Program
Rocky Mountain Dental Conference
Suction Solutions
Tobacco Settlement Endowment Trust
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, 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.
7 It's Fall - Time to Sign Up for OkMOM by Lindsay Smith, DDS
STATE ASSOCIATION
16 ODA's Top 24 Wins of 2024
24 ODA Awards Nomination Form
ADA NEWS
8 Oklahoma Dentist Selected as Second Vice President of the American Dental Association
9 Texas Court Strikes Down Corporate Transparency Act
30 Community Water Fluoridation is Safe
LEGISLATIVE LOOP
11 Introducing our ODA Lobbyist Team: Samantha Davidson Guinn
14 Election Analysis provided by Cornerstone Government Affairs
CLINICAL
17 Case Study: Broken Implant Collar by Dominque Angibeau, DDS
19 Case Study: Non-Healing Ulcer Under Tongue by Elena V. Dupalo, DDS and Kathleen E. Higgins, DDS, MS
21 Research: What Happened to WREB? by Mark Christensen, DDS, MBA
CLASSIFIEDS
35 Classifed Ads
Would you like to submit a case study, scientific article, or editorial for publication in the Journal?
Email editor@okda.org with story ideas.
Is Your Information Correct?
Help the ODA keep you informed about legislative actions, educational opportunities, events, and other important member-only news. Contact Ansley Jinkins at ajinkins@okda.org or 800.876.8890 to provide ODA with your current contact information.
Your Oklahoma Dental Association's Top 24 Wins of 2024
Legislative Loop: Introducing ODA Lobbyist Samantha Davidson Guinn
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
ODA OFFICERS 2024-2025
PRESIDENT
Daryn Lu, DDS president@okda.org
PRESIDENT-ELECT
Twana Duncan, DDS presidentelect@okda.org
VICE PRESIDENT
Nicole Nellis, DDS vicepresident@okda.org
SECRETARY/TREASURER
Sydney Rogers, DDS treasurer@okda.org
SPEAKER OF THE HOUSE
Mitch Kramer, DDS speaker@okda.org
IMMEDIATE PAST PRESIDENT
Paul Wood, DDS pastpresident@okda.org
ADMINISTRATIVE STAFF
EXECUTIVE DIRECTOR
F. Lynn Means
DIRECTOR OF GOVERNANCE & FINANCE
Shelly Frantz
DIRECTOR OF MEMBERSHIP
Ansley Jinkins
DIRECTOR OF COMMUNICATIONS & EDUCATION
Jill Johnson
DIRECTOR OF MEETINGS & EVENTS
Lindsay Dennis
CALENDAR
See more online at OKDA.ORG/CALENDAR
January 10
Council on Nominations Zoom at 8:00am
January 10
Student Legislative Lunch OU College of Dentistry
January 13
Annual Meeting Planning Committee Zoom at 3:00pm
January 13
Legislative Town Hall #1 Zoom at 6:00pm Register to attend: okda.org/denpac
January 17
Legislative Town Hall #2 Zoom at 1:00pm Register to attend: okda.org/denpac
January 13
Annual Meeting Planning Committee Zoom at 3:00pm
January 17
Oklahoma County Dental Society Dinner and O cer Installation Lively Hotel 5:30pm
February Children's Dental Health Month
February Gum Disease Awareness Month
February 7-8
Oklahoma Mission of Mercy Exchange Center at Expo Square, Tulsa
February 14 Council on Government A airs ODA Office & Zoom 8:00am
February 21
ODA Council on Bylaws, Policy, and Ethics Meeting ODA Office & Zoom 12:00pm
SAVE THE DATE
OKLAHOMA MISSION OF MERCY
February 7-8, 2025
Exchange Center at Expo Square - Tulsa Volunteer registration now open at okmom.org
February 25
ODA/DENPAC
Legislative Reception ODA Office, 5:00pm - 7:00pm Register to attend: okda.org/denpac
February 28
ODA Women in Dentistry Luncheon First National, OKC 11:00am - 1:00pm
March 3-7
Dental Assistants
Recognition Week
March 6
Dentist Day
March 7
ODA Board of Trustees Meeting ODA Office & Zoom 1:30pm
March 7
Southwest District Component Meeting
March 24
ODA Board of Trustees Meeting Zoom at 5:30pm
ODA/DENPAC LEGISLATIVE RECEPTION
February 25, 2025
ODA Office Register to attend online at okda.org/denpac
ODA WOMEN IN DENTISTRY LUNCHEON
February 28, 2025
First National Center - Oklahoma City Online registration opens in January at okda.org/events
ODA ANNUAL MEETING
April 11-12, 2025
Southern Hills Marriott - Tulsa Registration opens January 10 at odaannualmeeting.org
Stay connected with the ODA!
DENPAC GOLF TOURNAMENT
May 30, 2025
The Golf Club of Edmond
Combining over 65 years of experience and state-of-the-art technology to provide your patients with the best endodontic care.
It's Fall - Time to Sign Up for OkMOM!
I don’t know about you, but I love this time of year. We are finally getting that great fall weather, and with it, we enjoy college football, Major League Baseball playoffs and fireside chats on the patio.
And if it’s October, it means registration has opened for the annual Oklahoma Mission of Mercy (OkMOM). The 2025 event will be held at the Tulsa Fairgrounds on February 7 and 8!
This will mark the third time the event has been held here in Green Country, including the inaugural OkMOM in 2010. Since that year, over 19,000 patients have been treated with over 116,000 dental procedures at a value of $16.5 million.
And this year, we are proud and grateful to be the beneficiaries of an American Rescue Plan Act (ARPA) grant from the State of Oklahoma that will completely underwrite the event.
With around 1,500 patients treated each year, OkMOM truly fills a need in our state as we are helping serve
those who are experiencing a barrier to their dental care.
The need is great with over 50 percent of Oklahomans having no dental benefit plan, 31 percent of third graders experiencing untreated decay in our state, and 43 percent of our state’s population not seeing a dentist in the past year.
OkMOM serves an integral part of shouldering this burden in our state, as each OkMOM patient receives an average of $900 in care annually. This is life changing service focusing on removing pain and infection for these patients.
Our profession is in a unique position to help decrease the burden on our healthcare system by minimizing emergency room visits with basic dental procedures such as extractions and fillings. By providing these basic services focusing on emergent care, we can have an impact on the health of our state for years to come.
Whether you have volunteered for every OkMOM since 2010, experienced one or two events, or will be volunteering for the first time in 2025, THANK YOU for taking the time away from your families, practices, and busy schedules.
This event would not be possible without each and every one of you, and we are profoundly grateful. Additionally in 2025, we are excited to offer Veterans the opportunity to be pre-screened on Thursday and receive care first when the clinic opens Friday morning.
Always a fun weekend, OkMOM is a place where you can reconnect with
classmates, dental school faculty, and colleagues whom you may not get to see as much as you would like.
I encourage you to get a group of classmates and work a shift together, side-by-side. Bring your entire staff and spend a day team building while providing a service to those less fortunate in our community. Or bring an aspiring dentist to experience the camaraderie of our great profession, ensuring the next generation of dentists also learns to have a servant heart.
I look forward to seeing you all February 7th and 8th, 2025 at the Exchange Center at Expo Square Tulsa Fairgrounds!
We need all the support we can get, and every volunteer will be a vital part of OkMOM 2025.
Thank you in advance for your immense generosity. I am so proud to be part of the Oklahoma Dental Association, Oklahoma Dental Foundation, and the Oklahoma Mission of Mercy!
For more information on the Oklahoma Mission of Mercy and to register to volunteer, please visit okmom.org.
Lindsay Smith, DDS Tulsa, OK OkMOM Co-Chair 2025
NATIONAL ADA NEWS
Oklahoma Dentist Selected as Second Vice President of the American Dental Association
Tamara S. Berg, D.D.S., a private practice dentist in Yukon, Oklahoma, is the new Second Vice President of the American Dental Association (ADA).
Dr. Berg was recently elected at the ADA House of Delegates Meeting at ADA SmileCon™ in New Orleans, La., on Oct. 22.
Dr. Berg has been an engaged member of the ADA for 29 years, serving many leadership roles including President of the Oklahoma Dental Association (ODA) and a member of the ADA Council on Membership.
“Being in private practice for more than 30 years, I have witnessed firsthand the challenges and
opportunities within the field,” said Dr. Berg, Second Vice President of the ADA for the 2024-2025 term.
“I’ve experienced the same issues you have, and together, we will collaborate to find innovative and sustainable solutions that improve the patient experience and help us be more successful on every level.”
Dr. Berg has been an active member, leader and mentor with numerous other dental organizations, including the American Association of Women Dentists, the American College of Dentists and Pierre Fauchard Academy. Dr. Berg has also been honored with several awards, with highlights including the ODA Ethics
and Professionalism award; the ODA Distinguished Dental Service award, the Oklahoma University College of Dentistry Alumnus of the Year award and the Robert K. Wynn Public Information award, among others. Dr. Berg graduated from the University of Oklahoma College of Dentistry and resides in Yukon, Oklahoma with her husband Lowell and two sons Karsten and Clayton.
ADA Corporate Communications
NATIONAL ADA NEWS
Texas Court Strikes Down Corporate Transparency Act
A U.S. District Court for the Eastern District of Texas issued a nationwide preliminary injunction Dec. 3 that blocks enforcement of the Corporate Transparency Act. The move comes less than one month before the rule’s year-end filing deadline hits.
The Corporate Transparency Act was enacted in 2021 to crack down on money laundering operations posing as businesses, requiring qualifying businesses to disclose their beneficial ownership information to a database maintained by the U.S. Department of the Treasury’s Financial Crimes Enforcement Network.
But in Texas Top Cop Shop v. Garland, the plaintiffs alleged that the Corporate Transparency Act oversteps Congress’ jurisdiction to regulate interstate and foreign commerce
and infringes on First Amendment protections. Judge Amos L. Mazzant III agreed that the act appears ‘likely unconstitutional.’
“For good reason, plaintiffs fear this flanking, quasi-Orwellian statute and its implications on our dual system of government. As a result, plaintiffs contend that the [Corporate Transparency Act] violates the promises our Constitution makes to the people and the states,” the judge wrote. “Despite attempting to reconcile the [Corporate Transparency Act] with the Constitution at every turn, the government is unable to provide the court with any tenable theory that the [Corporate Transparency Act] falls within Congress’s power.”
The decision follows a March case,
by Olivia Anderson, ADA
National Small Business United v. Yellen, in which a federal judge in the U.S. District Court for the Northern District of Alabama ruled that the Corporate Transparency Act is unconstitutional. FinCEN appealed the decision, which is currently pending in the 11th Circuit.
It is unclear how FinCEN will respond to the nationwide injunction, but affected entities are currently no longer mandated to comply with the Corporate Transparency Act filing Jan. 1, 2025, filing deadline.
The ADA said it will continue to work with Congress, its small businesses D.C. partners and the new administration to look for a permanent solution.
Introducing our ODA Lobbyist Team
The Oklahoma Dental Association is proud to announce that we have contracted with Cornerstone, a bipartisan, employee-owned consulting firm specializing in federal and state government relations, public affairs and strategic communications, political consulting, grant consulting and business advisory services.
Cornerstone provides a team of lobbyists and brings a broad and diverse range of services that are based on the team’s significant experience working in and with state and local government, as well as solid working relationships across Oklahoma.
Samantha Davidson Guinn, Principal and Counsel at Cornerstone Government Affairs in Oklahoma City, joined the firm in 2023. She has extensive experience in government and policy, previously serving as Deputy Attorney General of Oklahoma, Policy Director for Governor Stitt, and Senior Policy Advisor in the Oklahoma
Senate. She also held leadership roles in healthcare policy and communications. Samantha holds a JD from Oklahoma City University School of Law and a BS in Agricultural Communications from Oklahoma State University.
MORE ABOUT SAMANTHA
How do you stay informed about legislative and regulatory developments?
I stay informed through multiple ways. We have a legislative tracking service that monitors legislation throughout the process. I constantly monitor the news to track what elected officials and industry are pushing or saying in the media. I also keep in close contact with elected officials, agency staff, other lobbyists, and industry leaders both during and outside of the legislative session to keep a pulse on the latest developments.
What is your approach to building and relationshipsmaintaining with policymakers?
I really try to get to know policymakers well before I ever have an “ask” of them. It pays huge dividends to take the time to really understand he or she as a person by asking questions about his or her family, hobbies, district they represent, and businesses outside of the legislature. It is honestly one of my favorite parts of lobbying, to genuinely get to know policymakers. Once I have a request or need to lobby a policymaker on something, I have already built that relationship and there’s a trust that’s developed.
by ODA Staff
What is your strategy for helping the ODA achieve our goals?
We are developing a comprehensive plan and strategy to develop key champions for dentistry within the legislature. This is best accomplished through a “grass roots” campaign/ initiative. Nothing resonates better with legislators than hearing from constituents. Through fundraising efforts, as well hosting coffee, lunch, or dinner meetings with legislators, we can develop these key relationships that translate into champions for our policy items.
How do you handle potential conflicts of interest?
Cornerstone Government Affairs is very intentional about conflict checks and prefer long term partnerships with our clients. Integrity and trust is all we have in this industry, and we are committed to serving as that trusted advisor for our clients.
How do you measure success – personal and professional?
I measure success by my ability to accomplish goals and by making a difference. I feel most accomplished when I’ve either achieved a goal or by doing something that is bigger than me. I want to make a positive impact in my community. Success to me is feeling that I’ve done that.
continued on page 13
ODA Lobbyist Samantha Davidson Guinn
LEGISLATIVE LOOP
Introducing our ODA Lobbyist Team, continued
Would you say you are a people person, and why?
Absolutely. I genuinely love getting to know people. I think it would be hard to be in my profession if I were not a people person. I’m an extrovert in the truest form. I get my energy from being around people.
What have your three most prominent achievements as a Lobbyist been?
This past session we were able to overturn the Governor’s veto for a client. This was an extremely difficult task, but we were able to accomplish it. This was an interesting task for me as I’ve previously served in the Governor’s administration, which leads me to my second most prominent achievement. I wasn’t a lobbyist at the time, but in the Governor’s first term, I served as the Policy Director. We successfully passed agency reform, as well as put millions back into the state’s rainy day fund. Lastly, I’d say anytime we are able to defend a client against legislation which negatively impacts their industry it is a rewarding achievement.
How do you spend your free time?
I spend free time with family and friends. I love being outdoors, riding horses, hiking, attending concerts, trying new restaurants, and water skiing at the lake.
Who would you have dinner with – anyone past or present – and why?
I would have dinner with Reba McEntire. I grew up listening to her music. As a gal who grew up in a small town in Oklahoma, she’s always inspired me.
Why did you become a lobbyist?
In college I was chosen to participate in a leadership program. We spent the year studying how policy affects the different quadrants of the state. We traveled to the state capitol, as well as Washington, D.C., to meet with policymakers. It was during this program that I really caught the political bug. I wanted to be a part of the political process and help shape policy for my state.
I’ve held several staffing roles within state government. Over the years, I learned what a difference a lobbyist can make for both the client, as well as the state. I enjoy that what I do can have a lasting impact for my client and their business and/or the state as a whole.
Who is your mentor(s) and why?
Former State Senator and current Corporation Commissioner, Kim David, has always been a mentor to me. As a senate staffer, she really empowered me early in my career. She’s always been a sounding board and confidant. I’ve also looked up to her success and the way she carries herself.
What inspires you?
Making a positive impact. I want to leave this earth better than I found it.
LEGISLATIVE LOOP
2024 Election Analysis
provided by Cornerstone Government Affairs
Cornerstone Government Affairs has assembled the following report to assist our clients like Oklahoma Dental Association in providing results from the 2024 election and understanding the impact on the nation’s politics and policies of those results.
OKLAHOMA
OVERVIEW
Oklahoma remains solidly Republican and has maintained its trifecta. With 101 members in the House of Representatives and 48 in the Senate, more than 80% of elected officials are Republicans. While rural areas of the state remain strongholds for the GOP, metropolitan areas such as Tulsa and Oklahoma City are showing slight signs of becoming more politically mixed. Gov. Kevin Stitt (R-OK) and Lt. Gov. Matt Pinnell (R-OK) will both serve out the remainder of their terms, which extend through the end of 2026.
GOVERNOR
KEY TAKEAWAYS
Significant leadership changes are on the horizon in the Legislature.
The Republican Party maintained its dominance in Oklahoma, securing all Congressional seats and most Legislature seats.
In his final term, Gov. Stitt (R) has achieved numerous wins that align with his conservative agenda. Gov. Stitt lowered the state’s personal income tax, expanded school choice, increased teacher pay, and redirected funds to classrooms across the state. In the health care space, he worked to improve rural health care access and manage Medicaid costs. Gov. Stitt has also focused on attracting business investments, further promoting economic growth in the state. As Gov. Stitt is term limited, Oklahoma will see a shift in leadership, with the upcoming gubernatorial race in 2026 already shaping up to be highly competitive. Potential contenders include Attorney General Gentner Drummond, U.S. Rep Kevin Hern (R-01), House Speaker Charles McCall (R-22), Lt. Gov Matt Pinnell, and Superintendent of Public Instruction Ryan Walters.
OKLAHOMA SENATE
The Oklahoma State Senate is composed of 48 members, with 40 seats held by Republicans. Former Senate President Pro Tempore Greg Treat (R-47) will complete his term on Nov. 20, 2024, leaving the leadership position open. Initially, Sen. Greg McCortney (R-13) was elected as Sen. Treat’s successor, but in a surprising upset, Sen. McCortney lost his reelection bid, creating a significant shift in Oklahoma’s political dynamics. His unexpected defeat has led to a reshuffling of Senate leadership. Currently, Sen. Lonnie Paxton (R-23) has been chosen as the President Pro Tempore designate, awaiting confirmation by the Republican Caucus in November and a full Senate vote in January. Several newly elected senators will take office in February, filling seats left vacant by resignations, term limits, or election losses. Despite these leadership changes, the Senate is expected to maintain its focus on key priorities including education reform, budget transparency, mental health initiatives, and balanced tax policy to enhance state services and fiscal responsibility.
OKLAHOMA HOUSE
The Oklahoma House of Representatives consists of 101 members, with 20 held by Democrats. As the 2025 legislative session approaches, set to convene on Feb. 3, 2025, the House will see significant leadership changes. Former Speaker Charles McCall (R-22), the longest-serving Speaker in state history, is term-limited, making way for Rep. Kyle Hilbert (R-29) to become the youngest Speaker in Oklahoma’s history. With new leadership in both the House and Senate, expectations are high for the announcement of committee assignments, which will follow the Republican caucus retreat after the election. The departure of several long-serving members due to term limits and election losses has left many key leadership and committee
LEGISLATIVE LOOP 2024 Election Analysis, continued
provided by Cornerstone Government Affairs
roles up for grabs. In this new landscape, the House is expected to prioritize economic diversification, investments in state infrastructure, and potential tax reforms in the upcoming session.
BALLOT INITIATIVES
This November, Oklahoma voters decided on two constitutional amendments, both proposed by state lawmakers and approved by Gov. Stitt for the ballot. State Question 833 would permit the creation of Public Infrastructure Districts (PIDs), governed by a board of trustees. These districts would fund public works projects within their boundaries through a special tax, affecting only properties within the district. All property owners in the proposed area must agree to form a PID. State Question 833 failed to pass with 61% of Oklahomans voting no. State Question 834 seeks to clarify that only U.S. citizens can vote in Oklahoma. While it would not change existing law, supporters say it adds clarity, while opponents argue it feeds into anti-immigrant sentiment. State Question 834 passed overwhelmingly with 80% of Oklahomans voting yes. State Question 832, which would raise the state minimum wage to $15/hour by 2029, has been delayed until June 2026 by the Governor.
CONGRESSIONAL ELECTIONS
In Oklahoma’s 2024 congressional elections, the Republican party retained all five of its U.S House seats. In the 5th Congressional District, Rep. Stephanie Bice (R-05) solidified her hold on the seat with 60% of the vote, continuing to represent the district with a strong majority, further cementing the GOP’s strength in the state. Urban areas within the state like Oklahoma City and Tulsa have shown gradual demographic shifts in recent elections. The competitive 2020 race between Rep. Stephanie Bice, who narrowly won with 52.1%, and Kendra Horn at 47.9% highlights these emerging dynamics, yet all Republican candidates ultimately retained their positions across the board. Oklahoma did not have a Senate election in 2024, as both Sen. James Lankford (R) and Sen. Markwayne Mullin (R) continue their terms from previous victories.
PRESIDENTIAL ELECTION
President-elect Donald Trump once again carried the state by a wide margin, securing all seven of the State’s electoral votes and further reinforcing Oklahoma’s position as a Republican stronghold in presidential elections. Notably, President-elect Trump won all 77 counties in Oklahoma for a third time. Oklahoma remains one of the most reliably conservative states in the nation, and its strong Republican base, particularly in rural areas, played a key role in delivering decisive electoral votes.
GENERAL SUMMATION
The 2024 election results continue to reinforce Oklahoma’s reputation as a reliably Republican state, with the GOP maintaining control of all statewide offices and congressional seats. The continued control of Republicans in both urban and rural areas suggests that the state’s conservative policies will remain unchanged. However, 2026 will bring significant changes with the election of a new governor, as Gov. Stitt is term limited. Additionally, new legislative leadership could potentially reshape the state’s political landscape and key priorities. Issues within economic growth, infrastructure development, and tax reform will likely remain priorities as Oklahoma moves forward under a Republican trifecta.
CASE STUDY
Broken Implant Collar
In this case, we will be discussing a broken implant collar. The patient is 70 years old with a history of asthma, joint replacement, latex allergy, and thyroid disease. Dental history included history of composite restorations, amalgam restorations, root canal therapy, crowns, extractions, and implants. Patient clenches, grinds and occasionally wears her nightguard.
She presented with a fractured #4 and a loose implant crown on #3. As we examined the implant crown and fractured tooth, we noticed a fracture on the implant collar. The fractured implant collar was causing the implant crown's looseness and gingival irritation. It was decided to establish access to the cement-retained implant crown, remove the crown, and smooth out the broken portion of the implant. In addition, #4 would be extracted and an immediate implant placed.
The treatment began with accessing the implant crown. Diamond burs were used to access the abutment screw through the occlusal of the crown. The implant crown/ abutment was then removed. A diamond bur was used to smooth out the collar fracture. Smoothness was determined by the continuity from the fracture to the rest of the collar. The adjacent tooth, #5, was then extracted and an immediate implant was placed. Afterward, there were post-operative appointments for implant placement and adjustments to the collar as needed until inflammation in the area was resolved.
After 2 months of post-operative appointments, the tissue around #4 did not improve. A catch was still felt around the collar. At the second stage of implant surgery, the implant collar was then smoothed again along with a portion being removed. Pt was then seen for an additional post-operative appointment and the area was healing well.
In conclusion, long-term implant maintenance should take collar fracture into consideration in relation to bone loss and inflammation as a cause. Shear/lateral forces are not recommended on implant prosthesis, but patients with occlusal wear habits may need further monitoring of the occlusal wear after delivery.
It is important to treatment plan occlusal guards for all with implant patients with destructive occlusal wear patterns and emphasize compliance. In this case, compliance with occlusal guard could have saved not only tooth #4 but implant #3 as well.
by Dominique Angibeau, DDS
implant crown placed back on implant after collar was refined. Immediate placement of #4 implant.
ABOUT THE AUTHOR
Dr. Dominique Angibeau is a general dentist practicing in Houston, originally from Missouri City, TX. She earned a Bachelor of Biological Engineering from LSU and completed her dental education at the University of Texas School of Dentistry at Houston, followed by a residency at the University of Oklahoma College of Dentistry.
Known for her compassionate approach, she prioritizes strong dentist-patient relationships and patient education to promote oral health. Dr. Angibeau is an active member of the ADA, AGD, and Spears Education, staying current on advancements in dental care. In her free time, she enjoys dining out, live music, traveling, pilates, reading, and college football.
FIGURE 1
#3 implant with broken collar and #4 root tip.
FIGURE 2
#3
FIGURE 2
Periapical radiograph of #3 implant and #4 implant. #3 implant collar is still visible.
STATEMENT OF OWNERSHIP, MANAGEMENT, AND CIRCULATION
1. Publication Title: Oklahoma Dental Association Journal
2. Publication Number: 284-980
3. Filing Date: November 5, 2024
4. Issue Frequency: every other month
5. Number of Issues Published Annually: 6
6. Annual Subscription Price: $56
7. Complete Mailing Address of O ce of Publication: Oklahoma Dental Association
317 NE 13th St, Oklahoma City, OK 73104
Contact Name: Jill Johnson, (405) 848.8873
Editor Name: Mary Hamburg, DDS
Managing Editor: F. Lynn Means
8. Complete Mailing Address of Headquarters or General Business: Oklahoma Dental Association
317 NE 13th St, Oklahoma City, OK 73104
9. Full Names and Complete Mailing Addresses of Publisher, Editor and Managing Editor:
Publisher: Oklahoma Dental Association, 317 NE 13th St, Oklahoma City, OK 73104
Editor Name: Mary Hamburg, DDS
Managing Editor: F. Lynn Means
10. Owner: Oklahoma Dental Association, 317 NE 13th St, Oklahoma City, OK 73104
15. Extent and Nature of Circulation
a. Total Number of Copies (Net press run)
b. Paid Circulation
1. Mail Outside-County Paid Subscriptions Stated on Form 3541
2. Mail In-County Paid Subscriptions Stated on Form 3541
3. Paid Distribution Outside the Mails Including Sales rough Dealers and Carriers, Street Vendors, Counter Sales, and Other Paid Distribution
4. Paid Distribution by Other Classes of Mail rough the USPS
c. Total Paid Distribution [Sum of 15b]
d. Free or Nominal Rate Distribution
1. Outside-County included on PS Form 3541
2. In-County included on PS Form 3541
3. Other Classes rough the USPS
4. Free Distribution Outside the Mail (Carriers or Other Means)
e. Total Free Distribution (Sum of 15d)
f. Total Distribution (Sum of 15c and 15e)
g. Copies Not Distributed
12. Tax Status: Has Not Changed
13. Publication Title: Oklahoma Dental Association Journal
11. Known Bondholders, Mortgagees, and Other Security Holders Owning or Holding I Percent or More of Total Amount of Bonds, Mortgages, or Other Securities: None
14. Issue Date for Circulation Data: September/October 2024
h. Total (Sum of 15f and g)
i. Percent Paid (15c divided by 15f times 100)
16. Electronic Copy Circulation
17. Publication of Statement of Ownership required. Will be printed in the November/December 2024 issue of this publication
18. Signature and Title of Editor, Publisher, Business Manager, or Owner F. Lynn Means, Managing Editor, November 5, 2024
CASE STUDY
Non-Healing Ulcer Under Tongue
A 58-year-old woman presents to the clinic with a chief complaint: a non-healing ulcer under the tongue with tenderness and burning. This patient started a new sublingual prescription medication one month before this appointment, and she reports consistent burning. Her social history is significant for tobacco use, one half-pack per day for the past 20 years, and daily alcohol consumption. During clinical examination, an ulcerated 1.0 x 0.5 cm mixed red and white exophytic lesion was detected in the left floor of the mouth extending from the mandibular gingiva to the depth of the mandibular lingual vestibule. A biopsy of this lesion confirmed a diagnosis of oral squamous cell carcinoma.
Seven years prior, the patient was referred from a private dental office for a mixed red and white lesion with uneven borders on the left floor of the mouth. A biopsy of the area revealed a diagnosis of mild epithelial dysplasia.
Mild, moderate, and severe dysplasia can precede oral squamous cell carcinoma. Unlike other areas of the body, there is not always a predictable rate of transformation for any grade of dysplasia into oral squamous cell carcinoma. Therefore, any grade of epithelial dysplasia requires excision and careful monitoring. Oral squamous cell carcinoma is the most common malignancy of the oral cavity, with high rates of morbidity and mortality. Even with advances in medical and surgical procedures, the 5-year survival rate is only 50-60%.
This clinical case highlights the importance of routine follow-up for any biopsy-proven diagnosis of epithelial dysplasia.
by Elena V. Dupalo DDS and Kathleen E. Higgins, DDS, MS
REFERENCES
Chamoli, A. (2021, July 28). Overview of oral cavity squamous cell carcinoma: Risk factors, mechanisms, and diagnostics. National Library of Medicine. Retrieved April 6, 2021, from https:// pubmed.ncbi.nlm.nih.gov/34329869/
McCord, C. M. (2021, September 21). Oral Squamous Cell Carcinoma Associated with Precursor Lesions. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/34193432/
Regezi, J. A. (2010). Oral Pathology: Clinical Pathologic Correlations (15th ed.). Elsevier. https://doi.org/9780323297684
ABOUT THE AUTHORS
Dr. Higgins is originally from the Washington, DC area and completed her undergraduate, masters, and doctorate education in Virginia. Upon graduation from Virginia Commonwealth University School of Dentistry in 2017 she pursued oral pathology residency training at New York Presbyterian Queens. During residency she reviewed countless oral biopsies, treated oral
medicine patients, as well as taught students, residents, and medical colleagues. She went on to complete a Head and Neck Pathology Fellowship at the University of Chicago, where she participated in both an active oral pathology biopsy service as well as the head and neck surgical pathology service that included examination and review of large head and neck cancer cases. In her free time she enjoys cooking and spending quality time with her husband and their English Bulldog, Scully.
Dr. Dupalo, a long-time resident of Sacramento, CA, has deeprooted ties to her community. She began her academic journey at San Jose State University, earning a Bachelor of Science in Health Science with a major in Social Work. Driven by her passion for dentistry, she pursued her doctorate at the University of California, San Francisco, graduating in 2019. After completing an Advanced Education in General Dentistry (AEGD) residency at the University of Oklahoma College of Dentistry, Dr. Dupalo is excited to return to Sacramento. She is eager to rejoin a private practice, bringing with her a wealth of new skills to better serve the community she knows and loves.
What happened to WREB? The Merger of Regional Testing Agencies
INTRODUCTION
Before the 1970s, most states developed and administered a clinical assessment for licensing qualification. Regional testing agencies arose in the 1970s as states in various regions began collaborating to create and administer the clinical examination required for dentist licensing. Collaboration offered many advantages, particularly for states lacking a dental school or convenient examination facility. As regional states collaborated, examination administration became standardized, examination content became unified, and the number of participating states grew.
enabled a standardized and anonymous appeals process and a practice (occupational task) analysis to support examination content.
WREB continued to operate until August 2021, when it merged with CDCA. Before the merger, WREB examinations were recognized for licensing in approximately 44 states. CDCA (ADEX) examinations were accepted for licensing in 48 states. Oklahoma began accepting the WREB
The Western Regional Examining Board (WREB) was one of several regional testing agencies that administered a clinical assessment to help inform the jurisdictional authority responsible for dentist licensing in the United States. Other widely recognized regional testing agencies are the Northeast Regional Board of Dental Examiners (NERB), the Commission on Dental Competency Assessment (CDCA), the Central Regional Dental Testing Service (CRDTS), the Southern Regional Testing Agency (SRTA), and the Council of Interstate Testing Agencies (CITA).
Oklahoma began accepting the WREB examination for dentist licensing in 1997. In 2005, the WREB examination replaced the Texas Board of Dental Examiners’ own state-specific clinical exam for dentist licensing. The transition to WREB was part of a broader effort to standardize dental licensure across various states.
by Mark Christensen, DDS, MBA
WHAT CHANGED
Why, after almost half a century of successful operation, did WREB so suddenly disappear? And what does this portend for the other remaining regional testing agencies?
WREB was the regional agency that most Western states initially joined. Many of these states did not have a dental school or facility to conduct a clinical assessment. Member states without a dental school when WREB was founded include Alaska, Arizona, Idaho, Montana, Nevada, New Mexico, and Utah. These states sent students to dental schools out of state across the country. Some of these students wished to return to their home state to practice. For this reason, they frequently persuaded their school to host the WREB examination. Hence, WREB was early on invited to examine candidates in schools across the country.
Certain sections of the clinical licensing examination (endodontic treatment, for example) have long been conducted as a simulation. An initiative to move from a patient-based format to a more highly simulated format for all examination sections was already underway when the COVID-19 pandemic struck. In the spring of 2020, the pandemic suddenly precluded performing the clinical licensing examination with patients. This accelerated developments and enabled, of necessity, the creation and acceptance of an entirely simulated and more highly standardized clinical assessment.
WREB introduced or reinforced innovations over the years that advanced patient-based clinical assessment. These included strict candidate anonymity, robust examiner calibration, test specifications that include the criteria against which candidate performance is judged, and a transparent scoring methodology. Regionalization also
In 2006, the California Dental Board and Division of Consumer Affairs began recognizing the results of the WREB Dental Examination for dentist licensing in California. For almost fifteen years afterward, WREB continued administering dental examinations at schools in the West and across the country for applicants seeking licensure in Western states, particularly California.
Sometimes overlooked, however, is that in November 2019, a few months before the onset of the pandemic, California also began to accept the ADEX examination for dentist licensing. When this occurred, no state exclusively required the WREB examination. Both examinations were no longer needed. When the pandemic struck, WREB and CDCA (ADEX) were testing at schools nationwide.
Their examination results were recognized as satisfying the clinical examination requirements for licensing in almost all states, and their examinations were offered at many of the same sites.
Having two different clinical examinations for the same purpose in the same space became confusing for students trying to decide which exam to take, dental education programs trying to determine which exam to host, and state boards tasked with meaningfully distinguishing the differences. The reasons for regional testing agencies finally disappeared. The regional structure no longer served states, stakeholders, or the dental profession. continued on page 23
RESEARCH
What happened to WREB, continued
Recognizing this and that gaining or even retaining market share would have required the development of a robust marketing department and the allocation of a significant portion of candidate examination fees to marketing that would not necessarily improve the quality of the examination or benefit the profession, WREB initiated a conversation with other testing agencies.
In the beginning, regional exams provided important benefits. They enabled:
• For states: sharing the burden of developing and administering exams.
• For students: increased standardization and exam results portability.
• For schools: simplified test preparation of students.
• Better implementation of the Standards for Educational and Psychological Testing (candidate anonymity, examiner calibration, psychometric standardization, documentation, and the production of technical reports).
recognized for licensing by almost every jurisdiction, including Puerto Rico, Jamaica, and the U.S. Virgin Islands.
Passing an ADEX hand-skills (psychomotor) clinical licensing examination is currently a requirement or pathway for initial licensing in every state except New York and Delaware. Delaware has its version of a clinical licensing examination. New York requires completing a post-graduate residency program of at least a year. Except for these and a recent idiosyncratic and problematic Board decision in Nebraska to accept only CRDTS, the ADEX Dental Examination administered by CWC has become the national clinical assessment standard for dentist licensing. Like CODA and the Joint Commission’s National Board Dental Examination, the ADEX Dental Examination is also being administered internationally.
After 2020, multiple regional examinations competing for market share in the same space:
• Unnecessarily complicated things for states.
• Unnecessarily confused and complicated things for students.
• Unnecessarily complicated things for schools.
• No longer benefited the dental professions.
The ADEX Dental Examination administered by CWC is now the national clinical licensing examination for dentistry. This assertion depends on how “national” is defined, but consider that, as of this writing, the ADEX Dental Examination:
• Is administered at every dental school in the country.
On August 3, 2021, CDCA and WREB merged to become a single agency: CDCA-WREB. A year later, on August 1, 2022, another regional testing agency, CITA, combined with CDCA-WREB. The resulting agency, CDCA-WREBCITA (CWC), now uniformly administers the ADEX examination at every dental school nationwide. The results of this examination are universally portable and
DISCUSSION
The shift away from patients to allsimulation and the consolidation of regional testing agencies signifies the beginning of a new chapter for initial dentist licensing. What does this mean for the remaining independent regional testing agencies: CRDTS, SRTA, and others?
Regional innovation initially introduced new ideas. These ideas and practices were shared at national meetings, improving the quality of all exams. However, the regional testing agencies that now remain are operating in the same space and using rhetoric about the benefits of “competition” as an excuse to propagate the existence of no longer needed entities. Since students decide which examination to take, competition in the same space for candidates and schools is geared toward making the exam more attractive to students, i.e., cheaper, easier to access or pass, etc. Competition for students now is not likely to improve the examination quality or even sustain the established standard.
• Is administered to more than 6500 graduating student candidates each year.
• Satisfies the clinical exam licensure requirements in almost all licensing jurisdictions (96-98%).
• Has multiple national offices and 800-850 examiners nationwide.
• Is now explicitly codified as the required clinical examination for licensing in approximately a third (17) of states.
• Is now being administered internationally and achieving international recognition like CODA and the Joint Commission’s National Board Dental Examination.
The clinical licensing examination is not a consumer item like a washing machine, automobile, or computer; it is an assessment instrument for determining clinical competency or a measure of applicant quality that contributes to the standardized requirements for entry-level licensing Licensing is a tool of regulation, an aspect of government.
Governmental regulation is best served by a single, uniform standard that is universally accepted, clearly identified, and readily addressed.
Most jurisdictions also require the completion of a CODA-accredited dental education. One entity, CODA, currently accredits dental education programs. It would not be better if two or three accrediting agencies were competing for schools. Multiple accrediting agencies competing for continued on page 25
RESEARCH
What happened to WREB, continued
schools in the same space would not likely improve dental education standards. Instead of proposing an additional accreditor, those concerned about the quality of dental accreditation should first work with CODA to improve the already existing, universally recognized accreditation process.
Having multiple manufacturers compete for contracts to supply parts for a manufactured product is preferable. But this is not about parts suppliers; it’s about a professional standard—establishing and documenting a standard measure of competence or applicant quality— to support licensure. In this context, having a single, uniform standard that is universally recognized is preferable. Competition for establishing the standard in the same space where the test taker (student) is the decision maker is only liable to reduce the quality of the standard.
There also are ethical issues. Should the infiltration or manipulation of state boards be attempted in the interest of testing agency preservation? Should a substantial portion of candidate examination fees be spent on attorneys and lobbyists or on flying spokespersons around the country to make presentations to gain or hedge against the loss of market share? How does this benefit the profession? Such questions have become relevant for the smaller regional testing agencies that now may be struggling to remain viable.
CONCLUSION
WREB’s recent merger and disappearance signal the beginning of a new era. The era of regional dental testing agencies, which lasted approximately half a century and benefited professional regulation in its heyday, is now closing. The smaller independent clinical testing agencies that remain will likely struggle to retain market share. Some of their examiners may already be examining for CWC. The smaller remaining agencies will likely need to choose how they, too, will come together to support the preservation of a single national clinical (psychomotor)
assessment standard or redefine themselves and the role they will play in supporting dental regulation going forward.
REFERENCES
1 Northeast Regional Board of Dental Examiners (NERB) in 1969, Central Regional Dental Testing Service (CRDTS) in 1972, Southern Regional Testing Agency (SRTA) in 1975, and Western Regional Examining Board (WREB) in 1976.
2 WREB examinations remain named or codified in the rules or regulations for the licensing of dentists in many U.S. jurisdictions. Applicants who passed a WREB examination before WREB’s merger with CDCA still have clinical examination credentials to satisfy the licensing requirements in most states.
3 Christensen ML. The Changing Face of Dental Licensing Examinations. J California Dental Assoc 2023; 51:1. Accessed Oct 10, 2024, at: https://www. tandfonline.com/doi/full/10.1080/19424396.2023 .2176578
4 Dental Board of California, Department of Consumer Affairs, Meeting Minutes, Jan. 27, 2006. Sacramento, CA. [cited 2022 Oct 20]. Accessed Oct 10, 2024, at: https://www.dbc.ca.gov/about_us/ meetings/minutes/20060127_board.pdf
5 Acadental DTX CompeDont™ development to simulate enamel, dentin, caries, and pulp tissue in simulated teeth. [cited 2024 Feb 24]. Accessed Oct 10, 2024, at: https://acadental.com/product_page. php?id=282084279-72592283
6 Dental Board of California Votes (Nov. 15, 2019) to Implement the ADEX Dental Examination for Licensure Immediately. American Board of Dental Examiners, Inc.; 2019 [cited 2022 Oct 5]. Accessed Oct 10, 2024, at: https://www.cdcaexams.org/ wp-content/uploads/2019/11/Press-Release-CABoard-and-ADEX-Dental-Licensure.pdf
7 CDCA, WREB Announce Merger, The Commission on Dental Competency Assessments, Linthicum, MD; 2022 [cited 2022 Oct 24]. Accessed Oct 10, 2024, at: https://adextesting.org/ cdca-wreb-announce-merger/
8 CDCA-WREB, CITA Announce Combination, The Commission on Dental Competency Assessments, Linthicum, MD; 2022 [cited 2022 Oct 24]. Accessed Oct 10, 2024, at: https://www. cdcaexams.org/cdca-wreb-cita-announce-pendingcombination/
9 ADEX Dental Initial Licensure Acceptance (map) [cited 2024 Feb 24]. Accessed Oct 10, 2024, at: https://adextesting.org/
10 Nebraska stopped recognizing the American Board of Dental Examiners (ADEX) exam for dentist licensing starting with the 2023-2024
testing cycle. Nebraska Governor Jim Pillen has urged the Board to reconsider and expand testing options to address the state's shortage of dentists. Accessed Oct 11, 2024, at: https:// alliancetimes.com/gov-pillen-calls-on-stateboard-to-expand-access-to-dentists-in-nebraska/ In its meeting on October 4, 2024, the Nebraska Board again approved recognition of the ADEX Dental Examination for initial dentist licensing beginning July 1, 2025 (for the 2025/2026 testing cycle). Accessed Oct 23, 2024, at: https:// dhhs.ne.gov/licensure/LU%20Agendas%20 Minutes/100424dentminutes.pdf
11 CDCA-WREB-CITA is now administering the ADEX Dental Examination at the University of La Salle Bajío located in Leon, Guanajuato, Mexico, and King Abdulaziz University in Jeddah, Saudi Arabia, a dental school already accredited by CODA. Accessed Oct 10, 2024, at: https://www. lasallebajio.edu.mx/oferta/idp_en.php and https:// www.arabnews.com/node/2411191/saudi-arabia
ABOUT THE AUTHOR
Mark L Christensen, DDS, MBA is an assistant professor at the University of Utah School of Dentistry. He has been a state dental board member, commissioner for the Commission on Dental Accreditation, commissioner for the Joint Commission on National Dental Examinations, and chair of the Committee for an Integrated Examination (CIE) that developed and validated the Integrated National Board Dental Examination (INBDE). He has been president of WREB and of the American Association of Dental Boards. Dr. Christensen is a Life Member of the ADA and the AADB, and a fellow of the International College of Dentists and the American College of Dentists.
Maximizing ePrescribing Software: Best Practices
Provided
ePrescribing software is no longer the new kid on the practice efficiency block. For many dental practices, it’s time to consider whether you’re maximizing your ePrescribing solutions.
And yet, not all ePrescribing software is created equally. So, when choosing your software, look for a few key features, some of which are standard, some of which are not:
• Integration with EHR Systems - Seamless communication and data sharing between ePrescribing software and EHR systems ensures accurate and up-to-date patient information.
• Clinical Decision Support - Real-time alerts and suggestions help dentists make informed prescribing decisions, including drug interactions, allergies, and contraindications.
• Medication History TrackingComprehensive access to a patient’s medication history prevents duplications and ensures continuity of care.
• Refill Management - Simplifies the refill process, including automatic reminders and refill requests.
• Drug Interaction and Allergy Alerts - Immediate alerts for potential drug interactions and known allergies, improving patient safety.
• Secure Messaging and Communication - Encrypted messaging capabilities for secure communication between dentists and pharmacies.
• Real-Time Benefits VerificationInstant checks on patient insurance coverage and medication costs provides cost-effective prescribing options.
• Electronic Prior AuthorizationStreamlined process for insurance approvals when medications require prior authorization.
• EPCS and State PDMP integrationSecure and compliant prescribing of controlled substances, meeting DEA and state regulations.
• Patient-Specific Dosing Recommendations - Tailored dosing recommendations based on patientspecific factors.
by ODA Partner, iCoreConnect
Written by Robert McDermott, President & CEO
approaches to maximize their ePrescribing software solution.
A few fundamental strategies include:
Conducting comprehensive staff training, ensuring all dental providers and supporting staff are thoroughly trained in using the ePrescribing system. It’s great to have tools around, but if your staff doesn’t know what it can do or how to use it, you certainly won’t get the most out of it.
• Audit Trails and ReportingDetailed logs and reports of all prescribing activities for transparency, accountability, and regulatory compliance.
• Mobile Accessibility - Access to ePrescribing features via mobile devices adds flexibility and convenience.
• Customizable TemplatesPredefined and customizable prescription templates streamlines the process for commonly prescribed medications.
• Insurance Compliance - Ensures prescriptions are aligned with insurance formularies, promoting cost-effective and covered medication choices.
• Remote Prescription Cancellation - Cancel prescriptions remotely if needed, ensuring patients do not receive medications that are no longer necessary or safe.
• Pharmacy DirectoryComprehensive directory of pharmacies to facilitate direct transmission of prescriptions to the patient’s preferred location.
• Adherence Monitoring Tools - Tools to track and improve patient adherence to prescribed medications, including reminders and follow-up alerts.
ePrescribing software can enhance the efficiency, safety, and quality of the prescribing process in any dental practice.
Ensure ePrescribing solution integration with EHRs and practice management systems. A unified system allows dental providers to access comprehensive patient information, including medication history and insurance details, in real time.
Customizing ePrescribing workflows to match the specific needs of your practice from templates, alerts, and default settings can streamline the prescribing process and reduce the time spent on each prescription.
However, to fully leverage the benefits, dental practices must adopt strategic
Leverage the software’s reporting and analytics to provide valuable insights into prescribing patterns and practice performance, from frequent prescription errors or delays in the prescribing process.
Ultimately, maximizing the potential of ePrescribing software involves a multifaceted approach that includes staff training, system integration, workflow customization, data-driven improvements, and patient engagement. These strategies can help ensure dental practices get the most out of their ePrescribing software.
Book a demo of iCoreRx cloud ePrescribing software from ODA Rewards Partner iCoreConnect today to improve the efficiency and safety of prescription management while significantly enhancing patient satisfaction and trust. Visit iCoreConnect.com/OK22 or call 888.810.7706. ODA members receive substantial discounts on iCoreRx.
The 2025 Oklahoma Dental Association membership renewal period begins this month. Make sure to renew by January 1 to maintain all of the great benefits your membership provides.
Our strength in Washington, D.C., at our State Capitol, and in your community is reliant on our united front from an organized dentistry perpective, and we need your support to help us continue the fight.
Choose a Payment Plan
Did you know you don’t have to pay your ODA/ADA/Component (Tripartite) dues all at once?
ODA understands that it may work better for you to remit your membership dues over multiple payments instead of all at once. We are excited to provide you with the opportunity to pay your 2025 membership with one of the following convenient payment plans:
• 2 monthly payments
• 4 monthly payments
• 6 monthly payments
• 12 monthly payments
Sign up for Automatic Renewal
This plan allows your membership to be renewed automatically and paid with your credit card or an ACH payment each year. You may choose a one-time payment or a 6-month or 12-month payment plan that the ODA will process at the beginning of each year until you cancel by contacting the ODA. You will be able to update your credit card information as needed.
The ODA will process auto renew payments on the 15th of each month. One-time renewal payments will be processed on January 15.
Please note: Those on the auto renew plan will be charged the same amount they contributed the previous year, including any additional voluntary contributions. ODA also reserves the right to charge the credit card on file at any time for past due payments that did not go through on prior attempts. To cancel, change, or update automatic renewal preferences, please contact the ODA.
Early renewal and automatic renewal help save ODA money on sending notices and invoices. Thank you!
n Serving the OKC Metro for 43 years - since 1977
n Your patient’s experience is top priority
n 3D CBCT scanning for improved diagnosis
n Complex endodontic cases welcomed
n Complex and “heroic” teeth salvage
n Build-up and post & core placement available
n Cutting edge instrumentation and disinfection
n Zeiss microscopes used on every case
n Specializing in finding 4+ canals in molars
n Surgical and nonsurgical retreatment
n General anesthesia and oral sedation
We pride ourselves in a trusted referral pattern that ensures your patient returns to you holding you in high regard - regardless of the reason for referral. We speak highly of you to your patient and reassure them they are in good hands in your care.
We value communication between you and our office. Give us a call to talk about anything. We are even happy to help you navigate through a difficult case in your chair.
Dr. Spencer Hinckley and Dr. Percy Bolen
NATIONAL ADA NEWS
Community Water Fluoridation is Safe
The ADA has reaffirmed its stance that community water fluoridation is safe and beneficial to oral health, following a federal judge’s ruling that the U.S. Environmental Protection Agency must take action regarding fluoride in drinking water. While the EPA is required to take action, the ruling did not ban or in any way limit the addition of fluoride to public drinking water supplies.
In a Sept. 25 statement, the ADA said it remains “staunchly in support” of community water fluoridation at optimal levels to help prevent tooth decay.
“The district court ruling against the Environmental Protection Agency provides no scientific basis for the ADA to change its endorsement of community water fluoridation as safe and beneficial to oral health,” reads the release.
U.S. District Court Judge Edward Chen specified in his Sept. 24 ruling that although his finding does not “conclude with certainty” that fluoridated water is harmful to public health, there is evidence that fluoride in drinking water poses a potential risk of cognitive decline.
“Given the seriousness of reduced IQ, and the ample support in the record that the United States population is at risk of experiencing IQ decrements of over four IQ points, the severity of the hazard at issue weights in favor of finding the risk at issue unreasonable,” wrote Judge Chen.
Several advocacy groups petitioned to establish a case that fluoride posed an unreasonable risk of harm sufficient to require a response by the EPA under the amended Toxic Substances Control
Provided
by American Dental Association
Act, which allows citizens to petition the EPA to consider whether a chemical presents an unreasonable risk of injury to health.
This ruling comes after the Department of Health and Human Service’s National Toxicology Program released “Monograph on the State of Science Concerning Fluoride Exposure and Neurodevelopment and Cognition.” The August report found that drinking water at more than twice the recommended limit is “consistently associated” with lower IQ in children.
The report notes that the findings are limited to fluoride exposures that are more than double (≥1.5 mg/L) what the Centers for Disease Control and Prevention currently recommends for the optimal level of community water fluoridation (0.7 mg/L).
NATIONAL ADA NEWS
Community Water Fluoridation is Safe, continued
An ADA expert committee examined the report, stating the monograph does not provide any new conclusive evidence that warrants changes in current community water fluoridation practices for public health policy consideration.
The ADA continues to endorse fluoridation of community water as a necessary way to prevent tooth decay and promote oral health. The Association notes that the CDC named it one of the 10 great public health achievements of the 20th century and that for more than 75 years scientific evidence has pointed to fluoridation as safe and effective.
Judge Chen said the Toxic Substances Control Act requires the EPA to engage with a response since the court found an unreasonable risk of injury. He did not state what exactly the response must be.
“Amended [Toxic Substances Control
Act] leaves that decision in the first instance to the EPA. One thing the EPA cannot do, however, in the face of this Court’s finding, is to ignore that risk,” he wrote.
ADA President Linda J. Edgar, D.D.S., said in a statement that oral health is essential and that community water fluoridation has been proven to prevent at least 25% of tooth decay in children and adults.
“The scientific weight of sound evidence around the benefit of community water fluoridation is clear and compelling,” Dr. Edgar said.
Because of the widespread misinformation circulating online and in social media around community water fluoridation, the ADA urged its members to be cautious of “pseudoscientific information.”
“This information is not always based on research conducted according to impartial and evidence-based scientific methodology; and the conclusions drawn from research are not always scientifically justifiable or without bias,” the release concludes.
For more information on community water fluoridation and ADA advocacy, visit ADA.org/fluoride.
REGISTRATION IS NOW OPEN!
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Hyped!
RMDC promises to surprise and delight members of the whole dental team with these great features:
• 110+ included courses
• 85+ speakers and key opinion leaders
• 200+ exhibitors
• 4 fun social events
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• NEW! Professional Industry Panels
• Hot dental topics and innovations
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• NO COST EXPO Hall for dental team members
What are you waiting for?
ODA member dentists enjoy 10% OFF REGISTRATION with Code: neighbor10
JANUARY 23-25, 2025 ›› DENVER, CO
AEGD CASE PRESENTATION
Vertical Root Fracture
A 64-year-old female presented to the OU College of Dentistry AEGD clinic with a chief complaint of pain on biting on her upper right side. It was determined that #4 had a vertical root fracture spanning mesiodistally across the entire occlusal surface of the tooth. The fracture was so extensive that when placing an explorer on the fracture line, the two portions exhibited mobility and splayed out. The tooth was deemed non-restorable.
After discussing various treatment options, the patient chose to have the tooth extracted and an implant placed. The tooth was extracted the same day. After extraction, a corticocancellous bone graft and collagen plug were placed. Primary closure was obtained. The patient had a family wedding planned four months from the day she presented for the extraction and stated that she would like to have a tooth in that area for the wedding.
Due to the urgency, the Dentsply Azento System was chosen. The Azento System is a digital platform that streamlines the process of placement and immediate loading of single tooth implant restorations. After three months of healing, a CBCT and iTero full-mouth intraoral scan were taken and uploaded onto the Azento platform to create a surgical and restorative treatment plan. The treatment proposal was ready to review and approve within a few days. Once necessary changes were made, the Azento kit was approved, sent for processing, and shipped. The kit included the implant, a custom Atlantis abutment and temporary crown, a custom healing abutment, surgical guide, and all necessary twist drills to prepare the osteotomy. Both a custom abutment and temporary crown or a custom healing abutment are included to use dependent on the outcome and stability achieved on the day of surgery.
On the day of surgery, the surgical guide was placed and stabilized by the adjacent teeth. The guide includes an access hole to allow for adequate irrigation during placement of the implant. A tissue punch drill was used to remove the tissue through the guide. The osteotomy was then prepared using the Astra EV twist drills.
An Astra 4.2x9mm PrimeTaper EV Osseospeed implant was placed. Excellent primary stability was achieved at 35 Ncm. A timing marker on the surgical guide was used to rotate the implant to the correct position for placement of the custom abutment. The custom abutment and temporary crown were tried in to verify seating and then cemented together extraorally using Rely-X luting cement. The screw-retained crown and abutment were placed and torqued to 15 Ncm. The access hole was closed with tefflon tape and flowable resin composite. The temporary crown was taken entirely out of occlusion and the patient was informed to avoid chewing in that area. The patient was extremely excited to leave with a tooth that day and even more excited to have it done prior to the wedding. She will be seen back after three months of healing for the fabrication of her final restoration.
by Lauren Parker, DDS
ABOUT THE AUTHOR
Dr. Lauren Parker was born and raised in Norman, Oklahoma and attended the University of Oklahoma where she received her Bachelor of Arts in Psychology. She then attended the OU College of Dentistry where she received her DDS and recently completed her AEGD residency. Dr. Parker will be joining a private practice in Norman.
CLASSIFIEDS
POSITION OPEN
Hygienist - Oklahoma City, OK
Hygienist position for family practice office in South OKC. Monday through Thursday 8am to 5pm. Some experience preferred. Email resume to dasokc@gmail.com or call 405-632-5562
EQUIPMENT FOR SALE
Dentist retiring and selling all equipment, which will be available November 1, 2024.
Three complete operatories including: Adec 311 dental chair unit; Digital Shick X-rays & computers; Suction system; Handpieces - Electric and air operated; Schumacher surgical equipment & Forceps. Also: Adec LISA water steam sterilizer; Assistina handpiece cleaner/oiling system 301; PLUS all hand instruments, scalers, and supplies; stackable electric washer/dryer and refrigerator.
Call Charlie for more info at 405-249-2308.
JOB OPENING
PRACTICE FOR SALE
South Central Oklahoma
General Practice for Sale: 2600 sq ft, 5 ops, great visible location, 4 days per week, 8 days hygiene, softdent, cerec, laser, intraoral cameras, digital radiography, super staff, collections $1.1 million.
Contact: Call or text (580) 221-4767.
PRACTICE FOR SALE
Oklahoma City, OK
Prime location second generation dental practice space for lease. Located on 4440 NW Expressway in Oklahoma City with great visibility, up to $150k buildout allowance, 50,000 VPD. Call 214-405-1935 or email : Pakzadadvisory@gmail.com.
Associate Dentist, Stigler, OK
POSITION OPEN
Associate Dentist
Oklahoma City, OK
We are a well-established, privately-owned dental practice located in Oklahoma City. Our focus is on delivering high-quality dental care in a patientcentered, compassionate environment. With a loyal patient base and a dedicated team, we pride ourselves on building long-term relationships with our patients and providing comprehensive dental services.
Position Overview:
We are seeking a motivated and skilled Associate Dentist to join our team. The ideal candidate will be passionate about patient care, have excellent communication skills, and be eager to grow within a supportive and collaborative environment.
PRACTICE FOR SALE
Oklahoma City, OK
General Practice for Sale: Prime OKC Metro Area dental practice minutes from downtown. Features include 5 remodeled operatories, 9,000 active patients, 12-15 new patients monthly, and a 4-day workweek. With $725,000 in collections and $205,000 in SDE, it offers strong financials. A 50/50 partnership opportunity is available as one doctor plans for retirement.
Contact: Headwaters Practice Transitions at bailey@headwaterstransition.com or (719) 694-8320 (Ref: HWO11724)
PRACTICE FOR SALE
Private practice located in Stigler, OK seeking associate with possible buyout in future. Very well established office that has been in business for 45 years with a loyal patient base. Only private practice in Haskell County, located between Eufaula Lake and Kerr Lake. Office is in prime location right on the main highway across from Choctaw Travel Plaza. Building is 2000 sq ft, has 3 DR operatories, 1 hygiene operatory, break room has capabilities to be another operatory if needed. Equipment is older but fully functional. Office is open Tuesday-Thursday 8 to 5, and Friday 8 to 3 (only hygiene patients are seen on Saturdays currently). Office has Dentrix software. Currently providers for 4 insurance companies including Medicaid and have FFS patients as well. Practice offers preventive, restorative, crown/bridge, denture/partials, some oral surgery, and some implants. Definite growth potential since the office currently refers for orthodontics, endodontics, periodontics, and some oral surgery and implants. Email lyndiejoan@gmail.com or call (918) 448-0181.
Claremore, OK
General Practice for Sale: 3 -3.5 days/ wk, producing approximately 700k/yr, 6 days hygiene/ wk, Dentrix, Dexis imaging, digital pan, laser, refer out most speciality work, 2000 sq/ft building for sale located in Claremore on busy state hwy. We take 4-6 weeks vacation/yr, doctor retiring.
Contact: (918) 810-5948
POSITION OPEN
Oklahoma City, OK
Great location by I-240 and Sooner, Close to Tinker, Boeing, Northrop Grumman, and Pratt-Whitney, and South Heart Hospital. Dr can stay at least 1 year. Build out is 6 years old. Better than new.
Call 405-741-9000.
Key Responsibilities:
• Provide high-quality dental care to patients of all ages, including preventive, restorative, and cosmetic treatments
• Perform examinations, diagnoses, and treatments with a focus on patient comfort and education
• Collaborate with our experienced dental team to ensure a smooth and efficient workflow
• Maintain accurate patient records and adhere to all practice protocols and safety standards
Qualifications:
• DDS/DMD from an accredited dental school
• Active Oklahoma dental license (or ability to obtain one)
• Strong clinical skills with a commitment to continued education and professional development
• Excellent communication and interpersonal skills
What We Offer:
• Competitive salary and benefits package
• A supportive and well-trained team, allowing you to focus on patient care
• State-of-the-art equipment and a modern, comfortable work environment
If you are a dedicated and compassionate dentist looking to join a thriving practice, we would love to hear from you!
How to Apply: Please send your resume and a cover letter to kevintm526@yahoo.com or contact us at 405-535-6976 for more information.
