July/August 2018 | Vol. 109, No. 4
OU College of Dentistry
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Contents
ADVERTISERS Thank you to these businesses who advertise in the ODA Journal
July/August 2018 | Vol. 109, No. 4
Inside Front Cover Valliance Bank Back Cover Delta Dental of Oklahoma
EDITORIAL 0 6 Guest Editorial: Raymond Cohlmia, DDS
ASSOCIATION 04 Calendar of Events
Advertisers
3000 Insurance Group Commerce Bank DentalPost Endodontic Associates Lewis Health Profession Services Paragon Dental Practice Transitions Southwest Dental Conference Works24
Oklahoma Dental Association
0 5 Supporting Oklahoma Veterans 08 ODA Rewards Partners 09 ODA Rewards Partners Column
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10 Oklahoma Mission of Mercy 2019
Community Dental Health Coordinator
1 2 ODA Members in the News 1 4 ODA Marketing Coach 1 6 ODA Member Benefit Corner 17 Meet the Newest ODA Staff Member
23 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.
Match@ODA Brings Dentists Together
LEGISLATIVE LOOP 1 8 2017-18 Legislative Session Summary 1 9 2018 OKCapitol Club Members 2 1 ADA Advocacy News &
DENPAC Grand Level Members
2 2 Action for Dental Health Bill
SPOTLIGHT 23 Dr. Rachel Standlee and Dr. Lauren Nichols
Cover Photo: Several 2018 OUCOD Graduates celebrating during the ODA Senior Signing Day. Welcome New Members!
FEATURES 24 Community Dental Health Coordinator: A Valuable Asset to Your Dental Team 2 6 The Use of Air Polishing Devices by Oklahoma Dental Hygienists
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 © 2018 Oklahoma Dental Association.
29 Is Your Information Correct? Help the ODA keep you informed about legislative actions, CE opportunities, events and other important member-only news. Contact Kylie Ethridge, ODA Membership Director, at kethridge@okda.org or 800.876.8890 to provide the ODA with all of your current contact information.
Infant Oral Health Program at OUCOD
2 9 Infant Oral Health Program Introduced at OUCOD 30 OUCOD Annual Awards 31 OU ASDA Officers and Award Winners 31 Welcome New ODA Members
CLASSIFIEDS 33 ODA Classified Listings
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ODA JOURNAL STAFF EDITOR Phoebe Vaughan,DDS ASSOCIATE EDITOR Frank J. Miranda, DDS EDITORIAL BOARD MEMBERS M. Edmund Braly, DDS Mary Hamburg, DDS, MS Somer Heim, DDS Daryn Lu, DDS Mary Martin, DDS EXECUTIVE DIRECTOR F. Lynn Means DIRECTOR OF COMMUNICATIONS & EDUCATION Tina Evans MEMBER COMMUNICATIONS MANAGER Madison Huffines OFFICERS 2018-2019 PRESIDENT Shannon Griffin, DMD president@okda.org PRESIDENT-ELECT Daniel Wilguess, DDS presidentelect@okda.org VICE PRESIDENT Paul Mullasseril, DDS vicepresident@okda.org SECRETARY/TREASURER Robert Herman, DDS treasurer@okda.org SPEAKER OF THE HOUSE Doug Auld, DDS speaker@okda.org IMMEDIATE PAST PRESIDENT Juan Lopez, DDS pastpresident@okda.org ADMINISTRATIVE STAFF EXECUTIVE DIRECTOR F. Lynn Means DIRECTOR OF GOVERNANCE & FINANCE Shelly Frantz DIRECTOR OF COMMUNICATIONS & EDUCATION Tina Evans DIRECTOR OF MEMBERSHIP Kylie Ethridge OPERATIONS MANAGER Cerissa Frazier MEMBER COMMUNICATIONS MANAGER Madison Huffines SPECIAL PROJECTS MANAGER Abby Sholar
Stay connected with the ODA!
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journal | July/August 2018
CALENDAR OF EVENTS Visit the ODA’s online calendar at OKDA.ORG for all upcoming meetings and events. July 4-5 ODA Building Closed
September 3 ODA Building Closed
July 13 ODA Investments Committee 1:00 p.m. - 1:30 p.m. ODA Building
September 7 OkMOM Steering Committee 8:00 a.m. - 9:30 a.m. ODA Building
ODA Board of Trustees 1:30 p.m. - 4:30 p.m. ODA Building
Annual Meeting Planning Committee 10:00 a.m. - 11:00 a.m. ODA Building
July 20 ODA Council on Governmental Affairs 9:00 a.m. - 11:00 a.m. ODA Building
Tulsa County New Dentist Party 7:00 p.m. - 9:00 p.m. At the Home of Drs. Ben and Eugenia Johnson
ODA Annual Meeting Vision Committee 11:00 a.m. - 12:30 p.m. ODA Building
September 11 Tulsa County Dental Society Meeting 5:30 p.m. - 8:00 p.m. Ti Amo Ristorante
ODA Council on Membership and Membership Services 1:00 p.m. - 3:00 p.m. ODA Building
September 13 ODA Progressive Office Tour Oklahoma City
August 3 ODA Council on Dental Care 1:00 p.m. - 2:30 p.m. ODA Building August 21 ODA Student Fall Festival 5:30 p.m. - 7:00 p.m. ODA Building August 23 Oklahoma County New Dentist Party 6:00 p.m. - 8:30 p.m. At the Home of Dr. Edward Harroz III August 24 South Central States Meeting 1:00 p.m. - 5:00 p.m. Grapevine, TX August 25-26 ADA District 12 Pre-Caucus Grapevine, TX
September 14 Oklahoma Dental Foundation Board Meeting 1:30 p.m. - 3:30 p.m. ODA Building Southwest District Dental Society Meeting Yukon September 15 DENPAC Wine Tasting 6:00 p.m. - 10:00 p.m. At the Home of Dr. Robert Herman, Tulsa See page 22 September 21 ODA Risk Management Seminar 8:30 a.m. - 12:00 p.m. Sheraton Hotel, Downtown OKC See page 12 September 25 ODA Mentor Meet & Greet ODA Building September 28 Northwest District Dental Society CE & Meeting Enid
THANK YOU FOR RENEWING YOUR MEMBERSHIP!
If you're reading this issue of the ODA Journal, it means you've renewed your ODA, local society and ADA membership for 2018 - THANK YOU! Non-renewals have now been dropped from the Journal mailing list and have lost all membership benefits. We hope you'll agree that your membership in organized dentistry represents an investment in both your future and the future of your profession. Perhaps that's why close to 100% of all ODA members renew their membership, year after year. Working together, we can preserve the future of dentistry and ensure the highest level of the public's oral health. The Oklahoma Dental Association couldn't do it without you, the members. In 2018, and beyond, we sincerely pledge to do all we can to advance the art and science of dentistry while serving our member dentists. THANK YOU AGAIN FOR RENEWING!
Opportunities to Support Oklahoma Veterans in Need of Dental Care Most of us have friends or family members who have served our country through the military. In fact, there are many dental professionals in Oklahoma with current and previous military service and we are all grateful for how their sacrifice has secured our freedoms. Veterans' benefits are a small compensation for the men and women who have served our country. Although there are diverse benefits, dental care is NOT one of those benefits. Low-income, uninsured veterans do not receive dental benefits unless they have a 100% service-connected disability. D-DENT is dedicated to helping our veterans obtain access to dental care at no cost. This is done through raising funds allocated for veterans and hosting a Community Dental Clinic that provides free dental care through volunteer dentists. D-DENT raises funds for veteran dental care through its annual Veterans Golf Tournament. The 22nd annual golf event will be on Monday, August 20, 2018, at River Oaks Golf Club in Edmond, OK with a 9:00 a.m. shotgun start. Come participate in the fun and you may be a lucky winner of a new Lexus from Eskridge Lexus of Oklahoma City with a hole in one! D-DENT’s Community Dental Day is on Friday, November 9, 2018. D-DENT is now accepting volunteers who can provide fillings, extractions, prophies, SRP, and oral cancer exams to low-income, uninsured veterans in a central clinic setting. Come be a part of serving those who served us! For more information on either event, contact D-DENT at 405-424-8092 or visit www.d-dentok.org for more details.
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ODA GUEST EDITORIAL
Opportunities from the Past…and Future Raymond Cohlmia, DDS Dean, University of Oklahoma College of Dentistry
This year marks the end of an era of amazing accomplishments and the beginning of a future of new opportunities. June 30, 2018 marked the end of President David Boren’s 24-year tenure as the University of Oklahoma’s 13th president. During his reign, the University has excelled in just about every category and he has supported the College of Dentistry as an integral part of the University. As you may recall, our college was threatened with closure back in the late ‘80s; since then, we have continued to grow and become a leader in clinical dental education as one of the most well-respected programs in the nation. Nationwide, dental applications are down while ours are skyrocketing. Last year alone, we had over 1,600 applications for admittance! I recall a conversation with President Boren about seven years ago when we were about to embark on our new adventure in clinical dental care delivery here at the college. He said, “The dental school does not create graduates that are just a part of our university or state, the dental school creates those that become a large part of other people’s lives. To that end, the college will always be a part of this great university.” President Boren has been not only a strong supporter of OUCOD, but also an integral part of the lives of so many faculty, staff and students. From the bottom of our hearts, we say thank you! A new era for the university began on July 1 when James L. “Jim” Gallogly became
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journal | July/August 2018
OU’s 14th president. Coming from a different background than many of his predecessors, President Gallogly will bring with him new opportunities. We at the College of Dentistry look forward to working with him, especially with his established networks in the healthcare field. President Gallogly was integral in leadership at the famed MD Anderson Cancer Center in Houston, Texas. My initial conversations with him have been in the areas of networking relations with healthcare entities for opportunities with our college and to further strengthen our patient care and research missions. I am excited about these future opportunities. Today, the college continues to move forward at a strong pace despite unfortunately minimal state support. These last several years have been a challenge, yet we still continue to press forward to remain a strong clinical educational program. Further, we have made great progress with our goal of giving our graduates more “relevant” clinical experiences. As an example, the last graduating class (Class of 2017) had placed more digitally designed and milled restorations than the last many years of classes combined. Moreover, I am pleased to announce that we are bringing a 3D full-scope digital lab online that will have a broad array of 3D printing and scanning, and a host of integrated services. These new modalities will not only be taught and used here, but also made available to any that require
such services. We will be having an announcement and reception in the near future for you to come down to see this latest addition to our college. Our faculty practice will be moving out of the DCSB building in early 2019 to a nearby building on 10th Street purchased late last year by the Health Sciences Center campus. This relocation will allow us to begin plans for a new preclinical laboratory for our students. Additionally, our Capital Campaign is moving forward and hopes to gain the funds necessary to undertake our next clinic renovation, the 4th-floor Pediatric and Orthodontic clinic. In summary, our vision continues a focus on customer service, a global presence, sustainability, innovation, and nimbleness. Our everyday decisions in the education, research, and community integration fields are built on these five key values. To make our dreams a reality will require your continued support through the J. Dean Robertson Society or the Capital Campaign. This is critical for your college and ultimately for the future of our profession. A sincere thank-you for your continued support. As always, my door remains open and my phone readily available to hear from you. If you have the time and are in the neighborhood, please drop in. I would be so excited to personally show you the wonderful work our faculty and staff perform on a daily basis to ensure the future of our profession!
Get Your Member Badge! DO YOU HAVE THE 2018 ODA MEMBER BADGE ON YOUR WEBSITE? DOWNLOAD IT TODAY AT OKDA.ORG/MEMBERS-ONLY
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ODA PARTNERS COLUMN The ODA endorses companies that have been researched and proven to offer products and services that provide real savings. By being an ODA member, you’re automatically eligible for these savings. Below is information about our newest Partner. Learn about all of the Partners at www.okda.org/rewards-partners.
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ok Mission of Mercy FAQs In about seven months, the Oklahoma Dental Association and the Oklahoma Dental Foundation, together with the Delta Dental of Oklahoma Foundation, will host the 10th annual Oklahoma Mission of Mercy (OkMOM) in Oklahoma City, OK. Drs. Shannon Griffin and Chris Fagan are planning for the 2019 event along with the clinic leads. OkMOM 2019 will be a weekend dedicated to serving the uninsured and underinsured population in need of dental services. Online volunteer registration will open on October 15, 2018 at okmom.org. Please follow OkMOM on Facebook (@oklahomamissionofmercy) and Twitter (@OkDentalMission) for updates.
10th Annual
If you plan to volunteer for OkMOM, here are the answers to some of our most commonly asked questions. Where and when is the clinic being held? The Oklahoma Expo Hall at the Oklahoma Fairgrounds 3213 Wichita Walk Oklahoma City, OK 73107 Clinic Set-up: Thursday, January 31, 2019 Treatment Days: February 1 & 2, 2019 Clinic opens at 5:00 a.m. on treatment days. Will there be designated parking for OkMOM volunteers? Yes, free parking will be available at the Oklahoma Expo Hall on the Oklahoma Fairgounds property. Will snacks/meals be provided? We will have a hospitality room for your use during the event with complimentary food and drinks. What can OkMOM patients expect? Patients will complete a health information form first. Then they will be assessed in medical and dental triage, then receive treatment based on their most urgent needs, with the goal of eliminating pain and infection. Treatments can include cleanings, fillings, extractions, anterior root canals and limited partial dentures. I really want to volunteer, but I am unable to commit to both clinic days. May I volunteer for a half day? Yes! There are several shift options available. You can volunteer anywhere from one half-day shift, to the whole weekend and clinic set-up. Can I earn Continuing Education credit at OkMOM? Yes. Dentists can earn hour by hour up to 10 hours. Hygienists can earn hour by hour up to 5 hours. I have a dental license from another state. Can I still participate? Yes. An out-of-state dentist or hygienist can apply for a temporary license to work at the event. Out-of-state dentists and hygienists need to complete a Special Volunteer License form and send it to the Oklahoma Board of Dentistry to receive their temporary license. This form can be found at www.okmom.org/volunteers. 10 journal | July/August 2018
What should I bring to the event? • You can bring your own equipment to OkMOM; just be sure to clearly label it. However, since this is a MASH-style event where every chair is needed to be fully operational at all times, there is the possibility that another dentist could use the equipment temporarily while you are on a break. You are responsible for your equipment. • Otherwise, only bring necessities! We cannot store your items, so leave what you will not use during your volunteer hours in your car or at home. • Be sure to bring a smile and a good attitude! What should I wear to the event? All volunteers who register online are provided a t-shirt to wear while volunteering at the event. This helps identify who’s working and in which positions. Volunteers who register on-site are not guaranteed a t-shirt. Disposable gowns will be provided for dental volunteers for infection control purposes. Scrubs, sweatpants, jeans and casual (comfortable) closed-toe shoes are recommended. Can my assistant be assigned to me during the event? Simply make note of your preference on the volunteer registration form. We cannot guarantee volunteer placement, but we will do our best to accommodate your request. Your assistants must register individually. Dentists who are not paired with their own assistant will be provided an assistant. Are chairside stools provided for dentists and assistants? One chairside stool will be provided for each dental chair. It is intended for the dentists to use during treatment. Assistants who want a chairside stool should bring their own, clearly labeled with their name. Can dental students or hygiene students treat patients? OkMOM is a great learning opportunity, and we encourage students to volunteer in multiple types of shifts. However, only fourth-year dental students are allowed to volunteer in a dentist role, under supervision by a licensed dentist.
Other than dental professionals, will you need additional volunteers? Of course! There are many areas where we need help, such as... -Food Service -Patient Exit Interviewers -Patient Hospitality -X-ray Technicians -Patient Registrars -Waste Management -Lab Technicians -Dental Equipment Maintenance -Patient Runners -EMTs Can I bring volunteers who are minors? To ensure everyone’s safety, volunteers must be at least 18 years old. However, 16 and 17 year-olds may volunteer with permission from a parent or guardian. The permission form can be found at www.okmom.org/volunteers. What should I tell individuals interested in obtaining care at OkMOM? Patients will be seen on a first-come, first-served basis. Cleanings, fillings, extractions and some replacement teeth will be offered. Because of the expected volume, it is likely we will have to turn people away, so those who want to receive treatment are encouraged to take advantage of our overnight waiting option. Patients who are in pain often have an accompanying infection. OkMOM does not want anyone to wait until the event to seek critical dental or medical attention, as a delay could lead to more serious consequences. And, while the hope is to be able to treat close to 2,000 patients, there’s still a risk volunteers won’t be able to see everyone waiting in line for care. Every attempt will be made to care for those who are present. If I can’t volunteer at the event, is there another way I can help OkMOM? Absolutely! A project of this size requires a substantial budget to cover clinic expenses (equipment and facility rentals, supplies, pharmaceuticals, food costs, etc.). Consider donating money or in-kind products or services. Your contribution will make a difference in treating over a thousand patients. Monetary donations may be made at www.okmom.org/donate. In-kind products and services may be made by contacting Abby Sholar at asholar@okda.org.
C okmom mom C OK ok oklahoma city February 1 & 2, 2019 : OKC Fairgrounds
Join us as the Mission meets in okc for our
10th annual event #OkMOMOKC OkMOM Updates: okmom.org
Y X a www.okda.org
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ODA Members in the News
Dr. Colin Holman removed seven infected teeth in Sumatran orangutan Dr. Kathy Henry Spotlighted in TulsaPeople Check out page 24 of the June issue of TulsaPeople for a highlight on Dr. Henry's volunteer leadership with the Oklahoma Mission of Mercy.
Toba, a 50-year-old orangutan at the OKC Zoo, had severe dental disease, including a bacterial infection in her jaw. Colin Holman was brought in to consult and assist in her treatment. Read more at www.okczoo.org/blog.
Find a digital copy of the issue at https://issuu.com/tulsapeople.
oklahoma dental association
RISK MANAGEMENT Friday, september 21 8:30 a.m. - 12:00 p.m. Sheraton Hotel - Downtown OKC register: okda.org/education odA Member Dentists: $89 Registration fee 12 journal | July/August 2018
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ODA MARKETING COACH
Protect Your Profits by Retaining Your Patients
So some of your patients have had lessthan-ideal experiences at your practice. Do you accept losing those patients to your competition? You shouldn’t. Retaining your patients is cheaper - yes, cheaper - and more profitable for your practice than acquiring new ones. It can be easy to retain your customers when you start from within the office. You should also consider rewarding your loyal patients who have sent other patients your way. Eighty percent of “switchers” feel the business could have done something to retain them Your staff may be fearful to alert you when a patient had an unsettling experience, but step 1 is to change that perception. If they don’t tell you, then you can’t solve the problem right away. Many patients would appreciate you personally sitting with them so they can talk about why the experience didn’t work for them. Then, you can solve the issue either immediately or have them return and ensure that they get the proper service the second time around.
This one-on-one experience could prevent them from giving your practice a bad review on Yelp or Google. In fact, it may persuade them to give you a positive review, or tell their friends and family about how happy they were with how their visit was handled. Fifty-two percent of consumers have switched providers in the past year due to poor customer service This stat may even tie back to the first one. It’s important that you and your staff are on the same page on how to keep your patients happy. You may not always be available to handle every possible situation, so give your staff some freedom on when to bend the rules and for whom. Oftentimes when your staff is empowered to handle certain, less sensitive circumstances on their own, they don’t need to alert you, and the situations may not escalate to something that does require your involvement. Seventy-five percent of consumers say they favor companies that offer rewards The simplest rewards make patients
happy. All they are really looking for is acknowledgement for their loyalty and referrals. Here are some ideas: Loyalty Program: • Get your teeth cleaned twice a year for two consecutive years and receive a free teeth whitening. Referral Program: • Invite a family member to visit our practice and receive 10% off your next visit. Retaining your patients is all about keeping them engaged in different and rewarding ways. Although it may seem time-consuming, there are digital tools that automate the promotion of loyalty programs and office promotions. For tools that can help you with automation, please visit go.demandforce.com/OklahomaDental.
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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 which you’re looking, we’re there every step of the way.
Plan Your Practice
The ODA has added a new member benefit to the members-only website: “Plan Your Practice.” It focuses on practice transition for both those who are seeking new professional opportunities and for those on the other end of the spectrum who are seeking to grow or sell their practice. This page is a one-stopshop for dentists at every stage of their career and provides a wealth of resources presented by local industry experts, ADA, ODA, and the Board of Dentistry.
16 journal | July/August 2018
The “Plan Your Practice” webpage features a webinar series of “fast facts” on the transitioning to or from private practice. These five-minute videos deliver the fast facts from the banking, healthcare realty, insurance, and supplier industries, with the opportunity to seek further resources from those experts. In addition to resources and the webinar series, we have also created a “Find Your Match” webform that aims to “match” members with other members whose professional needs meet theirs. Based on the success of our annual Match@ODA program, this webform allows you to submit what you are looking for, with the hope that another member is looking for the same thing.
Simply complete the webform and once we have a “match” to your submission, you will be connected to the fellow professional whose needs match yours! Whether you are a new graduate looking for an associateship, or an established professional looking to expand your practice, we want to provide the connections you need to make your practice and career successful. Connections and employment resources are one of the many reasons organized dentistry exists - let us help you get the “fast facts” or “meet your match” today!
Meet the ODA Operations Manager Cerissa Frazier Cerissa is an Oklahoma native who grew up in NW Oklahoma City. As the ODA Operations Manager, she will manage the ODA Rewards Partner Endorsement Program and the Mediation Review Program. She coordinates the annual Dentist Day at the Capitol event along with managing all of the building/grounds services contracts. Additionally, she will provide staff support to the Council on Governmental Affairs and DENPAC, as well as manage the Exhibit Hall during the ODA Annual Meeting. "I’m really looking forward to helping plan and execute the ODA Annual Meeting and the Oklahoma Mission of Mercy (OkMOM)." Prior to joining the ODA team, Cerissa worked as the Office Administrator for the Oklahoma Dental Foundation. The majority of her professional experience has been in project management and retail management. Where is your favorite place to eat in Oklahoma? My mama’s dining room table! What is your favorite quote? “A man who stands for nothing will fall for anything.” – Malcolm X “When sleeping women wake, mountains move.” – Chinese proverb What book are you currently reading? The Serial Killer’s Daughter by Lesley Welsh Contact Cerissa Frazier at cfrazier@okda.org or 405.848.8873
What would your ideal vacation look like? I would love to go somewhere warm by the beach or stay in a cabin in the mountains for two or three days. What is the best concert you have ever attended? Ledisi, Winter 2016
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LEGISLATIVE LOOP
2017-18 Legislative Session Summary
Legislative Overview & Political Update
By Scott Adkins, ODA Contract Lobbyist scottadkinsconsulting@valornet.com
After nearly 16 consecutive (and contentious) months of legislative sessions, the 2018 regular session ended on May 3, a full three weeks before the Constitutional deadline, when the Legislature adjourned sine die. The last year and a half included two regular legislative sessions, two special sessions, numerous attempts to raise revenue for education and healthcare programs, the largest teacher protest in recent memory, and at least 25 legislators choosing not to seek reelection. The second session of the 56th Oklahoma Legislature began in February with the failure of House Bill 1033XX, a package of revenue and reform ideas offered by the Step Up Oklahoma Coalition. The bill – which would have raised $581 million in recurring state revenue and paid for a $5,000 teacher pay raise – included a $1.50 per pack tax increase on cigarettes, a six cents per gallon tax increase on both gasoline and diesel fuel, an increase in the gross production tax (GPT) on oil and gas production from two percent to four percent on all wells, a $1.00 per megawatt hour tax on the production of electricity by commercial wind turbines or other zeroemission facilities, and additional taxes on little cigars, chewing tobacco, smokeless tobacco and snuff. The failure of that bill, which would have provided sustainable revenue for healthcare programs and a teacher pay raise, led to a massive teacher walkout and protest at the state Capitol. The threat of the walkout was likely the impetus for lawmakers – after more than a year of discussing and voting on various revenue raising measures – to finally agree to a revenue package to provide recurring revenue to the state. In April, the Legislature finally crossed the three-fourths majority requirement 18 journal | July/August 2018
to raise revenue, a threshold that had proven impossible to overcome during the previous year. House Bill 1010XX was the first bill since voters passed State Question 640 in 1992 to achieve the 75 percent approval threshold, as required by the state Constitution. The bill raised more than $450 million by placing a $1.00 per pack tax on cigarettes and a similar tax on little cigars, increasing the tax on gasoline by three cents per gallon and the tax on diesel fuel by six cents per gallon, placing a $5.00 per night lodging tax on the rental of hotel and motel rooms, and increasing the gross production tax (GPT) on all wells from two percent to five percent. The House later repealed the hotel and motel tax after the Senate announced they couldn’t pass the revenue package with the lodging tax in the bill. The Legislature also passed a separate measure (House Bill 1011XX), which raised an additional $84 million by capping itemized deductions at $17,000 for state income tax filers. The bill exempts charitable donations and medical expenses from the cap. The revenue generated from those measures was used to provide teachers a $6,100 pay raise and an additional $480 million for K-12 public education for FY 2019. In addition, the Legislature provided pay raises for state employees and school support personnel. Despite these efforts, teachers walked out as planned in early April and protested for three weeks at the Capitol for additional school funding. The walkout was the largest and longest demonstration at the Capitol in recent memory, with more than 30,000 teachers each day on the Capitol grounds. The walkout ended when both the governor and the Senate leadership made it clear they
were not raising any additional revenue for schools this session. When the session was all said and done, the Legislature passed a $7.6 billion appropriated budget for FY 2019, a 10.9 percent increase over the 2018 budget. The additional $745 million in this year’s budget will help fund the largest teacher pay raises and common education budget in history and provide an increase to every state agency over last year’s appropriated budget. The Legislature is also on track to deposit more than $300 million into the state’s Rainy Day Fund at the end of June. The additional money for this year’s budget and the Rainy Day Fund was the result of growth revenue from an improved economy and revenue raised during the last 16 months. While revenue-raising efforts and the teacher walkout dominated the headlines, the Legislature was also able to pass several notable policy bills this session. Governor Mary Fallin has signed the following bills into law. Education As usual, education funding and policies were the primary topic of discussion at the Capitol this year. The FY 2019 budget includes a 19.8 percent increase for common education. The $2.9 billion K-12 education budget – the largest appropriation for common education in history – includes $353 million to fund pay raises averaging $6,100 per teacher, $52 million for support personnel pay raises, $24 million for flex benefits and an additional $50 million for the classrooms, which includes $33 million for textbooks.
The Legislature also provided an additional $7.5 million to higher education to fund concurrent enrollment options, which allows juniors and seniors the opportunity to earn college credit while still in high school, and passed Senate Bill 1196, which allows eligible high school students to participate in any concurrent enrollment program regardless of location in the state. Other notable education bills include: Senate Joint Resolution 70 lets citizens vote to allow local school boards flexibility to spend building funds for other purposes. Senate Joint Resolution 72 lets citizens vote to adopt the computer science academic standards for K-12 schools. Senate Bill 929 changes various definitions associated with weighted points assigned
K
elements of the U.S. naturalization test in state standards on civics.
Senate Bill 980 creates a tiered certification program for teachers to include initial, career, mentor and leadership certifications.
Occupational Licensing Senate Bill 1475 creates the Occupational Licensing Advisory Commission to review each occupational or professional licensing law every four years and to make recommendations to the Legislature.
House Bill 3220 authorizes the State Board of Career and Technology Education to develop a certification system for teachers and instructors who teach in technology center school districts. Senate Bill 1198 reauthorizes the Public School Classroom Support Revolving Fund income tax checkoff. Senate Bill 1604 provides a pay raise for teachers and support staff in the Career Tech system. House Bill 3311 requires inclusion of
House Bill 2933 directs an administrative body or official with authority over occupational licensing or certification to grant a one-year waiver of fees associated with licensure or certification to a lowincome applicant. House Bill 2772 changes current law to have the Oklahoma Board of Cosmetology and Barbering certify, rather than license, hair-braiding technicians. Continued on next page
WE DON’T FUNDRAISE. WE FRIENDRAISE!
CAPITOL CLUB Dr. Jeffrey Ahlert Dr. Errol Allison Dr. Jim Ambrose Dr. Michael Auld Dr. Douglas Auld Dr. Tamara Berg Dr. Elizabeth Bohanon Dr. Ryan Brackett Dr. M Edmund Braly Dr. George Bridges Dr. Matthew Bridges Dr. C Todd Bridges Dr. Nathan Brown Dr. Steven Brown Dr. Patricia Cannon Dr. Wuse Cara Dr. J Andrew Carletti Dr. Bobby Carmen Dr. Chasity Carper
to students with learning disabilities in the state school funding formula.
THANK YOU TO THESE 2018 DENPAC CAPITOL CLUB MEMBERS!
Dr. Jason Carper Dr. Mary Casey-Kelly Dr. Adam Cohlmia Dr. Jeff Cohlmia Dr. Raymond Cohlmia Dr. Matthew Cohlmia Dr. Debbie Corwin Dr. James Corwin Dr. Russell Danner Dr. Susan Davis Dr. David Deason Dr. Steven Deaton Dr. William Deprater Dr. Brian Drew Dr. Heath Evans Dr. Christopher Fagan Dr. Timothy Fagan Dr. Barry Farmer Dr. Michael Gliddon
Dr. Matthew Gray Dr. Shannon Griffin Dr. Clark Grilliot Dr. Mark Hanstein Dr. Leslie Hardy Dr. Aaron Harman Dr. Edward Harroz Dr. Richard Haught Dr. Christina Henry Dr. Robert Herman Dr. Jeffrey Hermen Dr. James Hooper Dr. Brad Hoopes Dr. Moiz Horani Dr. Donald Johnson Dr. Eugenia Johnson Dr. Katherine Johnson Dr. Krista Jones Dr. Thomas Kierl
Dr. Jandra Korb Dr. Robert Lamb Dr. Shannon Lewis Dr. Eric Loper Dr. Juan Lopez Dr. Gary Lott Dr. Jeff Lunday Dr. David Marks Dr. Alan Mauldin Dr. Stephen Mayer Dr. Janna McIntosh Dr. Glenn Mead Dr. Mohsen Moosavi Dr. Paul Mullasseril Dr. Samuel Owens Dr. Karen Reed Dr. Erin Roberts-Svob Dr. Brant Rouse Dr. Miranda Ruleford
Dr. Kyle Serfoss Dr. David Simon Dr. Floyd Simon Dr. Lindsay Smith Dr. Julie Speights Dr. James Strand Dr. Jackson Sullivan Dr. Joe Swink Dr. Jim Taylor Dr. Kara Tims Dr. James Torchia Dr. Vic Trammell Dr. W Scott Waugh Dr. Robert Webb Dr. Susan Whiteneck Dr. Daniel Wilguess Dr. C Rieger Wood Dr. John Wood Dr. William Yadon
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. www.okda.org 19
Criminal Justice Reform After several criminal justice reform efforts stalled in the Legislature last year, lawmakers modified several of those bills and passed them during the recent legislative session. The governor also signed Senate Bill 1590 authorizing the Oklahoma Capitol Improvement Authority to issue up to $116.5 million in bonds to finance the maintenance, repairs, equipment and improvements of existing Department of Corrections (DOC) facilities. Criminal justice reform measures include the following: House Bill 2281 adjusts penalties for numerous low-level property offenses, including larceny, forgery and other “paper crimes.� The threshold for a felony conviction for those crimes now matches the threshold set in House Bill 2751, which passed in 2016. House Bill 2281 creates a tiered penalty structure for property offenses by value. Senate Bill 649 reduces enhanced sentences for certain repeat nonviolent offenders and prohibits the use of previous convictions for possession of controlled substances to enhance sentences for subsequent convictions. Senate Bill 650 authorizes offenders with no more than one nonviolent felony to apply for expungement if they have no new convictions or pending charges within the last seven years. Senate Bill 689 allows offenders who have been sentenced to life without parole for a nonviolent crime to seek a sentence modification after serving ten years of their sentence, and it requires intervention programming on certain domestic violence convictions. Senate Bill 786 eliminates mandatory minimum sentencing and allows a judge to sentence up to the current maximum sentence of seven years in prison for burglary in the second degree. The bill also creates a new felony offense known as burglary in the third degree. Senate Bill 793 changes the penalties for commercial drug offenses and distinguishes conduct by possession with intent to distribute, distribution, and manufacturing and trafficking. 20 journal | July/August 2018
Senate Bill 1203 caps the costs and fine at $100 for a speeding violation between 1-10 mph over the limit. The Legislature also passed Senate Bill 1221 that would create a framework for Oklahoma to comply with U.S. Supreme Court rulings on imposing life without parole sentences for juvenile offenders. The Supreme Court has ruled that mandatory life without parole sentences for juveniles is unconstitutional and that states are required to consider the unique circumstances of each juvenile defendant in determining sentences. A life without parole sentence is not unconstitutional per se, but it should be reserved for those instances where the court determines a juvenile cannot be rehabilitated. Authored by state Sen. Anthony Sykes and state Rep. Josh West, Senate Bill 1221 would remove jurors from the sentencing phase for a juvenile defendant and allow only judges to decide whether a juvenile should be sentenced to life in prison without the possibility of parole. The judge would be required to take into account the immaturity and failure to appreciate risks and consequences associated with being young. The bill is awaiting action by the governor. Healthcare The Legislature passed two notable Medicaid reform measures this session. House Bill 2932 requires able-bodied adults to work, look for work or volunteer at least 20 hours each week in order to receive SoonerCare benefits. The bill exempts those under the age of 19, over the age of 60, pregnant, disabled or who are the parents of someone below the age of one year. House Bill 1270 requires the Oklahoma Health Care Authority (OHCA) to contract with an independent vendor to verify eligibility prior to awarding assistance. Opioids Epidemic An increase in deaths due to opioids during the last several years spurred lawmakers to restrict access to addictive prescriptions. Senate Bill 1446 requires doctors and chronic-pain patients to enter into a treatment agreement. The bill requires that a patient be staged through a limited initial prescription, a limited second prescription, and then be formally advised that continued opioid use can
result in addiction. The bill limits initial prescriptions for opioids to a seven-day supply and prohibits a second seven-day supply from being prescribed for at least seven days. Senate Bill 937 includes tribal governments on the list of entities that can be investigated by the Oklahoma State Bureau of Narcotics. House Bill 2795 directs medical facility owners that prescribe opioids to patients on a monthly basis to register annually with the Oklahoma Bureau of Narcotics and Dangerous Drugs Control. House Bill 2798 creates the Opioid Overdose Fatality Review Board. House Bill 2931 requires the use of electronic prescribing for all scheduled drugs. Government Modernization The Legislature appropriated $2 million to fund agency audits by the Agency Performance and Accountability Commission (APAC) that was created last session. Senate Joint Resolution 66 calls for a vote of the people to have the governor and lieutenant governor run for election on a joint ticket. House Bill 3036 authorizes the governor to appoint the health commissioner and makes the Board of Health advisory. House Bill 3603 authorizes the governor to appoint the executive director of the Tourism and Recreation Department and makes the tourism commission an advisory board. It has been a hectic year and a half at the state Capitol, and the work may not be done. Lawmakers may be back in special session later this summer if State Question 788, which would legalize the use of medical marijuana, passes on the June 26 ballot. Lawmakers would need to convene in order to create a regulatory framework to allow for implementation of the law. Of course, we will continue to keep you updated over the interim as elections and interim studies take place.
ADA Advocacy News ADA President Testifies Before House Appropriations Subcommittee ADA President Joseph P. Crowley recently testified before the House Appropriations Interior, Environment and Related Agencies Subcommittee about the oral health issues that affect American Indians and Alaska Natives. During his testimony, Dr. Crowley emphasized that the most critical account in the Administration's FY2019 Indian Health Service (IHS) dental program budget is for clinical services. The funding is critical to provide direct dental services including emergency, preventive and complex restorative care. For fiscal year 2019, the ADA requested $199 million for the IHS Division of Oral Health. The current proposed increase of $1.7 million is an unrealistic request to accomplish all that is still needed to help overcome oral disease as seen in these communities. Dr. Crowley also stated that in 2017 the IHS dental program provided over three million basic dental services in 404 dental programs in 35 states. The Administration's current request would be less than a dollar per visit. The ADA recommends that the IHS dental clinical services line be increased by at least $3 million since more still needs to be done to overcome the disparity of oral disease in tribal communities. The ADA thanked the committee for efforts thus far that have helped the IHS make progress on developing a centralized credentialing system. This will streamline the credentialing process and help fill dental vacancies with quality healthcare professionals in a timely, efficient manner. The ADA also encourages the IHS to develop procedures in order to centralize privileging across service units for volunteer healthcare providers.
ADA Supports Opioid Bills in the House As part of ongoing efforts to combat opioid misuse and ensure safer prescribing practices, the American Dental Association is supporting multiple bills in Congress. In advance of the House markup of legislation, ADA President Joseph P. Crowley and Executive Director Kathleen T. O'Loughlin sent letters to the House Ways and Means Committee Chair Kevin Brady (R-TX) and Ranking Member Richard Neal (D-MA) and to the House Energy and Commerce Chair Greg Walden (R-OR) and Ranking Member Frank Pallone (D-NJ) about the support for several bills focused on alleviating the opioid crisis. The legislative proposals include numerous provisions which would complement the ADA's ongoing efforts to keep prescription opioid pain medications from becoming a source of harm in our communities. Drs. Crowley and O'Loughlin also noted the federal response to the opioid crisis "still needs to distinguish pain management in dentistry from pain management in medicine," specifically when it comes to managing acute pain versus chronic pain.
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 open 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 2018 DENPAC GRAND ($1,000) LEVEL MEMBERS! Dr. Robert Herman
Dr. Paul Mullasseril
Dr. Mark Hanstein
Dr. Krista Jones
Dr. Lindsay Smith
Dr. Richard Haught
Dr. Juan Lopez
Dr. Douglas Auld
Dr. Matthew Cohlmia Dr. Shannon Griffin
Dr. Edmund Braly
Dr. Susan Davis
Dr. Todd Bridges
Dr. Michael Gliddon
www.okda.org
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Action for Dental Health Bill The U.S. Senate on June 6 introduced the Action for Dental Health bill, legislation aimed at improving oral health and access to oral health care. Sen. Cory Booker, D-N.J., along with Sens. Bill Cassidy, R-La., Mazie Hirono, D-Ohio, and Tim Scott, R-S.C., introduced the bill. The Action for Dental Health was introduced in 2017 by Rep. Robin Kelly, D-Ill., and Rep. Mike Simpson, R-Idaho, and the House overwhelmingly passed the bill in February. With passage, the ADA hopes the legislation will lead to: •
Improving oral health education and dental disease prevention through community outreach and case management.
•
Reducing the use of emergency rooms for dental care.
•
Helping patients establish dental homes.
•
Reducing barriers, including language barriers and cultural barriers, to receiving care.
•
Facilitating dental care to nursing home residents.
For more information about the ADA's Action for Dental Health initiative, visit www.ADA.org.
WINE TAon theS evening T I NofG SEPTEMBER 15, 2018
IN THE HOME OF
DR. ROBERT & SAVE
the
KRISTA HERMAN
tulsa, ok
D A T E BENEFITING
DENPAC
22 journal | July/August 2018
“The ODA Mentorship Program is life-changing.”
“I was paired with an ODA member who I now practice with. I couldn’t have asked for a better mentor to guide me and look up to.” -Dr. Shak Feroz ODA Member and 2015 Mentorship program participant ODA Mentor Program Sign-Up Coming soon! Contact Madison Huffines at mhuffines@okda.org for information about the program.
ODA MEMBER SPOTLIGHT
Dr. Rachel Standlee & Dr. Lauren Nichols
Match@ODA
By Madison Huffines, ODA Member Communications Manager With more than 2,000 dentists in the state of Oklahoma, the thought of selling your practice or filling a position in your office can be overwhelming. On the other side of the fence are new dentists and students on the brink of graduation who are looking for their next professional opportunity. With the classifieds section of the ODA website constantly growing and the ever-present job search in the new dentist population, the ODA Council on Membership and Membership Services came up with a solution -- the annual Match@ODA event. Created by Kylie Ethridge, Membership and Membership Services Director, this event is just a few years old and continues to evolve to best suit ODA members and fourth-year dental students. “Each year the event may look slightly different than the year prior,” Ethridge said. “We look at what the membership population needs the most and try to shape the event around what will be most beneficial. We love to hear about the success stories that come from this event where employers and those seeking employment are able to find their perfect ‘match’.” ODA Members like Dr. Rachel Standlee and Dr. Lauren Nichols can personally attest to the benefits of the Match@ODA event after they met each other through the program. Standlee, who practices in Tulsa, was unable to attend the event in person but sent a flyer and paperwork detailing an available associateship position in her office. Nichols, a fourthyear student from the OU College of Dentistry at the time, was interested in positions in Tulsa. Standlee said, “Because I could not physically attend, my favorite part was having students reach out to me after they already knew the opportunity
details from the flyer. We could discuss details from that point forward. The Match Program gave us a stable place to find each other.” After receiving information about Dr. Standlee’s open position, Nichols began the process of interviewing and ultimately was the best fit for the job. “The Match Program facilitated conversation between my employer and me. I would not have been able to find my ‘match’ if I had not participated,” Nichols said. “I would advise all students to attend the event, even if they think they already know where they’re headed.” The beauty of the Match@ODA event is that even if you’re unable to attend you can still make information about your opportunity available, and the ODA staff will work hard to ensure that those looking for opportunities like yours are given the appropriate information. The program also offers a confidential and secure environment in which you can share your opportunity should you decide to attend in person.
Dr. Rachel Standlee utilized the Match@ODA program and hired Dr. Lauren Nichols.
They discovered they graduated from the same high school and even grew up in the same neighborhood! Nichols has found a great support system in her new work home through shadowing Standlee and getting to know the patients. Standlee and her staff even sent flowers to Nichols during her licensure exam. The ODA is glad to have an event that can benefit long-time members, new dentists and dental students in one place. The next Match@ODA event will be Friday, February 8, 2019. If you have any questions or are interested in participating in this program, contact the ODA Membership Department at 800.876.8890 or membership@okda.org.
Nichols and Standlee have found that they are a great pair in more ways than just the day-to-day work in the office.
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ODA FEATURE
Community Dental Health Coordinator: A Valuable Asset to Your Dental Team By Tim Fagan, DDS, MS
Several alternative dental work force models have been proposed over the last few years as possible ways to help solve access to dental care problems. These dental positions include expanded-duty dental hygienists and/or assistants, dental therapists, and community dental health coordinators (CDHCs), with the latter two having received most of the attention recently. The purpose of this article is to provide current information on the status of dental therapists and CDHCs. Dental Therapists Currently, only Alaska and Minnesota have practicing dental therapists delivering dental care to patients. In contrast, there are CDHCs either in the educational process or actively working in over 30 states. Many of them are also professionally trained dental assistants or hygienists. Vermont and Maine have passed legislation authorizing dental therapists to perform dental procedures after significant additional training with varying degrees of independent practice without supervision of a dentist. These two states also mandate that dental therapists treat a large population of underserved patients. Native American tribes in Washington and Oregon have employed dental therapists to help deal with access to care issues on their tribal lands. On May 16th of this year, Arizona became the seventh state to allow dental therapists to practice. Governor Doug Ducey signed HB 2235, which requires that a dental therapist be a licensed dental hygienist who has graduated from an accredited dental therapy program and has completed 1,000 hours of dental therapy clinical practice under the direct supervision of a dentist. 24 journal | July/August 2018
After facing years of pressure from groups that support dental therapists (especially well-funded organizations like the Pew Foundation and the Kellogg Foundation), both the Kansas and Massachusetts dental associations recently agreed to support legislation enabling dental therapists to practice in their states. (The Kansas bill failed to pass.) In fact, dental therapy legislation was introduced in over 20 state legislatures this year alone. Although dental therapy is gaining traction in some states, there are published articles that dispute the effectiveness of therapists in solving access problems. Data from one study showed that the use of midlevel providers is not helping to stem the tide of the caries epidemic or reduce the population's need for these services.1 Concerning the impact of dental therapists on Minnesota’s Medicaid population since the legislation recognizing therapists seven years ago, Arizona Dental Association President Robert Roda stated in a recent editorial: “Since that vote seven years ago, the percentage of Minnesota’s Medicaid children receiving any dental service has stubbornly remained around 41 percent. Adding almost 80 dental therapists didn’t budge the rate at all. Nor did it reduce dental costs.”2
A community dental health coordinator, by comparison, may be the ideal dental team member to help patients locate and secure the dental care they need from a dentist. Many dentists are opposed to dental care being delivered by anyone outside of that care being directly supervised by a licensed dentist. Others have stated that everyone deserves care by a dentist; those patients who for whatever reason cannot
access dental care should not be relegated to receiving dental care from someone with less training and expertise than a licensed dentist. Still others state that dental therapists are not adequately trained to provide dental treatment to an adult population.3 Community Dental Health Coordinators A community dental health coordinator, by comparison, may be the ideal dental team member to help patients locate and secure the dental care they need from a dentist. According to the American Dental Association, CDHCs are community health workers with dental knowledge and skills who focus on dental case management, assisting patients as they navigate through the complexities of coverage in the healthcare system, oral health education and promotion, disease prevention, motivational interviewing, and overcoming language and cultural barriers. Their expertise links patients to available but underutilized dental care whether it be in a private dental practice or a community healthcare center. According to Bray and Herman, the ultimate goal of a CDHC is to connect patients to a dental home.4 The CDHC can perform clinical preventive services and community-based outreach functions. In addition to oral health promotion and disease prevention, they can interact directly with populations that are at risk for dental disease but are unsure of how to access a dental program. They operate within a State Dental Practice Act. For many families, knowing which dental services are needed, how to schedule appointments, and how to access the necessary transportation to get to appointments is critical. By acting as a “dental social worker” the CDHC can help with those issues. In addition, the CDHC can help manage behaviors frequently associated with dental treatment, such as fear and anxiety. By carefully explaining how dental disease starts and the various
Currently there are four CDT codes that may someday allow a dental office to be reimbursed by dental insurance for CDHCperformed activities: D9991 -- dental case management addressing appointment compliance barriers; D9992 -- dental case management care coordination; D9993 -- dental case management motivational interviewing; and D9994 -- dental case management patient education to improve oral health literacy. ++(This code includes translation services). These codes, currently reimbursed in the medical world, can be tracked to serve as a resource for a dental office to utilize in a state Medicaid pilot project to show how their value can be applied to oral health services. ways to prevent and treat it, parents gain an understanding of their important role in safeguarding their children’s oral health. As allowed by their state’s dental act, a CDHC may perform certain services such as sealant and topical fluoride applications under the supervision of a dentist. They might provide individual preventive services such as oral hygiene instructions, tobacco cessation, and dietary counseling. CDHCs encourage regular oral health services for special populations such as pregnant women, teething infants, diabetics and the elderly. Optimal oral health throughout life helps build healthy populations and results in cost savings within the overall health home as patients have fewer adverse outcomes. CDHCs are typically recruited from the same communities in which they will serve, often the actual communities in which they grew up. This all but eliminates cultural, language and other barriers that might otherwise reduce their effectiveness. Their connections to their communities help establish trust and make them excellent role models. By focusing on oral health education and disease prevention, the CDHC can empower people in underserved communities to manage their own oral
health. When disease requires treatment, the CDHC can link patients with dentists who can provide that treatment. They can also help obtain other services (child care, insurance enrollment, transportation, etc.) that patients may need in order to receive care. CDHCs can reduce the number of broken dental appointments by educating patients on the importance of oral health care and being able to secure dental access in a timely manner (thus increasing continuity of care). Community presentations by CDHCs may increase the number of new patients to a dentist by raising awareness of the dentist’s practice and the availability of care. CDHCs can become a practice’s “face” in the community via interactions with prospective patients, medical providers, state agencies, school groups, the business community, legislators and the media. For example, a CDHC can meet area pediatricians and their office staff to discuss the current ADA recommendations regarding the “Age 1” dental visit. Dental offices can then become the dental home for the referrals that will follow from the pediatrician’s office.3 As they partake in such activities, CDHCs can enhance the reputation and familiarity of a dental practice within the community.
In summary, by helping patients in need to identify and eliminate obstacles to dental care, CDHCs help put patients into the treatment chairs of dentists. The CDHC is a valuable member of the dental team and can greatly facilitate the process of helping patients get the very best dental care. Acknowledgement The author gratefully acknowledges Jane Grover DDS, MPH, Director, ADA Council on Advocacy for Access and Prevention, for her feedback and review of this manuscript. References 1. Wright JT: Do midlevel providers improve the population's oral health? JADA 144: 92–94, 2013. 2. Roda RS: State’s failed dental therapy experiment. ADA News 4-5, 4-16-2018 3. Nash DA, et al: The dental therapist movement in the United States: A critique of current trends. J Public Health Dent. 9-12-2017. 4. Bray B and Herman R: CDHC: The new team member that will grow all practices. SDDS Bulletin 35:6-8, 2018. Dr. Tim Fagan served as 2013-14 president of the Oklahoma Dental Association. He is the current District 12 Representative and Chair of the American Dental Association’s Council on Advocacy for Access and Prevention.
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The Use of Air Polishing Devices by Oklahoma Dental Hygienists By Aubrey Mouser, RDH, BSDH and Carolyn Hinckle, RDH, M.Ed 2018 Ishmael Award Winner INTRODUCTION According to the Centers for Disease Control and Prevention (CDC), half of all Americans aged 30 and over have periodontal disease.1 Pathogenic bacteria co-existing in oral biofilm is the primary etiology of periodontal disease. Dental professionals, especially dental hygienists, endeavor to promote those professional and patient interventions that mechanically remove biofilm. Hand or powered instrumentation routinely used for debridement is effective; however, this approach is technique-sensitive and requires diligence to successfully dismantle the organized and structured biofilm communities on tooth surfaces. Even when performed by a well-trained hygienist, patients often perceive debridement as an uncomfortable experience which has a negative impact on patient compliance.2 Dental hygienists have traditionally used air polishing devices as adjunctive aids to conveniently and effectively dislodge supragingival biofilm. Recent studies have evaluated the microbiologic effects, patient perceptions, and safety of air polishing devices as an aid to hand or powered instrumentation. Air polishers have been shown to adequately remove supragingival biofilm in three-millimeter pockets with the use of pressurized air, water, and particles of various abrasives. The most commonly used abrasive agent to remove stain and biofilm on enamel surfaces in shallow pockets is sodium bicarbonate.3 The handpiece nozzle is aimed toward the tooth at a distance of three to four millimeters. Maintaining the correct angulations of 60 degrees on anteriors, 80 degrees on posteriors, and 90 degrees on occlusal enamel surfaces is critical to prevent trauma of surrounding tissues.4 Although biofilm and stain removal with sodium bicarbonate powder causes minimal damage to sound enamel, adverse effects have been reported. Abrasive powders can damage cementum and dentin; hence, the use of sodium bicarbonate on exposed root structures is contraindicated.2,4 With 26 journal | July/August 2018
an increasing focus on effective biofilm management and patient compliance to dental recall visits, dental hygienists strive to determine professional intervention that results in both. Recent studies indicate greater patient support of air polishing as a favored treatment choice compared to regular hand instrumentation because of less pain, no sense of pressure, and a generally friendlier approach.5 Additionally, thorough biofilm removal with air polishers is less time-consuming. The air polisher will adequately debride the enamel surface when used with a consistent “smiling” sweeping movement above the gingiva for approximately 5-10 seconds. However, aggressive hand instrumentation and oscillating scalers are still needed for calculus removal on root surfaces because of the low abrasive properties.6 Historically, dental hygienists have addressed subgingival biofilm removal primarily with hand and powered instrumentation, although subgingival use of air polishers has been proposed for a decade. Air polishers successfully remove subgingival biofilm in periodontal pockets greater than four millimeters with a specific, pliable nozzle used with a low-abrasive glycine powder. The disposable nozzle is inserted at the base of the pocket parallel to root surfaces and applied coronally for 5-10 seconds.2,6 A clinical trial conducted by Flemmig7 suggested that air polishing with glycine powder removed subgingival biofilm more effectively than conventional therapy. The specialized instrument tip mechanically disperses air, water, and highly soluble glycine powder to accomplish treatment and alter oral microbiota. Glycine is nearly four times smaller in particle size than sodium bicarbonate and 80% less abrasive on human teeth.8 Glycine’s low abrasive properties cause minimal harm and render an advanced solution for patients. The utilization of the specialized tip and finer-particle abrasive agent results in fewer reported adverse effects such as pain, gingival erosion and recession, and tooth sensitivity.2,5,6 Glycine
powder in air polishers aids in providing adequate subgingival biofilm removal and contributes to maintenance of periodontal health. The purpose of this study was to determine the use of air-polishing devices by dental hygienists in Oklahoma and to investigate their knowledge regarding the devices’ microbiologic effects, safety, patient acceptance, and time efficiency. Materials and Methods Ninety participants were recruited to complete a survey at the 2017 Oklahoma Dental Hygienists’ Association annual meeting in Norman, Oklahoma. Participants were ODHA members who had been or were currently registered dental hygienists without regard to gender, age, or ethnicity. All participants were informed that their survey responses would remain anonymous and that participation was strictly voluntary. The survey consisted of 14 questions covering professional demographics (age, training, type of practice), the participant’s use of an air polisher in their practice, level of knowledge regarding use of an air polisher, as well as perceptions regarding advantages and disadvantages of use. Of the ninety participants, 42 had an Associate’s degree, 47 had a Bachelor’s degree, and one had a Master’s degree. Eighty respondents worked in a general dentistry practice either wholly or in combination with pediatrics, periodontics or other setting and one was in a periodontics setting; the remaining nine did not indicate a specific setting. Median practice experience was nine years and ranged from less than one year to 52 years. Use of the Air Polisher Sixty participants used an air polisher for supragingival biofilm or stain removal only rarely (six or fewer times a year) while seven never used one. Usage among the remaining 21 participants was fairly evenly distributed: seven - occasional use (1-2 times/month); six - regular use (1-2 times/ week); eight - daily use. Comparatively, air-
polisher use for subgingival debridement was less: 72 using one rarely (six or fewer times a year) and 11 never using one. Of the remainder, five used an air polisher occasionally, one regularly, and one daily. Two open-answer survey questions asked participants to identify advantages and disadvantages of using air polishers. Advantages were stain removal (noted by 86% of respondents), speed and efficiency (29%), use in difficult situations for cleaning (29%), and biofilm removal (25%). (NOTE: These questions did not differentiate between supragingival and subgingival use.) The most noted disadvantages were the mess created (81%) and poor patient acceptance (38%). A summary of advantages and disadvantages are listed as follows:
Importance of Air Polisher Characteristics Using a 1-5 scale (1-low, 2-slight, 3-neutral, 4-moderate, 5-high) participants were asked to rank the importance of the following characteristics of air polishing: antimicrobial effects, safety, patient acceptance, and time efficiency. The percentage of respondents assigning high importance to these characteristics were: safety (51%); patient acceptance (47%); time efficiency (45%); and antimicrobial effects (39%). All four characteristics were ranked as at least moderately important by 70% of respondents; 27% ranked all four characteristics as very important. Conversely, 10% or fewer ranked each characteristic as only of slight or low importance. None ranked all four characteristics either slight or low in importance; only one ranked three of four. Since this question appeared immediately following the question on supragingival air polishing frequency and before any mention of subgingival air polishing it is likely that these rankings pertain to supragingival air polishing.
elicited a preponderance of “unsure” responses – 51 and 58, respectively. Discussion This study indicates that dental hygienists in Oklahoma do not consistently use air polishers in a practice setting and further suggests a greater understanding of supragingival rather than subgingival use of air polishers. The study also reveals that the majority of participants use supragingival air polishers fewer than seven times a year. Sodium bicarbonate is commonly used in air polishers and indicated for sound enamel. Because its particle size is much larger than glycine powder and consequently more abrasive, sodium bicarbonate use on root structures should be avoided. Furthermore, most participants stated rare or no use of the air polisher subgingivally. It is important to note that participants’ self-assessed knowledge of the subgingival use of air polishers with glycine powder was predominantly below average to poor, suggesting an uncertainty about the efficacy of glycine powder in deep periodontal pockets, even though this alternative therapy method leads to an approximately 90 percent reduction in viable subgingival microflora count in a more safe, comfortable, and time-saving manner than conventional instrumentation.6 Periodontal pockets greater than 4mm can be safely debrided as a result of the low abrasive properties of glycine powder and the powder distribution method of the specialized instrument tip. Overall, the study’s results
Reported Disadvantages
Participant Response
Messy
47 (81%)
Poor patient acceptance and discomfort
22 (38%)
Time-consuming
5 (9%)
Damage on gums, tissue, and enamel
8 (14%)
Systemic Contraindications
6 (10%)
Bad taste and texture
6 (10%)
Lack of training and knowledge
3 (5%)
Question
4 (5%)
2 (3%)
3 (5%)
Sodium bicarbonate is commonly used in air polishers.
72 (92%)
Seldom use
Sound enamel is not damaged when using sodium bicarbonate.
63 (81%)
8 (10%)
7 (9%)
Reported Advantages
Participant Response
Sodium bicarbonate use on root structures is contraindicated.
33 (42%)
15 (19%)
30 (38%)
Glycine powder used in an air polisher is effective in pockets of 4-10 mm.
20 (25%)
7 (9%)
51 (65%)
Both glycine and erythritol can be safely used subgingivally in an air polisher.
16 (20%)
4 (5%)
58 (74%)
Stain removal
48 (86%)
Speed and efficiency
16 (29%)
Biofilm removal
16 (29%)
Difficult situations (orthodontic patients)
14 (25%)
Knowledge of Air Polisher Use Of 89 participants who self-rated their knowledge of subgingival use of an air polisher, 5 rated themselves as excellent, 18 good, 9 above average, 36 below average and 21 poor. Seventy-eight of these participants also provided their responses to five statements concerning use of an air polisher as “correct,” “incorrect,” or “don’t know.” The results were as follows: 'Correct"
All five statements are in fact correct. The first two statements were collectively answered ‘correct’ by 72 and 63 participants, respectively. Responses to the third statement were more evenly distributed: 33 “correct,” 15 “incorrect” and 30 “unsure”. The final two statements
"Incorrect"
'Dont Know'
correlate infrequent air polisher use with poor knowledge of the device. Increased usage will require adequate education and training. The authors acknowledge the sampling representation of the population as a www.okda.org
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possible limitation of the study. Participants were actively involved in the dental hygiene profession (given their participation at the ODHA meeting); it is possible this convenience sample was not fully representative of all Oklahoma dental hygienists. Additionally, there could have been some subconscious bias in answers based on strong opinions and experiences rather than on scientific facts. Conclusions With the increasing prevalence of periodontal disease, practicing dental hygienists need to be aware of the evolving techniques that effectively manage biofilm. Implementing proper air polisher training and education will equip dental hygienists to provide periodontal therapy with great results for patients. Air polishers minimally damage oral surfaces and tissues and therefore represent a safe and reliable treatment method. Advanced air polishing techniques remove subgingival biofilm as effectively as conventional methods and result in a favorable oral environment to maintain periodontal health. In addition to patient acceptance, air polishing is an extremely time-efficient biofilm removal
28 journal | July/August 2018
method. Pathogenic bacteria co-existing in biofilm is a source of periodontal disease and a threat to overall wellness; therefore, knowledge of this valuable therapy method is helpful to provide periodontal health for all patients. References 1. Eke PI, Dye BA, Wei L, ThorntonEvans GO, Genco RJ. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res [Internet]. 2012 Aug 30, 91(10):914–20. Available from: http://journals.sagepub.com/doi/ pdf/10.1177/0022034512457373. 2. Petersilka GJ. Subgingival air-polishing in the treatment of periodontal biofilm infections. Periodontol 2000. 2011 Feb, 55(1):124–42. 3. Petersilka GJ, Bell M, Mehl A, Hickel R, Flemmig TF. Root defects following air polishing. J Clin Periodontol. 2003 Feb, 30(2):165-70. 4. Barnes CM. An in-depth look at air polishing. Dimens Dent Hyg. 2010 Mar, 8(3):32-40.
5. Kargas K, Tsalikis L, Sakellari D, Menexes G, Konstantinidis A. Pilot study on the clinical and microbiological effect of subgingival glycine powder air polishing using a cannula-like jet. Int J Dent Hygiene. 2014 Aug 26, 13(3):161–9. 6. Petersilka G, Steinmann D, Haberlein I, Heinecke A, Flemmig T. Subgingival plaque removal in buccal and lingual sites using a novel low abrasive airpolishing powder. J Clin Periodontol. 2003 Apr, 30(4):328–33. 7. Flemmig TF, Arushanov D, Daubert D, Rothen M, Mueller G, Leroux BG. Randomized controlled trial assessing efficacy and safety of glycine powder air polishing in moderate-to-deep periodontal pockets. J Periodontol. 2012 Apr, 83(4):444–52. 8. Flemmig TF, Hetzel M, Topoll H, Gerss J, Haeberlein I, Petersilka G. Subgingival debridement efficacy of glycine powder air polishing. J Periodontol. 2007, 78(6):1002-10.
Infant Oral Health Program Introduced at OUCOD By Tim Fagan DDS, MS Clinical Professor and Division Head, OUCOD Division of Pediatric Dentistry Dental caries is the most common chronic disease in children.1 In fact, it is five times more common than asthma in childhood. Nationwide more than 28 percent of children have caries by the time they reach kindergarten.2 Untreated caries in children may lead to pain and infection which can progress to issues with eating, speaking, sleeplessness, and even learning. Early childhood caries continues to be a major disease burden in many areas of Oklahoma, especially in rural non-fluoridated areas. To help reduce early childhood caries in the state, and to provide graduating dentists from the University of Oklahoma College of Dentistry with the tools and experience to assist in this effort, the OUCOD Division of Pediatric Dentistry started an Infant Oral Health Program at the beginning of the summer semester in June. Infants and toddlers from the ages of 12 months to 3 years of age are now being scheduled in the college’s Pediatric Dental Clinic to give dental students the opportunity to gain hands-on experience and skills in examining, diagnosing and treating very young children. The students conduct oral health assessments, deliver preventive treatments, and participate in counseling sessions with parents, providing them with infant/toddler oral health prevention and education. If the child already has caries, the parent is provided with treatment options such as applying silver diamine fluoride to the lesions with frequent reevaluations to assess the effectiveness of the treatment and/or referring the child for definitive restorative care. This program is in alignment with the American Academy of Pediatric Dentistry and the American Dental Association recommendations that a child’s first dental visit occur with the eruption of the first tooth or no later than the child’s first birthday. Early dental exams and preventive care will protect a child’s oral health now and in the future. One major emphasis of the new program is to
give children the proper foundation for healthy mouths and teeth throughout their lifespans. As the AAPD likes to say, 1 + 1 = 0. One dental visit when there’s one tooth can equal ZERO cavities.
the chance of preventing dental problems. Ultimately the community will further benefit via a reduction in the occurrence of early childhood dental caries and less expenditures on dental restorative costs.
Parents participating in the program are provided a specific plan and thorough understanding of what needs to be done to grow their kids to be “cavity free”. They are shown how to properly brush and floss their infant’s teeth and how often it should be done. Based on a caries risk assessment, parents are given customized suggestions of things to do to prevent caries in their child such as diet and feeding recommendations and how often to visit a dentist in the future.
Dental students participating in this program benefit from actual hands-on experience with infants and toddlers. In the past the students have received lectures about infant oral health care but this program for the first time provides an opportunity to apply what they’ve learned in lectures with an actual infant or toddler. Also, both patients and the college benefit because the program is a way for the younger siblings of already established OUCOD pediatric patients to become patients. They are then retained in the pediatric/orthodontic program where the dental students can monitor the growth and development of the child from infant to toddler, toddler to child, and child to teenager. It also allows for “one-stop” service where a parent can get all the dental treatment their children might need at one convenient location.
The program is considered a win-win situation for both the community at large and the College of Dentistry. The community benefits from a low-cost program that teaches parents preventive measures and care to raise their infants and toddlers to have healthy mouths and teeth. The program provides oral health education to prevent dental problems, and parents are more informed on how to do so with their kids. The earlier the dental visit, the better
The goal of the program is for every dental student at the OU College of Dentistry
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to graduate with the skills, knowledge and confidence to effectively provide this service wherever they practice. As more dentists with this skill set spread across the state and help parents prevent dental problems in their infants and toddlers, it is hoped that a reduction in the occurrence of early childhood caries will begin to occur in Oklahoma. As this program grows it is planned to involve dental hygiene students in the “preventive counseling of parents” portion of the program so that they will also have this skill set upon
graduation. Eventually medical students also could rotate through the program to learn the requisite dental preventive skills so as to counsel the parents of the infants and toddlers they will see in their medical practices. For more information about the Infant Oral Health Program, please contact the Division of Pediatric Dentistry at the OU College of Dentistry at (405) 271-5579.
References 1. U.S. Dept of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, Md.: U.S. Dept of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health; 2000. 2. Perinatal and Infant Oral Health Care. American Academy of Pediatric Dentistry Reference Manual 2017-18, pp 208-212.
Annually, the senior student body recognizes OUCOD teaching and staff services. Congratulations to the following: Outstanding Full-time Faculty Dr. Andrew Goldbeck
Outstanding Part-time Faculty Dr. Rebecca King
Congratulations to the 2018 High Nobel Medals Distinguished Faculty Advisor Award Dr. Karen Rattan Staff Appreciation Award Ms. Liz Bennie Sponsor of the Year Award Ms. Bethany Trogstad of Aspen Dental
Outstanding Department Implantology
Integrity. Relationships. Peace of Mind. That’s the PARAGON way. PARAGON has guided thousands of buyers and sellers with superior dental transition services and support. Our clients are confident their goals are being met with fairness and integrity.
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30 journal | July/August 2018
Outstanding Staff Person Sharon Ingram
Approved PACE Program Provider FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement 4/1/2016 to 3/31/2020 Provider ID# 302387.
OU ASDA Congratulations to the 2018-19 OU ASDA Officers President Brittany Hand
President-Elect Edith QuiĂąonez
Vice President Mary Temple-Goins
Congratulations to the ASDA Award Winners ASDA Leader Awards Lynna Van Uzma Hajiyani Zack Siegler Schuyler Pracht Tuan Tran
Blake Campbell Karla Rios Eric Parsons Terrick Washington Olivia Pogodzinski
National Award of Excellence Lynna Van Delta Dental Distinguished Leader Award Will Seibold
Congrats, Grads!
Priyanka Agrawal Michael Ahlborn Rand Alzubi Joseph Apple Ashkaan Bahreini Travis Bates Joshua Brock Sharolyn Burton Amber Cantrell Sarah Chancey Yiyuan Chen Kameliya Chervilov Geetika Chirumamilla Brandon Cousins Anthony Don Hidayo Elmi Cameron Felt Ryan Flake
Taylor Francis Ramina Golshani Randi Gray Sarah Han Preston Harraman Kelly Harrelson Christy Heinze Stephanie Herbst Elizabeth Hoang Michael Hooper Brian Howell James Hudson Evan John Andrew Johnson Ashley Johnson Manju Kanagarla Sruthi Kondakindi Melissa Macy
Carmen Martinez Cody Mumma Steven Nguyen Tuan Nguyen Lauren Nichols Brandon Onley Nishita Philip Clark Plost Lana Richardson
Roger Richter Justin Roberts Jeffrey Scammahorn Byron Schroeder Kyle Sikes Gregory Stewart Stephanie Sugg Phuong Tran Andrew White
2018 Please join the ODA in welcoming our newest members of organized dentistry from the University of Oklahoma
class of
www.okda.org
31
More information coming soon to swdentalconf.org
Kay Bailey Hutchison Convention Center | Dallas, Texas Sponsored by: Dallas County Dental Society
www.swdentalconf.org
ODA is a Regional Affiliate of the SWDC 32 journal | July/August 2018
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. PRACTICES FOR SALE PRACTICE FOR SALE: EASTERN OKLAHOMA. “Collected” $941,000 in a 32 hour work week, Six chairs and digital X-rays throughout including panoramic. Highly trained staff remaining after the sale. Eleven computer terminals throughout the office. This practice is ready to go for the right buyer. It is located in the most beautiful area of Oklahoma and has excellent amenities in the vicinity. Plus if you like to hunt and fish, it is second only to paradise. Call Max or Jack at PROFESSIONAL PRACTICE ASSOCIATES at (405) 359-8784. FINANCING AVAILABLE
PRACTICE FOR SALE: BROKEN ARROW, OK. $850,000 in a 4-day week. Four ops full of excellent equipment and loaded with high tech; Laser, ALL digital X-ray and pan, intraoral cameras. Diagnodent, Carestream scanner, elec. Handpieces. Plenty of room for treatment area expansion if desired. Huge potential for growth as owner refers a lot of work. Leased office. Call Max or Jack at PROFESSIONAL PRACTICE ASSOCIATES at (405) 359-8784. FINANCING AVAILABLE
THE OFFICES LISTED MAY BE SEEN AT www.ppa-brokers.com or call Max or Jack at PROFESSIONAL PRACTICE ASSOCIATES at (405) 359-8784.
Place a Classified Ad
EQUIPMENT FOR SALE Intraoral X-Ray Sensor Repair/Sales Repairs with rapid turnaround. Save thousands over replacement costs. We specialize in Kodak/ Carestream, Dexis Platinum, and Gendex sensors. We also buy/sell dental sensors. Call us 919-229-0483 www.repairsensor.com
PRACTICE FOR SALE: SW of Oklahoma City in a short commutable drive. Two part-time satellite practice. Very low overhead. Practice collected $722K in 2015 with very large profit margin. A serious money maker!! Call Max or Jack at PROFESSIONAL PRACTICE ASSOCIATES at (405) 359-8784. FINANCING AVAILABLE
Submit a Listing
Submitting a classified ad is easy with our online form. Find the form and more information at www.okda.org/classifieds.
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800.460.4653 or 405.517.6900
rjones@works24.com
www.works24.com www.okda.org
33
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Promote MouthHealthy.org to Your Patients 34 journal | July/August 2018
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36 journal | July/August 2018