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THE JOURNAL
of the Philadelphia County Dental Society ________________________________________________________________________________
First District of the Pennsylvania Dental Association $SULO/0D\/-XQH 20 • Vol. 8 • No. ______________________________________________________________________________________________ Saul N. Miller, D'S, ¶ Editor
CONTENTS
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OFFICERS Lennie M. Checchio, DDS President Renee H Fennell, DMD President-Elect 6WDQOH\ : 0DUNLHZLF] ''6 Secretary A J. Chialastri, DDS Secretary Emeritus
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The JOURNAL is published by the Philadelphia County Dental Society, P.O. Box 189, Glendora, NJ 08028. The opinions expressed herein are those of the author under whose name they appear and are not to be regarded as representing the views of the Philadelphia County Dental Society unless so indicated. All advertising materials and correspondence, including classified advertisements and replies should be sent to: JOURNAL of the Philadelphia County Dental Society, c/o Caroline Power Gangl, 1315 Sylvan Road, Lancaster, PA 17601 or emailed to 3KLOD'HQWDO-RXUQDO#\DKRR FRP The Philadelphia County Dental Society does not approve or disapprove any products or services advertised in the JOURNAL. Articles for publication and additional requests for JOURNAL-related information should be sent to the Managing Editor via e-mail to 3KLOD'HQWDO-RXUQDO#\DKRR FRP. Articles and classified advertisements should be submitted as Word documents; all other advertising should be submitted in .pdf format (Adobe 6.0 or higher). Contact the Managing Editor via telephone at (717) 805-4130 or e-mail if you require additional information. Deadline for copy is the first of the month PRECEDING the month of issue. Subscription is included in the annual dues. The JOURNAL is published electronically four times a year, January through December. Single printed copies: $4.00. Standard postage paid at Philadelphia, Pennsylvania. Copyright 20 . The Philadelphia County Dental Society. &RYHU 3KRWR E\ &'& RQ 8QVSODVK
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President’s Message Lennie Checchio, DDS As I began to write this column on March 9, it was 72° F in Philadelphia. Robins had returned by the flock a few weeks ago, and snowdrops could be seen in protected spots in the neighbor’s flower beds. The greenery of tulips, daffodils and miniature iris emerged a few weeks ago. It looked like spring! Spring is viewed by many people as a period of renewal, thanks to all the beautiful colors that emerge in our landscape and many religious traditions that speak to renewal or rebirth. But I don’t know if people think of the work and effort that go into renewal. I also mentioned how, as dentists, we deal with the work of renewal all the time. Working to restore the patient's form and function can renew a person's spirit and overall health, along with the ability to smile and chew. Lurking in the background was the emergence of a new SARS-type of corona virus, COVID-19. The outbreak appeared to have started in a market in Wuhan, China, which was quickly quarantined. Then we heard about the cruise ship the Diamond Princess, where 10 passengers were exhibiting signs of the virus. Rather than allowing the passengers and crew to disembark, Japan’s Ministry of Health decided implement a 14-day quarantine of everyone on the ship after they removed the 10 ill passengers. As testing for the new corona virus began, people who tested positive were allowed to disembark to receive treatment in hospitals on the mainland. “Healthy” persons had to remain quarantined. Experts criticized the decision to keep everyone aboard the ship. In hindsight the quarantine was probably responsible for the 700 people, both staff and guests, who became ill. After almost a month on board, on February 16, passengers were allowed to begin disembarkation only to face another quarantine placed on them by their own governments when they arrived on native soil. Then, a virus hot spot emerged in Italy, another in Iran. But we in America only had to worry about the passengers from the Diamond Princess. Just two days after I started this message, the World Health Organization declared COVID-19, which health officials now knew had
first been identified in Wuhan in December 2019, had become a pandemic. It’s hard to believe you’re living in a pandemic when everyone around you seems fine. And therein lies the problem. People with COVID-19 can be infectious up to 14 or more days before they show symptoms, or they may not show any symptoms at all. Unfortunately the elderly and people with existing underlying diseases seem to be most vulnerable to the virus, that’s why people have been asked by mayors, governors, the president and most importantly specialists, to minimize the amount of time they spend in public and to maintain personal distancing. Remember how I started this message thinking this was a time of renewal? I think it can be if we all work together to minimize the spread of COVID-19. We are including in this issue lots of information about the virus for you to think about or implement. After all, I’ve also seen a small bird building a nest high up in a small tree. Why is he building it? He’s building it for the future, and the future is what all of us can look forward to when the pandemic is over. As you read the covid-19 related evolving guidelines, directives and articles, please note the advocacy efforts of staff, volunteers, leaders of PCDS, PDA and ADA, along with the deans from Temple, Penn and Pitt. There was a major commitment of time, effort and energy to negotiate with government agencies, political leaders and appointees regarding new guidelines and CE licensure requirements that will allow us to once again serve our patients and communities. THANK YOU TO ALL INVOLVED IN THE PROCESS.
THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY
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COVID-19 PANDEMIC
The Philadelphia County Dental Society, PDA and ADA have been working to keep you updated about evolving directives and guidelines regarding the corona virus pandemic and to respond to government agencies with concerns that may affect your patients and your practice. The following documents are among the latest corona virus-related communications. Petition from Philadelphia County Dental Society To the Pennsylvania Dental Association Seeking information about CE requirements for The 2021 Relicensure of members.
Given the current crisis of the coronavirus epidemic, the Board of PCDS is concerned about members who may not be able to fulfill the number of required courses in time for relicensure in 2021. The Society has had to cancel/postpone the March course and the next course which is scheduled for May 15 is within the current 8-week period when federal and state authorities are strongly urging the public not to hold gatherings of any size. Does the PDA have plans to request information from the State Board of Dentistry about this issue, specifically, how the Board might decide to provide relief from the requirements given the difficult situation our members might find themselves in at the time of relicensure next March? Such relief might include a longer timeline for attending courses or receiving approved credits, expanding the number of online courses that are currently approved and, in addition, having further recourse with specific courses that the Board requires such as Child Abuse, Opioids, and CPR. We believe that a Board opinion should arrive as soon as possible. Philadelphia and its surrounding counties are among the first and hardest hit by the epidemic and with a greater population density than the rest of the State, the City and its environs will most likely see a growing number of cases and concerns. We want to be able to provide support to our members about all their local concerns and we would look to the PDA to hopefully be able to provide us with some answers to their questions about CE and relicensure that we are certain to receive from our members. Respectfully submitted, Dr. Lennie Checchio President Philadelphia County Dental Society
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Updates & Information
DATE: March 26 FROM: ADA RE: ADA Calls on Members to Postpone Elective Dental Procedures On March 16, the American Dental Association called upon dentists nationwide to postpone elective dental procedures for three weeks in order for dentistry to do its part to mitigate the spread of COVID-19. Concentrating on emergency dental care only during this time period will allow dentists and their teams to care for emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments. The ADA recognizes that state governments and state dental associations may be best positioned to recommend to the dentists in their regions the amount of time to keep their offices closed to all but emergency care. This is a fluid situation, and those closest to the issue may best understand the local challenges being faced. The following should be helpful in determining what is considered “emergency” versus “non-emergency.” This guidance may change as the COVID-19 pandemic progresses, and dentists should use their professional judgment in determining a patient’s need for urgent or emergency care. 1. Dental emergency Dental emergencies are potentially life threatening and require immediate treatment to stop ongoing tissue bleeding, alleviate severe pain or infection, and include: x Uncontrolled bleeding x Cellulitis or a diffuse soft tissue bacterial infection with intra-oral or extra-oral swelling that potentially compromise the patient’s airway x Trauma involving facial bones, potentially compromising the patient’s airway Urgent dental care focuses on the management of conditions that require immediate attention to relieve severe pain and/or risk of infection and to alleviate the burden on hospital emergency departments. These should be treated as minimally invasively as possible. x Severe dental pain from pulpal inflammation x x x x x x x
Pericoronitis or third-molar pain Surgical post-operative osteitis, dry socket dressing changes Abscess, or localized bacterial infection resulting in localized pain and swelling Tooth fracture resulting in pain or causing soft tissue trauma Dental trauma with avulsion/luxation Dental treatment required prior to critical medical procedures Final crown/bridge cementation if the temporary restoration is lost, broken or causing gingival irritation
Other urgent dental care: x Extensive dental caries or defective restorations causing pain x Manage with interim restorative techniques when possible (silver diamine fluoride, glass ionomers) x Suture removal x Denture adjustment on radiation/oncology patients x Denture adjustments or repairs when function impeded x Replacing temporary filling on endo access openings in patients experiencing pain x Snipping or adjustment of an orthodontic wire or appliances piercing or ulcerating the oral mucosa 2. Dental non-emergency procedures Routine or non-urgent dental procedures include but are not limited to: x Initial or periodic oral examinations and recall visits, including routine radiographs x Routine dental cleaning and preventive therapies x Orthodontic procedures other than those to address acute issues (e.g. pain, infection, trauma) x Extraction of asymptomatic teeth x Restorative dentistry including treatment of asymptomatic carious lesions x Aesthetic dental procedures The ADA is committed to providing the latest information to the profession in a useful and timely manner. Please visit ADA.org/virus for the latest information. 5
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COVID-19 PANDEMIC ADA SAMPLE LETTER TO PATIENTS REGARDING COVID-19 & DENTAL SERVICES BEING RESTRICTED TO DENTAL EMERGENCIES
Dear valued patient: In an effort to support national efforts to fight the COVID-19 pandemic, our practice is taking the following steps to help assure your health and well-being and that of our community: x We are following directives from the Centers for Disease Control and Prevention (CDC) as a way to limit patient and staff exposure to this virus. x Your health, and the health of our dedicated staff, matters to us, so going forward we will suspend all non-emergency care for three weeks. x Patients will be seen only for urgent and emergency dental needs. We will contact you soon to reschedule routine hygiene appointments. If you are already scheduled for an urgent issue, we will contact you the day before your appointment to discuss your health status, health screening protocols and confirm whether the appointment should be kept. Of course, please call us right away if you have a dental emergency or need immediate care. The safety and well-being of our patients continues to be our primary concern. We will continue to monitor the status of COVID-19 nationally and within our community and keep you up to date regarding our plans to reopen for business as usual. I urge you to contact us if you have any questions or concerns. We can be reached by phone at XXX-XXX-XXX or by email to XXXXX@XXX.com and will respond as soon as we can. Thank you, 5
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THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY
Updates & Information FROM: PDA RE: Department of Health Issues New COVID-19 Guidance PDA Members, On March 22, the Pennsylvania Department of Health (DOH) released new guidance stating that dental facilities and offices must close immediately, even for emergencies, if they do not have all of the following protective equipment and protocol in place: • All personnel must follow proper protocol when donning and doffing personal protective equipment (PPE). • All personnel must use N95 masks or higher; goggles or a face-shield covering face and sides; disposable gowns and gloves. • Treatment must be provided in negative pressure isolation rooms with HEPA filtration. DOH did not consult with PDA prior to releasing its guidance. We are now working with the deans of Pennsylvania’s dental schools and have already communicated our concerns to DOH and asked for clarification on a number of issues that now arise because of this new guidance. PDA remains hopeful that we will be able to work with DOH to provide you with more information as soon as possible. If you have questions about this DOH guidance, please contact mss@padental.org. In addition, we will be consulting with PDA legal counsel today to see what options we may pursue. PDA will continue to be a trusted resource for information in the days ahead. We continue to update PDA members with all dental-related coronavirus developments via our PDA Go mobile app, with a comprehensive COVID-19 resources tab and a COVID-19 forum. If you have not yet downloaded PDA Go, please do so today to take advantage of these excellent resources. 5
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COVID-19 PANDEMIC
FROM: PDA RE: Demonstrating the Value of Organized Dentistry To our members, PDA leadership became aware of the directive that the Department of Health (DOH) published late last night earlier on Sunday afternoon (March 22). We immediately took action to reach out to the DOH for clarification and offer our guidance before it was to be released to the public. We attempted to set up a conference call last night, but DOH did not respond to our request. We have also been in touch with the deans of Pennsylvaniaâ&#x20AC;&#x2122;s dental schools, Dean Wolff at Penn, Dean Ismail at Temple and Dean Costello at Pitt. We have confirmed that the dental schools do not have negative pressure engineering controls, and most hospitals do not as well. Sunday evening, I sent the following questions to the DOH, and we are awaiting their response. 1. Is this a blanket mandate? According to the CDC, in their conversation with the ADA, these sorts of measures only apply to symptomatic patients, but we understand this mandate to cover every single citizen. 2. N95 masks are almost impossible to obtain. Some hospitals are actually working on ways to re-use these masks for their physicians since they are at the front lines and are running out. Many dental residency programs currently use Level 3 masks and we do not have access to N95s. 3. Is the DOH able to find a source to obtain N95s for dentists to treat patients? 4. Has the DOH identified any facilities within the state that have the ability to treat patients under this mandate? 5. If dentists cannot see emergency patients without following these guidelines, and a patient has a severe dental infection, swelling, bleeding or trauma, they will seek care in the emergency rooms of hospitals. How will this impact the emergency room physiciansâ&#x20AC;&#x2122;
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THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY
ability to provide definitive vs. palliative care to these patients? 6. Does this apply to all practice specialties, including orthodontic offices? 7. If dentists cannot see a patient because of this mandate, how will they be protected against potential claims of abandonment by patients? 8. If a patient is in need of dental clearance for cardiac surgery, chemo or radiation therapy, how will they access care? 9. What are the penalties for violating this order and which agency will enforce compliance with these? 10. Do you have an estimated timeline for the lifting of these guidelines? PDA is extremely disappointed that DOH did not consult with leadership or the deans of the dental schools prior to issuing these latest orders. This new order was issued without proper consideration and consultation. We are a compassionate profession, dedicated to proper patient care and relief of pain, and we are asking DOH to involve us in modifying these new guidelines. We will be consulting with PDA legal counsel today to see what options we may pursue. We encourage you to advise patients who call you with emergent and urgent dental needs to call the DOH at (717) 787-9857 or to search the DOH website to locate facilities, if any, that have the required engineering controls in place. Your voice and your welfare are important to us. If you have additional questions that you would like us to direct to DOH, please email us at mss@padental.org. Sincerely, Charles J. Incalcaterra, DMD President, Pennsylvania Dental Association 5
Updates & Information March 23, 2020 The Honorable Thomas Wolf Governor of the Commonwealth of Pennsylvania Office of the Governor, Room 225 Main Capitol Building Harrisburg, PA 17120 Dear Governor Wolf: On behalf of the more than 5,000 members of the Pennsylvania Dental Association (PDA), I am writing to express grave concern over the Department of Health’s most recent guidance entitled “Guidance on COVID-19 for Dental Health Care Personnel in Pennsylvania,” dated March 22, 2020. PDA leadership became aware of the directive that the Department of Health (DOH) published late Sunday night earlier on that same afternoon (March 22). We immediately took action to reach out to the DOH for clarification and offer our guidance before it was to be released to the public. We attempted to set up a conference call last night, but DOH did not respond to our request. We have also been in touch with the deans of Pennsylvania’s dental schools, Dean Mark Wolff at the University of Pennsylvania School of Dental Medicine, Dean Amid Ismail at The Maurice H. Kornberg School of Dentistry at Temple University and Dean Bernard Costello at the University of Pittsburgh School of Dental Medicine. We have confirmed that even the dental schools do not have negative pressure engineering controls, and most hospitals and federally qualified health centers do not as well. This guidance will effectively shut down most, if not all, dental facilities and offices. Patients seeking emergency care will flood hospitals’ emergency rooms, the very place we do not want them to go. PDA believes that dental offices should only be required to adhere to the latest restrictions found in this guidance when treating patients who need emergency aerosol-producing procedures. Therefore, dental offices may still offer emergency care to some patients. We ask that the Department consider immediately issuing another guidance making this modification. In addition, PDA posed the following questions to DOH and is still awaiting a response: 1. Is this a blanket mandate? According to the CDC, in their conversation with the ADA, these sorts of measures only apply to symptomatic patients, but we understand this mandate to cover every single citizen. 2. N95 masks are almost impossible to obtain. Some hospitals are actually working on ways to re-use these masks for their physicians since they are at the front lines and are running out. Many dental residency programs currently use Level 3 masks and we do not have access to N95s. 3. Is the DOH able to find a source to obtain N95s for dentists to treat patients? (continues on next page) THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY
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COVID-19 PANDEMIC 4. Has the DOH identified any facilities within the state that have the ability to treat patients under this mandate? 5. If dentists cannot see emergency patients without following these guidelines, and a patient has a severe dental infection, swelling, bleeding or trauma, they will seek care in the emergency rooms of hospitals. How will this impact the emergency room physiciansâ&#x20AC;&#x2122; ability to provide definitive vs. palliative care to these patients? 6. Does this apply to all practice specialties, including orthodontic offices? 7. If dentists cannot see a patient because of this mandate, how will they be protected against potential claims of abandonment by patients? 8. If a patient is in need of dental clearance for cardiac surgery, chemo or radiation therapy, how will they access care? 9. What are the penalties for violating this order and which agency will enforce compliance with these? 10. Do you have an estimated timeline for the lifting of these guidelines? PDA is extremely disappointed that DOH did not consult with the dental community or the deans of Pennsylvaniaâ&#x20AC;&#x2122;s dental schools prior to issuing the latest guidance, which was drafted without consideration of and consultation with these most significant stakeholders. We are a compassionate profession, dedicated to proper patient care and relief of pain, and we are asking DOH to involve us in modifying these new guidelines. In the meantime, we are encouraging our members to advise patients who call them with emergent or urgent dental needs to call the DOH at (717) 787-9857 or to search the DOH website to locate facilities, if any, that have the required engineering controls in place. We look forward to your reply. The dentists of the Commonwealth are ready and eager to help control the spread of this virus. The unintended consequences of this new directive, as highlighted in our questions above, have the potential to harm rather than help your valiant efforts on behalf of the citizens you are so admirably serving during this public health crisis. Sincerely,
Charles J. Incalcaterra, DMD President, Pennsylvania Dental Association cc:
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Dr. Rachel Levine, Secretary of Health, PA Department of Health 5
THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY
Updates & Information March 23, 2020 Dear Member of Philadelphia County Dental Society, We, the Board Members of PCDS, are acutely aware of the difficult situations that our members are facing during this unprecedented health crisis. We trust that you are receiving and reading the many timely and helpful messages from the Pennsylvania Dental Association and the American Dental Association. As many of you know who attend our Continuing Education Courses, the March course was cancelled and we are now uncertain whether the May course may also have to be cancelled. When and if that happens, you will be notified by the Pennsylvania Dental Association which now manages our CE programs. For those members who attend our courses and for those who get their credits in other ways, we are concerned that some of you may fall short of the required number of credits for relicensure next year. With that concern in mind, we have sent a petition to the State Board of Dentistry requesting information about whether the Board may approve changes in the number of credits, the mode of receiving those credits and even the deadline for getting the required number of credits. We have sent that petition through the Pennsylvania Dental Association and have requested that any responses be forwarded back to our component. Any information will, of course, be sent to all of our members as soon as it is received. Just this morning, we heard from the PDA that Governor Wolf has granted the Department of Stateâ&#x20AC;&#x2122;s request to suspend restrictions on distance-learning for continuing education requirements for certain licensed professionals which includes licensed dentists. In response to the information, the PDA has announced that it will work on increasing the number of online courses. You may read about this at: https://www.dos.pa.gov/Documents/2020-03-22-Continuing-Education-Suspensions.pdf Although we believe this is a step in the right direction, we have further concerns which are discussed in the attached letter to the State Board. Our Board members are struggling through the same difficulties and uncertainties as all our members, but we are aware, more than ever, of the benefits of membership in the Tripartite, the American Dental Association, the Pennsylvania Dental Association and your own Philadelphia County Dental Society. We are all very fortunate to be receiving the most up-to-date information, resources, and support that would otherwise be completely unknown to us. Our hope is that all of our members and their families stay safe and healthy through this crisis, Lennie Checchio, DDS President Philadelphia County Dental Society 5
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COVID-19 PANDEMIC
Dr. Chad Gehani, ADA President, sent the following update March 24 to bring members up to date on several legislative pieces. Hello, Fellow Dentists:
As the global situation on COVID-19 continues to evolve, the American Dental Association is committed to guiding the dental community through these challenging times. We are looking out for you, particularly as federal lawmakers work on legislation that could make a big difference for our profession. The Senate continues to work on the 3rd coronavirus legislative package, the Coronavirus Aid, Relief and Economic Security Act, also known as the CARES Act. The bill contains a number of provisions of importance to dentists and their dental practices. Despite much back and forth, the ADA is confident that Congress will complete the package shortly. We will send out details on the final provisions once they are available. You should know that our grassroots efforts over the last 48 hours regarding the CARES Act have been outstanding—117,462 dentists have sent 358,535 emails to Capitol Hill. There is no doubt that dentistry’s message has been received! By way of update, as you know the 2nd coronavirus legislative package, H.R. 6201, the Families First Coronavirus Response Act, was signed into law on March 18. It included some provisions that could affect your dental practice—primarily those concerning emergency paid sick leave and family medical leave. The Department of Labor (DOL) has released summary overviews of what the law will require of employers (and employees) for emergency paid sick leave and the Family Medical Leave Act (FMLA). Please keep in mind that we anticipate further guidance from the Department of Labor to clarify these provisions. Once we receive the additional guidance, we will send an update that may assist you with your business decisions. The summary outlines can be found here: x x x x
Families First Coronavirus Response Act: Employer Paid Leave Requirements Families First Coronavirus Response Act: Employee Paid Leave Rights COVID-19 and the Fair Labor Standards Act: Questions and Answers COVID-19 and the Family and Medical Leave Act: Questions and Answers
As you read the DOL guidance (above), please keep in mind that the ADA is still awaiting a response from the Department of Labor on our request that dental offices as small businesses (50 or fewer employees) be exempt from the emergency sick leave and FMLA, which would alter the requirements and impact of these provisions. We will update you immediately once we receive a response from the Department of Labor to our request. (Read the letter to the Department of Labor here.) We know that these are uncertain times, and the ADA will continue to be a resource now and in the weeks and months to come. Count on us—we are working hard for you. Stay well, Chad P. Gehani, DDS President 5
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Updates & Information FROM: PDA RE: Many COVID-19 Updates Posted
March 25 has been another busy day for PDA and our leadership. Staff has posted a number of COVID-19 updates on the various PDA communication platforms, notably: x x x x x
NEW Small Business Loans Available Teledentistry Services to Pennsylvanians During Coronavirus Emergency State Senator Scott Martin Demands Action from Wolf Administration New CE Guidelines â&#x20AC;&#x201C; Some Restrictions Suspended and Prescribing Controlled Substances.
Please be sure to check the PDA Go mobile app and the website (www.padental.org/covid19) frequently. We are working hard to be sure that you have the information you need to help you through this unprecedented crisis. If there is information you need that you donâ&#x20AC;&#x2122;t see listed, please contact us in the COVID-19 Forum on the PDA Go app. This morning there was an update to the guidelines for health care providers who are currently treating COVID-19 patients. This document was sent to physicians and hospitals and applies only to COVID-19 positive patients. This was an update of a directive sent out by DOH on March 10. It was not an update of the guidance document for dentistry sent out on March 22, as some people had been led to believe. Although these new medical guidelines do not address the production of aerosols generated in dentistry, we are hopeful that they may act as a framework for future updated guidelines for our profession. This afternoon our ADA Third District Trustee Dr. Linda Himmelberger, Immediate Past PDA President Jim Boyle, President Dr. Charles Incalcaterra, Ms. Peg Callahan, our PDA lobbyist, and representatives from other dental organizations spoke with Mr. Peter Blank, policy Director for the Department of Health, Ms. Keara Klinepeter, Special Advisor to the Secretary of Health, and April Hutcheson, Director of Communications. Mr. Blank began the meeting by acknowledging that dentistry was not adequately consulted when the March 22 dental guidelines were being developed, although he was under the impression that we had been, and promised to keep us engaged on a weekly or bi-weekly basis with conference calls where our concerns can be heard. Ms. Klinepeter also acknowledged that the Guideline that was issued today Interim Infection Prevention and control Recommendations for Patients with Known or Patients Under Investigation for 2019 Novel Coronavirus (2019-nCoV) in a Healthcare Setting, is in conflict with the directive issued on March 22. Everyone on the call was invited to give input and express our concerns about the guidelines of March 22. PDA expressed our main concern that our 12.8 million citizens of Pennsylvania are being denied access to dental care and that we need to find an interim solution to treat those with severe pain, swelling, bleeding or
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COVID-19 PANDEMIC dental trauma. We explained that we are a compassionate profession and we are aware that over 100 patients are in need of emergency care at Temple Dental School as of yesterday. Dr. Incalcaterra told them Lehigh Valley Hospital’s residency program cancelled over 70 emergency visits scheduled for this week, and LVHN residents are only able to provide palliative treatment in the emergency room. Our daily number of ER visits has skyrocketed. Dr. Boyle noted that the York residency program is also closed, and the renowned Hershey Medical Center sent a child with a dental infection to York for treatment. This is unacceptable. Dr. Himmelberger said that the science on N95 masks is not consistent. Some studies are showing no difference between using a surgical mask vs. an N95 and other studies contradict that, but research is continuing as we speak. We recognize that this virus may not behave as others before it but existing precautions and best practices may be an interim solution for us. PDA also explained that an antibiotic prescription and recommendation for over the counter pain relievers may only work for a short time, if at all, and are not the answer, especially with concern over antibiotic resistance. Some practitioners are resorting to online prescriptions of opioids. Definitive care must be provided since dental disease is progressive and does not go away on its own. They asked about “out of the box” solutions, such as setting up offices in hotels throughout the state. We told them we heard about portable units costing $4,800 plus modification of office space, which would incur unknown additional costs, and asked if they would be willing to pay for such units throughout the state. You know the answer to that. In the end, they did ask if the new medical guidelines that were issued yesterday for patients who are COVID-19 positive would be a possible solution for emergency care for COVID-19 negative patients. We agreed that it would and were told that we would hear back from them later today. We did, in fact hear back from them, and another conference call has been scheduled for 7:30 a.m. tomorrow morning so that we can review and comment on the new, revised mandate before it is finalized. In addition to the call tomorrow morning, PDA leaders have another conference call, this time with Dr. Levine and other stakeholders such as our dental school deans scheduled at 4:00 PM tomorrow afternoon. We sent questions that need to be addressed ahead of time so we will see if there has been any movement at that time. Your voices have been loud and clear, so let’s hope a reasonable solution can be reached. Please know that we are working hard to ensure that our patient’s needs are met, and that you and your staff members are safe during this challenging time in our lives. This afternoon, Drs. Tauberg and Paul Gleason were interviewed on WXPI, Channel 11 in Pittsburgh about the effect the March 22 mandate has had on the dentists’ ability to provide care to their patients who are in desperate need. In addition, several local papers have picked up this story and have spoken out about these most difficult guidelines. 5
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Updates & Information
‘Testing Is Becoming Less Valuable’: Philadelphia Signals Change in Coronavirus Strategy Philadelphia’s health czar, Dr. Thomas Farley, said March 23 emphasis for COVID-19 testing should be health care workers and patients already hospitalized (Source: NBC10 TV, Philadelphia) More than a dozen drive-thru testing sites are running across the Philadelphia region, but a top city official says that they are no longer useful in containing the corona virus.
“Our test results reflect spread that happened about 12 days ago,” Farley said. “And we have to assume there’s been quite a good deal of spread since that time until today.”
Test kit shortages and delays in receiving lab results have diminished the role of widespread testing, Dr. Thomas Farley, Philadelphia’s health czar, said Monday.
The lag between a test sample taken from a patient and the result reported back to local authorities has to do with a centralized, overloaded infrastructure. A test taken in Montgomery County, Pa., or Camden County, NJ, or New Castle County, Del., must be sent to a state or private lab for initial testing. There, it gets an initial “presumptive” positive or negative result.
Because of the shortage of supplies and the shortage of testing capacity, testing is becoming less valuable, Farley said. “It will be less of a focus of our overall response to this epidemic.” But as sites ramped up Monday, a bigger focus of testing is becoming clear: health care workers, first responders and those already hospitalized. That’s in part because testing potential cases among the general public may be losing steam as a containment strategy.
The test samples are then shipped to the Centers for Disease Control and Prevention in Atlanta, Ga., for a confirmation of the initial test.
Testing is still very valuable to preventing contagion among those already hospitalized or the health care workers on the front lines of the battle with the coronavirus, Farley noted.
Dr. Anthony Fauci, a member of the White House Coronavirus Task Force and director of the National Institute of Allergy and Infectious Diseases, told Science magazine in an interview published Sunday that testing has been a failure.
But a broader strategy in the weeks ahead for the general public will likely rely on self-isolation and sanitary rituals, like washing hands and social distancing. “Testing is still important for health care workers. We don’t want health care workers exposing their patients, and it’s important for the health of patients in the hospital,” he said. “But it’s less important for others.” A manager of testing sites for one of the Philadelphia region’s largest health care systems said kits are limited, and only certain people should be tested right now. Most sites require patients to already be in-network if they want a test. Patients also need pre-approval from their physician. Farley’s outlook comes at a time when states and counties are reporting ever-increasing numbers of confirmed cases. The daily tallies of those cases, however, reflect what has already occurred, health officials say. In Philadelphia, for instance, the 75 confirmed COVID19 cases that Farley reported on Monday [March 23] are for patients tested nearly two weeks ago.
This takes time, and state labs are swamped. Reporting even the initial result could be delayed.
Obviously, testing [for the new corona virus] is one issue that needs to be re-examined. Fauci said. “Why were we not able to mobilize on a broader scale?” Fauci asked. Fauci doesn’t think we can do that right now and believes we really need to look ahead. New York is also a state where officials have told those with mild COVID-19 symptoms to stay home and not try to get tested. In Pennsylvania, leaders are focusing their efforts in isolating people, the best chance to stop the virus from spreading quickly. Gov. Tom Wolf says the virus is sneaky. “You get it before you know you have it. Now, 80% percent who get it, they’re going to be OK. And if you’re part of that 80% you can be forgiven for saying, ‘What’s the big deal?’ The big deal is the 20% that are in danger,” Wolf said Monday. “And that 20% includes our loved ones and our neighbors. And our problem right now is that we cannot treat that 20% if the virus takes off as it did in Italy. We don't have the capacity in our healthcare system, so we need to buy time.” 5
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COVID-19 PANDEMIC
DATE: March 26 RE: Deans from Temple, Penn & Pitt and PDA Leaders in Action PDA Members: Your PDA leadership continues to work on communicating with Governor Wolf’s administration to modify the Department of Health’s guidance to dental health care providers (issued late on March 22), but that is far from the only thing your leaders are working on this week. President Dr. Charles Incalcaterra had a conference call this afternoon with the deans of Pennsylvania’s dental schools, Dean Mark Wolff at Penn, Dean Amid Ismail at Temple and Dean Bernard Costello at Pitt; and Mike Brunelle, Chief of Staff for Governor Wolf. On the call, they explained the dire need for patients who are in pain, and the need for dentists to be allowed to treat their patients immediately without the requirement of negative pressure engineering controls, but with use of proper patient screening, using Level 2 or 3 facemasks and proper disinfecting techniques, and social distancing techniques. Mr. Brunelle at first said that he would get back to us later this week, but Dean Ismail emphasized that dentistry needs an answer sooner, because many patients are suffering in pain. Mr. Brunelle will bring this to the Governor's attention at a staff meeting this evening and update us shortly after that. In addition, there is also a conference call scheduled with Secretary of Health Dr. Rachel Levine and PDA/dental schools’ leadership on Thursday evening. Dr. Incalcaterra also received a call from Dr. Dino R. Angelici, Dental Administrator for the Pennsylvania Department of Corrections, who expressed concern about the lack of dental care being afforded to the prison population. There are 125 dental personnel in the state prison system with over 45,000 inmates. The inability of dental personnel to provide necessary care for the relief of pain may create a dangerous atmosphere in the prisons. Dr. Linda Himmelberger, ADA Third District Trustee, participated in a lengthy call today with the ADA Board of Trustees and Officers, where they each shared what was happening in their states and received an update on the progress that each of the ADA Response Teams has made in addressing the many issues that have arisen as a result of this spreading contagion.
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The ADA is developing a dashboard so that everyone will easily be able to see what each team has addressed and will be addressing. The New Recommendations for Treating Patients, outlining what engineering controls and PPE you will need to safely treat patients will be coming out later tonight or early tomorrow morning. Incoming PDA President-Elect Dr. Gary Davis and a team of volunteers inventoried all of their MOM-nPA donations, searching hundreds of boxes and crates, and found 53,150 masks, 312 boxes of gloves, 893 gowns and 130 hand sanitizers. The MOM-n-PA board members and leads are donating all of these materials to 6 hospitals in need. President-Elect Dr. Jim Tauberg has been researching options for N95 masks and hand sanitizer that might be available for our member dentists and continues to seek other member benefits during this difficult time. The U.S. Senate is about to pass HR748, which will bring much needed economic relief. Expect passage tomorrow morning. Bear in mind, however, that once the bill passes, there will still be a delay in implementation until regulations can be written. ADA is exploring the possibility of hiring a national firm that would be able to answer the many questions that members are asking about unemployment for themselves and their staff. ADA has just added a Coding and Billing document to ada.org/virus; a piece on Telehealth is being developed. A reminder - if you click on “Other Resources” at the top of the page you will find access to other excellent resources. As you might expect, the ADA media platforms have been getting heavy traffic, not unlike our own PDA communication platforms. Marcelo Araujo, the VP of Science, at the request of the Italian ambassador, was asked to speak to the American Rome Club, a group of expats health professionals in Italy. The number of cases in Italy seems to be decreasing. They do not have the information resources that we have in the USA and asked ADA to share our resources, which ADA gladly did. There are talks underway with insurance companies who are collecting premiums, but clearly are not having to pay on claims. It is NOT business as usual at ADA; the full talent and energy of your dental society is being brought to bear on the crisis and is committed to helping members in every way possible. 5
Updates & Information
DATE: March 25 FROM: PDA RE: Licensed Health Care Practitioners Can Provide Telemedicine Services to Pennsylvanians During Coronavirus Emergency Health care professionals licensed under any of the Department of State's Bureau of Professional and Occupational Affairs (BPOA) licensing boards can provide services to patients via telemedicine during the coronavirus emergency. “Telemedicine provides health care professionals flexibility to continue treating their patients while following best practices on social distancing as outlined by the Department of Health,” Secretary Kathy Boockvar said. “The department requested, and Governor Wolf granted us, the authority to allow health care professionals from out-of-state to treat Pennsylvania residents using telemedicine, when appropriate, due to COVID-19.” This guidance applies to the following boards: Chiropractic, Dentistry, Medicine, Nursing, Optometry, Pharmacy, Podiatry, Psychology, Osteopathic Medicine, Nursing Home Administrators, Occupational Therapy Education and Licensure, Physical Therapy, Social Workers, Marriage and Family Therapists, and Professional Counselors, Examiners in Speech-Language Pathology and Audiology, and Veterinary Medicine. Currently, no Pennsylvania law prohibits the practice of telemedicine. All practitioners using telemedicine in Pennsylvania must remain informed on all federal and state laws, regulations and guidance regarding telemedicine, including a practitioner’s obligations under the Health Insurance Portability and Accountability Act (HIPAA) and recent guidance provided by the U.S. Department of Health and Human Services Opens in a new window.
PDA also received the following teledentistry update today, March 25, from United Concordia: United Concordia is closely monitoring COVID19 and its impact on the communities we serve. While the situation is constantly changing, one thing remains constant: our focus is on the health and well-being of our customers –members, dentists, employers, producers and partners –and our valued employees. We have implemented processes and work models to ensure we continue to deliver uninterrupted service, including our employees beginning to work from home as of March 19, 2020. To assist in keeping our network dentists, their office staff and our members safe, we will cover teledentistry services for the next 90 days. Evaluations should be conducted using video or photographs. Please be sure all claims for these services are submitted as procedure code D0140. Frequency limitations will be reviewed on a case by case basis. [3/26/20 UPDATE] It is important to note that numerous other insurance carriers are including teledentistry in their coverage plans and you can find that information here on pages 8-13 of ADA’s COVID-19 Interim Coding and Billing Interim Guidance questions and answers on this and other topics.
We continue to encourage you to visit the COVID-19 forum on our PDA Go mobile app for answers on this and many other issues. 5
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COVID-19 PANDEMIC
DATE: March 25 RE: New CE Guidelines with Some Restrictions Governor Wolf has granted the Department of State’s request to suspend restrictions on distance-learning for continuing education requirements for certain licensed professionals, including dentists. Many licensing boards of the Bureau of Professional and Occupational Affairs have ongoing continuing education requirements. Although only a few boards are currently in renewal, many “in-person” continuing education programs are canceling courses or closing education centers and it is unknown how long they may be impacted.
The State Board of Dentistry is one of the boards that have restrictions on the number or percentage of continuing education hours that can be done through distance education. The governor granted a suspension of restrictions that limited the ability of licensees to take classes online or participate in distance-learning opportunities for the current biennial renewal period to permit all licensees to complete their continuing education online during the COVID-19 pandemic. 5
DATE: MARCH 26 FROM: PDA RE: Department of Health REVISES Guidelines for Dental Practices After consultation with leaders in organized dentistry, the Pennsylvania Department of Health has released updated guidelines for dental practices in Pennsylvania. The newly released document (REVISED Guidance on COVID-19 for Dental Health Care Personnel in Pennsylvania) replaces the Guidance on COVID-19 for Dental Health Care Personnel in Pennsylvania issued on March 22, and these updated guidelines are effective immediately. “We compliment the Policy Office of the Department of Health as well as the Governor’s office for having engaged organized dentistry, especially the Pennsylvania Dental Association, in revising the regulations from the March 22 document and listening to our concerns,” said Dr. Charles Incalcaterra, PDA president. “Now, dentists in Pennsylvania can provide emergency dental care to patients who have been suffering with severe pain and swelling, or who have had traumatic injuries to their teeth as a result of accidents, without the requirement to use negative pressure rooms which are not available in dental offices, hospitals, public health facilities or dental schools. “We are also pleased that patients needing life-saving medical procedures, such as cardiac surgery, kidney transplants, radiation and chemotherapy, can be screened for dental clearance by their dentists. We look forward to communicating regularly with the Department of Health as this crisis unfolds.” Routine dental care is still prohibited under this order. Only true dental emergencies and patients with urgent
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dental needs can be seen, and pre-screening procedures should be implemented prior to dentists seeing the patient. PDA members should review the infection control processes as outlined in the document and review the treatment recommendations for patients who are COVID-19 negative or who are not suspected of having COVID-19, as well as those who are COVID19 positive or are suspected of having the virus. The Department of Health has committed to continuing conversations with PDA leaders and others on a regular basis as COVID-19 continues to spread in Pennsylvania. In the future, new guidelines for the safe provision of routine dental care, when permitted, will be developed in cooperation with organized dentistry. If you have any questions that you would like directed to the Department of Health, please email those questions to Marisa Swarney at mss@padental.org and we will forward them to DOH for you. 5 We are battling a dangerous contagion that is multiplying rapidly within the Commonwealth, with the number of cases doubling every 2 to 3 days. Approximately 1 percent of the patients who contract this disease die, which is 10 times greater than the number of people who die from the flu each year. We implore you, for your safety and the safety of your staff, families and friends, STAY SAFE. STAY HOME.
The Philadelphia County Dental Society and The Pennsylvania Dental Association present
The 2020 Liberty Continuing Education Series at the Philadelphia Hilton City Avenue Hotel 4200 City Avenue, Philadelphia, PA FOUR full-day programs are scheduled at the SPECIAL MEMBER TUITION of $480.00 (individual full-day courses, $175.00/PCDS Member Dentist) Programs begin at 8:30 a.m. and conclude by 3:30 p.m. (unless otherwise stated). Continuing education credits awarded; hours will be deducted for those who arrive late and/or leave prior to conclusion. In recognition of the need for quality continuing education, and in an effort to make such programs attractive and accessible to members, PCDS and PDA are proud to present this package as a MEMBERSHIP BENEFIT. Every effort is made to bring you outstanding programs at minimal cost to you. Information and materials presented by clinicians are intended for your personal evaluation and are not necessarily endorsed by PCDS and PDA. PDA does not express or imply that individual courses will be accepted for various state mandatory continuing education requirements. The individual license holder must consult the regulations pertaining to your state/s. NO REFUNDS on courses purchased as part of the CE package. Refunds for courses purchased individually will be issued less a 10% administrative fee if the registration is cancelled in writing seven days prior to the program you are attending. Refunds are not issued for no shows. Each full-day program includes lunch and FREE parking validation. At the end of the calendar year, PDA will provide you with an annual transcript of all courses you attended through the Liberty CE Series. NOT a PCDS Member? ADA members may become Associate Members of the Society. Dues are $157 for the calendar year (no pro-rating). Contact the PCDS Executive Office (215) 925-6050 for an application or become a member through the website at www.philcodent.org. NOT an ADA Member? Contact PCDS about the Liberty Enrollment Program that will enable you to register for courses at the LOW member rate.
PDA is an ADA CERP Recognized Provider ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at ADA.org/CERP.
For continuing education credit, as designated by PDA, see individual course descriptions. Learning objectives are available on the printed brochure mailed in December 2018. Visit www.padental.org/calendar for updates on the list of principal sponsors and participating partners.
Course Information Ă&#x17D;
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CE 71 – Friday, May 15, 2020 8:30 to 3:30 p.m. Bunts, Punts, and Elbows – The Sports Dentistry Side of Your Practice AND S.M.A.R.T. Dentistry for Your Practice: Simplified Methods and Restorative Techniques presented by Douglas Lambert, DDS (6 CE credits recommended for dentists, dental assistants & EFDAs) Sports Dentistry—Athletic injuries to the orofacial region and the dentition are on the rise. Unique and timely techniques employed for diagnosing, treating and restoring these accidents are paramount in the successful long-term results. This half-day lecture will help prepare you to assess and treat dental trauma. S.M.A.R.T. Dentistry—The importance of being a savvy decision-maker can make a big difference in both the day-to-day clinical efficiency of the practice and the overall success we desire for our patients. Implementing the concept of S.M.A.R.T. dentistry - Simplified Methods and Restorative Techniques can offer many fundamentals in both technique and material selection for the dentist and the entire staff to meet or exceed these goals.
Presented in cooperation with Catapult Education Dr. Lambert is a Fellow in the Academy for Sports Dentistry, the American Society for Dental Aesthetics and a Diplomat of the American Board of Aesthetic Dentistry. Dr. Lambert serves as an independent consultant and clinical researcher for many dental manufacturers. Look for notices/emails from PDA re: potential rescheduling or postponement of May 15, 2020, course due to pandemic. For questions contact Rebecca Von Nieda at rvn@padental.org or at (717) 234-5941, ext. 117.
CE 70 Friday, September 25, 2020 (rescheduled from March 18) 8:30 a.m. to 3:30 p.m. Be Aware of Wear – A Systemic Approach to Diagnosing
Treatment, Planning, and Restoring the Worn Dentition AND Diagnosis, Treatment Options and Rehabilitation of Difficult and Unusual Cases presented by Thomas E, Dudney, DMD (6 CE credits recommended for dentists, dental assistants & EFDAs) Worn Dentition—In today’s society tooth wear is more prevalent and it is therefore incumbent upon the entire dental team to be well versed in recognizing the clinical signs of wear while understanding the importance of prevention when possible and the restorative options when necessary. This half-day lecture will illustrate the different types of tooth wear with clinical examples and demonstrate a systematic approach to diagnosis and treatment. Difficult and Unusual Cases—Sometimes the restorative dentist encounters clinical situations that are out of the ordinary and can often be difficult to treatment plan. This half-day lecture will examine several such cases in order to explore treatment options and develop treatment plans. Treatment results will be demonstrated along with helpful clinical tips.
Presented in cooperation with Catapult Education Dr. Dudney is the clinical director for the newly formed Pacific Aesthetic Continuum (PAC) hands-on programs. He also is an accredited member of the American Society for Dental Aesthetics and a Diplomat of the American Board of Aesthetic Dentistry.
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CE 72 – Wednesday, October 28, 2020
8:30 to 3:30 p.m. Essential Pharmacology for Treating Medically Complex Dental Patients and Patients who Self-Medicate presented by Thomas Viola, RPh, CCP (6 CE credits recommended for dentists, specialists, hygienists, dental assistants & EFDAs) Are you confident in your knowledge of medications and dietary supplements, as well as their interactions, adverse reactions and effects on patient management and treatment planning? This comprehensive lecture explores the dental implications of the prescription medications, non-prescription medications, herbal products, nutritional supplements and substances of abuse most frequently used by patients. Participants receive this essential information in a format that is practical and entertaining for the entire dental team. Dr. Viola is a board-certified pharmacist, clinical educator, professional speaker and published author. Tom’s programs provide an overview of the most prevalent oral and systemic diseases and the most frequently prescribed drugs used in their treatment. Tom has no relevant financial relationships to disclose.
CE 73 – Friday, December 4, 2020 8:30 to 10:30 a.m. Child Abuse Recognition and Reporting for Dental Professionals (Act 31) presented by Angela M. Stout, DMD, MPH (2 CE credits recommended for dentists, specialists, hygienists, dental assistants & EFDAs & all office personnel) This lecture is custom designed for dental professionals and will fulfill Act 31 mandatory CE requirements for licensed dental professionals (dentists, hygienists and EFDAs). NOTE: You must be present for the entire program in order to receive credit. Allow sufficient time for traffic, parking and program registration. Attendees will be asked to provide their full name, license number, date of birth and the last 4 digits of their social security number at registration. PDA will transmit this information to the state to verify that you completed the course for license renewal in 2021. No on-site registration for this course. Child Abuse Recognition and Reporting for Dental Professionals will fulfill your Act 31 CE requirement and is included in the CE package tuition but may be ordered as a single event; to order ONLY the Act 31 course, see CE 31 on the registration form. Dr. Stout is a pediatric dentist in private practice in Erdenheim, PA. She completed her dental degree in 1993 at Temple University School of Dentistry and a three-year pediatric dental residency at the Children's Hospital of Pittsburgh. While teaching full-time, Dr. Stout completed a master’s degree in Public Health at University of Pittsburgh Graduate School of Public Health. Dr. Stout has no relevant financial relationships to disclose.
10:45 a.m. to 12:45 p.m. Radiation Safety for Pennsylvania Dental Professionals presented by Karen Pass (2 CE credits recommended for dentists, specialists, hygienists, dental assistants, EFDAs & all office personnel) A thorough understanding of the principals of radiation is critical to patient and staff safety. The purpose of this lecture is to identify and review the applicable Pennsylvania radiation safety regulations for dental professionals, including the requirements of Pennsylvania Code Title 25 §221.11. Ms. Pass is the co-founder and principal compliance consultant for inUnison Consulting, LLC, providing workshops and seminars as well as comprehensive onsite regulatory compliance programs for dental, medical and veterinary facilities. Ms. Pass has no relevant financial relationships to disclose.
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1:45 p.m. to 3:45 p.m. Pain Management Alternatives and Identification of Addiction (Act 124) presented by E. Steven Moriconi, DMD, FACD, FICD (2 CE credits recommended for dentists, specialists, hygienists, dental assistants, EFDAs & all office personnel) The lecture will fulfill the Act 124 of 2016, CE requirement for dentists who have a current DEA registration or use another DEA number (as permitted by law) to prescribe controlled substances. Pain management, identification of addiction and the practices of prescribing opioids will be discussed. Dr. Moriconi is in private practice in Jenkintown, PA, and is the surgeon-in-chief of the Dental Division at Abington Hospital. He also serves as the director of the General Practice Residency Program at Abington Hospital. Dr. Moriconi has no relevant financial relationships to disclose. Visit www.padental.org/calendar for updates on the list of principal sponsors and participating partners.
PCDS Continuing Education Convenient Relevant Affordable Helping you meet your legal and ethical responsibilities. Registration Form Î
Due to the global COVID-19 pandemic, PDA has CANCELLED all sessions of
Pennsylvania’s Dental Meeting scheduled April 24 - 25, 2020, at the Mount Airy Casino Resort in Mt. Pocono, Pa.
Pennsylvania’s Dental Meeting WILL NOT be rescheduled for 2020, but we are exploring options to bring PDA’s business meeting and town hall open forum to interested members. All registered attendees will receive a full refund of the fees paid. Please allow us time to process the refunds. Exhibitors and sponsors will receive a full refund of monies paid to PDA to support Pennsylvania’s Dental Meeting.
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Register online at www.padental.org/calendar. NOTE: Online registration is now available for PCDS member dentists and staff attending a course with the dentist. Associate Members, Liberty Enrollees and Non-Member Dentists and staff attending without a dentist, please register using this form.
Use a SEPARATE reservation form for each person - this form may be duplicated.
RESERVATION FORM / 2020 LIBERTY CONTINUING EDUCATION SERIES ATTENDEE’S FULL NAME ADA # ____________________________ DESIGNATION (DDS, DMD, RDH, EFDA, OTHER) ATTENDEE'S E-MAIL
April/May/June 2020
TEL # (
)
ADDRESS CITY/STATE/ZIP INDICATE ANY DIETARY OR ACCESSIBILITY NEEDS
2020 Dates & Courses CE 71 – Friday, May 15 - Sports & S.M.A.R.T. Dentistry CE 70 – Friday, September 25 - Worn Dentition & Difficult Cases (rescheduled from March 2020) CE 72 – Wednesday, October 28 - Pharmacology CE 73 – Friday, December 4 - full day includes Act 31; Radiation Safety & Act 124
Full-Day Programs: select option & include the CODE NUMBER for each course you will attend (e.g., 71). PCDS Member for four FULL-DAY programs: # ____ ____ ____ ____ PCDS Member for one or two FULL-DAY program: # ____ ____ no. of programs selected =
$480.00
Best Value!
$175.00 x ____ $_______
ADA Member Dentist for one FULL-DAY program: # ____ ____ ____ ____ $250.00 x _____ no. of programs selected =
$_______
Non-Member Dentist for one FULL-DAY program: # ____ ____ ____ ____ $300.00 x ____ no. of programs selected. =
$_______
Hygienist, EFDA, non-licensed Office Personnel employed PCDS/ADA or PDA member: # ____ ____ ____ ____ $95.00 x ____ no. of programs selected =
$_______
Hygienist, EFDA, non-licensed Office Personnel employed by non-member: # ____ ____ ____ ____ $125.00 x ____ no. of programs selected =
$_______
ACT 31 PROGRAM ONLY (does not include lunch) on December 4 - CE 31 PCDS/PDA Member Dentist
$60.00
Non-member Dentist
$160.00
Hygienist, EFDA or Non-Licensed Office Personnel
$60.00
PAYMENT TO PDA ENCLOSED IN THE AMOUNT OF
$________
Method of Payment: check (payable to PDA) Visa MasterCard American Express Discover Credit Card #
______________ __
Exp. Date _
_/__
Name Printed on Card/ Signature Mail completed form and payment to PDA, P.O. Box 3341, Harrisburg, PA 17105. Forms with credit card payments can be faxed to (717) 232-7169, attn.: Rebecca Von Nieda. Completed registration forms/on-line registration must be received no later than 10 business days prior to the course. Questions may be directed to Rebecca at rvn@padental.org or (717) 234-5941, ext. 117. Confirmations will be emailed to attendees. CE transcripts will be mailed to you each year in December. Each attendee is responsible for forwarding copies to the appropriate licensing or accrediting agencies (State Board, Specialty Boards, etc.).
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The University of Pittsburgh School of Dentistry Guidelines for Prescribing Pain Medications for Outpatient Procedures The ADA News reported in November 2019 that The University of Pittsburgh School of Dentistry became “the first institution of its kind to establish a set of opioid-free pain management guidelines for the majority of out-patient procedures performed in its dental clinics.” This was in an effort “to reduce opioid prescribing and abuse by emphasizing non-narcotics” for the management of pain. Dr. Bernard Costello, dean of Pitt’s dental school, wrote that the guidelines “should help provide a lower risk for our communities}so that addiction rates hopefully go down and our communities are not ravaged by this as they have been.” The new guidelines were instituted in early November 2019, and in a Pittsburgh Post-Gazette article Dr. Costello stated that the use of Tylenol and/or Ibuprofen can treat the vast majority of outpatients as a “first-line agent” for pain control, without the use of narcotics, while avoiding narcotic side-effects and the potential for addiction. The guidelines do include alternatives for patients that cannot tolerate the non-opioid regimen, or if increased pain relief is required. In this case, the prescribed amount is limited, and the patient’s record must be checked in the state’s Prescription Drug Monitoring Program. The editors would like to express our appreciation to Dean Costello for permitting us to reprint the new University of Pittsburgh School of Dentistry prescribing guidelines.
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University of Pittsburgh School of Dental Medicine
A commitment to opioid-free pain management GUIDELINES FOR PRESCRIBING PAIN MEDICATIONS FOR OUTPATIENT PROCEDURES
I.
Statement of purpose The rampant abuse of opioid medications has necessitated a dramatic change in the way healthcare providers consider managing pain after a procedure, or as part of ongoing treatment. Prescription pain medications are a part of a variety of strategies for managing pain. While much has been done to decrease the patterns of over-prescribing pain medications, these guidelines are provided to help guide clinicians when making decisions, specifically regarding the use of narcotic-based pain medications. It is very clear that a number of alternatives to narcotic pain medications are not just as effective as narcotic pain medications in many situations but are almost always preferred in patients undergoing outpatient procedures without incurring the risk of addiction, other risks, or the side-effects associated with narcotics. This document establishes guidelines for prescribing pain medication after procedures at the School of Dental Medicine. While it is recognized that narcotics can and should be avoided in most outpatient scenarios, clinical judgement should always be utilized when making decisions and individual care based on circumstances is needed. Exceptions are inevitable but should be rare.
II.
Guidelines for dental pain management In the process of delivering care and assessing post-operative pain the prescriber should try to estimate the severity, duration, and patient’s individual risk when prescribing pain medications. For example, the simpler the procedure (routine extractions as opposed to surgical extractions), the less likely the patient will suffer severe postoperative pain. In addition, individual patient characteristics may alter patient thresholds for pain or increase sensitivity to narcotics; for example, advanced age, history of substance abuse, obstructive sleep apnea, concomitant use of benzodiazepines or use other drugs that may cause respiratory depression or mental status changes. Pain is multifactorial, and it is up to the individual provider to make an informed decision regarding what medications are indicated in each clinical scenario. A. Providers should prescribe pain medication other than opioids as first-line analgesic therapy, unless contraindicated. B. The Patient’s Prescription Drug Monitoring Program (PDMP) database should be reviewed as per Commonwealth regulations, if considering prescribing an opioid. C. When opioids must be utilized primarily or as a rescue medication, the lowest potency opioid should be chosen to help relieve the patient’s pain. The duration of therapy should be estimated based on the severity of the procedural insult and nature of the procedure. D. Opioids should not be prescribed to a patient who is already prescribed opioid medications by another provider for chronic pain or substance abuse disorder (related or unrelated to current problem) without consultation with the pain management physician and a plan that is documented in the electronic medical record. E. When opioid prescriptions are provided, they should be limited to a three-day supply unless otherwise indicated for unusual circumstances.
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III.
Strategies for Anticipating the level of post-procedure pain in outpatients
While pain tolerance is variable in individuals, most procedures can be classified with potential pain levels as mild, moderate or high when the surgical disruption is typical for the procedure performed. Individual variations may necessitate modifying the guidelines. A. Pain levels i. Mild: simple extractions, anterior teeth, periodontally diseased teeth, asymptomatic teeth requiring an extraction (i.e. extractions for orthodontic purposes with no periapical pathology), elective root canal therapy, simple periodontal procedures. ii. Moderate: surgical extractions, difficult posterior teeth, mild to moderately symptomatic teeth (periapical pathology), apicoectomies, periodontal surgery in several areas, most autogenous bone grafting procedures. iii. High: very difficult surgical extractions, some completely impacted teeth, some severely symptomatic teeth (significant periapical pathology), some urgent or emergent root canal therapies where extensive inflammation is not relieved.
IV.
Prescribing Guidelines
NSAIDS Tolerated: Anticipated Pain Severity Analgesic Recommendation (typical dosing for a healthy adult) Mild Ibuprofen (400mg q4h, 600mg q6h, 800mg q8h) scheduled for 24 hours then PRN pain -orAcetaminophen 500 mg Q4h or 1000mg q8h scheduled for 24 hours then PRN pain Moderate
1. Ibuprofen (400mg q4h, 600mg q6h, 800mg q8h) scheduled for 24 hours then PRN pain -and2. Acetaminophen 500 mg Q4h or 1000mg q8h scheduled for 24 hours then PRN pain
High and Rescue
1. Ibuprofen (400mg q4h, 600mg q6h, 800mg q8h) scheduled for 24- 48 hours then PRN pain -and2. Acetaminophen 500mg Q4h or 1000mg q8h scheduled for 24-48 hours then PRN pain -andOxycodone 2.5 - 10 mg Q 4-6 h scheduled for 24 hours the PRN pain Typically, oxycodone 5 mg Q 4 to 6 h for 24 hours then PRN
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NSAIDS contraindicated: Pain Severity Mild
Analgesic Recommendation (typical dosing for a healthy adult) Acetaminophen 500mg q4h scheduled for 24 hours then PRN pain
Moderate
Tramadol 50 mg to 100 mg every four to six hours, not to exceed 400 mg
per day. -or-
Hydrocodone-Acetaminophen 5/325 mg q4-6h scheduled for 24 to 48 hours then PRN pain High
1. Acetaminophen 500mg q4h scheduled for 24 hours then PRN pain -and2. Oxycodone 2.5-10mg q4-6h scheduled for 24 hours then PRN pain
APAP contraindicated: Pain Severity Mild
Analgesic Recommendation Ibuprofen (400mg q4h, 600mg q6h, 800mg q8h) scheduled for 24 hours then PRN pain
Moderate
Ibuprofen (400mg q4h, 600mg q6h, 800mg q8h) scheduled for 24 to 48 hours then PRN pain -orTramadol 50 mg to 100 mg every four to six hours, not to exceed 400 mg
per day. High
1. Ibuprofen (400mg q4h, 600mg q6h, 800mg q8h) scheduled for 24 hours then PRN pain -and Oxycodone 2.5-10mg q4-6h scheduled for 24 hours then PRN pain -or Tramadol 50 mg to 100 mg every four to six hours, not to exceed
400 mg per day.
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THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY
Both APAP/Ibuprofen contraindicated: Pain Severity Mild-High
Analgesic Recommendation Oxycodone 2.5-10mg q4-6h scheduled for 24 hours then PRN pain
Additional Considerations x Patients should be warned to avoid acetaminophen (APAP), including combination formulations in prescription or in over-the-counter medications). x Maximum daily dose of APAP is 3,000 mg per day. To avoid potential APAP toxicity, consider prescribing an opioid rescue medication containing ibuprofen. x A typical adult maximum dose of ibuprofen is 2,400 mg per day. Higher maximal daily doses have been reported for osteoarthritis when under the direction of a physician. x A decrease in postoperative pain severity has been demonstrated when a nonsteroidal anti-inflammatory drug is administered pre-emptively. x Long acting local anesthetics can delay onset and severity of postoperative pain. x Perioperative corticosteroid (dexamethasone) limit swelling and decrease postoperative discomfort after third-molar extractions. x Tramadol and codeine should be avoided in children due to Black Box Warning. x Acetaminophen in children: 15mg/kg/dose, q6 hr. maximum 90 mg/Kg/ 24 hours. x Ibuprofen in children: 5-10mg/kg/dose q6 hours, maximum 40mg/Kg/24 hour References: Virginia Commonwealth University Opioid Prescribing Guidelines Bicket, M. et. al. Prescription Opioid Analgesics commonly unused after surgery. JAMA Surgery. 2017, 152, 11. Brummett, C. et.al. New persistent Opioid use after minor and major surgical procedures. JAMA Surgery. 2017, 152, 6. Scully, R. et.al. Defining optimal length of pain medication prescription after common surgical procedures. JAMA Surgery. 2018. 153, 1. Moore PA, Ziegler KM, Lipman RD, Aminoshariae A, Carrasco-Labra A, and Mariotti A. Benefits and harms associated with analgesic medications used in the management of acute dental pain: An overview of systematic reviews. J Am Dent Assoc. 2018:149(4):256-268. Denisco, Richard C. et al.(2011). Prevention of prescription opioid abuse. The Journal of American Dental Association, 142(7), 800-810. Thorson, D. et al. (2014). Acute pain assessment and opioid prescribing protocol. Institute for Clinical Systems Improvement. Massachusetts General Hospital. Opioid Prescription Strategy. Available at: http://www.massgeneral.org/orthohand/assets/pdfs/Hand_Service_Opioid_Policy.pdf American Dental Association Statement on the Use of Opioids in the Treatment of Dental Pain. 2016. "http://www.ada.org/en/about-the-ada/ada-positions-policies-and-statements/statement-on-opioids-dental-pain".
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Spread and Treatment of COVID-19 Gabe Mirkin, MD The United States now has the most cases of COVID-19 in the world because we were not prepared for the pandemic. COVID-19 first appeared in early December in a seafood and live animal market located next to a major train station in Wuhan, China. Three nearby countries, South Korea, Taiwan and Vietnam, were able to control the spread of COVID-19 because by the end of December, they had recognized the potential epidemic and aggressively tested suspected cases to separate them from society before they spread the disease logarithmically through their communities. A key to stopping an epidemic is to find and isolate cases before they infect the community. These three countries: 5 warned their citizens of the seriousness of COVID-19, 5 had the available diagnostic testing to diagnose infection, 5 offered special booths for testing individuals by insulated and protected workers, and 5 isolated the people who were found to be infected. As of March 27, we have no drugs that have been proven to be effective for shortening the course of COVID-19 infections. Several possible drugs are currently being tested in the midst of the massive outbreak in New York City. The inexpensive malaria drug, chloroquine phosphate, has been reported to reduce symptoms and hasten recovery in small studies (Biosci Trends, Mar 16, 2020;14(1):72-73). This is the drug that has been used for more than 70 years to treat malaria. The similar drug, hydroxychloroquine (trade name Plaquinil), is also being tested, alone or in combination with azithromycin (Zithromax), an antibiotic. The Japanese antiviral drug, favipiravir (Avigan) or favilavir, was tried in two studies in China,
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THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY
one on 340 patients and one on 70 patients, and appeared to be “safe and effective.” AIDS drugs, flu drugs, ACE inhibitor blood pressure pills, and interferon are all controversial, with most experts saying that they have not been shown scientifically to be effective. Pain medicines such as ibuprophen or Tylenol may relieve some of the discomfort, but do not shorten the course of the disease. Many companies are working to develop blood tests to see if a person has been infected with COVID-19 and is therefore now immune and protected from getting the infection again. These people may be in the front lines to treat people who are currently infected and may be able to donate blood with antibodies that could be helpful in treating COVID-19 patients. Vaccines are also being developed but will not be ready for 18-24 months. Restrictions on movement and social distancing should not be removed until the number of cases of COVID-19 starts to go down, and in my opinion, that is not likely to happen until July or August. For my latest summary and recommendations on COVID-19, see The Current Coronavirus Pandemic 5 Reprinted with permission of Dr Gabe Mirkin from his Fitness and Health E-Zine, March 27, 2020. To subscribe to his free newsletter, go to DrMirkin.com He does not sell, rent or give your e-mail address to anyone.
For the most current information about the COVID-19 virus, please visit the Pennsylvania Department of Health’s website.
COVID-19 News Briefs Summary and Answers About Families First Coronavirus Response Act The U.S. Senate and House passed a coronavirus legislation package March 18 that was signed into law by President Trump. HR 6201, the Families First Coronavirus Response Act, is of great interest to dentistry. The ADA summarized three issues of most interest to dental practices: (1) emergency paid sick leave; (2) emergency expansion of family and medical leave; and (3) tax credits. Today, PDA has more answers for you with a summary of the legislation from our legal counsel Eckert Seamans, as well as FAQS. Of note: The new law only applies to staff who test positive with coronavirus, are selfquarantined or are home with children because schools are closed. The leave time does not apply to business closures. In addition, the reimbursement for smaller businesses applies only if staff members are sick with COVID-19, self-quarantine or school closures. We know you have more questions about numerous employment issues surrounding the current crisis. Please direct your questions to Mary Donlin, interim executive director, at med@padental.org. 5
Federal Tax Filing Deadline Extended to July 15 The Internal Revenue Service and the Pennsylvania Department of Revenue have extended the deadline for individuals and businesses to file and pay federal and state income taxes until July 15. Additionally, all state penalties and interest on 2019 personal income tax payments will also be waived through the new deadline. Taxpayers who make quarterly estimated payments will also receive an extension. Both first and second quarter payments will be due July 15. More guidance from the IRS is available here. State guidance is available at: www.revenue.pa.gov 5
Business Loans and Support The Department of Community and Economic Development (DCED) offers working capital loans that could be of assistance to businesses impacted by COVID-19. Resources and
information will be posted to http://dced.pa.gov/resources as they become available. The U.S. Small Business Administration, in addition to local funding partners, may also be a source of assistance for affected businesses. The Wolf Administration announced March 19 the availability of low-interest loans for small businesses and eligible non-profits in all 67 counties in Pennsylvania through the U.S. Small Business Administration (SBA). Businesses seeking guidance from DCED can also contact its customer service resource account at ra-dcedcs@pa.gov or by calling 1-877PA-HEALTH and selecting option 1. The Pennsylvania Industrial Development Authority (PIDA) has approved funding to provide $61 million in low-interest loans to Pennsylvania’s small businesses impacted by the COVID-19 public health emergency. Loans of up to $100,000 will be available through the Pennsylvania Commonwealth Financing Authority (CFA) for small businesses with 100 or fewer full-time employees to use as working capital. In addition to a low interest rate, there will be no application fees, and the terms will include no payments and no interest during the first year of the loan. Funding for the program was made possible by the CFA’s transfer of $40 million in funding to PIDA. That money will be combined with existing funds in PIDA’s Small Business First Program to provide low-interest loans to small businesses. 5
On-Demand Now: COVID-19 Infection Control Protocols and Procedures Webinar The ADA teamed up with leading infection control experts from the Organization for Safety, Asepsis, and Prevention (OSAP) to provide the dental community with practical guidance and education as we navigate the challenges the COVID-19 is presenting to our profession. In the webinar, leading infection control experts Eve Cuny, MS and Kathy Eklund, RDH, MHP share answers to common questions about infection control protocols and procedures during the COVID-19 crisis, including: (continued on page 32)
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COVID-19 News Briefs (cont’d) What are the PPE requirements for treating patients? How do these requirements differ if the patient is confirmed to be COVID-19 positive? x What operatory room disinfection procedures should be observed? x What are the differences between the various types of masks? Which masks are appropriate for which procedures? x Are there special considerations for the use of cavitrons or high-speed handpieces? The full recording of this webinar is available for one hour of 1 free CE credit. x
WATCH THE WEBINAR NOW 5
Free CE Resources for You and Your Staff PDA’s online CE courses are available anytime. Visit www.padental.org/calendar and click on the Prerecorded Events tab to review the list of online CE courses. All PDA member dentists have a user id and password to access online CE. Non-dentist team members will need their own record in PDA’s database before they can access PDA’s online CE. Contact PDA with the name, mailing address and unique email address for each dental team member interested in completing PDA’s online CE courses. Online courses currently available include: x Act 124 - Pain Management Alternatives & Identification of Addiction – 2 CE credits x Radiation Protection Update – 2 CE credits x Promoting Human Papillomavirus (HPV) Vaccination in Primary Care and Dental Practices – 2 CE credits x
OSHADontics – Work Place Safety for Dental Offices – 1 CE credit
x
Antibiotic Stewardship – 1 CE credit
To Pull or not to Pull – 2 CE credits (Alternative treatment options for restorative and/or endodontic failures) New – Cyber Security Information Security Basics offers insight into the current threat landscape for cyber risk and explains the x
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THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY
basic fundamental protections organizations can put in place to reduce their cyber risk. We encourage you to take advantage of this excellent, free resource. 5
Opportunity to Help Long-Term Care Providers with PPE Hospitals and other long-term care facilities across the United States are running out of the masks, gowns, gloves, goggles and other equipment they need to protect staff against the unprecedented medical challenges from the coronavirus as they struggle to take care of patients. Pennsylvania’s long-term care providers, including nursing homes, personal care homes and assisted living residences are also facing the challenge of the shortage of personal protective equipment (PPE). If your practice is closed temporarily, please consider donating any PPE supplies that aren't immediately needed – perhaps a box or two of masks – to your local hospital or other longterm care facilities, to help our fellow caregivers in Pennsylvania. This is great way for the dental profession to continue to make valuable contributions and help our communities during this difficult time, even while your practice might be closed temporarily. While SourceOne no longer has masks available, you can still purchase other supplies. Gloves and wipes are both available to existing customers via PDA Perks at a maximum of two cases per week (subject to availability) and all other PPE products are being sold as available. SourceOne is doing whatever they can to bring in as much inventory as possible to prevent a disruption of supplies. If you would like to donate PPE supplies, please reach out to Shayna Varner at the Pennsylvania Health Care Association, at svarner@phca.org to coordinate your donation to ensure providers most in need receive these supplies. 5 (continued on page 33)
COVID-19 News Briefs (cont’d) Prescribing Controlled Substances During COVID-19
The Pennsylvania Department of Health is seeking to ensure that critical medications and treatments remain accessible to all who need them during the ongoing COVID-19 emergency. Following is a compilation of state and federal guidance and resources relating to prescribing controlled substances and treating patients with substance use disorders during this difficult time.
x x
x
x
Download Here
PA Unemployment or Workers’ Compensation Benefit Information
If you are employed in Pennsylvania and are unable to work because of coronavirus disease (COVID-19), you may be eligible for Unemployment or Workers' Compensation benefits. The Department of Labor & Industry will continue to provide important employment benefit updates as the situation evolves.
x
Visit our COVID-19 site for information and FAQs updated regularly.
x
Unemployment Compensation Benefits You may be eligible if: x Your employer temporarily closes or goes out of business because of COVID-19 x Your employer reduces your hours because of COVID-19 x You have been told not to work because your employer feels you might get or spread COVID-19 x You have been told to quarantine or self-isolate, or live/work in a county under government-recommended mitigation efforts Apply: x Online – it's the fastest and easiest way to get started Important info: x If you are eligible for UC, you will receive two letters and a four-digit PIN x
Your PIN will arrive in the U.S. mail – keep it in a safe, easy to remember place
If approved, your first benefit payment should arrive within four weeks of filing for UC Continue filing your bi-weekly claim (every two weeks) – even while waiting for approval We are experiencing very large call volumes. Please email us at uchelp@pa.gov, or via UC LiveChat. (NEW) The Waiting Week is suspended. Previously, claimants were not eligible for benefits during their first week of unemployment (the “waiting week.”) This has been suspended; eligible claimants may receive benefits for the first week that they are unemployed (NEW) Work Search and Work Registration requirements are temporarily waived for all UC claimants. Claimants are not required to prove they have applied or searched for a new job to maintain their UC benefits. Claimants are also not required to register with www.PACareerLink.pa.gov. At this time, benefits are not being extended beyond 26 weeks.
Workers' Compensation (WC) Benefits Two filing options: x If you believe you may have been exposed to COVID-19 in your workplace, you may be eligible for Workers' Compensation (WC) by either: 1. Notifying your employer to file a typical “disease-as-injury” WC claim, which requires you to provide medical evidence that you were exposed to COVID-19 in the workplace 2. Notifying your employer to file an “occupational disease” WC claim, which requires you to show that COVID-19 is occurring more in your occupation/ industry than in the general population Claims: x All WC claims (including COVID-19) are thoroughly reviewed, and decisions are made based on the facts and merits of each claim and the law (continued on page 34)
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COVID-19 News Briefs (cont’d) x
If your COVID-19 claim is denied, you may file a petition with the WC Office of Adjudication
x
Learn more about Workers' Compensation and the Injured Worker 5
https://www.nimh.nih.gov/health/find-help/index.shtml In addition, PDA’s Health and Well-Being Program, administered by the Physician’s Health Program, offers a comprehensive assistance program that responds to referral statewide, and offers a structured, monitored and long-term recovery program. The program responds in a compassionate and confidential manner to dental professionals suffering from substance use disorders or mental illness, such as anxiety and depression. If you are struggling and need assistance coping with increased stress and anxiety levels right now, or suffering from addiction or mental illness, or you are aware of somebody in the dental community who may be exhibiting warning signs, please consider contacting PDA toll free at (800) 223-0016. 5
Managing Anxiety & Stress During the COVID-19 Crisis The unknowns surrounding the coronavirus can cause additional stress and mental fatigue for dental professionals who already experience a high amount of stress and fatigue on a daily basis. The Centers for Disease Control and Prevention (CDC) has issued guidance on managing stress and anxiety, which can be found here: https://www.cdc.gov/coronavirus/2019-ncov/prepare/managing-stress-anxiety.html The National Institute of Mental Health is another helpful resource during this rapidly evolving situation.
MOM-n-PA DENTAL MISSIONS
“DENTISTRY WITH A HEART” Due to the COVID-19 pandemic, we have cancelled our June 2020 mission. IT HAS BEEN RESCHEDULED FOR JUNE 4 AND 5, 2021. Please block off these new dates in your calendars now! We apologize for the inconvenience as we know thousands look forward to this event every year. It was a tough decision, but it is important at this time to keep everyone safe. Stay safe and healthy, and we will see you at the Liacouris Center June 4 and 5, 2021!
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Dental Dates The JOURNAL welcomes news concerning activities of your dental study club or other bona fide dental associations. Send information (as formatted below) to the Journal of the Philadelphia County Dental Society at PhilaDentalJournal@yahoo.com Deadline for publication is the first of the month prior to publication (June 1 for July/August/Sept issue), and information will be published on a space-available basis.
Due to the COVID-19 pandemic, please reach out directly to the sponsoring organization to confirm the event has not been cancelled. MAY 6
CONTINUING EDUCATION FOR DENTAL EXCELLENCE – 6:30 p.m. Dinner meeting (Gallo’s Restaurant) featuring Rabie Shanti, DMD, MD, “Case Based Discussion of Benign and Malignant Pathology of the Oral Cavity.” For information, contact Vickie Fisher at (215) 732-4450 or Vickie.LocustStPerio@gmail.com or visit www.PhilaPerioImplants.com or www.LocustStPerioImplant.com
PHILADELPHIA COUNTY DENTAL SOCIETY – Continuing Education Program at the Hilton Philadelphia City Avenue Hotel. 8:30 to 3:30 p.m. “Bunts, Punts, and Elbows – The Sports Dentistry Side of Your Practice” AND “S.M.A.R.T. Dentistry for Your Practice: Simplified Methods and Restorative Techniques” presented by Douglas Lambert, DDS. Register online at www.padental.org/calendar. Look for notices/emails from PDA re: potential rescheduling or postponement of May 6, 2020, course due to pandemic. For questions contact Rebecca Von Nieda at rvn@padental.org or at (717) 234-5941, ext. 117.
15
JUNE 10
CONTINUING EDUCATION FOR DENTAL EXCELLENCE – 6:30 p.m. Dinner meeting (Gallo’s Restaurant) featuring Naren Rajan, DMD, Topic TBA. Sponsored in cooperation with Straumann. For information, contact Vickie Fisher at (215) 732-4450 or Vickie.LocustStPerio@gmail.com or visit www.PhilaPerioImplants.com or www.LocustStPerioImplant.com
JULY TBD
CONTINUING EDUCATION FOR DENTAL EXCELLENCE – 6:30 p.m. Dinner meeting (Gallo’s Restaurant). For information, contact Vickie Fisher at (215) 732-4450 or Vickie.LocustStPerio@gmail.com or visit www.PhilaPerioImplants.com or www.LocustStPerioImplant.com
AUGUST No classes scheduled at this time.
SEPTEMBER 16
CONTINUING EDUCATION FOR DENTAL EXCELLENCE – 6:30 p.m. Dinner meeting (Gallo’s Restaurant) featuring Katherine France, DMD, MBE, “Non-Surgical Temporomandibular Pain Management.” For information, contact Vickie Fisher at (215) 732-4450 or Vickie.LocustStPerio@gmail.com or visit www.PhilaPerioImplants.com or www.LocustStPerioImplant.com
25
PHILADELPHIA COUNTY DENTAL SOCIETY – Continuing Education Program at the Hilton Philadelphia City Avenue Hotel. 8:30 to 3:30 p.m. “Bunts, Punts, and Elbows – The Sports Dentistry Side of Your Practice” AND “S.M.A.R.T. Dentistry for Your Practice: Simplified Methods and Restorative Techniques” presented by Douglas Lambert, DDS. Register online at www.padental.org/calendar.
OCTOBER TBD
CONTINUING EDUCATION FOR DENTAL EXCELLENCE – 6:30 p.m. Dinner meeting (Gallo’s Restaurant). For information, contact Vickie Fisher at (215) 732-4450 or Vickie.LocustStPerio@gmail.com or visit www.PhilaPerioImplants.com or www.LocustStPerioImplant.com
(continued on paged 36)
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Dental Dates (cont’d) OCTOBER (cont’d) 28
PHILADELPHIA COUNTY DENTAL SOCIETY – Continuing Education Program at the Hilton Philadelphia City Avenue Hotel. 8:30 to 3:30 p.m. “Essential Pharmacology for Treating Medically Complex Dental Patients” AND “Self-Medication: Dental Considerations and Patient Care Planning” presented by Thomas Viola, RPh, CCC. Register online at www.padental.org/calendar.
NOVEMBER TBD
CONTINUING EDUCATION FOR DENTAL EXCELLENCE – 6:30 p.m. Dinner meeting (Gallo’s Restaurant). For information, contact Vickie Fisher at (215) 732-4450 or Vickie.LocustStPerio@gmail.com or visit www.PhilaPerioImplants.com or www.LocustStPerioImplant.com
DECEMBER 4
PHILADELPHIA COUNTY DENTAL SOCIETY – Continuing Education Program at the Hilton Philadelphia City Avenue Hotel. 8:30 to 3:30 p.m. “Child Abuse Recognition and Reporting” presented by Angela M. Stout, DMD, MPH; “Radiation Safety for Pennsylvania Dental Professionals” presented by Karen Pass AND “Pain Management Alternatives and Identification of Addiction” presented by E. Steven Moriconi, DMD, FACD, FICD. Register online at www.padental.org/calendar.
9
CONTINUING EDUCATION FOR DENTAL EXCELLENCE – 6:30 p.m. Dinner meeting (Gallo’s Restaurant) featuring Kathryn Gilliam, BA, RDH, FAAOSH, “The Celiac Surge: Oral Signs of a New Epidemic.” For information, contact Vickie Fisher at (215) 732-4450 or Vickie.LocustStPerio@gmail.com or visit www.PhilaPerioImplants.com or www.LocustStPerioImplant.com
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THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY
What Can You and Your Children Do While Staying at Home? Plenty! Take Virtual Field Trips to See the Best National Parks Kenai Fords National Park, Alaska Rappel into a crevasse, kayak through icebergs, and watch a glacier recede. Hawai’i Volcanoes National Park, Hawai’i Fly over an active volcano, explore a lava tube, and look out across volcanic cliffs. Carlsbad Caverns National Park, New Mexico Fly with thousands of bats, explore incredible formations, and trek by headlamp through a cave. Bryce Canyon National Park, Utah Gaze up at the night sky, ride horseback through a canyon, and see hoodoos up close. Dry Tortugas National Park, Florida Dive a shipwreck, swim through the third-largest coral reef in the world, and tour a Civil War-era fort.
Enjoy Music? Go to the Metropolitan Opera House New York’s The Metropolitan Opera has canceled the rest of its season in light of coronavirus, but opera fans will still have access to stream performances every night via the Met’s website. Carmen, La Boheme, Tristan and Isolde, and many more have been on the schedule. The Met also has a subscription service called Met Opera On Demand, which offers access to their entire library of recorded operas for $4.99/month (with a 7day free trial).
1. Visit www.metopera.org 2. Scroll until you find the “Nightly Opera Stream” 3. Click “Watch Now” on the current offering
Visit more than 2,500 Museums Go to Google Arts and Culture where you can visit more than 2,500 Museums around the world! There are LOTS of fun things you can see on Google Arts and Culture!
Read Digital Books and Magazines Read digital books, magazines and more with Scribd. They have opened their library for a free 30-day trial. Sign up at their website and start listening. After 30 days, the subscription is $8.99/month.
Let Your Kids Listen to Some of Their Favorite Stories Audible has introduced Audible Stories, which offers a number of classics, such as Winnie the Pooh, The Jungle Book, Alice’s Adventures in Wonderland, The Call of the Wild and more. Audible Stories can be accessed on your computer, tablet or smartphone. There is no log in or personal information required; just visit stories.audible.com, click “start listening” and let the stories come alive. Audible Stories is free for as long as schools are closed.
Watch Game of Thrones for a Full Week Free with HBO Now It’s not just Game of Thrones. HBO’s streaming service, HBO Now, offers all of its original TV shows, a number of blockbuster movies, and talk shows for 7 days free. After that, the cost is $14.99/month if you want it. 1. Visit the HBO Now sign-up page 2. Fill in your contact info and credit card number 3. Start watching
Are Your Kids Receiving Enrichment Assignments? Khan Academy Can Help! Khan Academy, a nonprofit that provides free educational curriculum for all ages, is going to make a lot of parents very happy with their at-home schedule templates. These free guides are organized by grade level, and establish class periods throughout the day, accompanied by links to Khan Academy lessons. It accounts for a full day, from wake-up to bedtime. (Good luck if you have teenagers!)
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Am Pract Philad Cty
10/2/12
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VALUATION • MARKETING NEGOTIATION • CONTRACT REVIEW FINANCING • MINIMIZING TAXES TRANSITION PLANNING WITH PATIENTS & STAFF AND SO MUCH MORE!
www.ameriprac.com
Philip A. Cooper, D.M.D., M.B.A. 704 East Main Street, Suite D • Moorestown, New Jersey 08057 856-234-3536 • 800-400-8550 • cooper@ameriprac.com 38
THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY
Membership Report
We welcome the following to membership in the Philadelphia County Dental Society FEBRUARY 2020 ACTIVE MEMBERS Dr. Rachel L. Bresler Temple University Kornberg School of Medicine, 2014 Case Western Reserve University School of Dental Medicine (Pediatrics), 2018 Dr. Takako Tanaka University of Detroit Mercy School of Dentistry Dental Clinic, 2009 University of Pennsylvania School of Dental Medicine (Oral Medicine), 2006 Dr.Wolodymyr Zin New York University College of Dentistry, 2007 RECENT GRADUATES Dr. Sara Gholam University of Pennsylvania School of Dental Medicine, 2017 Indiana University School of Dentistry/ Riley Children’s Hospital (Pediatrics), 2019
Dr. Jenish G. Kizhakkemuriyil University of the Pacific Arthur A. Dugoni School of Dentistry, 2019 GRADUATE STUDENTS Dr. Laurie Kane April/May/June April/May/June 2020 2020 University of Southern California, Herman Ostrow School of Dentistry, 2006 University of California, Los Angeles School of Dentistry (General), 2007 Temple University Kornberg School of Medicine (Pediatrics), 2021 Dr. Ryan Look Albert Einstein Medical Center (General), 2020 Dr. Amanda Settle University of Maryland School of Dentistry, 2018 St. Christopher’s Hospital for Children (Pediatrics), 2020
Classified Ads Classified Advertisement Policy. The Society reserves the right to accept, decline or withdraw classified advertisements at its discretion. The Society believes the advertisements that appear in these columns are from reputable sources; the Society neither investigates the offers being made nor assumes any responsibilities concerning them. Every precaution is taken to avoid mistakes, but responsibility cannot be accepted for clerical or printer’s errors. Requests to run advertisements “until further notice” cannot be accepted; the advertiser is responsible for renewals. Names of box number advertisers cannot be revealed. The JOURNAL reserves the right to edit copy of classified advertisements. Classified ads will not be taken over the telephone.
DOCTOR, ARE YOU SEEKING EMPLOYMENT? Call the Philadelphia County Dental Society at (215) 925-6050 or Fax (215) 925-6998 to have your name listed on our employment referral list. Monday, Wednesday & Thursday, 9 a.m. to 5 p.m. DOCTOR, ARE YOU LOOKING FOR AN ASSOCIATE or for a dentist to work in your practice? Call the Philadelphia County Dental Society at (215) 9256050 or Fax (215) 925-6998 for the list of dentists seeking employment. Monday, Wednesday & Thursday, 9 a.m. to 5 p.m. FOR SALE – Dental Practice located in South Jersey, 25 minutes to Atlantic City. Turn-key operation, 41 years established. Dentist retiring. 3 operatories, panorex, gendex, small equipment, all supplies, records. Price negotiable/Best reasonable offer. (609) 561-1500. POSITION AVAILABLE – Fee-for-service suburban Philadelphia multi-specialty group practice seeks individual for long-term relationship leading to equity ownership. Advanced training in restorative dentistry or experience required. Email dental632@comcast.net
PRACTICE TRANSITIONS – We specialize in Practice Sales, Appraisals and Partnership Arrangements. Ask about our free guides for Sellers and Buyers. For information on services and listings, contact Philip Cooper, D.M.D., M.B.A., American Practice Consultants, toll free 1-800-400-8550, or contact http://www.armeriprac.com PROPERTY & EQUIPMENT FOR SALE or RENT – 6800 Torresdale Ave., Philadelphia, 19135. Property consists of 2 stories over 2,000 square feet per floor. Upstairs are 3 rental properties currently occupied. Ground level dental office has 3 operatories furnished with modern A-DEC equipment in good condition. Also included would be several thousand patient files of neighborhood patients treated when I participated in HMO plans. I have additional offices which no longer afford me time at this location. This could be a GOLDEN OPPORTUNITY for any dentist who participates in HMO and/or Medicaid. For more information please call (215) 673-4017 or email at richardip@yahoo.com
THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY
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