The Journal of the Philadelphia County Dental Society Vol 87 Issue 1 by Teresa Ravert

of the Philadelphia County Dental Society January/February/March 2021

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THE JOURNAL

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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 SKRWR RI /RQJ %HDFK ,VODQG VXQULVH FRXUWHV\ RI 5LWD 6FXOO\ /DYHQEHUJHU FRS\ULJKW

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President’s Message Renee Fennell, DMD Dear Colleagues, What is your “FOCUS WORD” for 2021? At the beginning of every year, I look forward to retreating to my family’s favorite get away spot for a time of reflection, rejuvenation, and planning for the New Year. I choose one word that will serve as my mantra for the year, as I navigate my family, friends, home, office, and all the initiatives that I love working with including Philadelphia County Dental Society. Sad to say, it will not happen this year.

the end of the year, I successfully moved quickly on financial recovery information from my PDA Go* app that greatly benefited my practice. Merriam-Webster defines resilience as an ability to recover from or adjust easily to misfortune or change. Just what the pandemic served us – misfortune and change. So, where do we go from here? My 2021 word is “Reboot.” Merriam-Webster defines booting as starting a computer's operating system, so rebooting is to start it for a second or third time. Rebooting is usually necessary after a computer crashes, meaning it stops working because of a malfunction. Rebooting allows the computer (or our

I started 2020 with the word “Breathe” as my rallying call. I knew I would need to breathe from the stress of being the Community CoChair of the Mom-n-PA Free Dental Clinic here in Philadelphia. As the pandemic grew, we cancelled the Mom-n-PA Free Clinic, but I stayed with “Breathe.” All year, I reminded myself to take a deep breath as I tried to find a place of solace in my heart for those millions of people who lost loved ones, economic stability, and health. However, I quickly added “Resilience” as Covid-19 disfigured the face of the world. For most of us, it is still tough, but resilience is pulling us through. I shudder to think how I would have survived 2020 without membership in the tripartite of ADA/PDA/PCDS. Even at

practices) to restart and get back to working normally. I am happy to shut down 2020 and restart in 2021 anew even with the uncertainty. My PCDS president’s theme this year will also be “Reboot.” As many of you know, PCDS was particularly hit hard in 2020. Together let us strengthen our society as the leader of oral health care in Philadelphia representing our diverse membership. To start, I am proud to reboot with our new Executive Officers: ¾ President Elect – Janine Burkhardt, DMD ¾ Secretary – Stanley Markiewicz, DDS ¾ Treasurer – Kevin Klatte, DMD ¾ Board of Governors – Ingrid Carvo, DMD (continues on page 4)

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President’s Message (cont’d) ¾ Board of Governors – Jessica Yi, DMD ¾ Journal Editor – David Tecosky, DMD We are excited that they are coming on the Board of Trustees (BOT) with fresh, new ideas and energy. Please welcome them by participating with them on their upcoming projects. Secondly, we are working to increase our membership. We thank you for your membership! Unity and numbers are what give us a “seat” at the table when government policies are developed. We ask that you gently nudge your nonmember colleagues to renew or begin membership. Remind them that our advocacy in Harrisburg is effective. Recently the PDA advocated, and the Department of Health has now put Dentistry in Phase 1A for Covid-19 vaccinations. Hopefully, the pandemic will come to an end with the new vaccines.

Lastly, are you a social media influencer? Our website needs a reboot. We need you to oversee the establishment of a new, interactive website and increase our presence on social media. While the joyous season is fresh in our minds and hearts, after all the unique challenges of 2020, let us take this opportunity to focus on what is really important in life. “What sunshine is to flowers, smiles are to humanity. These are but trifles, to be sure; but scattered along life’s pathway, the good they do is inconceivable.” – Joseph Addison We encourage you to Reboot in 2021 and go forth to create more SMILES! Yours in Dentistry, Renee *The PDA Go app can be downloaded from

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Editor’s Report David Tecosky, DMD As I write this, the first Covid-19 inoculations are being administered to health-care personnel. I think, finally, we can see some light at the end of the Covid-19 pandemic tunnel we have all experienced for nearly 11 months. We all agree that this day could not come soon enough! By no means is the pandemic over, but perhaps we can learn some things about how we have operated over the last 11 months by looking in the mirror. Who really envisioned that we would still be dealing with the worst of this pandemic for this long? Most of us (I include myself as I was not alive in 1918 for the last brutal Spanish Flu pandemic) do not remember another worldwide event so severe. What have I learned? I learned that our efforts to minimize transmission of this virus through our screening and through engineering changes to the way we practice plus the addition of protection from airborne transmission by properly wearing PPE were, by and large, quite effective. Dentistry can be proud of its ability to deal with this pandemic. We certainly had experience in the use of PPE and the changes needed, for we did the same in the early 1980s when the AIDS scourge of HIV infection hit our profession like a Joe Frazier punch. In that time period, major changes to the way we prepared our operatories and protected ourselves, our team, and our patients from disease transmission were made. Some of us (most of us if you were to be honest) fought it with derision and scorn, but once the science was

clear, it was obvious that changes made were important and effective. During this pandemic, I believe dentistry took the issue seriously enough to be part of the nationwide conversation about how to respond. We, in Pennsylvania, should be thankful for the efforts of the Dental School Deans, the Pennsylvania Dental Association, the Pennsylvania Academy of General Dentistry, the State Department of Health, and other interested parties who partnered to create a fact-based response to the pandemic. I think we have something else to learn from this pandemic that we may not realize. I believe our attitude must stay positive and supportive to those we work with, to our patients who depend on us so much, and to our family and friends we return home to at the end of a stressful workday. This sense of certitude can be the springboard for confidence in those we cherish—our family, friends, co-workers, and patients. Take care of yourself, eat right get exercise, rest, and think positive. Pray for a positive end to this pandemic and give comfort to those who have lost someone near and dear to them. Finally, as we start the New Year, our cover photo sunrise represents the feeling of hope and expectation of the good year to come. Think positively about your future and good will follow.

Did you know…

Sometimes just knowing the data can make you feel better if you’re worried about the COVID-19 virus. If you are concerned about the number of known cases, the rolling 7-day average or the 14-day change in COVID-19 cases or deaths near your home or where a loved one lives, you can receive your own daily COVID tracker from the New York Times. Simply click here to access the input page and build your personal dashboard.

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PDA Trustee Report on ADA 2020 Annual Meeting Nipa Thakkar, DMD 2010 was the last American Dental Association meeting in Orlando, Florida. As a dental student at the time, my budget was limited. I felt hopeful that the next time would be different. In 2020, I would be able to purchase tickets to Universal Studios, stay at a hotel less than 30 minutes away from the convention center, and take the time to actually find a beach. 2020’s ADA meeting was absolutely different from ten years prior, but in ways none of us could have imagined. A virtual Annual Meeting and House of Delegates took place in October 2020. The ADA hosted 483 delegates, hundreds of vendors and content experts, and thousands of dental professionals in an online platform that resulted in a remarkable display of learning, networking, and advancement for our profession. We elected our 157th President, Dr. Cesar Sabates, and our Second Vice President, Dr. Maria Maranga. There were an unprecedented 110 resolutions considered at the business meeting, and many were adopted after thorough examination and debate. We will have an $8 dues increase to bring the budget in line with the current cost of living in the United States. We also adopted a resolution on the “Comprehensive ADA Policy Statement of Teledentistry,” providing a roadmap for our profession to navigate regulations for our policymakers on our behalf. Policy 19H amends the “Maximum Fees for Non-Covered Services” policy to oppose third-party payers from limiting dental fees for non-covered services while also positing that payment for covered services be based on an average of the costs of those services from dentists within a common geographic area. Other adopted resolutions included policy 1H, which outlines dentistry as an essential profession. It describes the scope of care dentists provide in diagnosing, preventing, and

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treating diseases and the need for us to remain available to provide our services in collaboration with other healthcare providers. Resolution 2H is a policy supporting the ban of e-cigarettes and vaping products that will undoubtedly make our profession’s stance on this dangerous habit known on the Hill. Pennsylvania’s delegation brought forward two resolutions that were both adopted. “Diagnostic Testing by Dentists” and “Vaccine Administration by Dentists.” The former speaks to dentists having the skills and knowledge to administer diagnostic testing for diseases that put our patients at risk and further explains that testing in this fashion is within our scope of practice. The latter expresses that this skill and knowledge should allow us to administer vaccines to prevent grave medical conditions for our patients and office staff. The House also directed the ADA’s councils to investigate logistics for progress for our association and profession in numerous areas, including our current dues structure, special care dentistry training, new dentist leadership involvement, virtual future, Silver Diamine Fluoride (SDF) administration, dental health prior to surgical medical procedures, and dental benefits in Medicare. All our lives have changed this year—2020 has harshly reminded us that change is the only true certainty. It was reassuring, however, to know that the business of our association remained possible due to the quick-thinking and innovative staff and Board of Trustees at our ADA. Although I did not get to feel the sand between my toes or visit the Wizarding World of Harry Potter, it was deeply satisfying to see your Pennsylvania delegation working hard remotely to make a lasting impact on our profession and challenge the status quo. We embraced change this year—and your dedicated leaders from Philadelphia represented an evolution in our ADA that will ensure 2020 is remembered for progress more powerful than the devastation of this terrible pandemic.

Election Results Elections were held at the Philadelphia County Dental Society’s Annual Business Meeting on November 17, 2020. Terms of office began on January 1, 2021. Installation Ceremonies will be held on February 2, 2021, via Zoom. President-Elect: Janine Burkhardt, D.M.D. Board of Governors: Secretary: Stanley Markiewicz, D.D.S. Jessica Yi, D.M.D., ’23 Treasurer: Kevin Klatte, D.M.D. Ingrid Carvo, D.M.D., ’23 The changes to the Philadelphia County Dental Society Constitution and Bylaws were approved as presented at the November 2020 meeting.

Membership Report We welcome the following to membership in the Philadelphia County Dental Society November 25, 2020 Dr. Ahmad Mousa ACTIVE MEMBERS Dr. Ingrid Carvo Harvard Dental School, 2018 VA Boston Healthcare System (General Dentistry), 2019 Dr. Fathi Elgaddari Temple University Kornberg School of Dentistry, 2019 New York University College of Dentistry (Periodontics), 2015

RECENT GRADUATES Dr. Katrina Aloian Midwestern University College of Dental Medicine, 2020 Dr. Rajdeep Batth University of Southern California School of Dentistry, 2020 Dr. Shilpa Emani University of Southern California School of Dentistry, 2020 Dr. Issam Ghaben University of Pennsylvania School of Dental Medicine, 2020 Dr. Mostafa Jabr University of Pennsylvania School of Dental Medicine, 2020 Dr. Shanmukha Kallan University of Colorado School of Dental Medicine, 2019

University of Colorado School of Dental Medicine, 2019 Dr. Priyanka Patel The University of Iowa College of Dentistry and Dental Clinics, 2020 Dr. Aldo Profika Boston University Henry M. Goldman School of Dental Medicine, 2020 Dr. Nicole Sarmiento University of Southern California School of Dentistry, 2019 Dr. Samir Zahedpasha University of Pennsylvania School of Dental Medicine, 2020

GRADUATE STUDENTS Dr. Tiffany Chu Virginia Commonwealth University School of Dentistry, 2020 Einstein Medical Center (General Dentistry), 2021 Dr. Shivani Desai Virginia Commonwealth University School of Dentistry, 2020 St. Christopher’s Children’s Hospital (Pediatrics), 2022 Dr. Mordechai Fried University of Pennsylvania School of Dental Medicine, 2020 Albert Einstein Medical Center Orthodontics), 2023

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COVID-19 News Briefs Editor’s Note: Just as the transmission speed of the latest mutation of the Covid-19 virus is faster than the original virus, news related to the virus changes daily, if not hourly. The following information was current at the time of publication.

DOH Verified Dentistry in Phase 1A in PA COVID-19 Vaccine Plan Late on Dec. 17, 2020, PDA received a communication from the Pennsylvania Department of Health (DOH) stating that dentistry is included under health-care personnel in the state’s updated COVID-19 Interim Vaccination Plan (published Dec. 11) and will therefore be included in Phase 1A of vaccinations. DOH reiterated that it will share further information as it becomes available and asked for our patience as it works out the logistics of vaccine distribution to the dental community.

Vaccine Resources Following the Pennsylvania Department of Health’s (DOH) December 30 order for vaccinating Phase 1A health care personnel, PDA provided a wealth of information for members, including a comprehensive overview of COVID-19 vaccines in Pennsylvania in our Vaccine FAQs. This information was distributed Dec. 30-31 and is still available on the PDA Go mobile app news feed, PDA Go COVID-19 Hot Topics Resources and PDA website. The DOH order became effective January 6 and requires that hospitals, health systems, Federally Qualified Health Centers (FQHCs) and pharmacies under DOH oversight reserve at least 10 percent of each shipment of vaccine to vaccinate health care personnel not affiliated with a hospital or health system. The order also directs vaccine providers to create processes for

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communicating to the health-care providers in their area, surveying to determine prioritization and for scheduling appointments; and to track and report to DOH. Additional information is available in a DOH fact sheet about the order, as well as a fact sheet on what the order means for enrolled COVID-19 vaccine providers. PDA continues to caution that, while the new order clarifies the path forward a bit, credible reports indicate roughly 95 percent of the 900,000 or so providers in Phase 1A have yet to be vaccinated. There is simply not enough supply to accommodate everyone at this time. It is likely that it will take some time before vaccine providers in all parts of the state can fully ramp up to execute the new DOH directives.

Wolf Extends Temporary Waiver of CPR Rules Certifications now in effect through March 31, 2021

Gov. Tom Wolf has approved the Department of State’s request to further extend the waiver that temporarily suspends the requirement that licensed dentists, dental hygienists and expanded function dental assistants under the State Board of Dentistry maintain active certifications in CPR and Basic Life Support (BLS). With this latest extension of the waiver, CPR or BLS certifications that were in effect on March 17, 2020, will remain valid and in effect until March 31, 2021.

PA Dentists with Clinical Lab Permits May Order, Administer COVID-19 Tests On Dec. 21, Gov. Tom Wolf has approved the Department of State’s request to authorize dentists and select groups of health care practitioners to order and administer COVID-19 tests for the duration of his emergency decla(continued on page 9)

COVID-19 News Briefs (cont’d) ration and an additional 90 days IF they have been issued a clinical lab permit from the Pennsylvania Department of Health to conduct diagnostic lab testing. Otherwise, all ordering and administration of COVID-19 tests would occur through the existing rules that allow other practitioners to perform functions, tasks and procedures delegated to them by a medical doctor or osteopathic physician in appropriate circumstances. Gov. Wolf’s authorization applies to: ¾ Chiropractors ¾

Dentists

Optometrists

Pharmacists

Podiatrists

PDA has been working on this testing issue for several months, directly lobbying Governor Wolf back in October and also making a push on our members’ behalf during discussions with the Department of Health and the State Board of Dentistry. According to the Department of State’s announcement, this decision was made to bolster Pennsylvania’s ongoing efforts to contain and mitigate the pandemic by increasing testing access to identify COVIDpositive individuals and help prevent further transmission of the virus, while also providing licensed health care practitioners the ability to test their patients prior to performing elective and non-elective procedures, should they so choose.

ADA Webinar on Vaccines and Dentists’ Role on Tap Jan. 27 Program will focus on dentists as primary care providers regarding vaccinations

With COVID-19 vaccinations on everyone’s minds, a free January ADA webinar will address why dentists should be considered

primary care providers and how their background makes them well-trained for providing vaccines. Vaccinations by Dentists: A New Role in Primary Care will stream Jan. 27 at noon Central time, with continuing education credit pending. Participants will learn about the collaborative process for developing and passing vaccine legislation; the additional training recommended for dentists to include vaccinations as part of their scope of practice; and its implementation in the state of Oregon. In 2019, Gov. Kate Brown signed legislation allowing Oregon-licensed dentists to administer vaccines after completing Board-approved required training and following relevant rules to administer vaccinations safely. Participants will also receive an overview of the vaccines most likely to be initiated first in dental practice; learn about potential barriers amid the context of the COVID-19 pandemic; and about current and future opportunities for dentists in the overall health care system. Phillip T. Marucha, D.M.D., Ph.D., professor of periodontology at the Oregon Health & Science University School of Dentistry, will present. Dr. Marucha received his dental medicine degree from the University of Connecticut’s School of Dental Medicine and remained there for a certificate in periodontology and a doctoral degree in immunology. As a past faculty member at The Ohio State University, he developed a training program that provided opportunities for students, residents, and faculty to be engaged in research. In addition to his work as a clinician and leader, Dr. Marucha has been an active researcher and mentor, with a clinical and educational focus on the integration of oral health into the health-care system. (continued on page 10)

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COVID-19 News Briefs (cont’d) The ADA Council on Advocacy for Access and Prevention is presenting the webinar.

$900 Billion Coronavirus Relief Package Signed Expenses paid for with PPP loans now tax-deductible among provisions that will help dentists, practices

Congress passed a $900 billion COVID-19 relief bill Dec. 21, and President Donald J. Trump signed the bill Dec. 27. These are the COVID-19 relief provisions the American Dental Association believes are the most critical for dentists:

¾ Making expenses paid for with the Paycheck Protection Program (PPP) loans tax deductible. ¾ Eliminating the requirement that PPP loan forgiveness be reduced by the amount of the Economic Injury Disaster Loan (EIDL) grant that was received by the business. The bill also allocates additional EIDL grant money. ¾ Allowing PPP borrowers to utilize the Employee Retention Tax Credit. The bill also increases the wage cap and percentage of eligible wages for that credit. Fiscal Year 2021 Appropriations measures

The spending package includes $215 million for the Indian Health Services dental program — an increase of more than $4 million that will enable IHS to bring additional dental centers into the Electronic Dental Records System as well as expand access to dental services in isolated and rural areas through dental support centers. An additional $67 million is earmarked for IHS recruitment and retention programs. The bill also allocates $485 million for the National Institute of Dental and Craniofacial Research — a $7 million increase from 2020 — to continue critical research projects including COVID-19-related research. Area Health Education Centers will receive $43 million — a $2 million increase — to expand workforce training and health

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care delivery in rural and underserved areas, including helping patients find dental treatment outside of hospital emergency departments. Other significant measures

¾ Makes 501(c)(6) organizations eligible for PPP funds if they have less than 300 employees and meet certain lobbying restrictions. ¾ Eases the forgiveness process for PPP loans that are $150,000 or less. ¾ Allocates $3 billion in additional grants to reimburse hospitals and health care providers for health care-related expenses or lost revenue directly attributable to the pandemic. ¾ Provides additional funds for COVID19 testing, contact tracing and vaccines. ¾ Extends mandatory funding through 2023 for community health centers ($4 billion), National Health Service Corps ($310 million), and the Teaching Health Center Graduate Medical Education Program ($27 million). ¾ Allocates $3.6 million in funding for Health Professions Opportunity Grants, which provides education and training for low-income individuals in health care fields, including dental assisting and dental hygiene. ¾ Calls for medical and nursing schools in the United States to form partnerships with schools in Mexico to ensure Mexican schools have comparable accreditation standards and medical and nursing students can pass American licensing exams. Dental schools were not included. ¾ Lowers the medical expense deduction on taxes to 7.5% from 10%, which can also be used for dental expenses. (continued on page 11)

COVID -19 News Briefs (cont’d) ¾ Allows individuals to carryover any unused health and dependent care flexible spending account benefits from 2020 into the 2021 plan year, along with other FSA plan flexibilities. ¾ Eliminates surprise billing in most circumstances. (The surprise billing provisions do not include dental offices, but the bill gives HHS the ability to add additional types of health facilities.) ¾ Closes a loophole under current law that exempts online e-cigarette retailers from having to verify the age of their customers upon delivery. ¾ Extends pandemic-related unemployment benefits. The ADA has updated its fact sheet on small business loans with additional specifics on PPP and EIDL grants. Read the fact sheet here. The ADA continues to advocate for issues and policies that affect the profession of dentistry including student loans, surprise billing, non-covered services, and additional small business relief.

Securing PPE Continues to Be Priority for Dentistry To ensure dental practices have enough personal protective equipment (PPE), the ADA is urging two federal agencies to improve access to PPE so that dentists and dental team members can continue to treat patients safely during the pandemic. In Dec. 16, 2020, letters to the Federal Emergency Management Agency and U.S. Department of Health and Human Services, ADA President Daniel J. Klemmedson, D.D.S., M.D., and Executive Director Kathleen T. O’Loughlin, D.M.D., said the Association has “grave concerns regarding the cost, availability, and distribution of personal protective equipment.”

“Dentistry is an essential health-care service, and dentists and their teams are essential health care workers who need access to PPE in order to stay safe from the coronavirus,” they wrote. In the letter, Drs. Klemmedson and O’Loughlin highlighted the work of the ADA’s Health Policy Institute, which has been collecting and tracking PPE data on N95/KN95 and surgical masks, face shields, gowns, disinfecting supplies, and gloves since the onset of COVID-19. HPI has found that prices are up “significantly” and said nearly one-third of dentists have reported that prices “have at least tripled.” Surgical masks and gloves have also seen the largest price increases, and four- and five-fold price increases are not uncommon, HPI said. The ADA shared two dental supply companies’ PPE experiences during the pandemic. Benco, a privately owned distributor, told ADA News that PPE prices have been increasing for gloves at unprecedented levels. Benco also said that the company “simply cannot procure enough gloves to meet demand.” Patterson, another major dental supply distributor, indicated that global demand for PPE is at “a level never experienced before.” For Patterson, “the limited number of manufacturers, raw material requirements, global logistic challenges, and import/export issues are the major factors impacting prices in the marketplace,” wrote Drs. Klemmedson and O’Loughlin. The ADA said that with larger distributors unable to fill the demand, dentists are increasingly relying on a larger number of distributors for PPE. Prior to the pandemic, 9 percent of dental practices said they utilized Amazon for PPE but now some 32 percent of practices say they have been utilizing the online retailer’s services to stock their practices. (continued on page 12)

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COVID-19 News Briefs (cont’d) Many dentists have also reported using multiple distributors after previously relying on one. Dentists are finding it moderately to very difficult to purchase gloves in their preferred sizes and material. Third-party brokers have become involved in the distribution process. “This is causing price increases for mainstream distributors and ultimately to the end customer,” Drs. Klemmedson and O’Loughlin wrote. “As FEMA works with HHS and other partners to ensure limited supplies of critical PPE are available to essential health care workers, the ADA wants to ensure that dental practices are supplied with these important health care products for the safety of our patients and our dental teams,” the letter concluded. For more information about the ADA’s advocacy efforts during COVID-19, visit ADA.org/COVID19Advocacy.

Fulfill Act 31 and Act 124 CE Requirements Online

PDA is offering live, virtual CE courses to help you fulfill your CE requirements. Visit www.padental.org/calendar to register for the following live, virtual CE courses: ¾ Tuesday, Jan. 12, 2021, 7:00 pm to 9:00 pm Pain Management Alternatives and Identification of Addiction (satisfies Act 124) ¾ Wednesday, Jan. 27, 2021, 7:00 pm to 9:00 pm Child Abuse Recognition and Reporting for Dental Professionals (satisfies Act 31) ¾ Friday, Jan. 29, 2021,10:00 a.m. to Noon Child Abuse Recognition and Reporting for Dental Professionals (satisfies Act 31)

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New Online Self-Study CE Courses PDA has added three new courses to help you earn CE credits to renew your license in March 2021: ¾ Dental Ceramic Selection – Making Predictable Happen (1 CE credit) ¾ HIPAA Compliance for Dental Teams (1 CE credit) – Complimentary for PDA member dentists ¾ Principles of Infection Prevention and Control for Dentistry (1 CE credit) – Complimentary for PDA member dentists Visit www.padental.org/calendar and click on the Prerecorded Events tab to review the complete list of online CE courses.

Mark Your Calendar Now for PCDS In-Person CE! In-person courses will be held from 8:30 am to 3:30 pm at the Philadelphia Hilton City Avenue Hotel at 4200 City Avenue, on the following dates: Friday, September 10, 2021 Wednesday, October 20, 2021 Wednesday, November 17, 2021 Friday, December 3, 2021

Pennsylvania’s Dental Meeting to Be Held in Arizona – Virtually – on April 9-10, 2021! PDA has partnered with the Arizona Dental Association to bring the Western Regional Dental Experience (WRDE) to Pennsylvania! The entire dental team can participate in a selection of 18 different live, virtual lectures and an exhibit hall. ALL clinical CE sessions completed on April 9 and 10 will count as in-person CE even though you will participate online. The PA State Board of Dentistry considers live, online courses that offer the opportunity for interaction as in-person learning. During daylight savings time, there is a 3-hour time difference so a course that begins at 9:30 a.m. in Arizona will start at 12:30 p.m. in PA. For PA participants, the last course will begin at 6:00 p.m. or 6:30 p.m. and finish by 8:30 p.m. You and your dental team can start the next licensure cycle by earning up to 13 in-person CE credits toward the hours you need to renew your dental license in 2023! And, the recordings of the sessions will be available through mid-May so you can earn additional self-study CE credits all for one, low price. Registration is open — visit www.padental.org/PDM.

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Health Watch Gabe Mirkin, MD Low Vitamin D Increases COVID-19 Risks If your vitamin D level is below 30 ng/mL, you are at increased risk for contracting COVID-19. A review of 40 studies showed that adequate vitamin D reduced the frequency and severity of COVID-19 infections and hospital admissions, and lowered the death rate (BMJ, Oct 5, 2020;371:m3872). Another review of 86 papers showed the benefits of vitamin D for all aspects of COVID-19 infections (Front Public Health, Sept 10, 2020;8:513). Several studies show that vitamin D deficiency has been associated with increased death rate from COVID-19 (Scientific Reports, Nov 19, 2020;10:20191; Eur J of Endo, medRxiv, May 7, 2020; JAMA Netw Open, Sept 3, 2020;3(9):e2019722). The most recent studies suggest that you should take vitamin D pills to raise blood levels above 30 ng/mL, and most people can do this by taking 1000 IU pills each day. There is no evidence that higher doses of vitamin D offer greater protection from COVID-19 than moderate doses. Blood levels higher than 60ng/mL can cause serious tissue damage.

Vitamin D Strengthens Your Immune System Vitamin D helps your immune system to fight off the effects of COVID-19. Doctors are treating severe COVID-19 with dexamethasone, which has a similar steroid structure to that of vitamin D. COVID-19 can kill by causing an overactive immune system called â&#x20AC;&#x153;cytokine storm,â&#x20AC;? and vitamin D helps to reduce cytokine storm by decreasing the production of T helper cells and inflammatory cytokines (APMI, 2019;127:681-687), and by increasing anti-inflammatory cytokines (Nutrients, 2020;12:E236). Vitamin D deficiency is associated with other risk factors for severe COVID-19, such as obesity, diabetes, older age or darker skin (NFS Journal, Aug 2020;20:10-21; BMJ Nutrition, Prevention &

Health, May 13, 2020). How Common is Vitamin D Deficiency? About 42 percent of North Americans have low levels of vitamin D, including 82 percent of African Americans and 70 percent of Hispanics (Nutr Res, Jan 2011;31(1):48-54). You need to get vitamin D from sunlight exposure, the foods that you eat, or vitamin D pills. Foods that contain some vitamin D include coldwater fish such as salmon, herring, sardines or mackerel, and red meat, liver and egg yolks. Many North Americans get enough vitamin D in the summer but need

pills or fortified foods in the winter months. In warmer weather, you can usually get enough vitamin D with 10 to 20 minutes of sunlight exposure of a small area of skin 3 to 5 times a week.

Do Not Overdose on Vitamin D You cannot be poisoned by vitamin D through sun exposure or diet alone, but vitamin D poisoning can occur when people take high-dose supplements for an extended time. Unless your doctor prescribes higher doses, you should not take more than 2000 IU/day. Vitamin D is harmless in your body when it is bound to vitamin D receptors and carrier proteins. (J Clin Endocrinol Metab, 1986 Oct;63(4):954-9). However, having extra vitamin D floating in your system overwhelms vitamin D receptors to cause a marked increase in calcium to be absorbed from your gut (Am J Clin Nutr, 2004 Dec;80(6 Suppl):1689S-96S) and removed from your bones (Oman Med J, 2011 May;26(3):201-4) to cause high blood calcium levels that can bind to and damage every cell in your body. High blood calcium levels from excess vitamin D can cause bone loss, brittle bones and bone pain. People who took high doses of vitamin D (4000 and 10,000 IU/day) for three years lost far more bone than those who took the recommended 400 IU/day (J Bone and Mineral Research, September 11, 2020). High levels of vitamin D also cause low levels of vitamin K2, with resultant loss of bone (Med Hypotheses, 2007;68(5):1026-34). Vitamin K2 helps to keep calcium in bones. After several months of having high blood calcium levels and having no symptoms at all, you can develop kidney failure and not even know it. You may develop nausea, vomiting, diarrhea, constipation, or muscle weakness. You can also develop high blood pressure, kidney stones, or calcium in your arteries to increase risk for a heart attack. Since vitamin D accumulates in and is released very slowly from fat, it can take months for blood levels of vitamin D to return to normal.

My Recommendations I think that everyone should get a blood test for hydroxy vitamin D, particularly in the winter months when your levels are likely to be lowest. During this pandemic, you should not let blood levels of hydroxyvitamin D drop below 20 ng/mL and most recent papers now recommend 30 ng/mL or more. Unless your doctor recommends higher doses, you should not try to get levels much higher than 30 ng/mL, since very high levels can harm you. (continued on page 16)

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Health Watch (cont’d) If your blood levels of hydroxy vitamin D are below 30 ng/mL, take vitamin D3 pills of at least 1000 IU/day for one to two months. If your blood levels of vitamin D do not return to normal, check with your doctor about taking higher doses or getting a medical evaluation for the cause of your deficiency. Anyone suspected of being infected with COVID-19 should get a hydroxy vitamin D

blood test and immediately start taking vitamin D3 supplementation if the blood level is below 30 ng/mL. Reprinted with permission of Dr Gabe Mirkin from his Fitness and Health E-Zine, Jan. 1, 2021. To subscribe to his free newsletter, go to DrMirkin.com He does not sell, rent or give your e-mail address to anyone.

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 EMPLOY-MENT? 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) 925-6050 or Fax (215) 925-6998 for the list of dentists seeking employment. Monday, Wednesday & Thursday, 9 a.m. to 5 p.m. 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 1800-400-8550, or contact http://www.armeriprac.com

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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) 6734017 or email at richardip@yahoo.com

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 (March 1 for April/May/June issue), and information will be published on a spaceavailable basis.

Due to the COVID-19 pandemic, please reach out directly to the sponsoring organization to confirm the event has not been cancelled. JANUARY 2021 11

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 6:30 pm to 8:00 pm, Penn Orthodontic Department Lecture Series featuring Nipul Tanna, DMD, MS, “Evaluation and Management of Periodontal Boundaries During Orthodontic Treatment.” Register online www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 5:30 pm to 7:00 pm, Center for Persons with Disabilities Presentation Series featuring Ann Eshenaur Spolarich, RDH, PhD, FSCDH, “Preventive Health Considerations for Individuals with Special Needs.” Register online at www.dental.upenn.edu/cde.

PENNSYLVANIA DENTAL ASSOCIATION – Virtual Continuing Education Program. 7:00 pm to 9:00 pm, “Pain Management Alternatives and Identification of Addiction” (satisfies Act 124); 2 CE credits Register online at www.padental.org/calendar.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 5:30 pm to 7:00 pm, Center for Persons with Disabilities Presentation Series featuring Alicia Risner-Bauman, DDS, FADPD, DABSCD. “Medical Immobilization and Protective Stabilization: Techniques for Providing Safe and Effective Care in Professional and Home Settings.” Register online at www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 5:30 pm to 7:00 pm, Center for Persons with Disabilities Presentation Series featuring David Fray, DDS, MBA, “Integrated Health Promotion and Prevention: A Journey to Wellness.” Register online at www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 5:30 pm to 7:00 pm, Center for Persons with Disabilities Presentation Series featuring Marc Ackerman, DMD, MBA, FACD, “Straighter: Orthodontics and the Patient with Special Health Care Needs.” Register online at www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 6:00 pm to 8:00 pm, Dr. Rodrigo Neiva presents the Department of Periodontics Chair’s Lecture Series featuring Snjezana Pohl, Dr. med, Dr. med. dent., “Two Novel Techniques Utilizing Pediculated Connective Tissue Graft.” Register online at www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 7:00 am to 8:00 am, Quarterly Combined TMJ Lecture Series featuring Gino Inverso, DMD, MD, “The Use of Bone Anchored Sutures in TMJ Internal Derangement.” Register online at www.dental.upenn.edu/cde. (continued on page 18)

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Dental Dates (cont’d) JANUARY 2021 (cont’d) 19

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 5:30 pm to 7:00 pm, Center for Persons with Disabilities Presentation Series featuring Steven Perlman, DDS, MScD, DHL (hon), “Advocacy, Policy and Treatment of Children and Adults with Disabilities.” Register online at www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 5:30 pm to 7:00 pm, Center for Persons with Disabilities Presentation Series featuring Rick Guidotti, “POSITIVE EXPOSURE: Seeing Beyond the Diagnosis.” Register online at www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 5:30 pm to 7:00 pm, Center for Persons with Disabilities Presentation Series featuring Lyubov Slashcheva, DDS, MS, FABSCD, “Therapeutic Oral Care Considerations for Adults with Intellectual and Developmental Disabilities.” Register online at www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 6:00 pm to 8:00 pm, Dr. Rodrigo Neiva presents the Department of Periodontics Chair’s Lecture Series featuring Theofilos Koutouzis DDS, MS, “Alveolar Ridge Management Concepts: From Simple to Complex.” Register online at www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 5:30 pm to 7:00 pm, Center for Persons with Disabilities Presentation Series featuring Miriam Robbins, DDS, MS, “Defining Disabilities: Disabilities Across a Lifetime.” Register online at www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 5:00 pm to 6:30 pm, The Excellence in Restorative Dentistry Lecture Series featuring Carlo E. Poggio, DDS, MSD, PhD, “Complex Treatments in Full Digital Workflow.” Register online at www.dental.upenn.edu/cde.

PENNSYLVANIA DENTAL ASSOCIATION – Virtual Continuing Education Program. 7:00 pm to 9:00 pm “Child Abuse Recognition and Reporting for Dental Professionals” (satisfies Act 31); 2 CE credits. Register online at www.padental.org/calendar.

PENNSYLVANIA DENTAL ASSOCIATION – Virtual Continuing Education Program. 10:00 am to noon. “Child Abuse Recognition and Reporting for Dental Professionals” (satisfies Act 31); 2 CE credits. Register online at www.padental.org/calendar. (continued on page 19)

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Dental Dates (cont’d) FEBRUARY 4

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 6:00 pm to 8:00 pm, Dr. Rodrigo Neiva presents the Department of Periodontics Chair’s Lecture Series featuring Roger Hill, DDS, “Treating ‘Hopeless’ Teeth.” Register online at www.dental.upenn.edu/cde. UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 6:30 pm to 8:00 pm, Penn Orthodontic Department Lecture Series featuring Normand Boucher, DDS, MS. Register online www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 6:00 pm to 8:00 pm, Dr. Rodrigo Neiva presents the Department of Periodontics Chair’s Lecture Series featuring Joseph R. Greenberg, DMD, FAGD, “Altering Occlusal Vertical Dimension to Enhance Esthetic Restorative Dental Treatment.” Register online at www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 6:00 pm to 8:00 pm, Dr. Rodrigo Neiva presents the Department of Periodontics Chair’s Lecture Series featuring Lorenzo Tavelli, DDS, MS, “PeriImplant Phenotype and Soft Tissue Dehiscences. Improving Health, Esthetics and Patient’s Comfort.” Register online at www.dental.upenn.edu/cde.

MARCH 4

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 6:30 pm to 8:00 pm, Penn Orthodontic Department Lecture Series featuring Hellen Teixeira, DDS, MS, DscD. Register online www.dental.upenn.edu/cde.

UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE – Virtual Continuing Education Program. 6:00 pm to 8:00 pm, Dr. Rodrigo Neiva presents the Department of Periodontics Chair’s Lecture Series featuring Isaac Tawil, DDS, MS. “Dynamic Navigation in Implant Dentistry.” Register online at www.dental.upenn.edu/cde.

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