August/September 2015 Nugget by Sacramento District Dental Society (SDDS)

the

August / September 2015

Occupational

Hazards

Useful tips to stay safe and aware

A PUBLICATION OF THE SACRAMENTO DISTRICT DENTAL SOCIETY

special events

at a

2015-2016

DECEMBER 4, 2015

Annual Holiday Party, Installation of Officers

MAY 6, 2016

Swing for Smiles Golf Tournament Empire Ranch

general meetings 3 CEU, core/20% • 5:45pm – 9:00pm • Hilton, Arden West

SEPTEMBER 8, 2015 tue

New Member Night

business forums 6:30pm–9:00pm • SDDS Classroom

SEPTEMBER 17, 2015 thu

The Business of Dentistry For Dentists (No CEU)

continuing education SDDS Classroom

SEPTEMBER 18, 2015 fri

Implant Throwdown (3 CEU, core)

Amy Morgan (Pride Institute)

Team Motivation: All to Benefit the Ultimate Care for Your Patient (5 CEU, 20%)

Guy Acheson, DDS; Debra Finney, MS, DDS; Kevin O’Neill, DDS, MSD (SDDS Members)

NOVEMBER 12, 2015 thu

Amy Morgan (Pride Institute)

OCTOBER 6, 2015 tue (note change)

Cyber Security: Protecting You & Your Patients (2.5 CEU, core)

OCTOBER 2, 2015 fri Anthony Feck, DMD (DOCS)

Large Group Practice & Your Dental Practice (3 CEU, 20%)

SD Reliance (SDDS Vendor Member); 360 Risk Partners

MARCH 17, 2016 thu

From the Terrible Twos to the Terrible Teens:The Challenges & Rewards of Treating Them All (5 CEU, core)

Recruitment Night

Anders Bjork (California Dental Association)

NOVEMBER 10, 2015 tue

Staff Night

Your Practice, Your Patients & Your Team: Getting to Know the Right Balance (3 CEU, 20%) Kerry Straine (Straine Consulting)

JANUARY 12, 2016 tue

Hygiene Night

Preventing Hospital Acquired Pneumonia... One Clean Mouth at a Time (3 CEU, core) Barbara Quinn, RN

MARCH 8, 2016 tue

Spouse Night

Dentistry’s Response to Bioterrorism or a Public Health Emergency (3 CEU, core) Jim Wood, DDS

APRIL 12, 2016 tue

Alma Mater Night

Peer Review Process: Your Best Member Benefit (3 CEU, core) Henrik Hansen, DDS

MAY 10, 2016 tue

Foundation Night

Cleft Palates and Syndromes (3 CEU, core) Snehlata Oberoi, BDS

Possibilities, Perils, & Practicalities of Dental Practice Ownership from Start to Finish (No CEU) Kerry Straine (Straine Consulting)

APRIL 7, 2016 thu

Things That Keep You Up at Night: HR Nightmares (2.5 CEU, 20%) Mari Bradford (CEA/SDDS Vendor Member)

lunch & learn 2 CEU, core • 11:30am–1:30pm • SDDS Classroom

Greg Psaltis, DDS

NOVEMBER 13, 2015 fri

The CSI Effect: Mass Disaster & Intimate Partner Violence Recognition (5 CEU, core) Anthony Cardoza, DDS

APRIL 8, 2016 fri

Manual Day: Build & Complete Your OSHA, Employee & HIPAA Manuals in One Day! (5 CEU, core) LaDonna Drury Klein, RDA; Mari Bradford (CEA); Teresa Pichay (CDA)

Tony Vigil (DESCO) (SDDS Vendor Member)

APRIL 22, 2016 fri

APRIL 14, 2016 thu

SDDS Members

FIY: Fix It Yourself!

Office Emergencies: You Need to Know More Than CPR Craig Alpha, DDS (SDDS Member)

hr webinars 1 CEU, 20% • Noon–1:00pm • Call from home or office Presented by the California Employers Association (CEA)

SEPTEMBER 9, 2015 wed

Top 10 Ways to Stay Out of Court

OCTOBER 28, 2015 wed NOVEMBER 17, 2015 tue Alternative Work Week

JANUARY 20, 2016 wed 2016 Labor Law Update

FEBRUARY 18-19, 2016

OCTOBER 9, 2015 fri

SEPTEMBER 30, 2015 wed

Hire Slow, Fire Fast

MIDWINTER CONVENTION

Adult Oral Conscious Sedation (7 CEU, core)

MARCH 23, 2016 wed

Empowering Communication Skills with Patients, Your Practice & Your Co-Workers

Pearls in the Backyard (7 CEU, core)

OCTOBER 23, 2015 fri

California Dental Practice Act, Infection Control, & OSHA Refresher (6 CEU, core) Nancy Dewhirst, RDH

MAY 20, 2016 fri

California Dental Practice Act, Infection Control, & OSHA Refresher (6 CEU, core) Marcella Oster, RDA

cpr bls renewal 4 CEU, core • SDDS Classroom • 8:30am–12:30pm

NOVEMBER 6, 2015 fri JANUARY 22, 2016 fri APRIL 23, 2016 sat AUGUST 3, 2016 wed (evening) NOVEMBER 11, 2016 fri Please see sdds.org or registration forms for more information about all programs.

Contents Aug / Sept 2015 VOLUME 61, NUMBER 7

Musculoskeletal Disorders:

FEATURES

Protect Your Assets! Hana Rashid, DMD

Hazard Recognition:

More Than Just Bloodborne Pathogen Awareness Donna Klein, RDA, BS

COVER IMAGE CREDIT: ISTOCK

Biofilms & Waterlines

Questions & More Questions Nancy Dewhirst, RDH,BS

Just Announced!

2015 International College of Dentists Special Citation Award Winner

Nugget Editorial Board Carl Hillendahl, DDS • Editor-in-Chief Paul Binon, DDS, MSD Donna Galante, DMD Matthew Hall, DDS Brandon Martin, DDS, MS James Musser, DDS Hana Rashid, DDS Ash Vasanthan, DDS, MS

Editors Emeritus William Parker, DMD, MS, PhD Bevan Richardson, DDS

Awards

International College of Dentists (ICD) 2015 • Special Citation Award, unusual concept 2014 • Outstanding Cover, honorable mention 2014 • Golden Pen, honorable mention 2013 • Outstanding Cover 2012 • Overall Newsletter 2010 • Platinum Pencil Outstanding use of graphics

Specials 24 25 35

Women’s Empowerment - Heather’s Story Notice of 2015 SDDS Elections Notice of 2015 SDDF Elections

Regulars

4 5 7 8 13 16 19 20 23 24

November 2014 Issue The Forgotten Wars: Stories of Service Editor: James Musser

President’s Message Cathy’s Corner You Should Know From the Editor’s Desk Volunteer Opportunities An Ethical Dilemma Job Bank Event Highlights: Dental Day at Raley Field YOU: The Dentist… the Business Owner Foundation

27 29 30 31 32 33-34 35–37 38 40

Trustee Report YOU: The Dentist… the Employer Advertiser Index Committee Corner We’re Blowing Your Horn! Membership Update Vendor Members Classified Ads SDDS Calendar of Events

2007 • Overall Newsletter 2007 • Outstanding Cover 2007 • Golden Pen, honorable mention Article / series of articles of interest to the profession

The Nugget • Sacramento District Dental Society • www.sdds.org

President’s Message Keeping You

Up to Date!

ime flies and we are in the throes of another summer of heat and drought. Our Dental Society continues to surge forward with the issues that we have been tasked to work on. The biggest news this summer has been the Special House in June and the decision of our CDA delegates to move forward with a new endeavor the help our members address the coming changes in the dental workspace. TDSC will be aimed at keeping small dentist owned offices competitive against the influx of new corporate dental organizations. Organized dentistry wants to ensure that clinical decisions are in the hands of licensed

By Viren Patel, DDS 2015 SDDS President

practitioners and not influenced unduly by the machinations of large venture capitalists looking for a quick profit. The welfare of our patients has always and should continue to be the backbone of our profession. I am optimistic that our profession can move forward with this new entity bolstering our ability to provide excellent, ethical care. Our Large Group Task Force has been gathering information to keep our SDDS members informed. Look for their report in this issue (Committee Corner, page 31) and their October Nugget. Our goal is to keep you up to date! 

T H E S A C R A M E N T O D I S T R I C T D E N TA L S O C I E T Y P R E S E N T S

MIDWINTER CONVENTION & EXPO front office

boot camp

February 18 & 19, 2016

Sacramento Convention Center

Classes Scheduled

supreme

Don’t miss out

Early

tHURSDAy, February 18 | 7:30am-5:30pm Friday, February 19 | 7:30am-4:00pm

4 | The Nugget • Sacramento District Dental Society

speakers Grand Slam! meals included

Lots of CE licensure renewal courses

70 Vendors

Cathy’s Corner LEADERSHIP President: Viren Patel, DDS Immediate Past President: Kelly Giannetti, DMD, MS President Elect/Treasurer: Wallace Bellamy, DMD Secretary: Nancy Archibald, DDS Editor: Carl Hillendahl, DDS Executive Director: Cathy Levering Dean Ahmad, DDS, MS Margaret Delmore, MD, DDS Volki Felahy, DDS Bryan Judd, DDS Beverly Kodama, DDS Lisa Laptalo, DDS Peter Worth, DDS Adrian Carrington, DDS Terry Jones, DDS

EXECUTIVE COMMITTEE

BOARD OF DIRECTORS

It’s so Obvious!

By Cathy B. Levering

SDDS Executive Director

hen thinking about my Cathy’s Corner (again at deadline time!)… it occurred to me that it was very obvious. What is a member benefit that I can focus on this month and add to our countdown?

It is so obvious…

TRUSTEES

I’m thinking about all the work we have done at SDDS this summer:

CPR: Greg Heise, DDS Ethics: Jag Heir, DMD, MD Leadership Development: Kelly Giannetti, DMD, MS Membership: Kristen Adams, DDS Peer Review: Brett Peterson, DDS

COMMITTEES

• Scheduled and planned our February Midwinter Convention (thanks to Justine and her wonderful planning skills)

STANDING

• Developed the theme and design of Midwinter (go team!)

CE Task Force: Nancy Archibald, DDS Social Media Task Force: Kristen Adams, DDS/Bryan Judd, DDS 1T1B Task Force: Guy Acheson, DDS GMC Denti-Cal Task Force: Terry Jones, DDS/ Warren McWilliams, DDS Large Group Practice Task Force: Peter Worth, DDS Amalgam Advisory: Wai Chan, DDS/Viren Patel, DDS Budget & Finance Advisory: Wallace Bellamy, DMD Bylaws Advisory: Kelly Giannetti, DMD, MS Fluoridation Advisory: Kim Wallace, DDS/Rick Kennedy, DDS Forensics Advisory: Mark Porco, DDS Legislative Advisory: Steve Leighty, DDS Strategic Planning Advisory: Wallace Bellamy, DMD/Nancy Archibald, DDS

TASK FORCES ADVISORY WORKGROUPS

• Published our Directory • Kept the Nugget on schedule, and we are working on October’s as well • Hosted 500 at the RiverCats in June • Scheduled and planned CE programs through June 2016 • Reorganized our office • Hired our 3 newest team members: Jessica and Rachel (both graphic designers and “da bomb!”) and Beth (our wise and wonderful Membership Coordinator) And if Beth looks familiar, I am proud to share that she is the daughter of our dear Dr. Bob Gillis! • Hired our SDDS intern for the summer, Karisa (she’s hoping to go to dental school next year and her dad, Dr. Tom Yamamoto, is our member!) • Regrouped for Smiles for Kids 2016 and we’re off to a great start with Delia leading the charge

Foundation: Kevin Keating, DDS, MS Golf Tournament: Damon Szymanowski, DMD SacPAC: Matthew Campbell, Jr. DDS Smiles for Kids: Donald Rollofson, DMD

SPECIAL EVENTS OTHER

SDDS STAFF

So, without a brick hitting me in the head… obviously, one of the best Member Benefits is our wonderful SDDS Staff! Thank you Rachel, Justine, Jessica, Delia, Karisa and Beth… YOU are the BEST! To all of our members, please stop by and meet our newest members of our team. 

Top 10 Member Benefit Countdown! 1. January: You received a FREE 2015 Employment Law poster! 2. February: SDDS Midwinter Convention & Expo!

The Nugget is an opinion and discussion magazine for SDDS membership. Opinions expressed by authors are their own, and not necessarily those of SDDS or The Nugget Editorial Board. SDDS reserves the right to edit all contributions for clarity and length, as well as reject any material submitted. The Nugget is published monthly (except bimonthly in June/July and Aug/Sept) by the SDDS, 2035 Hurley Way, Ste 200, Sacramento, CA 95825 (916) 446-1211. Acceptance of advertising in The Nugget in no way constitutes approval or endorsement by Sacramento District Dental Society of products or services advertised. SDDS reserves the right to reject any advertisement. Postmaster: Send address changes to SDDS, 2035 Hurley Way, Ste 200, Sacramento, CA 95825.

3. March: Amy Morgan Pride Institute programs (now Sept. 17-18, 2015)! 4. April: SDDS Vendor Members! 5. May: SDDS Job Bank (see page 38)! 6. June/July: The PAG (see inserted brochure)! 7. August/September: OUR SDDS STAFF! www.sdds.org • August / September 2015

You are not a policy number.

And at The Dentists Insurance Company, we won’t treat you like one because we are not like other insurance companies. We were started by, and only protect, dentists. A singular focus that leads to an unparalleled knowledge of your profession and how to best protect you. It also means that TDIC is in your corner, because with us, you’re never a policy number. You are a dentist.

Endorsed by the Sacramento District Dental Society

Protecting dentists. It’s all we do.

800.733.0633 | tdicsolutions.com | CA Insurance Lic. #0652783

Know

you should

Paid Sick Leave Law – AB304 UPDATE! Reprinted with permission from CDA. The rules for California’s mandatory Paid Sick Leave (PSL) Law have been amended! The Healthy Workplaces, Healthy Families Act of 2014, which went into full effect on July 1, 2015, was amended on July 13, 2015. AB 304 is intended to clarify this confusing new Law. AREA OF CLARIFICATION: NEW PROVISIONS Eligibility: Employees must work in California, for the same employer, for 30 or more days to be entitled to paid sick leave. Accrual Rate Options: Allows employers additional options for accrual (other than 1 hour for each 30 hours worked), provided that the accrual is on a regular basis and the employee will have 24 hours of accrued sick leave available by the 120th calendar day of employment, or each 12 month period. Accrual Rates for Exempt Employees: Exempt employees are deemed to work 40 hours/workweek unless the employee’s normal workweek is less than 40 hours, in which case the employee will accrue based on normal hours. Lump Sum: An employer may also provide no less than 24 hours or three days of PSL which is available to use by the 120th calendar day of employment. Employers who offer “Unlimited Leave”: The bill would permit an employer who provides unlimited sick leave to its employees to satisfy notice requirement by indicating “Unlimited” on the employee’s itemized wage statement.

Reinstatement of PSL: Employers are not required to reinstate accrued PSL to an employee, rehired within one year of separation from employment, if they were paid out at the time of termination, resignation or separation. Rates of Pay: Nonexempt employees (2 options): 1). Calculate paid sick time rate in same manner as the regular rate of pay for the workweek (i.e. the rate used to calculate overtime), regardless of whether the employee works overtime, or 2). Divide the total wage by total hours worked in the full pay period of the prior 90 days of employment. Exempt employees: Calculate rate of pay in the same manner as the employer calculates wages for other forms of paid leave time. Paystub Notification: Employers must provide an employee with written notice showing the amount of PSL, or paid time off (PTO) in lieu of sick leave, available for use on the employee’s itemized wage statement or in a separate writing with each payment of wages. Employers do not have to show time used. Notification of PSL by Employee: An employer is not obligated to inquire into or record the purposes for which an employee uses paid leave or paid time off. (DLSE actually takes the position that employers MAY NOT inquire about this.) The new law, is available at: http://leginfo.legislature.ca.gov/faces/ billNavClient.xhtml?bill_id=201520160AB304 Visit www.employers.org or call 800.399.5331 for more information.

Increased Frequency of Banking Wire Scam Attempts from Bill Muller, Muller and Associates

Things to remember:

We have seen an increased frequency of a banking wire scam going around via email.

• Be wary of email and always use caution opening attachments.

The nature of this threat is that the email appears to come from a principal at your company, but on closer review there is a variation in how the name or company is spelled.

• With respect to wire transfers, review company procedures for how payees get added and approved to online banking. • Firms that are using wire transfers should consult their bankers and CPAs for adequate accounting controls.

The email asks for a wire transfer. Often it includes a legitimate looking invoice or it might say “I am travelling and will provide details when I return”.

CDA establishes The Dentists Service Company Reprinted with permission from CDA. CDA is constantly looking for new ways to support members in their practices and has created a new subsidiary called The Dentists Service Company (TDSC), which has been approved by the CDA House of Delegates. TDSC will support members with the business side of their practices and help them be more competitive and efficient. While ensuring all clinical-care decisions and practice ownership remain with dentists, TDSC plans to offer group purchasing of supplies, practice advising, marketing, human resources and assistance with forming group practices.

During the next couple of years, TDSC will be in a development phase. Following that, TDSC’s services will be available to all CDA members, both general dentists and specialists, and the group-purchasing option will be accessible, along with existing Practice Support resources, as a CDA member benefit. As CDA moves forward with TDSC’s development and implementation process, we will continue to share information with members in the CDA Update, e-newsletter and on cda.org.

WATCH YOUR MAILBOX! CA Dental Board License Renewal Notices were sent out in envelopes from the Department of Automotive Repair. www.sdds.org • August / September 2015

From the Editor’s Desk Musculoskeletal Disorders PROTECT YOUR ASSETS!

By Hana Rashid, DMD Associate Editor

Dr. Hana Rashid started out as a dental assistant for Beautiful Smiles Dentistry prior to attending dental school. She completed her undergraduate studies at UC Davis, with a major in Genetics and a minor in Psychology. A graduate of the University of the Pacific Arthur A. Dugoni School of Dentistry in 2009, she went on to complete a 1 year General Practice Residency in Fresno, CA. She joined her mother, Dr. Ibtisam Rashid in August 2010 as Associate Dentist. Spending time with patients and providing quality care in a friendly environment are her core values.

s dentistry continues to evolve with newer technology, so too must the rules and regulations of the dental workplace. No matter how much we try to avoid it, OSHA will always be around the corner waiting to regulate. While we may never eradicate needle sticks, spread of disease, falls, back injuries, contamination or exposure to hazardous chemicals, there will always be room in our OSHA manuals to update our protocols for handling each to minimize further risks or damages. According to an article written by Teresa Pichay for CDA in January 2014, the lack of an injury and illness prevention plan topped OSHA’s list of citations among all dental offices from October 2012-September 2013. CDA has a downloadable Injury and Illness Prevention Plan form, which designates someone to a specific role (Exposure Control, Hazard Communication, Fire and Emergency, General Office Safety and even Ergonomics). That way, the entire dental team can divide and conquer the OSHA manual and make it less intimidating to follow and enforce. Injury prevention is a big deal in our profession. As a practitioner with Scoliosis since childhood, I’m already compromising a long, healthy career in dentistry. Having gone to a chiropractor, a few orthopedic surgeons, physical therapists, massage therapists and now, an acupuncturist, keeping my career as a dentist is proving to be costly. This could have been prevented from getting worse by establishing protocol for protecting my staff and myself from repeated injuries. A few simple solutions could have been to adjust the patient’s chair, improve the operatory lighting, use sharp instruments, change the working distance on my loupes or adjust the height and support of our chairs to cater to our needs. I am guilty of compromising myself to keep a patient where they are currently positioned rather than do these minor adjustments for my comfort. “I’m

8 | The Nugget • Sacramento District Dental Society

almost done,” I would say to myself, and while I may not notice the strain in my back for one patient, I do notice it at the end of the day when I have been repeatedly sitting poorly or overcompensating my back muscles. Musculoskeletal disorders (MSDs) in dentistry have various causes. The fact that numerous sources are beginning to consider MSDs an epidemic should warn future generations of dental professionals of what is to come if they do not take care of their bodies now. Despite being taught by instructors in school about proper positioning of the doctor, hygienist, patient, assistant and light for each quadrant being worked on, we have completely abandoned those ideals. Once our dentistry stopped being graded and examined relentlessly, the work hours became frazzled, assistants were everywhere and positioning patients seemed to be a hassle. What we fail to recognize is that our jobs can actually be done more efficiently, and without compromising our health, with just simple tweaks to our chairs, lighting, instruments and even how we schedule patients. Sometimes, having back-to-back crown preps or SRPs is just backbreaking, and wrist-breaking. We should schedule patients to allow for microbreaks for our bodies to refresh and regroup to prevent continual fatigue, especially if we’re sitting in the same position or doing the same hand motion for a long time. How we hold or grip our instruments can affect our most important assets-our hands. Research has shown that gripping small or narrow instruments for extended periods can cause carpal tunnel syndrome, among many other hand and wrist disorders. The best solution is to prevent the pinching grip altogether but I have found that the thicker ergonomic mirror handles help prevent the muscle pain that I used to experience with the traditional, small-diameter handles. The pinching of the fingers around the handle is not as tight and

REFERENCES 1. Nancy Dewhirst, RDH, BS. Ergonomics Lecture, SDDS Midwinter 2015 2. Anne Nugent Guignon. Glove Solutions.http:// www.dentistryiq.com/articles/dem/print/ volume-8/issue-2/focus/glove-solutions.html. 3. Melanie Simmer-Beck and Bonnie Branson. Instrumentation without Pain: Strategies to Improve the Ergonomics of Scaling and Root Planing. Dimensions of Dental Hygiene. November 2011; 7 (11): 46-48.

the handles are lighter. Another solution to hand and wrist injuries could be just to wear the proper glove size. Anne Nugent Guignon, RDH, MPH wrote for Dentistry IQ addressing solutions for the many different brands and types of gloves in the dental marketplace. While glove size varies with each brand, it may take some time to find the proper fit. Most practices supply only nitrile gloves to prevent cross-contamination with latex gloves and to not have to worry about latex allergies. This is fine, except that some nitrile brands are too thick and could be placing too much pressure on the hand by putting the thumb in a closed position or they’re not long enough to accommodate fingers comfortably. Nowadays, some nitrile brands have developed newer gloves that feel like latex- I love my Lavender Nitriles from Kimberly Clark, which is now known as “Halyard Health.” One of the biggest concerns for dental professionals is that we have static postures that even if we own the priciest ergonomic chair, our muscles will always be prevented from maintaining neutrality. Having a neutral position prevents our muscles from fatiguing and allows us to keep working comfortably and for extended periods. Unfortunately, the definition of a neutral position is infinite, as neutrality in dentistry means to adjust seating positions rather than remaining in one position for the duration of the appointment. Going from one patient to the next is a great adjustment, but staying with one patient for a long period requires that we adjust our positions to avoid straining of the muscles in one position. Nonetheless, establishing core strength is the best solution to keeping the body upright regardless of how we are positioned. 

4. Mahmoud Zaerian. Musculoskeletal Disorders and the Impacts on the Health Professional. http://www.oralhealthgroup.com/news/ musculoskeletal-disorders-and-the-impactson-the-dental-professional/1000226354/?&er= NA. 2009 5. Abdul-Rahim Shaik, et al. Work-Related Musculoskeletal Disorders Among Dental Surgeons: A Pilot Study. Contemporary Clinical Dentistry. 2011; Oct-Dec 2 (4): 308-312.

TAKE A MOMENT A DAY I had the pleasure of attending an Ergonomics class taught by Nancy Dewhirst, RDH, BS at Midwinter this year and I managed to pick up a few stretches that I can do in between patients that don’t require too much time to set aside. Active breathing, where the ribs are expanded outwards and upwards during inhalation and air is pushed out of the lungs completely during exhalation, feels like a workout initially but becomes second nature once it is incorporated daily. The benefits are stronger inspiratory/expiratory muscles, and of course, more oxygen to the brain and body. We all feel better during those sluggish times during the day, especially around 2:30pm and all we want is something sugary or caffeinated as a boost. Instead of caving in to those snacks, a few simple stretches, regardless of what they are, can help get through the day more efficiently and keep our bodies actively and properly engaged.

1 2

C HEST OPENING: Clasp arms behind back and open your chest. C HIN TUCKS: Tuck chin to chest then while head is forward, make a double chin but pulling the neck back, hold for 5 seconds and feel that stretch on the back of your neck.

3 4

S CAPULAR ROTATION: With arms at sides, bend elbows 90 degrees and pull shoulder blades together. Hold for 10 seconds. S HOULDER SHRUG: With arms at sides, shrug shoulders up to ears, hold for 3 seconds, then roll and lower shoulders backwards. Keep elbows straightened.

OCCUPATIONAL HAZARDS

Hazard Recognition

MORE BLOODBORNE PATHOGEN THAN

J UST

AWA R E N E SS

Dental professionals may be at risk for exposure to numerous workplace hazards. These hazards include, but are not limited to, the spectrum of bloodborne pathogens, pharmaceuticals and other chemical agents, human factors, ergonomic hazards, noise, vibration, and workplace violence to name a few.

By Donna Klein, RDA, BS Trainer, OSHA, Infection Control

Ms. LaDonna Drury-Klein RDA, BS, is a dedicated, engaging trainer in OSHA, Infection Control and regulatory issues affecting the profession. Following 18 years of clinical experience and 20 years as an educator, LaDonna has successfully authored textbooks for dental assisting, served as a two-time appointee to the Dental Board of California under Governor Gray Davis, and is the Chief Executive Officer of the Foundation for Allied Dental Education.

s it relates to workplace hazards and bloodborne diseases, the CDC estimates that 5.6 million workers in the health care industry and related occupations are at risk of occupational exposure to bloodborne pathogens, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and others . All occupational exposure to blood or other potentially infectious materials (OPIM) place workers at risk for infection with bloodborne pathogens. As a reminder, OSHA defines blood to mean human blood, human blood components, and products made from human blood. Other potentially infectious materials (OPIM) is defined as all human body fluids including saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids.

training within our dental offices, reviewing the Bloodborne Pathogens Standards, and ensuring this basic knowledge remains foremost in our minds during our day-to-day clinical operations.

This is what we know, or should already know, if we are performing annual OSHA

Workers in many different industries and occupations can be exposed to risk factors at

TheNugget Nugget••Sacramento SacramentoDistrict DistrictDental DentalSociety Society 10 ||The

But what other hazards are we missing? What aspects of safety and health, injury and illness prevention, and general office safety are we overlooking? Let’s examine just two other aspects of what the Federal Standards for workplace protection and safety call upon us to know and, in some cases, establish written programs within the workplace to ensure all employees are aware and adequately trained – Ergonomics and Vaccinations. 1. Ergonomics: Did you know Musculoskeletal Disorders (MSDs), which affect the muscles, nerves and tendons, (including those of the neck, upper extremities and low back), are one of the leading causes of lost workday injury and illness?

There are a number of workplace hazards any industry or profession encounters daily work, such as lifting heavy items, bending, reaching overhead, working in awkward body postures and performing the same or similar tasks repetitively. But work-related MSDs can be prevented. Incorporating Ergonomics --- the act of fitting a job to a person --- helps lessen muscle fatigue, increases productivity and reduces the number and severity of work-related MSDs. In the workplace, applying ergonomic principals can substantially reduce the number, severity, and the associated costs of MSDs resulting from physical overexertion. The following are important elements of an ergonomics program: Provide Management Support - A strong commitment by management is critical to the overall success of an ergonomic process by clearly defining goals and objectives for the ergonomic process, discussing them with staff, assign responsibilities to designated staff members, and communicate clearly with staff. Involve Staff - A participatory ergonomic

approach, where workers are directly involved in worksite assessments, solution development and implementation is the essence of a successful ergonomic process.

Provide Training - Training is an important

element and ensures that workers are aware of ergonomics and its benefits, become informed about ergonomics related concerns in the workplace, and understand the importance of reporting early symptoms of MSDs.

Identify Problems - An important step in

the ergonomic process is to identify and assess ergonomic problems in the workplace before they result in MSDs.

Evaluate Progress of the Ergonomic Program - Established evaluation and

corrective action procedures need to be in place to periodically assess the effectiveness of the ergonomic process and to ensure its continuous improvement and long-term success. 2. Vaccinations: Did you know – the CDC (Centers for Disease Control and Prevention), the Advisory Committee on Immunization Practices (ACIP), and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recommends

that all U.S. health care workers get vaccinated annually against influenza?

These agencies define healthcare workers and include (but are not limited to) physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, students and trainees, contractual staff not employed by the healthcare facility, and persons (e.g., clerical, dietary, housekeeping, maintenance, administrative, billing, and volunteers) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted to and from healthcare workers and patients. There are several flu vaccine options for the 2014-2015 flu seasons. Traditional flu vaccines made to protect against three different f lu viruses (called “trivalent” vaccines) and vaccines made to protect against four different flu viruses (called “quadrivalent” vaccines) are available. Trivalent flu vaccine protects against two influenza A viruses (an H1N1 and an H3N2) and an influenza B virus. Healthcare workers should be aware of the types of flu vaccinations, as some workers are allergic or sensitive to components of the vaccines; they are: Standard-dose trivalent shots (IIV3) are manufactured using virus grown in eggs. Different flu shots are approved for people of different ages, but there are flu shots that are approved for use in people as young as 6 months of age and up. An intradermal trivalent shot, which is

injected into the skin instead of the muscle and uses a much smaller needle than the regular flu shot, is approved for people 18 through 64 years of age. A high-dose trivalent shot is approved for people 65 and older. A trivalent shot, containing virus grown in cell culture, is approved for people 18 and older. A recombinant trivalent shot that is egg-free is approved for people 18 years and older. There are a number of workplace hazards any industry or profession encounters daily and in this article we have touched on two areas that are not commonly discussed or reviewed as we engage in training. While traditionally standard OSHA topics involving disease

transmission, sterilization, infection control and post-exposure protocols are common practice in annual OSHA training, let’s also continue to learn more and engage in discussion during training about the other aspects of keeping our workplace safe and secure for all employees. Review your dental office policies and safety programs regarding vaccinations and ergonomics – it is a great start at looking beyond Bloodborne Pathogens and hazards in the workplace. 

REFERENCES 1. US Department of Labor Statistics, Safety and Health Topics, Bloodborne Pathogens and Needlestick Prevention 2. C enters for Disease Control and Prevention, Influenza Vaccination Information for Healthcare Workers, June 11, 2015

licensure renewal SDDS Classroom

OCTOBER 23, 2015 fri

California Dental Practice Act, Infection Control & OSHA Refresher (6 CEU, core) Nancy Dewhirst, RDH (DOCS) Are you a licensee who’s looking to bang-out all the mandatory courses in one day? Say no more — our All-In-One covers the following: • 2-hours of California Dental Practice Act • for California licensees • 2-hours of Infection Control for California licensees • 2-hours of OSHA refresher to include bloodborne pathogens, hazard communication, materials safety, general office and all the required elements of your compliance in the office for all those classified as being exposed to pathogens We encourage all licensed as well as unlicensed staff to attend this comprehensive education day which covers scope of practice, infection control regulations from the Dental Board, employee safety issues from Cal-DOSH and a review of the duties and functions of practitioners in dental healthcare provision.

www.sdds.org • August / September 2015

| 11

OCCUPATIONAL HAZARDS

Biofilms & Waterlines: Questions & More Questions

We just tested our dental unit waterlines and found out that even though we have been using a waterline cleaning product, the lines were really contaminated! We had assumed we were fine until the test results led us to believe that our product had failed. The manufacturer solved the mystery right away. They said we should “shock” the lines with another product monthly, as well as use the daily chemical tablet. A fter asking around, only one of my colleagues is doing that! Most just put a tablet or drop of solution in the water bottle, never doing the big shock treatment. A couple use distilled or tap water most of the time, and “treat their waterlines” once a week with the same product I use daily. Some offices never use any waterline cleaner at all in their bottles, and others don’t have bottles. So why is there so much confusion? And should everyone get their waterlines tested?

By Nancy Dewhirst, RDH,BS Ms. Nancy Dewhirst graduated from, and was a clinical instructor in dental hygiene, at USC and teaches oral pathology, preventive dentistry and infection control at West Coast University Department of Dental Hygiene. She is a nationally recognized speaker, author and consultant focusing on infectious diseases, clinical safety, instrument sharpening, ergonomics and preventive dentistry. Nancy is a “Top 100 U.S. Speaker” and is on the CDA, ADA and OSAP speakers/consultants bureaus. She is an experienced author of journal articles, has contributed to textbook chapters and guidelines such as the 2009 ADA Infection Control Wall Poster.

Great Question! By now most offices know that they are required to use “safe” potable water to do general dentistry, and STERILE water for surgery. However, the workers in charge of waterline management may not know exactly how to achieve those two goals. Here are some basic facts that may help: 1. All waterlines will become contaminated beyond acceptable levels if they are not treated. Testing untreated waterlines is not recommended because they are expected to be highly contaminated. Testing is recommended to confirm the success of waterline treatment protocol. 2. The nature of the problem is that biofilms with mixed microbial species adhere to the internal lumen of the waterlines, providing a constant source of water contamination. The problem is due to nature of the dental unit design. Inside the waterlines, the high surface area-to-water volume ratio creates the perfect biofilm incubator. 3. “Shocking” or “purging” waterlines: If water alone (without a chemical additive) is drawn from a bottle and flows through waterlines, the biofilm

12 | The Nugget • Sacramento District Dental Society

will build up in the lines within about 5 days requiring removal at least weekly. The usual way to do this is with a “shock” chemical treatment, or the “purge” protocol involving an extended “soak” of the lines with a toxic chemical that dislodges the biofilm and must be rinsed out prior to patient care. When a daily chemical product (tablet or liquid) is added to the water bottle, biofilm growth is slowed, but not always stopped – so the shock treatment is still required, but may be done less frequently. 4. Many people confuse this “shock” step with a simple “flushing” of the water through dental ports or handpiece tubing. 5. “Flushing” waterlines is defined as running treatment water at full flow volume out of all tubing and ports. ADA and CDC standards recommend flushing the waterlines for at least 2 minutes at the beginning of the day to expel accumulated biofilm organisms and their byproducts. Flushing the lines for 20 – 30 seconds between patients is recommended to expel retracted patient materials from the lines to prevent crosscontamination. 6. If a waterline maintenance product (containing silver ions, chlorhexidene, citric acid, iodine, etc.) is added to the patient treatment water (tablets, drops etc. added daily), biofilm growth is slowed down. Periodic removal of the biofilm layer is still needed, but not as frequently; the usual recommendation is once per month. This requires a special product, takes time, and should be a regularly scheduled protocol! 7. The most common dental equipment design that allows access to the waterlines is the bottle, or “reservoir”. Removable bottles allow workers to control the type of treatment water and to add chemicals. 8. Chemicals may be added to the water bottles in the form of tablets or liquid, or cartridges may be installed that draw water from the bottle and add the chemical before the water enters dental unit tubing. Two types of cartridges show successful results: one eludes elemental iodine and one adds silver to the water.

9. If no water bottles are installed, there are two ways to treat the dental water. Iodine cartridges may be installed at the base of the dental unit to treat incoming “city water”. These cartridges elude iodine into the treatment water as it passes through them. The manufacturer claims that the “shock” protocol is not needed. The second option is a “whole office” system. These systems route the water through filters and provide a way to add chemicals to the plumbing in one central location away from the individual dental units. Water pipes deliver the water to the dental chairs. Several chemicals are used in these systems. Long distances of plumbing can dilute the anti-biofilm agent, reducing the effectiveness of treatment. Biofilm may quickly return on hidden piping connections, possible dead-end plumbing, and any spot where water stagnates. 10. If anti-biofilm strategies are used, waterlines should be tested to confirm that the goal of < 500 colony forming units (CFU’s) is being met. 11. There is no hard and fast rule on waterline testing. This is an implied rule: offices are required to use potable water, therefor they must determine if they are doing that. Testing is the only way to do that. 12. Only those offices that are using a DUWL cleaner should test their water, for the purpose of validating their success. Untreated waterlines are expected to grow high levels of bacteria. 13. There are several commercial waterline testing services and products. ProEdge, in Colorado, provides a mail-in waterline service with written reports. At least one university, Loma Linda University in California, also offers this service. Germaphene offers in-office testing products that include an incubator and vials. 14. Due to expense and time, it makes sense to test a limited number of representative waterlines on a rotating schedule to “spot check” the system. As long as numbers are acceptable, this assures that the system is likely to be working well. Such testing will identify the need to alter protocol or change products. If new State or Federal waterline testing recommendations are adopted, those should be followed. 15. Hidden waterline filters can typically be found at the base of dental units. These might become fouled with biofilm and need to be changed regularly. Such internal reservoirs of biofilm can undermine even the most conscientious waterline efforts by continuing to “seed” the system with biofilm and organisms.

Volunteer opportunities SMILES FOR KIDS VOLUNTEERS NEEDED: Doctors to “adopt” patients seen on Smiles for Kids Day 2015 for follow-up care. TO VOLUNTEER, CONTACT: SDDS office (916.446.1227 • smilesforkids@sdds.org)

SMILES FOR BIG KIDS VOLUNTEERS NEEDED: Dentists willing to “adopt” patients for immediate/emergency needs in their office. TO VOLUNTEER, CONTACT: SDDS office (916.446.1227 • sdds@sdds.org) AUBURN RENEWAL CENTER CLINIC VOLUNTEERS NEEDED: General dentists, specialists, dental assistants and hygienists. TO VOLUNTEER, CONTACT: Steve Holm (916.425.6766 • sholm@goldrush.com)

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16. Organisms enter the DUWL’s from a variety of points. The water source may contain pioneer organisms that grow biofilm, including distilled water, city water, U.V. treated water, and filtered water. Workers’ contaminated hands can introduce pathogens while changing bottles. Human pathogens may enter dental water tubing by retraction from patients through handpieces. The inside of water reservoirs (bottles) may grow a biofilm, and the bottle opening may be contaminated during filling or drying.

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17. Dental workers often confuse suction line cleaning with waterline maintenance! Every person who manages the dental waterlines must be well educated about biofilms and equipment.

VOLUNTEERS NEEDED: Greatest need is general dentists and oral surgeons, also looking for hygienists, assistants, and general volunteers.

continued on next page

VOLUNTEERS NEEDED: Dentists who can provide free dental screenings to event participants during the walk on September 19th. TO VOLUNTEER, CONTACT: Courtney Fong (916.501.1572 • courtneyfong@live.com)

GOLD COUNTRY VETERANS STAND DOWN

TO VOLUNTEER, CONTACT: Heidi Christopher (916.709.2547•heidichristopher.tdh@gmail.com) http://www.californiacareforce.org/ www.sdds.org • August / September 2015

| 13

OCCUPATIONAL HAZARDS

More and more of my colleagues use the iodine cartridge product inside their water bottle to treat their waterlines. They were told that they do not have to shock the waterlines again after they install the product. Is it true that they don’t need to do any further maintenance of the waterline system because the product is installed?

Chemicals may be added to dental unit water by adding a tablet or liquid to the bottle, or by installing a cartridge that eludes an active ingredient such as iodine or silver into downstream water.

If any new system is installed into a heavily contaminated dental unit, most manufacturers recommend shocking the system to remove the layers of biofilm prior to installation. This simply improves the effectiveness of the active ingredient. If heavy biofilm is in the lines, the active ingredient is “used up” faster by the biofilm, reducing the concentration in the treatment water. The manufacturer has advised me that it is best to shock the system prior to installing the cartridges. After the iodine cartridge has been in place, when it is time to replace the cartridge, shocking the lines is not necessary. Other cartridges that use silver to treat the water have different instructions. Remember, it is always best to call the manufacturer of both the waterline cleaner and the dental unit waterline bottles to get the answer directly from them.

With the cartridge that goes inside the dental water bottle, is it right to leave the bottles in place overnight, or should we take them off and let them dry out?

The cartridges treat the water from the reservoirs. The treated water goes directly to the dental tubing from there. The cartridges do not treat the water in the bottles. The water in the bottle and the outside surface of the cartridge can become very contaminated if the bottles are not maintained. I’ve seen biofilm build up in the water bottles and create a film on the outside of the cartridges if the bottles are not cleaned and emptied of water. It is possible that the heavy contamination can challenge the cartridge so much that the product may become over-burdened.

Dental unit reservoirs should be emptied nightly and waterlines should be drained to discourage biofilm growth.

Here is the recommended simple maintenance of waterline reservoir bottles: the bottles should be emptied every night so that the surfaces dry out, which discourages biofilm from forming. The outer surface of the cartridge can be gently wiped dry using a clean gauze square while carefully avoiding contamination of the cartridge. Clean gloves should be worn. The inside of the bottle can

14 | The Nugget • Sacramento District Dental Society

be simply drained or vigorously agitated and then drained. If the inside of the bottle needs to be cleaned, agitating the bottle with soap and water will usually be enough. The bottle MUST be completely rinsed of soap! Avoid physically scraping the inside of the bottle while cleaning. Avoid contaminating the inside of the bottle with sponges or reused materials such as cloth towels. Avoid using bleach or other caustic chemicals in the bottle that may react with the iodine cartridge.

Our office empties dental unit waterline bottles out at night, but they just pour out the water and screw the bottle back on to keep it clean inside. I can see that it is still very wet inside. Is this how it should be done?

The office is right to empty the bottles to optimize their line-drying efforts. They should run the water completely out of all hoses and ports, and drain the bottle as much as they can. You can blow compressed air into the lines to help dry them out, but completely drying out the dental unit waterlines is virtually impossible. The fluid pathway will still be moist, but emptying the lines and bottle discourages stagnation of water and reduces the possibility of biofilm build-up. The bottle may be inverted overnight on a clean absorbent surface or rack, protected from contamination, but the cartridge should be protected from contamination and damage while the bottle is off to reduce the chances that janitors or dental workers may hit it or contaminate it. If the bottle is re-attached to the unit overnight while empty but damp, mold and/ or bacterial colonies may grow inside the bottle and on the outside of the cartridge.

Our office does not use an anti-biofilm product in our waterlines, but we do have bottles. We fill the bottles with filtered water, and empty the bottles every night. I think we heard that if we empty the water out nightly, we don’t need to shock the system. Is this true? …And if not, how often we they do the shock treatment?

Emptying out the bottles every night does reduce the biofilm growth, but not enough to prevent biofilm in an “untreated” system. Without an anti-biofilm product, waterlines should be shocked once a week, even if they are emptied every night. I would highly recommend that your office uses a waterline anti-biofilm product (such

as tablets, drops or cartridges), to retard the growth of biofilms. Besides the benefit of having more reliable water quality, you will only need to shock the system every month or two rather than weekly. Either way, shocking the system is a fact of life unless you convert to one of the cartridge systems that do not recommend periodic shocking protocol.

Our office does periodontal surgery. What is the best waterline treatment for us?

For surgical procedures, only sterile water, delivered through a sterile delivery system may be used. This means you need to bypass the dental unit waterlines. A sterile water syringe, peristaltic pump, or bulb syringe can provide sterile irrigation and cooling water. AquaSept is an autoclavable detachable system that works well. There are many DUWL maintenance products and choices available. It is vitally important to match the system to the type of dentistry done, and to make sure that office staff is able and willing to maintain the selected system. Many offices are using such products, but may not be following

White in-line filters at base of dental unit must be changed regularly because they may become a source of waterline contamination.

directions, and may not be getting acceptable results. Waterline testing is needed to confirm the effectiveness of dental waterline treatment protocol. If no anti-biofilm product is added to dental treatment water, biofilm builds up and must be removed weekly. Daily anti-biofilm water treatment retards the growth of biofilms, but most manufacturers recommend periodically shocking the lines with strong chemicals that remove built-up biofilm – usually on a monthly schedule. Wet surfaces and stagnant water promote biofilm growth. Reservoir bottles should be emptied overnight and allowed to dry. Water should be flushed before seeing patients in the morning and between patients. Manufacturers directions should be followed to insure safe and effective water management. Consult with manufacturers of both dental equipment and waterline anti-biofilm products. 

REFERENCES 1. CDC. Guidelines for infection control in dental health-care settings. MMWR 2003;52(RR-17). 2. ADA Council on Scientific Affairs. Statement on dental unit waterlines; 2012. Http://www.ada. org/1856.aspx 3. G runinger, S. (2014). Disease Transmission Through Dental Unit Water: An Update. ADA Professional Product Review. 9(2), 8. ISSN 19308736 4. S arrett, D. (2014). A Laboratory Evaluation of Dental Unit Waterline Systems. ADA Professional Product Review. 9(2), 9-17. ISSN 1930-8736

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An Ethical Dilemma The Dilemma: You have a patient who loves to smile, but has been hiding behind overlapping central incisors for years. You suggested short term orthodontics (approximately 6 months of treatment) to improve the alignment of the maxillary anterior teeth. The patient was thrilled by the option, but tells you she saw an orthodontist last year who said she really needs 2 years of treatment.

WHAT SHOULD YOU DO? A. Call the orthodontist who did the last consultation and ask the doctor if it will be okay if you proceed with anterior alignment only. B. Explain that orthodontists tend to be very idealistic and want everything to be perfect even if the patient doesn’t want everything to be perfect. As the patient, you have the right to decide what you want to do with your teeth. Remind them that their bite has been that way for 40 years, and there won’t be any problems with leaving it that way for another 40 years. C. Let the patient know there are many treatment options available including comprehensive orthodontics with full bite correction, limited orthodontics focusing on limited treatment goals, or “instant orthodontics” utilizing restorative dentistry. Review the benefits and risks of each treatment option in detail. Refer to other professionals as needed if any alternatives are outside of your training or comfort level. After the patient has made a treatment decision, be respectful and supportive. D. Tell the patient to go get another consultation that can act as the “tie-breaker”.

By Brandon Martin, DDS, MS Ethics Committee Member

Recommendation:

hoice “C” is the best option. The ADA Code of Ethics calls for Patient Autonomy - the dentist has the duty to “treat the patient according to the patient’s desires, within the bounds of accepted treatment” while giving due consideration to “the patient’s needs, desires, and abilities.” Additionally, the Code of Ethics requires Nonmaleficence – we have the duty to refrain from harming our patients. We are tasked with “keeping knowledge and skills current” and to “seek consultation whenever the welfare of patients will be safeguarded or advanced by utilizing those who have special skills, knowledge, and experience.” Doctor-patient communication is the key to a successful and mutually beneficial relationship. As part of our informed consent process we should review the proposed treatment, reasonable alternatives, and explain risks and benefits. After adequately reviewing treatment options, the patient should be involved in the treatment decision. The dentist should encourage patients to seek the best treatment option that will minimize harm

16 | The Nugget • Sacramento District Dental Society

and maximize benefit. To minimize harm, the dentist should carefully evaluate which option is best for the particular case, and refer if they feel others may be more skilled or experienced. To maximize benefit, the dentist should educate patients and make them part of the treatment process. To best serve our patients it is important to keep our knowledge and skills current, to effectively communicate the risks and benefits of different treatment options, and help promote our patient’s welfare by making informed treatment decisions. 

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www.sdds.org • August / September 2015

| 19

Dental day at

Raley Field

RiverCats vs. Reno Aces • Event Highlights • June 18, 2015 What a great evening! We had nearly 500 members and family/friends attending. Dr. Viren Patel threw the first pitch and Dr. Brock Hinton’s daughters, Cassie and Allie, sang in the 7th Inning Stretch “Take Me Out to the Ball Game.” We had a really fun time and hope to see you next year!

Next General Membership Meeting: SEPTEMBER 8, 2015 www.sdds.org/general-meetings TheNugget Nugget••Sacramento SacramentoDistrict DistrictDental DentalSociety Society 20 ||The

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22 | The Nugget • Sacramento District Dental Society

YOU

THE DENTIST, THE BUSINESS OWNER

YOU ARE A DENTIST. You’ve been to school, taken your Boards and settled into practice. End of story? Not quite. Are you up to speed on tax laws, potential deductions and other important business issues? In this monthly column, we will offer information pertinent to you, the dentist as the business owner.

Why is Process Tilted

By Tim Giroux, DDS Western Practice Sales (SDDS vendor member)

Toward the Seller? I am looking for a practice to purchase. It seems like the process is tilted toward the sellers. Why? While dental brokers do represent only the seller, the process is not really tilted towards the sellers. Good dental brokers are critical in obtaining and deciphering the necessary information so that buyers can make an educated decision. The argument then is why there are not brokers to represent buyers. I would contend that a good broker who digs out the necessary practice financial information, computer reports and prepares the cash flow analysis does that for the benefit of the buyer and lender. Lenders essentially represent the buyer as they cannot afford to make a bad loan. Lenders definitely appreciate brokers in the transaction if the broker does his job on obtaining this information. I would also

contend that most of the “dental” attorneys and CPA’s in the business are more biased to the buyer as they understand the debt load and demands on the newer dental graduates. Ultimately, supply and demand as well as normal market forces dictate the price of the practice. Since scratch starts now cost $300400K to build out, take 9 months to complete and provide no patients or revenue upon opening the doors, it makes sense to buy a practice with cash flow. The issue then becomes what I call the “Million Dollar Question”: How much will you generate once YOU take over the practice? It should be obvious that the answer will be different for every dentist, as we could put a patient in the middle of 10 dentists and get 10 different treatment plans from watching a few fillings to a complete full mouth rehab! With that in mind, how could any dentist rely on the opinion of a

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broker, consultant, accountant or attorney to determine if a practice is the “right” practice? These professionals can certainly point out industry standards for expenses, profits and relevant legal issues, but only YOU know where you fit on that scale mentioned above. Are you a dentist that will watch a few fillings or recommend a full mouth rehab? Only you can answer this and all due diligence should be completed with this in mind. All the professionals listed to help buyers will be making an assumption that the dentistry produced is “usual and customary”. None can know what is “usual and customary” for you. Brokers can provide you with all of the information to make an informed decision, and industry professionals can provide advice, but only YOU, the buyer, can determine if a practice is right for you! 

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www.sdds.org • August / September 2015

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A charitable 501-C3 organization

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Our cup runneth over with donations in memory of Dr. Bob Gillis

• Dr. Gary Ackerman

• Dr. Herbert Hooper

• Ms. Kathy Anderson

• Ms. Norma Jennings

• Mr. & Mrs. Jack and Carol Bacigalupi

• Dr. Richard Kennedy

• Dr. Richard Barnes

• Dr. Grace Lee

• Mrs. Ann Berlo

• Dr. George Maranon

• Mr. Roy Bushey

• Pacific Coast Society for Prosthodontics

• Dr. Wai Chan

• Dr. Beverly Kodama

Heather’s story At Women’s Empowerment we have a special tradition when a woman in our program secures a job. She proudly walks in to our office and then (usually while jumping for joy) she rings the job bell before a cheering audience of supporters.

• Dr. Pamela Di Tomasso • Dr. James Peck • Dr. Kent Farnsworth

• Ms. Gina Robinson

• Dr. David Feder

• Dr. Brian Royse

• Dr. Kelly Giannetti

• Mr. & Mrs. Stanley and Carol Scott

• Mrs. Mary Louise Gillis • Mr. & Mrs. Richard and Sandra Giusti

• SDDS

• Mr. and Mrs. Jay and Deb Greenwood

• Dr. Robert Tilly

• Dr. Enborg Halle

• Ms. Kamala Tyagarajan

• Mrs. Mary Ann Harris

• Dr. Kim Wallace

• Dr. Gregory Heise • Dr. Alan Hickey

• Whiteman, Osterman & Hanna Attorneys at Law

• Dr. Irene Hilton

• Dr. Wesley Yee

• Mr. & Mrs. David and Jane Hinman

• Kaiser Permanente, South Sac

• Dr. Norman Spalding • Dr. Glen Tueller

My family and I would like to thank everyone for all their support and prayers during this difficult time, in the loss of my husband, our father, grandfather and brother. Thank you for your generous donations to the Sacramento District Dental Society Foundation, Smiles for Big Kids program. He would have been deeply touched by your support of a program he loved so much. With Grateful Hearts Mary Lou Gillis and The Gillis Family

By Lisa Culp Women’s Empowerment

Executive Director and Founder

“It was so scary for my children. They didn’t understand why we had to move so often, or where we were going. I wanted us to have a real home.” Coming to Women’s Empowerment changed everything. After graduating from our jobreadiness program, she received the support and resources she needed to secure a job. “Women’s Empowerment is the reason why I have a job today.” Heather joins thirty formerly homeless women who have proudly rung the job bell in the last two months.

This is one of my favorite moments to witness here at Women’s Empowerment. As a jobreadiness program, we truly value the dignity that comes with having a job. We see every day the fundamental shift that occurs when a woman feels like a valued, contributing member of her community.

It is so rewarding and fulfilling to have a job. I feel like I can be someone that my children look up to—like a productive member of society. I feel like a completely different person.

Many of the women I work with express to me that their biggest dreams are to come home—to a safe home, to their home—after a long day of work, and share dinner with their children. For many of us, that is a given we enjoy every day. For homeless women, this dream exists amongst a daily struggle of chaos, fear, and shame.

Heather is currently working as an office clerical assistant and is looking forward to the next chapter.

So when I hear that job bell ringing, I celebrate donors and volunteers like you. Her aspirations of providing for her family are possible because of the generous investments you have made in the lives of women and children in our community. I’d love for you to meet Heather. She is a living example of how your gifts transform lives. “I never had a resume before coming to Women’s Empowerment, and the last job I’d had was eleven years ago.” Her family, including her three-year old son Andrew and two-year old son Daniel, had been homeless off-and-on for three years.

24 | The Nugget • Sacramento District Dental Society

And thanks to our partnership with The Sacramento District Dental Society Foundation, Heather also received a brandnew smile—something that greatly improved her confidence, as when she first came to Women’s Empowerment she was missing most of her teeth. Heather and her family recently moved into their own home. “The day we moved in, my son turned to me and said, ‘this is my home? We get to stay here?’ He was so excited.” Heather feels grateful to be a part of her children’s life. “It is a true honor to attend back to school night with them, to be at their picture day. I love being their mother. Every night, after I get home from work, my children and I eat dinner together at our kitchen table, in our home. We’re all together now.”

SAMPLE BALLOTS BELOW NOTICE OF SDDS ANNUAL MEETING & ELECTIONS To be held at General Meeting Sept 8, 2015

SDDS Executive Committee

President: Wallace Bellamy, DMD President Elect / Treasurer: Nancy Archibald, DDS Secretary: Margaret Delmore, MD, DDS Immediate Past President: Viren Patel, DDS

Board of Directors

Greg Heise, DDS (2016–2017: 1st term) Bryan Judd, DDS (2016–2017: 2nd term) Matt Korn, DMD (2016–2017: 1st term)

DENTAL

EQUIPMENT

& TOOLS FOR SALE

Existing Board Members continuing term:

Dean Ahmad, DDS • Volki Felahy, DDS • Lisa Nielsen Laptalo, DMD • Peter Worth, DDS

Existing Trustee continuing term:

Trustees

Terrence Jones, DDS (2014-16) Adrian Carrington, DDS (appointed to fill Dr. Robert Gillis’ term)

Delegates

to CDA House of Delegates (2-year term, 2015–16): Volki Felahy, DDS Bryan Judd, DDS

Carl Hillendahl, DDS Beverly Kodama, DDS

Existing Delegates continuing term:

Nancy Archibald, DDS Wallace Bellamy, DMD Kelly Giannetti, DMD, MS Viren Patel, DDS Peter Worth, DDS

Guy Acheson, DDS Margaret Delmore, MD, DDS Steve Leighty, DDS Kim Wallace, DDS

NOTICE OF FOUNDATION ANNUAL MEETING & ELECTIONS

To be held at General Meeting Sept 8, 2015

Board of Directors

Margaret Delmore, MD, DDS (2016) Debra Finney, MS, DDS (2016–2017: 3rd term) Kelly Giannetti, DMD (2016-2017: 1st term) Bryan Judd, DDS (2016-2017: 1st term) Viren Patel, DDS (2016) Existing Board Members continuing term:

Kevin Keating, DDS, MS • Robert Daby, DDS • Bev Kodama, DDS • Adrian Carrington, DDS • Steven Cavagnolo, DDS • Kent Daft, DDS • Dennis Peterson, DDS • Kathi Webb, Associate Member

SAMPLE BALLOTS ABOVE

-Planmeca ProOne Panoramic X-Ray -Mobile Newport N2O System - Midmark M3 & M9 Autoclaves - MAXI SWEEP 53100 Ultrasonic Cleaner - Pelton Patient Chairs, Doctor & Assistant Stools - Hygiene Cart - Pelton LFT1 Track Lights - Various Instruments & Impression Trays.

Please contact Beth Heneger for prices and information. phone: (916) 402-9506 email: egillis75@sbcglobal.net www.sdds.org • August / September 2015

| 25

Sacramento Study Club Presents

Order the rst edition limited print now! For a free copy please send us your order via E-Mail at drantipov@drantipov.com with your doctor’s name and mailing address. Also available at Amazon Kindle and iTunes.

Join us at our Study Club continuing education monthly courses/lectures. sacramentostudyclub.com

Send your request to Alexander V. Antipov, D.D.S.

Galleria OMS 911 Reserve Dr, #150 Roseville, CA 95678 Office: 916-783-2110 Fax: 916-783-2111

Guide To Immediate Implants And Teeth

Patient Guide To Corrective Jaw Surgery

A must-have 32-page educational paperback for doctors and their patients planning to undergo extractions of teeth, immediate implant placement, immediate loading, and final restoration. A step-by-step Guide to surgical and restorative stages.

A 68-page Guide contaning real patients’ “Before” and “After” photos. Includes post-op rehabilitation notes taken by an actual patient.

sacramentostudyclub.com

We Reach Your Patients! 1.7 MILLION LISTENERS And that’s just on the radio! SACRAMENTO

LET US HELP YOU!

KBEB | KFBK | KHYL | KQJK | KSTE SacSales@iHeartMedia.com GET HEARD

26 | The Nugget • Sacramento District Dental Society

BE LOVED

Trustee Report Adrian Carrington, DMD, MS & Terrence Jones, DDS CDA Trustees

July 24-25, 2015

COMMITTEE SLATE

Highlights of the CDA Board of Trustees Meetings The Nominating Committee met on July 25 where they selected the following slate for presentation to the 2015 house:

Actions Taken * All actions of the Board will be moved to the House of Delegates for ratification (board report 3) or separate resolution.

•

Petition for Charter in Western Los Angeles Area: The board, in closed session, amended and approved noticing

President-Elect Clelan Ehrler, DDS

the house with the potential CDA Bylaws amendments to change the number of components based on the petition received requesting for a new charter in the Western Los Angeles area. The Executive Committee also held a special closed session meeting to discuss the information regarding the petition for a new component.

Elections and Nominations to Fill Trustee Positions on Committees and Board of Directors: The board elected trustee members to the specified committees and boards of directors of TDIC/TDIC Insurance Solutions (TDIC/TDIC IS), The Dentists Service Company (TDSC), CDAHCI and the CDA Foundation (foundation). •

Vice President Natasha Lee, DDS Treasurer Kevin Keating, DDS, MS Secretary R. Del Brunner, DDS Speaker of the House Craig Yarborough, DDS, MBA

The special HOD on June 19th approved the Dentist Service Company Project (see You Should Know, page 7).

business forum

continuing education

The Business of Dentistry

TEAM MOTIVATION: ALL TO BENEFIT THE ULTIMATE CARE FOR YOUR PATIENT

6:30pm–9:00pm • SDDS Classroom • No CEU

Presented by Amy Morgan (Pride Institute)

Thursday, September 17, 2015 This course will cover:

8:30am–1:30pm • SDDS Classroom • 5 CEU/20%

Presented by Amy Morgan (Pride Institute)

• Building your culture based on your values and vision

Friday, September 18, 2015

• Matching your goals to your vision

You’ll learn how to:

• Gaining buy-in from your team by promoting an environment of care and interdependence

• Create a compelling statement of goals for your practice

Space is limited, register today! $69 Member Price

• Learn the key essentials to creating a culture that values team energy • Identify new methods of improving performance shortfalls that affect morale • Reward and recognize your team based on performance Don’t miss this opportunity! $175 Member Price

www.sdds.org • August / September 2015

| 27

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YOU

YOU ARE A DENTIST. You are also an employer. Employee evaluations, hiring and firing, labor laws and personnel files are an important part of that. This monthly column, will offer current employment law information pertinent to you —

THE DENTIST, THE EMPLOYER

Minimum Requirements

the dentist, the employer.

BER MEM IT! F E N E B

California Lactation Accommodation Law

SDDS HR Hotline FREE TO SDDS MEMBERS!

1.800.399.5331

By CEA Staff

Do you have an employee returning from maternity leave? Here’s everything you need to know to make your office compliant with the California Lactation Accommodation Law. Provide Break Time for Employee to Express Breastmilk.

Employers shall provide a reasonable amount of time to accommodate an employee desiring to express breastmilk for th eemployee’s infant child. If possible, the break time should coincide with the employee’s paid break time. If not, the break time need not be paid. How Much Time Does an Employee Need to Express Breastmilk?

Typically, a lactating woman would need to express breastmilk about every 2-3 hours when she is away frm her baby. Twenty to forty minutes is generallyu needed for each pump session. Women who double pump (pump both breasts at the same time), generally take less time for pumping

than women who single pump (pump one breast at a time). Women need time to set yp and clean equipment, collect, label and store milk. SOme women prefer to work while pumping by reading or reveiwing worl related materials. If however, additional time is unpaid, consider allowing employees to arrive earlier or stay later than their normal work schedule to make up their time.

• Women’s lounge area • First aid room

Employers that do not comply with the provisions of the law could be subject to a civil penalty of one hundred dollars ($100) for each violation by the Labor Commisioner. Exemptions

Provide the Employee with the Use of a Room to Express Breastmilk.

An employer is not required to provide unpaid break time if to do so would seriously disrupt the operations.

Employers shall make a reasonable effort to provide employees witht the use of a a room or other locatuon for the employee to express milk. This place should not be a toilet stall.

Although not required by law to be provided by the employer, the following items are generally needed to express milk in the workplace.

WORKPLACE SPACES USED FOR EXPRESSING BREASTMILK: • Vacant office

Civil Penalty for Violators

• Room which can be arranged to be used during specific times of the day

• Dressing room • Cubicle with a curtain (last resort, if no other space is available!)

A room can be made private by having a lock on the door, placing a message on the door that the room is in use, drawing blinds or curtains, covering curtain-less windows with paper if necessary, or setting up a portable partition.

• Clean, safe water source, sink, disinfectant dish soap, and paper towels nearby for washing hands and breast pump equipment. • Refrigerator or ice chest to keep breatmilk from spoiling. • Room or space with an electrical outlet for employees who use an electric breast pump to express milk. • Comfortable chair to sit in while expressing milk. • Small table for pumping supplies.

www.sdds.org • August / September 2015

| 29

Advertiser INDEX Dental Supplies, Equipment, Repair Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member

Analgesic Services Inc. . . . . . . . . . . . . . . . . . . . . 28, 36 Burkhart Dental Supply. . . . . . . . . . . . . . . . . . . . . . . 36 Desco Dental Equipment. . . . . . . . . . . . . . . . . . . . . . 36 Henry Schein Dental. . . . . . . . . . . . . . . . . . . . . . . . . 36 Heraeus Kulzer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Patterson Dental. . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Robert Gillis, DMD, MS . . . . . . . . . . . . . . . . . . . . . . . 25

Dental Services Vendor Member

Pacific Dental Services. . . . . . . . . . . . . . . . . . . . . . . 36

Education Vendor Member

Sacramento Study Club . . . . . . . . . . . . . . . . . . . . . . 26 The Foundation for Allied Dental Eduation. . . . . . . . . 36

Financial, Insurance & Investment Services Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member

Ameriprise Financial â&#x20AC;&#x201C; The Chandler Group . . . . 21, 37 Bank of the West. . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Fechter & Company. . . . . . . . . . . . . . . . . . . . . . . . . . 37 Financial Management Associates, LLC.. . . . . . . . . . 37 First US Community Credit Union . . . . . . . . . . . . . . . 37 Innovative Solutions CPAs & Advisors, LLP . . . . . . . . 37 Kaneski Associates . . . . . . . . . . . . . . . . . . . . . . . . . 37 Magilla . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Mann, Urrutia, Nelson, CPAs . . . . . . . . . . . . 17, 28, 37 TDIC & TDIC Insurance Services . . . . . . . . . . . . . 6, 37 Union Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22, 37 Wells Fargo Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Human Resources Vendor Member Vendor Member

California Employers Association (CEA) . . . . . . . 36, 39 Resource Staffing Group. . . . . . . . . . . . . . . . . . . . . . 36

IT, Billing & Security Vendor Member Vendor Member Vendor Member

Pact-One. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 SD Reliance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 xTerraLink, Inc.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Legal Services Vendor Member

The Goldman Law Firm . . . . . . . . . . . . . . . . . . . . . . 30 Wood & Delgado . . . . . . . . . . . . . . . . . . . . . . . . 18, 36

Media & Advertising Vendor Member Vendor Member

Comcast Business. . . . . . . . . . . . . . . . . . . . . . . . . . 36 iHeart Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Sacramento Magazine. . . . . . . . . . . . . . . . . . . . . . . . 36

Office Design & Construction Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member

SACRAMENTO DISTRICT DENTAL FOUNDATION DOESâ&#x20AC;Ś

Blue Northern Builders, Inc. . . . . . . . . . . . . . . . . 15, 37 Healthcare Cabinet Co. . . . . . . . . . . . . . . . . . . . . . . 37 Olson Construction . . . . . . . . . . . . . . . . . . . . . . . 22, 37 Wells Construction . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Western Contract . . . . . . . . . . . . . . . . . . . . . . . . 17, 37

Practice Sales, Lease, Management &/or Consulting Vendor Member Vendor Member

Henry Schein - Wagner . . . . . . . . . . . . . . . . . . . . . . 30 Integrity Practice Sales . . . . . . . . . . . . . . . . . . . . 21, 36 Western Practice Sales . . . . . . . . . . . . . . . . . . . . 23, 36

Real Estate TRI Commercial . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Waste Management Services Vendor Member

Red Dog Shredz . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Star Group Global Refining . . . . . . . . . . . . . . . . . . . . 37

Nov 13, 2015 Friday

Feb 4, 2016 Thursiday

Mar 16, 2016 Wednesday

May 16, 2016 Wednesday

See insert for details and buy tickets

Committee Corner Large Practice

Task Force Update

robably every article submitted in next month’s issue of the Nugget will begin with a few sentences describing how the quantum shift of the business side of dentistry is affecting practicing dentists. The ADA, and especially CDA, are extremely aware of these shifts and are proactive with monumental changes to help the membership (You Should Know, page 7). Our SDDS Large Practice Task Force was convened at the beginning of the year, at the request of our President, Viren Patel, to examine some of the issues involved in these changes at a more local level. That seems like an eternity ago. The first meetings were dedicated to finding focus. What was our purpose? Were we to be a fact finding committee? Were we to help SDDS dictate policy? If so, were we to be “for or against” new ways of conducting the business of running a practice in this ever increasingly competitive world?

By Peter Worth, DDS

Large Practice Committee Chair

Members of the Task Force were selected to form a diverse group. Differences in age, sex, and ethnicity were all selected randomly. Several members have been in solo practice for years; others have worked in large group practices. Opinions of their experiences varied from disliking it, to feeling comfortable with it. Discussions were sometimes quite emotional, as you may imagine. In the end, the Task Force chose to be informational only. Our purpose is to try to provide the membership with as much

information as possible, in an attempt to approach “reality.” The articles in the Nugget will reflect this. There will be opinion pieces that may reflect negatively toward some versions of the large practice model (keep in mind they are not all the same!). Some articles are written by dentists managing large practices. Pay attention to the article written by Anders Bjork. His view of the dental world is unbiased (you might want to attend the October SDDS general meeting to hear him in person). Hopefully, you will find the selection informational and unbiased. Enjoy! 

LARGE PRACTICE TASK FORCE MEMBERS Peter Worth, Chair Toni Accettura Nima Aflatooni Craig Alpha

Rob Berrin Paul Binon Colleen Buehler C. C. Chiang

Eric Grove Ryan Hecht Sirisha Krishnamurthy Damon Szymanowski

LINK OF THE MONTH! www.sdds.org/continuing-education/courses/

2015 SDDS Committee Schedule TASK FORCES

ADVISORY COMMITTEES

1T1B

Amalgam Advisory Schedule as needed

Sept 1, Nov 3

Nov 6

Budget and Finance

Executive Committee (7:00am)

Ethics (6:15pm)

GMC Denti-Cal

Bylaws

Large Group Practice/ Corporate (6:30pm)

Fluoridation

Foundation Board (6:15pm)

Forensics (6:30pm)

Golf Tournament

Meeting Dates TBA Meeting Dates TBA Meeting Dates TBA

TBA

Social Media

Schedule as needed Schedule as needed Schedule as needed Oct 26

LEADERSHIP

Board of Directors (6:00pm)

Oct 9, Dec 4

FOUNDATION Sept 14 • Dec 2 Completed

Legislative (6:00pm)

OTHER

WORKGROUPS

Meeting Dates TBA

Dental Careers

Nugget Editorial (6:15pm)

Schedule as needed

Oct 26

Geriatric Outreach

Strategic Planning

Sept 28 • Oct 7

TBA

Schedule as needed

STANDING COMMITTEES

CPR (6:00pm)

Oct 27

Membership (6:30pm)

Sept 14 • Nov 18

Leadership Development Completed

Peer Review (6:00pm) Sept 16 • Oct 15 • Nov 18 • Dec 10

Sac Pac

CDA Delegates (6:00pm)

Schedule as needed

www.sdds.org • August / September 2015

| 31

We’re Blowing your horn! Congratulations to... Nancy Archibald, DDS, on her lunch group meeting regularly for over 20 years, always welcoming young female dentists to join them. (Pictured left to right; Drs. Denise Jabusch, Kasi Franck, Nancy Archibald, Elizabeth Roullier-Bunz, Beverly Kodama, and Allison Trout). (1)

Colleen Buehler, DDS & David Steinberg, DDS, on their recent engagement! (2)

Bob Church, DDS, and his wife Jeanne on their 50th wedding anniversary! They were married the day after Bob graduated from Creighton Dental School in 1965 and have three wonderful kids and 5 grandchildren, who they go to visit frequently. Brock Hinton, DDS, on winning Best of Show in the California Open for his red tailed hawk wood carving. He has an article in Wildfowl Carving Magazine showing how he carved his piece. (3) The Keating Death Riders, Dr. Kevin, Paul and Dr. David Keating — and the guy who didn’t make it— on making the Tahoe Death Ride! (4)

Hana Rashid, DDS, on your marriage to Joe Torri. (5) Ron Ask, DDS & Jerhet Ask, DDS, on providing free dentistry to over 400 Maasai people and other local residents in Kenya. Dr. Jerhet Ask stated, “It was awesome to help the Massai people feel better about themselves and set out on the road to good dental health.” The trip was a very rewarding experience for the dentists and their families. (6)

32 | The Nugget • Sacramento District Dental Society

WELCOME to SDDS’s new members, transfers and applicants.

New Members LEVI AZURDUY, DDS

SDDS (doctor’s line) . . . . . (916) 446-1227 ADA . . . . . . . . . . . . . . . (800) 621-8099 CDA . . . . . . . . . . . . . . . (800) 736-8702 CDA Contact Center . . . . (866) CDA-MEMBER (866-232-6362) CDA Practice Resource Ctr . cdacompass.com TDIC Insurance Solutions . (800) 733-0633 Denti-Cal Referral . . . . . . (800) 322-6384 Central Valley Well Being Committee . . . (559) 359-5631

KEEP US

UPDATED! Moving? Opening a new office? Offering new services? Share your information with the Society! We can only refer you if we know where you are; and we rely on having your current information on file to keep you informed of valuable member events!

Give us a call at (916) 446-1227

2015

JACQUELINE SANDERS DELANEY, DMD

General Practitioner 7275 E Southgate Dr., Ste 110 Sacramento, CA 95823 916.391.7525

General Practioner 40169 Truckee Airport Rd. # 204 Truckee, CA 96161 (530)587-9095

Dr. Azurduy graduated from MexicoUniversidad De La Salle in 2012.

Dr. Jacqueline Delaney graduated from University of Nevada, Las Vegas in 2014.

OKSANA BOYECHKO, DMD

IMPORTANT NUMBERS:

Aug/Sept

Transferred from San Gabriel Valley Dental Society General Practitioner Pending Office Address Dr. Boyechko graduated from Oregon Health Science University in 1999. She currently resides in Citrus Heights.

PAMELA CAVINESS, DDS

General Practioner 1500 21st St. Sacramento, CA 95811-5216 (916) 914-6394 Dr. Pamela Caviness graduated from Loma Linda University in 1987.

CATHY CHAN, DDS

General Practitioner 11155 International Dr. Rancho Cordova, CA 95670 (916) 861-1724 Dr. Cathy Chan graduated from University of California San Francisco in 1992, and did her residency in pediatric dentistry at Northwestern University, Children’s Memorial Hospital, Chicago. Fun Fact: In her spare time likes to travel to L.A. to visit her family and try all kinds of foods.

CURTIS CHU, DDS

General Practitioner Transferred from Napa-Solano Dental Society 2041 Bronze Star Dr, Ste 100 Woodland, CA 95776 (530) 662-7592 Dr. Curtis Chu graduated from Walla Walla College in Washington State in 2003. Fun Fact: Dr. Chu collects and builds large Lego sets and used to be able to solve a Rubik’s cube on average in 26 seconds.

SHAKIBA FEROZ, DDS

General Practioner Pending Office Address

Dr. Feroz graduated from University of California, San Francisco in 2015.

QUINCY GIBBS, DDS

General Practice, Prosthodontics 6409 Folsom Blvd Ste # 2 Sacramento, CA 95816 (916) 454-0855 Dr. Quincy Gibbs graduated from UOP Arthur A. Dugoni, School of Dentistry in 2004 and University of California, San Francisco in 2015 in Prosthodontics. Fun Fact: In his spare time he likes spending time with his five year old daughter.

JESSICA KANG, DDS

General Practioner Transferred from San Francisco Dental Society Pending Office Address Dr. Jessica Kang graduated from UOP Arthur A. Dugoni, School of Dentistry in 2013. Fun Fact: In her spare time, Dr. Kang enjoys hiking and exploring the woods.

BENJAMIN KLOSS, DMD

General Practitioner 2370 E Bidwell St Ste 110 Folsom, CA 95630 (916) 983-1114

Dr. Kloss graduated from Midwestern University in 2015. He currently practices and resides in Folsom.

CLIP OUT this handy NEW MEMBER UPDATE and insert it into your DIRECTORY under the “NEW MEMBERS” tab.

In Memoriam DR. C. GRANT MCDANIEL

DR. EDWARD F. DRIEMEYER

Dr. Grant McDaniel passed away on June 9, 2015 at the age of 73. He graduated from UOP and was a life member of SDDS; he had been a member since 1969.

Dr. Edward F. Driemeyer passed away on June 9, 2015 at the age of 92. He graduated from the College of Physicians and Surgeons San Francisco in 1946. He was a life member of SDDS, and had been a member since 1947. www.sdds.org • August / September 2015

| 33

New Members BIRINDERJIT MAND, DDS

General Practitioner 9450 Fairway Dr, Ste 110 (916) 380-3866

Dr. Mand graduated from Tufts University School of Dental Medicine in 2014.

ERIC MUFF, DDS

General Practice, Prosthodontics 12065 Persimmon Ter. Auburn, CA 95603-3853 ck! (530) 823-9136 Welcome Ba

Dr. Eric Muff graduated from UOP Arthur A. Dugoni, School of Dentistry in 2015.

SHIVAM NAND, DMD

General Practioner Transferred from Tri-County Dental Society Pending Office Address Dr. Nand graduated from Western University of Health Sciences in 2015. Fun Fact: In his spare time he likes playing sports and going to Kings games. Go Kings!

SHAILAIN PATEL, DMD

General Practioner Transferred from Stanislaus Dental Society 4515 Fermi Pl Suite # 106 Davis, CA 95618 (530) 750-1955 Dr. Patel graduated from from Kornberg School of Dentistry, Temple University in 2015. Fun Fact: I guess I was meant to be a dentist, since my initials are SRP....or wait, maybe I should have been a hygienist....

DON PHIPPS, DDS

General Practioner 161 Palm Ave ste 12 Auburn, CA 95603 (530) 885-0697

Aug/Sept

2015

HARKEET SAPPAL, DDS

(as of 7/31/15):

General Practitioner 2830 G Street Ste 100 Sacramento, CA 95816 (916) 446-9100

Dr. Sappal graduated from Nova Southeastern University in 2015. He currently practices in Sacramento and resides in Vacaville.

DUC-VINH VO, DDS

General Practitioner Pending Office Address (916) 284-4755 Dr. Duc-Vinh Vo graduated from University of California-San Francisco 2014. Fun Fact: In his spare time he enjoys photography, playing the piano, and spending time with my family and friends.

MICHAEL YOUNG, DDS

General Practioner Welcome 11670 Atwood Rd Auburn, CA 95603-9522 (530)887-2800 1350 E.Main St. Grass Valley, CA 95945 (530)477-8545

TOTAL MEMBERSHIP

1,606 MARKET SHARE: 79% RETENTION RATE: 95%

Back!

Dr. Michael Young graduated from UCLA School of Dentistry on 2010.

Pending Applicants Maha Almusawi, DDS Rachel Appelblatt, DDS Alex Keith, DDS Stephanie Kim, DDS Jeremy Starr, DDS Archana Wakode, DDS

Dr. Don Phipps graduated from University of Nevada, Las Vegas in 2015. Fun Fact: Dr. Phipps likes to go river rafting.

TOTAL ACTIVE MEMBERS: 1,301 TOTAL RETIRED MEMBERS: 232 TOTAL DUAL MEMBERS: 4 TOTAL AFFILIATE MEMBERS: 12 TOTAL STUDENT/ PROVISIONAL MEMBERS: 8 TOTAL CURRENT APPLICANTS: 6 TOTAL DHP MEMBERS: 43 TOTOAL NEW MEMBERS FOR 2015: 61

34 | The Nugget â&#x20AC;˘ Sacramento District Dental Society

VENDOR MEMBER SPOTLIGHTS:

At TDIC, protecting dentists is all we do. This singular focus and our 35-year history has earned TDIC the loyalty of over 18,000 dentists nationwide as well as an “A” rating from the A.M. Best Company for 21 consecutive years.

Products and Services

Products and Services:

• Mobile dental office modular trailers that facilitate your patient flow during remodels (site specific)

We have insurance products to protect every aspect of your business and personal life. Coverages specifically underwritten by The Dentists Insurance Company include Professional Liability, Commercial Property and Workers’ Compensation. Life, Health, Disability, Long-Term Care, Business Overhead Expense, Home and Auto products are underwritten by other insurance carriers, brokered through TDIC Insurance Solutions and Lockton Affinity.

• Complete architectural and engineering services for obtaining large or small remodels and new tenant improvements • Turn-key construction with continued support David Olson 209.366.2486 info@olsonconstructioninc.com www.olsonconstructioninc.com

we love our SDDS Vendor Members!

Benefits, Special Pricing and/or Discounts Extended to SDDS Members: To learn more about our multipolicy, Risk Management, new graduate and other discounts, please call TDIC at 800.733.0633.

Chris Stafford, Vice President, Sales and Service chris.stafford@cda.org Blair Tomlinson, Sales Manager blair.tomlinson@cda.org insuranceinfo@cda.org www.tdicsolutions.com

SDDS VENDOR MEMBERSHIP SUPPORT IS A WIN-WIN RELATIONSHIP! SDDS started the Vendor Member program in 2002 to provide resources for our members. No, Vendor Members are not exclusive, and we definitely have some competitive companies who are Vendor Members. But our goal is to give SDDS members resources that would best serve their needs. We suggest that members reach out to our Vendor Members and see what is a best “fit” for their practice and lifestyle. We currently are nearing 40 Vendor Members. They pay $3,900 per year; that includes a booth at Midwinter, three tables at General Meetings, advertising in The Nugget, and much more. Our goal is to provide Vendor Members with the opportunity to connect with and serve our members. We realize that you have a choice for vendors and services; we only hope that you give our Vendor Members first consideration. The Vendor Members program and the income SDDS receives from this program helps to keep your dues low. It is a wonderful source of non-dues revenue and allows us to provide yet another member benefit. Additionally, we reach out to our Vendor Members for articles for The Nugget (nonadvertising!). Our Vendor Members are financial, investment and insurance companies, legal consultants, dental equipment and supply companies, media and marketing companies, hr consultants, construction companies, billing consultants, practice sales and brokers, practice resource and staffing consultants, technology, HIPAA and security consultants, and even our Crowns for Kids refining partner! (See pages 36-37 for our list of current Vendor Members). www.sdds.org • August / September 2015

| 35

Kim Parker, Executive VP Mari Bradford, HR Hotline Manager 800.399.5331 www.employers.org

Vendor Member since 2004

CA Employers Association

Western Practice Sales

Brian Flanagan & Kirsi Kilpelanien 855.337.4337

Tim Giroux, DDS, President John Noble, MBA 800.641.4179

www.integritypracticesales.com

Vendor Member since 2014

Integrity Practice Sales

www.westernpracticesales.com

Resource Staffing Group

Wood & Delgado

Debbie Kemper 916.993.4182

Patrick J. Wood, Esq. Jason Wood, Esq. 800.499.1474

www.resourcestaff.com

www.dentalattorneys.com

SD Reliance Management

xTerraLink, Inc.

Dan Edwards, President 866.722.8663

Dennis Krohn Jr., President 916.367.4244

Rami J. Zreikat / Alnore Deen 916.608.9902 â&#x20AC;˘ 916.206.1858

Comcast Business

Sacramento Magazine

Lisa Geraghty 916.817.9284 lisa_geraghty@cable.comcast.com

Becki Bell, Marketing Director 916.452.6200

business.comcast.com

36 | The Nugget â&#x20AC;˘ Sacramento District Dental Society

www.sacmag.com

W W W. S D R E L I A N C E . C O M

www.xterralink.com

Education

www.sdreliance.com

Vendor Member since 2002

www.pact-one.com

Vendor Member since 2014

PACT-ONE Solutions

Vendor Member since 2012 Vendor Member since 2003 Vendor Member since 2007

www.pattersondental.com

Vendor Member since 2003

Practice Sales

www.pacificdentalservices.com

Vendor Member since 2015

Tiffany Hart 503.757.3023

Vendor Member since 2011

Dental Services HR & Legal

Pacific Dental Services

www.heraeusdentalusa.com

Vendor Member since 2010

James Ryan 800.736.4688

Vendor Member since 2015

Patterson Dental

Christina Vetter 409.649.8921

Vendor Member since 2005

Heraeus Kulzer

Mark Lowery, Regional Sales Manager 916.626.3002

DENTAL

IT, Billing & Security

www.descodentalequipment.com

Henry Schein Dental www.henryschein.com

Media & Advertising

www.burkhartdental.com

The Foundation for Allied Dental Education LaDonna Drury-Klein 916.357.6680 www.thefade.org

Vendor Member since 2015

www.asimedical.com

Vendor Member since 2014

Tony Vigil, President 916.259.2838

Vendor Member since 2011

DESCO Dental Equipment

Dave Little, Branch Manager 916.784.8200

Vendor Member since 2004

Burkhart Dental Supply

Geary Guy, VP / Steve Shupe, VP 888.928.1068

Vendor Member since 2014

Dental Supplies, Equipment, Repair

Analgesic Services, Inc.

John Urrutia, CPA, Partner Chris Mann, CPA, CFP, Partner 916.774.4208

www.kaneskiassociates.com

Philip Kong 916.533.6882 - cell philip.kong@wellsfargo.com www.wellsfargo.com

Vendor Member since 2013

Wells Fargo Bank

www.muncpas.com

Lydia Ramirez, Vice President 916.321.3145 www.unionbank.com

THIS COULD BE YOU!

The Dentists Insurance Company Chris Stafford 800.733.0633 www.tdicsolutions.com

Olson Construction, Inc.

Marc Davis / Morgan Davis / Lynda Doyle 916.772.4192

Gordon St. Cyr and Gary St. Cyr 916.853.9556

David Olson 209.366.2486

www.bluenorthernbuilders.com

www.dentalcabinets.biz

www.wellsconstruction.com

www.westerncontract.com/studio

www.olsonconstructioninc.com

Waste Management

Claire Blocker 916.202.0624

Vendor Member since 2015

Vendor Member since 2007

Western Contract

Nicole Wells 916.788.4480

Vendor Member since 2014

Wells Construction, Inc.

Vendor Member since 2013

Healthcare Cabinet Co.

Blue Northern Builders, Inc.

Vendor Member since 2013

Union Bank Vendor Member since 2010

Mann, Urrutia, Nelson, CPAs

916.774.6250 800.316.3129

Vendor Member since 2011

Kaneski Associates

www.innovativecpas.com

Vendor Member since 2004

www.firstus.org

Ben Anders, CPA 916.646.8180

Star Group Global Refining Jim Ryan, Sales Consultant 800.333.9990 www.stargrouprefining.com

www.sdds.org â&#x20AC;˘ August / September 2015

Vendor Member since 2009

Gordon Gerwig, Business Services Mgr 916.576.5650

Innovative Solutions CPAs & Advisors, LLP

Insurance Services

Ted Darrow, Client Relations/Marketing 916.985.9559

Vendor Member since 2011

First US Community Credit Union

www.fechtercpa.com

Vendor Member since 2005

www.bankofthewest.com

Vendor Member since 2009

Craig Fechter, CPA 916.333.5360

Vendor Member since 2014

Fechter & Company

Mary Alajou, VP Sacramento / Butte Area Manager 916.949.2687

Financial Management Associates, LLC www.fmacentral.com

Office Construction

Bank of the West

Vendor Member since 2010

www.ameripriseadvisors.com

Vendor Member since 2015

Thomas Chandler 916.789.9393, ext. 03197

Vendor Member since 2015

Financial Services

Ameriprise Financial â&#x20AC;&#x201D; The Chandler Group

| 37

Classified Ads PRACTICES FOR SALE

EMPLOYMENT OPPORTUNITIES

FOR LEASE DENTAL OFFICE SUBLEASE AVAILABLE IN FOLSOMORANGEVALE AREA. Furnished and equipped $275 per day 4 week days and weekends available. It’s an easy way to start your practice! Call 916.987.0444 08/09-15-C

SEEKING AN ENTHUSIASTIC, TAKE CHARGE DENTIST to become an associate and join our team orientated dental family in Lincoln, CA. Must possess great people skills, be able to multi-task, have knowledge on using dental software (ie- Eaglesoft) and most importantly know how to have fun and take care of people. We are currently looking to fill a Monday, Tuesday, Thursday and Friday schedule 7:30am to 4:30pm. Please send your CV to sacramentodmd@gmail.com. We look forward to having a wonderful person join our dental team! 06809-15

DENTISTS SERVING DENTISTS — Western Practice Sales invites you to visit westernpracticesales.com to view our practices for sale and see why we are the broker of choice in Northern California. Please call 800.641.4179. 03-09

START YOUR OWN DENTAL PRACTICE without incurring any debt. Sublease available in El Dorado Hills. State of the Art Office, Digital X-rays, everything you need to start seeing patients right away. Call 916.677.7221 for more information. 08/09-15

SACRAMENTO DENTAL OFFICE BUILDING FOR SALE— 8,000 sq. ft. As is, needs your vision, two stories, elevator, near Arden Mall. Contact Joe Hruban at 530.746.8839 or joe@omni-pg. com, Omni Practice Group #01821307. 08/09-15

3021 EL CAMINO AVE. DENTAL BUILDING BETWEEN WATT AVE. & FULTON AVE. For Rent at $2400/mo Or Option To Buy. Highly successful, free standing dental building over the years (approx. 1750 sq ft perimeter). Excellent visibility from El Camino Ave. on a highly trafficked street. 10 car parking/handicap waiting room, 4 operatories, 2 private offices, large lab area, and 3 rest rooms (patient bathroom, employee bathroom and dentist bathroom). This office is available now. Call John Morrisey, DDS for further details and negotiations. 916.833.7326. 08/09-15

ON-CALL & PART-TIME DENTISTS NEEDED—For a non-profit community health clinic providing care to Native Americans and the economically disadvantaged. Visit www.Chapa-de.org/jobs or Email resume to HR@chapa-de.org. 06/07-15

PROFESSIONAL SERVICES

WE CATER TO COWARDS. Here at Dental Excellence, we strive to provide the ultimate calm and comforting patient experience. Looking for an associate with 3-5 years of experience. Must have confidence in their skills, gentle touch to accommodate our fearful patients and have a flexible schedule. Must be available to work on Saturdays. Email greenhavendental@ yahoo.com or call 916.395.5700. 06/07-15 WELLSPACE HEALTH ORGANIZATION (an FQHC) is taking applications for fill-in/part-time/full-time dentists. Send your resume/CV to kdubois@wellspacehealth.org. 01/15 PEDIATRIC—Kids Care Dental seeks another SUPER STAR dentist to join our AMAZING team and help open our newest LODI location. Position available to pedos or generals who LOVE kids. Our non traumatic philosophy focuses on superior customer service and exceptional patient care in a non threatening environment. We get kiddos to actually look forward to coming to the dentist. Beautiful high end private offices and a CULTURE that can’t be beat provide a great place to practice and a great income for our doctors! Patients love us...come find out why! 4 days/ Week starting in April. Email dboyes@ kidscaredental.com. 03-15 DENTIST (MIDTOWN) Our amazing dental practice is in search of the Ultimate Dentist! We want a committed doctor to join forces and continue to evolve with our constant pursuit of greatness! We’ll talk about hours and perks once we read your resume. This is a great opportunity to work with our team. F/T or P/T position. Send us a current resume along with a letter stating why you should be selected. Don’t be shy, we really love that! What makes you stand out in the dental crowd? What makes you memorable to patients? What are your best attributes as a dentist? OUR MUSTS: High level work ethic and a passion to be a life-long learner. Check us out at DiTomassoDental.com. Send resume to: drpam@ ditomassodental.com 08/09-15

5-STAR COUNTRY CLUB DENTAL BUILDING. Premium location, 1901 Watt Ave. ADA compliant. Rare opportunity for space. 4 state-of-the-art operatories and a lab. Remodeling with your choice of interior decor. Call 916.225.8768 or email evangelinmiller@gmail.com. 08/09-15 BREATHE AGAIN CPR on or off site, group or individual. Healthcare Provider classes taught by AHA-certified instructors. Same-day CPR certification/card available. Contact Linda at 408.497.5910 or breatheagaincpr55@yahoo.com for information. 06/07-15 MONEY IS WALKING OUT THE DOOR. Have implants placed in your office and keep the profits. Text name and address 916.769.1098. 12-14 LEARN HOW TO PLACE IMPLANTS IN YOUR OFFICE OR MINE. Mentoring you at your own pace and skill level. Incredible practice growth. Text name and address to 916.952.1459. 04-12

POSITIONS WANTED

SACRAMENTO DENTAL COMPLEX has one small suite which can be equipped for immediate occupancy. Two other suites total 1630 sq. ft which can be remodeled to your personal office design with generous tenant improvements. 2525 K Street. Please call for details: 916.448.5702. 10-11 LOCATION, LOCATION, LOCATION: DENTAL OFFICE AVAILABLE, 3000 L Street 1,535 sf with 5 operatories, recently remodeled. Fully serviced lease with ample free parking. Contact Kelly Gorman 916.929.8100. 03-13 SUNRISE DENTAL PLAZA, SUITE #106 FOR LEASE, 7916 Pebble Beach Dr., Citrus Heights. Four operatories and a lab with 1304 square feet. Well established professional dental building. For more information, please call or email Marty at 916.966.5772 or mshep6944@aol.com. 08/09-14

LOCUM TENENS. UOP grad to work in your office while you are on vacation, sick or maternity leave or emergency. Great references. Please call 530.644.3438. 04-13

SDDS member dentists can place classified ads To place an ad in The Nugget Classifieds, visit www.sdds.org/NUGGET.html

Selling your practice? Need an associate? Have office space to lease? SDDS member dentists get one complimentary, professionally related classified ad per year (30 word maximum). For more information on placing a classified ad, please call the SDDS office at 916.446.1227.

38 | The Nugget • Sacramento District Dental Society

FOR FREE!

MEMB E BENEF R IT!

California Employers Association

Summer Special! TM

ONLY FOR SDDS HOTLINE MEMBERS... To complement your Hotline Membership!

If your business is a member of a current CEA Hotline, you qualify for our

CEA’s On-Line Membership is a self service plan that provides you with complete access to our website including the “Members Only” pages.

Summer Special

A CEA On-Line Membership Gives You Unlimited Access To:

On-Line Membership

$345/year!

•

HR forms & fact sheets including Paid Sick Leave Policy Templates!

(Regularly $395/year)

•

HR Answers Now!, the online labor law library, with State & Federal employment laws for all 50 states.

•

to develop and customize job

•

Performance reviews wizard to develop and customize performance reviews

•

HR Reference Guide (On-Line)

•

The California Employers Report and monthly email The California Employers Report

•

CEA Weekly Email Updates

•

Discounts on all CEA products & events

SDDS Click Member Here to Click Subscribe Beneﬁt Here to

800.399.5331 employers.org

PRSRT STD US POSTAGE PAID PERMIT NO. 557

2035 Hurley Way, Suite 200 • Sacramento, CA 95825 916.446.1211 • www.sdds.org

SACRAMENTO, CA

ADDRESS SERVICE REQUESTED

SDDS CALENDAR OF EVENTS SEPTEMBER

OCTOBER

8 General Membership Meeting CE Endo vs. Implant Throwdown Guy Acheson, DDS; Debra Finney, MS, DDS; Kevin O’Neill, DDS, MSD Hilton Sacramento Arden West 5:45pm Social / 6:45pm Dinner & Program 9 HR Webinar Top 10 Ways to Stay Out of Court Noon–1:00pm 14 Foundation Board Meeting

6:15pm / SDDS Office

Membership Committee Meeting

6:30pm / SDDS Office

17 Business Forum The Business of Dentistry – For Dentists 2 Continuing Education Amy Morgan (Pride Institute) CE Adult Oral Conscious Sedation 6:00pm–9:00pm / SDDS Classroom Anthony Feck, DMD (DOCS) 18 Continuing Education 8:30am–1:30pm / SDDS Classroom Team Motivation: All to Benefit the Ultimate Care for Your Patient CE 6 General Membership Meeting (note date change) Large Group Practice & Amy Morgan (Pride Institute) CE Your Dental Practice 8:30am–1:30pm / SDDS Classroom Anders Bjork (CDA) 28 House of Delegates SDDS Caucus Hilton Sacramento Arden West 6:00pm / SDDS Office 5:45pm Social / 6:45pm Dinner & Program 30 Lunch & Learn Continuing Education 9 Continuing Education FIY: Fix It Yourself! From the Terrible Twos to the Terrible CE Tony Vigil (Desco, Vendor Member) Teens: The Challenges & Rewards of 11:30am–1:30pm / SDDS Classroom Treating Them All

For more calendar info and to sign up for courses online, visit: www.sdds.org

Greg Psaltis, DDS 8:30am–1:30pm / SDDS Classroom

front office bOOT CAMP

supreme sPEAKERS licensure renewal courses

Lots of CE & 70 Vendors

EARN

CE UNITS! 5:45pm: Social & Table Clinics 6:45pm: Dinner & Program Hilton Sacramento Arden West (2200 Harvard Street, Sac)

September 8, 2015

Endo vs. Implant Throwdown

New Member Night

Presented by: Guy Acheson, DDS, Debra Finney, MS, DDS & Kevin O’Neill, DDS, MSD Do treatment decisions keep you up at night? What considerations go into making those decisions? Good people with good intentions… but you need to know your limitations! This “Throwdown” format will provide the audience with different aspects and considerations from the Endodontist, the Periodontist and the General Dentist point of view.

OCTOBER 6TH GENERAL MEMBERSHIP MEETING: Recruitment Night