MARCH 2010 TDA TODAY by Texas Dental Association

MARCH 2010 JUNE, 2008

VOLUME 9, 11,ISSUE ISSUE63

AVAILABLE AVAILABLEONLINE ONLINEAT ATTDA.ORG TDA.ORG

TDA Hosts a Successful Every Member MattersState Strategy Conference The Texas Dental Association hosted a State Strategy Conference March 5-6, 2010, at the Omni Rise’ Lyman, DDS, TDA Future Focus Committee Hotel in downtown Austin. This initial conference brought together from 14organization. constituent associations to Membership growth34isrepresentatives vital to any thriving The Texas Dental Association (TDA) Board is strongly exchange approaches and ideascommitted regarding legislative, public, andgoal institutional strategies to preserve to the Membership within the “TDAdesigned 2009” strategic plan, which addresses continued growth. the dentist’s role as head of theIdental teamto and protect theasfuture of dentistry. am proud report that, evidence of that commitment and for the second year in a row, the TDA received All participants agreed that more than organized dentistry must present a unified, thenow, following ADAever, awards in 2008: coordinated approach to access• to care that includes educating legislators and the public as toawhy Greatest Percentage Membership Net Gain: Texas had net gain of 198 members in the year 2007. alternative unsupervised practice models are not the solution for resolving access issues. • Top Constituent Dental Society with Greatest Percentage of Non-Members to Membership: The agenda included an exciting presentation by Dr. James Crall, American Academy of Pediatric Represents a conversion of 4.7 percent of non-members into membership at end of year 2007. Dentistry Child Advocate — National Health Policy Center UCLA He Retention advised the Rate Percentage in 2007: Represents a 97 • TopOral Constituent Dental Society to 2008. Improve representatives to acknowledge the percent significant disparitiesretention in oral health the population and from the previous year. Association rate,status whichamong is an increase of 7 percent develop plans aimed at addressing disparities. He also promoting oral health services as of 111 (L-R) Georgia Dental Association president Dr. • those Greatest Percentage of suggested New Dentist Members: Represents a gain new dentist members (those essential, not optional, health services. Kent Percy, Indiana Dental Association president dentists who are 1-9 years out of school). Dr. J. Mark Thomas, and TDA past president Dr. Overall, this first of hopefully many meetings was a resounding success and participants left knowing Another example of the commitment to the growth of our Association is the TDA Externship Program, which builds student awareness they had a network of valuable resources and opportunities to shape oral health policy about the national and Hilton Israelson. of organized dentistry. This innovative program, created in 2007, offers students the opportunity to gain insight into the different components state levels. The attendees agreed that organized dentistry must leverage collective resources to strengthen the of organized dentistry including legislative and regulatory affairs, membership, governance, continuing education, and charitable dentistry and practice environment for the profession and ensure the best possible dental care for the patient. to gain a better understanding of their role as future leaders of the dental team. The program is open to dental students from each of the three dental schools in Texas. This year the externship program will take place June 20 – June 27 in Austin at the TDA central office. As an ongoing effort to enhance the value and benefits of the Association, the TDA Council on Membership developed a survey that was sent to all members in 2006. The results clearly showed that members have a high satisfaction rating with benefits such as the TEXAS Meeting, TDA publications, and the ability to participate philanthropically in the TDA Smiles Foundation. A great number of the discounted programs offered to members through the TDA Perks Program also received a high satisfaction rating. In accordance with the strategic plan, the Council on Membership, will survey members again in 2009. Participation from all members and a collaborative effort between the ADA, TDA, and local component societies are the keys to successful membership recruitment and retention. We encourage every member to get involved whether it is by attending local meetings, taking part in Give Kids a Smile! Day activities, volunteering at a Texas Mission of Mercy, or participating in TDA Legislative Day activities Stategrowth Dental Society presidentand Dr. of organized (L-R) Kansas Dental Association president-elect (L-R) Mississippi Association ADA delegate in Austin. EachDental member matters and is essential (L-R) to theDelaware continued of our(DSDS) Association dentistry. Dr. James Russell Dumas, Louisiana Dental Association Sharon W e lsh, DSDS past president Dr. Charles Calhoon, Dr. David Hamel, Dental Association This is the seventh and final in a series of articles focused on the TDA’s accomplishments guided by the strategic plan. ToGeorgia view the entire plan, Patient and Alabama Dental Association president-elect Dr. Deborah Protection Task Force chair Dr. Ty Ivey, and Illinois president-elect Dr. Eddie Hebert, and Louisiana Dental log in at www.tda.org and click on “TDA 2009” under “Current Issues” on the member homepage. For more information, please contact Lyda Creus Association governmental affairs chair Dr. Bill Hall. Bishop. State Dental Society president-elect Dr. Darryll Beard. Molanphy, staff liaison to the Future Focus Committee, at the TDA central office, (512) 443-3675.

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Membership How did you complete that sentence? Our public image is one of the most important issues facing the TDA today. The fact is that creating a positive public imagewill is something we all striveand forparticipation every day in our personal Dentists value membership in the TDA.lives, our practice lives, and in our dental profession as a whole. The public’s perception of our profession consistently ranks at the top of our member’s concerns in the recent surveys that we have conducted. As a result, it isObjectives one of the seven goals (Public Image) of the strategic plan, TDA 2014. There are five objectives of the public image goal in TDA 2014, and they can be 1. in Improve perceived benefits of membership in TDA. found their entirety on the value TDA and website. By attaining these objectives, the TDA hopes to: 1) promote the dentist as the authority on oral health; 2) educate a. Increase members’ knowledge about the impact and benefits TDA membership. the public about the importance of oral health; 3) increase awareness about TDAofcharitable services; 4) promote the TDA member as a valuable member of the b. Ensure that components are an integral aspect of the membership process. community and 5) promote the collaborative efforts of the TDA with other health organizations. Create greater awareness of the availability of so thetoPeer Review, & Judicial, Management benefits. Youc.can imagine the depth and complexity of this issue, continue theEthics road traveled by and Risk TDA 2014 Public Image Goal d. Actively promote adherence to the Code of Ethics. earlier leaders of the TDA, your Future Focus Committee (the committee charged with overseeing e. Enhance communication with members non-members. TDA will promote a positive image of the implementation of the TDA 2014) recently asked oneand of the principles of the PulsePoint f. Build student awareness of and interest in organized dentistry andthe membership Group (an Austin-based communications management consulting firm) to address TDA Boardin TDA.the profession of dentistry ongoingofcontact with students throughout dental school. regardingg.the Ensure “public image” the TDA. Objectives: h. Work closely with dental faculty. What we learned is that not only areschool there many new ways for us to reach out to our members, 1. Promote the TDA dentist as the definitive i. and Evaluate number of nonmember dentists who attend andwith participate inisTDA activities (TEXAS Meeting, Smiles our patients the public at large, but that the best way to communicate someone still peer authority on all oral health issues to the Foundation programs, etc.). to peer. How that peer-to-peer communication takes place is what has changed so dramatically. The public and the medical community. Metrics rather lively discussion focused on the dramatic change brought about by social media. “Social media” Educate the public regarding the 1. umbrella Seventy percent for of active licensed dentists in TXYouTube, will be members of TDA 2009 (baseline2. of 68.5% in January 2007); increase is the definition Facebook, Twitter, My Space, etc. Haven’t heard by of those critical importance of good oral health. membership retention rate to 97 percent by April 2007 (baseline 96% in 2006). websites? A lot of us have not used or even heard of this “social media” phenomenon. However, of 3. affairs Promote awareness of TDA-sponsored a-d. Increase the number of dentists serving on component peer review andtoethics committees to attain a those websites just mentioned, Facebook alone has 400,000,000 users. Social media are the X and and judicial Y charitable services and increase public participation rate of 2-5 percent relative to the total number of component society members by August 2009. generations what newspaper, radio, and TV were to previous generations. recognition of people who participate. Ninety percent TX the dental school graduates actively in TX will be members 2.How does all of this of affect public image of the TDA? Whylicensed should we be interested in social of TDA five years after graduation (89% 4. Promote the image of the TDA dentist dental student conversion from thegathered graduating class of 2005 media? The dissemination of the information by the TDA mightinbeTexas). more accessible to our measured as a valuable member of the community. 3. Increase the number of member dentists actively participating in TDA by 1 percent a year (as by a variety of means younger members through social media. Will the TDA abandon the traditional medium we use 5. legislative Promote TDA’s collaborative efforts/ – participation at TX Meeting, TMOM, TXDDS, FSI programs, DENPAC participations, TDA day) with annual to communicate with one another? No, we will still have those avenues, but if we don’t look into partnerships with other oral health report to TDA Board by the Council on Membership. enhancing our presence in the social media arena, we may lose dentists who otherwise would be 4. Establish baseline at TDA activities (CAS, TDA Smiles Foundation,organizations. Membership) productive members. As theof oldnonmember saying goes, participation “If you aren’t the lead dog, the view never changes”. 5. Established baseline of members’ understanding of and satisfaction with the benefits of their TDA membership through Member Benefits and Services Survey (completed Nov 2006), re-evaluate % increase at that time for 2009. 6. Sixty-five percent of all full-time faculty will be TDA members by 2009 (2006 baseline = 63%).

TDA Presents Award to Rep. Chuck Hopson

TDA Member Receives Prestigious Medicaid in My Office? National Yes, I Think Award So! Dr. Xochitl Anderton Richard M. Smith, DDS of Lubbock named Geiger Gibson Emerging TDA Smiles Foundation Leader TMOM gains ardent advocate TDA Member Visits Haiti Ask President Dr.the Manuel Carrasco of Odessa Incoming President’s message shares experience Hilton Israelson, DDS TDA Member Inducted Into Honor Let’s Talk Society Outgoing President’s message Foundation A. TDA DavidSmiles May, Jr., DDS Fluoride Fest Lampasas 2008-2009 TDADental BoardFoundation of Directors Capital Area partnership Meet Your TDA Staff TDA’s Finance Director TDAnew Perks Program Dee Dee Delagarza TEXAS Meeting Preview Congratulations to TDA Evidence-based Tip of the Month Component Societies TSBDE Rule Update Streamline Your Insurance Claims Speeding up confirmation of benefits Medicaid and eligibilityUpdate TSBDE Rule Update April Requirements for dental office Journal News radiograph machines

Dr. R. Lee Clitheroe, TDA Future Focus Committee Development Manpower Advocacy Image ExcellenceDental Association The Public Image of the Texas is …

Inside Inside

At the conclusion of each legislative session, the TDA Board of Directors approves

The TDAinwill update strategic with statewide retreat in August of 2008. “Excellence Patient Advocacyit’s Awards” to select plan lawmakers whoanother were instrumental in assisting

TDA with its legislative agenda. The TDA proudly awarded Texas House Representative Chuck Hopson (R-Jacksonville) an award on February 22 in Jacksonville. Local dentists, elected officials, and the Speaker of the Texas House Joe Straus (R-San Antonio) attended the event. In addition to successfully carrying TDA’s dental assistant legislation through the 81st Legislative Session, Rep. Hopson was supportive of numerous bills related to oral health and medicine. As a pharmacist in Jacksonville, Rep. Hopson knows first-hand the many issues that health care providers face on a daily basis. (L-R) Pictured are Speaker of the Texas House Joe The event came at a pivotal time in the election process, just 1 week before the primary. Straus, Texas Rep. Chuck Hopson, recipient of the TDA Rep. Hopson faced opposition from two challengers and the award ceremony produced local “Excellence in Patient Advocacy Award,” and television and newspaper coverage. Rep. Hopson won his primary race with more than 60 TDA president Dr. Matthew B. Roberts. Photo2009. courtesy of the Jacksonville Daily Progress. percent the vote andAssociation will return members for a sixthfrom termacross to thethe Texas of TDA’s Representatives. In 2003,ofTexas Dental stateHouse develop first strategic plan, TDA

In Special the News Prosthodontics Issue TDA members in the news Removable Partial Dentures — Treatment Now and for July Journal News the Future Tooth Whitening: A ClinicalforReview Functional Impressions Complete Denture Fabrication TDA Historical Perspectives Dentists, dental hygienists, and the Edentulism and Comorbid Factors dental team The 2007 C.T. Rowland Award Around the State Orthodontic case report April 10 The El PasoFest, Dental Conference Fluoride Goliad April 15 – 17 Around the State

Star of the South Dental Meeting, Houston August 14: TDA Board Meeting April Texas 16 Austin, ADA 15th District Delegation Caucus15-19: Meeting, Austin October ADA Annual Session San Antonio, Texas

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TDA Member Inducted Into Health Clinic’s Honor Society Dr. David F. Nichols of Tyler was inducted into Bethesda Health Clinic’s Doctor Luke Society in Tyler last month. Dr. Nichols is the fi rst dentist to be inducted into the prestigious society, formed to honor medical professionals who demonstrate a caring spirit and reach out to those who cannot aff ord adequate medical care.

TDA Member Visits Haiti

Dr. Manny Carrasco Helps Earthquake Victims Nicole Scott, Managing Editor Periosteal elevator. Orthopedic rongeur. Hemostats. Th ose are the only dental instruments Dr. Manuel “Manny” C. Carrasco of Odessa could gather to perform dental extractions in Haiti last month. He wasn’t sure what to expect, but he was certain that he could provide Dr. Manny Carrasco of Odessa performs a tooth help to Haiti’s earthquake survivors. extraction on a patient in Haiti.

Dr. Carrasco, along with a registered nurse, a certifi ed registered nurse anesthetist, and his pastor formed a medical team of volunteers from Dr. Nichols the Mid-Cities Community Church in Odessa, equipped with only Inductions result from a sponsorship donation of $25,000 to the society. Sponsors their skills and a small amount of supplies. include friends and family members, as well as local hospitals, clinics, foundations, “We had two missions,” says Dr. Carrasco. “Do no harm. Take care of and businesses. their immediate needs.” Th e Bethesda Health Clinic has treated more than 12,000 people and had more than 18,000 volunteer hours last year.

Alliance to the ADA Provides Dental Health Books to San Antonio Libraries Ms. Cindy Bates, District 8 Trustee, Alliance to the ADA Th e Alliance to the American Dental Association (AADA) District 8 Trustee Ms. Cindy Bates of San Antonio donated 20 copies of “Ready, Set, Brush” for distribution throughout the San Antonio Public Library system to promote good oral hygiene.

Th ree weeks after January’s 7.0 magnitude quake, the volunteers fl ew to Haiti on a small private airplane piloted by a Tampa, Florida, businessman who got wind of their mission. Th ey circled the Port-auPrince airport fi ve times to allow for incoming and outgoing military fl ights. Once they landed the scene on the ground was devastating.

A man carries a coﬃn down the street in Portau-Prince, Haiti.

“It looked like war-time at the airport,” says Dr. Carrasco. “You go through customs and see all these people with signs saying, ‘Food,’ ‘Water,’ ‘Money.’ It was just chaos.” People grabbed at them. “Th ey were in survival mode,” he says. Th e group headed to their host church, Gerald Bataille Ministries, which also had the only water fi ltering system for that local, battered community. From there, they went to what was left of the Port-au-Prince General Hospital, the grounds of which served as a staging area for emergency relief. Dr. Manny hugs a 5-year-old patient whose

resilience and strength was an inspiration, he says.

After walking through the gates of the hospital grounds, the amount of people waiting for emergency help stunned him. “I was shocked. I couldn’t grasp that.”

“Ready, Set, Brush” is a preschool level, Sesame Streetthemed book that illustrates the elements of good oral Pictured are San Antonio Central Library children’s hygiene. By submitting services coordinator Ms. Viki Ash, her grandchildren a grant request to the Carlos and Iris Bernal, and (right) AADA District 8 AADA, Ms. Bates received Trustee Ms. Cindy Bates. the books for distribution in public and school libraries as part of the organization’s national dental health outreach programs. In addition to donating the books, Ms. Bates and members of the Alliance to the San Antonio District Dental Association performed a Sesame Street-themed puppet show and distributed children’s toothbrushes.

International medical and emergency volunteers were using parts of the hospital not destroyed in the quake. “In the operating rooms, surgeons were using just headlights. Triage tents were set up outside because they didn’t know how stable the building was.” Dr. Carrasco walked into one of the numbered triage tents and said, “Who’s in charge?” Operating on a fi rstname basis, Dr. Gene from Russia helped him set up shop. Dr. Carrasco was now “Dr. Manny.” For 5 days, an estimated 900 people came through his medical relief tent. It was a “conveyer belt of patients,” Dr. Manny says. And, the injured kept coming. Cuts, scrapes, amputations, crushing injuries. “You’d look out (at the crowd) and just start working.” He performed only a handful of dental procedures — about fi ve extractions and removal of a large mass. Without modern conveniences of panographs or suction, the procedures were made even more diffi cult with the language barrier. Translators helped decipher the Haitian French-Creole language. To see more pictures and read the rest of the story about Dr. Carrasco’s experience in Haiti, please visit the Current Issues section on tda.org.

Happy, Healthy Smiles … That’s Our Mission! Fluoride Fest Lampasas Yields Flying Colors and Big Smiles All Around Hundreds of children from the Lampasas Independent School District attended the TDA Smiles Foundation’s (TDASF) Fluoride Fest in Lampasas last month. Th e event’s goal was to educate the community’s youngest members on the correlation of good oral health and overall systemic health and to communicate the benefi ts of public water fl uoridation to community leaders. Th e Lampasas kindergarteners through second graders made their way through Fluoride Fest’s fi ve stations, which included some components of the United Ways of Texas Cavity Free Corral curriculum: 1. Saddlebag Snacks: Healthy snacks and fl uoridated bottled water were available; 2. Plaque Round-Up: Squirting animal puppets with human mouths and dental hygiene puppeteers taught proper brushing and fl ossing techniques; 3. Prairie Tattleteeth: Hand mirrors and coloring sheets helped children identify their primary dentition; 4. Fitness Rodeo: Physical fi tness disguised as active play taught the lessons of maintaining healthy bodies; 5. Fluoride and Exams: Drs. Beverly B. Zinser of Georgetown, Barry J. Currey and W. Kurt Loveless, both of Lubbock, Vincent Ip of Austin, and Jay Elder of Lampasas examined participants, ordered topical fl uoride and sealant treatments, and sent home notes suggesting hygiene and restorative care that could be provided the following day at the Smiles on Wheels event. Want a Fluoride Fest in your community? If your community’s water is not actively fl uoridated and has a lessthan-ideal naturally occurring fl uoridation level, contact the TDASF at tdasf.org.

TDASF Partners with the Capital Area Dental Foundation As an objective to the Public Image goal on the TDA 2014 Strategic Plan, the TDASF is charged with the promotion of collaborative eff orts and partnerships with other oral health organizations. Th us, TDASF formed a partnership with the Capital Area Dental Foundation (CADF). Th rough grant funding from the RGK Foundation of Austin, CADF launched an initiative to serve the elderly and permanently disabled patient base in their area. As a result, Missy Quintana, a CADF part-time employee, will manage the TDASF’s Texas Donated Dental Services cases for Williamson, Travis, Hays, Burnet and Bastrop Counties. Th e goals for the CADF program are to recruit dentists for program participation and eliminate the wait list for the area. Th e program also aids the foundation greatly as fi ve counties have now been removed from the 254 counties statewide that a single TDASF caseworker manages.

Missy Quintana, Capital Area Dental Foundation

Missy’s background includes extensive case work experience in El Paso and Maryland. She and her husband Jay, along with her daughters Sydney and Tyler, relocated to Austin for Jay’s career with Cornerstone Hospital.

Access to Care Update At last month’s Smiles on Wheels Lampasas, TDASF’s most recent mission event, dentist volunteers saw 150 patients and provided more than $94,000 in charitable dentistry. TDASF’s next stop is Tyler for the sixth Texas Mission of Mercy (TMOM) for that area — and the landmark 20th since the program’s inception! TMOM Tyler will be executed in the “distributed style,” utilizing a large group of volunteer dentists’ offi ces to be used in place of the TDASF’s portable dental equipment. A small portable clinic will be erected in the style of a Smiles on Wheels event. Please join with us at tdasf.org.

Dr. Barry J. Currey, a Lubbock pedodontist, clowns around with a child at Fluoride Fest in exchange for a thorough oral exam.

March 2010 / TDA Today / 2

Dr. Vincent Ip of Austin participated in Fluoride Fest as a first-time volunteer.

April 15 – 17

Please join the TDASF at the Star of the South’s “Reaching New Heights” 24-foot climbing wall in the exhibit hall!

Dr. Xochitl Anderton Named Geiger Gibson Emerging Leader Lubbock dentist is first in profession to receive national award Th e Geiger Gibson Program in Community Health Policy at Th e George Washington University School of Public Health and Health Services named Dr. Xochitl Anderton of Lubbock a recipient of its Emerging Leader Award in Washington, D.C. last month. Dr. Anderton, the dental director at the Community Health Centers in Lubbock, received the award for extraordinary service and leadership in clinical management.

In The Loop Matthew B. Roberts, DDS, TDA President 2009-2010 Th e March primary elections are in the books. As you know by now, Governor Rick Perry won without a runoff and will face Bill White in the November general election. We unfortunately lost the only dentist in the legislature, Dr. Ybarra Rios, who was unable to win against her primary opponent and will not return to Austin for her second term next January. Late last month your leadership, along with our director of legislative aff airs and outside lobbyists, presented Texas Representative Chuck Hopson his “Excellence in Patient Advocacy Award” in Jacksonville. District 3 President Mike Hatchett did a great job organizing member attendance at the luncheon honoring Rep. Hopson. Speaker of the Texas House Joe Straus also attended and commented on the turnout and support for Rep. Hopson in his re-election bid. Rep. Hopson has been a great friend of dentistry, and we look forward to working with him again in the coming session. Your Texas Dental Association hosted the fi rst States Strategy Conference the the fi rst weekend in March. Please read the accompanying summary of the meeting for further information on what took place. My hope is that, from this beginning, a multitude of ideas and strategies can be developed and implemented to thwart any outside interferences to what we in Texas believe is the best way to solve the access to care issues we face. As my year winds down, I hope that the communications eff orts and the ability to disseminate information have been acceptable. Websites, Facebook, Twitter, the Texas Dental Journal, and this publication have all been utilized in an eff ort to reach as many people as possible, with the latest information, in as timely a manner as can be accomplished. Th is is not a static fi eld in which we live, and continual improvements will be examined in an eff ort to communicate quickly. So, until next month, enjoy the articles and stay “In the Loop”.

Evidence-Based Practice Tip of the Month

She is the fi rst dentist to receive this distinguished award, which was presented at the 6th annual symposium at the National Association of Community Health Centers Policy and Issues Forum. Established in 2007, the Emerging Leader award highlights a new generation of health center leaders. One or more recipients are selected annually.

Stephen R. Matteson, DDS, Editor

Complications of Tongue Piercing I am still taken aback when I see metal jewelry in the tongue. Maybe this is an attractive adornment to some, but it concerns me to think about the potential post placement and long-term complications. Published articles on the subject reinforce my concerns and I have listed a few statements from the scientifi c literature. For the interested reader, PubMed IDentifi cation numbers (PMID) are provided for each article to facilitate searching pubmed.gov. After calling up pubmed.gov, enter the PMID number in the search box and you will be taken directly to the abstract (if available) of the article. Th e following are excerpts from the literature: “Th e prevalence of oral piercing ranged from 3.4 percent to 20.3 percent. Immediate post-operative complications reported were swelling and/or infections (24%-98%) pain or tenderness (14%-41%) (PMID 17993034) (1).” “A patient with Ludwig’s angina, secondary to tongue piercing is presented” (PMID 9062002) (2).” “Intraoral piercing and tongue jewelry place athletes at greater risk (of injury) when competing with mouth guards in place. All body jewelry should be removed in sporting events (PMID 12004711) (3).”

New Money-Saving Perks Programs

“We describe a previously healthy adult who had a solitary cerebellar brain abscess … diagnosed 4 weeks after the tongue piercing procedure (PMID12522766) (4).”

Th e TDA Financial Services, Inc. Board approved four new money-saving programs for TDA members at its February 19 meeting in Austin. JLT Energy Consultants will qualify TDA member dental offi ces located in deregulated areas for lower electricity price tiers. LifeGas (replacing the AirGas program) now off ers TDA members discounted rates on medical gases. LifeGas’ excellent delivery service is available to most TDA members. LOGIX Communications now off ers TDA members $500 off the $1,000 installation fee on its Direct-T Solutions (T-1) bundled product, which includes: local and long-distance phone services; Internet, e-mail and web hosting; voicemail, fax-to-e-mail services and more. Th e Reynolds Company specializes in establishing new dental offi ces, and will assist TDA members free of charge with all phases of real estate consulting. For more information on these and many other valuable Perks programs, or to receive Perks’ e-newsletters, visit tdaperks.com, or call (512) 443-3675.

“… side eff ects (of tongue piercing) are associated with intraoral piercing, including pain, swelling, infection, gingival trauma, chipped or fractured teeth, increased salivary fl ow, calculus buildup, and interference with speech and swallowing. We present a case report of periodontal treatment of traumatized gingival treatment caused by a tongue stud (PMID 16300253) (6).”

TDA Welcomes New Staﬀ

Kristen Ponder joins the TDA Smiles Foundation team as the Texas Donated Dental Service program associate. She is currently attending Austin Community College to pursue a degree in accounting. She currently lives in South Austin with her husband Jose Ramos, Jr., and their son Xavier.

“We present the case of a 27-year-old man with a recent tongue piercing and infective endocarditis of the aortic valve. He was treated with a 6-week course of intravenous antibiotic but eventually required a Ross procedure for progressive aortic insuffi ciency (PMID 15961010) (5).”

Also take a look at PMID 19822789 and PMID 17517312. I could only fi nd the titles: “Multiple brain abscesses associated with tongue piercing” and “Th rombophlebitis of the sigmoid sinus after tongue piercing: a case report” (7, 8). So, although rare, serious medical complications can occur associated with tongue piercing, and we could inform our patients accordingly. References 1. 2. 3. 4. 5. 6. 7. 8.

Levin L, Zacik Y. Oral piercing: complications and side eff ects. Am J Dent 2007 Oct(5):340-4. Perkins CS, Meisner J, Harrison JM. A complication of tongue piercing. Br Dent J 1997 Feb 22; 182(4):147-8. McGeary SP, Studen-PAvlocich D, Ranalli DN. Oral piercing in athletes: implications for general dentists. Gen Dent 2002 Mar-Apr;50(2);168-72. Martinello RA, Cooney EL. Cerebellar brain abscess associated with tongue piercing. Clin Infect Dis 2003 Jan 15;36(2):e32-4. Epub 2003 Jan 3. Lick DS, Edozie SN, Woodside KJ, Conti VR. Streptococcus viridens endocarditis from tongue piercing. J Emerg Med 2005 Jul;29(1):57-9. Choe J, Almas K, Schoor R. Tongue piercing as a risk factor to periodontal health. N Y State Dent J 2005 Aug-Sep;71(5):40-3. Herskovitz MY, Goldsher D et al. Multiple brain abscesses associated with tongue piercing. Arch Neurol 2009 Oct;66(10): 1292. Nicolas J, Soubeyrand E et al. Th rombophlebitis of the sigmoid sinus after tongue piercing: a case report. J Oral Maxillofac Surg 2007 Jun;65(6):1232-4.

It’s Almost Here … Make Plans Now for the 2010 TEXAS Meeting Th e TDA Council on Annual Session encourages TDA members to make arrangements now to attend Th e TEXAS Meeting, 140th Annual Session of the Texas Dental Association, scheduled May 6-9, 2010, at the Henry B. Gonzalez Convention Center in San Antonio. REGISTER TODAY — Avoid additional onsite fees and receive your materials in advance by registering before April 6, 2010. Register online at texasmeeting.com. HOTEL RESERVATIONS — Don’t delay booking your hotel room, the April 6, 2010, deadline is quickly approaching. Take advantage of these special hotel rates. Make Hotel Reservations online at texasmeeting.com. CE VERIFICATION — Th e TEXAS Meeting will meet all of your continuing education needs. Attendees can earn up to 18 hours of continuing education within 3 days. Verifi cation Certifi cates are available onsite or electronically following the meeting. ONE-STOP SHOPPING — Th e 2010 Exhibit Hall promises to be the biggest and best ever. Take advantage of special pricing on the latest supplies and services to enhance your practice. We look forward to seeing you in San Antonio! For additional information, please visit texasmeeting.com or call the TDA Annual Session staff at (512) 443-3675. March 2010 / TDA Today / 3

TSBDE Rule Update This recurring section is designed to help TDA members keep up with important Texas State Board of Dental Examiners (TSBDE) rules, other regulations, and state law affecting their practices. Question: Do I need to take a patient’s blood pressure or pulse measurement every time the patient has an appointment at my dental office?

EDITORIAL STAFF Dr. Stephen R. Matteson, D.D.S., Editor Nicole Scott, Managing Editor Barbara S. Donovan, Art Director Paul H. Schlesinger, Consultant

Answer: TSBDE Rule 108.7(2)(B) states that the initial limited physical examination should include, but shall not necessarily be limited to, blood pressure, and pulse/heart rate as may be indicated for each patient. The TSBDE has determined that the minimum standard of care requires the recording of at least an initial baseline blood pressure/pulse reading during the initial limited physical examination of a dental patient. The dental practitioner should also record blood pressure and pulse heart rate as indicated for invasive procedures and as required by Board rules regarding procedures involving sedation and anesthesia.

BOARD OF DIRECTORS Matthew B. Roberts, D.D.S., President Ronald L. Rhea, D.D.S., President-Elect Hilton Israelson, D.D.S., Immediate Past President Vice Presidents Craig S. Armstrong, D.D.S., Southeast Johnny G. Cailleteau, D.D.S., Southwest J. Brad Loeffelholz, D.D.S., Northwest Arlet R. Dunsworth, D.D.S., Northeast Senior Directors R. Lee Clitheroe, D.D.S., Southeast John W. Baucum III, D.D.S., Southwest Kathleen Nichols, D.D.S., Northwest Donna G. Miller, D.D.S., Northeast Directors Karen E. Frazer, D.D.S., Southeast Lisa B. Masters, D.D.S., Southwest Robert E. Wiggins, D.D.S., Northwest Larry D. Herwig, D.D.S., Northeast

If the dental practitioner is unable to obtain a patient’s vital signs, the dental practitioner must document in the patient’s record an acceptable reason why the attempt to obtain vital signs was unsuccessful. Also, please note that blood pressure and pulse measurement need not be taken on a patient that is 12 years of age or younger unless there is a specific medical need. For more information contact TDA policy manager Diane Rhodes at (512) 443-3675 or diane@tda.org.

Medicaid Update As a Texas Medicaid provider, the Health and Human Services Commission (HHSC) is interested in any ideas, issues, concerns, or suggestions you may have about Texas Medicaid. To that end, HHSC is excited to introduce you to the IMPROVE (Interactive Medicaid Provider Voice) system. It was developed to utilize the knowledge and experiences of Medicaid providers to improve Medicaid and access to care for Medicaid patients. The IMPROVE system allows providers to pinpoint systemic issues within the Medicaid program and offer suggested resolutions. Some of the advantages to accessing IMPROVE include: • Opportunity to incorporate fresh provider ideas and innovation into Medicaid. • Increases access to care for your patients through improved Medicaid procedures and policies. • Potential for increased provider participation and satisfaction with Medicaid. • Ability to interact directly with Medicaid and receive answers from Medicaid personnel well-versed in the area of your concern. • Allows HHSC to address your issues and concerns. Using the IMPROVE system is easy. You will simply need your national provider identifier (NPI) number. To get started go to http://www.hhsc.state.tx.us/medicaid/improve.html.

VOLUME 11, ISSUE 3 AVAILABLE ONLINE AT TDA.ORG

TDA Today (USPS 022-007) is published monthly except for December by the Texas Dental Association, 1946 S. IH-35, Ste 400, Austin, Texas 78704-3698, (512) 443-3675. Periodicals Postage Paid at Austin, Texas and at additional mailing offices. POSTMASTER: Send address changes to TDA TODAY, 1946 S. IH-35, Ste 400, Austin, TX 78704-3698. Annual subscriptions: Texas Dental Association (TDA) members, $5. In-state American Dental Association (ADA) affiliated, $15 + tax. Out-of-state ADA affiliated, $15. In-state non-ADA affiliated, $30 + tax. Out-of-state non-ADA affiliated, $30. Single issue price: TDA members $1. In-state ADA affiliated, $3 + tax. Out-of-state ADA affiliated, $3. In-state non-ADA affiliated, $6 + tax. Out-of-state non-ADA affiliated, $6. Contributions: Manuscripts and news items of interest to the membership of the Association are solicited. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. Please refer to Instructions for Contributors in the annual September Directory of the Texas Dental Journal for more information. The Information for Contributors is available at tda.org. Every effort will be made to return unused manuscripts if a request is made but no responsibility can be accepted for failure to do so. Anonymous communications will receive no consideration whatsoever. All statements of opinion and of supposed facts are published on authority of the writer under whose name they appear and are not to be regarded as the views of the Texas Dental Association, unless such statements have been adopted by the Association. Articles are accepted with the understanding that they have not been published previously.

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Your Staff Can Have Perks, too. For only $10 per employee/year, your staff can become TDA Team Members. TEAM membership gives your staff access to many of the beneﬁts you enjoy as TDA members through the Perks Program. Download the TEAM-membership application form from the “Valuable Resources” page at tdaperks.com. Questions? Contact TDA Perks Program at (512) 443-3675. Going to the TEXAS Meeting in May? Stop by the TDA Pavilion and register your staff. While you’re there, don’t forget to register to win a Dell laptop. Your staff can enter to win, as well!

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MARCH 2010

J. Preston Coleman, D.D.S., Secretary-Treasurer Glen D. Hall, D.D.S., Speaker of the House Michael L. Stuart, D.D.S., Parliamentarian Stephen R. Matteson, D.D.S., Editor Mary Kay Linn, Executive Director William H. Bingham, Legal Counsel