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TEXAS DENTAL
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THE EL PASO CONVENTION CENTER • elpasodentalconference.org
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TEXAS DEnTAl Dental JournAl Journal Established February 1883 Established February 1883
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ON THE COVER Chicano Luis Jiménez, is on display The life-size fiberglass sculpture “Plaza de los Lagartos” (Alligator Plaza), designed by famous artist Luisartist Jiménez, is on display at the San Jacinto Plaza park in downtown El Paso. The sculpture pays homage to alligators that lived in a pond in the park in the 1950s and were the central attraction. The El Paso District Dental Society is preparing for the 51st annual El Paso Dental Conference, September 19-20, 2013, at the El Paso Convention Center. For more information, please visit elpasodentalconference.org.
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OUTGOING PRESIDENT’S ADDRESS, MAy ADDRESS, May 2, 2013
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AMERICAN DENTAL ASSOCIATION 15TH DISTRICT TRUSTEE’S ADDRESS, May 2, 2013
Michael L. Stuart, DDS, President Michael L. Stuart, DDS, President
Hilton Israelson, DDS, ADA 15th District Trustee Hilton Israelson, DDS, ADA 15th District Trustee
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INCOMING PRESIDENT’S ADDRESS, May 5, 2013
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EL PASO DENTAL PASO DENTAL CONfERENCE CONFERENCE
David A. Duncan, DDS, President-elect David A. Duncan, DDS, President-elect
LOSS Of Loss of SIGHT Sight Caused CAUSED by Calcium CALCIUM Hydroxide HyDROxIDE Paste PASTE Accidentally ACCIDENTALLy Splashed SPLASHED into INTO the THE Eye EyE during DURING Endodontic ENDODONTIC Treatment: TREATMENT: Case CASE Report REPORT Mariusz Lipski, DDS, PhD; Jadwiga Buczkowska-Radlińska, DDS, PhD; Monika Góra, DDS, PhD Mariusz Lipski, DDS, PhD; Jadwiga Buczkowska-Radlińska, DDS, PhD; Monika Góra, DDS, PhD This reprint from the Journal of the Canadian Dental Association Journal of the Canadian Dental Association includes a case of a dentist who accidentally splashed endodontic calcium hydroxide into her own eye, thus losing vision in the affected eye.
MONTHLYFEATURES 492
View From Austin View From Austin
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In Memoriam / TDA Smiles Foundation In Memoriam / TDA Smiles Foundation
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Guest Essay Guest Essay
and Memorial and Honorarium Donors and Memorial and Honorarium Donors
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and Maxillofacial Pathology Case Oral and Maxillofacial Pathology Case Oral
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of Events Calendar of Events Calendar
of the Month of the Month
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Value for Your Profession Value for Your Profession
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Critically Appraised Topic of the Month Critically Appraised Topic of the Month
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Advertising Briefs Advertising Briefs
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Oral and Maxillofacial Pathology Case of Oral and Maxillofacial Pathology Case of
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Index to Advertisers Index to Advertisers
the Month Diagnosis and Management the Month Diagnosis and Management
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Texas Dental Journal l www.tda.org l June 2013
TDA members, use your TDA members, use your smartphone smartphone to scan this QR to scan this QR Code and access the Code and access the online Texas Dental Journal. online Texas
Editorial Staff
Editorial Advisory Board
BOARD OF DIRECTORS TEXAS DENTAL ASSOCIATION
Stephen R. Matteson, DDS, Editor-in-Chief Daniel L. Jones, DDS, PhD, Associate Editor Harvey P. Kessler, DDS, MS, Associate Editor Nicole Scott, Managing Editor Lauren Oakley, Publications Coordinator Barbara Donovan, Art Director Paul H. Schlesinger, Consultant
Ronald C. Auvenshine, DDS, PhD Barry K. Bartee, DDS, MD Patricia L. Blanton, DDS, PhD William C. Bone, DDS Phillip M. Campbell, DDS, MSD Michaell A. Huber, DDS Arthur H. Jeske, DMD, PhD Larry D. Jones, DDS Paul A. Kennedy Jr, DDS, MS Scott R. Makins, DDS Daniel Perez, DDS William F. Wathen, DMD Robert C. White, DDS Leighton A. Wier, DDS Douglas B. Willingham, DDS
The Texas Dental Journal is a peer-reviewed publication. Texas Dental Association 1946 S IH-35 Ste 400, Austin, TX 78704-3698 Phone: 512-443-3675 • FAX: 512-443-3031 E-Mail: tda@tda.org • Website: tda.org Texas Dental Journal (ISSN 0040-4284) is published monthly, one issue will be a directory issue, by the Texas Dental Association, 1946 S IH-35, Austin, TX, 78704-3698, 512-443-3675. Periodicals Postage Paid at Austin, Texas and at additional mailing offices. POSTMASTER: Send address changes to TEXAS DENTAL JOURNAL, 1946 S IH 35, Austin, TX 78704. Annual subscriptions: Texas Dental Association members $17. In-state ADA Affiliated $49.50 + tax, Out-ofstate ADA Affiliated $49.50. In-state Non-ADA Affiliated $82.50 + tax, Out-of-state Non-ADA Affiliated $82.50. Single issue price: $6 ADA Affiliated, $17 Non-ADA Affiliated, September issue $17 ADA Affiliated, $65 NonADA Affiliated. For in-state orders, add 8.25% sales tax. Contributions: Manuscripts and news items of interest to the membership of the society are solicited. Electronic submissions are required. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. For more information, please refer to the Instructions for Contributors statement printed in the September Annual Membership Directory or on the TDA website: tda.org. 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. Authors must disclose any financial or other interests they may have in products or services described in their articles. Advertisements: Publication of advertisements in this journal does not constitute a guarantee or endorsement by the Association of the quality of value of such product or of the claims made of it by Texas Dental Journal is a member of the its manufacturer. American Association of Dental Editors. Member Publication
PRESIDENT Michael David A.L.Duncan, Stuart, DDS 806-355-7401, 972-226-6655,davidduncandds@gmail.com mstuartdds@sbcglobal.net PRESIDENT-ELECT David DavidH. A.McCarley, Duncan, DDS DDS 806-355-7401,drdavid@mccarleydental.com 972-562-0767, davidduncandds@gmail.com IMMEDIATE PAST PRESIDENT J.Michael PrestonL.Coleman, Stuart, DDS DDS 210-656-3301, 972-226-6655, mstuartdds@sbcglobal.net drjpc@sbcglobal.net VICE VICE PRESIDENT, PRESIDENT, NORTHWEST NORTHEAST David ArthurC.C.Woodburn, Morchat, DDS DDS 903-983-1919, 806-358-7471, amorchat@suddenlink.net olddave1@gmail.com VICE PRESIDENT, NORTHEAST SOUTHEAST JeanM. E. Cammarata, Bainbridge, DDS DDS Rita 214-388-4453, jbainbridgedds@sbcglobal.net 713-666-7884, rmcdds@sbcglobal.net VICE PRESIDENT, PRESIDENT, SOUTHWEST SOUTHEAST VICE Gregory Oelfke, DDS T. BethK.Vance, DDS 713-988-0492,tbeth55@yahoo.com greg@oelfke.com 956-968-9762, SOUTHWEST VICE PRESIDENT, NORTHWEST Yvonne DDS MichaelE.J.Maldonado, Goulding, DDS 915-855-2337, yvonnedent2000@yahoo.com 817-737-3536, mjgdds@sbcglobal.net SENIOR SENIOR DIRECTOR, DIRECTOR, NORTHWEST NORTHEAST Steven J. Hill, DDS Jean E. Bainbridge, DDS 806-783-8837, sjhilldds@aol.com 214-388-4453, jbainbridgedds@sbcglobal.net SENIOR DIRECTOR, NORTHEAST SOUTHEAST Jerry J. K. Hopson, Gregory Oelfke,DDS DDS 903-583-5715, greg@oelfke.com 713-988-0492,dochop@verizon.net SENIOR DIRECTOR, DIRECTOR, SOUTHWEST SOUTHEAST SENIOR William S. Nantz, DDS Yvonne E. Maldonado, DDS 409-866-7498, wn3798@sbcglobal.net yvonnedent2000@yahoo.com 915-855-2337, SOUTHWEST SENIOR DIRECTOR, NORTHWEST Joshua A. Austin, DDS David C. Woodburn, DDS 210-408-7999,olddave1@gmail.com jaustindds@me.com 806-358-7471, DIRECTOR, DIRECTOR, NORTHWEST NORTHEAST Charles Miller,DDS DDS Jerry J. W. Hopson, 817-572-4497, 903-583-5715,cwdam@sbcglobal.net dochop@verizon.net DIRECTOR, NORTHEAST SOUTHEAST William DDS WilliamH.S.Gerlach, Nantz, DDS 972-964-1855, 409-866-7498,drbill@gerlachdental.com wn3798@sbcglobal.net DIRECTOR, SOUTHWEST SOUTHEAST DIRECTOR, Karen JoshuaA.A.Walters, Austin, DDS 713-790-1111, kwalters@sms-houston.com 210-408-7999, jaustindds@me.com SOUTHWEST DIRECTOR, NORTHWEST John B. Mason, DDS Steven J. Hill, DDS 361-854-3159, jbmasondds@aol.com 806-783-8837, sjhilldds@aol.com SECRETARY-TREASURER Ron Collins, DDS 281-983-5677,roncollinsdds@hotmail.com roncollinsdds@yahoo.com 281-983-5677, SPEAKER OF THE HOUSE John W. Baucum III, DDS 361-855-3900, jbaucum3@msn.com PARLIAMENTARIAN Michael Vaclav, DDS David H. McCarley, DDS 806-355-7463, 972-562-0767, drvaclav@suddenlinkmail.com drdavid@mccarleydental.com EDITOR Stephen R. Matteson, DDS 210-215-1515, texdented@gmail.com 210-277-8595, EXECUTIVE DIRECTOR Aaron Washburn 512-443-3675, aaron@tda.org LEGAL COUNSEL Mr. William Bingham William H.H. Bingham 512-495-6000, bbingham@mcginnislaw.com
Texas Dental Journal l www.tda.org l June 2013
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Dr. Gwen Corbett, a Fortress Dentist.
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www.dds4dds.com
Texas Journal Dental Journal l www.tda.org l 2013 August 747 Texas Dental l www.tda.org l June 487 Texas Dental Journal l www.tda.org l August 2011 691
2013 TEXAS MEETING Photo Contest Winners 2013 TEXAS Meeting Exhibitors & Sponsors
SPECIAL THANKS
Black & White/Abstract/Artistic First: Dr. Rajat Diwan Second: Dr. Mary Fischer Third: Dr. Donald Ruthven Honorable Mention: Dr. Saskia Vaughan
Their support is invaluable to the
Built Environment
Texas Dental Association’s produc-
First: Dr. Steven Aycock Second: Dr. John Corbet Third: Dr. Kerry Williams Honorable Mention: Ms. Lisa Anderson
tion of one of the largest dental meetings in the country. We appreciate their support and the important role they play in the success of the TEXAS Meeting. Visit texasmeeting.com to view the sponsors and exhibitors from the 2013 TEXAS Meeting.
See you next year!
Natural Wonders First: Dr. William Parker (Best in show) Second: Ms. Patti Widdowson Third: Ms. Kandy Clements Honorable Mention: Dr. Barton Allen Honorable Mention: Ms. Irma Cantu Garza
Portraits First: Dr. Kurt Loveless Second: Dr. Bill Devine Third: Dr. Edwin Roberts Honorable Mention: Dr. Mary Fischer
Sports/Human Endeavor First: Dr. Weldon Bryant
Plan now to particpate in the 2014 Photo Contest, May 1-4.
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While you’re at tda.org, be sure to check out the following:
. . . . . .
Update your Profile Pay your Dues Read current/past issues of TDA Today Review TDA References Check out the Calendar of Events Look up peers in the Directory
New Topics have been added to the Third Party web tool (member homepage) Members can also sign up for a Personal Web Page or link to an existing website.
PRACTICES ARE SELLING FOR CASH NOW! INCREASE PRACTICE VALUE ANALYZE KEY AREAS OF YOUR PRACTICE
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SIZE OF PATIENT BASE
3 YEARS OF GROWTH TRENDS
NEW PATIENT FLOW
EXPLORE INTERNET MARKETING
ACTIVE RECALL
20% – 30% OF GROSS
“OPERATING PROFITS”
HYGIENE PROFITS MOST IMPORTANT
As an Appraiser/Consultant, I must know the practice in order to educate the Buyer concerning the practice future potential. A bunch of numbers/proformas do not give necessary information about your practice. My appraisals provide all the data above and more. Numbers alone rarely sell a practice. My appraisal is a 75 – 100 page Management Study with the Goodwill/Intangibles based upon comparable area practice sales (plus Tangibles). Routinely, our Practice Sales will bring 97% – 100% of the Appraised Value.
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Journal l www.tda.org l June 2011 2011 TexasTexas DentalDental Journal l www.tda.org l October
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The View From Austin Stephen R. Matteson, DDS, FICD, Editor-in-Chief
Texas Dental Publication Archives Update The TDA has established several mechanisms for members to search for published information in the Texas Dental Journal, TDA Today newsletter, and Smart Mouth using the TDA website, tda.org.
The TDA has established several mechanisms for members to search for published information in the Texas Dental Journal, TDA Today newsletter, and Smart Mouth using the TDA website, tda.org.
Using the pull-down selection for “Publications” on the website, members may choose: • •
Texas Dental Journal and view the current or past issues online back to 2010. Smart Mouth is the semi-annual 12-page publication started in 2012 for patient information.
Three “Archive” selections are available: 1. More than 40 oral pathology cases of the month date back to 2010, and offer an excellent review of oral pathology examples and provide useful comparisons for dentists with cases that present in their offices. The cases are listed alphabetically by diagnosis. To view, please visit tinyurl.com/ oralpath. 2. More than 40 “Evidence-Based Tips of the Month” were originally published in the TDA Today newsletter date back to 2009. These short reviews of specific evidence-based topics are listed by date of publication. To view, please visit tinyurl.com/EBTTDA. 3. “Critically Appraised Topics (CATs) of the Month” are short synopses of the current literature on specific topics and are published in the Journal by date of publication. To view, please visit tinyurl.com/CATofthemonth. The Editor hopes this information will assist members in keeping up-to-date with the current dental literature.
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ORAL and MAXILLOFACIAL PATHOLOGY LABORATORY Anne Cale Jones, DDS H. Stan McGuff, DDS
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Texas Dental Journal l www.tda.org l June 2013 AAFE-DJ-Texas-3.3125x9.5.indd 1
4/9/13 11:45 AM
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Guest Essay
A FAST Lesson in Stroke Treatment Dr Ben Taylor “I woke up with a headache…” Originally printed in the San Antonio District Dental Society newsletter. Reprinted with permission.
O “I felt “closed in,” unable to communicate, unable to move, and it was obvious to the technician what was wrong. I had suffered a stroke.”
n Saturday January 12, 2013, I got a FAST lesson in stroke treatment. I woke up with a headache around 6:30 am, I assumed the headache was the result of “cedar fever” and took some ibuprofen, 4 hours later I took acetaminophen; and then 4 hours later ibuprofen again; so my day began. I did very little early in the day because of the headache, but by 3:00 in the afternoon the headache was numbed somewhat; just in time for the 50th wedding anniversary mass for our
Beyond F.A.S.T Other Symptoms You Should Know: •
Sudden numbness or weakness of the leg
•
Sudden confusion or trouble understanding
•
Sudden trouble seeing in one or both eyes
•
Sudden trouble walking, dizziness, loss of balance or coordination
•
Sudden severe headache with no known cause
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gardener and his wife. During the mass in Spanish, I felt out of place and I even had trouble keeping up with the “Our Father,” but thought nothing of it. The reception was to be held at 6:00 pm, and our microwave had cratered so Patty and I headed to Best Buy to buy a new microwave. In the parking lot Patty laughed at my telling her that there were “seats” on the next aisle instead of parking places, and I was confused how those words came out of my mouth. By then the headache had come back with a vengeance. In the store, the clerk asked what we were looking for, I answered, “A microhave.” Trying again resulted in another “Mocrohave,” and I pointed to Patty to who correctly said, “a microwave,” and looked at me weird; little did we know that this was aphasia, and was the first sign of an impending stroke. On the way home from the store I felt funny but did
not want to talk because I was afraid of what I would say. We dropped the microwave off at the house and ran off to the reception. Blas, our gardener, and his wife speak no English and we speak no Spanish, so I was safe speaking nothing to them, but just smiling as he spoke. We then sat at a table with some Blas’s grandsons. I tried to be courteous but when I tried to communicate, I had little luck. Then about 6:45 pm food was served. Thinking this would allow me to avoid conversation, I tried to cut a chicken breast, but was too weak. I attempted again to no avail. I set the knife down and when the young gentleman across suggested the meat was tough, I could not respond. I tried to pick up the knife again but to my amazement my right hand did not move, although I had thought I felt it move. I tried again but it was no use, although, my hand seemed to move, my eyes
could see that it did not. I looked up at the young man across from me and saw a shocked look in his face, as I felt the right side of my face droop. The exact timing of what happened next is unclear to me, but soon a policewoman was sitting beside me asking my name. I could not answer. The policewoman told me that my wife had called EMS and they would be here soon. Patty had been googling “misspeaking words” and “headaches,” and was reading about strokes. When she noticed the look on the young man’s face across the table, she then looked over at me and saw the facial droop and immediately called 911. She then went to the outside of the hall where we had seen the policewoman when we came in. Patty told her she had called EMS and thought I had a stroke. The policewoman told her she had EMS training and would stay with me while Patty waited outside for the ambulance. The first responder to get to the reception was a firetruck, and they rushed inside. An ambulance arrived within a few minutes. The EMS responder asked me if I was okay but I could not answer. I felt “closed in,” unable to communicate,
unable to move, and it was obvious to the technician what was wrong — I had suffered a stroke. In came the gurney. The ambulance driver told Patty they would take me to St. Luke’s Baptist Hospital and she should go and wait for us there, that it would be a little while for them to get me ready for transport. The EMS technician told me that Patty would wait at the hospital. I was happy she would not be in the ambulance if I was going to die, which I thought I was going to do. Finally, with an IV secured, the monitors attached, and me secured in the gurney, the ambulance got off, lights flashing, sirens sounding. The ride was frightening as I saw my oxygen saturation level drop to 73. As I thought of my impending death, I thought of my granddaughter who was due the next week and how my death would upset my daughter. I did not want to die; the time seemed to move too slowly. I wanted to tell the driver to “hurry up and get me to the hospital, I did not want to be DOA!” But of course I could not communicate the message. Finally we arrived at St. Luke’s Hospital, and as the doors opened I saw Patty, my lovely wife, and was happy. They moved
me into emergency room #3, and quickly sent me to get a CAT scan and a chest x-ray. As they were x-raying me, they talked to Patty about a possibility of the “clot buster drug,” TPA (tissue plasminogen activator). They described it is having the ability to dissolve a blood clot as fast as an ice cube under a heat lamp. They gave Patty the informed consent telling her it could kill me, but she knew I would not want to live this way. The only catch was that a neurosurgeon would have to determine if the treatment would be viable as the treatment must be started within 3 hours of the onset of the symptoms. But when did my symptoms start? The headache, the misspoken words, the muscle weakness, the facial paralysis — who knows? The neurosurgeon who was to direct the treatment was located in Florida; patched in over the Internet, he examined me. He asked me to tell him my name and raise my hand. Of course I was “closed in” and unable to do what he asked. He looked at my CAT scan, read my ECG and my vital signs, and then asked Patty questions about the day. Finally, he gave the word for the nurse to give the TPA — the time was around 7:45 pm. Within 10 minutes, I started to feel I could move; I nodded my head when the nurse asked a question. Then I
looked at Patty and told her, “I need…to…pee!” Joyous voices came as the nurse gave Patty a urinal for me. Then the nurse asked, “What animal says meow?” I said, “Cat.” The nurse started dancing with joy saying, “He is coming back!” I realized I was saved, that I was no longer “closed in.” By the following day my improvement continued until I had full use of my arms and legs, my face was not drooped, and all that seemed to be left was a lack of ability to structure sentences, a condition called expressive aphasia. The days that followed were full of tests, CAT scans, MRIs, MRAs, and blood tests. I now had a San Antonio neurosurgeon, Dr Lee Birnbaum, the interim director of stroke at UTHSCSA. Dr Birnbaum is a board certified neurologist and is also board certified in his subspecialty of vascular neurosurgery. In addition, he completed a 2-year fellowship in endovascular neurosurgery and is the only endovascular neurologist in San Antonio. Dr Birnbaum diagnosed me with a spontaneous dissecting carotid artery, a condition that resulted in left middle cerebral artery infarct stroke.
Continued on next page
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I want to thank those of you who prayed and wished me well, but I want you to all learn from my experience. On Wednesday, January 16, I was discharged to go home with some speech deficits but no apparent physical limitations. I also got discharged with several medications: Coumadin, Lovenox (an injectable blood thinner), and Crestor. I have started speech therapy, and I am improving daily. Time is of utmost importance in a stroke situation; as well as where you go for treatment. At the first sign of a stroke EMS should be called. EMS knows which hospitals are stroke hospitals and those
that have TPA. If Patty would have taken me to another hospital or in a car, delays in treatment would have resulted. The EMS workers contacted the charge nurse of the emergency room so when we got to the hospital, I was rushed into an emergency room although many other patients were waiting. With a quick confirmation of the symptoms by the ER physician, I was whisked to CAT scan and the process was started. The “telemedicine” doctor from Miami is one of many around the country on call for multiple stroke centers around the country and is available immediately by Internet. This is different to a normal emergency room where an on-call doctor gets to the emergency room when they can. The “clot buster” TPA should
be administered within 3 hours ideally. In my case the TPA was administered within an hour and a half of the major part of my stroke, thus resulting in my quick recovery and my slight residual effects. This story could have ended differently, if everything had not gone as it did. Perhaps I would have passed on without ever seeing my precious granddaughter; perhaps I would have had permanent paralysis that would have prohibited me from holding her. As it was, my daughter gave birth to Charlee Ann the day after I was discharged from the hospital and I got to be there for the birth. On the day of this draft, Friday, January 25, I was back in the office seeing a light schedule of exam patients. With 3 to 6 months
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of anticoagulant therapy, then aspirin therapy, the chance of recurrence of this type of stroke is 1% per year for the next 10 years; so I hope to see many years of birthdays for Charlee. FAST is the acronym used by the Stroke Center; the words are Face, Arm, Speech, and Time. In my case my face, arm, and speech were affected and thanks to the FAST action of my wife, Patty, no time was wasted and I was lucky. People that delay are not so lucky; again, there are only 3 hours to get the TPA. If you or anyone you know have any symptoms of stroke, do not delay, call EMS and do it FAST!
A One-Day Symposium Presented by TDA Perks Program
Fri. June 21st 2013 10 AM-4 PM | Dallas County Dental Society Executive Office 13633 Omega Road; Dallas, TX 75244 Getting ready to start your own practice? This FREE-for-TDA-members symposium will help guide you through the process. And Perks will provide you a complimentary lunch! The Program will cover: • • • •
Accounts Receivable Compliance Real Estate Practice Financing
• Patient Financing • Online Marketing • Insurance
Contact Josh at the number below to register.
For more information, call:
Or visit Perks online:
(512) 443-3675
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The ADA Annual Session is your national dental meeting. Visit ADA.org/session for more information and register May 1!
The 143rd Annual Session of the TDA
Outgoing President’s Address to the Texas Dental Association House of Delegates May 2, 2013 Michael L. Stuart, DDS, President
T
ennessee Williams said, “Time is the longest distance between 2 places. It can also be the longest place between the same place.” Here we are, once again, in San Antonio on the first weekend in May, taking care of the business of the Texas Dental Association. As your president, I can assure you that we have had a very successful year. When I came into office, TDA had several major challenges facing it. As president, I had 3 central issues commanding most of my attention. First, we had the awesome task of finding a new executive director to replace our longtime successful ED, Mary Kay Linn. After a long, intense search, the Board hired Aaron Washburn. I can tell you with all confidence that we hired the right person. Aaron has been a delight to work with, and he has established good relationships with both our staff and our members. Aaron has traveled with me to most of my component visits since he became ED, as he wanted to meet you in person. He is a personable, very smart individual! We are in good hands for many years to come with Aaron at the helm. Aaron, welcome! Thank you for coming to Texas! A second important issue facing us related to membership. As I said to you in my speech last year, our market share has continued to decline. While the total numbers of TDA members
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The 143rd Annual Session of the TDA
TDA President Dr Michael Stuart (right) congratulates 2013 Gold Medal winner Dr Paul Stubbs of Georgetown at the 2013 TEXAS Meeting in San Antonio.
has continued to grow, due to the influx of large numbers of dentists coming to Texas, our market share is just over 65%. To help reverse this trend, last year’s House of Delegates authorized a task force to determine how TDA could change to become attractive to dentists of all ages, especially younger dentists. I was privileged to appoint the members of this most important group. We called it the Task Force on Relevancy. One of the best things I did was ask Dr Ralph Cooley of Conroe to serve as chair. Members of this task force included dentists who were
both young and experienced, male and female, and who practiced in different types of models and lived in different areas of the state. Working with our outstanding TDA Director of Membership Lee Ann Johnson, we chose Sara Sladek to be our outside consultant. Ms Sladek is the author of the best-selling book The End of Membership as We Know It. This talented task force worked together well and offered several recommendations to our Board of Directors. Enthusiastically supported, these recommendations will result in substantial actions positioning the
Texas Dental Association to be the organization our Texas dentists will want to join. TDA will provide such value to its members that to not be a part of it would be unwise. We are great today! Let’s resolve to be even better in the future! A third challenge facing our Association was something we face every 2 years, a very important legislative session. In response to the wishes of last year’s House and at the direction of our Board
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Outgoing President’s Address
Pictured at the 2013 TEXAS Meeting in San Antonio are (L-R) TDA Speaker of the House Dr John Baucum of Corpus Christi, President Dr Michael Stuart of Sunnyvale, and Secretary-Treasurer Dr Ron Collins of Houston.
of Directors, our Council on Legislative and Regulatory Affairs began the audacious task of determining how to best deal with a fast-growing segment of our dental profession, practices owned or managed by nondentists. While Dr Rick Black of El Paso will report to you in detail about our legislative successes and disappointments, I can tell you that I am very proud of TDA’s efforts this session. Our goal always is to protect patients and strive to support a practice environment which allows dentists to practice with
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autonomy, being in charge of all treatment plans as well as treatments. We have done that this year with the bills we have supported. You can be proud of the TDA legislative effort. I also want to tell you of a recent exciting development. The Board voted to contract with a new vendor to assist us in the development of a brand new website for the Association. Please be on the lookout for this new site to be unveiled sometime this summer. It promises to be a modern, navigable site, one which you will want to visit often.
Now, I want to speak to you from my heart. I must confess that I love to watch westerns. Give me an old John Wayne movie or an old episode of Gunsmoke, and I’ll be happy. One of my favorite recent western movies is Open Range starring Robert Duvall and Kevin Costner. In this movie, the characters played by Duvall and Costner come up against a cattle owner who does not want them bringing their cattle through the open range near his ranch. After a particularly nasty gunfight, Duval has shot the rancher several times, mortally injuring him.
As he lies dying, Duval asks him a most important question, “What have you done? Here you are, bleeding and dying, and for what? A bunch of cows? Just a few cows! Are they worth dying for?� This point applies to dentistry. No, not for cows, but for gain. I feel very passionate about this. I am afraid many in our beloved profession are selling the soul of dentistry for the sake of material gain. In my opinion, the over diagnosis and over treatment of patients who entrust us with their health threatens to diminish dentistry in the eyes of the public to the point of changing the image of dentistry from a respected profession to that of a trade. Now, I do not say this lightly. Dentistry has always been at or near the top of respected professions in polls taken for many years. Recently, we have fallen to fifth in trustworthiness, a fall of several places. Trust is something that takes many years to earn, and it takes many years to lose. I am afraid we are in midst of the downward trend of that hard-earned trust. I know you can relate to what I am about to say. I have quite a few patients come to my office seeking a second opinion for a diagnosis. Many times, they come to my office after a dentist has diagnosed and recommended many thousands of dollars of treatment. These patients often do not have the money to have this work performed and are
American Dental Association President Dr Robert A. Faiella presents TDA President Dr Michael Stuart with a plaque for outstanding service as president of the TDA at the 2013 TEXAS Meeting in San Antonio.
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Outgoing President’s Address questioning whether or not they truly need it. More often than not, after a thorough exam and radiographs, I find that too many of these patients have been overly-diagnosed. They have been told they need multiple restorations, extensive endodontic therapy, and 4 quadrants of scaling and root planing, when, in fact, they need very little of it. I often have to try and explain to a patient that different eyes see things differently. I try to never implicate a dentist for fabricating unnecessary work, but, in my mind, I suspect that the dentist has done so simply for the purpose of monetary profit. As I said, I know many of you have had the same experiences. While this activity is not representative of all dentists, enough of it is happening to give me great concern. I have been in practice and owned an office for many years. I know all too well the pressures of making enough profit to keep the office going. The temptation to diagnose unneeded dentistry is one all of us face. We must, however, resist that temptation. Two very important entities make and maintain dentistry as a profession: One, our education, and 2, our code of ethics. We must abide by our ethical standards, which
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Trust is something that takes many years to earn, and it takes many years to lose. I am afraid we are in midst of the downward trend of that hard-earned trust. very clearly say that dentists must diagnose with honesty and integrity. So, I ask you like Robert Duvall asked the rancher in the movie, “What are we doing? Bleeding our profession, and for what? A few dollars! Just a few dollars!� Those few dollars are just not worth it! Now I know my words this morning will do little to change what is happening. However, the bully pulpit that is mine this morning demands that I warn our dentists of this most alarming trend. I challenge our Texas dentists and, yes, dentists across our nation to practice what I call Golden Rule Dentistry. If you were the patient and knew what the doctor knew, could you even once try and sell unneeded dentistry to those who look to you for an honest, professional diagnosis? If those in this room and those who read these words in the Texas Dental Journal will determine in their hearts to practice Golden Rule
Dentistry, we may be able to make just a small dent in the increasing trend of profit-first dentistry. Will you join me as we commit to practice, not as trade sellers, but as professionals? Our patients deserve no less. It has been the thrill of my life to serve as your president this year. From the bottom of my heart, I thank you for the trust you have given me. The work of the Texas Dental Association will continue under the competent leadership of Dr David Duncan of Amarillo. May God bless him and all of us as we continue to serve this honored profession.
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The 143rd Annual Session of the TDA
TRUSTEE’s Address to the Texas Dental Association House of Delegates May 4, 2013
Hilton Israelson, DDS, American Dental Association 15th District Trustee We must create and seize every opportunity to live the call to action, in both word and deed, if we want the public to view us as truly being the nation’s leading advocate for oral health. The entire tripartite needs to rally around this Call to Action.
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I
t’s an honor to be your trustee and as I complete my second year serving Texas on the ADA Board of Trustees I want you all to know how much I appreciate all the support that you give me. I also want to extend a warm Texas welcome to my ADA second-year classmates who are attending our meeting. They are: Dr Jeffrey Dow from Maine, Dr Gary Roberts and his wife Teresa from Louisiana and Dr Gary Yonomoto and his wife Toy from Hawaii. Dentistry as a profession is extraordinary, and organized dentistry plays a major role in maintaining its elevated status. The ADA is doing great things…for dentists and for the public. We are a strong advocate for dentists, and we need more of our colleagues to join the ADA…to leverage our strength in numbers—in order to effect positive change for our members, our patients and for the nation’s oral health. I don’t need to remind you, there’s a lot that the ADA does. We are a lot of things. We are many faces wearing many hats. We are dedicated to the profession—but we are not just dentists for dentists. We really are the leading advocate for public oral health.
The 143rd Annual Session of the TDA
Pictured at the GOLD (Graduates of the Last Decade) Reception at the 2013 TEXAS Meeting are (L-R) TDA President Dr Michael Stuart of Sunnyvale, Dallas County Dental Society Executive Director Jane Evans, and American Dental Association 15th District Trustee Dr Hilton Israelson of Richardson.
“WE ARE THE VOICE OF DENTISTRY.” We can — and do — make a difference in people’s lives. Yet, for all the good work we do through supporting such endeavors as Give Kids A Smile and community water fluoridation, which was recently endorsed by the Surgeon General, the undisputed measure for our organizational performance is membership market share — and it is declining because we aren’t keeping pace with the growing dentist market. Over the past 10 years, we have added more than 7,000 additional net members. But the market has grown by nearly 22,000 dentists. In 5 years our membership market share has dropped from 71% to 66.2%. Our market share in Texas is at 65.1% which is below the overall ADA membership market share.
There are several key member segments where we lag in terms of attracting and keeping members: women dentists, ethnically, and racially diverse dentists and non-U.S. trained dentists.
Are we too busy debating, adjusting, and reinterpreting, turning our efforts to other projects, and ultimately failing to speak in one united voice for the tripartite?
Additionally, there has been a slow erosion of general dentists during this period as well.
Are we still being reactive rather than proactive?
Without strong numbers…without a strong market share, we lose our voice on all these initiatives.
Organized Dentistry Faces Challenges Our shrinking market share threatens to lead us down the road to irrelevancy. Yet, where is the urgency in our tripartite? Have we subjected ourselves to overconfidence and complacency? Have we lost focus of our measure of performance?
Increasing membership remains a top priority for the ADA and the impact is being felt throughout the tripartite. One example is the Membership Program for Growth (MPG). MPG provides funding to constituent and component dental societies so they have the resources to implement creative strategies that affect recruitment and retention.
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Trustee’s Address MPG programs helped to deliver more than 3,000 new and renewed members to the tripartite as of 2012 and those numbers continue to climb. These activities at the state and local levels are having an impact, which is very important, considering that a strong membership base is our foundation. Collectively, by pooling our resources via our member dues, the ADA can accomplish far more for the dental profession than individual dentists could on their own. Consider what the ADA has accomplished in the areas of: • • • • •
Science; Collaboration; Advocacy; Education; and, Promoting public health.
These are tangible benefits that we can describe to nonmember dentists, but I’d like to add one more: •
ADA Membership makes us part of a community.
Dentists may become so buried in their careers that they don’t see the forest for the trees. Joining the ADA exponentially expands a dentist’s network at both a professional and a personal level. So today, I’m asking everyone here to make a commitment to our profession: a commitment that together, we will share the value of ADA membership with at least one nonmember dentist…that we will show them that the choice between ADA membership and no membership at all isn’t really a choice. We need to promote the ADA’s strengths: • • • • •
Tangible benefits for members; Advancing profession through science and research; Supporting dental education; Advocating for dentistry and public oral health; and Providing vital information to the public.
Across the tripartite, we need to align in promoting the ADA’s strategic initiatives. At its December meeting, the Board of Trustees spent significant time working on strategic initiatives.
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ADA 15th District Trustee Dr Hilton Israelson greets TDA President Dr Michael Stuart during the House of Delegates at the 2013 TEXAS Meeting.
We identified priority areas on which we would like councils, commissions and committees to focus. The Board concluded that 2 areas, in particular, merited Association-wide emphasis in 2013: 1. Building member value; and 2. Implementing the Call to Action / Access to Oral Health Platform. Regarding The Call to Action, the past and present show us that decision makers, influencers, and the public react positively to a suite of solutions that seek to break down barriers to oral health by delivering care now, preventing disease, and educating the public about how to get and stay healthy. A more focused articulation of ADA policies and initiatives to do this can significantly increase the extent to which the Association is viewed as both a trusted source of information about oral health.
We are also — through our tripartite — a committed advocate in state and national legislatures for people who currently do not have or are unable to obtain dental care.
Today, I realize that I’m preaching to the choir. Everyone in this room comprises the vertebrae that serve as the backbone of organized dentistry.
A suite of existing ADA policies and initiatives needs to be utilized in advocacy and communications at both the state and national levels, in order to promote the association’s positions on oral health.
You already demonstrate the commitment and dedication it takes to serve in an active, elected position. Yet, all of us must do more to reach those dentists who are not participating in organized dentistry. Whatever your career stage…whether you are a new dentist building your career or an established dentist nearing retirement, the ADA has a tremendous number of helpful resources for you.
Our Call to Action includes frequently and consistently communicating dentistry’s positive story and the contributions dentists make to oral health. It also includes providing care now by leveraging capacity in the current system so dentists can provide that care through innovative collaborations and working with other health care providers. Additionally, it features working to prevent disease before it starts and providing people with the knowledge that empowers them to be good stewards of their own oral health. We must create and seize every opportunity to live the call to action, in both word and deed, if we want the public to view us as truly being the nation’s leading advocate for oral health. The entire tripartite needs to rally around this Call to Action. At the same time, we need to continue to build member value. Building member value is job one for all of us. Only by doing so will we be able to convince dentists that they truly need to join the ADA. With this in mind, the Board asked each ADA council, commission, or committee to: •
•
•
• •
Identify at least 1 new member benefit, whether within their domain or not, that would add significant value to members. Regularly consider, at its meetings, explicitly how its actions contribute to member value and to include this in the meeting minutes. Assess all programs and services to determine which provide the highest value and which can be considered “excellent.” Increase communication to members and potential members about the ADA’s value proposition; and, Continue to focus on member career enhancement.
As the #1 Association representing all dentists, we’re committed to helping you achieve the highest levels of success. The ADA, state and local dental societies reach out to nonmembers in a variety of ways. But we need to all make the commitment to make that critical personal connection. Dentist-to-dentist outreach is a crucial part of the mix. And we’ll be a stronger ADA and a stronger profession if everyone’s involved. As a tripartite, we have to train grassroots organizers at the local level, coordinate membership drives, direct more resources to recruiting new members and retaining the ones we already have…with focus on lagging membership segments. We can also strategically build these efforts into our councils and committees, targeting market segments such as non-majority and non-solo practice dentists through the New Dentist Committee, Council on Communications, and by building strong relationships with educational leaders. We can’t limit our efforts to recruiting at the entrylevel. The ADA can expand on its efforts to build on the mission of its Institute for Diversity in Leadership. We need more diversity not just in our membership, but in our leadership, to reflect the changing face of America. We are a diverse nation and our profession is growing to reflect this. As an organization, the ADA has not kept up with this growth.
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Trustee’s Address This year, the ADA has developed a Member-GetA-Member Campaign that provides resources and incentives to help members to get more involved. Dentist-to-dentist outreach is vitally important. The ADA is America’s leading advocate for oral health and we have built an enormous network of collaboration to bring our message to the public. This message will be announced this month at the Washington Leadership Conference. To carry this message the ADA has engaged a national public relations firm, Fleishman Hillard whose responsibility it is to strategically broadcast a prevention focused public relations program. Valuable tools that come with membership are resources that help dentists succeed and excel throughout their careers, such as: •
•
•
•
•
The Center for Professional Success, which debuts with a soft launch this month and its formal launch in September. The Center will provide member dentists and the profession with credible, compelling and timely information and tools that can positively impact their practice, profession and personal lives — “best-in-class” resources that will help to better connect members to the ADA. The ADA Center for Evidence-Based Dentistry™, which provides support for clinical decisions and helps dentists integrate scientific evidence into patient care. JADA and the ADA News, which provide information at our members’ fingertips, capturing the latest in dental research, practice and issues affecting the profession. The Ad Council public service campaign, a children’s oral health campaign launched last August. MouthHealthy.org, our award winning, consumer website, which provides robust information on the importance of oral hygiene and visiting their dentists.
These outreach efforts provide information to millions of people to help them improve their oral
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health and establishes ADA as the leading resource of oral health information. Along with “supporting my profession,” our member surveys tell us that “advocacy” is 1 of the top reasons dentists belong to the ADA. The ADA represents nearly 7 out of 10 dentists. Our “7 out of 10” numbers empower ADA advocacy initiatives by helping to preserve the doctor/patient relationship, protecting the practice of dentistry by ensuring that at all times we are the leader of the dental team, shielding dentists from new taxes, reducing the cost of doing business, addressing access to oral health for Medicaid recipients and the under-served, and weighingin on issues large and small. Examples of these issues are repealing the McCarronFerguson Act that grants anti-trust law immunity to insurance companies thus allowing them to collude amongst each other and they are also advocating for the removal of the “2.3% Medical device Tax” and other tax issues affecting small businesses. We are a financially stable organization. During tough economic times, we’ve worked hard to realize long-term savings by cutting the ADA’s operating budget and aligning our annual budget with the ADA Strategic Plan. At the end of 2012 we saw a positive impact on our budget. However our dues revenue has remained flat the last few years. Our non-dues revenue has increased and this is where our focus needs to be directed in order to keep us financially viable and also to allow us to maintain our current dues. With the recovery of the financial markets we have seen a strong recovery in our portfolio. Our reserves have returned from a low of 30% of the annual operating budget to 48% with our target being 50% based on a resolution from the ADA House. The current ADA Strategic Plan expires at the end of 2014. I have been honored with the Chairmanship of the Strategic Planning Steering Committee.
Pictured at the 2013 TEXAS Meeting in San Antonio are second-year members of the American Dental Association Board of Trustees: Drs Gary Roberts of Louisiana, Hilton Israelson of Richardson, Gary Yonomoto of Hawaii, and Jeffrey Down of Maine.
The sStrategic trategic plan consists of two phases The first phase is doing an external environmental scan and the second phase is the internal strategic plan. This plan will be a full working plan that will allow the ADA to determine its budget based on the strategic plan and will have buy-in from both the members and the staff. Some of the critical issues that we will be looking at are: ••
••
••
Dental student debt that in many cases takes away the graduating dentist’s freedom to choose their career path. The generational gaps with their different approaches to clinical dentistry and to organized dentistry. Dentists working for large group dental practices may already receive benefits through the large group practice and may choose not to be members of the ADA.
••
We do not know at what rate they are joining the ADA, but we do know anecdotally that they don’t feel welcome and our value proposition might not be unique. The Affordable Care Act, which will have a definite effect on how patient’s are treated and this will vary from state from state to state depending on how their State Exchanges are set up.
Both the ADA Foundation and ADABEI, the ADA’s for-profit arm are back working at full speed carrying out their responsibilities. The Foundation was very active helping the dentists who suffered great loss because of hurricane Sandy and they also helped the lone dentist in West, Texas, whose dental practice was less than a half mile away from the fertilizer plant that exploded. I know that I speak for everyone here when I express my desire to bolster the foundation of organized dentistry. I want future generations to inherit
a strong and secure ADA. These future generations are going to be made of men and women of many colors and backgrounds. If we want them to someday speak of us as men and women possessing great vision and an unbridled passion for all that’s right about organized dentistry— then we need to start going out of our way to welcome them in the ADA now. Otherwise, future generations are going to speak of us as men and women of a once-great organization, or perhaps not even speak of us at all. That’s almost unimaginable: I can’t imagine the profession without the ADA. Working together, we can fortify the foundation of our organization and continue building it. Let’s start now. now.
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The 143rd Annual Session of the TDA
Incoming President’s address to the Texas Dental Association House of Delegates May 5, 2013
David A. Duncan, DDS, President-elect
W
hen I served on your board of directors some 10 years ago, I was perfectly content to be at the table as long as it was not the head. Needless to say this is a totally different situation I find myself in today. It’s a little intimidating to follow in the steps of past TDA presidents, some of whom are my mentors, such as Vaclav, Smith, Findley, Black and Stuart. I want you to know that I do consider this a privilege and honor, and I will attempt to serve to the level of those before me, and to the level for which you have grown accustomed.
I am not going to tell you that dentistry is at a crossroads; we all know it, we all see it, and we all live in it every day. We find ourselves faced with more government intervention, more thirdparty interference, unfavorable media, hard economic times, and the rapidly growing number of non-dentist owned practices. We have to deal with uncensored social media such as Facebook, LinkedIn, Pinterest, Angie’s List, Twitter, and blogs too numerous to mention. We have to acquire and become efficient with new technology that is constantly emerging with the intent of making our patient’s treatment better and our lives easier. The average age of this house is 53 years old; the average age of licensed dentists in Texas is 49 years old. I mention these facts because, across America, traditional association models are dying. In TDA’s case, the total number of members is going up; however, the market share is going down. Simply stated, dentists are entering the profession and moving into Texas at a faster pace than they are joining.
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In my opinion, the elephant in the room today is the changing business model and how vastly different it is than the business model we 50+ year olds are use to. When we graduated, we had minimal debt. We did not face non dentist involvement. Medicaid was part of a practice, not a practice all its own. We actually considered not accepting third-party payments. And, many of us went straight out of dental school into solo practice, no GPR’s, no group settings, no associateships. All in all, we employed those tried and true philosophies of “hanging a shingle,” or “build it, and they will come ” Ask today’s younger dentist if any of those scenarios play into their decision-making process, my guess is they do not. The younger dentist has to develop a better business mind faster than we did; they are in debt an average of 8 to 10 times more than what we were, they can consider large company dentistry a valid option, and third-party involvement is a must. Medicaid is a valuable component for many practices and, for some, almost 100% of their revenue. Younger dentists tend to want to practice with someone and many of them further their education before entering the workplace. With all these differences I feel like TDA has to ask itself, “Are we prepared to give all our dentists the same opportunities to practice in the style and manner in which they choose?” I will stand here and tell you that I prefer to work as the only dentist in the office without guidance from a business partner, and I do not participate in any insurance programs, as do a majority of my age group, which is the same age group that are in many of the leadership positions of this organization. I will also stand here and tell you I believe it is the TDA responsibility to assure all our members that TDA will represent them and fight for their pursuit of an honest living, even though it may not resemble my workday. I actually had a very valued staff member of TDA, in a roundabout way, refer to me as “Old Guard”
TDA President-elect Dr David A Duncan of Amarillo participates in the House of Delegates at the 2013 TEXAS Meeting in San Antonio.
the other day! After I picked my partial plate up off the desk and adjusted my hearing aid to make sure I had heard him or her correctly, I realized that even though I am one of the youngest presidents of TDA, I’m still considered “Old Guard.” Well, I’m “Old Guard” in the fact that I believe in an organized effort to represent dentistry. I’m “Old Guard” in the fact that I believe a patient and his or her dentist should decide on their best treatment plan. And I’m “Old Guard” in the fact that I believe a dentist should be the head of the dental team. At the end of the day I think we are still pursuing the same things we did 20, 30, or even 40
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Trustee’s Address Trustee’s Address but part of the job. We have lost some ground over the past few years likeexperience, to see us regain that. We Caption to and I would history, and expertise, have all talked about the value of membership but come if we don’t start mentoring how do we successfully convey that value to non-members? the younger generations and I don’t know. What I do know is that organization entrusting theman with fundamental is best run by members who have a vested interest positions within this organization because they feel a sense of ownership and then the “Old Guard” isbelonging. going to Can we say that our younger feel thatstate sense grow oldmembers and lonely. The of ownership and belonging? Have we welcomed them trusts the younger dentists with at society meetings? the Havewell webeing reached out to them on a of the public, I think personal level? Or, have we just told them that we know we should start trusting them best because we sit atwith the the headrunning table? of Statistics tell us TDA. Frankly, that by 2015, Baby Boomers will cede the majority of some of us are getting tired and the workforce to the Millennials (those born between could use a breather. I say we 1977 and 1997). exploit the young and naive, let’s of the American Dental Association years ago. We want to practice play golf or go fishing and let them and Texas Dental Association were unencumbered and in a manner I think it is time for some changing of the guard. I go to the meetings. The “World is not only a privilege but part of the that is ideal for our patients think the “Old Guard” has to start turning over some Flat” thanks to technology, let’s let job. We have lost some ground and ourselves. Lately, dentistry of the keysover to the “Young Guard.” While there are those that live in that world every the past few years anddefinitely I would like seems as if it is under attack arenas of TDA that need history, experience, day take us where we need to go. to see us regain that. We have all from the media. You can’t turn and expertise, if we don’t start mentoring the younger talked about the value of membership on the TV or computer without generations and entrusting them with fundamental In closing, my message to you but(left) howpresents do we successfully convey another negative story TDA President Dr David A. there Duncanon of Amarillo positions within this organization then the “Old Guard” throughout this next year will be value to non-members? I Dr L. Stuart of Sunnyvale with the that Outgoing theMichael screen. Unfortunately, some is going todon’t grow old and lonely. The state trusts the President’s Award at the House of Delegates on May 5, 2013. one of evolution. We must ensure know. What I do know is that an of them are accurate; however, younger dentists with the well being of the public, I think that the association’s culture organization is best run by members some are not. I think it’s time we should start trusting them with the running of TDA. ago. We want to practice unencumbered and in a continues to meet the needs who have a vested interest because for TDA to get the good stories Frankly, some of us are getting tired and could use a manner that is ideal for our patients and ourselves. of our median member while they feel a sense of ownership and about dentistry out there and breather. I say we exploit the young and naive, let’s play Lately, dentistry seems as if it is under attack from evolving into an association that belonging. Can we say that our that is what we intend to do. It golf or go fishing and let them go to the meetings. The the media. You can’t turn on the TV or computer is a vast resource to the dentist younger members feel that sense of is our job to let everyone know “World is Flat” thanks to technology, let’s let those that without another negative story there on the screen. practicing in a corporate setting ownership and belonging? Have we that the TDA Smiles Foundation live in that world every day take us where we need to go. Unfortunately, some of them are accurate; however, as well as a new generation of welcomed them at society meetings? has provided over $12 million some are not. I think it’s time for TDA to get the dentists starting their practice Have we reached out to them on a dollars in care to over 26,000 In closing, my message to you throughout this next good stories about dentistry out there and that is in a very different world. If we personal level? Or, have we just told Texans since 2001. To date year will be one of evolution. We must ensure that the what we intend to do. It is our job to let everyone don’t, we will face the same fate them that we know best because we this year, the TDA has issued 8 association’s culture continues to meet the needs of our know that the TDA Smiles Foundation has provided many other associations in this sit at the head table? median Statisticsmember tell us whileasevolving press releases all with positive into an association that over $12 million dollars in care to over 26,000 Texans country. You will hear me restate that by 2015, Baby Boomers will cede messages about the profession is a vast resource to the dentist practicing in a corporate since 2001. To date this year, the TDA has issued this message at board meetings, the majority of the workforce to the and our association. We have setting as well as a new generation of dentists starting 8 press releases all with positive messages about as I visit component societies, and Millennials (those born between 1977 also increased our social media their practice in a very different world. If we don’t, we the profession and our association. We have also as I talk with TDA councils and and 1997). following by 30% since the will face the same fate as many other associations in increased our social media following by 30% since the committees and staff. If we choose beginning of the year. this country. You will hear me restate this message at beginning of the year. to remain viable as an association, I think it is time for some changing of board meetings, as I visit component societies, and as I we must make changes throughout the guard. I “Oldwith Guard” The profession was was once considered TDA has councils and committees and staff. If we The dental dental profession one ofthink thetalk theasassociation structure which to start of to theremain keys viable oncemost considered one ofprofessions the choose an association, we must make the trustworthy in the U.S.,turning and over some will benefit generations of Texas to the “Young Guard.” While there most trustworthy changes throughout the association structure which will being members of professions the American Dental Association dentists for years toyears come. are definitely arenas of TDA that need in the U.S., and being members benefit generations of Texas dentists for to come. and Texas Dental Association were not only a privilege
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On behalf of the El Paso District Dental Society, it is a pleasure to welcome the members of the Texas Dental Association to the 51st Annual El Paso Dental Conference, September 19-20, 2013, at the El Paso Convention Center. Surrounded by the Chihuahuan Desert, El Paso is situated in the westernmost corner of the state. The only major Texas city on Mountain Time, it’s flanked by the Rio Grande River and the Franklin Mountains that extend north into New Mexico. This year we will have our 3rd annual 5K run/1-mile walk. The “Tooth Trot” will be held at McKelligon Canyon, El Paso, Texas. Proceeds from the race will benefit the Wounded Warrior Project. Come see our lovely city and enjoy our sunny weather! Experience the hospitality of this unique area of Texas while partaking in the world-class CE offered at this year’s conference. For more information about the conference and the race, please visit elpasodentalconference.org or call Yoli Alva-Corella, 915-540-1705.
Rita Zamora
September 19, 2013 Title: Social Media in Dentistry Date: Thursday, 8:30 am-11:30 am, 1:00 pm-4:00 pm Course Code: T04 CE: 6 Hours (Non-technical course; may not qualify for State Board CE hours). Rita Zamora is an authority in social media marketing and training for dental professionals. This seminar is ideal for those who have never been on Facebook or Google Plus or who have very little experience with either social platform. Learn what the differences are between Profiles and Business Pages, and which is best for marketing your practice. Experience a basic tour of Facebook and Google Plus. Learn about the unique marketing benefits that each has to offer. You will leave the program with familiarity of Facebook and Google Plus as well as basic strategies and tactics you can put into place right away for general or specialty practices. Learn what top dental practices are doing today to successfully grow their practices with social media. This is a non-technical seminar, yet you’ll walk away with secrets to grow your practice with some of the hottest dental marketing techniques today! Learning Objectives: • Understand how advertising and internet marketing have changed and what this means for your practice. • Become familiar with Facebook and Google Plus. • Discover the benefits of marketing with Facebook and Google Plus. • Discover techniques to protect and enhance your online reputation. • Identify which social media strategies and tactics work best in generating word of mouth and exposure for your practice. • Identify the top social media platforms for marketing your practice. Intended audiences: dentists, hygienists, dental assistants, office personnel, lab technicians. Educational funding sponsored by Patterson Dental.
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Sergio Kuttler, BS, DDS September 20, 2013 (all day)
Title: “Simplicity in Endodontics” — An Achievable Goal and “A New Way Of Looking At Filling Techniques” Date: Friday, 8:30 am-11:30 am, 1:00 pm-4:00 pm Course Code: F03 CE: 6 Hours The field of endodontics is still experiencing a virtual explosion of new techniques, instruments, and materials. How many of these will stand the test of time is yet to be determined. Learning objectives: • Understand the ability of a single file system over multiple files systems in preparing canals without procedural errors. • Understand the objectives of canal instrumentation and how to achieve these objectives with one single NiTi file system based on research. • Know the advantages of one single file NiTi system over other ones. • Know the advantages of core-obturation materials for 3D obturation of the prepared canal space based on the “best evidence possible.” • Understand that science needs to direct education if endodontics is to be taken seriously. Intended audiences: dentists, hygienists, dental assistants Educational funding sponsored by Dentsply Tulsa Dental Specialties.
Jamison R. Spencer, DMD, MS September 19, 2013 (all day)
Title: TMD Cranial Facial Pain Thursday, 8:30 am-11:30 am, 1:00 pm-4:00 pm Course Code T01 CE: 6 Hours Temporomandibular Disorders and Craniofacial Pain are difficult subjects. Many dentists typically receive very little education and exposure to treating patients with TMJ problems. Despite this unfortunate lack of training, we must understand how to diagnose and help our patients with these problems. Dental professionals in particular must know the mechanisms that lead to TMJ problems, how to recognize them, how to prevent them when possible, and how to help their patients suffering with these disorders find the relief they so desperately need. Dr. Spencer will discuss how the diagnosis and basic treatment of common temporomandibular disorders and craniofacial pains can be simple and straight forward. His paradigm is not based on symptomatic treatment alone, but in discovering the root cause of the problems, and explaining how bruxism is related. Intended Audience: dentists, hygienists, dental assistants, lab technicians
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Jamison R. Spencer, DMD, MS September 20, 2013 (all day)
Title: Sleep Medicine in Dentistry Date: Friday, 8:30 am-11:30 am, 1:00 pm-4:00 pm Course Code: F01 CE: 6 Hours Millions of people have problems with snoring and sleep apnea. The treatment of snoring and sleep apnea using oral appliances has exploded in the past few years. As more and more patients are diagnosed with sleep apnea, and with the high rate of patient non-compliance on Continuous Positive Airway Pressure (CPAP), oral appliance therapy will become an extremely popular treatment option. Dentists are not only uniquely qualified to provide the necessary dental treatment for this life threatening disorder, but are also uniquely positioned to screen and refer our own patients for sleep apnea diagnosis. This lecture includes the basics of normal sleep, snoring and sleep apnea in adults in children, and the dental professional’s role in screening, referral and treatment of snoring and sleep apnea using oral appliances alone and in conjunction with CPAP as part of a multi-disciplinary team. Dr Spencer will review many of the most popular oral appliances and discuss pros and cons of each. The bruxism/sleep apnea connection will be fully addressed. Intended Audience: dentists, hygienists, dental assistants, lab technicians
Harold L. Crossley, DDS, MS, PhD September 19, 2013 (all day)
Title: Avoid Liability — Know Your Patients’ Medications and Their Impact on Dental Treatment! Date: Thursday, 8:30 am-11:30 am, 1:00 pm-4:00 pm Course Code: T02 CE: 6 Hours Your patients are living longer thanks to their medications but many of the physician-prescribed medications used by your patients have dental implications and side effects affecting your treatment plan. This presentation includes the indications, contraindications, and side effects of the most commonly prescribed medications. These medications represent 30% of all prescriptions taken by your dental patients and familiarity with these drugs will provide the dental practitioner with a better appreciation for the health profile of your dental patient. Learning objectives: • Medications that could adversely interact with dental drugs • Why your patient is taking their medications • What oral side effects may be caused by these medications • Maximum doses for commonly prescribed pain medications • When not to prescribe NSAIDs • How to manage patients taking some of the newer anticoagulant medications • How to combine analgesics to maximize their effects • Indications and contraindications for opiate analgesics • Current recommendations for SBE and orthopedic prosthesis prophylaxis Intended Audience: dentists, hygienists, dental assistants, office personnel Texas Dental Journal
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Harold L. Crossley, DDS, MS, PhD September 20, 2013 (all day)
Title: Street Drugs Exposed — What Your Patients and Your Kids Are Not Telling You! Date: Friday, 8:30 am-11:30 am, 1:00 pm-4:00 pm Course Code: F02 CE: 6 Hours What questions should I be asking my patients to avoid drug interactions with street drugs? The dental team is in a unique position providing dental care to a patient population that may be regular users or experimenting with mood altering drugs. This dynamic, brutally honest, and graphic presentation will take you from the streets and into the office to help you identify and manage the substance abusing patient. Discussion includes the origins, types, mechanisms of action, and signs and symptoms of commonly abused prescription and illicit drugs. Learning objectives: • Signs and symptoms of commonly abused prescription and illicit drugs in patients and adolescents • The biochemical basis for the disease of addiction • What medications to avoid with the suspected drug-abusing patient • How to recognize and manage the doctor shopper • How to manage the chemically-dependent patient • What are “meth mouth”, “lean”, “whippets”, “parachuting”, “bath salts”, “Spice Diamond, Spice Gold”, and more • Why some people become addicted and others do not • How does my kid get intoxicated on hand sanitizer? Must be 18 years of age or older to attend (no exceptions). Intended audiences: dentists, hygienists, dental assistants, office personnel, lab technicians
David J. Ahearn, DDS September 20, 2013
Title: This Can All Be Easier: Projects That Will Make Your Office a Fun, Easy and Productive Place to Work! / Lean Is Green: How to Design and Build a Healthy and Highly Productive Practice Date: Friday, 8:30 am-11:30 am, 1:00 pm-4:00 pm Course Code: F04 CE: 6 Hours (Non-technical course; may not qualify for State Board CE hours). As dental practices become more and more sophisticated, the work of clinical staff has become an extremely challenging, seemingly impossible endeavor. Dr Ahearn will show you how to reduce clutter, decrease inventory, improve on-time performance, speed room turnaround, simplify infection control, increase office profitability and more! Enjoy a healthy, less stressful workplace and grow your practice. Also, your office can be both environmentally friendly and extremely productive. Lean production techniques in a great design can significantly increase your economic return. This course will give you tools for a better future, while entertaining you regarding present day problems. Intended audiences: dentists, hygienists, dental assistants, office personnel
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Vernon Burke, DMD, MD; Alfredo Arribas, DDS, MS; Reo P. Pugao, DDS, MD September 19, 2013 (all day)
Title: Review of Oral Surgery Topics in Dentistry Date: Thursday, 8:30 am-11:30 am, 1:00 pm-4:00 pm Course Code: T03 CE: 6 Hours Drs Burke, Arribas, and Pugao will present topics in oral surgery that the dental community faces often (and rarely). Timeless topics such as pathology of the hard and soft tissues of the jaws and complications in dentoalveolar surgery will be discussed. The presenters will also discuss newer technologies in the treatment of missing teeth, pathology, and trauma. The purpose of these lectures is to strengthen the knowledge base and review topics you will face in your dental practices. Lecture topics: • Pathology of the soft tissue • Pathology of hard tissue • Management of complications of extractions • Odontogenic infections • Dental treatment of patients taking bisphosphonates • Dentoalveolar trauma • Advances in surgical planning, from implants to reconstruction • Surgical highlights Intended audiences: dentists, hygienists, dental assistants
REGISTRATION
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REGISTER ONLINE AT WWW.ELPASODENTALCONFERENCE.ORG Or return this completed form to: El Paso Dental Conference, 1713 Weston Brent Ln, El Paso, TX 79935 (There will be a $15 service fee for our staff to register your office)
For questions, please contact Yoli Corella: 915-540-1705; Fax 915-599-8579; E-mail yoli.epdc@hotmail.com
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“Tooth Trot” 5 K Run / 1 Mile Walk
Registration and information at www.raceadventuresunlimited.com. ($20 for registration before race day, $25 on race day, $15 for anyone registering a team of 10 or more people) Tooth Trot Total $_________________ $15 Service Fee to register your office online by our staff
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Credit Card Information Name as it appears on card: _________________________________________________________________________________________ Mailing address (if different than above)________________________________________________________________________________ Card Type: _____Visa _____ MC _____ Discover Credit Card Number:__________________________________________Expiration Date: MO/YR____________Security Code___________ REFUND POLICY: ALL REQUESTS FOR REFUNDS OR CANCELLATIONS MUST BE RECEIVED IN WRITING ON OR BEFORE 9/14/13 AND WILL BE ASSESSED A 20% ADMINISTRATION CHARGE. ThereJournal will be a $15 service fee if you choose to mail in your form and have the EPDC staff register for you online 526 Texas Dental l www.tda.org l June 2013
CASE REPORT
Abstract
Loss of Sight Caused by Calcium Hydroxide Paste Accidentally Splashed into the Eye During Endodontic Treatment: Case Report Mariusz Lipski, DDS, PhD; Jadwiga Buczkowska-Radlińska, DDS, PhD; Monika Góra, DDS, PhD Reprinted with permission from J Can Dent Assoc 2012;78:c57.
C
alcium hydroxide is widely used as an intracanal medication in root canal treatments. The most common and effective type of calcium hydroxide is in an aqueous suspension. It kills a wide spectrum of bacteria and remains active for a long time. The antibacterial effect of calcium hydroxide is due directly to its high pH (12–13) (1-4). However, tissue damage occurs when calcium hydroxide is applied beyond the root canal space. De Bruyne and others, and Bramante and others described cases of overextending a calcium hydroxide intracanal dressing into the periradicular and soft tissue after iatrogenic perforation of maxillary incisors (5,6). The result was severe necrosis of gingival and oral mucosa. Sharma and others described 2 cases in which calcium hydroxide was injected into an artery through the root canal system of maxillary canals (7). In both cases, the
Lipski
Buczkowska-Radlińska
Góra
Dr Lipski is professor of conservative dentistry and endodontics in the department of preclinical conservative dentistry and preclinical endodontics, Pomeranian Medical University, Szczecin, Poland. Dr Buczkowska-Radlińska is professor of conservative dentistry and endodontics in the department of conservative dentistry, Pomeranian Medical University, Szczecin, Poland. Dr Góra is assistant professor of conservative dentistry and endodontics of department of conservative dentistry, Pomeranian Medical University, Szczecin, Poland. Correspondence to: Dr Mariusz Lipski, Department of preclinical conservative dentistry and preclinical endodontics, Al. Powstańców Wlkp. 72, 70-11 Szczecin, Poland. Email: lipam@pum. edu.pl.
Calcium hydroxide, widely used in endodontic treatment, is a strong base that may cause irreversible injury to vital tissue that comes into contact with this substance. We present the first case of a dentist who accidentally splashed endodontic calcium hydroxide into her own eye. After washing with copious amounts of water for several minutes, she was treated in the hospital within 30 minutes of the accident. Because of the burning caused by the base solution, the dentist lost vision in the affected eye. She returned to the hospital several times for treatment of a corneal abscess and corneal fungal infection. She had the keloid that formed between the eyeball and eyelid removed 3 times. Calcium hydroxide can cause blindness when it comes into contact with the eye. Clinicians should take adequate precautions to prevent this serious complication. In case of an accident, it is important to wash the eye efficiently.
Tex Dent J 2013;130(6): 529-532.
The authors have no declared financial interests. This article has been peer reviewed.
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CLINICAL
REPORT
insult resulted in severe clinical signs, including necrosis of the gingival mucosa, oral mucosa and the skin. Ahlgren and others reported inferior alveolar nerve paresthesia caused by calcium hydroxide paste introduced into the mandibular canal (8). However, Fava described a case of calcium hydroxide overfilling in the maxillary sinus that was beneficial: 3 months after the incident, the patient was free of symptoms, although a radiographic mass was visible in the sinus (9). Recently, another study described a case of necrosis observed on the left infraorbital area of the skin and concomitant hypoesthesia of the infraorbital nerve and mental nerve (embolia cutis medicamentosa) after calcium hydroxide was injected during endodontic treatment (10).
then ejected from the needle directly into her left eye, causing an instant, strong, burning pain. The dentist immediately proceeded to rinse her eye with tap water for several minutes. During this procedure, she felt a sharp, unpleasant, tearing chest pain that radiated out to both shoulders and the mandible. With help, she went to the hospital and underwent treatment about 30 minutes after the incident. The treatment at the hospital included cleaning the remaining calcium hydroxide from the conjunctival sac and its fornices, prolonged rinsing of the conjunctival sac with 0.9% sodium chloride, administering the patient’s own blood under the conjunctiva, and neutralizing the calcium hydroxide with sodium edetate, according to the treatment protocol. The ophthalmic examination revealed
a lack of tear secretion, shortening of the conjunctival sack (adhesion between the palpebral conjunctiva and the ocular conjunctiva), swollen palpebral and ocular conjunctivas, and burned tissue. The cornea was deeply burned, appearing opaque like porcelain. Corneal fluorescein staining was positive, indicating damage to the cornea. Other sections of the eye could not be examined clinically because of the lack of corneal translucency. The symptoms of chest pain suggested a diagnosis of myocardial infarction, which was confirmed by cardiac diagnostics. Both cardiac and ophalmologic treatments commenced concurrently. Intensive conservative pharmacological treatment was applied to the eye; however, because of the chemical burn, oculopalpebral adhesions had formed, and the conjunc-
Here, we present a case of a calcium hydroxide intracanal dressing accidentally splashed into the eye of a dentist during root canal therapy that resulted in the loss of all sight in the injured eye. To our knowledge, no similar case has been previously reported.
Case Report A dentist accidentally splashed calcium hydroxide into her own eye while applying an aseptic endodontic treatment to a second mandibular premolar. When the dentist tried to apply a calcium hydroxide intracanal dressing (Calasept, Scania Dental, Sweden) directly from a syringe with a needle, she found that the needle was blocked. To examine the patency of the needle closely, she removed her protective glasses and pressed the syringe plunger. The preparation
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Figure 1. Photograph of a corneal ulceration in the process of healing. Located in the centre of the cornea, the ulceration has affected the ingrowing vessels from the limbus region that form a seam toward the centre of the cornea. The cornea is entirely opaque.
CLINICAL
tival sac had become shallow because of adhesions between the ocular and palpebral conjunctivas. The dentist lost vision in the injured eye because of the burning. She returned to the hospital several times for treatment of a corneal abscess and corneal fungal infection (Figure 1). In addition, she had a keloid that formed between the eyeball and eyelid removed 3 times, and plastic surgery on the conjunctiva 3 times.
Discussion Chemical eye injuries caused by exposure to acids and alkalis (bases) are the most common type of ocular burn. Alkali burns are typically more serious than acid burns because the alkali can rapidly penetrate the cornea into the anterior chamber of the eye (5–15 minutes) and damage the iris, ciliary body, lens, and trabecular network (11-13). Alkali damage includes saponification of cell membranes, cell death and disruption of the extracellular matrix. Alkalis can continue destroying tissues within the eye for several days. Penetration rates differ with different types of alkalis. One of the most rapidly penetrating alkalis is ammonium hydroxide, followed by sodium hydroxide, potassium hydroxide, calcium hydroxide and sodium hypochlorite. Although calcium hydroxide penetrates more slowly than several other alkalis, it quickly saponifies membranes, and the newly created soap particles tend to gather in the fornices that provide a reservoir for ongoing injury (14,15). In this case report, a dentist lost total sight in one eye after splashing
calcium hydroxide into her eye. To our knowledge, this is the first case of a chemical injury to the eye caused by endodontic calcium hydroxide. However, Ingram reported a case of a corneal burn caused by splashing a 5.25% sodium hypochlorite solution into the eye of a patient during endodontic therapy (16). In that case, the hypochlorite caused only slight edema of the conjunctiva and loss of epithelial cells in the cornea. Two days after the accident, the patient was asymptomatic and seemed completely healed. However, the dentist in this case report had severe damage and lost all sight in the affected eye. This was probably due to the ineffective removal of the calcium hydroxide at the site of injury, likely because the calcium hydroxide was trapped in saponified tissues, which made it difficult to remove from the recesses of the eye. For effective removal, the eyelid should be flipped inside-out, but this was done too late for our patient. Mechanical removal of the particles in her eye was done in the hospital 30 minutes after the injury. Alkali substances can penetrate the cornea to the anterior chamber of the eye and cause irreversible destruction of the deeper structures of the eye within several minutes. Training health care personnel in the skills of turning the eyelid inside-out and thorough eye washing on site within the first few minutes of an accident is of prime importance. According to the latest guidelines, the eye should be washed for several minutes with saline or tap water; specialist help and treatment should be sought immediately after washing is completed.
REPORT
Conclusion This case report emphasizes the importance of taking special care with calcium hydroxide, a commonly used endodontic treatment, to avoid eye contamination because it can cause blindness. Both the patient and the care provider should wear eye protection, such as glasses or a dental safety face mask. If calcium hydroxide is splashed into the eye, the eyelid flip should be done immediately with copious washing, followed by prompt ophthalmologic consultation. References 1.
2.
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Duarte MA, Midena RZ, Zeferino MA, Vivan RR, Weckwerth PH, Dos Santos F, et al. Evaluation of pH and calcium ion release of calcium hydroxide pastes containing different substances. J Endod. 2009;35(9):1274-7. Epub 2009 Jul 2. Ballal NV, Shavi GV, Kumar R, Kundabala M, Bhat KS. In vitro sustained release of calcium ions and pH maintenance from different vehicles containing calcium hydroxide. J Endod. 2010;36(5):862-6. Epub 2010 Feb 21. Delgado RJ, Gasparoto TH, Sipert CR, Pinheiro CR, Moraes IG, Garcia RB, et al. Antimicrobial effects of calcium hydroxide and chlorhexidine on Enterococcus faecalis. J Endod. 2010;36(8):1389-93. Epub 2010 Jun 19. Asgary S, Nosrat A, Seifi A. Management of inflammatory external root resorption by using calcium-enriched mixture cement: a case report.J Endod. 2011;37(3):411-3. Epub 2010 Dec 30. De Bruyne MA, De Moor RJ, Raes FM. Necrosis of the gingiva caused by calcium hydroxide: a case report. Int Endod J. 2000;33(1):67-71. Bramante CM, Luna-Cruz SM, Siepert CR, Bernadineli N, Garcia RB, de Moraes IG, et al. Alveolar mucosa necrosis induced by utilisation of calcium hydroxide as a root canal dressing. Int Dent J. 2008;58(2):815. Sharma S, Hackett R, Webb R, Macpherson D. Wilson A. Severe tissue necrosis following intra-arterial injection of endodontic calcium hydroxide: a case series.
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CLINICAL
8. 9. 10. 11. 12. 13. 14. 15. 16.
REPORT
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(5):666-9. Ahlgren F, Johannessen ACH, Hellem S. Displaced calcium hydroxide paste causing inferior alveolar nerve paraesthesia: report of case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96(6):734-7. Fava R. Calcium hydroxide paste in the maxillary sinus: a case report. Int Endod J. 1993;26(5):306-10. Wilbrand JF, Wilbrand M, Schaaf H, Howaldt HP, Malik CY, Streckbein P. Embolia cutis medicamentosa (Nicolau syndrome) after endodontic treatment: a case report. J Endod. 2011;37(6):875-7. Epub 2011 Mar 3. Adepoju FG, Adeboye A, Adigun IA. Chemical eye injuries: presentation and management difficulties. Ann Afr Med. 2007;6(1):7-11. Kuckelkom R, Schrage N, Keller G, Redbrake C. Emergency treatment of chemical and thermal eye burns. Acta Ophthalmol Scand. 2002;80(1):4-10. Schrage NF, Langefeld S, Zschocke J, Kuckelkom R, Redbrake C, Reim M. Eye burns: an emergency and continuing problem. Burns.2000;26(8):689-99. Agarwal T, Vajpayee RB, Sharma N, Tandon R. Severe ocular injury resulting from chuna packets. Ophthalmology. 2006;113(6):961.e1. Epub 2006 Apr 17. Schmidt SM, Schmidt CJ, Adler M, Rahmani B. Corneal injury due to calcium hydroxide containing food preparation product (“cal�). Pediatr Emerg Care. 2008;24(7):468-70. Ingram TA 3rd. Response of the human eye to accidental exposure to sodium hypochlorite. J Endod. 1990;16(5):235-8.
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Oral and Maxillofacial Pathology Case of the Month Clinical History A 74-year-old man presented to his dentist with painful facial edema over the maxillary right central incisor area. He was being treated, apparently successfully, for myasthenia gravis of 2 years duration and hyperlipidemia of 4 years duration. His medications included CellCept (mycophenolate; 500 mg qid), pyridostigmine BR (60 mg q4h prn), Mestinon (pyridostigmine; 180 mg. 1/2 cap po hs), simvastatin (20 mg) and prednisone (12.5 mg qd). The dentist noted, in addition to the facial changes, erythema, swelling, and tenderness of the vestibular region above the maxillary right central incisor, with a radiolucency of the apical region extending along the mesial root with irregular thickness and loss of the lamina dura (Figure 1A). The patient presented with early periodontitis with generalized gingival recession, but all periodontal sulcular depths for the incisor were equal to or less than 3 mm. Incision and drainage was unproductive and so the dentist prescribed amoxicillin (250 mg qid) and referred the patient to an endodontist for definitive treatment of “a dead tooth.” The endodontist determined that the central incisor was necrotic while all adjacent teeth tested vital. He diagnosed “chronic suppurative apical periodontitis” and initiated endodontic therapy with gutta percha, cotton pellet, and Cavit (Figure 1B). Four months after final fill, the facial edema and tenderness recurred. At endodontic reevaluation adjacent teeth all remained vital to testing and the sulcular depths all remained 3 mm or less. The patient was reluctant to
Blum
Bouquot
Dorn
Gary Blum, DDS, MS, private practice of periodontics, Corpus Christi, Texas Jerry Bouquot, DDS, MSD, FICD, FACD, FRCM (UK), adjunct professor, Department of Diagnostic & Biomedical Sciences, University of Texas School of Dentistry at Houston Samuel Dorn, DDS, FACD, FICD, FPFA, professor and chair, Department of Endodontics, University of Texas School of Dentistry at Houston
submit to an apicoectomy because of healing difficulties after previous surgical procedures and so the existing gutta percha fill was redone with Ca(OH)2 used for intracanal medication; re-medication was done 2 weeks later. After 6 more weeks the patient returned with purulent drainage from the sulcus. An additional month of canal remedication did not stop the drainage and so the patient was referred to a periodontist. The periodontist noted a probing depth of 9 mm on the mesio-facial aspect of the right incisor, with a 4 mm depth on the mesio-palatal surface. An apical sinus tract was present on the facial gingiva, in addition to the purulent exudate draining from the facial pocket. The tooth was not mobile. The radiograph continued to show a J-shaped
Figure 1. a) Original presentation with an “inverted J-shaped” radiolucency of the mesial root surface, wrapping around the apex of the right central incisor; b) Immediately after endodontic therapy; c) Four months later, after second refill with medication; d) The J-shaped radiolucency remains 9 months after the patient’s initial appointment and after multiple endodontic procedures.
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Figure 2. At surgery an irregular mesial and facial root surface (arrow) is obvious on the apical third of the root; inset shows fragments of cementum removed from the root surface.
vertical radiolucency along the mesial surface, with loss of the lamina dura and apparent extension into adjacent cancellous bone (Figure 1D). Chronic bruxism, malocclusion, and generalized gingival recession were also noted, but the incisor lesion was presumed not to be part of the more generalized periodontitis. After consultation with the general dentist, endodontist, and medical specialists, it was decided to explore the area surgically. With amoxicillin (500 mg) premedication and chlorhexidene asepsis, a full thickness mucoperiosteal flap was elevated, revealing discolored, somewhat curved, calcified fragments resembling cementum (Figure 2). These were easily removed from the root surface by root planing and the entire accessible surface was root planed with hand and ultrasonic instruments to a hard, clean surface. The osseous defect extended from the mesial to distal line angles of the facial aspect of the root, but no mobility was evident at surgery. Cortical demineralized freeze dried bone allograft mixed with CaSO4 was placed over the exposed root surface and covered with a collagen membrane at flap closure. The biopsied sample showed large numbers of chronic inflammatory cells admixed throughout a fibrous connective tissue with focal areas of edema and with degenerated squamous epithelium along some edges (Figure 3). One epitheliumcovered edge had a linear strip of calcified, lamellated tissue attached. Separate denuded strips of the same type of calcified fragments were also seen (Figure 4). What is the final diagnosis? See page 536 for the answer and discussion.
Figure 3. Fractured fragment of cementum is attached to the top edge of the tissue, adjacent to hyperplastic but degenerated squamous epithelium, which in turn overlies fibrous connective tissue with numerous chronic inflammatory cells (nondecalcified specimen; 100x magnification).
B
Figure 4. a) Linear fragment of cementum shows little or no attached soft tissue, horizontal fractures are artifacts from processing; b) higher power view shows a few Sharpey’s fibers (arrow) attached to cementum in one area decalcified specimen, 40x and 100x magnification.
Figure 5. a) Extracted endodontically treated tooth with large area of delamination or tearing away of entire thickness of surface cementum; b) Extracted tooth with large region of missing cementum with clefting or lifting away of cementum on one edge (lower right); presumably the missing cementum fragment was left in the socket after extraction (decalcified specimens; 40x magnification). Texas Dental Journal l www.tda.org l June 2013
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Oral and Maxillofacial Pathology Diagnosis and Management
CEMENTAL TEAR AND CHRONIC PERIODONTITIS Oral and Maxillofacial Pathology Case of the Month (from page 534)
Discussion The microscopic diagnosis was “chronic gingivitis/periodontitis with cemental tear.” In large part this was based on the pocket-like epithelium seen adjacent to a cementum fragment in the sample (Figure 3), but combining the radiographic and microscopic features, a more appropriate diagnosis would be “cemental tear with chronic nonsuppurative osteomyelitis,” since there was destruction of the lamina dura with extension of inflammation into the cancellous bone (Figure 1D) (1,2). This entity is often referred to simply as “cemental tear” (3-9). The cemental tear is a pathologic entity that is so seldom discussed that the vast majority of dentists, including diagnostic specialists, are largely unaware of it. Considered to be quite rare, with fewer than 20 reported cases, it seems to be very much underdiagnosed, as attested to by the fact that the present authors have collected 14 new cases in their own practices over the past decade (10). We suspect that more than a few cases of cemental tear are misdiagnosed as “endo/perio” lesions or laterally located radicular granulomas, with subsequent extraction because the radiolucency does not heal, the pain does not subside and the case is presumed to be an endodontic
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failure. Similarly, when the tear is near the cementoenamel junction it is easy to misdiagnose as a localized periodontitis, treating it repeatedly and eventually extracting the tooth because the radiolucency does not heal, the pain does not subside and the case is presumed to be a periodontal failure. The key to the diagnosis is the unique vertical radiolucency along the lateral root surface, with loss of the lamina dura. If the tooth is nonviable, the radiolucency typically takes on the J-shape noted in the present case (Figure 1). Without apical involvement, the radiolucency presents as a thin or moderately thickened linear radiolucency, mimicking a thickened periodontal ligament or as a D-shaped radiolucency if inflammation extends more deeply into cancellous bone. When mandibular molars are involved the vertical radiolucency may occur between the roots, perhaps with destruction of all interradicular bone, mimicking localized periodontitis or buccal bifurcation cyst. Awareness of the unique radiographic presentation of the cemental tear will lead to a more enlightened differential diagnosis and more appropriate therapy. In the present case, for example, with a working diagnosis of cemental tear, surgical removal of the cementum fragments and careful
root planning proved a successful treatment: the area healed well and remains in good health 8 months after surgery (5,11-15). Others have reported excellent results lasting for many years (5,8). The cemento-dentin junction is known as the weakest, least calcified portion of the root (excluding pulp, of course). Comprised primarily of extracellular matrix “fillers” such as proteoglycans and mucopolysaccharides, it contains fewer strong connecting fibers than either the underlying dentin or the overlying cementum (16). To compound the problem, some individuals have an apparent developmental defect with a special weakness of the dentin-cementum attachment, resulting in multiple cemental tears over time (17). Because of this weakness, cementum can be forcibly separated in vivo from the underlying root dentin by a sharp, excessive bite on a hard object, food or an opposing tooth (6,7). When this occurs the detached fragment, or cemental tear, remains embedded within the periodontal ligament, moving with each applied occlusal force and ultimately acting as a local irritant, producing a chronic, lowgrade inflammatory response. This response is, of course, initially confined to the ligament itself, but by the time of diagnosis months or years have passed and the adjacent
bone has become involved, with destruction of the lamina dura and extension of the inflammatory process into the surrounding cancellous bone and marrow, often with a variably intense level of pain or tenderness. Overlying marginal gingiva may be red and distended if the tear is high on the root, often associated with a periodontal pocket. With more apical lesions there is no increased probing depth unless suppuration occurs, as in the late stage of the present case. When this happens crevicular epithelium can creep down to the region of the cementum fragment(s), possibly reaching all the way to the apex (Figure 2). The most appropriate diagnosis at this late stage is, as previously mentioned, chronic nonsuppurative osteomyelitis or chronic fibrosing osteomyelitis, caused, obviously, by a loose fragment of cementum (11-13). This terminology is problematic, however, since the word “osteomyelitis” so often is inadvertently and wrongly equated with “acute osteomyelitis,” leading to a knee-jerk reaction: use of long-term antibiotics. Most forms of chronic osteomyelitis are very different from the more standard acute osteomyelitis and the cemental tear-associated lesions, specifically, are much like the nonsuppurative periapical granuloma, ie, a localized, self-limiting inflammation…antibiotics need not be applied (5,11-15). Unlike the septic periapical granuloma, cemental tear lesions are not usually infected and have little or no tendency to suppurate or produce draining sinus tracts, bacteremia or exuberant surface responses. Sepsis, when present, usually results from either: 1. a tear that is close to the gingival sulcus, becoming secondarily infected and easily mistaken for a periodontal
abscess or infected pocket; 2. or a tooth with pulpal sepsis involving apical bone and extending into the region of cemental irritation, as occurred in the present case and possibly occurs in many so-called “endo/perio” lesions. It should be mentioned, with regard to endodontic lesions that endodontically treated teeth are at increased risk of cemental tear, which might explain at least some endodontic “failures” occuring many months or years after initial treatment (8). At a microscopic level the cemental fragments may be isolated, as in Figure 4, but are usually surrounded by or attached to fibrous tissue infiltrated by numerous chronic inflammatory cells, ie, chronic fibrosing osteomyelitis (18). A few of our personal cases, however, have shown the cementum fragment to be literally “encased” within very dense, avascular, uninflamed collagen, like scar tissue, hence, seem to represent a variant of the recently reported intramedullary fibrous scar (19). To diagnose this disorder as simply “cemental tear,” which is the universal practice, is to refer only to the cause of the disease, not the disease itself. We are not suggesting changing the name, only that the clinician be mindful of the fact that it is an inflammatory bone disorder, not just a piece of broken cementum. Additionally, it is very likely, although unproven, that torn cementum is a common feature of teeth, especially in older individuals, and that the great majority cause so little harm that they never produced bone destruction, radiographic changes or symptoms. One of the present authors has collected more than 150 extracted teeth with apparently innocuous partial or complete delamination of cementum, all from teeth with no
presurgical suggestion of cemental tear (Figure 5). Simple curettage seems to be all the treatment needed for cemental tear, perhaps with apical or periodontal procedures which assure proper healing and repair (11-14). When the tooth is endodontically treated, the cemental tear must be treated before proper evaluation of the endodontic therapy can take place. When a periodontal pocket/sinus tract has occurred, the area can be treated as a routine periodontal problem so long as the cemental tear has been adequately removed. Diagnosis is the key and we suggest that cemental tear be included in the differential or working diagnosis of vertical radiolucencies, especially when an endo/perio lesion is suspected. References 1.
2.
3.
4.
5.
6.
7.
Neville B, Damm D, Allen C, Bouquot J. Oral and maxillofacial pathology, 3rd edition. Philadelphia, W. B. Saunders; 2008. Bouquot J, McMahon R Primary chronic osteomyelitis (PCO) – clinicopathologic parameters and proposed classification of low grade jawbone inflammation. Proceedings, 14th Biennial Congress, Internation Association of Oral Pathologists, Seoul, South Korea, August, 2010. Leknes KN, Lie T, Selvig KA. Cemental tear: a risk factor in periodontal attachment loss. J Periodontol 1996; 67:583-588. Brunsvwold MA, Lasho DJ. Cemental tears related to severe localized periodontal disease. Pract Periodontics Anesthet Dent 2000; 12:536 539-540. Chou J, Rawal YB, O’Neil JR, Tatakis DN. Cementodentinal tear: a case report with 7-year follow-up. J Periodontol 2004; 75:1708-1713. Lyons CT, Peacock ME, Cuenin MF, Swiec GD, Dickey DJ. Severe localized periodontal destruction associated with cervical cemental separation. Gen Dent 2005; 53:212-214. Tulkke MJ, Baisden MK, McClanaban SB. Cemental tear: A case report of a rare root fracture. J of Endo 2006, 32:1005-1007.
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8.
Lin HJ, Chan CP, Yang CY, Wu CT, Tsai YL, Huang CC, Yang KD, Lin CC, Chang SH, Jeng JH. Cemental tear: clinical characteristics and its predisposing factors. J Endod 2011; 37:611-618. 9. Lin HJ, Chang SH, Chang MC, Tsai YL, Chiang CP, Chan CP, Jeng JH. Clinical fracture site, morphologic and histopathologic characteristics of cemental tear: role in endodontic lesions. J Endod 2012; 38:1058-1062. 10. Bouquot J, Makins S, Dorn S, Blum G. The vertical radiolucency – Fourteen cemental tear cases: histopathology/radiology. Proceedings, annual meeting, American Association for Dental Research, Tampa, Florida, March, 2012. 11. Schallhorn RA. Diagnosis and management of vertical bony defects in periodontal disease. Gen Dent 2012; July/ August:290-297. 12. Müller HP. Cemental tear treated with guided tissue regeneration: a case report 3 years after treatment. Quintessence Int 1999; 30:111-115.
13. Harrel SK, Wright JM. Treatment of periodontal destruction associated with a cemental tear using minimally invasive surgery. J Periodontol 2000; 71:17611766. 14. Camargo PM, Pirth FQ, Wolinsky LE, Lekovic V, et al. Clinical repair of an osseous defect associated with a cemental tear: a case report. Int J Periodontics Restorative Dent 2003; 23:79-85. 15. Kasaj A, Gortan-Kasaj A, BrisenoMarroquin B, Willershausen B. Treatment of severe localized periodontal destruction associated with a cemental tear: a case report and review of the literature. Gen Dent 2009; 57:e5-9. 16. Yamamoto T, Domon T, Takahashi S, Islam N, Suzuki R, Wakita M. The structure and function of the cemento-dentinal junction in human teeth. J Periodontal Res 1999; 34:261-268. 17. Watanabe C, Watanabe Y, Miyauchi M, Fujita M, Watanabe Y. Multiple cemental tears: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:365372.
18. Bouquot J, Qari H, McMahon R. Chronic fibrosing osteomyelitis (CFO) – new or long forgotten jawbone disease? Proceedings, Biennial Congress, International Association of Oral Pathologists, Sao Paulo, Brazil, August, 2012. 19. Bouquot JE, McMahon RA, Suarez P. Intramedullary fibrous scar -- 321 examples of a previously unreported avascular fibrosis of jawbones. Proceedings, annual meeting, American Association of Oral & Maxillofacial Pathology, Tucson, Arizona, May, 2010.
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Memorial and Honorarium Donors to the Texas Dental Association Smiles Foundation
In Memory of: Vince Olvera Dr Sherman T. Coleman, Jr. Dr Juan F. T. Huerta
Robertson Orchard Dental Associates
Robert Weatherly
Nueces Valley District Dental Society
Mr Tom Flynt Mrs Joyce Cook Dr Walter Krause Dr Hubert C. Askew
In Honorarium: Wade Barker Cate Baggett
Your memorial contribution supports: • •
educating the public and profession about oral health; and improving access to dental care for the people of Texas.
Please make your check payable to:
TDA Smiles Foundation, 1946 S IH 35, Austin, TX 78704
In Memoriam Those in the dental community who have recently passed Allen, William M Corpus Christi, Texas February 28, 1922 – April 6, 2013 Good Fellow, 1972 • Life, 1987 • Fifty Year, 1998 Broaddus, Luther L San Antonio, Texas January 21, 1929 – February 23, 2013 Good Fellow, 1979 • Life, 1994 • Fifty Year, 2011 Cochran, John D San Antonio, Texas November 21, 1933 – April 27, 2013 Good Fellow, 1984 • Life, 1999 • Fifty Year, 2008 Coleman, Sherman T Victoria, Texas January 1, 1945 – April 10, 2013 Diehl, George F Harlingen, Texas August 20, 1929 – April 18, 2013 Good Fellow, 1981 • Life, 1994 Fifty Year, 2004 Dornburg, Larry A Victoria, Texas February 12, 1925 – May 3, 2013 Good Fellow, 1973 • Life, 1990 • Fifty Year, 1998 Gibson, Thomas E Jr Montgomery, Texas January 6, 1923 – February 15, 2013 Good Fellow, 1979 • Life, 1988 • Fifty Year, 2003 Lyle, Robert L Pampa, Texas July 22, 1929 – April 6, 2013 Good Fellow, 1986 • Life, 1994 • Fifty Year, 2011 Overton, J D San Antonio, Texas July 23, 1952 – April 20, 2013 Patterson, Barden E Richmond, Texas March 7, 1934 – April 11, 2013 Good Fellow, 1987 • Life, 2000 • Fifty Year, 2011
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CALENDAR OF EVENTS JULY2013 18-20
The American Dental Association will host its 26th New Dentist Conference in Denver, CO. For more information, please contact Mr. Ron Polaniecki, ADA, 211 East Chicago Avenue, Chicago, IL 60611. Phone 312-440-2599; FAX: 312-440-2883; E-mail: polanieckir@ada.org; Web: ada.org.
AUGUST2013 9-10
540
The TDA Smiles Foundation will hold a 20-chair Texas Mission of Mercy in Texarkana. For more information,
Texas Dental Journal l www.tda.org l June 2013
please contact Foundation Manager Judith Gonzalez at TDASF, 1946 S IH35 Ste 300, Austin, TX 78704; Phone: 512-448-2441; E-mail: judith@tda.org; Web: tdasmiles.org.
15-17
The California Dental Association presents The Art and Science of Dentistry at Moscone West, in San Francisco CA. For more information, please contact Ms Deborah Irwin, CDA, 1201 “K” Street Mall, Sacramento, CA 95853. Phone: 916443-3382 Ext 4470; FAX: 916-5545937; E-mail: debi@cda.org; Web: cda.org.
SEPTEMBER2013 26-28
The Texas Academy of General Dentistry will host its annual Lone Star Dental Conference in Austin, Texas. For more information, please contact Laura Ceglio, Communications Coordinator, TAGD, 409 W Main St, Round Rock, TX 78664. Phone: 512-244-0577; FAX: 512-244-0476; E-mail: Laura@tagd. org; Website: tagd.org.
OCTOBER2013 4-5
The TDA Smiles Foundation will hold a 40-chair Texas Mission of Mercy in Abilene. For more information, please contact Foundation Manager Judith Gonzalez at TDASF, 1946 S IH35 Ste 300, Austin, TX 78704; Phone: 512-448-2441; E-mail: judith@tda.org; Web: tdasmiles.org.
7-12
The American Association of Oral and Maxillofacial Surgeons will host its 95th annual meeting in Orlando, FL. For more information, please contact Dr Robert C. Rinaldi, AAOMS, 9700 W. Bryn Mawr, Rosemont, IL 60018. Phone: 847-678-6200; FAX: 847-6786286; Website: aaoms.org.
16-19
The American Student Dental Association will host its 37th Annual ASDA Conference in Naples, FL. For more information, please contact Dr Dan Ward, ASDA, 635 Madison Ave, New York, NY 10022. Phone: 800454-2732; E-mail: dward@columbus. rr.com; Website: asdatoday.com.
31-5
The American Dental Association will host its 154th Annual Session in New Orleans, LA. For more information, please contact ADA conference and meeting services, ADA, 211 East Chicago Ave Ste 730, Chicago, IL 60611-2678. Phone: 312-4402500; FAX: 312-440-2707 ; E-mail: annualsession@ada.org; Website: ADA.org.
31-2
The Alliance of the American Dental Association will host its annual conference in New Orleans, LA. For more information, please contact Ms Patricia Rubik-Rothstein, AADA, 211 East Chicago Ave Ste 730, Chicago, IL 60611-2678. Phone: 312-4402865; FAX: 312-440-2587; E-mail: manager@allianceada.org; Website: AllianceADA.org.
The Texas Dental Journal’s Calendar will include only meetings, symposia, etc., of statewide, national, and international interest to Texas dentists. Because of space limitations, individual continuing education courses will not be listed. Readers are directed to the monthly advertisements of courses that appear elsewhere in the Journal.
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Provided by TDA Perks Program
value for your
profession
Set Your Practice Apart with Audio Marketing Eoghan McCloskey, Ace Media Products
Most dentists are familiar with marketing through traditional means, such as signage and print ads. While these are important, dentists that also focus on how their practices sound can separate themselves from their competition.
On-Hold Messaging As your patient roster grows, you’ll need to place callers on hold. What will these callers hear? Some businesses opt for music or a generic “thank you for holding” message. Using one of these options is certainly better than having silence, but why not make the most of this time by marketing your practice and services? A hold messaging system does just that. With one, your callers hear personalized, branded messages about your practice. Some providers offer you the ability to change your messages throughout the year, rather than be stuck with one set of messages. This option adds more value to your system. For instance, you can run Halloween-themed messages in October and a “happy holidays” message in December, emphasize National Children’s Dental Health Month in February, and market promotions and seasonal specials. The possibilities are endless. Real-time hold message marketing doesn’t just make your practice sound more professional; when used properly, it can be a documented way of adding revenue to your practice. The most recent survey statistics available from the On-Hold Messaging Association (OHMA) show that among small businesses that use some kind of on-hold messaging, those that change their messages 6 times or more per year are more likely to attribute
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hold messaging to an increase in sales, and describe it as a useful marketing tool they’d recommend to other businesses. Even if you don’t change your messages on a regular basis, a hold message system is more likely to add revenue to your business than not: 25% of respondents said they could attribute specific sales directly to holdmessage marketing. 85% described hold messaging as a useful marketing tool they’d recommend to other businesses.
Overhead Music What your patients hear while they’re in your office is another critical component of audio marketing for your practice. Do they hear drills from operating rooms; or a news anchor talking about war, economic ruin, and international strife? Do they hear a radio station playing advertisements for other dental offices? All of these can contribute to a negative patient experience. Using an overhead music service would eliminate these issues. A typical overhead music service would combine music of your choosing with voiceovers describing the importance of dental health and informing your customers about all the dental products and services you offer. Some providers allow you to customize music selection down to specific artists and songs, and messages to your practice. Still other providers even allow you to sell ad space on your own overhead music broadcast. For instance, say your office is 2 doors down from an Italian restaurant. You sell ad space to the Italian restaurant; your overhead music provider produces the ads, which play on your overhead broadcast. You would generate extra revenue for your practice, and foster relationships with other businesses. “No office of mine goes without it,” says dental practice consultant Kimberley Franek. “Overhead music benefits both the patient and the practice in 2 ways. First, having predetermined music removes the concerns of questionable
Technology Focus: Voice over Internet Phone Systems (VoIP) Why More Small Businesses are Switching to VoIP Traditional turn-key and private branch exchange (PBX) phone systems are popular options for small business owners, such as dentists. However, small businesses are increasingly opting for Voice over IP (VoIP) systems, which use an internet connection (rather than traditional copper-wire phone lines) to make and receive calls. Why? Using a business VoIP system in your office can dramatically cut costs and offer unique features that can be of great value to your business. “VoIP… provides streamlined billing, consistent monthly fees that can be accurately predicted, and a very low start-up cost,” and “comparable quality for a fraction of the price” of traditional phone systems, says Kimberley Franek, a dental practice consultant specializing in assisting dentists with opening new and expanding existing practices. She also notes that though VoIP systems use the most up-to-date phones, they can easily be set up in a few minutes with very little wiring. Some business owners have resisted switching to VoIP for fear that service will be less consistent than that of traditional landline service. Though some elements of the VoIP platform are still in developmental stages, many dentists and other small business owners find the benefits of VoIP phone systems outweigh the risks of committing to an emerging technology. For instance, you can program your phones to automatically play a “closed for lunch” message during lunch hours, and automatically switch to a normal greeting when lunch hours are over. Click-to-dial features allow you to make outbound calls by simply clicking a phone number on your computer screen. Remote extension setup allows you to take office calls when you’re out of the office, and make outbound calls from your office number without being physically in the office. Even ancillary features, such as voicemail-to-email and fax-to-email, reduce paper and ink waste, and improve office efficiency. Some of these features are not even available on non-VoIP phone systems; and where they are, tend to be very difficult and cost inefficient to implement.
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lyrics or annoying instrumentation, while providing a calming, enjoyable atmosphere.” Overhead music also “masks the sounds of drills and private discussions between patients and their providers while leading the appointment to its conclusion without ‘dead air’ and the sounds of clocks ticking.” Plus it provides a more enjoyable workspace and just enough pep in your staff’s step, she notes.
A Word of Caution Perhaps at this point you’re thinking, “That all sounds well and good, but I can’t afford an overhead music system, so I’ll just play the radio until I can afford one.” This may seem like a tempting alternative, but broadcasting the radio or a CD to your patients via your telephone’s hold feature or overhead speakers violates federal
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copyright laws — unless you obtained a license to rebroadcast those media (a license which costs much more than an overhead music service or hold messaging system). It’s true that some overhead music systems require a significant investment, particularly if you don’t already have a speaker system in place. But it’s worth the investment to ensure your overhead music is legal, improve patient experience, market all your products and services — and to have the opportunity to generate extra revenue by selling commercial time on your broadcast. TDA Perks partner, Ace Media Products, provides custom on-hold messaging and overhead music service for offices, as well as VoIP (voice over internet phone service).
For more information regarding Ace Media Products, please call 800-8929179 or visit acemediaproducts.com. For more information regarding TDA Perks Program, please visit tdaperks. com or call 512-443-3675. References 1. “On-Hold Messages Drive Sales, Bring Value to Businesses, National Survey Finds.” PRWeb, February 15, 2013. http://www. prweb.com/releases/2013/2/ prweb10430714.htm. 2. Broadcast Music, Inc. (BMI). Music Licensing for Businesses Using Music on Hold. Common Questions. (http://www.bmi. com/licensing/entry/music_on_ hold).
Michael B. Hamilton, D.D.S. has acquired the practice of Byron A. Brown, D.D.S. - Fort Worth, Texas Wesam Salha, D.D.S. has joined the practice of
Call 1-800-232-3826 or visit us online at www.AFTCO.net for a free practice appraisal, a $2,500 value!
Barry W. Heaton, D.D.S. -
Houston, Texas
AFTCO is pleased to have represented all parties in these transitions.
AFTCO is the oldest and largest dental practice transition consulting firm in the United States. AFTCO assists dentists with associateships, purchasing and selling of practices, and retirement plans. We are there to serve you through all stages of your career.
“Over $1.5 Billion in Practice Sales� Texas Dental Journal l www.tda.org l June 2013
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ADVERTISING BRIEFS Practice OpportunitieS ABBEVILLE DENTISTRY: We are seeking an honest, hardworking, patient focused dentist who want to contribute to a culture of caring, nurturing and skilled professionals. If you have the desire to be a part of a team where you can focus on patients and not worry about the headaches that come with the business side of dentistry, please call us. If you are seeking an environment that provides stability, growth and continuing education, we’d like to share with you how you can fit into that plan. Twenty years ago, I started my practice simply dedicated to serving my patients and community. Now, I’m privileged to guide over 10 practices and 80 wonderful staff. I’ve turned the administrative, operations and marketing efforts over to people who enjoy doing those sorts of things so our doctors and staff can focus on their patients. I’ve also been able to provide young doctors with an environment where they can grow and practice what they love doing without the worry of costly overhead or administrative headaches. At the same time, offering the potential for significant income and a great life balance. You’ll enjoy a great environment with no egos and no political barriers. We’re growing and need a few quality individuals to join us in creating something truly special. We’re forming a new, interactive, fun environment that kids and their parents will find refreshing and exciting. If you’d like to talk about this opportunity, please give me a call. I’d be happy to share the vision, the success and the expectations we have while answering your questions candidly and openly. I hope you’ll consider this position and give me a call. Britt Bostick, DDS,. 806-438-5745 or email bbost38521@aol.com.
ADVERTISING BRIEF INFORMATION SUBMISSION AND CANCELLATION DEADLINE: 20th, 2 months prior to publication (eg, November 20th for January issue) MONTHLY RATES: First 30 words = $40; each additional word = 10¢ Ads must be submitted via e-mail, fax, or web and are not accepted by phone. Journal editors reserve the right to edit copy of classified advertisements. Any dentist advertising in the Texas Dental Journal must be a member of the American Dental Association. Advertisements must be not quote revenues or gross or net incomes; only generic language referencing income will be accepted.
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ADS WATSON, BROWN & ASSOCIATES: Excellent practice acquisition and merger opportunities available. DALLAS AREA: 6 general dentistry practices available (Dallas, North Dallas, Highland Park, and Plano); 5 specialty practices available (2 ortho, 1 perio, 1 pedo). FORT WORTH AREA: 2 general dentistry practices (north Fort Worth and west of Fort Worth). CORPUS CHRISTI AREA: 1 general dentistry practice. CENTRAL TEXAS: 2 general dentistry practices (north of Austin and Bryan/College Station). NORTH TEXAS : 1 orthodontic practice. HOUSTON AREA: 3 general dentistry practices. EAST TEXAS AREA: 2 general dentistry practices and 1 pedo practice. WEST TEXAS: 3 general dentistry practices (El Paso and West Texas). NEW MEXICO: 2 general dentistry practices (Sante Fe, Albuquerque). For more information and current listings, please visit our website at www.adstexas.com or call ADS Watson, Brown & Associates at 469-222-3200. AMARILLO: General dentist for a locally owned practice looking to provide care for our patients as well as build their own patient base. Ownership opportunity available. Please contact Dr Britt Bostick, bbost35821@aol.com or call 806-438-5745. AMARILLO: Pediatric dentist for a locally owned practice looking to provide care for our patients as well as build their own patient base. Ownership opportunity available. Please contact Dr Britt Bostick, bbost35821@aol.com or call 806-438-5745. AMAZING Practice Sale: (Sherri L. Henderson & Associates, LLC) NORTHEASTERN OKLAHOMA GREEN COUNTRY. This great general practice draws from five large surrounding counties and is 35 minutes from Tulsa. BUSY TRAFFIC LOCATION; 1,550 sq ft 2 ops, 1 hygiene op, and 1 additional shared hygiene op. The doctor is retiring after 45 years in practice. GREAT production potential and chance to own or lease ½ of the beautiful free standing building (3,100 sq ft). Pictures available — #3001. Call Sherri at 972-562-1072; www.slhdentalsales.com. Anxious to sell in the CORPUS CHRISTI AREA: Sherri L. Henderson & Associates. The DDS is relocating to another city. The general practice was established in 1982 in a professional office complex with 1,400 sq ft and 3 existing treatment rooms. This location would make a great place for a start-up or satellite practice and it has plenty of space next door for expansion. The location is
on one of the busiest streets with access to Padre Island Drive. This is a cash basis practice with a dedicated loyal staff and great revenue potential. The current owner has extensive experience with TMJ and sleep apnea and would be willing to return to the practice periodically if the new owner was interested. #3070 (Pictures available) Contact 972-562-1072 or email: sherri@slhdentalsales.com; www.slhdentalsales.com. ARLINGTON / FORT WORTH: Associate position available. Full-time dentist and specialist needed to join our successful dental group in Arlington & Fort Worth. Interested candidates should email CV to info@ ismiledental.net. ASSOCIATE FOR TYLER GENERAL DENTISTRY PRACTICE: Well-established general dentist in Tyler with over 30 years experience seeks a caring and motivated associate for his busy practice. This practice provides exceptional dental care for the entire family. The professional staff allows a doctor to focus on the needs of their patients. Our office is located in beautiful east Texas and provides all phases of quality dentistry in a friendly and compassionate atmosphere. The practice offers a tremendous opportunity to grow a solid foundation with the doctor. The practice offers excellent production and earning potential with a possible future equity position available. Our knowledgeable staff will support and enhance your growth and earning potential while helping create a smooth transition. Interested candidates should call 903-509-0505 and/or send an e-mail to steve.lebo@sbcglobal.net. Associate needed for dental office in small, quaint town. Potential for practice purchase. 361-6458148. ASSOCIATES and PARTNERS AVAILABLE: Sherri L. Henderson & Associates. Is it time for you to add another provider? Is it time for you to go golfing or fishing more? Let us help you find the perfect associate and potential buyer. We have candidates ready in all parts of Texas looking for your specific practice profile. There are many graduates as well as very experienced dentists looking for the opportunity to transition into your already established practice. These dentists have great people skills, case presentation experience and can be a very valuable and reliable addition to your bottom line. If you are confused about the right timing or simply would like to talk about
the opportunities, call us today for a complimentary consultation in person or by telephone. We are experienced in practice sales, associate and partner placement and can assist you in making that transition dream become a reality. 972-562-1072 or e-mail sherri@ slhdentalsales.com; www.slhdentalsales.com. AUSTIN: Progressive, patient centric office is seeking an experienced dentist; must be friendly, caring and professional. Opportunity is available (if desire) for practice ownership. Serious inquiries email: fahoosha@ gmail.com, mike@miloinc.com. AUSTIN PEDIATRIC PRACTICE SEEKING FULL TIME ASSOCIATE: Great benefits! Progressive, fast-paced practice. Capable caring staff. We are looking for a bright career-oriented pediatric dentist to join an organization committed to providing high quality dental care to children and adolescents. Our dental team strives to offer exceptional care with integrity. Send your confidential resume to dentalresume27@yahoo.com for consideration. AUSTIN, SAN ANTONIO & DALLAS AREA PRACTICE OPPORTUNITIES MCLERRAN & ASSOCIATES: SAN ANTONIO (ID #T212): Established general family practice with large, primarily fee-for-service/PPO patient base, healthy new patient flow, consistent annual revenue over 7 figures per year, 6 fully equipped operatories and an experienced staff. The practice and real estate are both available for purchase. WEST TEXAS (ID #T211): Associate to purchase opportunity in this thriving, well-established periodontal specialty practice located in low competition and growing area. SAN ANTONIO (ID #T209): Located on the east central side of town in a medical center building, this established pediatric specialty practice has seen consistent revenue in the mid 6 figures with low overhead. Excellent stand alone or satellite office! SAN ANTONIO (ID #T206): Established, 2-location general family practice with total collections in the mid-6 figures on a limited schedule and no external marketing. Low overhead and tremendous upside potential to make this a great starter opportunity. SAN ANTONIO (ID #T205): This is an opportunity to purchase an established general dentistry practice for much less than it would cost to start a practice from scratch! The practice has a fee-for-service/PPO patient base and has collections in the low 6 figures on a 2-day work week with no external marketing, providing tremendous upside potential through increasing operating Texas Dental Journal l www.tda.org l June 2013
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ADVERTISING BRIEFS days/hours and implementing a marketing plan to increase new patient flow. The office is located in a high traffic area in North/Central San Antonio and features 3 fully equipped operatories with modern equipment and digital X-ray units (4th plumbed operatory available for expansion) and a very low monthly rental rate. SAN ANTONIO (ID #T201): Established practice offering general dentistry to a diverse patient base. Consistent revenues in the mid-6 figure range strictly through word of mouth and patient referrals. The office has 4 fully equipped operatories with room to add an additional 3 operatories. Excellent opportunity for less than the cost of a start up. SAN ANTONIO (ID #T185): Well-established periodontal specialty practice available for purchase. Contact us now for more information on this excellent opportunity. SAN ANTONIO (ID #T181): Low overhead general family practice located in 4 operatory, paperless and digital office. Large Medicaid/PPO patient base, well-established location and upside potential make this a solid opportunity. EAST OF SAN ANTONIO (ID #T140): Quality, comprehensive family practice located in freestanding building with 3 equipped operatories. This practice has seen strong growth the last 3 years and is a great opportunity for doctor looking for a practice in lower competition area near San Antonio. The practice and real estate are available for purchase. (ID #T113): Oral surgery specialty practice. Very good referral base. Almost new build out, great location and excellent equipment. Good gross and net! Transition available. SAN ANTONIO (ID #T060): Prosthodontic practice with almost new equipment and build out. Tremendous upside potential and beautiful office! Perfect for stand-alone or satellite office. AUSTIN (ID #T210): This large oral surgery practice has an established, diverse referral base and 2 attractive locations in the Austin area. The practice boasts incredibly strong gross collections and strong profitability over the past few years and still offers the opportunity for further growth. The sellers are looking for a dual degree doctor (DDS, MD) to purchase 50% or 100% of the practice and are willing to continue working part-time for several years following the sale to maintain production and transfer the referral relationships. WEST OF AUSTIN (ID #T208): This attractive, general dentistry practice is located in a beautiful, vibrant town in the Texas Hill Country approximately 1 hour west of Austin. The office is located in a charming craftsmen style bungalow situated on a busy street and encompassing 1,800 sq ft with 3 fully equipped operatories (the real estate is also for sale). The practice has a fee-for-service/PPO patient base and consistent
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annual revenue in the mid 6 figures. You can purchase this established practice for less than it would cost to start an office from scratch! AUSTIN/SANTONIO AREA (ID #T207): This established, general dentistry practice is located in a growing community along the I-35 corridor between Austin and San Antonio. The practice boasts a 100% fee-for-service patient base, annual revenues in the mid-6 figures, exceptional cash flow, 3 fully equipped operatories (with a 4th plumbed operatory), modern equipment and attractive dĂˆcor. AUSTIN (ID #T204): This established, general dentistry practice in north Austin has 5 operatories, a predominantly fee-for-service patient base, annual revenue in the mid-6 figures and outstanding net cash flow of over 50%. The practice also offers tremendous upside potential, as the office is open only 3.5 days per week and has no external marketing. KILLEEN AREA (ID #T202): This is an opportunity to purchase a small, established general dentistry practice with solid cash flow and a predominantly fee-for- service/PPO patient base. Even with reduced office hours, the office realized annual revenues of in the mid 6 figures over the last 3 years. This practice has tremendous upside potential, evidenced by the fact that it collected in the high 6 figures in 2009. The office has 4 fully equipped operatories and is located within a professional building right in the heart of a high traffic vicinity of the Killeen/Fort Hood area. This is a great starter practice for any motivated and eager dentist! AUSTIN (ID #T203): This small, fee-for-service general dentistry practice has been established for 90 years and has annual collections in the low 6 figures. The office is located in a professional building situated on 38th Street in Central Austin. The office space encompasses approx. 1,110 sq ft and features 2 fully equipped operatories and 1 additional plumbed operatory. This is a great starter practice, satellite office, or merger opportunity! CENTRAL TEXAS (ID #T191): Established general dentistry practice located in a great community 1 hour north of Austin. Annual collections near 7 figures with extremely strong cash flow. Four operatory facility in freestanding building with excellent visibility. Strong upside potential! AUSTIN, SOUTH (ID #T188): Practice owner is looking for a parttime associate doctor to work 2 to 3 days per week (with the potential to become a full-time position) in a large, established, fee-for-service practice in south Austin. The associate must be available to work on Friday, possess a strong clinical skill set, and have the ability to provide at least 3 of the following services: endodontics, implant placement, third molar extractions, IV sedation, and periodontal surgery. WACO AREA (ID #T189): Well
ADVERTISING BRIEFS established family practice in low competition area. Minimal investment, strong upside and opportunity to own real estate make this attractive opportunity. WACO/ DALLAS AREA (ID #T134): General practice in low competition area. Fee-for-service practice with good patient flow. No competition. Can operate as a satellite or become a full-time office. NORTH TEXAS/ABILENE AREA (ID #T195): Small, established general family practice located in quickly growing small town community. Tremendous upside potential! VICTORIA/CORPUS CHRISTI AREA (ID #T171): Well-established, general family practice with large patient base, strong number of new patients per month, committed staff, and solid upside potential, with gross income in mid-6 figures. Practice is located in freestanding building that is available for purchase with practice. Contact McLerran & Associates: Paul McLerran, DDS, David McLerran or Brannon Moncrief in Austin 512-900-7989, San Antonio 210-737-0100, or Dallas 214-960-4461. Practice sales, appraisals, buyer representation, and lease negotiations. To request more information on our listings, register at www.dental-sales. com Awesome practice in LONGVIEW, TEXAS — For Sale: SLH Dental Sales is looking for a qualified buyer that would like the opportunity to immediately transition into a general dental office in this growing town of east Texas. The owner is willing to stay for a negotiated amount of time if necessary to insure a smooth transition. The location of the practice is near the hospital in a beautiful scenic area surrounded by many professional buildings. The staff is excited and ready for a future owner that will allow the current owner to pursue other opportunities. The office space is 1,500 sq ft with 4 treatment rooms equipped, 2 private offices, and 6 highly experienced employees. The owner occupies a portion of the building complex and is looking to transfer ownership of both patient base and the building space immediately. For more information, please contact our office at 972-5621072, e-mail sherri@slhdentalsales.com, or visit our website at www.slhdentalsales.com (Pictures available). Listing #3050. BEAUMONT AREA: For sale: Well-established 3 operatory, 17-year-old general practice. Great location with good visibility and high traffic flow. Modern equipment and computer system with Eagle Soft dental software. Staff is excellent and long standing. Practice is fully functional in all aspects and ready for buyer to step in seamlessly.
Building is a free standing country style office in beautiful condition and seller will sell or lease. Please inquire via email at drbob.willis@henryschein.com. BEAUTIFUL EAST TEXAS: Long standing general practice in a stable community of over 14,000 with a great referral base. Three ops, full-time hygienist and great staff. Doctor desires a quick sale and will aid in a smooth transition. Opportunity for ownership and start building equity for a minimal investment, with scheduled patients on day one. Contact Dr Guy Walker, Paragon Dental Transitions 573-225-2877. www.paragon.us.com. BROWNSVILLE SEEKING ASSOCIATE: Established general dental office in Brownsville (30 minutes away from South Padre Island) is seeking a caring, energetic associate. We are a busy office providing dental care for mostly children. Our knowledgeable staff will support and enhance growth and earning potential allowing the associate to focus on patient dental care. Interested candidates should call 956546-8397. Consulting & Staging For Your Transition! SLH DENTAL SALES (Sherri L. Henderson & Associates) — Are you prepared for the future? Let us help you make a transition plan- we can analyze the market, review your current patient base, secure the staff, spruce up the office space and much more. We specialize in practice transition consulting and can assist you in a plan to help you create all the right conditions to begin that step from retiring to starting up a new practice. Our team has decades of hands on experience in the dental market place as practice owners, employees and management advisors. We are here to help you prepare for an associate, partner, start-up or practice sale. We have a huge database of qualified applicants waiting and the time could not be better to begin the process. Our contact with you is strictly confidential and we are happy to schedule a complimentary consultation to discuss your options. Call 972-562-1072 or e-mail sherri@slhdentalsales.com; www.slhdentalsales.com. CORPUS CHRISTI: Established, successful practice in a niche market limited to removable prosthetics, extractions and related services, in Corpus Christi, is available for ownership due to current practice owner’s transition to retirement. Opened since 2003, this practice has a history of providing excellent care and services to the patients of southeast Texas. No personal financial investment Texas Dental Journal l www.tda.org l June 2013
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ADVERTISING BRIEFS required - owner is willing to finance purchase due to profitability and excellent cash flow. flow. Affiliation Affiliation with a long-standing dental services organization allows the owner to focus on treating patients and less time on the administrative burdens of a busy practice. practice. Please Please call, e-mail or fax for additional information and detail. detail. Guaranteed salary plus minimum bonus compensation and full benefits package. Phone: 800-313-3863; E-mail: michele.rowland@affordablecare.com. DALLAS / FORT CURRENT PRACTICE WORTH: SALEArea OPPORTUNITIES clinics seekingFROM associates. DDR DENTA: Earn significantly Serving Texas above Dentist industry for average Over 40 income Years. with paid GENERAL health and—malpractice Houston (Bellaire insurance / Post while Oak): working Terrific ingrowth a great facility nestedorine-mail neighborhoods and practice with great environment. Fax 312-944-9499 cjpatterson@ schools. Fronts high traffic Chimney Rock. Interior and kosservices.com. equipment rebuilt in 2009. Total of 8 operatories plumbed in use. Free standingorbuilding with with 4 operatories DALLAS AND ROCKWALL: Orthodontic other specialty 7,000 for office total lease sq fttothat share is also withfor owner. sale. Call Furnished DDR ATand 800-9308017 or www.ddrdental.com. — Houston equipped. Dallas office is 4,000PERIODONTAL sq ft in Lake Highlands (Galleria): area. Rockwall Veryoffice high-end, is 1,800 wellsq established ft in antique periodontal building and staffrcppc@sbcglobal.net. and great referral base. Five operatory practice, great furnishings. E-mail with 2 hygiene and surgical suite. Call DDR AT 800-930GENERAL —Fifteen Houston 8017 or www.ddrdental.com. DALLAS AREA: New practice opportunity. miles WellDallas. established (Memorial): from downtown Over 5practice, years ofmedian clinical gross experience patient base, 6 operatories, hygiene, 4 revenue, great required. We are fair and nice. Pay based on(2collections. equipped and great growth material opportunity with dental). PPO andFully Medicaid accepted. Application at www. 2,700 total sq ft available. Call DDR AT 800-930-8017 or mockingbirddentalgroup.com. www.DDRDental.com. DALLAS: Solo general practice in North Dallas serving DALLAS local Asian / FORT community. WORTH:Well Areamaintained clinics seeking facility associates. on busy Earn significantly street with 3 ops and above fourth industry plumbed. average Doctor income retiring with and paid desires a quick malpractice transition. insurance Long -time while loyal working staff. Mainly in a great FFS health and with exceptional rate and low overhead. Contact environment. Faxcollection 312-944-9499 or e-mail cjpatterson@ Dr Guy Walker Paragon Dental Transitions 573-225-2877 kosservices.com. www.paragon.us.com. DALLAS AND ROCKWALL: Orthodontic or other specialty DENTALONE PARTNERS is opening offices in Austin to share with owner.new Furnished and office for lease and the surrounding Dallas office areas. is 4,000 Eachsqpractice ft in Lake is unique Highlands in that equipped. it has Rockwall an individual name like sq Preston Hollow building Dental Care area. office is 1,800 ft in antique and or WatersideE-mail Dentalrcppc@sbcglobal.net. Care. Our patient base consists of furnishings. approximately 70% PPO and 30% fee-for-service. All our offices topNew of the line Pelton and Crane equipment, DALLAShave AREA: practice opportunity. Fifteen miles digital X-rays, andDallas. intra-oral We offer competitive from downtown Overcameras. 5 years of clinical experience compensation packages To on learn more fair andwith nice.benefits. Pay based collections. required. We are about working withaccepted. one of DentalOne Partner practices, PPO and Medicaid Application material at www. please contact Andrew Risolvato at 972-755-0838 or mockingbirddentalgroup.com. andrew.risolvato@dentalonepartners.com. DALLAS: Solo general practice in North Dallas serving local Asian community. Well maintained facility on busy
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DENTALONE is opening newDoctor officesretiring in Dallas street with 3 PARTNERS ops and fourth plumbed. and and theasurrounding areas.Long Each-time practice unique in that quick transition. loyalisstaff. Mainly FFS desires it hasexceptional an individual name like Preston Hollow DentalContact Care with collection rate and low overhead. or Dental Care. Our patient base573-225-2877 consists of Guy Walker Paragon Dental Transitions Dr Waterside approximately 70% PPO and 30% fee-for-service. All our www.paragon.us.com. offices have top of the line Pelton and Crane equipment, digital X-rays PARTNERS and intra-oral cameras. Weoffices offer competitive DENTALONE is opening new in Austin compensation packages with benefits. To islearn more and the surrounding areas. Each practice unique in that about working withname one oflike DentalOne PartnerDental practices, individual Preston Hollow Care it has an please contactDental Andrew Risolvato at 972-755-0838 orof or Waterside Care. Our patient base consists andrew.risolvato@dentalonepartners.com. approximately 70% PPO and 30% fee-for-service. All our offices have top of the line Pelton and Crane equipment, DENTALONE is opening new in San digital X-rays,PARTNERS and intra-oral cameras. Weoffices offer competitive Antonio and the surrounding areas. Each practice is packages with benefits. To learn more compensation unique in that itwith hasone an individual namePartner like Preston of DentalOne practices, about working Hollow Dental Care or Waterside Dental Care. Ouror Andrew Risolvato at 972-755-0838 please contact patient base consists of approximately 70% PPO and Andrew.Risolvato@dentalonepartners.com. 30% fee-for-service. All our offices have top of the line Pelton and Crane equipment, digitalnew X-rays, andinintraDENTALONE PARTNERS is opening offices Dallas oral cameras. We offer competitive compensation and the surrounding areas. Each practice is unique in that packages with benefits. learn moreHollow about working nameTolike Preston Dental Care it has an individual with one of DentalOne Partner practices, please contact Dental Care. Our patient base consists of or Waterside Andrew Risolvato 972-755-0838 or andrew.risolvato@ 70%atPPO and 30% fee-for-service. All our approximately dentalonepartners.com offices have top of the line Pelton and Crane equipment, digital X-rays and intra-oral cameras. We offer competitive DENTALONE PARTNERS opening newTo offices the packages iswith benefits. learn in more compensation upscale suburbswith of Houston. Each practice is unique in that one of DentalOne Partner practices, about working it has an individual name like GulfatBreeze Dental Care please contact Andrew Risolvato 972-755-0838 or or Waterside Dental Care. All of our offices have top of the andrew.risolvato@dentalonepartners.com. line Pelton and Crane equipment, digital X-rays, and intraoral cameras.PARTNERS Our patient consists approximately DENTALONE is base opening new of offices in San 70% PPOand andthe 30% fee-for-service. We offerpractice competitive surrounding areas. Each is Antonio compensation packages with benefits. learn more unique in that it has an individual nameTo like Preston about with or DentalOne Partner Hollowworking Dental Care Waterside Dentalpractices, Care. Ourplease contact Andrew Risolvato at 972-755-0838 andrew. patient base consists of approximately 70%or PPO and risolvato@dentalonepartners.com. 30% fee-for-service. All our offices have top of the line Pelton and Crane equipment, digital X-rays, and intraDFW AREA: Seeking general dentistscompensation and specialists. Our oral cameras. We offer competitive offices arewith located in theToDallas Fort Worth We are packages benefits. learn/more about area. working looking energetic associates. graduate with onefor ofcaring, DentalOne Partner practices,New please contactand experienced dentists welcome. We or offer benefits, a helpful Andrew Risolvato at 972-755-0838 andrew.risolvato@ working environment and an opportunity to grow. We dentalonepartners.com accept most insurance and Medicaid. Please submit your resume via e-mail to jennifer@smileworkshop.com DENTALONE PARTNERS is opening new offices in theor call our office at 214-757-4500. upscale suburbs of Houston. Each practice is unique in that it has an individual name like Gulf Breeze Dental Care or Waterside Dental Care. All of our offices have top of the line Pelton and Crane equipment, digital X-rays, and intraoral cameras. Our patient base consists of approximately
ADVERTISING BRIEFS DFW,PPO 70% AUSTIN, and 30% SANfee-for-service. ANTONIO, ANDWe HOUSTON: offer competitive ASSOCIATE DENTIST OPPORTUNITY: packages with Pacific benefits. To Dental Services learn more and its compensation about working supported owner with dentists DentalOne have Partner exciting practices, associateship please opportunities throughout Risolvato at the972-755-0838 state of Texasor (DFW, andrew. Austin, contact Andrew risolvato@dentalonepartners.com. San Antonio, and Houston). Practices are uniquely named (ie The Woodlands Smiles Dentistry and Orthodontics) DFWowned and AREA:by Seeking general general dentists dentists make and all clinical specialists. decisions Our offices in a traditional, are located practice in thesetting Dallas while / Fort PDS Worth provides area. We theare business support caring,services. energeticAssociates associates. New see 12 to graduate 13 patients and looking for aexperienced day in a PPO/FFS dentists setting welcome. (no Medicaid). We offer benefits, Practicesa helpful working are stateenvironment of the art, fully anddigital, an opportunity and equipped to grow. withWe most insurance and Medicaid.lasers, Pleaseand submit acceptCAD/CAM Cerec 4.0 with Omnicam, intra-your resume oral cameras. via e-mail Exciting to jennifer@smileworkshop.com comp package with full benefits, or call office at 214-757-4500. our malpractice CE, insurance and partnership/ownership opportunities. To learn more, please visit www.jobs. DFW, AUSTIN, SAN ANTONIO, AND HOUSTON: ASSOCIATE pacificdentalservices.com. DENTIST OPPORTUNITY: Pacific Dental Services and its supported DFW: GP/special ownerinterest dentistsinhave extractions, exciting implants, associateship sedation. throughout the state of Texas (DFW, Austin, opportunities Associate buy-in and partnership opportunities. Mobile/ San Antonio, and Houston). itinerant/portable dental practice Practices for sale are uniquely DFW areanamed mostly extractions/implants and portable Dentistrysedation; and Orthodontics) in multiple (ie The Woodlands Smiles quality GP offices; by general low overhead; dentists make greatalllifestyle; clinical decisions GPR/AEGD and owned settingpractice while PDS provides Contact the in a traditional, preferred; 3 to 5practice years private experience. Associates see 12 to 13 patients business support services. infohr@vipsdental.com or 972-955-9135. a day in a PPO/FFS setting (no Medicaid). Practices state of the art, fully digital, and equipped with arePASO/HORIZON: EL Orthodontist needed ASAP on CAD/CAM with Omnicam, lasers,This andisintraCerec the east side of El4.0 Paso and Horizon area. a part oral cameras. comp package withsalary. full benefits, time position 2Exciting days per week. Excellent Great insurance partnership/ownership CE, malpractice environment. Send resumeand to info@txkidsdental.com. opportunities. To learn more, please visit www.jobs. pacificdentalservices.com. EL PASO: Full-time position for a general dentist. Donít waste your best years at dead end jobs. Great earning potential and future partnership option.implants, Affordable El Paso DFW: GP/special interest in extractions, sedation. Dental is looking for apartnership Texas-licensed dentist to work full Associate buy-in and opportunities. Mobile/ time in our office indental El Paso, TX. Applicant mustarea be licensed itinerant/portable practice for sale DFW mostly in the state of Texas and 1 year of experience. If extractions/implants andhave portable sedation; in multiple interested please submit a resume to the following email quality GP offices; low overhead; great lifestyle; GPR/AEGD address: provide an accurate preferred;drdarj@gmail.com. 3 to 5 years privatePlease practice experience. Contact contact number and email infoHR@Vipsdental.com oraddress. 972-955-9135. PASO/HORIZON: Orthodontist neededwould ASAP on EL PASO: General dentist / implantologist like an the east side associate to work of El with Paso until and Horizon he or she area. feelsThis comfortable is a part time position days per week. Great in taking over 2the practice. PlanExcellent to retire salary. at the end of environment. 2013. Cam-LogSend implants, resume bone to info@txkidsdental.com. grafts — will teach my associate these procedures. Also I do all other general EL PASO: procedures. Full-time position dentist. dentistry Officefor hasa 3general operatories andDonít 1,400 waste your best at dead retail end jobs. sq ft. Located inyears an attractive stripGreat in eastearning El Paso. potential and future staff partnership option. Affordable El Paso Courteous, talented willing to stay with new doctor. Dental is looking for a Texas-licensed dentist to work full
timeTony in our office inDDS, El Paso, mustorbee-mail licensed Call Marquez, PhDTX. at Applicant 915-594-4048 in the state of Texas and have 1 year of experience. If me at marquezdental@gmail.com. interested please submit a resume to the following email address: EL PASO:drdarj@gmail.com. We are hiring a skilled Please andprovide compassionate an accurate contactto number and email address. dentist join our stable and successful practice. We are seeking a highly professional dentist with a knack EL PASO: General dentist / implantologist would like an for general dentistry. Prospective candidates must associate to work with until or she comfortable be dynamic, fun loving, and he looking forfeels a long-term in taking over the Plan to retire at the affording end of commitment. Our practice. practice is highly productive 2013. Cam-Loganimplants, bonetografts will teach my our providers opportunity attain—competitive associate theseIfprocedures. I do all other general compensation. interested, Also please forward your CV to dentistry procedures. Office has 3 operatories and 1,400 annette@vistahillsfamilydental.com. sq ft. Located in an attractive retail strip in east El Paso. Courteous, talented staff willing to stay with newprivate doctor. FORT WORTH OUTLYING COMMUNITY: Quality Call Tonyinterviewing Marquez, DDS, at 915-594-4048 e-mail practice for PhD a full-time associate / or successor. me at marquezdental@gmail.com. Owner is seeking a highly ethical, moral practitioner to join this predominately fee-for-service practice. Nice facility EL high PASO: We are hiring acommunity skilled andsouth compassionate in growth outlying of Fort Worth. dentist seeking to join our stable and practice.Ideally, We Owner successor, notsuccessful just an associate. are seeking dentist withofaclinical knack the applicanta highly shouldprofessional have more than 1 year for general dentistry. Prospective candidates must experience. Please send introductory letter with resume be dynamic, loving, and Health lookingProfession for a long-term regarding DPfun #373 to Lewis Services Inc commitment. OurRd practice is highly productive affording at 101 W Renner Ste 145, Richardson TX 75082-2002 ourbyproviders opportunity to attainFax competitive or email to an dan@lewishealth.com. is 469-546-3645. compensation. If interested,contact please Dan forward your CV to For additional information, Lewis at 972-437annette@vistahillsfamilydental.com. 1180. FORT WORTH OUTLYING COMMUNITY: Quality private FULLY EQUIPPED MODERN DENTAL OFFICE SPACE practice interviewing forHas a full-time associate / successor. AVAILABLE FOR LEASE. 4 ops. Current doctor is only Owner is 2seeking highlyGreat ethical, moral practitioner join working days a aweek. opportunity to start uptonew this predominately fee-for-service practice. Nice days facility practice (ie, endo, perio, oral surgery). Available are in high growth outlying community south of Fort Worth. Monday, Tuesday, Thursday per week. If you are wanting Owner seeking successor, notCall just214-315-4584 an associate. or Ideally, an associate, please inquire. e-mail the applicant should have more than 1 year of clinical ycsongdds@yahoo.com. experience. Please send introductory letter with resume regarding DP Well-established, #373 to Lewis Health Profession Services GALVESTON: successful practice of Inc at 101 Wneeds Renner Rd Ste 145, Richardson 35 years full-time associate dentistTX for75082-2002 FFS/PPO or by email to dan@lewishealth.com. Fax is 469-546-3645. practice. Experienced staff, new equipment, Galveston. For additional information, Danimplants, Lewis atand 972-437Senior owner loves to teachcontact sedation, other 1180. procedures. No Medicaid, DHMO practice in 6 surgical ops, 2 surgical suites, all operatories computerized with FULLY EQUIPPED MODERNcameras; DENTAL digital OFFICEpanoramic SPACE digital X-ray and intra-oral AVAILABLE FOR LEASE. Haseasy 4 ops. Current doctorvisit is only X-ray; paperless charts for documentation. working 2 days a week. Great to start upsouth new todaysdentistrytexas.com. Theopportunity Galveston area is just practice (ie, endo, perio, oral surgery). Available days are of Clear Lake 25 minutes which has planned communities Monday, Tuesday, Thursday pereducational, week. If you recreational are wanting with superior schools, multiple an associate, please as inquire. 214-315-4584 e-mail and cultural venues well asCall access to all of theorHouston ycsongdds@yahoo.com. cultural and sport venues, shopping and restaurants. We Texas Dental Journal l www.tda.org l June 2013
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ADVERTISING BRIEFS are minutes away GALVESTON: Well-established, from all typessuccessful of water sports practice including of several needs marinas. full-time http://goo.gl/maps/lWkF. associate dentist for FFS/PPO Possibility 35 yearslarge practice. of buy-in Experienced and partnership staff,possible new equipment, after an interim Galveston. term. Interview today! loves E-mail to teach CV tosedation, kkcarroll10yahoo.com implants, and other or call Senior owner surgical procedures. No Medicaid, DHMO practice in 6 832-385-8875. ops, 2 surgical suites, all operatories computerized with GARY CLINTON X-ray and intra-oral NORTH GARLAND cameras; digital PRACTICE panoramic OFF digital X-ray; HWY 190: paperless High charts growthfor area. easyIndocumentation. North Garland, visit a high growth area of Garland. G-1 TheWell-established Galveston area is practice; just south todaysdentistrytexas.com. of digital Clearwith Lakeall25 the minutes bells and which whistles. has planned Dentistcommunities taking early with retirement superior forschools, health reasons. multiple Excellent educational, opportunity; recreational excellent cultural fullvenues recall. as Restorative well as access practice to all high of the visibility Houston and cultural location.and A free sport appraisal venues,can shopping be veryand costly restaurants. to one party We minutes away fromisall types of waterappraiser, sports including are or both. Gary Clinton a senior dental a 27large marinas. http://goo.gl/maps/lWkF. Possibility several year member of the Institute of Business Appraisers, Inc. I follow buy-inthe and business partnership valuation possible standards after an ofinterim the North term. of E-mail CV to Standards kkcarroll10yahoo.com or call Interview American today! Business Valuation Counsel, NABVSC. 832-385-8875. Experience is critical in this most complex of business transitions. “For almost 40 years you’ve seen the name...a name Gary you Clinton can trust.” North I personally Garland handle Practice every sale/ off Hwy 190:and High growth area. In North Garland, a high transition complete Professional Certified Appraisals area of Garland. G-1 Well-established for growth which Congress has set guidelines under thepractice; North all the bells and whistles. Dentist taking early digital withBusiness American Valuation Standards Council. If buyer for health reasons. Excellent retirementyour purchases building with the practice,opportunity; there is no recall. Restorative practice high visibility additional excellent full charge. Every call is very confidential. General A free appraisaland canpractice be very sales. costly to onefunding party and location. specialty appraisals 100% is a seniorWATS dental800-583-7765. appraiser, a 27available. or both. Gary DFWClinton 214-503-9696. year member of the Institute of Business Appraisers, Inc. followCLINTON the business valuation standards ofPRACTICE the North IGARY DENTON PEDO/ORTHO American FOR SALE:Business Four-chair Valuation bay plus Standards 2 operatories Counsel, equipped; NABVSC. Experience another bayisunequipped critical in this formost 4 more complex chairs;offast business growing area; excellent opportunity. almost 40 years A freeyou’ve appraisal seencan thebename...a very transitions. “For costly to one or both. Gary Clinton a senior name you canparty trust.” I personally handle is every sale/ dental appraiser, a 27-year member ofCertified the Institute of transition and complete Professional Appraisals Business Inc.set I follow the business valuation for whichAppraisers, Congress has guidelines under the North standards of the North American Business Valuationbuyer American Business Valuation Standards Council. If Standards NABVSC. Experience critical your building with the practice,isthere is in nothis purchases Counsel, most complex of business transitions. “For almost 40 charge. Every call is very confidential. General additional years you’ve seen the name...a namesales. 100% you can trust.” I and specialty appraisals and practice funding personally handle every sale/transition800-583-7765. and complete available. DFW 214-503-9696. WATS Professional Certified Appraisals for which Congress has setClinton guidelinesDenton under thePedo/Ortho North American Business Gary Practice Valuation Council. If 2buyer purchases your for Sale:Standards Four chair bay plus operatories equipped; building withunequipped the practice,for there is nochairs; additional charge. 4 more fast growing another bay Every call is veryopportunity. confidential.A free General and specialty area; excellent appraisal can be very appraisals andparty practice sales. 100% funding costly to one or both. Gary Clinton is aavailable. senior DFW WATSmember 800-583-7765. appraiser, a 27-year of the Institute of dental214-503-9696. Business Appraisers, Inc. I follow the business valuation standards of the North American Business Valuation
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GARY CLINTON HOUSTON PRACTICES FOR SALE: H-1 Standards Counsel, NABVSC. Experience is critical in this Far North of Woodlands Near 7-figurealmost gross with complex of businessArea. transitions. “For 40 most 5 operatories; exceptional recall;name well you established. Digital years you’ve seen the name...a can trust.” I equipment. A premier Hygieneand profits will cover everypractice. sale/transition complete personally handle debt service.Certified H-2 Southeast Houston/Pearland Area: Professional Appraisals for which Congress Retiring dentist. Very desirable practice; digitally equipped has set guidelines under the North American Business with 4 operatories professional center above average StandardsinCouncil. If buyer purchases your Valuation gross on with 4 days. free appraisal very costly to one building theApractice, there can is nobe additional charge. party Gary Clinton is a senior dental appraiser, a callboth. is very confidential. General and specialty Every or 27-year member of the sales. 100% Institute of Business Appraisers, appraisals and practice funding available. Inc. I follow the business valuation standards of the North DFW 214-503-9696. WATS 800-583-7765. American Business Valuation Standards Counsel, NABVSC. Experience is critical in this most complexfor of business Gary Clinton Houston Practices Sale: H-1 transitions. almost 40 years you’ve seengross the name...a Woodlands Area. Near 7 figure with 5 Far North of “For name you can trust.” I personally handle every sale/ exceptional recall; well-established. Digital operatories; transition and completepractice. Hygiene Professional Certified A premier profitsAppraisals will cover equipment. for Congress has set guidelines under theArea: North service. H-2 Southeast Houston/Pearland debtwhich American Business Valuation Standards buyer Retiring dentist. Very desirable practice;Council. digitally Ifequipped purchases your building with the practice, thereaverage is no in professional center above with 4 operatories additional Everyappraisal call is very General gross on 4 charge. days. A free canconfidential. be very costly to one and appraisals andispractice funding or both. Gary Clinton a seniorsales. dental100% appraiser, a partyspecialty available. DFW 214-503-9696. 800-583-7765. of the Institute WATS of Business Appraisers, 27-year member Inc. I follow the business valuation standards of the North GARY CLINTON NORTH OF DALLAS/DENTON Business Valuation Standards Counsel,AREA NABVSC. American GENERAL PRACTICES SALE:complex D-1 Denton Practice: is critical in FOR this most of business Experience Five operatories; almost nice equipment. 30 plus yearthe dentist 40 years you’ve seen name...a transitions. “For retiring. transition; No lowhandle fee plans. Plano youFlexible can trust.” I personally everyD-2 sale/ name area practice: General dental practice; some implants; transition and complete Professional Certified Appraisals fee-for-service/PPO practice; great visibility. Gross is in the which Congress has set guidelines under the North for 6 figure range. D-3 Valuation Frisco/McKinney area practice:buyer Well American Business Standards Council. If establishedyour restorative/preventive practice;there Grossis near purchases building with the practice, no 7 figures; 6charge. fully equipped operatories; beautiful office Every call is very confidential. General additional withspecialty windowsappraisals overlooking A free appraisal can be and andcreek. practice sales. 100% funding very costly to one party or both. Gary Clinton is a senior available. DFW 214-503-9696. WATS 800-583-7765. dental appraiser, a 27-year member of the Institute of Business Appraisers, Inc. of I follow the business valuation Gary Clinton North Dallas/Denton Area standards the North for American Valuation sale:Business Practice: General of Practices D-1 Denton Standards Counsel, NABVSC. Experience critical in this nice equipment. 30 plusisyear dentist Five operatories; most complex of business almost 40 retiring. Flexible transition;transitions. No low fee“For plans. D-2 Plano years you’ve seen the name...a name you canimplants; trust.” I area practice: General dental practice; some personally handle every sale/transition and complete fee-for-service/PPO practice; great visibility. Gross is in the Professional Certified Appraisals for which Congress area practice: Well 6 figure range. D-3 Frisco/McKinney has set guidelines under the North American established restorative/preventative practice;Business Gross near Valuation Council. If buyer purchases fully equipped operatories; beautiful your office 7 figures; 6Standards building with the practice, there additional with windows overlooking creek.isAno free appraisalcharge. can be Every call isto very General and specialty very costly oneconfidential. party or both. Gary Clinton is a senior appraisals and practice sales. 100% funding available. a 27-year member of the Institute of dental appraiser, DFW 214-503-9696. WATSfollow 800-583-7765. Appraisers, Inc. I the business valuation Business standards of the North American Business Valuation
ADVERTISING BRIEFS Standards GARY CLINTON Counsel, NORTH NABVSC. Experience OF FORT WORTH is critical PRACTICE in this FOR SALE: complex Urgent of business as doctor transitions. “For wants to movealmost out of 40 state most to years pursue you’ve other seen opportunities. the name...a name Great you location can trust.” I with high growth potential; handle 7,000 every records; sale/transition nice equipment; and complete 6 figure personally range Professional collections Certified working Appraisals 112 days forinwhich 2012.Congress Doctor is open has set toguidelines offers. A free under appraisal the North can American be very costly Business to one party or both. Standards Gary Clinton Council. If is a buyer seniorpurchases dental appraiser, your a Valuation 27-year building member with the of practice, the Institute there is ofno Business additional Appraisers, charge. Inc. call is very the business confidential. valuation General standards and specialty of the North EveryI follow American appraisals Business and practice Valuation sales. Standards 100% funding Counsel, available. NABVSC. Experience DFW 214-503-9696. WATS is critical in this most 800-583-7765. complex of business transitions. “For almost 40 years you’ve seen the name...a name Gary you Clinton can trust.” North I personally of Forthandle Worth every Practice sale/ Urgent as doctor wants toCertified move out of state transition for Sale:and complete Professional Appraisals other opportunities. Great with high for to pursue which Congress has set guidelines location under the North American Business Valuation records; Standards nice equipment; Council. If6buyer figure growth potential. 7,000 workingwith 112the days in 2012. Doctor purchases range collections your building practice, there is nois additional open to offers. charge. A free Every appraisal call is very can confidential. be very costlyGeneral to one or both. Gary Clinton a seniorsales. dental100% appraiser, a and partyspecialty appraisals andispractice funding available. 27-year member DFW 214-503-9696. of the Institute WATS of Business 800-583-7765. Appraisers, Inc. I follow the business valuation standards of the North Business Valuation Standards American GARY CLINTON PRACTICES FOR SALE:Counsel, F-1 FortNABVSC. Worth/ criticalFast in this most area. complex of business Experience is Area. Weatherford growing Average gross; 6 almost 40 years the name...a transitions. “For operatories; excellent lease. Few you’ve dentistsseen in area. Seller you canPrimarily trust.” I personally handle every sale/ is name relocating. fee-for-service. A free appraisal transition and complete Certified Appraisals can be very costly to oneProfessional party or both. Gary Clinton is a Congress has set guidelines underofthe senior for which dental appraiser, a 27-year member theNorth Institute American Valuation Standards Council. If buyer of BusinessBusiness Appraisers, Inc. I follow the business valuation your with the practice, is no standards purchases of thebuilding North American Business there Valuation Standards additional Counsel, charge. Every NABVSC. call isExperience very confidential. General is critical in this most and specialty complexappraisals of business and transitions. practice sales. 100% “For almostfunding 40 years you’ve seen the name...a name you 800-583-7765. can trust.” I available. DFW 214-503-9696. WATS personally handle every sale/transition and complete Professional Certified Appraisals whichF-1 Fort Congress Gary Clinton Practices forforSale: Worth/ has set guidelines under growing the North American Business Weatherford Area. Fast area. Average gross; 6 Valuation Standards If buyer purchases your operatories; excellentCouncil. lease. Few dentists in area. Seller building with the practice, there is no additional charge. fee-for-service. A free appraisal is relocating. Primarily Every is very and specialty very costlyconfidential. to one partyGeneral or both. Gary Clinton is a can becall appraisals andappraiser, practice sales. 100% fundingofavailable. senior dental a 27-year member the Institute DFW 214-503-9696. WATS of Business Appraisers, Inc. I800-583-7765. follow the business valuation standards of the North American Business Valuation GARY CLINTON PRACTICES SOUTH OF is DALLAS: Counsel, NABVSC. Experience critical inWaco this Standards area near 7-figure gross 30-year-old generalalmost practice most complex of business transitions. “For 40for sale —you’ve Exceptional practice; excellent recall; seen the name...a name you cancosmetic; trust.” I years implants and restorative; transition and/or personally handle every sale/transition andcomplete completesale; PRN Transition. A freeAppraisals appraisal can veryCongress costly to one Professional Certified for be which party both. Gary Clinton a senior dental Business appraiser, a setorguidelines under theisNorth American has 27-year member of the Institutebuyer of Business Appraisers, Standards Council. If purchases your Valuation building with the practice, there is no additional charge.
Inc. I follow the business valuation standards of the North Every call is very confidential. General and specialty American Business Valuation Standards Counsel, NABVSC. and practice sales. 100% funding available. appraisals Experience is critical in this most complex of business DFW 214-503-9696. WATS 800-583-7765. transitions. “For almost 40 years you’ve seen the name...a name can trust.” I personally handle every sale/ Gary you Clinton Practices South of Dallas: Waco transition and complete Professionalgeneral Certified Appraisals area near 7-figure gross 30-year-old practice for for which Congress practice; has set guidelines North — Exceptional excellent under recall; the cosmetic; sale Americanand Business Valuation Standards Council. If buyer implants restorative; transition and/or complete sale; purchases your building with thecan practice, is to noone Transition. A free appraisal be verythere costly PRN additional charge. Every call isis avery confidential. Generala party or both. Gary Clinton senior dental appraiser, and specialty appraisals and practice sales. 100% funding 27-year member of the Institute of Business Appraisers, available. DFW WATS 800-583-7765. follow the 214-503-9696. business valuation standards of the North Inc. I American Business Valuation Standards Counsel, NABVSC. GARY CLINTON TExAS 2 ORAL is critical in this most SURGERY complex ofPRACTICES: business Experience Oral surgeons retiring; transition. Seller out; almostflexible 40 years you’ve seen thephase name...a transitions. “For work for purchaser PRN. Six figures collected past 3 years; name you can trust.” I personally handle every sale/ room for 2and surgeons. Both are in mid-sized communities. transition complete Professional Certified Appraisals All confidential. Gary Oral Surgery for which Congress hasClinton, set guidelines underAppraiser. the North 1-800-583-7765. Business Valuation Standards Council. If buyer American purchases your building with the practice, there is no GARY CLINTON PRACTICE FOR SALE: charge.WEST EveryDALLAS call is very confidential. General additional Doctor retiringappraisals for healthand reasons; well-established 30+ specialty practice sales. 100% funding and year old practice. High demand lower income area. A 800-583-7765. available. DFW 214-503-9696. WATS free appraisal can be very costly to one party or both. Gary is a senior appraiser, a 27-year GaryClinton Clinton 2 Oral Practices: Texasdental Surgery member of theretiring; Instituteflexible of Business Appraisers, Inc. I out; Oral surgeons transition. Seller phase followfor thepurchaser business PRN. Six valuationfigures standards of thepast North collected 3 years; work American Valuation Counsel, NABVSC. room for 2Business surgeons. Both areStandards in mid sized communities. Experience is critical inClinton, this most complex business confidential. Gary Oral SurgeryofAppraiser. All transitions. “For almost 40 years you’ve seen the name...a 1-800-583-7765. name you can trust.” I personally handle every sale/ transition and complete Professional Certified Appraisals Gary Clinton West Dallas Practice for Sale: for which Congress has setreasons; guidelines under the North retiring for health well-established 30+ Doctor American BusinessHigh Valuation Standards Council. If buyer year old practice. demand lower income area. A purchases yourcan building with theto practice, there is no free appraisal be very costly one party or both. additional charge. Everydental call is appraiser, very confidential. Gary Clinton is a senior a 27-yearGeneral and specialty appraisals practiceAppraisers, sales. 100%Inc. funding of the Institute and of Business I member available. 214-503-9696. WATS 800-583-7765. the DFW business valuation standards of the North follow American Business Valuation Standards Counsel, NABVSC. GARY CLINTON WEST TExAS “BIG COUNTRY” Experience is critical in this most complex of business PRACTICE FOR SALE: dentist in small transitions. “For almostOnly 40 years you’ve seenprogressive the name...a community. dental high nethandle practice. Upgraded you canFamily trust.” I personally every sale/ name Equipment. A free appraisal can be very costly Appraisals to one transition and complete Professional Certified party or both. Garyhas Clinton is a seniorunder dentalthe appraiser, which Congress set guidelines North a for 27-year member ofValuation the Institute of Business Appraisers, American Business Standards Council. If buyer Inc. I followyour the building businesswith valuation standards of the North purchases the practice, there is no American Business Valuation Counsel, NABVSC. charge. Every call isStandards very confidential. General additional Experience is critical in this complex of business specialty appraisals andmost practice sales. 100% funding and available. DFW 214-503-9696. WATS 800-583-7765. Texas Dental Journal l www.tda.org l June 2013
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ADVERTISING BRIEFS transitions. Gary Clinton “For West almostTexas 40 years “Big you’ve Country” seen the name...a name Practice you can fortrust.” Sale:I personally Only dentist handle in small every progressive sale/ transition community. Family and complete dental Professional high net practice. Upgraded Certified Appraisals for Equipment. which Congress A free appraisal has set guidelines can be very under costly thetoNorth one party or both. Gary American Business Valuation Clinton isStandards a senior dental Council. appraiser, If buyera purchases 27-year member your building of the Institute with theof practice, Business there Appraisers, is no Inc. I followcharge. the business valuation of the North additional Every call is very standards confidential. General and American Specialty Business Appraisals Valuation & Practice Standards Sales. Counsel, 100% funding NABVSC. available. ExperienceDFW is critical 214-503-9696. in this mostWATS complex 800-583-7765. of business transitions. “For almost 40 years you’ve seen the name...a name GARY you CLINTON, can trust.” BROKER/SENIOR I personally handle APPRAISER/ every sale/ and complete Professional Certified Appraisals transition CONSULTANT WITH ALMOST 40 YEARS IN DENTISTRY: for We which need sellers Congress — general has set guidelines and specialty under practices! the North We American Businessbuyers. Valuation Standards buyer have pre-qualified When we sellCouncil. If your practice, if purchases youroffice, building with thereal practice, is no you own your there is no estatethere commission. additional Gary Clinton charge. — PMA. Every I need call ispractices very confidential. General in or near Austin, and SpecialtyDFW Appraisals & Practice funding San Antonio, and Houston areaSales. 100% and other metro available. DFW Texas locations which 214-503-9696. WATS are in high demand. 800-583-7765. Call me confidentially. 1-880-583-7765 or 214-503-9696 Dallas area. Gary Clinton, Broker/Senior Appraiser/ Consultant with almost 40 years in dentistry: We need sellers — general and specialty practices! GENERAL: Houston (I-45 North) 6-figure gross with We have net pre-qualified buyers. When wefor sell your practice, high income. Six-figure income dentist. Growth if you own yourwithin office,patient there is no real opportunity base. Wellestate caredcommission. for facilities Gary 7Clinton — PMA. I practices in or near with operatories. Call need DDR AT 800-930-8017 or Austin, www. San Antonio, DFW and Houston area and other metro ddrdental.com. Texas locations which are in high demand. Call me confidentially. 1-880-583-7765 214-503-9696 Dallas GENERAL: Golden Triangle (PortorArthur): Six-figure gross area.very high net income practice in small gulf coast town. and Dentist earns 6 figures per year for work 4 days a week. 2,200 GENERAL: sq ft Houston with 6 fully (I-45 equipped North) 6-figure operatories, gross4with dentist and high 2 hygiene. Extensively remodeled 2001. RealGrowth estate for net income. Six-figure incomeinfor dentist. sale. opportunity Single tenant, stand-alone 30-plus space within patient base.building, Well cared for facilities parking bordered byCall 2-lane and residential area. with 7 operatories. DDRstreet AT 800-930-8017 or www. High ddrdental.com. patient growth. Patients from major employers such as Shell, DuPont, Texaco, Chevron and Shell. Call DDR AT 800-930-8017 or www.ddrdental.com. GENERAL: Golden Triangle (Port Arthur): Six-figure gross and very high net income practice in small gulf coast town. GENERAL: Houston (Bellaire/Post Dentist earns 6 figures per year forOak): workTerrific 4 daysgrowth a week. practice great facilities nested in neighborhoods 2,200 sq with ft with 6 fully equipped operatories, 4 dentistand and schools. Fronts high traffic Chimney and for 2 hygiene. Extensively remodeled in Rock. 2001.Interior Real estate equipment 2009. Totalbuilding, of 8 operatories plumbed sale. Single rebuilt tenant,instand-alone 30-plus space with 4 operatories in 2-lane use. Free-standing building with parking bordered by street and residential area. 7,000 total sqgrowth. ft, also Patients for sale. from Call DDR AT employers 800-930-8017 High patient major suchor www.ddrdental.com as Shell, DuPont, Texaco, Chevron and Shell. Call DDR AT 800-930-8017 or www.DDRDental.com. GENERAL DENTIST: Lone Star Family Health Center. Our federally center has an opening for a GENERAL:qualified Houstonhealth (Bellaire/Post Oak): Terrific growth practice with great facilities nested in neighborhoods and
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full-time generalhigh dentist who would Rock. see a variety schools. Fronts traffic Chimney Interiorof and patients, provide dental cleanings equipment rebuiltrestorative in 2009. Total of 8services, operatories plumbed and near Houston in a highly withextractions. 4 operatoriesWe in are use.very Free-standing building with desirable offer competitive excellent or 7,000 totalarea. sq ft,We also for asale. Call DDR salary, AT 800-930-8017 benefits and we are a loan repayment site. Applications www.drdental.com will be held in confidence. For further information please contact usDENTIST: at jfaulkner@lonestarfamily.org. GENERAL Lone Star Family Health Center. Our federally qualified health center has an opening for a GERIATRIC DENTAL IS LOOKING full-time general dentist who wouldFOR seeDENTISTS a variety ofTO WORK 1 provide TO 3 DAYS A WEEKdental AT NURSING patients, restorative services,HOMES cleaningsIN THE extractions. We FOLLOWING AREAS: North FortinWorth/midand are very nearTexas: Houston a highly cities; Central Waco/Temple; South Texas: Weslaco/ desirable area.Texas: We offer a competitive salary, excellent McAllen/Brownsville (Spanish) is desired). The benefits and we are a(bilingual loan repayment site. Applications daysbe ofheld workinare flexible between Monday and Saturday will confidence. For further information please and are us typically 8:00 AM to 5:00 PM. The ideal candidate contact at jfaulkner@lonestarfamily.org. should be a licensed dentist with a background in Geriatric Dentistry and over 3 years of service. Dental Services is looking for dentists to Geriatric Dental Offered: fillings, extractions, dentures, work 1cleanings, to 3 daysX-rays, a week at nursing homes in and surgery. Description of services: comprehensive the oral following areas: North Texas: Fort Worth/midexams,Central explanation of treatment options, of cities; Texas: Waco/Temple; Southtraining Texas: Weslaco/ nursing home staff on(bilingual proper daily oral hygiene. If you are McAllen/Brownsville (Spanish) is desired). The interested in this position, please email jodywilliamson@ days of work are flexible between Monday and Saturday gmail.com with your current resume. Youcandidate can and are typically 8:00most AM to 5:00 PM. The ideal contactbe him after submitting youraresume at 512-695should a licensed dentist with background in Geriatric 3138. Thisand is aover contract job.ofPrincipals only. Recruiters, Dentistry 3 years service. Dental Services please don’t contactX-rays, this job poster. Please do dentures, not contact Offered: cleanings, fillings, extractions, job poster about other services, productscomprehensive or commercial and oral surgery. Description of services: interests. exams, explanation of treatment options, training of nursing home staff on proper daily oral hygiene. If you are GOLIAD: Associate/buy-in interested in this position, partnership please emailopportunity jodywilliamson@ available inwith highyour producing and high collection practice. gmail.com most current resume. You can 100% fee-for-service practice.your If you have excellent contact him after submitting resume at 512-695communication skills, a job. Principals light touch andonly. above average 3138. This is a contract Recruiters, skills, we should meet. Our Cerec technology, please don’t contact this jobpractice poster. uses Please do not contact places and about restores implants, is 100% digital has a job poster other services, products or and commercial high emphasis on cosmetic dentistry. Great emphasis on interests. patient comfort with oral sedation used extensively. Our town hasAssociate/buy-in an excellent school district and our patients have GOLIAD: partnership opportunity a great appreciation for quality Visit our website available in high producing and dentistry. high collection practice. at www.goliaddentalcare.com. Danexcellent Garza at 361100% fee-for-service practice. IfCall youDr have 645-2381 or email dmolar@sbcglobal.net. communication skills, a light touch and above average skills, we should meet. Our practice uses Cerec technology, GP / ORTHODONTIC OPPORTUNITY KNOCKING! places and restores implants, is 100%ISdigital and hasAre a you aemphasis GP with orthodontic you like on high on cosmeticinterests? dentistry. Would Great emphasis to learncomfort more about possibilityOur patient withorthodontics oral sedationwith usedthe extensively. of limiting toexcellent orthodontics some day?and Do our youpatients like the have town has an school district of small town living, no traffic jams, aVisit paradise for aidea great appreciation for quality dentistry. our website outdoor activities and yet only aCall short ride Garza to large at www.goliaddentalcare.com. Dr Dan at town 361645-2381 or email dmolar@sbcglobal.net.
ADVERTISING BRIEFS amenities? GP / ORTHODONTIC Here is your OPPORTUNITY chance. In the IS small KNOCKING! town ofAre you a GP withOK Tishomingo, orthodontic we have aninterests? opportunity Would for the youright like to learntomore person become about anorthodontics associate (with with buyout the possibility future) to join aofbusy limiting 9 chair to orthodontics GP-orthodontic some clinic day? with Docurrently you like the over ideaorthodontic 600 of small town cases living, in progress. no traffic The jams,goal a paradise is for thefor right outdoortoactivities person start practicing and yetrestorative only a shortdentistry ride to large 90% town and amenities? Here your chance. In the small town of year orthodontics 10%isthe first year, with each succeeding Tishomingo, moving forward OK we toward haveaan fullopportunity orthodonticfor practice. the right Even if person you have toan become orthodontic an associate interest(with but are buyout low on future) confidence, to join anot busy a problem. 9 chair GP-orthodontic Dr Austin has been clinicteaching with currently orthodontics over to 600 GPs for orthodontic 20 years. cases If interested, in progress. please The contact goal isDrfor Austin the right at person to startorpracticing restorative dentistry 90% and 580-371-2396 ronaustin79@gmail.com. orthodontics 10% the first year, with each succeeding year moving HARLINGEN/TExAS VALLEY. One full-time or 2 part-time Even if forward toward a full orthodontic practice. positive, you have skillful an orthodontic general dentists interest needed. but are low Well onestablished confidence, practice, not a problem. ownedDrbyAustin Dr Joehas B. been Whitley, teaching servesorthodontics children ages to 12 GPstofor 1720 delivering years. If interested, preventive,please restorative, contactand Dr some Austin at prosthetic 580-371-2396 services. or ronaustin79@gmail.com. Excellent fee schedule no Medicaid or DMOs. Virtually no down time and doctor compensated based on production, Valley. not collection. Please send all HARLINGEN/Texas One full-time or 2 part-time queries/CVs to whitleydental@aol.com call Pam at 361positive, skillful general dentists needed.orWell established 991-7207. practice, owned by Dr Joe B. Whitley, serves children ages 12 to 17 delivering preventive, restorative, and some HILL COUNTRY WEST AUSTINfee AREA: Sherrino L. Henderson prosthetic services. Excellent schedule Medicaid or & Associates, LLCno- down This istime an exceptional for DMOs. Virtually and doctoropportunity compensated abased General DDS to become an associate in thesend Lakeway on production, not collection. Please all area. (3,250 to sq whitleydental@aol.com ft, 7 ops, in-house lab, paperless andat7361queries/CVs or call Pam full-time 991-7207.staff members). Work days: Tuesday - Friday and 1 Saturday per month (Five days per week available and monthly guarantee if desired). Training implants, HILLaCOUNTRY WEST AUSTIN AREA: Sherri L. in Henderson endodontics oral surgery would be a great benefit.for & Associates,and LLC This is an exceptional opportunity Location are available. Call Sherri @ 972-562a Generalpictures DDS to become an associate in the Lakeway 1072 214-697-6152. area. or (3,250 sq ft, 7 ops, in-house lab, paperless and 7 full-time staff members). Work days: Tuesday - Friday HOUSTON ANDper SANmonth ANTONIO: Care per For week Kids, aavailable pediatric and 1 Saturday (Five days focused practice, is opening new practices in the San guarantee if desired). Training in implants, and a monthly Antonio and Houston area. Wewould are looking for energetic endodontics and oral surgery be a great benefit. full-time general dentists and pediatric dentists to join are available. Call Sherri @ 972-562Location pictures our We offer a comprehensive compensation and 1072team. or 214-697-6152. benefits package including medical, life, long- and shortterm disability flexibleCare spending, and 401(K) HOUSTON ANDinsurance, SAN ANTONIO: For Kids, a pediatric with employer contribution. Newpractices graduatesinand practice, is opening new the dentists San focused with experience are welcome. part of our outstanding and Houston area. WeBe area looking for energetic Antonio team, providing for TexasĂ kids. Please contact Anna full-time generalcare dentists and pediatric dentists to join Robinson 913-322-1447; e-mail arobinson@amdpi.com; our team.at We offer a comprehensive compensation and FAX: 913-322-1459. benefits package including medical, life, long- and shortterm disability insurance, flexible spending, and 401(K) with employer contribution. New graduates and dentists with experience are welcome. Be a part of our outstanding
HOUSTON AREA:care Great for a pediatric foropportunity TexasĂ kids. Please contact Anna team, providing dentist. part-time positione-mail available now in the Houston RobinsonA at 913-322-1447; arobinson@amdpi.com; area. Flexible scheduling and a great work environment. FAX: 913-322-1459. Already established a flow of patients. Requirements: HOUSTON Great opportunity for a pediatric Texas StateAREA: license. For more information, please e-mail dentist. A part-time position available now in the Houston mydentalsmile@gmail.com. area. Flexible scheduling and a great work environment. HOUSTON, DALLAS, aSAN HealthDrive is seeking Already established flowANTONIO: of patients. Requirements: part-time a mobile practice providing license.We Forare more information, please e-mailthe Texas Statedentists. highest standard of dental care to the elderly residents of mydentalsmile@gmail.com. extended care facilities. Please contact Tanya Jones at 857HOUSTON,orDALLAS, SAN ANTONIO: HealthDrive is seeking 255-0293 tjones@healthdrive.com. part-time dentists. We are a mobile practice providing the HOUSTON/AUSTIN/DFW: GP/special interestresidents in highest standard of dental care to the elderly of endodontics. Associate, buy-in and partnership extended care facilities. Please contact Tanya Jones at 857opportunities. Mobile/itinerant/portable dental practice 255-0293 or tjones@healthdrive.com. for sale area mostly endodontics; in multiple quality GP offices; low overhead; greatGP/special lifestyle; GPR/AEGD Houston/Austin/DFW: interest inpreferred; 3 to 5 years private practice experience. Contact infohr@ endodontics. Associate, buy-in and partnership vipsdental.com or 972-955-9135. opportunities. Mobile/itinerant/portable dental practice for sale area mostly endodontics; in multiple quality GP KILLEEN: Dental office building for sale in a very busy offices; low overhead; great lifestyle; GPR/AEGD preferred; professional plaza, near Killeen Civic Center, 2,047 sq ft. 3 to 5 years private practice experience. Contact infohr@ Office condo, 5 ops, 1 steri center, 1 X-ray room for pano, 2 vipsdental.com or 972-955-9135. offices, 1 reception room, 1 patient waiting room, 1 break room, 2 storages, 1 unisex restroom, telephones with KILLEEN: Dental office building for sale5 in a very busy voicemail, 9 speakers with amp. Entire office is networked professional plaza, near Killeen Civic Center, 2,047 sq ft. with For5 details please call Laurie 254-519-2875, OfficeCAT-5. condo, ops, 1 steri center, 1 X-rayatroom for pano, 2 e-mail cfdental1@gmail.com. offices, 1 reception room, 1 patient waiting room, 1 break room, 2 storages, 1 unisex restroom, 5 telephones with MCALLEN AREA. Growing and expanding pediatric dental voicemail, 9 speakers with amp. Entire office is networked practice has immediate position for a full-time pediatric with CAT-5. For details please call Laurie at 254-519-2875, dentist. We are looking for an enthusiastic, skilled clinician e-mail cfdental1@gmail.com. with a strong work ethic. Our core value is to treat our patients if theyGrowing were ourand own family. Our office has MCALLENasAREA. expanding pediatric dental state-of-the-art equipment including digital radiographs practice has immediate position for a full-time pediatric and computerized records. Weenthusiastic, offer conscious sedation We are looking for an skilled clinician dentist. in office and general anesthesia at local hospital. have our with a strong work ethic. Our core value is to treatWe apatients well-trained staff. Our practice is located in one of the as if they were our own family. Our office has fastest communities in America. Rio Grande Valley offers state-of-the-art equipment including digital radiographs aand multitude of activities, a vibrant nightlife and is a short computerized records. We offer conscious sedation one hour drive to South Padre Island. Compensation in office and general anesthesia at local hospital. We have on collection. Desirable toisbelocated fluent in in one Spanish. We well-trained staff. Our practice of the abased provide work Visa/ green card sponsorship. Interested fastest communities in America. Rio Grande Valley offers candidates contacta Dr Daniel Mego at 956-854a multitudeplease of activities, vibrant nightlife and is a short 4146, dfmego@gmail.com. one hour drive to South Padre Island. Compensation based on collection. Desirable to be fluent in Spanish. We MEDICAL CENTER AREAcard PRACTICE FOR SALE. provide work Visa/ green sponsorship. Interested Partnership dissolving. Priced below market. Call Jim candidates please contact Dr Daniel Mego at 956-854Robertson 713-688-1749. 4146, dfmego@gmail.com. Texas Dental Journal l www.tda.org l June 2013
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ADVERTISING BRIEFS MIDLAND: Medical Center One of the Area fastest Practice growingfor citiessale. in Texas needs aPartnership dynamic, caring, dissolving. Priced patient-focused below dentist market. Call to join our Jim growing Robertson 713-688-1749. practice. Associate and/or buy-in opportunities are available. Please contact Dr Britt Bostick, DDS at bbost35821@aol.com MIDLAND: One of the fastest or call 806-438-5745. growing cities in Texas needs a dynamic, caring, patient-focused dentist to join our ORTHODONTIC Associate FOR and/or SALE: buy-in 5 chair opportunities orthodontic growing practice.PRACTICES practice are available. in McKinney. Please contact Eight chair Dr Britt orthodontic Bostick, DDS office at in Arlington. Texas Practice orTransitions, call 806-438-5745. Inc. Rich Nicely has bbost35821@aol.com been serving Texas dentists since 1990. Visit www.tx-pt. com ORTHODONTIC or call at 214-460-4468; PRACTICES FOR rich@tx-pt.com. SALE: 5 chair orthodontic practice in McKinney. Eight chair orthodontic office in PARIS Arlington. / WYLIE: TexasGreat Practice opportunity Transitions, forInc. a pediatric Rich Nicely dentist has Texas dentists since www.tx-pt. to been joinserving our expanding practice. We1990. Visit are actively looking comthe or right call atassociate 214-460-4468; for who is Rich@tx-pt.com. interested in a once in a lifetime opportunity. We are opening a third location to PARIS / WYLIE: opportunity a pediatric dentist our practice justGreat 1 hour outside of for Dallas. The need for atopediatric join our expanding dentist in the practice. area isWe tremendous are actively and looking we are associate who is interested in a direction. once in a the for the onlyright pediatric office within 50 miles any We lifetime are looking opportunity. for someone We are who opening is personable, a third location caring, to justa1fast-paced hour outside of Dallas. The needinfora energetic, our practice loves working environment dentist in theWe area tremendous are busy a pediatric pediatric practice. areiswilling to trainand thewe right office 50 miles direction. the only pediatric individual if working withwithin children is yourany ambition. If for you someone is personable, caring, We are you joinlooking our team, will bewho personally mentored by loves a afast-paced working environment Dr energetic, Allen Pearson, board certified pediatric dentist,in a pediatric are willing to to develop train the right and busyyou will bepractice. given theWe opportunity working with your ambition. If experience individual ifin all facets of children pediatricisdentistry, including: you join our team, you will beoral personally mentored by IV behavior management, using conscious sedation, board certified pediatric dentist, sedation Dr Allen Pearson, as well asa practice and business management. Current and you associate will be given is producing the opportunity gross personal to develop income of experience 6 figures in plus all on facets a 4-day of pediatric work week, dentistry, working including: only 11 months year. For moreusing information, oral conscious pleasesedation, visit our IV behavioramanagement, web sites:aswww.wyliechildrensdentistry.com and www. sedation well as practice and business management. parischildrensdentistry.com. your CV to Current associate is producingPlease gross e-mail personal income allenp12345@gmail.com. of 6 figures plus on a 4-day work week, working only 11 months a year. For more information, please visit our PEDIATRIC PRACTICE FOR SALE: Very large private and www. web sites: www.wyliechildrensdentistry.com pediatric practice in large metropolitan areayour in Texas, parischildrensdentistry.com. Please e-mail CV tomix of PPO and Medicaid in a beautiful, free standing 5,000 allenp12345@gmail.com. sq ft building with 10 chairs. Highly profitable private practice established years. Texas Transitions, PEDIATRIC PRACTICE30 FOR SALE: VeryPractice large private Inc. Rich Nicely hasinbeen Texas dentists since 1990. practice largeserving metropolitan area in Texas, mix pediatric Visit www.tx-pt.com or call at 214-460-4468; rich@tx-pt. of PPO and Medicaid in a beautiful, free standing 5,000 com. sq ft building with 10 chairs. Highly profitable private practice established 30 years. Texas Practice Transitions, SAN ANGELO: 5 operatory, Inc. Rich NicelyFor hassale: beenExcellent serving Texas dentists35-year-old since 1990. general practice. Recently remodeled location in a busy Visit www.tx-pt.com or call at 214-460-4468; rich@tx-pt. complex. Solid fee-for-service patient base. All modern com. equipment. Solid hygiene program. Mid- to high-6 figure
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collections consistently, 98% collections rate. 35-year-old Recent SAN ANGELO: For sale: Excellent 5 operatory, practice appraisal. Other unique perks location to this practice. remodeled in a busy general practice. Recently Doctor moving out of state, willing to negotiate on price, complex. Solid fee-for-service patient base. All modern and transition details as well as sell/lease of high-6 building. hygiene program. Mid- to figure equipment. Solid Please inquire by e-mail 98% at texasdentistry@hotmail.com. collections consistently, collections rate. Recent practice appraisal. Other unique perks to this practice. SAN ANTONIO WEST: Associate needed.on price, moving NORTH out of state, willing to negotiate Doctor Established general practice seekingofquality and transition detailsdental as well as sell/lease building. oriented associate. New at graduate and experienced by e-mail texasdentistry@hotmail.com. Please inquire dentists welcome. GPR, AEGD preferred. Please contact Dr Henry Chu at 210-684-8033 orAssociate versed0101@yahoo.com. SAN ANTONIO NORTH WEST: needed. Established general dental practice seeking quality SUGAR CYPRESS, PEARLAND AND THE orientedLAND, associate. New graduate and experienced WOODLANDS: Full-GPR, and AEGD part-time positions available. Well preferred. Please contact Dr dentists welcome. established rapidly growing practices that offer great 210-684-8033 or versed0101@yahoo.com. Henry Chu atand financial opportunity. High income potential and future equity E-mail CVPEARLAND to Dr MikeAND Kesner, SUGARposition. LAND, CYPRESS, THEdrkesner@ madeyasmile.com. WOODLANDS: Full- and part-time positions available. Well established and rapidly growing practices that offer great TExAS PRACTICE TRANSITIONS, Rich and Nicely financial opportunity. High income INC. potential future has been serving Texas dentists since 1990. Visit www. equity position. E-mail CV to Dr Mike Kesner, drkesner@ tx-pt.com or call at 214-460-4468; Rich@tx-pt.com. madeyasmile.com. ORTHODONTIC PRACTICES: 5 chair orthodontic practice in McKinney. EightTransitions, chair orthodontic office Arlington. Practice Inc. RichinNicely Texas PEDIATRIC: Very large pediatric practice inwww. large been serving Texasprivate dentists since 1990. Visit has metropolitan area Texas, mix of PPO and Medicaid in tx-pt.com or call atin214-460-4468; Rich@tx-pt.com. a beautiful, freePRACTICES: standing 5,000 sq ftorthodontic building with 10 5 chair practice ORTHODONTIC chairs. Highly profitable practice established 30 in McKinney. Eight chairprivate orthodontic office in Arlington. years. MCKINNEY: Mid-sized in 5 treatment Very large privatecollections pediatric practice in large PEDIATRIC: rooms in a beautifully finished 100% metropolitan area in Texas, mixfacility, of PPOpaperless, and Medicaid in digital practice with a digital pano. NORTH TEXAS: a beautiful, free standing 5,000 sq ft building with Large 10 prosthodontic practice 30 minutes from established Dallas, premier Highly profitable private practice 30 chairs. free standing building with 7 ops, 100% digital, 100% full years. MCKINNEY: Mid-sized collections in 5 treatment fee. RURAL 30 MINUTES FROMfacility, DALLAS.paperless, Smaller practice rooms in a beautifully finished 100% in a nice free standing building, digital X-rays, 100%Large full digital practice with a digital pano. NORTH TEXAS: fee. DALLAS SUBURB: Large practice, 6 ops, 100% digital, prosthodontic practice 30 minutes from Dallas, premier 1,900standing full fee patients, 8 days of hygiene. WEST 100% TEXAS,full building with 7 ops, 100% digital, free small practice Panhandle area.DALLAS. Smaller ONE HOUR NORTH OF 30inMINUTES FROM practice fee. RURAL HOUSTON: Medium-sized full-fee practice, free-standing in a nice free standing building, digital X-rays, 100% full building, digital X-rays. EAST TEXAS: low100% overhead, fee. DALLAS SUBURB: Large practice,Very 6 ops, digital, medium full fee practice in hygiene. free standing 1,900 fullsized fee patients, 8 days of WESTbuilding. TEXAS, small practice in Panhandle area. ONE HOUR NORTH OF THE HINDLEY GROUP, LLC full — DALLAS PRACTICE SALE: Very HOUSTON: Medium sized fee practice, free standing busy, thriving general dental practice with exceptional building, digital X-rays. EAST TEXAS: Very low overhead, revenuessized and profit operatories medium full feemargin. practiceSix infully-equipped free standing building. with OpTime digital X-ray system in 3,000 sq ft facility. NewHINDLEY patients average month. PRACTICE Large Medicaid THE GROUP, 52 LLCper — DALLAS SALE: Very component. Call 800-856-1955 or email exceptional busy, thriving general dental practice withjenny@ thehindleygroup.com. and profit margin. Six fully-equipped operatories revenues
ADVERTISING BRIEFS with OpTime digital X-ray system in 3,000 sq ft facility. patients average month. Large Medicaid NewHINDLEY THE GROUP, 52 LLCper - NORTH OF HOUSTON component. Call PRACTICE SALE: Well-established 800-856-1955 or30-year-old email jenny@ general thehindleygroup.com. dental practice with high revenues on 4 days per week. Five fully equipped operatories with 2 dedicated to THE HINDLEY GROUP, - NORTH HOUSTON hygiene. ScanX digital LLC X-ray system!OFExcellent staff PRACTICE SALE: general and mentor! CallWell-established 800-856-1955 or30-year-old email jenny@ dental practice with high revenues on 4 days per week. thehindleygroup.com. Five fully equipped operatories with 2 dedicated to hygiene. ScanX THE HINDLEY GROUP, digital LLC X-ray - SOUTH system! Excellent OF HOUSTON staff and mentor! CallPRACTICE 800-856-1955 email jenny@ ORTHODONTIC SALE:or Recently opened thehindleygroup.com. orthodontic practice office in 3,500 sq ft building with 5 fully equipped treatment rooms! Mostly pediatric (40 THE HINDLEY GROUP, LLCcompetition - SOUTH OFand HOUSTON cases in bands). Limited motivated seller! ORTHODONTIC PRACTICE Great opportunity for startSALE: up orRecently satellite!opened Call 800-856practice office in 3,500 sq ft building with 5 orthodontic 1955 or email jenny@thehindleygroup.com. fully equipped treatment rooms! Mostly pediatric (40 casesHINDLEY THE in bands). Limited GROUP, LLC: competition ASSOCIATESHIPS and motivated — NEWseller! for start upASSOCIATESHIP: or satellite! Call Well 800-856LISTING Great opportunity — WEST HOUSTON established 1955 or email family jenny@thehindleygroup.com. general dental practice. Strong revenues on 4 days per week. Seven fully equipped operatories with 3 usedLLC: forASSOCIATESHIPS hygiene. Direct digital THE HINDLEY GROUP, — NEW X-rays. patients per month. Pre-determined LISTING30—new WEST HOUSTON ASSOCIATESHIP: Well established buy-in terms. Greatgeneral mentor! dental NEWpractice. LISTINGStrong SOUTH OF family revenuesASSOCIATESHIP: DALLAS on 4 days per week. LargeSeven thriving fully family equipped general dental operatories practice withlocated 3 usedinfor moderate hygiene.size Direct suburb digital south of Dallas. X-rays. 30 Associate new patients wanted per tomonth. Pre-determined join a 2 doctor practice and eventually buy-in terms. buy-out of senior doctor.SOUTH Beautiful Greatinterest mentor! NEW LISTING OF new DALLAS fully facility; ASSOCIATESHIP: digitized with Large 7 fully thriving equipped family operatories general and dental an practice additional located 3 hygiene in moderate rooms and size2suburb portable south hygiene of Dallas. Associate carts. Very strongwanted revenues to and join healthy a 2 doctor profit practice margin. and eventually buy-out Outstanding staff and interest excellent of senior mentors! doctor. Pre-determined Beautiful new facility;terms. buy-in fully digitized SOUTH with TEXAS 7 fully ASSOCIATESHIP: equipped operatories Busy general and an practice dental additional in small 3 hygiene townrooms near McAllen, and 2 portable Texas. hygiene Fully carts. Very digital office, strong modern revenues equipment, and healthy excellent, profit dedicated margin. Outstanding staff! Strongstaff revenues. and excellent Doctor mentors! Pre-determined wishes to bring on a buy-in associate young terms. SOUTH to train TEXAS and mentor ASSOCIATESHIP: and eventually Busy general sell dental practice out 100%. Pre-determined in small town buy-in nearterms McAllen, secure Texas. Fully guess-less digital opportunity office,for modern transition equipment, to ownership. excellent, SOUTHWEST dedicatedOF staff! Strong HOUSTON ASSOCIATESHIP: revenues. Doctor Thriving wishes family to bring general on adental young practice associate located in to small train and townmentor approximately and eventually 30 minutes sell out from100%. the coast. Pre-determined Doctor hasbuy-in historyterms in thesecure area and guess-less good opportunity reputation which for transition generates toover ownership. 50 newSOUTHWEST patients per OF HOUSTON month. Beautiful ASSOCIATESHIP: new facility! Thriving Very family stronggeneral one doctor dental practice revenueslocated on 4Ω days in small pertown week.approximately Excellent mentor! 30 minutes Prefrom determined the coast. Doctor buy-in terms. hasCall history 800-856-1955 in the areaorand email good reputation jenny@thehindleygroup.com. which generates over 50 new patients per month. Beautiful new facility! Very strong one doctor revenues on 4Ω days per week. Excellent mentor! Pre-
THE HINDLEYbuy-in GROUP, terms. Call LLC — NEW 800-856-1955 LISTING —-or HOUSTON email determined GENERAL DENTAL PRACTICE SALE: Newly established jenny@thehindleygroup.com. general dental practice just outside 610 Loop. Open 6 days a week. 5,200 sq ft facility withLISTING 7 fully equipped THE HINDLEY GROUP, LLC — NEW —- HOUSTON GENERAL DENTAL operatories. DirectPRACTICE digital X-ray. SALE: Mostly Newly fee-for-service established and general PPO. 50 dental new patients month. High Call6800practiceper just outside 610revenues. Loop. Open 856-1955 or email days a week. 5,200jenny@thehindleygroup.com. sq ft facility with 7 fully equipped operatories. Direct digital X-ray. Mostly fee-for-service and THE GROUP,per LLCmonth. — URGENT — Call 800PPO.HINDLEY 50 new patients High LISTING revenues. 856-1955 or VICTORIA GENERAL email jenny@thehindleygroup.com. DENTAL PRACTICE SALE: Doctor recently passed away unexpectedly leaving well established, dental with strong—restorative THE HINDLEYgeneral GROUP, LLC —practice URGENT LISTING revenues healthyDENTAL profit margin. Open 4 days a week. VICTORIAand GENERAL PRACTICE SALE: Doctor recently passed Remodeled interior and updated to leaving digital X-rays away unexpectedly well at end established, of 2012. Experienced general dental loyal staff practice remain withwith strong temporary restorative doctors keeping the office open. Calla 800revenuesand andhygienists healthy profit margin. Open 4 days week. Remodeled 856-1955 orinterior email jenny@thehindleygroup.com. and updated to digital X-rays at end of 2012. Experienced loyal staff remain with temporary doctors THE HINDLEY GROUP, LLC — ALBUQUERQUE, and hygienists keeping the office open.NEW Call 800MExICO DENTAL PRACTICE SALE: Same location 856-1955GENERAL or email jenny@thehindleygroup.com. for 8 years. Three fully equipped operatories. Steady THE HINDLEY growth with 20-40 GROUP, newLLC patients — ALBUQUERQUE, per month. Significant NEW Medicaid with growing PPOPRACTICE revenues.SALE: Call 800-856-1955 MEXICO GENERAL DENTAL Same location for 8 or email years. jenny@thehindleygroup.com. Three fully equipped operatories. Steady growth with 20-40 new patients per month. Significant Medicaid THE HINDLEY withGROUP, growingLLC PPO —revenues. NEW LISTING Call 800-856-1955 — or email jenny@thehindleygroup.com. NORTHWEST HOUSTON GENERAL DENTAL PRACTICE SALE: Well established, very traditional practice with moderate fee-for-service and healthy THE HINDLEY GROUP, LLCrevenues — NEW LISTING — profit margin. OpenHOUSTON 4 days a week. 1,200DENTAL sq ft facility with 3 NORTHWEST GENERAL PRACTICE fully operatories. retiring. Call with 800-856SALE:equipped Well established, veryDoctor traditional practice 1955 or email jenny@thehindleygroup.com. moderate fee-for-service revenues and healthy profit margin. Open 4 days a week. 1,200 sq ft facility with 3 WEST HOUSTON PRACTICE FOR SALE. Doctor800-856retiring. fully equipped operatories. Doctor retiring. Call All fee-for-service. Call Jim Robertson 713-688-1749. 1955 or email jenny@thehindleygroup.com.
OFFICE SPACE
West Houston Practice for sale. Doctor retiring. All fee-for-service. Call Jim Robertson 713-688-1749. AUSTIN: Excellent office location just north of the Mueller development. This space not only close to Mueller households but also, University Hills, Windsor Park, French AUSTIN: Place, and Excellent other East office Austin location neighborhoods. just north ofBuilt the in Mueller the development. late 60s/early 70s, This this space building not only is iconic close to forMueller the period. households built Specifically but also, for dental/ University orthodontist Hills, Windsor offices, Park, it would French Place, be perfect and other for a dentist East Austin to move neighborhoods. into with most Built of in thethe late 60s/early 70s, infrastructure already thisinbuilding place. Simply is iconicinstall for the operatories period. Specifically and other equipment built for dental/ and you orthodontist are ready to offices, go. It can it would also be totally perfectremodeled for a dentist fortoyour move specific into with needs most andoftaste. the infrastructure already in place. Simply install operatories
Office Space
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ADVERTISING BRIEFS This other and property equipment has 2 buildings. and youBuilding are ready 2 stands to go. Italone can also and is totallysqremodeled ft. Buildingfor 1 isyour currently specific setneeds up asand a duplex taste.with be1,100 This property separate electric hasmeters. 2 buildings. EachBuilding side is 1,150 2 stands sq ft.alone All space and is 1,100 currently sq ft. available. BuildingContact 1 is currently Greg Brooks set up as 512-799-8973, a duplex with separate electric meters. Each side is 1,150 sq ft. All space tgregorybrooks@gmail.com. is currently available. Contact Greg Brooks 512-799-8973, CARROLLTON: Great opportunity for orthodontist or tgregorybrooks@gmail.com. pedodontist. Fully equipped orthodontic office with CARROLLTON: 5 ops in main treatment Great opportunity area, separate for orthodontist private office, or pedodontist. consult room,Fully pano/ceph equipped room, orthodontic and lab. All office dental withchairs, 5 ops in units, equipment main treatment and furnishings area, separate included. private Located office, in professional pano/ceph withroom, 4 general anddentists lab. All dental and a board chairs, consult room,building units, equipment certified periodontist, and furnishings all with established included.practices Located and in building with 4 general dentists and a board professional would be good referral sources. An excellent opportunity with established certified for a newperiodontist, orthodontist,allpedodontist or onepractices seeking and a satellite good Ready referraltosources. start patients An excellent tomorrow! opportunity Space would beoffice. a new pedodontist one seeking a forfor is rent orthodontist, and/or purchase. Premier or location just 1 block satellite south George office.Bush Ready turnpike to startand patients 1 block tomorrow! north of Newman Space Premier location just one is for rent Smith Highand/or School.purchase. Please call 214 850-8087. block south George Bush turnpike and one block north of HighDental School. Please call 214and 850-8087. Newman CORPUS Smith CHRISTI: office, equipped furnished for sale or lease. Dental medical specialty center. Five ops, andsqfurnished Christi: 2Corpus doctor offices, labDental space,office, gardenequipped area, 1,421 ft. Call or lease. Dental medical specialty center.361-851Five ops, for sale Don Deaver 361-813-7262 or Allen Doty, Broker 2 doctor offices, lab space, garden area, 1,421 sq ft. Call 0214. Don Deaver 361-813-7262 or Allen Doty, Broker 361-8510214.TExAS DENTAL PRACTICE: Malakoff, Texas, dental EAST practice for sale. Malakoff is near Athens, Texas. Dentist EAST TEXAS DENTAL Malakoff Texas Dental retiring due to health.PRACTICE: General practice established in this Practice for location in 1974. sale. Malakoff Location will is near make Athens, a great Texas. Dentist place for a retiring due start-up or satellite to health. General practice duepractice to numerous established surrounding in this small towns. in 1974. Location The practice, will equipment make a great and real place estate for a location are available for purchase. highway is also start-up or satellite practiceLot dueon tomain numerous surrounding available for futurepractice, office site. There isand a great small towns. The equipment real potential estate for practice is only 3 days a week. For are growth. availableCurrent for purchase. Lot on main highway is also more information either of the Stanley available for futurecontact office site. There is following: a great potential Fulgham, 817-657-7239, 9:00isAM to38:00 Monday practice only daysPM a week. For for growth. Current through Saturday or email either to stanleyf@sbcglobal.net. contact of the following: Stanley more information Donna Fulgham, 214-642-2038 9:00 to 8:00 PM or Fulgham, 817-657-7239, 9:00 AM to AM 8:00 PM Monday email to Saturday rodneyshouse@comcast.net. through or email to stanleyf@sbcglobal.net. Donna Fulgham, 214-642-2038 9:00 AM to 8:00 PM or EL PASO: New dental offices for lease at Renova to rodneyshouse@comcast.net. email Plaza. Seeking complimentary specialties to 3 general practitioners 1 periodontist. Suites be finished EL PASO: Newand dental offices for lease at can Renova to suit.Seeking Highestcomplimentary quality architecture and construction Plaza. specialties to 3 general in upscale neighborhood; strong demographics. Agent: practitioners and 1 periodontist. Suites can be finished ETZOLD & CO 915-845-6006. quality architecture and construction to suit. Highest in upscale neighborhood; strong demographics. Agent: ETZOLD & CO 915-845-6006.
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EL PASO: Selling a state of the art general practice with orthodontic patients. Building is 6,000 sq ft for sale or lease. Whole building available. Partnership also available as well as many other options. Building is beautiful and only 1 year old with 11 ops fully equipped with digital X-rays, Softdent, Adec, Marcus equipment. Located on east side of El Paso. For more information please contact Dr Oscar Vargas at 915-276-2242. FORT WORTH / TCU DENTAL OFFICE FOR LEASE: Building has 4 dental offices and 1 unit available. Comes with 2 examining rooms with chairs, third room does not have a chair. Has a private office with a 1/2 bathroom, reception plus waiting area, lab room, approximately 1,200 sq ft. Great location near TCU. Very seldom does this building have a vacancy. Our current dentist is retiring. 2417 Park Hill Drive. Contact Sharon May at sharon@maysrealty.com or call at 817-721-3759. equipped Dental dental suites FORT WORTH: Fully Equipped Suites for for lease lease in in growing North Fort Worth. Ideal for dental specialist-oral surgeon, endodontist or periodontist. Please contact Jennifer at 817-366-2268. GRANBURY: Great location, high visibility and traffic. Approx 6,000 sq ft building, approx 3,000 sq ft of dental; 6 ops. For lease or possible sale. Call 817-263-9014 or e-mail jeremy@mirandadentistry.com. HOUSTON: General practice for sale north of downtown Houston in developing area. Three fully equipped ops, ops, plumbing to add 2 more. Annual gross high 6 figures- no DMO. Non-practicing owner. Asking price is negotiable. Low overhead. For inquiry email nate.1974@yahoo.com. MCKINNEY: Two-chair Two chair dental practice for sale. Primarily a Medicaid practice for over 10 years. Located in a nice office building close to 380 and 75. This place is ready to walk in a treat patients. Great for a new grad in a growing community. For more information, contact Tom at 214538-6560 or e-mail collincountydentalpractice@aol.com. MIDLAND: FOR SALE — General practice of 64 years in Midland. If interested please contact us at 432 682-0477. NORTH DALLAS: Well established restorative general dentistry practice available for immediate purchase. Four purchase. Four operatories equipped. Very attractive facility in multi-story equipped. Very mixed use office building. Dentrix dental software, Scan
ADVERTISING BRIEFS mixed X digital. All use office fee-for-service building. Dentrix patientdental base. Owner software, selling Scan X digital. to disability All fee-for-service but will provide patient long base. termOwner transition selling if due desired. Three to due to disability but 4 hygiene will provide dayslong per term week. This transition practice if desired. Three a purchaser to 4 hygiene to have days over per2week. years of This clinical practice will require experience. DP#363. Contact will require a purchaser to haveDan over Lewis 2 years at Lewis of clinical Health Profession Services experience. DP#363. 972-437-1180 Contact Danor Lewis dan@lewishealth. at Lewis Health com. Profession Services 972-437-1180 or dan@lewishealth. com. NORTH TEXAS DENTAL PRACTICE OPPORTUNITIES: Lewis Health NORTH TExASProfession DENTAL PRACTICE Services has OPPORTUNITIES: multiple career opportunities Lewis Health Profession available inServices the greater has multiple Dallas/Fort career Worth opportunities for sale,inassociate the greater opportunities, Dallas/Fortfinished Worth area. Practicesavailable out dental area. Practices offices, for and sale,specialty associatepractice opportunities, opportunities. finished Health Profession Servicespractice has 30 years experience Lewis out dental offices, and specialty opportunities. practice transitions, withhas over in dental Lewis Health Profession Services 30 1,000 years successful experience in dental practice completed. Dentistry transitions, withisover our only 1,000business. We successful transitions deal with Dentistry all clients. Lewis Health Profession confidentially transitions completed. is our only business. We offers seller representation, confidentially deal with all clients. buyer representation, Lewis Health Profession assessments, associate placement and opportunity offers seller representation, buyer representation, opportunity assessments, associate placement and
strategic planning services. Please services. Please check out our web website at www.lewishealth.com for current opportunities. sitewww.lewishealth.com at for current opportunities. Contact Dan Lewis at Lewis Health Profession Services 972-437-1180 or dan@lewishealth.com for additional information. Well established restorative general RICHARDSON: Well-established dentistry practice available for immediate purchase. Four purchase. Four operatories equipped. Professional equipped. Professional building. Dentrix building. Dentrix dental software. All software. All fee-for-service patient base. Owner base. Owner selling due to disability. Three to disability. Three to 4 hygiene days per week. DP#367. Contact week. DP#367. Contact Dan Lewis at Lewis Health Profession Services 972-437-1180 or dan@lewishealth. com. ROUND ROCK: Orthodontist needed next to dentist in high growth high traffic area in Round Rock, north of Austin in one of the fastest-growing counties. For more information, e-mail john@herronpartners.com or call 512-457-8206.
DDR Dental Trust
Serving Texas Dentists for more than 40 Years
• Practice Appraisals • Practice Sales • Associate Agreements
800-930-8017
James L. Dunn, Trustee Texas Dental Journal l www.tda.org l June 2013
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ADVERTISING BRIEFS FOUR OPERATORY PRACTICE FOR SALE: SAN ANTONIO FOUR-OPERATORY We have outgrown the space, looking to relocate. Space is perfect for a specialist. Transition available. The space is located right off the Dominion Country Club golf course in San Antonio. Very modern, tranquil, pleasant location, granite countertops, plumbed for nitrous, second floor with balcony. Please contact Dr Stratton at 210-687-1150 or e-mail tiffini@dominiondentalspa.com.
For FOR Sale SALE EQUIPMENT FOR SALE: New handheld portable X-ray unit. New intraoral wall X-ray unit, new mobile X-ray on wheels. New chairs/units operatory packages, new implant motors. Everything is brand new, with warranty. Contact nycfreed@aol.com.
Interim SERVICES Services INTERIM OFFICE COVERAGE for vacations, maternity leave, illness. Protect your practice and income. Forest Irons and Associates, 800-433-2603 (EST). Web: www.forestirons. com. “Dentists Helping Dentists Since 1983.” PROFESSIONAL PRACTICE COVERAGE by a Texas colleague during personal, maternity or disability leave. Keep your cash flowing, your staff busy, overhead covered, and DOCTORS PER patients treated when you’re not there. Docters Per Diem team members perform full production schedules DIEM members team perform full production schedules or just or justsitting. baby sitting. Avoid gaping your schedule baby Avoid gaping holes inholes yourin schedule weeks, andmonths again, months later because weeks, and again, later because patientspatients weren’tweren’t seen seenbooked and booked for more extensive follow-up byoryou and for more extensive follow-up by you foror for hygiene recall. a standard percent of production. hygiene recall. FeeFee is a isstandard percent of production. Short notice is ok. Some on our Texas team are seeking partnership and or buy-in opportunities. Try before you buy! All inquiries treated with absolute confidentiality. All team members are fully licensed with liability insurance PER DIEM most and DEA authority. DOCTORS Docters Per Diem Inc.INC. hashas thethe most distinguished and experienced team of dentists in Texas. Why not join us? There’s no charge and no obligation ever. Our fee paidis by theby‘host’ practice. WorkWork only when ever. Ouris fee paid the ‘host’ practice. only and where you wish. and butter procedures. New when and where you Bread wish. Bread and butter procedures. dentists welcome. DOCTORS PER DIEM INC. Register: New dentists welcome. Docters Per Diem Inc. Register: www.doctorsperdiem.com/register. Email: docs@ doctorsperdiem.com; 800-600-0963. Trusted integrity, since 1996.
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Miscellaneous MISCELLANEOUS LOOKING TO HIRE A TRAINED DENTAL ASSISTANT? We have dental assistants graduating every 3 months in Dallas and Houston. To hire or to host a 32-hour externship, please call the National School of Dental Assisting at 800383-3408; Web: schoolofdentalassisting-northdallas.com. THE NATIONAL SCHOOL OF DENTAL ASSISTING...NORTH DALLAS offers the Texas RDA course and exam. Call 800383-3408 for available dates.
Starting a new practice? Do you need help with demographics, hiring staff, implementing systems, designing a logo and web site? Would you like to be guaranteed your practice will produce a half a million or more your first year or we will give you 110% of our fee back? Would you like to grow your practice by more than 6 figures this year? Would you like help with office systems and insurance? If so, Veatch Consulting can help! We will guarantee in your first year of working with us we will grow your office by 6 figures in revenue or we will give you our fee back! Please call Matthew with Veatch Consulting for details at 303-621-5387 or e-mail at veatchconsulting@comcast.net. Also, please visit us at veatchconsulting.com.
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Your Patients Trust You. Who can YOU Trust? The Professional Recovery Network (PRN) addresses personal needs involving counseling services for dentists, hygienists, dental students and hygiene students with alcohol or chemical dependency, or any other mental or emotional difficulties. We provide impaired dental professionals with the support and means to confidential recovery. If you or another dental professional are concerned about a possible impairment, call the Professional Recovery Network and start the recovery process today. If you call to get help for someone in need, your name and location will not be divulged. The Professional Recovery Network staff will ask for your name and phone numbers so we may obtain more information and let you know that something is being done.
Statewide Toll-free Helpline 800-727-5152 Emergency 24-hour Cell: 512-496-7247
Professional Recovery Network 12007 Research Blvd. Suite 201 Austin, TX 78759 www.rxpert.org
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Pre-screened vendors. Excellent customer service. Exclusive discounts and benefits.
FINANCIAL COLLECTIONS
DISPOSAL/RECYCLING
INSURANCE INSURANCE
AMALGAM SEPARATION
Bank of America Business: (866) 570-1601 (Code: UABOI9) Consumer: (800) 932-2775 (Code: VABQ92)
INSURANCE INFORMATION
SCRAP PRECIOUS METAL RECOVERY D-MMEX: (800) 741-3174
CREDIT CARD PROCESSING
E-Claims & Eligibility Connect: (866) 325-2467
TekCollect: (866) 652-6500, ext. 539
CREDIT CARD — TDA PERKS
Best Card: (877) 739-3952
LOANS (PRACTICE)
Bank of America: (800) 497-6076; Code: 1D7F3
PATIENT FINANCING
CareCredit: (800) 300-3046 ext. 4519
HUMAN RESOURCES EMPLOYMENT AGENCY, ONLINE DentalSpots.com: (800) 971-8008
MEDICAL PLAN, DISCOUNT
TDA Perks Card has three available packages. This is NOT insurance, nor is it intended to replace insurance. http://tinyurl.com/perkscard
COMPLIANCE/TRAINING COMPLIANCE TRAINING (OSHA, HIPAA, HB300)
Smart Training, LLC: (469) 342-8300
TRAINING/RECERTIFICATION (ACLS, PALS, BLS, CPR) HeartSafe America: (877) 731-7467
TDA Financial Services Insurance Program All types: office and personal: (800) 677-8644 Insurance Answers Plus: (800) 683-2501
ELECTRONIC CLAIMS PROCESSING
HeartSafe America: (877) 731-7467
Atlas Resell Managment: (512) 377-6077
DISINFECTANT, SPORE TESTING
Dental Space Advisors: (972) 231-8900 Corporate Headquarters: Dallas/Ft. Worth (With Offices in Houston & Austin/San Antonio)
ON-HOLD PHONE MESSAGING
Sharps: (800) 772-5657, ext. 140
DEFIBRILLATORS
EQUIPMENT, USED (BUY, SELL)
MARKETING
SHARPS DISPOSAL (BY MAIL)
SUPPLIES
OFFICE, SETUP/STARTUP
REAL ESTATE (COMMERCIAL)
Solmetex: (800) 216-5505
OSHA Review, Inc.: (800) 555-6248
GLOVES The Glove Group: (800) 570-1492 OFFICE SUPPLIES
Office Depot: (512) 284-3392
PHILIPS SONICARE, ZOOM!
Ace Media Products: (800) 892-9179
Philips Zoom!: (800) 422-9448 Philips Sonicare: (800) 676-7664
ONLINE MARKETING AND COMMUNICATIONS
SEDATION EQUIPMENT, SUPPLIES
Demandforce: (800) 210-0355
PATIENT TEXT COMMUNICATIONS theTEXTdoctor.com: (888) 330-7291
PRINTING, PROMOTIONAL PRODUCTS, DIRECT MAIL PrintCity.com: (800) 757-5110
WEBSITE DESIGN
ProSites: (888) 932-3644
Scan QR code to learn more about TDA Perks.
Sedation Resource: (800) 753-6376
AUTO AUTO LEASING
Autoflex Leasing: (800) 678-3539
AUTO RENTALS
AVIS: (800) 331-1212; Use Code: W220700 Budget: (800) 527-0700; Use Code: Z930600
Revised 04/22/13
For more information, call:
(512) 443-3675
Or visit Perks online:
tdaperks.com 563
Texas Dental Journal l www.tda.org l June 2013
PROTECT... Your Income | Your Family | Your Lifestyle Against Career-Ending Accidents and Illnesses
Up To $1,000,000 of Lump Sum Disability Benefits for TDA Members
Will your disability insurance be enough? Texas Dental Association Members have a unique opportunity to obtain a special benefit with these key features: You will be paid up to $1,000,000 of lump sum benefits when an accident or illness prevents you from practicing in your specialty. Benefit is paid in addition to current in-force DI coverage with no offsets. No medical exam required or the need to answer medical questions.
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www.TDAmemberinsure.com 564
Texas Dental Journal l www.tda.org l June 2013
Enrollment period ends soon!