OFFICIAL PUBLICATION OF THE TEXAS ACADEMY OF GENER AL DENTISTRY
FALL 2015, VOLUME 41, ISSUE 4
DR. CRAIG ARMSTRONG Announced as 2015 Texas Dentist of the Year™! WHAT INSPIRES YOU?
Wimberley Strong
Case Study
Audrey Stansbury, DDS, FAGD
Jennifer Roe, DDS, FAGD
Gerard Macy, DDS, FAGD
PRESIDENT’S MESSAGE James S. Bone, MS, DDS, MAGD, “One of the People”
“Do what you do so well that they will want to see it again and bring their friends.” – Walt Disney One of the main points in the Texas Academy of General Dentistry’s strategic plan is to deliver world class service. As an organization, I believe we have some incredible programs. Our FellowTrack programs are envied by the rest of the nation. Our MasterTrack program is second to none, creating enduring friendships and incredibly unique learning opportunities. Our New Dentist Study Clubs are like no other—no one else has even conceived of the idea. We are creating a pipeline from student member to young dentist to Fellow to Master. And then we continue to foster these ideas through the Master Study Club. It is a JOURNEY of Life Long Learning! It is truly MAGICAL! But where does the Magic come from? It does not come from something you learn during one of the courses; continuing education courses are a dime a dozen. It is not that these events are held at fancy resorts and hotels; there are far more exotic and enticing destinations. Our members don’t come to just sit in a classroom and learn; they come for something much greater. They come to share their experiences. They come to learn from their friends. They come for the camaraderie. The Magic comes from the people. Whether they are members of FellowTrack, New Dentist Study Club, MasterTrack, or Master Study Club; our members in these programs are truly incredible people. Even with these great TAGD educational opportunities, we may still need to look at new and inventive ways to reach our members. Many organizations have seen a decrease in the number of attendees to their conferences. Today continuing education is available everywhere. Dental journals, podcasts, and webinars bring education right to our homes. Whether it is the cost of travel or time away from family, people are not as inclined to travel for continuing education. To stay relevant we may have to make changes that fit these new paradigms. When designing an educational program, we might consider a number of different delivery methods to best meet the challenges and circumstances of our members. One approach to education which appeals to a wider range of learning styles is to integrate both face-to-face instruction and online or digital learning platforms. “Blended learning” integrates traditional classroom and technology-based training as a more inclusive approach to education. Yet, blended learning can also be observed in a broader sense as embracing both formal and informal frameworks for instruction to allow flexibility and accessibility to education for our members; allowing programs to develop and evolve with new technology and research. Traditional face-to-face learning can be supplemented with hands-on activities, practice-based experiences, webinars, podcasts, or engagement with social media tools. Employing a variety of modalities for instruction lends itself to different types of learners, enforces participant accountability, and offers review opportunities. For instance, we might consider putting on a webinar that would be tied to one of our face-to-face meetings. Although both could be stand-alone courses, together they could offer a more enhanced learning opportunity. Another way we may use blended learning might be with our New Dentist Study Clubs. We currently have New Dentist Study Clubs in Dallas, Houston, San Antonio and Corpus Christi. What if we could take content from one study club and send it to another, one with less access to speakers? We could link the smaller groups with programs in the larger cities through live video in a way that might create interaction and synergy among the groups, even if they are at the far corners of this large state. The content could be specifically designed to drive members to the New Dentist Conference and the Lone Star Dental Conference for a grand finale!
What we need are the program directors, the mentors, and the members! What we need is the MAGIC…the People! As Disney once said “First, Think. Second, Believe. Third, Dream. And finally, Dare.” Who will join me on the JOURNEY? Who will Dare?
DISCLAIMER: The TAGD does not necessarily endorse opinions or statements contained in articles or editorials published in the TexasGP. The publication of advertisements in the TexasGP does not indicate endorsement for products and services. Texas GP is published quarterly by the Texas Academy of General Dentistry, 1016 La Posada Dr. Suite 200, Austin TX 78752. Address changes should be sent to the TAGD. TexasGP is provided as a member service to members of the TAGD. Nonmember subscription rates are $25.00 individual and $40.00 institutional. Canadian orders add $5.00; outside the U.S. or Canada, add $10.00. Single copy rates are $3.00 to individuals and $4.50 to institutions (orders outside the U.S. add $1.00 postage). All orders must be prepaid in U.S. dollars. Printed in U.S.A. Copyright 2015, Texas Academy of General Dentistry, Austin, TX. No portion of TexasGP may be reproduced in any form without prior written permission from the TAGD. The opinions expressed by TexasGP are not necessarily endorsed by the TAGD.The publication of an advertisement in TexasGP does not indicate endorsement for products and services. TAGD/AGD approval for continuing education courses or course sponsors will be clearly stated.
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BOARD OF DIRECTORS PRESIDENT James Bone, DDS, MAGD Kerrville IMMEDIATE PAST PRESIDENT Kevin Gureckis, DMD, MAGD Boerne PRESIDENT ELECT Marc Worob, DDS, FAGD Austin SECRETARY/TREASURER Jeffrey Geno, DDS, MAGD League City EDITOR Andrew Lazaris, DDS, FAGD Plano
DIRECTORS Randall Farmer, DDS, FAGD Houston Bryan Moore, DDS Dallas Mary Mellard, DDS, MAGD San Antonio Shane Ricci, DDS, FAGD Plano J. Dempsey Speer, DDS, FAGD Corpus Christi Tor Gotun, DDS, MAGD Austin NATIONAL TRUSTEE Douglas Bogan, DDS, FAGD Houston
TABLE OF CONTENTS What Inspires You? – Dr. Audrey Stansbury
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Advocacy Pulse – On the Frontline
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2015 Lone Star Dental Conference Recap
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Leadership Awards
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Texas Academy Awards – Texas Dentist of the Year™ & New Dentist of the Year
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Wimberley Strong
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Treating a Complex and Multidiscipline Patient: A Case Study
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Tribute to Connie Sonnier
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Photo Contest Winners
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Calendar of Events
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REGIONAL DIRECTOR David Tillman, DDS, MAGD Fort Worth
COMPONENT PRESIDENTS BRAZOS VALLEY AGD Craig Scasta, DDS, FAGD Bryan
HOUSTON AGD Randall Farmer, DDS, FAGD Houston
CENTRAL TEXAS AGD Jason Carlyon, DDS Austin
PANHANDLE AGD Tom Karr, DDS, MAGD Amarillo
DALLAS AGD Phil Estes, DDS, FAGD Frisco
SAN ANTONIO AGD Kristen McBride, DDS, FAGD San Antonio
EL PASO AGD Patrick Mitchell, DDS, FAGD El Paso
SOUTH TEXAS AGD Ted Thompson, DDS, FAGD Corpus Christi
FORT WORTH AGD Will Goodwin, DDS Fort Worth
WEST TEXAS AGD Shihab Diais, DDS, FAGD Odessa
TEXAS ACADEMY OF GENER AL DENTISTRY STAFF EXECUTIVE DIRECTOR Francine Johannesen EDUCATION DIRECTOR Lindsey Robbins EDUCATION ASSISTANT Aleisha Stills DIRECTOR OF FINANCE Nadia Baig
COMMUNICATIONS MANAGER Leah Thompson COMMUNICATIONS COORDINATOR Joy Garza MEMBERSHIP SPECIALIST Megan McBride
CONTACT TAGD 1016 La Posada Drive, Suite 200 Austin, Texas 78752 www.TAGD.org T
512-371-7144
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EDITOR’S MESSAGE By Andrew Lazaris, DDS, FAGD
As many of you already know, our previous Executive Director, Connie Sonnier, passed away on August 14, 2015, after a long battle with cancer. When I first started practicing, Connie was TAGD to me. She was the one that I went to when I had a question about my CE transcript or courses. I was always so impressed with her knowledge of all things AGD. I felt like she knew every member, every course going on in the state and everything going on legislatively at all times. To be honest, I was a bit intimidated by her at first. But, that quickly faded as I got to know her. I learned that she was uncomfortable speaking in front of people, but she was so passionate about TAGD that she did it anyway. I learned what a hard worker she was and how accessible she was. I learned how respected she was nationally and with other dental groups. She loved her family and her profession and I respected her humility. One of my favorite memories with Connie came when I was planning the catering for the first MasterTrack course in Dallas. Connie told me that they typically budgeted $70/day per person at the other MasterTracks. But to my dismay, despite spending 2 days and contacting dozens of restaurants, I could NOT find a way to spend that much money. Worriedly, I called Connie, to tell her of my failure and ask for advice. After a looong pause, I was relieved to hear Connie start to laugh on the other end. She said, “That’s how much we budget when we are meeting in a hotel. You know you don’t have to spend that much, right?” “Ohhhhh”, I replied sheepishly. We shared a long laugh and thus was born our first inside joke. Connie, you were a special person; your life had meaning and you will be missed. Fall 2015 | 3
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what inspires you?
“I am inspired to make a difference in people’s lives.”
Audrey Stansbury, DDS, FAGD
consequently had a new dental hygienist, Millie. I was grateful that she took the time to teach me how to brush my teeth properly and educate me on why it was important to floss. She also took measurements of my recession and explained that I might need gingival grafting if I continued to brush too hard! I had never had my teeth cleaned by anyone who really seemed to care about my oral health. I had been contemplating what to major in and what career path to take. I was so impressed with my hygienist’s professionalism, expertise and care, that I started asking her about her career in Dental Hygiene. She encouraged me to pursue Dental Hygiene, even writing a letter of recommendation for my application. I was accepted into the Dental Hygiene program in 1996.
What encouraged you to go back to school? I am the youngest of five children and the only member of my family to go to college. In high school, I had earned enough academic scholarships to pay for my Associates Degree at Richland College in Dallas. I loved school as a child and was a very good student. I was always the “teacher’s pet”. I was the kid who loved learning and would stay after school to learn advanced subjects. I used to cry when school was out for the summer. All my life I dreamed of becoming a Veterinarian. My plan was to transfer to Texas A&M for Veterinary Medicine. Then I fell in love and my plans took a different path. I married at 19 years old and dropped out of college with 1.5 years of college credit. I knew I had disappointed my mother, as I was her last chance to have a kid graduate from college. My mother was Japanese and
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education was of the utmost importance to her. She encouraged me to be a good student and expected me to make A’s in school.
My biggest challenge while in hygiene school was converting from a full-time mom to a full time student. My children had to learn how to take care of themselves a little more. They learned to do laundry and make their own lunches for school! My husband stepped in by helping with more of the household chores and driving the girls to their afterschool activities. None of us realized the impact that the dental hygiene curriculum would have on our household. I was at the school 40 hours a week!
At 22 years old, and 24 years old I had two daughters and stayed home with them until the youngest was in kindergarten. At that time, I decided it was time for me to go back to school. I enjoyed being a stay at home mom. I think I was a great mom and homemaker, but I also knew I had the potential to do something more with my life.
I graduated from Baylor College of Dentistry’s Dental Hygiene program as the Gold Medallion Winner and took a job working for a periodontist.
What was your biggest challenge? I earned my first degree (a Bachelor’s Degree in Dental Hygiene from Baylor College of Dentistry) when I was 36 years old. When my youngest started kindergarten, I started working parttime as a cashier at Home Depot and reenrolled at Richland College, determined to complete my Associates Degree.
While most dentists my age have already been practicing for over 20 years, I am still new to the practice of dentistry. I strive to master each procedure I perform, by improving my skill and using new products and techniques that work better. I love new technology and am enthusiastic about learning. I feel like dentistry is moving so fast in regards to technology, that if I don’t stay motivated to keep up, patients may perceive my practice as being “behind
Along the way, I had changed dentists and
What inspired you and kept you motivated? I am inspired to make a difference in people’s lives. Dentistry gives me the means to do so.
What advice do you have for dentists in continuing their education? General dentists graduate from school being only competent at a variety of dental procedures. However, to perfect these procedures, I would advise new dentists to recognize the aspects of dentistry they are weak in and take as many CE courses possible. There are so many materials and techniques being utilized by other experienced dentists. It is great to be among peers in a CE class who are willing to share their knowledge to help one another provide the best possible care for patients. I have found that even if you take only one little pearl from a 3 hour CE course, that little pearl could make a huge impact on your practice! Once you are comfortable with the scope of procedures you perform, challenge yourself to expand your scope of practice. For example, when I first graduated, I was hesitant to perform root canals through crowns, especially PFM’s. I challenged myself to do so and now am pretty comfortable, especially with all ceramic crowns that allow for more visibility. I have also incorporated placing implants in my practice after taking hours of didactic and hands on coursework. Dentistry would be boring if I just did fillings all day long!
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the times.” I don’t want to be known as an old dentist who practices in the dark ages. My patients also motivate me. I have a true love for my patients. They have become my community. I care for them as I would my own family. I strive to provide individualized care in a personal way. Mine is not a fast-paced office. I schedule patients one at a time so I can give them my full and undivided attention.
“... I would advise new dentists to recognize the aspects of dentistry they are weak in and take as many CE courses possible.”
Do you think you have a unique perspective coming into it at a different part in your life? Yes, being older I probably value my career a little more due to the sacrifice that my husband and children made for me to be able to go back to school. I know that not everyone who wants to be a dentist gets to be a dentist. Therefore, I am thankful to the Lord that He blessed me by allowing me to be a part of this great profession. Patients respect me more than they probably would a 26 year old, especially because I had been a dental hygienist. Plus, I know my years of practice are limited since I was so late in getting started. I have a sense of urgency in learning all that I can before I retire. What was your experience going through dental school later in life? Do you think it has changed how you practice or interact with your clients? I think it was definitely an advantage to graduate dental school with more life experiences under my belt. My more mature clients are comfortable with me being closer to their age. I already had children, so relating to kids was easy. Being older definitely has been an advantage.
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ADVOCACY PULSE – ON THE FRONTLINE By Fred T. Philips, DDS | TAGD Advocacy Council Member
Dentistry is Our Story Dentistry is changing. It is getting more high tech every year. Better materials, more options; what a great time to care for patients! Dentistry is also not changing. Our tradition of personal care for our patients is steadfast. Our high ethical standards are a core value of Texas dentists. Outstanding dental education from three great schools is the foundation for this success story. We have traditions we want to keep.
Remember the day you left dental school with a diploma and a desire to go into your community and take care of people? When you did, you learned all of the laws, statutes, acts, fees, policies, and licenses that are required to practice. With every legislative cycle, there are more and more of these for us to know and learn. Texas is a study in diversity. Different geography and different people. Small towns and metroplex areas. Various practice models and a wide variety of methods for delivery of care. Yet, we all know honest, compassionate, tender loving dental care will work in all these diverse settings. That core value is Our Story. Dentistry has had terrific ambassadors of Our Story. Just take a moment to think of the mentors who have affected who you are today and what your values have become. Those folks are our history, and each of us plays a little part. They tell Our Story to those who need to know. Yes, to Senators and Representatives because legislators accept the responsibility of listening, deciding, and voting for what will make the future chapters of Our Story. We believe Texans deserve quality care by a dentist. Not by a less-educated, lesstrained oral health care provider that will remove the dentist from the patient. Three outstanding dental schools provide 354 dentists each year for this to work well. We have a wisely crafted Dental Practice Act; let’s work to keep it as the Sunset Commission process reviews it. I believe it is the best in the country, and then probably the best on the planet. Yes, Texas should be just that: the model for dental care world-wide. Too lofty you say, well, I think it’s worth working toward. It’s Our Story. Be proud of this story of dentistry in Texas. It is deeply steeped in a tradition of hard work and putting patients first. Too busy to tell the story? Then donate a little more to the Advocacy Fund. That money gets us in the door to tell Our Story. Take an active part in advocacy for dentistry, after all, you are part of Our Story.
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Advocacy and Legislative Updates To stay current on legislative updates check the Gatekeeper section in the TAGD monthly newsletter or visit www.TAGD.org/gatekeeper to get caught up!
Advocacy Council Members Chair - Brooke Loftus Elmore, DDS, FAGD Advocacy Consultant - David Mintz Joey Cazares, DDS, FAGD Fred Philips, DDS Susan Putthoff, DDS Dave Roberts, DDS Jennifer Bone, DDS, MAGD Shane Ricci, DDS, FAGD Donna Miller, DDS, MAGD James Bone, DDS, MAGD
“Texas should be...the model for dental care world-wide.”
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LONE STAR DENTAL CONFERENCE This year’s action packed conference included two days of CE and events featuring speakers Dr. John Flucke and Lois Banta, Dentalosophy, Lunch & Learn table discussions and much more! Over 20 exhibits provided attendees many opportunities to meet with company representatives for hands on demonstrations of new products and services.
TEXAS ACADEMY AWARDS PRE-PARTY
2015 LONE STAR DENTAL CONFERENCE PHOTO RECAP
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ComeDrumforFun, a West African percussion ensemble energized guests attending the Texas Academy Awards pre-party. The party recognized (11) New Dentist of the Year Nominees and announced 2015 winner, Dr. Phil Estes.
TEXAS ACADEMY AWARDS Celebrating general dentistry and Texas Dentist of the Year™ nominees, this celebratory dinner opened with the presentation of the flags by the University of Texas Army ROTC, followed by the National Anthem sung by TAGD Regional Director, Dr. David Tillman. Dr. James and Jennifer Bone introduced each of the (17) Texas Dentist of the Year™ nominees followed by the announcement of the 2015 Texas Dentist of the Year™- Dr. Craig Armstrong.
2015-2016 INSTALLATION OF TAGD OFFICERS & BOARD OF DIRECTORS Special guest Dr. Mark Donald, AGD President, proudly installed our 2015-2016 TAGD Board of Directors.
LEADERSHIP AWARDS
Presidential Awards 1. Dr. Jennifer Bone 2. Dr. Jeff Geno Presidential Recognition Dr. Summer Ketron Dr. Joey Cazares Dr. David Roberts
Advocacy Leader Award 3. South Texas AGD Component Technology Award 4. Fort Worth AGD Component Service Award 5. Central Texas AGD Component Membership Award 6. Houston AGD
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Continuing Education Award 7. San Antonio AGD New Component Award 8. West Texas AGD Component Leader of the Year Award 9. Dr. Andrew Lazaris Component of the Year
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TEXAS DENTIST OF THE YEAR ™ Dr. Craig Armstrong
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“Trying to put down in words what it means to have been selected as the recipient of the TAGD Texas Dentist of the Year™ is a far bigger challenge than I thought it would be. I think the main reason is because by simply being nominated you feel that you have already received a great honor. Having Texas Dentist of the Year™ and my name mentioned at the same time takes my breath away. This award is the highest a Texas dentist can receive and I am humbled, honored and grateful for being the 2015 recipient. Perhaps the biggest surprise to me has been the response that I have received from my fellow nominees and dental colleagues throughout organized dentistry both inside and outside of the state of Texas. The outpouring of support and congratulations only serves to highlight the significance of this tremendous award. When I looked at the trophy and came to realize the names that were on it, I was even more humbled. The names on this trophy are a virtual who’s who among dentists in the state of Texas; many of whom I consider mentors. To suggest I feel a sense of responsibility when I look at my name alongside these great leaders is a vast understatement. Thank you to the Texas Academy of General Dentistry for this coveted award. I promise to live up to the honor that has been bestowed upon me.”
-Craig Armstrong, DDS, MAGD
“Thank you to the Texas Academy of General Dentistry for this coveted award. I promise to live up to the honor that has been bestowed upon me.” 10 | Fall 2015
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NEW DENTIST OF THE YEAR ™ Dr. Phil Estes
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“It is a tremendous honor to be awarded the 2015 Texas New Dentist of the Year Award! I give my Lord and Savior Jesus Christ all the credit, because without His love, I wouldn’t know what love is and would not be able to reflect His love to my patients and colleagues. I thank my wife Jenny for being there for me the past six years and my staff for supporting me along the way. I accept this honor as a clear message that my efforts in organized dentistry are appreciated. I pledge my commitment to doing everything I can to become the best general dentist possible and to help everyone in my profession to do the same.”
- Philip Norman Ralph Estes, DDS, FAGD
VISION FOR THE FUTURE OF DENTISTRY Dentistry is a profession of enduring relationships. Without them, it isn’t a profession. But it must be. Otherwise it simply becomes a mere commodity that is bought and sold, based on supply and demand, as recently addressed by Howard Farran, DDS, MBA in the April 2014 Dentaltown Magazine article, The Challenging Landscape of Dentistry. “That would be the end of dentistry as we know and love it.” Dentistry is much more than a service that is sold based on simple economics. It is about trust and a personal touch that rarely exists in other professions. We do extremely difficult procedures in extremely challenging conditions that cannot be automated or simplified much. Our patients are counting on our clinical judgment, skill, and experience to improve and protect their quality of life, putting their minds at ease. We take away their pain, prevent illness, and enhance self-image like no other profession. Dentistry is scary for most patients and they won’t trust just anyone. As dentists and in particular general dentists we are on the frontlines of a battle in order to preserve and strengthen this unique profession by building relationships with the people of our community and practices. We are not medical doctors, pharmacists, or optometrists. We have a much more challenging work and business environment that’s still up for grabs, unlike theirs, which is why we must build enduring patient relationships that improves our ability to serve them and to learn as we go along.
“I pledge my commitment to doing everything I can to become the best general dentist possible and to help everyone in my profession to do the same.” Fall 2015 | 11
By Jennifer M. Roe, DDS, FAGD
When I think about the Memorial Day weekends of my life, I have great memories. In addition to remembering those who died fighting for our freedom, there was also celebration with friends and family, BBQ pits, swimming holes, and ice chests full of cold drinks. The Memorial Day weekend of 2015 started out this way for hundreds of residents and vacationers in Wimberley, Texas. Little did they know that their holiday was soon to end in tragedy. Saturday night many people went to bed after watching the news. If you live in Central Texas, you have seen the weather reports before…”Flash Flooding. Turn around, don’t drown.” Those who live or vacation on the Blanco River, had seen the river rise, but the water had never gotten near their homes. Around 1 a.m. Sunday morning a, 44-foot tall wave destroyed a bridge and crippled another. It also swept away or flooded over 1,000 homes up and down the river. In a community of only 2,582 full-time residents, this number is staggering. As one of the dentists in this wonderful community, I have heard many of the stories of the survivors. “I grabbed my wife and 4-year old grandson and we climbed into the rafters of our attic and watched the water reach the top of the attic ladder. We thought we were going to die.” “My son has been wearing these rubber boots for the last week, because he wears a size 14 and the shelter doesn’t have any shoes in his size.” “I woke up to my bed floating and hung onto a tree for 4 hours before the water receded.” “We lost everything. Our entire house was washed away and smashed into the bridge. We can’t even find portions of our house.” As horrific as all these stories are, these people were the lucky ones. They didn’t lose a loved one. The most heartbreaking story is the tragedy of the vacationers from Corpus Christi.
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Ralph Carey, a retired dentist from Corpus, his wife Sue, his daughter Michelle, son-in-law Randy, and grandson, Will; along with longtime friends, Jonathan and Laura McComb and their two children Andrew and Leighton, were staying in a home that was pushed off its foundation and smashed into a bridge. Jonathan was the sole survivor. 4-year old Leighton McComb and 6-year old Will Charba still have not been found. Wimberley has a pretty good sized retirement community. Many of the older Wimberley residents have been coming to Wimberley all their lives to visit or vacation. It was a dream come true to retire in this “little bit of heaven”. That dream was shattered by the viciousness of Mother Nature. One of my patients is a retired judge. His home was only half destroyed. His main regret is losing a lifetime of personal journals in which he was going to write his memoir. Other people lost priceless items like military medals, family heirlooms, and of course pictures. These are things that cannot be replaced. Wimberley is different and special. You can’t put a name to it or necessarily explain it. It just is. The aftermath of this horrific flood was proof of the specialness in this community. The outpouring of volunteers, money, food, clothing, shelter, and love was enormous. It was awesome!
“The world breaks everyone, and afterward, some are strong at the broken places.” – Ernest Hemingway
It reminded me how our country pulled itself up by the bootstraps after 9/11 and EVERYONE wanted to do something. People came from all over to help with search and rescue and clean-up. Homes were opened up to those who no longer had one; emotional, spiritual, and monetary help was provided by many of the churches and businesses; and everyone prayed. We prayed that by some miracle one of those babies would be found alive. We prayed for Jonathan. We prayed for the families who had lost loved ones, and we prayed for those who had lost their homes. Our “little bit of heaven” has been hit hard. We’ve been knocked down, but the referee hasn’t gotten to 10 yet. Money is still coming in, but not as fast, nor as much. Volunteers are still helping out, but not as many. People who weren’t affected still care, but life moves on…summer is over, school has started, and for goodness sake Halloween is just around the corner. The pictures are no longer on everyone’s Facebook feed, the media has left town, and just like with every natural disaster the immediate response has worn off. But, Leighton and Will are still missing; I can’t imagine how Jonathan wakes up and faces every new day; and there are so many who still don’t have homes. We still need help. A long term recovery team organization has been assembled for the communities devastated by this flood. The Blanco
River Regional Recovery Team has a simple mission: to assist in the long term recovery of survivors of the Memorial Day Flood. The Blanco River Regional Recovery aims to help communities develop sustainable, ecological, simple, easyto-maintain systems to get assistance to everyone who needs it. At this point in the recovery effort what is needed are monetary donations and volunteers. Both skilled and unskilled volunteers are still in great demand.
“You never know how strong you are…until being strong is the only choice you have.” – Cayla Mills About Jennifer M. Roe, DDS, FAGD Dr. Roe obtained her dental degree from The University of Texas Health Science Center at San Antonio. She is a member of the American Dental Association and the Academy of General Dentistry. Dr. Roe is currently in MasterTrack, and just received her Fellowship from the AGD in June of 2015. She resides in the Heart of the Texas Hill Country with her husband and 3 children (ages 9, 6, and 2). Dr. Roe has a full-time private practice in Wimberley, TX and is honored to be a part of such a great community.
If you are interested in volunteer efforts please email for more information. For general information, or how to donate monetarily, email or go to www.br3t.org.
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CASE STUDY
TREATING A COMPLEX AND MULTIDISCIPLINE PATIENT WITH THE PROCESS OF COMPLETE DENTISTRY SMILEBEFORE MAKEOVER PATIENT PHOTO
By Gerard Macy, DDS, FAGD
Patient: Shelly Age: 43 Occupation: Daycare Center Director Medical history: No significant health history or medications
Introduction: Patient is the director of the local Mother’s Day Out program in community. She presented for an evaluation of several decayed teeth with a history of significant “jaw pain”, headaches, dental infection and a smile she was embarrassed about. Shelly stated a history of years of dental neglect while focusing on providing for her children. There was no history of drug abuse, but, she did state a history of facial trauma in her twenties.
Abstract: By utilizing a comprehensive system that focuses on functional esthetics, one can treat a complex case in an orderly fashion that leads to predictable dentistry that meets the requirements for a stable and esthetically pleasing occlusion. On a more personal level, this was a complete mission case that involved multiple specialties and dental labs that completely changed the patient’s life.
TREATMENT PLANNING By utilizing a step by step system, we evaluated her current TMJ health and she was classified as a Dawson Type II. Doppler Auscultation confirmed likely medial pole separation with possible perforation. Ideally, we would have confirmed this with imaging, but, this was not possible in her case. Due to the extent of decay and infection, the decision was made to stabilize the patient and treat the bacteria. Our treatment plan consisted of the following phases:
PHASE 1
PHASE 2
Gross Decay Removal Removal of hopeless teeth
Orthodontic treatment to correct severe crowding in maxillary anterior Placement of implant in site # 29
PHASE 3 Treatment of Localized Periodontal Disease
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Re-evaluation of occlusal analysis with new diagnostic models, CR record and FaceBow transfer. Preparation of upper arch to restore into CR with ideal function
PHASE 4 Stabilization of bite in provisionals to ensure complete comfort and lack of symptoms in TMJ and verification that a stable bite could be maintained for at least six month with no changes needed.
PHASE 6
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Placement of definitive restorations on upper arch. Fabrication of lower implant retained RPD.
Fabrication of Superior Repositioning Splint
DISCUSSION When dealing with a complex case, it can be overwhelming and intimidating on how to manage the multiple needs a patient presents us with. By utilizing a system approach that focused on Centric Relation and functional esthetics, we were able to develop a plan that met all of the patient’s needs. One of the most important steps to this case was proper treatment planning and diagnosis. Utilizing high quality diagnostic models, a centric relation bite record, facebow transfer and proper photographs, we were able to deliver exceptional results. In this fashion, we completed the case four separate times
1. Treatment plan on paper | 2. Diagnostic models and wax-up | 3. Provisional stage | 4. Final restorations In this case, the provisional stage was a key component as it allowed us to verify appropriate function and esthetics. Without modifications to this key step, we would not have been able to make the necessary changes to the restorations to verify optimum occlusion and esthetics. By utilizing the approved provisional model, we provided an accurate index for the lab to deliver the restorations as requested.
CONCLUSION
REFERENCES
Our biggest challenge with this case was keeping Shelly in stable and functional occlusion that did not significantly worsen her TMD pain. Utilizing the process of complete dentistry as taught by Dr. Pete Dawson provided us a framework to manage this difficult case in a step by step process.
Misch, Carl E. Contemporary Implant Dentistry, Third Edition. Mosby Elsevier, 2008. Print Dawson, Pete. Functional Occlusion From TMJ to Smile Design. Mosby Elsevier, 2009. Print Dent Assist. 2004 Nov-Dec;73(6):20, 22-4, 63.
In the end, we were able to manage the extensive decay, periodontal disease, and, most importantly, provide a functional occlusion that is stable and healthy with exceptional esthetics. A special thanks to the following key members that donated services to make this exceptional case possible.
Local chemotherapeutics as an adjunct to scaling and root planning. Breault LG1, Spadar SE.
About Gerard Macy, DDS, FAGD
DR. GEORGE STEELE (ORTHODONTIST, CANTON, TX) DR. KETAN PAREKH (PINNACLE OR AL SURGERY, ROCKWALL, TX) JEFF STUBBLEFIELD, DAL SIGNATURE RESTOR ATIONS (PEORIA, IL) TR ADITIONS DENTAL LAB (CANTON, TX)
Dr. Gerard Macy completed his undergraduate degree at the University of North Texas in Denton and his dental degree at Baylor College of Dentistry. While at the Baylor College of Dentistry, he received the Operative and Pediatric Dentistry award. He is a member of the American Dental Association and Academy of General Dentistry. Dr. Macy is a proud scholar of the Dawson Dental Academy and has made a commitment to lifelong learning in order to provide his patients the best care possible.
Fast Track to Mastership Interested in receiving 96 hands-on hours this year? The MasterTrack™ program is for YOU! By joining, you’ll have access to high quality, affordable continuing education and one-on-one staff support. MasterTrack™ fulfills all of the subject code participation requirements needed for Mastership in four years. The program brings together service oriented and business savvy decision makers with a dedication to excellence. People just like YOU. Call now to reserve your space! For any questions about the MasterTrack™ Program, please contact Lindsey Robbins by email or at 512-371-7144. Already a Master? Check out the Master Study Club – a program created by Masters for Masters! Earn hours towards LLSR and stay connected with your peers.
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At Texas Academy of General Dentistry It’s All About Your Success! IN LOVING MEMORY
CONNIE SONNIER, CAE February 27, 1956 - August 14, 2015 Connie Sonnier, former Executive Director, dedicated her time and services to the Texas Academy of General Dentistry 1999-2014. Memorial donations may be made in Connie’s memory to the Jack T. Clark Foundation here.
PURSUIT to RECRUIT! The Texas AGD was honored to host the AGD President, Dr. W. Mark Donald at this year’s annual Lone Star Dental Conference. He addressed the members at both the Leadership Reception and during the Texas Academy Awards with a membership challenge to recruit one new member. “We all should be ambassadors for the AGD, which means we should all be proud enough of the AGD and our membership in the AGD to ask our colleagues to join. When is the last time you asked someone to join?” If someone joins between October 1st and December 31st, they will get up to 15 months of membership for the price of one year with AGD’s “three for free” membership deal.
“I challenge seasoned dentists to select a new dentist who has been in practice for more than 5 years and actually sponsor that membership. What better way to show them the value than showing them how important it is to you.”
-W. Mark Donald, DMD, MAGD Summer Fall 2015 | 17
2015
Thank you to all of the talented dentists for submitting amazing art by entering this year’s TAGD Photo Contest. All photo submissions were exhibited at the Lone Star Dental Conference and were well praised by all the attendees.
CONTEST First Place
Second Place
Honorable Mention
So You Think You Can Dance by Partha Mukherji
Sunset Valley View by Saskia Vaughan
Beach Silhouette by Steven Vaughan
Judging Notes 1st / So You Think You Can Dance
Tells a story and shows culture. People are laughing, smiling and just having a great time. A memory they can all share together captured in one shot. A shot like this is what photography is all about.
2nd / Sun Set Valley
The black and white really adds interest into the picture and how you can see the reflection of the clouds in the picture is really awesome too.
Honorable Mention / Beach Silhouette
I love how the photographer captures a bird soaring through the air next to the sun and how it also shows a story. The different exposures used to create the Silhouette isn’t easy but focusing on the sun like that is a smart way to do it.
Thank you to Matt Mirarchi for agreeing to judge this year’s photo contest. Matt Mirarchi is a professional photographer from Dallas TX, skilled in many styles of photography including portrait and wedding photography. He has travelled in many parts of the United States for photography, including New York/ New Jersey and the state of Alaska. 18 | Fall 2015
TEXAS ACADEMY OF GENER AL DENTISTRY
Calendar of Events NOVEMBER 2015
DECEMBER 2015
Wednesday, November 4 Dallas FellowTrack Making the Leap from Graduate to Business Owner w/ Darren Boggs & Russell Wallace
Tuesday, December 1 Houston AGD NDSC Implant Failures and Slow Eruption w/ Dr. Eric Scheyer
Wednesday, November 11 Houston FellowTrack The Practice Transition Process & Trends for New Dentists w/ Dr. Tom Guglielmo & Patrick Johnston
Saturday, December 5 TAGD Board Meeting Austin, TX
Thursday, November 12 San Antonio AGD Thursday CE Series #2 Bone Grafting w/ Dr. Steve Buckley
THANK YOU TO OUR STATEWIDE EDUCATION PARTNERS
Friday-Saturday, December 11-12 Texas AGD Master Study Club Lost Pines, TX December 25-January 1 TAGD Office Closed
Tuesday, November 17 Houston AGD NDSC Henry Schein Wednesday, November 18 SAFE San Antonio NDSC Social
For more info or to register
Thursday, November 19 Dallas AGD NDSC Peri-Implantitis Increased Incidence: A Challenge Ahead w/ Dr. Aline Speer
call the TAGD office at 512-371-7144 or visit tagd.org/events
November 26-27 TAGD Office Closed
Hiring dental assistants? Are they registered with the Texas State Board of Dental Examiners? TAGD offers prospective RDA’s an online course that will provide them with the knowledge and understanding of the critical concepts associated with each of these areas of certification: Radiology, Infection Control and Jurisprudence.
TAGD Online Courses Want to earn CE’s to continue your lifelong learning, but don’t have the time to leave your practice? Avoid travel time by taking it from the convenience of your home or practice. View our full list of online courses here. NEW! Online Fellowship Review coming soon!