THE NEXT DDS Magazine Fall 2013 by The NEXTDDS

The Educational Resource Exclusively for Dental Students

THE

T H ETN HEEX NTEDXDTSD.D c oSm. c oSUMMER m FALL 2013 / VOLUME 3 ISSUE 1

GOING PRO:

MAKING THE LEAP FROM STUDENT TO PROFESSIONAL

• Find the Right Associateship • Join the Ideal Group Practice • Make the Most of Your Specialty Training

THENEXTDDS.com: A GROWING EDUCATIONAL RESOURCE Scan a Tag using your mobile device to automatically open THENEXTDDS webpage Published by

Give Kids A Smile

Oral Cancer Awareness at Nova CDM

THE NEXT DDS Feature Interview

It’s more than a store.

Now you can research and order more than 1,700 Nobel Biocare products from anywhere – 24/7. Using “Quick Order” you can expedite your purchase through the order history function.

NEW

The “My Catalog” feature lets you create your own product catalog to share with your treatment team for streamlined communication.

The Online Store is easy to use from your smart device! Nobel Biocare’s new Online Store: store.nobelbiocare.com

Your business is our business. At Nobel Biocare our mission is to provide dental professionals with superior products and services that will in turn help improve the quality of life for their patients. The Nobel Biocare Online Store was first launched in 2004. Recognizing the growing generated of at BeQRious.com number customers who choose to order products via the Internet, Nobel Biocare has developed a brand new

e-commerce site that makes the buying experience more user-friendly. Robust search capabilities let you refine your search by connection type, drill protocol, compatible components, and more, making it easier to find exactly what you need. The Online Store also offers product descriptions, article numbers, and a virtual database of Nobel Biocare products – all at your fingertips.

Try it now: store.nobelbiocare.com Scan the QR code with your smart device to learn more. Nobel Biocare USA, LLC. 22715 Savi Ranch Parkway, Yorba Linda, CA 92887; Phone 714 282 4800; Toll free 800 993 8100; Technical services 888 725 7100; Fax 714 282 9023 Nobel Biocare Canada, Inc. 9133 Leslie Street, Unit 100, Richmond Hill, ON L4B 4N1; Phone 905 762 3500; Toll free 800 939 9394; Fax 800 900 4243 © Nobel Biocare USA, LLC, 2013. All rights reserved. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare. Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability.

Out with the old.

In with the new.

Introducing the new LOCATOR® Overdenture Implant System (LODI) featuring narrow diameter implants. Designed to work perfectly with our best-in-class 2.5mm Cuff Heights 4mm

LOCATOR A achments, LODI offers the valuable a ributes of narrow diameter implants, but with the flexibility of a unique two-piece coronal design not found with O-Ball mini implants. It’s this unique design that allows for the flexibility of a achment replacement should wear occur throughout time. LOCATOR Overdenture Implants are constructed from the strongest titanium

2.4mm Diameters 2.9mm

available and feature a proven RBM surface. The LODI system incorporates all of LOCATOR’s sought-a er features, including its patented, pivoting technology and customizable levels of retention, while also having a dramatically reduced vertical

Included with each implant

height compared to O-Ball mini implants.

Say so long to O-Rings and hello to the LOCATOR Overdenture Implant System. For more information, call 1.855.868.LODI (5634) or visit our website at www.zestanchors.com/lodi/71

THE

Fa l l 2 0 1 3 C o n t e n t s

16 A DENTAL CAREER

IN THE U.S. MILTITARY

53 PROTECT YOURSELF FROM EMPLOYEE THEFT by Gene Heller, DDS

56 THE NEXT DDS INTERVIEW

JENNA HATFIELD-WAITE

GIVE KIDS A SMILE EXTENDING CARE TO UNDERSERVED CHILDREN AROUND THE COUNTRY

THE NEXT DDS

Fall 2013

Volume:3

Issue:1

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THE

Fa l l 2 0 1 3 C o n t e n t s

FOREWORD GOING PRO: FROM STUDENT TO PROFESSIONAL

by Alyssa Ochs

10 WAYS TO KEEP THE ENERGY FLOWING by Sherry L. Granader

29 33

IMPRESSION MAKING: SOFT TISSUE CONSIDERATIONS AND TOOTH PREPARATION by Ernesto A. Lee, DMD

ORAL CANCER AWARENESS An Interview with Uyen Nguyen

BY THE NUMBERS

A PASSING GRADE FOR YOUR PASSWORDS

by John Papa

THE EVOLUTION OF THE TELEPHONE

For reader inquiries: Tel: 201-490-8811 xmg@thenextdds.com

© 2013 Next Media Group, Inc. All rights reserved. THE NEXT DDS is published and copyrighted by Next Media Group, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form—print, electronic, or otherwise—without the expressed written permission of the Publisher. Opinions expressed in the articles and communications contained in this publication are those of the authors and not necessarily the editor(s) or the Publisher. The editor(s) and Publisher disclaim any responsibility or liability for such material and do not guarantee, warrant, or endorse any product presented in this publication, nor do they guarantee any claim made by the manufacturer of such product or service.

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Experience precision engineering.

Rely on quality-assured and long-lasting restorations.

Satisfy every need with a wide variety of lightweight bars and attachments. Access tools for effective patient communication.

NobelProcera Titanium Implant Bar Overdenture

Itâ&#x20AC;&#x2122;s called NobelProcera. A single system that lets you provide your patients with individualized prosthetic solutions for every indication. Gain the peace of mind that comes with complete coverage including extensive warranty, quality assurance and material certification. Prescribe wide selection of individualized restorations, generated ataBeQRious.com all in biocompatible materials, that yield a consistent fit

and natural-looking esthetics. As a pioneer in CAD/CAM dentistry, NobelProcera uses innovative digital technology and centralized precision milling for tooth- and implant-based copings to full-arch bridges and implant bars. Partner with Nobel Biocare and make a real and lasting difference to the well-being of your patients. Their smile, your skill, our solutions.

To purchase products and to find out more information go to store.nobelbiocare.com or call 800 322 5001. Scan the QR code with your smart device to learn more. Nobel Biocare USA, LLC. 22715 Savi Ranch Parkway, Yorba Linda, CA 92887; Phone 714 282 4800; Toll free 800 322 5001; Technical services 888 725 7100; Fax 714 282 9023 Nobel Biocare Canada, Inc. 9133 Leslie Street, Unit 100, Richmond Hill, ON L4B 4N1; Phone 905 762 3500; Toll free 800 939 9394; Fax 800 900 4243 ÂŠ Nobel Biocare USA, LLC, 2013. All rights reserved. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare. Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability.

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Important Safety Information: PreviDent ® 5000 Booster Plus (1.1% Sodium Fluoride) is a dental caries preventative toothpaste for adults and pediatric patients 6 years of age and older. The product is for once daily, topical use. It is not to be swallowed. Allergic reactions and idiosyncrasies have been rarely reported. See page 3 for brief summary of risk information. Comparison vs ClinPro™ 5000 toothpaste and MI Paste Plus™ topical creme. Comparison vs PreviDent® 5000 Booster. ‡ Optimized fluoride delivery system. *

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Fall 2013

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†

References: 1. Data on file; Colgate-Palmolive, 2012. In vitro pH cycling model after 10 and 20 days. 2. Data on file; Colgate-Palmolive, 2012. In vitro standard method for enamel fluoride uptake.

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f r o m

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1.1% Sodium Fluoride PRESCRIPTION STRENGTH TOOTHPASTE

DESCRIPTION: Self-topical neutral fluoride dentifrice containing 1.1% (w/w) sodium fluoride for use as a dental caries preventive in adults and pediatric patients. Active Ingredient: Sodium fluoride 1.1% (w/w) INDICATIONS AND USAGE: A dental caries preventive; for once daily selfapplied topical use. It is well established that 1.1% sodium fluoride is safe and extraordinarily effective as a caries preventive when applied frequently with mouthpiece applicators. 1-4 PreviDent® 5000 BoosterPlus brand of 1.1% sodium fluoride toothpaste in a squeeze bottle is easily applied onto a toothbrush. This prescription toothpaste should be used once daily in place of your regular toothpaste unless otherwise instructed by your dental professional. May be used in areas where drinking water is fluoridated since topical fluoride cannot produce fluorosis. (See WARNINGS for exception.) CONTRAINDICATIONS: Do not use in pediatric patients under age 6 years unless recommended by a dentist or physician. WARNINGS: Prolonged daily ingestion may result in various degrees of dental fluorosis in pediatric patients under age 6 years, especially if the water fluoridation exceeds 0.6 ppm, since younger pediatric patients frequently cannot perform the brushing process without significant swallowing. Use in pediatric patients under age 6 years requires special supervision to prevent repeated swallowing of toothpaste which could cause dental fluorosis. Pediatric patients under age 12 should be supervised in the use of this product. Read directions carefully before using. Keep out of reach of infants and children. PRECAUTIONS: General: Not for systemic treatment. DO NOT SWALLOW. Carcinogenesis, Mutagenesis, Impairment of Fertility: In a study conducted in rodents, no carcinogenesis was found in male and female mice and female rats treated with fluoride at dose levels ranging from 4.1 to 9.1 mg/kg of body weight. Equivocal evidence of carcinogenesis was reported in male rats treated with 2.5 and 4.1 mg/kg of body weight. In a second study, no carcinogenesis was observed in rats, males or females, treated with fluoride up to 11.3 mg/kg of body weight. Epidemiological data provide no credible evidence for an association between fluoride, either naturally occurring or added to drinking water, and risk of human cancer. Fluoride ion is not mutagenic in standard bacterial systems. It has been shown that fluoride ion has potential to induce chromosome aberrations in cultured human and rodent cells at doses much higher than those to which humans are exposed. In vivo data are conflicting. Some studies report chromosome damage in rodents, while other studies using similar protocols report negative results. Potential adverse reproductive effects of fluoride exposure in humans have not been adequately evaluated. Adverse effects on reproduction were reported for rats, mice, fox, and cattle exposed to 100 ppm or greater concentrations of fluoride in their diet or drinking water. Other studies conducted in rats demonstrated that lower concentrations of fluoride (5 mg/kg of body weight) did not result in impaired fertility and reproductive capabilities. Pregnancy: Teratogenic Effects: Pregnancy Category B. It has been shown that fluoride crosses the placenta of rats, but only 0.01% of the amount administered is incorporated in fetal tissue. Animal studies (rats, mice, rabbits) have shown that fluoride is not a teratogen. Maternal exposure to 12.2 mg fluoride/kg of body weight (rats) or 13.1 mg/kg of body weight (rabbits) did not affect the litter size or fetal weight and did not increase the frequency of skeletal or visceral malformations. There are no adequate and well-controlled studies in pregnant women. However, epidemiological studies conducted in areas with high levels of naturally fluoridated water showed no increase in birth defects. Heavy exposure to fluoride during in utero development may result in skeletal fluorosis which becomes evident in childhood. Nursing Mothers: It is not known if fluoride is excreted in human milk. However, many drugs are excreted in milk, and caution should be exercised when products containing fluoride are administered to a nursing woman. Reduced milk production was reported in farm-raised fox when the animals were fed a diet containing a high concentration of fluoride (98-137 mg/kg of body weight). No adverse effects on parturition, lactation, or offspring were seen in rats administered fluoride up to 5 mg/kg of body weight. Pediatric Use: The use of PreviDent® 5000 BoosterPlus in pediatric age groups 6 to 16 years as a caries preventive is supported by pioneering clinical studies with 1.1% sodium fluoride gels in mouth trays in students age 11 to 14 years conducted by Englander et al.2-4 Safety and effectiveness in pediatric patients below the age of 6 years have not been established. Please refer to the CONTRAINDICATIONS and WARNINGS sections. Geriatric Use: Of the total number of subjects in clinical studies of 1.1% (w/v) sodium fluoride, 15 percent were 65 and over, while 1 percent were 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.5 ADVERSE REACTIONS: Allergic reactions and other idiosyncrasies have been rarely reported. OVERDOSAGE: Accidental ingestion of large amounts of fluoride may result in acute burning in the mouth and sore tongue. Nausea, vomiting, and diarrhea may occur soon after ingestion (within 30 minutes) and are accompanied by salivation, hematemesis, and epigastric cramping abdominal pain. These symptoms may persist for 24 hours. If less than 5 mg fluoride/kg body weight (i.e., less than 2.3 mg fluoride/lb body weight) has been ingested, give calcium (e.g., milk) orally to relieve gastrointestinal symptoms and observe for a few hours. If more than 5 mg fluoride/kg body weight (i.e., more than 2.3 mg fluoride/lb body weight) has been ingested, induce vomiting, give orally soluble calcium (e.g., milk, 5% calcium gluconate or calcium lactate solution) and immediately seek medical assistance. For accidental ingestion of more than 15 mg fluoride/kg of body weight (i.e., more than 6.9 mg fluoride/lb body weight), induce vomiting and admit immediately to a hospital facility. A treatment dose (a thin ribbon) of PreviDent® 5000 BoosterPlus contains approximately 2.5 mg fluoride. A 3.4 FL OZ (100 mL) bottle contains approximately 605 mg fluoride.

The Importance of Peer Review

ince its inception, THE NEXT DDS has used peer review to ensure that articles, instructional videos, podcasts, etc. shared with you meet appropriate quality standards. It’s the single-most important difference between THE NEXT DDS and the blogs, wikis, and other online resources availed to you as skilled Internet users. This peer-review process is essential not only to your instructors and your understanding of fundamental concepts in dentistry, but your future patients as well. Manuscripts that we secure or those submitted to THE NEXT DDS undergo immediate review of their appropriateness for you, our voracious audience of aspiring dental professionals. Submissions that fit our goal of excellence in adjunct education are subsequently reviewed by Academic Advisory Board members with specialized expertise in the field. These reviewers gauge the submitted text, script, or images according to several criteria that include technical/scientific accuracy, composition, clinical relevance, clinical competency, and quality of the figures. In this endeavor, the Academic Advisory Board members are committed to helping you prepare for milestones in your university training as well as supporting you with the competency to meet the oral healthcare needs of the public after graduation. Our goal is to publish and post instructional materials to address our broad educational mission, mirroring as possible the pedagogy to which you are exposed throughout your classroom and clinic training. Some manuscripts satisfy the necessary standards upon their initial submission; yet others meet appropriate quality standards as a result of our “progressive” peer review—wherein our Board helps mentor the submitting author to achieve the desired educational outcome. Whether adding appropriate visuals, noting current research that should be included, or sharing helpful guidance on the focus and structure of the presentation, we appreciate all the Board does to improve the integrity of each submission and enhance the understanding of our growing audience. This progressive peer review and the mentoring process foster collaboration between the Board and the submitting author, but more importantly, ensure THE NEXT DDS delivers quality materials to you. Our target is well-supported dental education, and the progressive peer review ensures that each submission achieves this goal.

DOSAGE AND ADMINISTRATION: Follow these instructions unless otherwise instructed by your dental professional: 1. Adults and pediatric patients 6 years of age or older, apply a thin ribbon of PreviDent® 5000 BoosterPlus to a toothbrush. Brush teeth thoroughly once daily for two minutes, preferably at bedtime, in place of your regular toothpaste. 2. After use, adults expectorate. For best results, do not eat, drink, or rinse for 30 minutes. Pediatric patients, age 6-16, expectorate after use and rinse mouth thoroughly. Rev. 07/12

1946_cp_BoosterPlus_ad_PI_final.indd 1

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7/2/13 3:19 PM

Richard M. Groves Vice President of Editorial Services, Next Media Group Follow Rich On Twitter @thenextdds

Fall 2013

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THE NEXT DDS

ORIENTATION

GOING PRO: FROM STUDENT TO PROFESSIONAL

R A D U AT I N G F RO M DENTAL SCHOOL IS AN AMAZING ACCOMPLISHMENT ACHIEVED BY ONLY AN ELITE FEW IN THE HEALTHCARE PROFESSION. Although graduation day is a milestone in every dental student’s life, it’s also a pivotal decision-making time that opens up a world of opportunities. Many dental school graduates choose to pursue their education even further by specializing in an advanced field. Other graduates prefer to get straight to work by accepting an associate opportunity at an existing practice. Still others join a dental group practice to kick start their careers. By asking good questions and taking advantage of every resource and opportunity to learn about the transition from dental school to the dental profession, you will inevitably set yourself up for success. No matter which pathway to the profession you choose, your ultimate career goals will be similar. During this critical transition period,

THE NEXT DDS

by Alyssa L. Ochs

you will undoubtedly gain experience in procedures that your patients depend upon you to perform. Although you’ve already been providing patient care in the dental school clinic, this may be one of the first times you do so independently. The early career of a dentist is an exciting time to learn about work environments, gain confidence, and decide which career path is right for you. Many dental school graduates pursue postdoctoral education to receive training in a specific field they are passionate about or to get a leg up on the competition. A 2011 American Dental Education Association (ADEA) report indicated about 37% of dental school graduates advanced to specialize in an advanced field.1 More than 700 different postdoctoral programs are available today. There are currently nine dental specialties recognized by the American Dental Association (ADA), so you may prefer to choose from one of these sub-fields:

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DENTAL SPECIALTIES Recognized by the American Dental Association • • • • • • •

Dental Public Health Endodontics Oral and Maxillofacial Pathology Oral and Maxillofacial Radiology Oral and Maxillofacial Surgery Orthodontics and Dentofacial Orthopedics Periodontics

• Pediatric Dentistry • Prosthodontics

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ORIENTATION

DENTAL SPECIALTIES RECOGNIZED BY THE AMERICAN DENTAL ASSOCIATION • Dental Public Health • Endodontics • Oral and Maxillofacial Pathology • Oral and Maxillofacial Radiology • Oral and Maxillofacial Surgery • Orthodontics and Dentofacial Orthopedics • Periodontics • Pediatric Dentistry • Prosthodontics

Ask good questions and take advantage of every resource to learn about the transition from school to work.

THE NEXT DDS

URL

aspendentaljobs.com Year Founded

1998

Whether it’s periodontics, oral and maxillofacial surgery, or prosthodontics, working in a specialized field has its risks and its benefits. More education equates to more student loans and more time spent with professors instead of patients. But upon successful completion of a specialized program, graduates may be qualified to work in exclusive environments and be eligible to earn higher compensation. Since all those fees for transcripts, essays, and interviews add up, it’s helpful to outline your advanced education expenses with an application expense tracking worksheet2. If you’re considering postdoctoral education, carefully review application processes on your top schools’ websites so you don’t miss crucial deadlines.

Mission Statement

ASSOCIATESHIPS

1. Tremendous Earning Potential 2. Defined Path to Ownership 3. Proven Practice Models

According to the ADA , two out of every three dental school graduates pursue associateships after graduation. Associateships are a popular option because they allow graduates to gain experience alongside an experienced dentist while still earning a reliable paycheck. However, not all associateships are created equal. Some associates work in large group practices and others for individual practice owners. Associateships are a great option if you’re not yet in a financial position to take large risks, since they require no initial capital. The downside is a smaller income, restrictions on managerial roles, and limitations on effecting change in the office. THE NEXT DDS offers numerous resources to help you get started on your exploration of this topic and even to help evaluate an associateship opportunity.4 A good compromise for graduates who choose the associateship path is the “buy in” option. Associates who have practice equity often have the option to make an investment and become a partner in the practice, resulting 3

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Aspen Dental dentists are skilled clinicians, trained at some of the nation’s most prestigious dental schools. Each possesses a thorough knowledge of the most up-to-date dental and denture procedures. Though their backgrounds are diverse, they all share one common goal: to help their patients get the care they need. States of Coverage / Emphasis

AL, AZ, CT, FL, GA, IL, IN, IA, KY, ME, MA, MI, NE, NH, NY, OH, OK, OR, PA, RI, SC, TN, VT, WA, WI Benefits

Social Media Handles

https://www.facebook.com/AspenDental, @aspendentaljobs.com Blog Address

http://www.aspendental.com/dental-blog/ Phone/Email Contact

Phone: 866-529-2361 www.aspendentaljobs.com/dentists.htm Best reason to consider this organization

Our success is a direct result of empowering and supporting ambitions dental professionals. Together, we can build and develop successful, patient-focuszed dental practices.

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aspendentaljobs.com

Be the dentist you want to be. At Aspen Dental, you have the power to earn a high income, own a practice one day, and focus on what you love most: dentistry. You also have the chance to make a real diďŹ&#x20AC;erence in the lives of patients. So join the team thatâ&#x20AC;&#x2122;s spreading good dental health and goodwill all over America. To learn more, please visit our website or call us today at 866.745.9679 to talk to a recruiter.

practice made perfect

ORIENTATION

in higher income and greater responsibility. Dental recruiting agencies like Henry Schein Nationwide Dental Opportunities (www.dentalopportunities.com) can provide placement assistance for graduates seeking associateships.

URL

http://www.heartlanddentalcare.com/

THE GROUP PRACTICE

For dental school graduates beginning their careers, the group practice path is an especially practical one

THE NEXT DDS

For dental school graduates beginning their careers, the group practice path is an especially practical one. It is extremely difficult to establish a successful solo dental practice fresh out of school with minimal professional experience. Group practices can provide you with shared management responsibilities, shared patient coverage, and flexible schedules. It is often beneficial for earlycareer dentists to work in a team environment to learn about different management styles, patient manners, and areas of expertise. To do well in a private practice, you may also need experience managing employees, marketing your practice, negotiating contracts, and managing the cash flow. These tasks can become time consuming and detract from the value of your clinical services. However, group practices often offer comfortable benefit packages like retirement plans, health plans, investment options, and vacation time. Many group practices like Aspen Dental, Heartland Dental Care, and Pacific Dental Services — each of which has joined THE NEXT DDS in supporting your university training—provide associate dentists with immediate benefits and the opportunity to grow into managing clinical directors or even practice owners. Founded in 1998, Aspen Dental has a practice model based on five core tenants: 1) access to care, 2) comprehensive care, 3) quality service, 4) training, and 5) teamwork. Aspen believes in their numerous training tools, resources, and emphasis on teamwork produces the greatest results. Heartland Dental Care, established in 1997, is a model for large group practice. Heartland provides you and your team with leadership and support through world-class continuing education, and services such as staffing, human resources, purchasing, marketing, administrative needs, and financial and information technology. Since its 1994 founding, Pacific Dental Services has always promoted the concept of excel-

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Year Founded

1997 Mission Statement

To support dentists as they deliver the highest quality dental care and experiences to the communities they serve, while providing exceptional careers for all of our team members and creating value for our stakeholders. States of Coverage / Emphasis

AZ, FL, GA, IL, IN, IA, KY, MD, MI, MO, NE, NV, NY, OK, OH, PA, SC, TN, TX, VA, WI Benefits

1. CONTINUING EDUCATION: World-class CE opportunities with networking and leadership training 2. MENTORING: Each new dentist is assigned a mentor from one of the 800+ affiliated dentists 3. LOCATION: More than 425 dental offices in 21 states and growing Social Media Handles

https://www.facebook.com/ HeartlandDentalCare, @HeartlandDental http://www.linkedin.com/company/heartlanddental-care Blog Address

http://www.smilingmagazine.com/ Phone/Email Contact

Phone: 866-586-7694 Email: Recruiting@heartlanddentalcare. com Best reason to consider this organization

Heartland Dental Care’s unparalleled CE offerings, industry relationships, exceptional non-clinical administrative support and growth potential will allow affiliated dentists the opportunity to be the best dentists they can possibly be.

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+ SUPPORTED AUTONOMY

You want to kick-start your dental career. “The career partnership my wife and I chose to engage in with Pacific Dental Services® has enabled us to accomplish significant results in the profession and in my ability to earn a robust income to provide for my family. The support services and collaboration with some of the best minds in business have helped me incur far less risk for myself as a younger clinician in our current economy.”

Todd Cockrell, DMD Multiple-Office Owner Dentist

1-855-JOIN-PDS joinpds@pacden.com

Hear what numerous supported Owner Dentists have to say about the advantages of PRIVATE PRACTICE + ® at: PacificDentalServices.com

By providing Supported Autonomy, PRIVATE PRACTICE +, supported by PDS®, frees you to build a successful dental practice, backed by the country’s leading dental business-support organization. You’ll enjoy excellent income potential with asset growth, plus a better work/life balance.

ORIENTATION

URL

http://pacificdentalservices.com/ Year Founded

1994 Mission Statement

Our vision is to be The Greatest Dental Company in America. We do whatever is in our power in supporting dentists and team members to provide the highest quality dental care to patients of our supported offices. States of Coverage / Emphasis

AZ, CA, CO, GA, ID, MO, NM, NV, OR, TX, UT, WA Benefits

1. Excellent income and ownership opportunities 2. Balanced lifestyle and mentorship support 3. Modern dentistry, integrated specialties and continuing education Social Media Handles

lence through teamwork. Its Private Practice+ program enables dentists to build their own successful dental practice while being backed by the country’s leading support organization. For a closer look at each, please see each accompanying sidebar at page right.

CONCLUSION Ultimately, the field of dentistry is rewarding, respected, and offers a work-life balance that is uncommonly refreshing in the medical profession. While these are the most popular career options among dental school graduates today, they aren’t the only ones. Dentistry opens itself up to professional opportunities in a wide variety of work environments, including emergency rooms, research laboratories, international relief organizations, and even the military. Before making a decision, consider where you want to live, how flexible your finances are, and what work style makes you happiest. Take into consideration that people today are living longer and increasingly obsessed with looking younger. Not only are the cosmetic and implant industries booming, more low-income families are gaining access to dental insurance for six-month checkups and regular cleanings. Fortunately for all graduates, the demand for dentistry is high and it's increasing every year.5

Twitter: @PacificDental Facebook: PacificDentalServices Blog Address

http://www.pacificdentalservices.com/ blog/

Alyssa Ochs is a Chicago-based writer specializing in travel, health, and nutrition topics as well as blogging, and social media.

The early career of a dentist is an exciting time to learn, gain confidence, and decide which path is right for you.

References

Phone/Email Contact

Rebecca Sorci, Dental Education Relations Manager (714) 845-8584 sorcir@pacden.com Best reason to consider this organization

With the innovative PRIVATE PRACTICE + model from Pacific Dental Services, you’ll have ownership opportunities with true autonomy – plus benefit from a proven support structure. You’ll be in control of treatment plans while boosting income, reducing risk, and enjoying far better work/ life balance.

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1. American Dental Education Association. ADEA survey of dental school seniors, 2011 graduating class. Available at http://www.adea.org/publications/library/ADEAsurveysreports/Pages/ADEASurveyofDentalSchoolSeniors2011GraduatingClass.aspx 2. American Dental Association. Advanced dental education: Application expense tracking. Available at http://www.ada. org/sections/educationAndCareers/pdfs/advdentaled_ app_finance_worksheet.pdf. Accessed June 19, 2013. 3. American Dental Association. Associateships. Available at http://www.ada.org/sections/educationAndCareers/pdfs/ associateships.pdf. Accessed June 19, 2013. 4. Dunning, DG. Seven suggestions for initially exploring a possible associateship opportunity. Available at http:// www.thenextdds.com/Articles/Seven-Suggestions-forInitially-Exploring-a-Possible-Associateship-Opportunity/. Accessed June 2, 2013. 5. Aegis Communications. The dental career path: Did you choose the right profession? Inside Dentistry 2006;2(9).

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career spotlight

A DENTAL IN THE

CAREER

U.S. MILITARY

ndecided about your post-graduation plans? Donâ&#x20AC;&#x2122;t think practice ownership or residency

is right for you just yet? Want to get out and see the world while still practicing dentistry? Consider a career as a Federally Employed Dental Professional. There are nearly 5,000 dentists currently working for the United States Government, the Department of Veteransâ&#x20AC;&#x2122; Affairs, and the U.S. Military.1 Military dentists may serve either in the U.S., or oversees, and aid the U.S. Army, Navy, and Air Force with the dental and oral health needs of their members.

Advance Your Career

While Serving Your Country

THE NEXT DDS

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United States Air Force

United States Army

United States Navy

The United States air force offers an environment of discovery, learning, and career advancement that takes dentists beyond the norm of in-office paperwork, and lets them focus on treating patients and solving dental problems. Dentists in the air force are responsible for tending to the oral health needs of the thousands of airmen and their families, both domestically and abroad. The Air Force has a variety of specialties programs for which they offer special training opportunities, from comprehensive general dentistry, to orthodontics, to oral and maxillofacial surgery. The Air Force also offers additional graduate medical education, medical research opportunities, and continuing medical education programs to help meet professional CE requirements to advance your career in the air force or in the private sector.

The United States Army offers dental professionals immediate access to one of the world’s best networks. There is no need to stress about starting a practice, establishing a patient base, hiring staff, or purchasing equipment, and you will have the opportunity to begin directly treating the men and women of the U.S. Armed Forces at home or abroad. The Army offers great benefits for dental professionals, ranging from 30 days’ paid vacation, comfortable housing options, continuing education scholarship programs, loan repayment programs, and sign-on bonuses of up to $75,000. Dentists also have the option of serving full-time as an officer on active duty, or maintaining a private practice within their own community and serving as needed in the Army Reserve.

The United States Navy offers dentists the opportunity to serve sailors, marines, and services members—as well as their families. In addition, Navy dentists are afforded the chance to aid with humanitarian causes in the United States, and around the world, including underserved countries where dentistry is more of a luxury than an expectation. You have no need to worry about the private practice concerns of malpractice insurance, expensive equipment coasts, and paperwork. The Navy accepts applicants in all stages of their dental career, from student to specialist. Students are afforded scholarships, including the Navy Health Professions Scholarship Program (HPSP), which can reimburse up to 100% of dental school tuition, plus a $20,000 signing bonus and monthly stipend of $2,000. The Navy offers careers in more than a dozen specialty areas, and a work environment unlike any other.

A lot of time in the civilian sector, you’re more concerned with what’s going to make you money versus what’s best for the patient. There’s never a monetary issue, I’m never worried about finances, I’m never worried about having the equipment. I can come in and know that I can treat someone 110% with state of the art equipment every single day. — Major James W. Pledger Oral & Maxillofacial Surgeon

You don’t have to worry about the soldier’s ability to pay the bill, or insurances. It lets me concentrate on dentistry. There’s amazing technologies that are at our fingertips here, where you can’t always have those in a private practice. — Major Michele Pawlowicz General Dentist (Reserve)

In the world of Navy Health Care, you can attain a broader spectrum of experience faster as you find yourself at the forefront of the dental field. — United States Navy

For more information about a career with the United States Air Force, visit www.airforce.com/healthcare/dentist For more information about a career with the United States Army, visit www.goarmy.com/amedd/dentist For more information about a career with the United States Navy, visit visit www.navy.com/careers/healthcare/dentist.

Conclusion The United States Military offers a variety of great alternatives to dental students and recently graduated dental professionals. All three branches of the military (Army, Navy, Air Force) that offer these exciting career opportunities provide dentists with the opportunity to practice their profession while avoiding all the paperwork and office worries that accompany private practice ownership. They offer immediate competitive pay to dental professionals (unlike a residency program), while still providing the opportunity for training in various continuing education topics and specialty fields. These career paths are a great way to serve your country, while still bettering yourself as a dentist and aspiring towards your professional goals.

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Give Kids a

Smile

EXTENDING CARE TO UNDERSERVED CHILDREN AROUND THE COUNTRY interviewed by Rich Groves

LISTEN TO THE FULL PODCAST INTERVIEW BY SCANNING THIS TAG!

MACKENSIE TAPPE

ETHAN PURYEAR & KRIS NORBO

DR. DAVID BROWN

DB AMANDA MEYER

THE NEXT DDS

very February, caregivers across the country take part in Give Kids A Smile events. Founded by the American Dental Association in 2003, this monthlong initiative was put in place to raise awareness of pediatric oral health and to provide children with much-needed oral care. In addition to opening their doors to more than 450,000 children nationwide, practicing dentists and dental students participated in large events and activities designed to educate community children about the importance of oral health, to promote beneficial oral habits, and to remove the stigma often associated with going to the dentist. THE NEXT DDS was lucky enough to interview a number of participants, and podcasts featuring Mackensie Tappe (MT) of the University of Minnesota School of Dentistry, Ethan Puryear (EP) and Kris

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Norbo of the Virginia Commonwealth University School of Dentistry can be accessed via the tags on the sides of this page. THE NEXT DDS also spoke with Dr. David Brown (DB), an organizing and participating professor from the University of Nebraska Medical Center, as well as UNMC dental student Amanda Meyer

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How was patient turnout for your Give Kids A Smile event? MT At The University of Minnesota School of Dentistry, we treated 178

children. They were lined up outside when we started—most appointments were prescheduled and the result of promotional efforts involving local non-profit organizations, local media, school districts, and a host of related community groups..

We saw 104 over the course of the entire day, which is great for VCU. We did a total of 828 procedures—which equates to approximately $50,000 worth of care.

At the University of Nebraska, we saw about 180 children for treatment. The children traveled up to three hours by bus and came from 12 rural communities. We actually hired three large highway buses to shuttle most of the children to the college, then back home at the end of the day.

How did this year’s turnout compare to previous GKAS events? MT We actually saw fewer children this year than in 2012. This was

(AM), about their GKAS activity. While all the participants shared unique details of the day’s events, there were several across-the-board similarities. The contents of these interviews were enlightening and gave valuable insight into how GKAS is coordinated and conducted in different schools around the U.S.

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because of a few factors that we already knew about—one being that there were 67 new offices in Minnesota this year that opened their doors that same day for their own Give Kids A Smile events. Another factor was the Affordable Care Act coming into play in Minnesota, which has allowed parents and children to visit their regular dentists on any day, rather than waiting on a weekend day for care at the University.

EK We do not have the exact numbers, but one of our faculty members

involved in the event said that we had surpassed all numbers from years prior. Most of our patients were already scheduled, but we did see a lot of walk-ins as well.

DB It has been pretty consistent over the past 10 years, actually. We rou-

tinely perform about 1,200 to 1,400 procedures, and deliver care of about $100,000 at private practice rates.

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THE NEXT DDS

A "Smile Day" Experience Courtesy of the dental students and faculty of the University of Louisville School of Dentistry

How did you promote GKAS in your area?

How many students from your class participated in the event?

MT We worked with United Way, and they ran most of our advertising—a

lot via television advertising. On January 7, we started running TV ads and set up a hotline that the patients could call to set an appointment with one of the local clinics. We also advertise at local homeless shelters and some of the food shelters in local communities, and we work with the Minneapolis school districts; their faculty sent out advertisements to students’ parents. We speak with some of the local clinics and practices that participate and, if they fill up, they send the children to us. Otherwise we just send out fliers, use word-of-mouth, and Craigslist, which was actually very successful for us this year. We also get some help from the Minnesota Dental Association. It’s a very extensive network.

To promote Give Kids A Smile at VCU School of Dentistry, we used a lot of word-of-mouth and some television advertisements, and we put up fliers around the area too.

UNMC used district health departments, school nurses, and faithbased agencies that know about the needy kids in their areas to spread the word.

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MT We include all the dental students at the University of Minnesota,

from dental therapy to dental hygiene. From the dental students alone we had around 247 volunteers. Including non-dental volunteers, those being children of the faculty or pre-dental students, we had about 270 total volunteers.

From our D3 class, there were ten dental students and eight dental hygiene students. There were also a number of residents and faculty, and several private practitioners who even helped out and took on a considerable work load.

DB We had 200 student volunteers, 15 residents, and 50 faculty mem-

bers. They were joined by a small group of local practitioners and about a dozen rural private dentists who do advanced patient screenings for us. Additionally, at the University of Nebraska, we like to use Give Kids a Smile Day as an opportunity for Interprofessional Education with students from our College of Nursing. 70 nursing students participated throughout the day doing “well child checks”, aerobic exercise activities, and shadowing dental and dental hygiene students in the clinic.

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What was the most common procedure performed? MT

Most common, both this year and last year, were preventative and sealants procedures, which is good for us because it says that these children are taking care of themselves. We especially like seeing those children who are repeat visitors from year to year, since we are not seeing new cavities forming. We are seeing them taking care of their dentition, and what we are teaching them is actually sticking, so our biggest procedures this year were, by far, preventatives and sealants. Every child that walked through our door also received a radiograph and a complete oral health screening, and from there it was decided whether they needed operative or preventative care.

How where the children’s attitudes throughout the day? Did they seem excited? MT

We saw a lot of caries among this patient base, but our most common procedure was the application of sealants. We placed over 200 sealants throughout the day. In addition, we provided some restorative care, prophylaxis, and fluoride treatment. Prophylaxis and fluoride were about the same in number, but not quite as many as sealant cases. Definitely sealants. We did over 650 sealants, followed by prophylaxis, all forms of restorative care, some extractions, and a few pulpotomies. We also placed a couple stainless steel crowns, and worked on nine endodontic cases throughout the day.

There’s a mix of emotions. There are some children who have never been to this event before, and they are a little bit apprehensive and a little bit scared. For that reason we have our pediatric dentistry residents and faculty in attendance, since this is what they specialize in and work with every day. Some of the kids are very excited, though. Some of these children are repeat visitors. I recognized children who have been in GKAS since my first year, and this is their third year attending the event. We try to have activities for the children to keep them occupied while they wait for their appointments. We had a face painter this year, and we bring in students from the medical school, the veterinary school, the nursing school, the physical therapy school, and they come in and bring projects for the kids to do while they wait, to try to keep their minds occupied. We try to keep them entertained and keep their spirits up.

VISITORS…AND

You get a bit of a mixed bag. Give Kids a Smile includes all kinds of people with different experiences and expectations. Generally, I would say that the kids enjoyed the experience. We put in a lot of effort to make it a fun time for them. We were in our pediatric clinic here at the school, so it is already geared towards treating kids, but we try to have fun activities in the waiting areas to accommodate them. Of course you would have some hesitant patients, but you would also have patients that were in pain. Knowing that they would get their needs taken care of and not be in pain anymore would help our young patients overcome the little bit of anxiety they might have.

SEEING THEM

DB The kids are always very excited

WE LIKE SEEING CHILDREN WHO ARE REPEAT

and have a lot of fun every year. One year we even had a stowaway who came back for a second year even though he did not need any dental work. He just had so much fun the first time that he wanted to come back!

TAKE CARE OF THEIR DENTITION — Mackenzie Tappe

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our profession and pledge to help those who are in need no matter whether they can pay or not, no matter what circumstance they are in, no matter where they come from. We as dental professionals are here to help people, and I think GKAS Day is the perfect example of us giving back to the community and to those who are most deserving. Dental care for a lot of these children is something they both need and deserve, and it’s a privilege for me to be able to help these kids who are in need. It is also a really great learning experience for many University of Minnesota dental students, because they don’t work with children on a daily basis. We do our pediatric rotation, but we really need to learn, as dental professionals, how to be patient with children, and how to work with this important audience. It makes us better dental professionals, and allows us to give back to the communities that made us who we are today.

Can you tell us about the most memorable or unique case you or your classmates treated? MT One of the most unique cases was a 17-year-old child who had never

received care before. It wasn’t the uniqueness of her case that caught my attention; it was her attitude toward dental care and trying to convince her that seeing a dentist was important. She was already going to lose three or four of her permanent teeth which, as a dental provider, is just crushing because she is so young, and that’s just leading down the path toward full dentures in the next few years. As dental providers, we want to do everything we can to save teeth, but it’s hard to work with a patient who doesn’t care about his or her teeth. That was just a mental psyche or the societal psyche that she had grown up with; losing teeth was, to her, a natural part of life. So trying to change her attitude was probably the most difficult, unique case.

EK It is important for the VCU School of Dentistry because we have a mis-

sion as a University to reach out and to be involved in our community, and events like this help us to reach a population that otherwise might not have care. Obviously it’s good for our school in that respect, but really it’s a mission of serving our patients, reaching a patient base that needs care, helping to establish a dental regimen here at the school, and ultimately getting them to improve their oral health. That goes for our school, and that goes for our profession as a whole. There’s a lot of talk today about healthcare reform and a lot of talk about access to care, and it’s great to be able to actually put your hands on something and do something yourself that can be looked at and tracked. It’s a great feeling for all of us personally and as a school community in that respect.

We didn’t do many complex cases during the actual event. We were able to re-appoint patients for general anesthesia or oral sedation at later dates if their cases were too complex, depending on our University’s OR or sedation schedule. We did do some surgeries and more in-depth cases, but they were completed on later dates.

AM The most complicated or unique case that I came across was a sweet

7-year-old girl who had decay on virtually every primary tooth that was still in her mouth, which was not her full dentition. I don’t know the exact reason behind her poor oral health, but lack of home care was definitely suspected. We extracted six teeth and placed two stainless steel crowns, and by that time we had only completed work in two quadrants. No matter how hard we worked, it seemed like that there was still always something to do. She was an absolute doll of a patient though, and never fussed once the whole time!

DB This initiative is important for us because it allows UNMC faculty to

Why do you think this GKAS initiative is important to your school and future profession? MT The first day we start dental school, one of our main events is our

White Coat Ceremony. That is the time when we sign the oath of

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demonstrate our service to the community and our professional responsibility as dentists. It is important for the University to fulfill its obligation of contributing to the dental safety net for the entire state. It’s also obviously important for the students to gain more experience working with multicultural and younger patient populations that they are not used to seeing in regular school clinics, and to gain experience in a public health environment providing important oral health chare to needy and underserved children. I know for a fact that this event drives some students make commitments to careers in pediatric dentistry and/or public health, which is great.

THE NEXT DDS would like to personally thank Mackensie Tappe, Ethan Puryear, Kris Norbo, Dr. David Brown, and Amanda Meyer for taking the time to speak and engage with us about these fantastic events. Our appreciation to Ms. Julie Heflin, Health Communications Specialist at University of Louisville Health Sciences Center, for sharing the great images from their LASDA GKAS event. All the activities for Give Kids A Smile seemed to be rousing success stories, and we hope this success carries over into next year, and beyond!

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THE NEXT DDS

h e a l t h

f i t n e s s

WAYS TO KEEP THE

ENERGY FLOWING

This may sound impossible but is much easier than you think. Keeping protein and fiber in mind, your minimeal could be something as simple as an apple with almond butter, a vegetable omelet, salmon over mixed greens with some whole-grain crackers, hummus with fresh vegetables, or Greek yogurt with some berries. Eating a huge meal demands more of your energy to digest and can leave you feeling lethargic—not what you need when you’re working on that troublesome carious lesion!

by Sherry L. Granader Sports Nutritionist

illions of Americans complain about fatigue, stress, and not having enough hours in the day. How you sleep and eat influences the energy you need to wake each morning refreshed and ready to take on the day. Even if you don’t rely on coffee or energy drinks, it is worth considering what you can do to keep yourself energized throughout a demanding day in dental school or clinic. Here are some smart strategies that help keep you energized in front of your professors or patients:

4 1

Eat Breakfast Even if you are not hungry, make an effort to eat some quality protein and fiber within one hour of waking. A blender smoothie that you make at home using good-quality protein derived from whey or egg whites is one good option; simply add some berries for fiber, pour into a thermos, and you are good to go.

THE NEXT DDS

Keep Emergency Foods On Hand There is nothing worse than being stuck in traffic or the classroom without any food or water. Keep emergency foods available so you will always have something to stabilize blood sugar levels. A protein bar that contains at least 15 to 20 grams of protein is a healthy choice.

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Eat A Mini-Meal Every 3 Hours

Manage Mental Strain Not always so easy for today’s dental student! Stress, sadness, boredom, anger, and worrying can take a toll on your health and vitality. Life can be difficult for everyone, and how you react to stressful situations can help you get back on track quickly. Keeping fears, stress, and anxiety pent up may seem the appropriate way to handle these emotions, but discussing your concerns with a trusted friend can go a long way in maintaining your stamina.

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h e a l t h

f i t n e s s

— continued from previous page

Keep Great Music On Hand

Are you a Pandora, Spotify, or iTunes user? There is nothing better than listening to some great music to instantly decrease tension or increase energy. Listening to music while on the treadmill makes it easier to keep up the pace and distract you from fatigue. Create a playlist of your favorite songs that you can turn to when you need a quick pick-me-up.

Limit Caffeine Consumption In The Afternoon

It may perk you up for a few hours, but too much afternoon caffeine can wreck havoc with the quality of your sleep. Many “decaffeinated” beverages still contain some caffeine so be sure to monitor your intake carefully.

B-Complex

A quality B-complex supplement is a wonderful way to support the adrenal glands, hence de-stressing the body. While taking a B6 or B12 vitamin supplement can be an option for energy, it throws off the balance of the rest of the B vitamins. Look for a Stress Formula B-complex from a reputable supplement manufacturer and always follow label directions.

THE NEXT DDS

Taking short, shallow breaths reduces the supply of energizing oxygen to the brain and body, leaving you feeling mentally and physically drained. Try the “Triple Four” method--take a deep breath in for four seconds, hold it for four more, then exhale for a count of four. Remembering to practice deep breathing can be difficult at times, especially when you are under a deadline. Post a calming picture next to your computer with the word “breathe” next to it to serve as a friendly reminder to take in some deep breaths.

BOOSTING ENERGY LEVELS NATURALLY WITHOUT FALSE STIMULANTS INCREASES MENTAL AND PHYSICAL ENERGY 10

Water, Water, Water Staying hydrated is one of the best ways to stay energized. Even mild dehydration can cause blood to thicken, forcing the heart to work harder to carry it to organs, cells, and tissues—resulting in fatigue. Consuming enough water helps keep energy-giving nutrients flowing throughout your body. Additionally, you should eat foods that contain water naturally (grapefruit, broccoli, yogurt, carrots, oranges, watermelon).

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Breath

Aqua Therapy Splashing water on your face or even taking a shower when you feel exhausted can actually increase energy levels, especially when you are feeling overwhelmed. Swimming laps can actually give a valuable burst of energy and make you feel better.

Boosting energy levels naturally without false stimulants increases mental and physical energy, increases your ability to handle stress, and improves immune function and metabolism. As your natural energy levels increase, the desire for false or addictive stimulants decreases leading to greater health and energy without the highs and lows. Keep the energy flowing naturally!

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LEARNING OBJECTIVES: This article highlights soft tissue considerations and tooth preparation principles for restorative dentistry. Upon completing this article, the reader should: • Understand the role of soft tissues in impression making • Comprehend methods for exposure of subgingival finish lines

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he achievement of accurate impressions is the aggregate result of the successful integration of several related factors. This feature discusses the impression endeavor from the concept of an integrated and dynamic system, where decisions regarding material selection (Table 1) or techniques constitute interdependent fractions of a protocol that may vary in response to clinical circumstances. It must be clearly understood, therefore, that no individual factor can be solely responsible for achieving predictable, accurate impressions. While many protocols may work successfully, this is only as a result of the careful selection of their components. The disparate adoption of the latest materials, equipment, and techniques may not necessarily ensure clinical success.

Soft Tissue Considerations Gingival Management Adequate gingival health is a prerequisite for the achievement of predictable impressions. Gingival inflammation is characterized by the presence of an inflammatory infiltrate within the connective tissue, proliferation of capillary blood vessels, and ulcerated sulcular epithelium (Table 2).1-3 Inflamed tissues will have a tendency to bleed more readily upon physical stimulus.4 Uncontrolled extravasation will complicate the impression procedure and significantly hinder the performance of elastomeric materials. Additionally, a correlation has been demonstrated between gingival inflammation and increased crevicular fluid flow.5-7 Moisture control is thus rendered more difficult by the presence of inflamed tissues.

TABLE 1. Rationale for Impression Material Selection

Technical Considerations

Practical Considerations

• • • •

Accuracy Handling characteristics Wetting ability Easily accepted by patients

Dimensional stability User friendly Tear resistance Reasonable cost

TABLE 2. Gingival Inflamation: Clinical Implications *Clinical Professor, Department of Periodontics and Director, Postdoctoral Periodontal Prosthesis/Fixed Prosthodontics Program at Penn Dental Medicine; private practice in Bryn Mawr, PA. Ernesto A. Lee, DMD, 976 Railroad Avenue, Suite 200, Byrn Mawr, PA, 19010 Tel: 610-525-1200 • drernestolee@gmail.com

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• • • • •

Ulcerated sulcular epithelium is prone to extravasation Proliferation of capillaries makes hemostasis more difficult Increased crevicular fluid flow complicates moisture control Assessment of inflamed gingival margin levels is inaccurate Postoperative soft tissue response becomes less predictable

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CLINICAL STUDY

FIGURE 1. Impression procedures in the presence of inflamed gingival tissues will result in less predictable postoperative margins.

FIGURE 2. Smoothly finished preparations are

reproduced more clearly in the impression, facilitating visual identification of the finish lines.

FIGURE 3. Supragingival margins should be

used whenever possible to facilitate impression procedures.

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An additional consideration is the lack of predictability of the gingival margin levels when inflammation is present.8 Following the impression procedure, the postoperative recovery may be altered by the healing response to the inflammatory process, resulting in unstable gingival margin levels that may expose restorative finish lines (Figure 1). Therefore, except under emergency circumstances, gingival and periodontal health must be instituted prior to fixed prosthodontic procedures. Plaque-related etiologic factors should be brought under control with oral prophylaxis or scaling and root planing, followed by the implementation of an effective hygiene program. In situations where existing defective margins or inadequate gingival embrasures make inflammation control impossible by means of plaque removal, correction of the restorative contributing factors must take place prior to the resolution of gingival inflammation. A prudent course of action would be to place a properly fitting and contoured provisional restoration, and wait for adequate soft tissue healing prior to initiating impression procedures.9-11 Periodontal Management Although there are circumstances where the early placement of a provisional restoration is indicated in patients diagnosed with periodontitis, definitive impression making should only be undertaken following the completion of periodontal therapy. Of significant concern to the restorative dentist is the allowance of sufficient time to provide for adequate healing of the attachment apparatus following periodontal surgery.12,13 Although a waiting period of 4 to 6 weeks postoperatively is commonly recommended, the author advocates postponing definitive impression making for 10 to 12 weeks to allow for maturation of the gingival/periodontal complex.14 A particular concern is the coronal gingival profileration that may occur for an extended period after periodontal surgery, and is commonly observed following crown lengthening procedures. Although the attachment apparatus will appear histologically healed 4 to 6 weeks after surgery, the biologic width may take up to a year to re-establish itself. Premature intervention will result in the placement of restorative

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margins that appear acceptable initially, but eventually impinge upon the biologic width.15 These principles must be applied regardless of osseous crest involvement. Many aesthetic crown-lengthening procedures for example, are limited to the excision of gingival tissue. Ignoring the above soft tissue healing considerations will often result in the appearance of â&#x20AC;&#x153;rolledâ&#x20AC;? gingival margins following placement of the definitive restorations.

Tooth Preparation and Finish Line Preparation The tooth preparation design should incorporate features that promote successful impression making. Excessive undercuts should be avoided, since they may complicate the removal of the impression, increasing the potential for distortion. Additionally, preparation of smooth axial surfaces and finish lines will enhance margin visibility and improved fit of the restorations (Figure 2). Finish line placement, however, remains the most significant factor influencing the outcome of the impression procedure. Successful capture of the finish line is more difficult as its location becomes more subgingival, regardless of the impression technique utilized. Conversely, supragingival finish lines eliminate the need for tissue retraction, facilitating the impression procedure (Figure 3).16 Aesthetic demands are often the rationale for subgingival margin location. When caries, defective restorations, or fractures are present, however, the finish line may need to be placed more subgingivally for the restorative margin to be located on sound tooth structure. Additionally, subgingival margins may be utilized to increase the ferrule effect on teeth requiring core buildup restorations, and to improve retention when short clinical crowns are present. Regardless of the rationale for their use, subgingival finish lines require the displacement or removal of the tissue obstructing access to the impression material.17 A critical assessment must be made at this juncture, because the means elected to manage the peripheral gingival tissue must be evaluated vis-Ă -vis its potential for causing postoperative recession. The type of finish line must also be compatible with the impression system utilized. A

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CLINICAL STUDY

FIGURE 4. Full chamfer or shoulder finish lines, judiciously placed 0.5 mm to 1 mm below the gingival margin, facilitate the impression procedure and are compatible with long-term soft tissue health.

FIGURE 5. Rotary curettage is an excisional

technique utilized to create a trough around the preparation.

FIGURE 6. Electrosurgery is technique sensitive

and should only be used as an adjuvant to restorative procedures. Its routine inclusion in impression making is contraindicated, as postoperative recession has been a consistent finding.

THE NEXT DDS

feather edge, for example, has been traditionally used in combination with the copper tube impression technique. If elastomeric materials are selected, however, a feather-edge or longbevel finish line will require more aggressive lateral tissue displacement or excision to avoid thin margins in the final impression that may distort during removal or model fabrication.18 Generally speaking, a chamfer or shoulder type of finish line placed 0.5 mm to 1 mm below the gingival margin lends itself to the achievement of predictable impressions (Figure 4). Methods for the Exposure of Subgingival Finish Lines There are a variety of techniques that have been utilized to manage the soft tissues and gain access to subgingivally placed finish lines. These techniques employ one or more of the following mechanisms: â&#x20AC;˘ Tissue resection/excision; â&#x20AC;˘ Mechanical displacement; and/or â&#x20AC;˘ Pharmacological reaction. Resection or Excisional Techniques Tissue resection or excisional techniques are those that depend on the removal of gingival tissue to expose the subgingival finish line. They include rotary curettage and electrosurgical or laser procedures. Rotary curettage or gingitage refers to the practice of removing the gingival wall of the sulcus with a high-speed rotary instrument (Figure 5). Certain types of diamond burs have been specifically designed for this purpose, and their objective is the simultaneous removal of gingival tissue during preparation of the finish line.19,20 Some clinicians advocate a more aggressive lateral tissue preparation in an effort to widen the trough and facilitate the flow of impression material. Although this scenario obviously provides improved access to the finish line area, it results in less-predictable impressions since the amount of bleeding elicited further complicates moisture-control endeavors, and it introduces the additional variable of tissue healing as well. A general disadvantage of the rotary curettage technique is the fact that hemorrhage is elicited and hemostasis becomes more dif-

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ficult. While reasonable bleeding control may be achieved in the presence of gingival health, even the slightest degree of inflammation may elicit excessive extravasation. Additionally, the healing response following rotary curettage may not be predictable in areas exhibiting thin tissue.21 Naturally, the potential for postoperative recession is directly related to the degree of tissue removed. Electrosurgery has also been utilized to eliminate gingival tissue and expose finish lines prior to impression making (Figure 6). Its advantage is that it effectively creates a trough for improved impression material flow while simultaneously cauterizing the exposed capillary vessels.22,23 It must be pointed out, however, that electrosurgery is technique-sensitive and often results in residual extravasation that must be controlled with more aggressive cauterization or additional means of hemostasis. The popularity of this technique has decreased in recent years, owing to the fact that permanent postoperative recession has been a consistent finding.24 Additionally, the literature suggests that the use of electrosurgery poses a significant risk of injury to the underlying osseous crest.25 As a result, the routine use of this technique for finish line exposure is contraindicated, and its current role is limited to situations not effectively managed with more biocompatible and predictable methods. Surgical lasers have also been utilized for sulcus preparation prior to impression making. Although an argument could be made that lasers may be kinder to the soft tissues than electrosurgical units, similar concerns remain regarding the predictability of postoperative gingival margin levels and injury to the alveolar bone. In summary, finish line exposure utilizing excisional techniques is less predictable than other currently available alternatives. The ultimate position of the gingival margin remains difficult to anticipate and the risk of exposed restorative margins is increased. This potential is accentuated in situations where a thin scalloped periodontal biotype is present. Therefore, the use of resective/excisional techniques should be reserved for the treatment of areas where aesthetic concerns are not a factor.

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Mechanical and Pharmacological Principles in Soft Tissue Management The exposure of subgingival finish lines prior to impression making is frequently approached through a combination of mechanical and pharmacological principles. The mechanical techniques rely on the introduction of a mass that will exert pressure on the gingival tissues in a lateral and/or apical direction. The force applied will displace the soft tissue, therefore exposing the finish line and facilitating its capture by the impression material. Mechanical gingival retraction techniques have traditionally relied on the placement of a cord or string into the sulcus (Figures 7 through 12). Other alternatives include kaolin-based, gingival retraction pastes. Older methods, such as the use of copper tubes to carry the impression material below the gingival margin, have decreased in popularity due to the development of more accurate and efficient techniques. The effect of mechanical gingival retraction is principally observed in the horizontal plane. This is because the unsupported gingival wall of the sulcus can be displaced laterally under physical pressure. Although the junctional epithelium may be invaded, mechanical gingival retraction is limited in an apical direction by the presence of the connective tissue attachment and the underlying alveolar crest. Pharmacological techniques expose the soft tissues to a chemical agent, taking advantage of the ensuing physiologic response to achieve gingival retraction and moisture control. These compounds typically decrease local circulation by temporarily constricting the lumen of blood vessels. In addition, several of these agents exhibit a styptic behavior upon contact with the tissues, further contributing to the achievement of adequate hemostasis and improved control of crevicular fluid flow. In combination with the transient contraction of soft tissue volume, these pharmacological effects potentiate the displacing effects of mechanical retraction methods. Hemostatic and Astringent Agents A variety of chemical agents have been utilized to increase the efficacy of the retraction technique. Hemostatic agents will cause constric-

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tion of peripheral blood vessels, resulting in a transient shrinkage of the surrounding gingival tissues. The degree of shrinkage is dependent on the degree of tissue vascularization as well as the proximity of the alveolar crest. The vascular and interstitial changes brought about by the inflammatory process result in decreased predictability of the retraction and anticipated rebound of the gingival margin. Commonly utilized hemostatic and astringent agents available include epinephrine, aluminum chloride, and ferric sulfate. Epinephrine is a vasoconstrictor capable of producing effective hemostasis and moisture control. Epinephrine is kind to the gingival tissue, with postoperative reactions comparable to those of other popular hemostatic agents.26,27 Although very prevalent in the past, the use of epinephrine has decreased in popularity out of concerns for its systemic interactions.28,29 Cardiovascular incidents and epinephrine syndrome were frequent complications associated with its use. Symptoms would include increased blood pressure, tachycardia, shortness of breath, and anxiety attacks. Epinephrine is the primary ingredient in preimpregnated retraction cords, some of which have been available in concentrations that significantly exceed the recommended safe dose. Considering that effective chemical agents are available that pose no systemic risk to the patient, the current use of epinephrine is difficult to justify. Aluminum chloride and ferric sulfate are locally acting agents utilized for gingival retraction, and these agents exhibit no systemic interactions.30 They display an astringent behavior upon contact with the tissue. The metallic ions will bind and precipitate proteins, but have so little penetrability that only the cell surface is affected. Both agents have been found to be very kind to the gingival tissues, and as effective as epinephrine in terms of tissue retraction and hemorrhage control.27,31,32 Ferric sulfate, however, will react with organic material and result in the creation of clots and iron precipitates. Material compatibility must also be taken into consideration when selecting a hemostatic agent. Aluminum chloride, for example, may interfere with the polymerization of some polyvinylsiloxanes.

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FIGURE 7a. Diagram demonstrates the use of the

double-cord technique for successful impression making in patients who present with thick gingiva. FIGURE 7b. The single-cord technique is used for patients with thin gingiva.

FIGURE 8. Cord retraction relies on the atrau-

matic introduction of a mass to laterally displace the gingival wall of the sulcus.

FIGURE 9. Cord packing is accomplished with the use of dedicated instrumentation.

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CLINICAL STUDY

Conclusion Impression making is a multifactorial process that includes more than just careful periodontal management and finish line placement. One’s understanding of impression materials, the rationale for material selection (e.g., accuracy, handling, wetting ability, tear resistance, dimensional stability), and impression technique—though beyond the scope of this discussion—are all critical parameters as well. Note:

FIGURE 10. Intraoral appearance following

placement of single retraction cord layer. While the exposed finish lines may be approximated to the retracted gingival margin levels, there is an

increased potential for supragingival restorative margins with this technique.

An unabridged version of this feature is available on www.thenextdds.com and readers are encouraged to visit for a full understanding of the topic and related resources. References 1. Waerhaug J. Anatomy, physiology and pathology of the gingival pocket. Rev Belge Med Dent 1966;21(1):9-15. 2. Page RC. Gingivitis. J Clin Periodontol 1986;13:345-359. 3. Weiss MD,Weinmann JP, Meyer J. Degree of keratinization and glycogen content in the uninflamed and inflamed gingival and alveolar mucosa. J Periodontol 1959;30:208. 4. Matheny JL, Abrams H, Johnson DT, et al. Microcirculatory dynamics in experimental human gingivitis. J Clin Periodontol 1993;20(8):578-583.

FIGURE 11. Double-cord retraction technique. Placement of the first cord layer has been completed.

5. Hakkarainen K, Asikainen S, Ainamo J. A 7-month study of sulcular fluid flow in the assessment of healing after debridement of deep pockets. J Periodontol 1986;57(1):14-19. 6. Griffiths GS, Sterne JA,Wilton JM, et al. Associations between volume and flow rate of gingival crevicular fluid and clinical assessments of gingival inflammation in a population of British male adolescents. J Clin Periodontol 1992;19(7):464-470. 7. Del Fabbro M, Francetti L, Bulfamante G, et al. Fluid dynamics of gingival tissues in transition from physiological condition to inflammation. J Periodontol 2001;72(1):65-73.

Intraoral appearance following placement of the second cord and re-preparation of the finish lines.

20. Tupac RG, Neacy K. A comparison of cord gingival displacement with the gingitage technique. J Prosthet Dent 1981; 46(5):509-515. 21. Kamansky FW, Tempel TR, Post AC. Gingival tissue response to rotary curettage. J Prosthet Dent 1984;52(3):380-383. 22. Klug RG. Gingival tissue regeneration following electrical retraction. J Prosthet Dent 1966;16(5):955-962. 23. Malone WF, Manning JL. Electrosurgery in restorative dentistry. J Prosthet Dent 1968;20:417-425. 24. DeVitre R, Galburt RB, Maness WJ. Biometric comparison of bur and electrosurgical retraction methods. J Prosthet Dent 1985;53(2):179-182.

9. Fugazzotto PA. Periodontal restorative interrelationships:The isolated restoration. J Am Dent Assoc 1985;110(6):915-917.

26. Harrison JD. Effect of retraction materials on the gingival sulcus epithelium. J Prosthet Dent 1961;11:514-521.

11. Waerhaug J.Temporary restorations: Advantages and disadvantages. Dent Clin North Am 1980;24(2):305-316. 12. Rosenberg ES, Garber DA, Evian CI.Tooth lengthening procedures. Compend Contin Educ Dent 1980;1:161-173. 13. Ochsenbein C, Ross SE. A re-evaluation of osseous surgery. Dent Clin North Am 1969;13:87-102.

15. Kois JC. Altering gingival levels:The restorative connection. Part I: Biologic variables. J Esthet Dent 1998;10:157-163. 16. Block PL. Restorative margins and periodontal health: A new look at an old perspective. J Prosthet Dent 1987;57:683-689.

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19. Ingraham R, Sochat P, Hansing FJ. Rotary gingival curettage – A technique for tooth preparation and management of the gingival sulcus for impression taking. Int J Periodont Rest Dent 1981;1(4):8-33.

25. Kalkwarf KL, Krejci RF, Edison AR, et al. Lateral heat production secondary to electrosurgical incisions. Oral Surg Oral Med Oral Pathol 1983;55(4):344-348.

14. Oakley E, Rhyu IC, Karatzas S, et al. Formation of the biologic width following crown lengthening in nonhuman primates. Int J Periodont Rest Dent 1999;19(6):529541.

18. Laufer BZ, Baharav H, Ganor Y, Cardash HS.The effect of marginal thickness on the distortion of different impression materials. J Prosthet Dent 1996;76(5):466-471.

8. Ferreira P, Fugazzotto PA, Parma-Benfenati S. Implications of the use of electrosurgical techniques in the presence of gingival inflammation. Gen Dent 1987;35(1):17-21.

10. Kois JC.The restorative-periodontal interface: Biological parameters. Periodontol 2000 1996;11:29-38.

FIGURE 12. Double-cord retraction technique.

17. Azzi R,Tsao TF, Carranza FA Jr, Kenney EB. Comparative study of gingival retraction methods. J Prosthet Dent 1983;50(4):561-565.

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27. de Gennaro GG, Landesman HM, Calhoun JE, Martinoff JT. A comparison of gingival inflammation related to retraction cords. J Prosthet Dent 1982;47(4):384-386. 28. Buchanan WT,Thayer KE. Systemic effects of epinephrineimpregnated retraction cord in fixed partial denture prosthodontics. J Am Dent Assoc 1982;104(4):482-484. 29. Shaw DH, Krejci RF. Gingival retraction preference of dentists in general practice. Quint Int 1986;17(5):277-280. 30. Nemetz EH, Seibly W.The use of chemical agents in gingival retraction. Gen Dent 1990;38(2):104-108. 31. Bowles WH,Tardy SJ,Vahadi A. Evaluation of new gingival retraction agents. J Dent Res 1991;70(11):1447-1449. 32. Weir DJ, Williams BH. Clinical effectiveness of mechanicalchemical tissue displacement methods. J Prosthet Dent 1984;51(3):326-329. Adapted with permission from Lee EA. Impression Making. In: Tarnow DP, Chu SJ, Kim J, eds. Aesthetic Restorative Dentistry: Principles & Practice. Mahwah, NJ: Montage Media Corporation, 2008: 217-255.

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INDICATION ARESTIN® (minocycline HCl) Microspheres, 1 mg is indicated as an adjunct to scaling and root planing (SRP) procedures for reduction of pocket depth in patients with adult periodontitis. ARESTIN® may be used as part of a periodontal maintenance program, which includes good oral hygiene and SRP. IMPORTANT SAFETY INFORMATION ARESTIN® should not be used in any patient who has a known sensitivity to minocycline or tetracyclines. The use of drugs of the tetracycline class during tooth development may cause permanent discoloration of the teeth, and therefore should not be used in children or in pregnant or nursing women. Hypersensitivity reactions that included, but were not limited to, anaphylaxis, angioneurotic edema, urticaria, rash, swelling of the face and pruritus have been reported with the use of ARESTIN®. In clinical trials, the most frequently reported nondental treatment-emergent adverse events were headache, infection, flu syndrome and pain. To learn more about the role of ARESTIN®, visit ArestinProfessional.com. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. REFERENCES: 1. ARESTIN® (minocycline hydrochloride) Microspheres, 1 mg. Prescribing Information. Horsham, PA: OraPharma, Inc.; 2011. 2. Dunston CR, Griffiths HR, Lambert PA, Staddon S, Vernallis AB. Proteomic analysis of the anti-inflammatory action of minocycline. Proteomics. 2011;11:42-51. ARESTIN® is a registered trademark of OraPharma, Inc. ©OraPharma, Inc. 2012 A-1445-12 8/12

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ORAL CANCER

Participants, above, received free oral cancer screening.

AWARENESS

The run’s organizer, oral cancer survivor and dental student at NOVA University, Uyen Nguyen (center, below), pictured with her classmates and members of the NSU Chapter of the Alpha Omega Dental Fraternity, Ireni Haroun and Janisha Patel.

An Interview with Uyen Nguyen NOVA Southeastern University School of Dentistry ‘14

n the United States, oral cancer kills nearly one person every hour of every day. As future dental professionals, its early detection is essential to your patients’ very lives. In this interview, THE NEXT DDS had the pleasure of speaking with Uyen Nguyen, herself an oral cancer survivor, and current dental student at the NOVA Southeastern University School of Dentistry. Uyen recently organized an oral cancer awareness 5k run/walkathon at NOVA, and we are hoping that, through this interview, we can help to bring her story to the national stage.

Let’s begin our interview with some statistics about oral cancer in the U.S., and why the activity that you conducted on behalf of NOVA and its dental students is so important? Statistics show that every hour of every day in the United States, a person dies from oral cancer. In the United States alone, there are approximately 100 new cases each day. It is also approximated that 50,000 Americans will be diagnosed with oral cancer or cancer of the pharynx this

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Fall 2013

year. Fortunately, if it is detected in the early stages of development, there is a recovery rate of 80% to 90%. Therefore, it is very important for everyone to see their dentist annually for an oral cancer screening. I decided to organize an oral cancer 5k run/walkathon this year because I wanted to pay my blessings forward. In August of 2012, I was diagnosed with Stage II Central Mucoepidermoid Carcinoma behind my soft palate. I was extremely blessed and lucky that my dental professors were able to

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s p e c i a l t i e s

Participants, above, file in at the starting line of the 5k • …and they’re off! (above right) • No time to stop and take in the beautiful scenery, the participants race on towards the finish, below.

catch my cancer early on, diagnose it, and treat it before it had the chance to spread. That said, it was obviously a tough journey to overcome the emotional, physical, and treatment challenges presented by my cancer. I lost a lot of weight because of the surgery and radiation therapy. I maintained a liquid diet for months because the ulcer developing in my mouth made it very difficult to eat. Due to the radiation treatment, I also suffered from dry mouth and I could not taste anything for a while, and, even when taste returned, it tasted like I had a bunch of pennies in my mouth. It even became difficult for me to open my mouth; even today, I can’t open my mouth more than 15 to 20 millimeters. Because I am training to become a dental professional, I know that a large portion of the public is not aware that cancer can be detected in the mouth, or that a person can even have oral cancer. This is why I wanted to spread awareness about oral cancer. I decided that my first step would be to organize this oral cancer awareness 5k, and I was really pleased by the outcome. Many people will never go through the screening process. It really relies on dental professionals to be advocates, and to be out there in the public much like you were through the coordination of the 5k. How was the turnout this year? This year, the NOVA 5k was a great success. We had more than 200 participants who came out to the event, and, to be honest, the success was made possible due to the great teamwork of the volunteers and sponsors. I worked with the student members of the NOVA Southeastern University

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Fall 2013

chapter of the Alpha Omega International Dental Fraternity and some members of the Truth Outreach Project Inc, which is a non-profit organization that devotes itself to helping the public become more aware of oral cancer. The president of the Truth Outreach Project is actually one of our dental faculty at NOVA.I really owe the success of the event to all the great volunteers. Do you think the diversity of the participants helped more actively promote the activity within the community? Definitely. There was so much that went into organizing the event, and if it wasn’t for each and everyone’s contribution, it wouldn’t have been possible to spread the word, or to educate anyone in the community about oral cancer, or about the availability of oral cancer screenings that we had at the event. I’m sure that were people participating in different ways--everything from awareness, to financial help, and other contributions. What were some of your goals for this oral cancer walk/run? The goal of this event was to spread oral cancer awareness in south Florida and nearby communities close to our school, and also to be able to provide free oral cancer screenings to anyone who wanted to receive one. As far as I’m aware, this year was one of the first times that we were able to provide free screenings for the community and all participants. In addition, we wanted to raise funds to assist the Truth Outreach Project in developing a future commercial that will provide education about oral cancer on a national level. I felt that our goals were met quite successfully, and we hope that more people will come out to the event in the future to get the oral screening and just have a fun time in general.

Volume:3

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Participants, above, glad to be finished? • Everyone gets to relax with refreshments after a nice run, above right. • See you again next year! (below)

Were there any surprises with any of the patients that came for the screening? In the future we hope to reiterate to our participants that the cancer screenings are in fact free. Based on my knowledge, no individuals were detected to have a pathologic lesion; however, some did receive a diagnosis of leukoplakia, which is basically a white lesion in their mouth, and they were instructed to follow up with their dentist. Since you have personal experience with this disease, what main things should future dental professionals know about oral cancer? Future dental professionals should know that although the elderly and those who smoke, consume alcohol, or have HPV are at high risk for oral cancer, they are not the only candidates at risk for oral cancer. I am a 29-year-old female, and I try to maintain a healthy lifestyle, and yet I was diagnosed with oral cancer. It’s unfortunate, but anyone might have it. I hope dentists and future dental professionals will not overlook the oral cancer screening because a patient is young or healthy, and that they will know to provide oral cancer screenings for anyone who comes into their offices. Another important fact that I think dentists should know about oral cancer is that, while all cancers may not be associated with pain, there will be some that do. My lesion appeared as a very tender, traumatic bruise, but it caused me to have a very sharp, radiating, shooting pain in my face and behind my ear. Based on my own experience, I believe dental professionals should give their patients extraoral and intraoral examinations, and really encourage their patients to help others become aware of oral cancer and the importance of getting regular check-ups with their dentists.

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Fall 2013

What are some signs or “red flags” that students and dental professionals should look for in their patients that they may suspect of having oral cancer? Oral cancer usually appears as a growth or a sore in the mouth that does not disappear or heal in about 2 to 3 weeks. The oral cancer screening process involves both a digital and tactile examination that includes screening the mucosa, the gingiva, the hard and soft palate, and especially around the tongue inside the mouth. That’s where we would usually find oral cancer. If you see a significant lesion, I would advise my future colleagues and any other dentists out there right now to really keep an eye on the lesion, and if it does not heal in 2 to 3 weeks, send the patient for a biopsy. What one piece of advice would you give a person to lower his or her risk of oral cancer? I would advise the person to not smoke, and, if they do, to really try to quit. The same goes for consuming alcohol. Also, given that the survival rate of oral cancer being as high as 80% to 90% if it is caught early, I would advise everyone to see their dentist annually and get their regular checkups. Thank you so much for spending time with us today Uyen, it’s been a pleasure talking to you. It’s been a great pleasure speaking with you too. I take this subject deeply personally, and I want to thank you for all the work you guys are doing in contributing to the awareness of oral cancer. I feel so touched by what you guys are doing, and for letting me spread this message to my fellow dental students around the country. Thank you so much.

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BY THE NUMBERS Curious about how dental students at other schools are using THENEXTDDS? Wondered about how they access the site, or the issues that are important to them? Here are more statistics we’re proud to share about how you and your classmates have engaged with THENEXTDDS in recent months.

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Questions tracked to NBDE I and II Return links to correct information for missed answers Instant, automated display of real-time results Random question banks Ability to save and finish test later

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D1-D4 STUDENTS

A PASSING GRADE FOR YOUR

passwords MAINTAIN PRIVACY AND SECURITY by John Papa

assword security has become almost as big an issue as privacy on the internet in recent years. Even in the face of password protection, capchas, and the ever-increasing number of sites that require a password for access, many people continue to use unreliable, easily deciphered, or repeated passwords to access much of their personal information. This practice can jeopardize one’s credit or financial situation, identity, and even, in some cases, personal safety.

COMMON PASSWORDS

In 2012, CBS News conducted a study to determine the most common passwords that people use on the internet.1 Investigators found that, despite all the warnings and information dissuading people from using common or repeated passwords, the top three most-used passwords remained unchanged from past years. Think you can guess the most common passwords for 2012? They were “password”, “123456”, and “12345678”. Odds are that the individuals using these passwords probably use them for multiple websites, further increasing their risk of losing something that could be very valuable.

REPEATED PASSWORDS

Aside from using common or generic passwords, repeating passwords on multiple sites is unnecessarily risky. In June of 2012, more than six

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million passwords were stolen from LinkedIn. A little more than a month later, nearly 450,000 passwords were stolen from Yahoo! It may be mildly irritating to reset your Yahoo or LinkedIn password, but imagine using that same password for your online banking account or primary email client. While having access to your emails may not seem like an immediate threat to your personal or financial security, just consider the “Forgot Password” link that many sites today feature. If a hacker gets access to this password, he or she can use that information to reset nearly all your passwords. You may think that your financial information is safe because you used a different password for your online banking account but, with access to your Gmail account, a hacker could reset your banking password and gain access to your financial information with relative ease.

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PASSWORD TIPS

These computer-generated passwords are virtually impossible to crack without a specific computer program, and incredibly difficult even with such capabilities. There are many password management programs you can choose from, including:

Remember these helpful tips for your passwords:

Create a password from the first letters of words in a movie quote or song lyric (i.e., IGTMHAOHCR for “I’m going to make him an offer he can’t refuse.”) Avoid using names or dates altogether, and do not use your address as numbers in your password.

Stay away from standard dictionary words (house, flower, baseball, etc.) as your password.

Do not use generic number sequences (e.g., 123), or anything like “password1”, which is often the workaround to comply with the “Must Use at Least One Digit” rule that many websites now follow.

THE NEW AND IMPROVED HACKER

With the ever-increasing power of home computers, it is becoming easier and easier for hackers to crack passwords through a “brute force” attack. That is to say, they can program a computer to randomly generate and check passwords at a rate of billions per second in extreme cases. With these enhanced capabilities, it has become easier to crack the traditional eight-character passwords than ever before. Experts suggest that, when using a computer-generated password, it is now more effective to use a password with 12 to 14 characters, as this makes the computer’s job exponentially more difficult, and potentially impossible.

(

HOW CAN I PROTECT MY PASSWORDS?

An effective way to make sure your accounts and passwords are more secure is to use some brand of password managing service. These services will not only generate random passwords for you, but also encrypt and store them for every website that you frequent. This allows you to simply remember one password for the password program, rather than one for each individual website.

1. IronKey Personal S200 2. Kaspersky Password Manager 4 3. LastPass 1.72 4. RoboForm 7 5. 1Password 6. Aladdin

PASSWORD SAFETY ON THE NEXT DDS

THE NEXT DDS is unique for its enrollment engine. Authentications from all web browsers are protected by an industry-leading SSL protocol that encrypts all valuable data entered into the site, performs certificate management, vulnerability assessment, and malware scanning. This protocol ensures that THE NEXT DDS is safe for each visitor, and that all personally identifiable information is secure on our servers. Users are granted total control and anonymity over their passwords for the site, and random passwords are computergenerated for those students who may forget their originals.

CONCLUSION

Even though Internet privacy has become a huge issue in recent years, people still continue the highly risky practice of using easily guessed, generic, or repetitive passwords. You never know when a large company site that you feel is secure, such as LinkedIn or Yahoo, might have their servers hacked and your passwords stolen. If such an event occurs, and you use the same password for all your websites, your money, your identity, your career, or even your friends/contacts could be in jeopardy. It is much, much safer to use password management software to generate and keep track of all your important passwords. As more and more personal and financial information makes its way on to the web, it becomes increasingly urgent that you take steps to protect it before it is too late.

1. http://www.cbsnews.com/8301-205_162-57539366/the-25-most-common-passwords-of-2012/

THE NEXT DDS

Fall 2013

Volume:3

Issue:1

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The perfect solution for your Dental Associate recruitment needs • Providing the skills to recruit Associate candidates for private practice, clinics, and dental organizations of every category • Proactive, efficient, and results driven • Personal attention to all the details of the recruitment process

Get optimal results to support your professional goals!

Speak with a Henry Schein Nationwide Specialist today!

or e-mail: ndo@henryschein.com www.dentalopportunities.com

b u s i n e s s

LISTEN TO THE FULL PODCAST BY SCANNING THIS TAG!

p r a c t i c e

Protect Yourself from

Employee Theft by Dr. Gene Heller

practice-owning dentist will face a multitude of business related

tasks, issues, and challenges, just like any business owner. One of these challenges is potential employee theft. This loss, due to employee dishonesty, may take the form of out right theft, fraud, or embezzlement. The good news is, with certain minimal

WARNING SIGNS OF THEFT

protective measures, the majority

The most common sign of theft by embezzlement is patient complaints regarding their accounts. The problem with relying on this sign to deter theft is that most of time the person who handles the complaint is also the thief. However, patient complaints that come to the attention of another staff person or the dentist must be carefully and fully investigated. Office petty cash should also be closely monitored, and only used for emergencies. Subsequently, constant requests for petty cash reimbursements should be closely moni-

of this theft is preventable. The key for dental students, as future business owners themselves, is to understand where the potential exists for theft to occur and to implement the necessary strategies to prevent this loss.

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tored, as outright theft of petty cash in a multiple-staff office is often difficult to track. Review of end-of-day reports may also show signs of a problem. Excess patient account write-offs or adjustments are warning signs, as are “inactivated” patient accounts. Increases in Accounts Receivables with no off-setting increase in overall office production are reasons for concern. Missing documents — invoices insurance claim forms, explanation-of-benefits forms, patient checks, practice checks, checking account records, patient clinical records,

THE NEXT DDS

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patient account records, etc — are definite signs of a problem. Sloppy filing and record keeping on the part of a staff person are also telling. The practice checking account also holds potential signs of a problem. Unusual deposit patterns and deposits that frequently do not add up to the total posted by the bank are one sign. The inability to balance the checking account is another. Missing sequential checks are a third. Counterfeit or duplicate checks can also be an issue which will lead to an inability to balance the checking account

EMPLOYEE THEFT Most theft by an employee involves three common steps. The first is “Motive”. The employee needs a reason to steal. Next, he or she needs the “Opportunity”. Finally, such employees need to be able to “Rationalize” their behavior. The key to preventing theft is to break the triangle by attacking the only area under the control of the dentist. Steps must be taken to remove the potential thief’s “Opportunity”.

Theft control begins by controlling how money is handled. First and foremost, all checks must be immediately stamped “For Deposit Only” upon receipt. Over-the-counter cash must be posted, with receipt given, before the patient leaves. If a receipt cannot be issued for some mechanical reason, the doctor must be immediately notified before the patient leaves. Bank deposits must be made daily, even if only one payment has been made and recorded all day. Who handles money is as important as how it is handled. Preferably, two individuals should handle different aspects of the day’s receipts. The first staff member should open mail-in payments, make a copy of any checks and/or explanations of benefits, and make the deposit, while the second should post payments and prepare and audit the computer generated deposit slip. In the event that only one person is available, someone other than this person (the dentist, the dentist’s spouse, etc.) must count and do the deposit. Deposit slips must be com-

THE DENTIST

MUST ALSO PERFORM SOME OF THE MONEY-HANDLING DUTIES.

pared to the computer-generated deposit slip by the practice owner daily. Some offices have required all monies to be placed in a bank bag and had the bank do the counting and make out the deposit slip. This amount is then compared with the computer-generated deposit slip. The dentist must also perform some of the money-handling duties. He or she must authorize any account adjustments and check the adjustment report daily, authorize and check refund requests, and sign and mail all checks if a staff person makes out the checks for vendors. Once the check has been signed, it should not be put back into the control of a staff person. Either the dentist or the his/her accountant must open and balance the bank statement. This means bank statements should be mailed to the dentist’s residence or directly to the accountant. Either the accountant or a payroll service should prepare payroll. Due diligence is also necessary for managing hourly staff members. Each office should use a time-clock, and any manual entries must be initialed by the dentist. Petty cash should be counted and balanced daily. The amount of receipts plus cash on hand should equal the same balance every day. Each day, the date, the receipt total, the cash total, and the sum of receipts and cash should be listed along with the initials of the person reconciling the petty cash.

CONCLUSION Many new dentists who acquire their dental practice by purchasing an existing practice face the same problem relative to implementing safeguards that older dentists in practice for many years face. Most theft, fraud, and embezzlement is avoidable if minimal safeguards are instituted. However, the dentist must take an active role. Those dentists who blindly trust their employees are the easiest targets and suffer the greatest losses. Nationally recognized expert in practice transitions and Vice President of Practice Transitions, Henry Schein Special Markets. Adapted with permission from Dentral Entrepreneur.

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The

Next DDS

JENNA HATFIELD-WAITE

ASDA REPRESENTATIVE TO ADA HOUSE OF DELEGATES ACCREDITATION STEERING COMMITTEE REPRESENTATIVE UNMC COLLEGE OF DENTISTRY

interviewed by Rich Groves

THE NEXT DDS

enna Hatfield-Waite will be graduating with her dental degree from the UNMC College of Dentistry in May of 2014. While at UNMC, Jenna has served as a student leader for her classmates and, through the American Student Dental Association, at the national level. In this interview, right on the heels of an externship in rural Nebraska, Jenna shares her thoughts on her active life as a dental student, the importance of organized dentistry, and next steps in her D4 year and her future transition to practicing dental professional. WHERE DID YOU COMPLETE YOUR UNDERGRADUATE DEGREE BEFORE COMING TO THE UNIVERSITY OF NEBRASKA MEDICAL CENTER TO PURSUE YOUR DENTAL CAREER? I did my undergraduate studies at the University of South Dakota. I attended on a volleyball scholarship but, being born and raised a Nebraskan, it was always my dream to come back here and go to dental school. It sounds cliché, but I’ve literally wanted to be a dentist my whole life. I can’t think of anything that I wanted to do aside from becoming a dentist. It started when I went to the orthodontist around fourth grade and heard his interactions with his assistant and the terminology they were using. I always felt like he was speaking a different language. I told my mom that I wanted to talk like my orthodontist, and she said, “Well, go to dental school and you’ll learn how to talk like that”. So that’s what got me interested in dentistry. I initially thought I would specialize in orthodontics, but the more that I learned about the different specialties, my greatest passion came to be general dentistry because it’s a mix of just about everything.

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Stay focused on your dental school goals, but donâ&#x20AC;&#x2122;t be afraid to take time every now and then to do something else that is important to you.

About Jenna: EDUCATION The University of Nebraska Medical Center College of Dentistry Lincoln, NE DDSâ&#x20AC;&#x201D; anticipated May 2014 University of South Dakota Vermillion, SD Bachelor of Science in Biology, Minors in Chemistry, Sociology, and Criminal Justice May 2010

AWARDS AND FELLOWSHIPS College of Dentistry Alumni Association Scholarship 2013-2014 UNMC Student Scientific Program: Patient Attitudes towards Doctor Attire: Does Business Attire Compared to Scrubs Affect What Your Patient Thinks of You UNMC College of Dentistry Curriculum Committee Class of 2014 Representative

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PROFILE: JENNA HATFIELD -WAITE

HOW DID YOUR UNDERGRADUATE STUDIES PREPARE YOU FOR DENTAL SCHOOL AT THE UNIVERSITY OF NEBRASKA? I majored in biology, and I needed to be very efficient in my courses because I was also an athlete. I had to complete my prerequisites in an effective manner, while also making myself as well rounded as possible. I minored in sociology and criminal justice to ensure that I not only had my natural sciences covered, but also a mix of social sciences to balance things out a bit.

WHAT WAS THE HARDEST PART ABOUT HAVING TO MULTITASK AS A STUDENT ATHLETE? It was really difficult to go from class, to practice, to a 3- or 4-hour chemistry lab. Figuring out how to fit all that into one day, and then having to keep up your grades while being on the road and travelling with the volleyball team was challenging. While this schedule seemed stressful as an undergrad, I think it helped prepare me for life as a dental student—to be successful in dental school you keep a similar schedule. As a dental student, you’re going all day long and often have to work into the night, then turn around and study right away. I think my undergrad experiences helped make the transition into dental school a little smoother for me, because I had already been practicing such a busy lifestyle in the years beforehand.

YOU ALSO BECOME A STUDENT LEADER AT UNMC. HOW DID YOU GET STARTED THERE? Because I was so involved in extracurricular activities as an undergrad, I wanted something besides classes and studying to fill my free time during dental school. My involvement with ASDA started at a Western Regional Meeting in San Antonio a few years back. I was debating whether or not to apply for a Trustee position, and what swayed me was a conversation I had

with Linda Cooper, ASDA’s meeting manager. I told her I was thinking about applying, and she told me that if I was interested that it didn’t hurt to just go for it. It was really Linda who gave me the little boost of confidence needed to pursue a national position. All the great experiences I’ve had since then as a leader have motivated me to stay involved in organized dentistry and take advantage of everything it has to offer.

IN YOUR POSTGRADUATE CAREER, DO YOU SEE YOURSELF CONTINUING IN SOME FASHION WITHIN ORGANIZED DENTISTRY? Definitely. I can’t imagine my life after dental school not involving organized dentistry in some fashion. I plan on staying a member of the organizations I’m already a part of at a national level, like the Academy of General Dentistry, and also keeping my membership with the ADA and the Nebraska Dental Association. I’d really like to take it beyond just being a member and become involved as a leader in these organizations. I’ve already been appointed to the ADA’s New Dentist Committee for this year as an ASDA representative. I’ve always been really interested in what the New Dentist Committee has to offer, so I’m hoping that being an ASDA representative on that committee that may lead to something else in the future when I’m a practicing dentist. Even beyond organized dentistry, I look forward to working in a town where I can be involved in the community, and be involved in the local YMCA or the school board, or something along those lines.

WHAT’S ON THE HORIZON FOR YOU, AND HOW DO YOU BEST PREPARE FOR YOUR NEXT STEP IN THE DENTAL PROFESSION? I already have a plan of where I want to go and what I want to do next. I’m hoping to go back to my hometown of Norfolk, Nebraska, and join a general practice there. I’ve been in contact with a dentist in my hometown who is looking to bring on an associate as his practice continues to grow and be

•

2008

2009-2010

2009

2010

2011

Received the Student Athlete Advisory Committee’s Courage Award after returning from a season-ending injury

Accepted at the UNMC College of Dentistry

Joined American Association of Women in Dentistry

Became an ADA Student Member

August 13, 2011

Attended the NCAA National Leadership Conference

Captain of girls volleyball team at the University of South Dakota

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Got married to husband Dirk!

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successful, so right now I’m just trying to figure out what the best process for joining that practice will be, and how to go about making that a reality. I’ve been thinking about how to put a team together to help me go through that process; finding an accountant, a lawyer, and all the people who need to be involved in a business decision like that. I didn’t have to think too hard about where I wanted to go; I’ve wanted to go back to my hometown for some time now.

WHAT TYPE OF RESOURCES DO YOU DRAW ON TO HELP GUIDE YOU THROUGH ALL THE RELATED FACTORS? One primary source is a practice management course that I’m currently taking. Our professor Dr. Dave Dunning does a great job bringing in outside speakers who specialize in each of the areas that we need to consider. We recently had a CPA talk to us about money management, and how to increase our credit before applying for small business loans. Dr. Dunning has had different practice transition firms come in to speak with us as well, and the textbook he put together has turned into a kind of bible for the process that I’m currently going through. I’ve highlighted it and put sticky notes in it because there are so many things in there that I like to refer to as I get further along in the transition process. I like that Dr. Dunning does not necessarily put his opinion into it, but rather gives as many options as possible and allows dental students to make the best informed decisions that we can from there. I also am in contact with recent graduates who have returned to the same area where I’m looking to go, and have already been through the transition process, or joined as an associate somewhere. That’s the nice thing about UNMC being a smaller school with only about 47 students per class; you’re very close to many upperclassmen and you know where a lot of them have ended up in the last couple years, so not too difficult to get back in touch with a few of those students and use them as resources. Association vendor fairs too have led to some good communications and opportunities with practice transition firms and dental CPAs. The fairs allow us to collect business cards, and to touch base with a variety of companies.

ARE THERE AREAS OF THE CURRICULUM THAT YOU’RE GOING TO WISH YOU HAD MORE EXPOSURE TO DURING YOUR DENTAL SCHOOL TRAINING? I feel like the common answer to this question for many students is practice management. Dental students tend to feel that they don’t have enough business information to run a practice when they graduate from dental school. However, what I’m starting to find out is that it’s not so much that dental students don’t have the information; it’s that practice management is one of those things that you’re not able to simulate or get hands-on until you’re out in the real world. Beyond that, clinically I would say that endodontics and full-mouth reconstruction are two areas I don’t foresee myself getting a lot of experience in before I graduate. This may be attributed to the demographics of this area, or it could be that there just aren’t as many patients in this area that are in need of those types of procedures. But those are definitely two areas that I would feel the least comfortable going into a practice and taking on without some additional education and training.

WHAT ROLE DO YOU SEE YOUR SMARTPHONE PLAYING IN YOUR PRACTICE OR POTENTIALLY HELPING YOU BECOME A BETTER PRACTITIONER? I think it’s a double-edged sword as far as connectivity with your office, your staff, or your patients. I can see it being a great tool to stay connected with the office, and being able to synch your calendar and see what you have coming up that week as far as appointments go. I really like some of the systems that we’ve heard about that are able to remind patients about their appointments via text and email versus a postcard or a phone call. At the same time, I feel that sometimes too much connectivity to your office can be a negative thing. Being focused on work while actually at work is a good thing; I don’t know if it’s as positive if I need to focus on work while at home. I look forward to having a family, and spending time with that family, and it seems unfair to them for me to be too connected.

•

2011

2012

March 2013

2013

Adopted a dog named Suki shortly after the wedding

Joined the Academy of General Dentistry

District 8 Trustee for American Student Dental Association

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Fall 2013

UNMC Student Scientific Program

Volume3

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Outreach Summer Participated in Give Kids a Smile Panhandle Dental Day in western Nebraska (Gordon, NE)

Outreach Summer Three-week externship to serve rural Nebraska (Pierce, NE)

THE NEXT DDS

PROFILE: JENNA HATFIELD -WAITE

It could take away from that family time if I always have my phone at my side, and being connected to my office in that way.

I CAN TELL THAT BALANCE IS A BIG PART OF YOUR LIFE. Definitely, and it’s something I’m still working on and learning how to do. I’m very thankful for my husband in that regard, because he does a good job of reminding me when I’m letting things get unbalanced. I have a passion for dentistry and I love being a dental student, but at the same time I need to get away from the stresses of being a dental student by focusing on other things in my life that allow me to stop thinking about dentistry for a day and just enjoy doing something else. I think that everyone needs that. Truthfully, that would be my best advice for a new, D1 dental student. Stay focused on your goal as far as dental school goes, but don’t be afraid to take time every now and then to do something else that is important to you. Whether it’s being with your family, or music, or art, or even reading a good novel now and then, you’ve got to make sure dental school is an enjoyable experience, and you can only do that by staying balanced as a person.

YOU MENTIONED THAT UNMC STUDENTS, BETWEEN THEIR THIRD AND FOURTH YEARS, WORK IN UNDERSERVED RURAL AREAS OF NEBRASKA. WHAT ABOUT THIS EXPERIENCE WAS MOST REWARDING FOR YOU?

THE NEXT DDS

Money always seems to be at the top of my priority list; whether it’s the massive amount of student loans I keep adding to every year of dental school, or money to pay for all the services we talked about earlier as I make my transition into private practice. How do I pay for a lawyer, an accountant, and a practice transition firm when I’m still trying to live off a student loan budget? I feel like that’s been a big topic that I’ve really got to work to figure out and find a solution to. Beyond that, I know the licensure process is coming up over this next year or two, and that feels a little grey cloud in the back of my mind that seems to follow me around everywhere.

There are many ways to be a supporter of an organization moving towards a common cause.

Living in a small rural community was a rewarding experience in and of itself, but also being able to serve so many patients in such a short period of time was a great learning experience. We worked for almost a day and a half and managed to treat more than 120 patients in that time—and that was just at our site. Seeing the impact that local practitioners can have on their communities was amazing for me. One dentist from a small town nearby had recently started accepting more Medicaid patients in his office. As a result, we noticed that our patient numbers were notably down this year compared to previous years. Being able to see the impact that one doctor was able to make in that community by accepting more Medicaid patients was an eye opener for me. In addition, it was really great to see how treatments provided by previous students were benefitting repeat patients. We attended to kids who had previously received sealants from our outreach clinic in past years, and we were able to see that had positively affected their oral health. It was good to witness positive outcomes from some of the preventative measures that had been put in place in years past.

WHAT ARE SOME OF THE CHIEF CONCERNS THAT YOU HAVE AS YOU START YOUR D4 YEAR?

Fall 2013

THE ADA AND LEGISLATORS, AMONG MANY OTHERS, ARE FOCUSED ON TRYING TO HELP ADDRESS THE ISSUE OF STUDENT DEBT. It’s reassuring to be reminded that, while I feel this way now, there have been many thousands of dental students in the past five years who have been able to successfully join practices, and successfully navigated this transition just like I am about to do. I know they’ve all been able to do it, and I’m sure I will too in time, but nevertheless it’s still stressful while you’re going through it.

WHAT LAST WORDS DO YOU WANT TO SHARE WITH THE NEXT DDS DENTAL STUDENT COMMUNITY?

I’m such a big advocate for organized dentistry, as you can tell from my record of participation and even this interview. I always try to remind dental students that if you don’t like the way something is, or the way something is being done, it does no good to complain if you aren’t personally trying to take some kind of action to fix it. People need to remember that taking action doesn’t necessarily mean you need to be the loudest voice, or the most heavily involved person; simply being a supporter of a common cause for an organization can make just as big a difference. Everyone has their unique role to play, and there are many different ways to be a supporter of an organization moving towards a common cause. You can’t be upset about something, or talk about how you dislike the way things are being done unless you’re willing to stand behind an organization or a cause dedicated to making changes happen.

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i n n o v a t i o n

D1-D4 STUDENTS

THE EVOLUTION OF THE

TELEPHONE

n April 1876, Alexander Graham Bell made the world's first telephone call at his lab in Boston. Since that time, the telephone has evolved at breakneck speed. Do any of you still have a landline phone? When was the last time that you used a pay phone? Better yet, when was the last time you actually SAW a payphone? THE NEXT DDS has assembled here a series of important milestones for a generation of students accustomed to having their address book, home computer, and internet access in the palm of their hands 24/7.

The famous phone call from Bell to Watson:

“WATSON, COME HERE, I WANT TO SEE YOU!”

The first U.S. public pay phone is installed at a Hartford, CT bank.

1876

1889

The U.S. has more than 80,000 pay phones.

1902

The number of payphones in the U.S. reaches 1 million.

1960

Motorola executive Martin Cooper makes world’s first cellphone call on a Motorola DynaTAC 8000X, which weighed 2.5 pounds! He called his rival CEO at AT&T to tell him that Motorola had won the race to cellular technology.

1973

Less than 11 years after the first cellphone call, more than 92,000 Americans use cellphones.

1984

Number of U.S. cellphone users reaches 290 million.

More than 95% of U.S. households have a landline phone. Do your parents still have a landline?

Less than 13% of all households in the U.S. have only landlines.

Smartphones overtake basic cellphones, accounting for more than 55% of all handsets sold in the U.S.

2010

2011

2001

1998 Pay phones reach a peak saturation of 2.6 million. This number drops drastically to 425,000 by 2011.

2013 Half of U.S. adults own smartphones; smartphones account for 80% of all devices sold by Verizon Wireless and AT&T.

THE NEXT DDS

20?? What's next? • OLED Technology • Piezoelectric devices

Fall 2013

Cell phone and mobile technology has advanced so rapidly over the past 40 years that companies are always on the hunt for the next big breakthrough. Organic Light Emitting Diodes (OLEDs) may allow phone design to become more flexible in the near future, and piezoelectric technology could allow phones to charge themselves through the small electrical currents that are caused by touching the screen. Imagine a smart phone you never needed to charge again; it may not be that far away! Whether you spend minutes or hours of your day browsing on your smartphone, THE NEXT DDS | Mobile is there to support your clinical and classroom requirements. Be sure to search for helpful information when you’re preparing for your exams, that challenging Class V case, or just to see what your fellow students have shared to enrich your dental school experience.

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THE

THE NEXT DDS has been developed as an adjunct to the traditional model of dental education, providing greater access to scientific resources and unparalleled communication between dental students. Many have embraced its vision of dental education and its objective of shaping the learning experience through technology. THE NEXT DDS is offered to enrolled dental students for free during their time in dental school thanks to the generous support of the following leading organizations in dentistry: PAGE

SPONSORING PARTNER

PAGE

SPONSORING PARTNER

27 www.aspendental.com

52 www.biolase.com

FINANCIAL

www.sonicare.com

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HAVE YOUR CAKE

AND EAT IT, TOO Introducing Resin 8 Colors from Hu-Friedy

FEATURING EVEREDGE® TECHNOLOGY

It’s not your birthday, but your wish just came true. With Hu-Friedy Resin 8 Colors, you can have the best of both worlds— the color resin you want, with the Hu-Friedy efficiency and quality you deserve. Hu-Friedy’s Resin 8 Colors are ergonomic, lightweight and offer a color-coding system based on specific areas of the mouth. Plus, each scaler and curette features Hu-Friedy’s proprietary EverEdge® technology, which keeps the working ends sharper longer. It’s time to treat yourself—with Resin 8 Colors, you can have your cake and eat it too.

How the best perform