2018 - Nov/Dec TFDA by Florida Dental Association

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We work for you.

“

As a new dentist, I am constantly striving to build a strong foundation for my future. By being a member of The Doctors Company, my career is not only protected by the largest doctor-owned malpractice insurer in the nation, but also rewarded at the end of my career. The Doctors Company awards a Tribute check to members upon retirement for their loyalty and

commitment to the practice of good dentistry. This reward will surely help down the line when I retire from the dental profession.

- Dr. Athas Kometas

— Dr. Jenna Pascoli

”

Call us at 800.877.7597 or visit fdaservices.com.

HELPING MEMBERS SUCCEED VOL. 30, NO. 7 • NOVEMBER/DECEMBER 2018

A PUBLICATION OF THE FLORIDA DENTAL ASSOCIATION

in every issue 3 Staff Roster 5 President's Message 8 Human Relations 10 Did You Know? 13 Info Bytes 14 Legislative Corner 18 news@fda 34 Get Involved! 94 Compleat Dentistry 97 Diagnostic Discussion 106 Career Center 111 Advertising Index 112 Off the Cusp

This is Your Florida Dental Association

This is Your American Dental Association

Meet Florida’s Dental School Deans

FDC2019 Speaker Preview — Medically Complex Patients and Medical Emergencies

Something New Under the (Florida) Sun

Are You Paying Too Little in Rent?

Donated Dental Services

Opioid Basics, FAQs and BOD Rule

Meet Your FDA Staff and Council Chairs

FDA Membership From A to Z

Member Milestones

Did You Know That Your Membership Can Do This?

Alliance of the Florida Dental Association

54 58

FDC2019 Speaker Peview — Treatment Planning and Restorative Options for the Edentulous Patient

Meet Your Six District Dental Associations

Driving Floridians to Find Their FDA Dentist

Top Tax Saving Moves

Is a Self-funded Group Health Insurance Plan Right for Your Dental Office?

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Exhibitor Marketplace

TODAY'S FDA ONLINE: floridadental.org

FLORIDA DENTAL ASSOCIATION NOVEMBER/DECEMBER 2018 VOL. 30, NO. 7

EDITOR Dr. John Paul, Lakeland, editor

STAFF Jill Runyan, director of communications Jessica Lauria, communications and media coordinator Lynne Knight, marketing coordinator

FDA/Alabama Dental Association "Big Sky Ski & Learn" Seminar

BOARD OF TRUSTEES Dr. Jolene Paramore, Panama City, president Dr. Rudy Liddell, Brandon, president-elect Dr. Andy Brown, Orange Park, first vice president Dr. Dave Boden, Port St. Lucie, second vice president Dr. Gerald Bird, Cocoa, secretary Dr. Michael D. Eggnatz, Weston, immediate past president Drew Eason, CAE, Tallahassee, executive director Dr. Karen Glerum, Boynton Beach • Dr. Jeannette Pena Hall, Miami Dr. Bernard Kahn, Maitland • Dr. George Kolos, Fort Lauderdale Dr. Eddie Martin, Pensacola • Dr. Jeffrey Ottley, Milton Dr. Paul Palo, Winter Haven • Dr. Howard Pranikoff, Ormond Beach Dr. Rick Mullens, Jacksonville • Dr. Beatriz Terry, Miami Dr. Stephen Zuknick, Brandon • Dr. Ethan Pansick, Delray Beach, speaker of the house Dr. Tim Marshall, Spring Hill, Treasurer • Dr. Romano, Miami, Treasurer-elect Dr. John Paul, Lakeland, editor

PUBLISHING INFORMATION

ADS Chris Brown

Today’s FDA (ISSN 1048-5317/USPS 004-666) is published bimonthly, plus one special issue, by the Florida Dental Association, 545 John Knox Road, Ste. 200, Tallahassee, Fla. 32303. FDA membership dues include a $10 subscription to Today’s FDA. Non-member subscriptions are $150 per year; foreign, $188. Periodical postage paid at Tallahassee, Fla. and additional entry offices. Copyright 2018 Florida Dental Association. All rights reserved. Today’s FDA is a refereed publication. POSTMASTER: Please send form 3579 for returns and changes of address to Today’s FDA, 545 John Knox Road, Ste. 200, Tallahassee, Fla. 32303.

EDITORIAL AND ADVERTISING POLICIES Editorial and advertising copy are carefully reviewed, but publication in this journal does not necessarily imply that the Florida Dental Association endorses any products or services that are advertised, unless the advertisement specifically says so. Similarly, views and conclusions expressed in editorials, commentaries and/or news columns or articles that are published in the journal are those of the authors and not necessarily those of the editors, staff, officials, Board of Trustees or members of the Florida Dental Association.

EDITORIAL CONTACT INFORMATION All Today’s FDA editorial correspondence should be sent to Dr. John Paul, Today’s FDA Editor, Florida Dental Association, 545 John Knox Road, Ste 200, Tallahassee, Fla. 32303. FDA office numbers: 800.877.9922, 850. 681.3629; fax 850.681.0116; email address, fda@floridadental.org; website address, www.floridadental.org.

ADVERTISING INFORMATION For display advertising information, contact: Jill Runyan at jrunyan@floridadental.org or 800.877.9922, Ext. 7113. For career center advertising information, contact: Jessica Lauria at jlauria@floridadental.org or 800.977.9922, Ext. 7115.

Today’s FDA is a member publication of the American Association of Dental Editors and the Florida Magazine Association.

TODAY'S FDA

NOVEMBER/DECEMBER 2018

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CONTACT THE FDA OFFICE 800.877.9922 OR 850.681.3629 545 John Knox Road, Ste. 200 • Tallahassee, FL 32303

EXECUTIVE OFFICE DREW EASON, Executive Director deason@floridadental.org 850.350.7109 GREG GRUBER, Chief Operating Officer/ Chief Financial Officer ggruber@floridadental.org 850.350.7111 CASEY STOUTAMIRE, Director of Third Party Payer and Professional Affairs cstoutamire@floridadental.org 850.350.7202 JUDY STONE, Leadership Affairs Manager jstone@floridadental.org 850.350.7123 LIANNE BELL, Leadership Concierge lbell@floridadental.org 850.350.7114

ACCOUNTING BREANA GIBLIN, Director of Accounting bgiblin@floridadental.org 850.350.7137 LEONA BOUTWELL, Finance Services Coordinator Accounts Receivable & Foundation lboutwell@floridadental.org 850.350.7138 DEANNE FOY, Finance Services Coordinator Dues, PAC & Special Projects dfoy@floridadental.org 850.350.7165 ALLEN JOHNSON, Accounting Manager allen.johnson@fdaservices.com 850.350.7140 MITZI RYE, Financial Services Coordinator mrye@floridadental.org 850.350.7139 STEPHANIE TAYLOR, Membership Dues Coordinator staylor@floridadental.org 850.350.7119

COMMUNICATIONS AND MARKETING JILL RUNYAN, Director of Communications jrunyan@floridadental.org 850.350.7113 LYNNE KNIGHT, Marketing Coordinator lknight@floridadental.org 850.350.7112 JESSICA LAURIA, Communications and Media Coordinator jlauria@floridadental.org 850.350.7115

FLORIDA DENTAL ASSOCIATION FOUNDATION (FDAF) R. JAI GILLUM, Director of Foundation Affairs rjaigillum@floridadental.org 850.350.7117

FLORIDA DENTAL CONVENTION (FDC) CRISSY TALLMAN, Director of Conventions and Continuing Education ctallman@floridadental.org 850.350.7105 KENLEE BRUGGEMANN, FDC Meeting Assistant kbruggemann@floridadental.org 850.350.7162 BROOKE MARTIN, FDC Marketing Coordinator bmartin@floridadental.org 850.350.7103 DEIRDRE RHODES, FDC Exhibits Planner drhodes@floridadental.org 850.350.7108 JENNIFER TEDDER, FDC Program Coordinator jtedder@floridadental.org 850.350.7106

GOVERNMENTAL AFFAIRS JOE ANNE HART, Chief Legislative Officer jahart@floridadental.org 850.350.7205 ALEXANDRA ABBOUD, Governmental Affairs Liaison aabboud@floridadental.org 850.350.7204 COURTNEY THOMAS, Governmental Affairs Legislative Assistant cthomas@floridadental.org 850.350.7203

INFORMATION SYSTEMS LARRY DARNELL, Director of Information Systems ldarnell@floridadental.org 850.350.7102 RACHEL BURCH, Computer Support Technician rburch@floridadental.org 850.350.7153

MEMBER RELATIONS KERRY GÓMEZ-RÍOS, Director of Member Relations krios@floridadental.org 850.350.7121 DESTINY SIMS, Member Access Coordinator dsims@floridadental.org 850.350.7100 ASHLEY MERRILL, Member Relations Coordinator amerrill@floridadental.org 850.350.7110 CHRISTINE TROTTO, Membership Concierge ctrotto@floridadental.org 850.350.7136

AUSTIN MOSER, Coordinator of Foundation Affairs amoser@floridadental.org 850.350.7161

FDA SERVICES 800.877.7597 or 850.681.2996 545 John Knox Road, Ste. 201 Tallahassee, FL 32303 Group & Individual Health • Medicare Supplement • Life Insurance Disability Income • Long-term Care • Annuities • Professional Liability Office Package • Workers’ Compensation • Auto • Boat

SCOTT RUTHSTROM, Chief Operating Officer scott.ruthstrom@fdaservices.com 850.350.7146 CAROL GASKINS, Assistant Manager – Sales & Service carol.gaskins@fdaservices.com 850.350.7159 DEBBIE LANE, Assistant Manager – Service & Technology debbie.lane@fdaservices.com 850.350.7157 ALEX KLINE, FDAS Marketing Coordinator alex.kline@fdaservices.com 850.350.7166 MARCIA DUTTON, Administrative Assistant marcia.dutton@fdaservices.com 850.350.7145 PORSCHIE BIGGINS, North Florida Membership Services Representative pbiggins@fdaservices.com 850-350-7149 MARIA BROOKS, SFDDA Membership Services Representative maria.brooks@fdaservices.com 850.350.7144 MANDY MOORE, Membership Services Representative mandy.moore@fdaservices.com 850.350.7156 EBONI NELSON, CFDDA Membership Services Representative eboni.nelson@fdaservices.com 850.350.7151 MELISSA STAGGERS, WCDDA Membership Services Representative melissa.staggers@fdaservices.com 850.350.7154 TESSA DANIELS, Membership Services Representative tessa.daniels@fdaservices.com 850.350.7158

CARRIE MILLAR Director of Insurance Operations carrie.millar@fdaservices.com 850.350.7155

YOUR RISK EXPERTS DAN ZOTTOLI, SBCS Director of Sales — Atlantic Coast 561.791.7744 Cell: 561.601.5363 dan.zottoli@fdaservices.com DENNIS HEAD, CIC Director of Sales — Central Florida 877.843.0921 (toll free) Cell: 407.927.5472 dennis.head@fdaservices.com MIKE TROUT Director of Sales — North Florida 904.249.6985 Cell: 904.254.8927 mike.trout@fdaservices.com JOSEPH PERRETTI, SBCS Director of Sales — South Florida 305.665.0455 Cell: 305.721.9196 joe.perretti@fdaservices.com RICK D’ANGELO, CIC Director of Sales — West Coast 813.475.6948 Cell: 813.267.2572 rick.dangelo@fdaservices.com

LIZ RICH, Membership Services Representative liz.rich@fdaservices.com 850.350.7171

To contact an FDA Board member, use the first letter of their first name, then their last name, followed by @bot.floridadental.org. For example, Dr. John Paul: jpaul@bot.floridadental.org.

The last four digits of the telephone number are the extension for that staff member.

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TODAY'S FDA NOVEMBER/DECEMBER 2018

FDA: 2019 Dentists' Day on the Hill

leadership

HELPING MEMBERS SUCCEED — IT’S WHAT WE DO

PRESIDENT’S MESSAGE JOLENE PARAMORE, DMD FDA PRESIDENT

Dr. Paramore can be reached at jparamore@ bot.floridadental.org.

That’s right: Helping members succeed. It’s our marching order. Your officers (pictured above) represent more than 8,000 Florida Dental Association (FDA) member-dentists and lead with relentless, positive action. While we don’t take ourselves too seriously, we take what we do as leaders very seriously. More than 450 FDA members serve in various volunteer leadership roles across the state. Helping members succeed is the FDA’s mission. We are Florida’s advocate for oral health. FDA membership is extended to ethical, Florida dentists. Everyone who meets that standard is welcome in the FDA. Though we’re all dental professionals, we all won’t have the same professional philosophy. Though we all practice dentistry, we won’t practice dentistry the same way or have the same practice delivery model. Though we all have a dental license, we all won’t have the same level of education and training. Though we all WWW.FLORIDADENTAL.ORG

have experience, we all won’t have the same experiences. THANK GOODNESS! Why, you ask? Because our differences are our greatest strength. Our profession is vital and vibrant today, yet we must continually work to protect and preserve its reputation and integrity. This takes every dentist, regardless of age, gender, race, ethnicity, location, specialty or practice style. Only by including and welcoming all dentists in the dental association will we reach our maximum success potential. This great variety of knowledge and experiences benefits our profession in many ways, sometimes when we least expect it and often when we need it the most. Our differences, when blended together with mutual understanding, allow us to be stronger, more relevant and more resistant to the shockers and stressors that will come our way. SEE PAGE 7 TODAY'S FDA NOVEMBER/DECEMBER 2018

FDA Foundation: Florida Mission of Mercy

leadership FROM PAGE 5

This year’s Florida Dental Convention (FDC) theme, “Elevate your game,” was especially relevant when you consider this motivational quote from Tai Lopez, “Never chase what you want. Elevate your game until what you want chases you.”

tice management support and services. By fostering a community that helps dentists focus on their passion to provide patients with the best level of care, FDA dentists are helping support and promote oral health in Florida.

As dentists, you are challenged to elevate your game in your practice. At a recent presentation, we also were challenged to do more. Elevate your perspective. Elevate your relationships. Elevate your engagement. Elevate your impact. I’m all in, are you? All it takes is effort.

My dad was a hospital administrator, past president of the Florida Hospital Association and public policy director for a large HMO. When I went to my first Dentists’ Day on the Hill, he told me to always be an honest, trusted resource for legislators and their staffers, that no one else knows your profession like you do and if the dental profession doesn’t take part in the political process, the political process will take the dental profession apart. Like it or not, we must be involved in the political process. In today’s climate of bitter partisan politics, where there are great divides between the parties, it is crucial for all to know the FDA and the ADA don’t support the Republican or Democratic Party. When our FDA members interact with legislators in Florida and in D.C., we are members of the TOOTH PARTY! Our FDA Political Action Committee (PAC) supports those R and D legislators who support the agenda of the Tooth Party regardless of which side of the aisle they occupy!

So, let’s do a quick risk assessment. What or who has the greatest potential to shock or stress our profession? The policy makers (legislators). The rule makers (Board of Dentistry). The insurance industry. The government (Pick your favorite regulatory entity). How do you as an individual dentist respond to these shockers and stressors? Do they break you? Do you know who to reach out to try to resolve your stressor? Do you have the kind of relationships to get an appointment with those who can help you respond? Wouldn’t you spend $1,200 to receive more than $38,000 in value, just from the FDA’s top five member benefits: advocacy, communications/marketing, FDA Services’ Crown Savings, annual convention and third-party payer assistance? In addition, the FDA offers personal assistance to navigate the trials and tribulations of dentistry to help you succeed! It’s called FDA membership! Not to mention that your membership also includes benefits from the American Dental Association (ADA) and your district association. The FDA team has the knowledge, experience, passion, skill and willingness to help our members succeed every day. The FDA can help strengthen us when we are stressed. The FDA is committed to providing and promoting a unified voice for dentistry, advocating for you and your patients, elevating your practice and professional success, and making an impact on oral health in Florida. Again, the FDA can help you when stressors enter your personal and professional life, so you emerge stronger from the experience based on the assistance and advice.

If you are an FDA member, THANK YOU for your commitment to the FDA by renewing your membership year after year. If you want to elevate your engagement, make sure you support the FDAPAC as a Century Club member and ADPAC when you renew your dues next month. If you are not a member, I invite you to join today. Simply go to floridadental.org to join or call and ask for our membership concierge, Christine, at 800.877.9922 to see if you are eligible for a non-member incentive to join. If you have a question for me, call me at 850.238.0000. I’m happy to listen. The most important FDA member benefit may not be immediately obvious or used. It’s when that personal or professional shocker or stressor comes along that you will be most thankful to be a member of an organization of professional colleagues who are dedicated to helping you succeed. Until the next message, I remain yours in the bond,

The FDA empowers our member dentists to build thriving practices and careers by providing governmental affairs efforts, insurance policies, professional development, and dental prac-

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TODAY'S FDA NOVEMBER/DECEMBER 2018

human relations

ARE EMPLOYEE HANDBOOKS WORTH THE TIME AND EFFORT?

DEBORAH S. MINNIS

Ms. Minnis practices labor and employment law at Ausley McMullen, and she also represents various local government bodies. She can be reached at dminnis@ausley.com. This article is for informational purposes only and is not intended to be a substitute for professional legal advice. If you have a specific concern or need legal advice regarding your dental practice, you should contact a qualified attorney.

The simple answer to that question is YES. As discussed in more detail below, having an employee handbook provides notice of the company’s expectations to all staff and helps the company work as a team.

n There is a clear mechanism for reporting problems happening in the workplace.

Employee Handbooks are a Smart Thing to Have.

n Paying particular attention to anti-harassment policies assures employees that their health and safety is valued and respected.

Though not required by law in Florida, an upto-date handbook is good for both employers and their employees. n It offers a centralized guide to workplace policies so everyone in the office can be on the same page. It sets out the vision and mission of the company. n If or when disciplinary measures must be taken, it provides a road map to follow. n Distributing an up-to-date handbook to your employees shows that you are invested in creating a fair workplace where your employees aren’t subject to ad hoc decisionmaking. n All staff receives notice of the company’s expectations. n Documented policies and procedures save time. Managers do not have to explain the same policies over to new employees. n Available benefits and eligibility requirements are explained.

n It helps to ensure that the company is complying with federal, state and local laws and regulations.

n A properly drafted and circulated employee handbook can provide support for defenses to allegations of wrongful termination claims. For example, in most unemployment procedures the appeals referee will ask if the employee violated a clearly set out policy or work rule. If the answer is no, more than likely the employee will be awarded benefits. More significantly, having a clearly and properly disseminated anti-harassment policy and procedure for investigating these claims can form part of the company’s defense to claims of a hostile environment.

So, What Should You Include in Your Employee Handbook? Employee handbooks should set out the vision and mission of the company. Employee handbooks should contain: n standards of conduct n work hours

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n disciplinary procedures n employee benefits n rules regarding overtime n leave policies n absenteeism policies n policies regarding use of personal electronic devices/internet usage n personal calls/emails n anti-harassment/anti-discrimination policies

It’s important to regularly review your handbook for outdated policies and to take into account recent changes in the law (i.e., sexual harassment and LBGTQ rights). Employment law is not set in stone — many courts face challenging new cases every year in which the parties seek to expand or contract the protections afforded by state and federal laws. Also, the company must adhere to the policies and procedures set out in the handbook. An employee handbook generally is not binding in the same way as an employment contract. But it’s a good rule of thumb that you shouldn’t include any policy or procedure in your handbook if you don’t mean it.

n procedures for reporting harassment, discrimination or other issues/concerns in the workplace

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TODAY'S FDA NOVEMBER/DECEMBER 2018

DIDYOU

BOD

INFORMATION ABOUT THE FLORIDA BOARD OF DENTISTRY

YOU ARE REQUIRED TO PROVIDE 24-HOUR EMERGENCY CARE

DR. DON ILKKA FDA LIASON TO THE FLORIDA BOARD OF DENTISTRY

Did you know that you are required, either personally or through another Florida-licensed dentist or through a reciprocal agreement with another group, to provide 24-hour emergency care for all patients under your continuing care? If you do not provide this emergency care, then you are subject to discipline by the Florida Board of Dentistry (BOD). Emergency care also is listed in the American Dental Association’s (ADA) Dental Patient Rights and Responsibilities Statement, and states that a patient has the right to reasonable arrangements for dental care and emergency treatment. The full list of patients’ rights and responsibilities can be found on the ADA’s website at bit.ly/2yWriyF.

CASEY STOUTAMIRE FDA DIRECTOR OF THIRD PARTY PAYER & PROFESSIONAL AFFAIRS

There are no clear-cut parameters on what type of practices will be enough to satisfy this rule. For example, is a 24-hour number for patients to call you enough; do you have to be available to have patients come into your office 24 hours a day, seven days a week? The reasonableness standard will apply here — is the access to emergency care you are providing to your patients reasonable under the circumstances? The BOD Rule on this issue is 64B5-17.004, Emergency Care: It is the responsibility of every dentist practicing in this state to provide, either personally, through another licensed dentist or through a reciprocal agreement with another agency, reasonable 24-hour emergency services for all patients under his/her continuing care.

If you have any questions, please contact Director of Third Party Payer and Professional Affairs Casey Stoutamire, Esq. at cstoutamire@ floridadental.org or 850.350.7202, or FDA Liaison to the Florida Board of Dentistry Dr. Don Ilkka at donjilkkadds@aol.com or 352.787.4748.

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FDA - HB21 Course

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info bytes

TECHNOLOGY IN A CRISIS

Life before Hurricane Michael seemed very different than today. After experiencing the hurricane, I’m unable to put into words the sheer devastation I witnessed in pictures and even some I witnessed with my own eyes. My house was without power for four days, internet six days and cell service for three days. You never realize how much you depend on technology until it’s not available anymore. My family and I are semi-preppers — we had a generator, gas, batteries, food and water rations for days. However, I wasn’t prepared for most of the technology that I own to be utterly useless. Trying to do the simplest things using almost non-existent data, limited cell capacity and a tiny phone screen was a great challenge. I managed to find a battery-powered radio, so I could find out what was happening in the outside world, but most radio stations were knocked out, too. A strange dynamic soon developed. My life no longer revolved around my phone or email. Normally, my teenage daughters will text me from their bedrooms 12 feet away, but now, we are talking face to face and communicating about important life issues. I seemingly no longer care about missing that important show, binge-watching Netflix, playing Fortnite or even watching Thursday night football (sacrilege!). They all take a backseat to reality when a crisis hits. This is the third year in a row Floridians have experienced something like this. There are some vital lessons to be learned in the aftermath of a crisis, to be remembered for the next time. Realize you may not always be able to use the technology that’s so convenient to you. Loss of power, internet or cell service can curtail many disaster plans when it’s difficult to communi-

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cate. Have backup options — even old school ones — just in case. Despite any number of celebrities advertising for us to “get a plan” for a disaster, truthfully, most of us don’t because we believe it will never happen to us … until it does, and then it’s too late. Take the time to discuss those plans with your immediate family and even notify some people outside the area just in case of the worst-case scenario. The things we consider so important, like immediately checking that text or email, watching that show or answering that phone call, don’t seem quite as important in the big picture. Technology can make things seem so easy that it will dominate our lives. We were meant to control the technology — not the other way around.

LARRY DARNELL, MBA, CAE FDA DIRECTOR OF INFORMATION SYSTEMS

Mr. Darnell can be reached at ldarnell@floridadental.org.

It’s hard to be others-focused when you are going through a crisis yourself. However, I’m encouraged by people’s use of social media after this crisis hit (and people got power back) because they are using it to rally communities together to feed people, meet needs and serve others. That’s the best use of technology. The things that divided us before Hurricane Michael seem to pale in comparison when life or death are on the line. Technology should improve our lives. A crisis tends to be one of the best teachers because it shows us something that can’t be given: perspective. When it comes to technology and your use of it, remember to keep things in perspective. That text, email, phone call … how many of us have interrupted a conversation, a meal or sleep to respond? Most of the time, it can and will wait. That is a hard lesson to learn. However, my dad used to say, “A lesson earned is a lesson learned.” TODAY'S FDA NOVEMBER/DECEMBER 2018

legislative corner

HERE’S THE 4-1-1 ON DENTAL THERAPY

JOE ANNE HART FDA CHIEF LEGISLATIVE OFFICER

Ms. Hart can be reached at jahart@floridadental.org.

Florida has become a targeted state for dental therapy legislation. Apparently, Pew Charitable Trusts, Kellogg Foundation, some dentists in academia and several other groups believe that the current dental team is insufficient to treat Floridians. Not only are they pushing dental therapy legislation as the solution to access to dental care, they have taken negative tactics to disparage organized dentistry for pursuing initiatives to help increase dentists working in underserved areas. Why are these groups and organizations investing millions of dollars in pushing dental therapy legislation, instead of investing these funds in programs that could help provide direct and immediate dental care? The Florida Dental Association (FDA) does not support adding a new licensed dental provider to the dental workforce. Florida currently has approximately 14,000 licensed dentists and 14,000 licensed dental hygienists practicing in the state, based on information provided through the Department of Health’s website. Florida has the most dentists and dental hygienists ever, and with three dental schools, there are roughly 300 new dentists graduating yearly. Dentists are challenged in many ways when entering the workforce. As small-business owners, dentists must consider many factors when deciding on a location to practice. Besides having a passion of helping and serving their patients, dentists must still consider their financial obligations, whether that be loan repayment or meeting their overhead expenses. Unfortunately, with these types of decisions,

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some areas of the state may suffer from having a low number of dentists deciding to practice in their community. The FDA supports proposals that promote and encourage dentists to consider these areas by receiving incentives to alleviate the financial burdens. Maximizing Florida’s existing dental workforce will allow for all Floridians to attain quality, comprehensive dental care from a highly trained dentist.

So, What’s the 4-1-1 on Dental Therapy? Who is a dental therapist? A dental therapist could be a high school graduate who receives three years of dental therapy training and would be authorized to perform irreversible surgical procedures, such as surgical extractions, partial root canals and administer local anesthesia under the general supervision of a dentist.

Are there CODA standards for dental therapy programs? Yes, the Commission on Dental Accreditation (CODA) approved educational standards for dental therapy programs in 2015.

Are there any CODA-approved programs in the United States? No, there are no CODA-approved programs in any state in the United States. The dental therapists practicing in Minnesota did not graduated from a CODA-approved program. WWW.FLORIDADENTAL.ORG

What states have authorized dental therapist legislation? Alaska (dental health aide therapists), Arizona, Maine, Minnesota, Oregon (pilot project), Vermont and Washington.

Which states have dental therapists practicing? Minnesota has about 80 dental therapists practicing and most of them are NOT practicing in rural areas. Even with dental therapists, in May 2017, Minnesota was in jeopardy of losing federal funding because it was failing to provide adequate dental care to children of low-income families. Oregon implemented a dental health aide therapist pilot project for tribal areas and failed one of its site visits due to individuals practicing outside of their scope of practice. Washington passed legislation specifically allowing dental therapists to practice, but only in tribal communities. Alaska has had dental health aide therapists practicing since 2005. Although, Arizona, Maine and Vermont have approved dental therapists’ legislation for their state, no dental therapists are licensed there because there are no CODA-approved programs in these states.

Are dental therapists the same as nurse practitioners and physician assistants? No, dental therapists are NOT like nurse practitioners and physician assistants. Nurse practitioners and physician assistants are required to have much more education and training than dental therapists.

Does Florida have a shortage of dentists? No, Florida does not have a shortage of dentists. Florida has approximately 14,000 licensed dentists; however, there is a maldistribution of dentists around the state, leaving the more rural areas without an adequate supply of dentists. The term “shortage” is used by some national groups to signify that people living in certain areas of the state do not have access to routine dental care. This does not mean that the state as a whole has a shortage of dentists.

WWW.FLORIDADENTAL.ORG

Are there programs and initiatives that focus on increasing dental care in underserved areas? Yes, the FDA has pursued reinstating the dental student loan repayment program, which incentivizes dentists to practice as full-time Medicaid providers in rural and underserved areas. In return, dentists are eligible for state assistance in repaying their student loans. This program is not a new program. Florida is one of only five states that does not have a dental student loan repayment program. This program and other initiatives outlined in Florida’s Action for Dental Health provide a multifaceted approach to addressing issues involved with increasing access to dental care. The FDA also supports community water fluoridation and community dental health coordinators, who help patients navigate the complicated health care system. Proponents for dental therapy will be working hard to get legislation passed in Florida. The FDA will be on the frontline for its members, educating legislators and stakeholders on the importance of Florida maintaining its high standard of care for all Floridians. Introducing dental therapists to Florida’s dental workforce does not guarantee an increase in access to dental care. Collaborative efforts are needed in oral health education and prevention. Promoting preventive dental care on the front end will provide greater benefits for everyone on the back end.

How can I help? The FDA is looking for members who are passionate about organized dentistry’s position on dental therapy and would like to be a part of the solution to access to dental care issues in Florida. If you would like to become more involved, please contact FDA Chief Legislative Officer Joe Anne Hart at jahart@floridadental.org or 850.350.7205.

TODAY'S FDA NOVEMBER/DECEMBER 2018

THIS IS YOUR

TRUSTEE DISTRICTS (number of delegates & states)

1st (31): Connecticut, Maine, Massachusetts,

New Hampshire, Rhode Island, Vermont

1 11

9 10 7

8 13

6 12

HERE IS HOW YOUR ADA WORKS!

2nd (36): New York 3rd (16): Pennsylvania 4th (37): Delaware, District of Columbia, Federal Dental Services, Maryland, New Jersey, Puerto Rico, Virgin Islands

5th (18): Alabama, Georgia, Mississippi 6th (21): Kentucky, Missouri, Tennessee, West Virginia 7th (25): Indiana, Ohio 8th (20): Illinois 9th (27): Michigan, Wisconsin 10th (21): Iowa, Minnesota, Nebraska, North Dakota, South Dakota

11th (27): Alaska, Idaho, Montana, Oregon, Washington 12th (18): Arkansas, Kansas, Louisiana, Oklahoma 13th (71): California 14th (33): Arizona, Colorado, Hawaii, Nevada, New Mexico, Utah, Wyoming

15th (27): Texas 16th (28): North Carolina, South Carolina, Virginia 17th (22): Florida American Student Dental Association (5)

24 MEMBERS

The American Dental Association (ADA) is the largest and most diverse dental association in the world. The ADA is a member-driven organzation, meaning that each of our 161,000 MEMBERS has a voice.

PRESIdent • president-elect • first vice president second vice president • speaker •treasurer

10 councils

board of trustees executive director/secretary

17 trustees The ADA is managed by the Board of Trustees (BOT) and governed by the House of Delegates (HOD). ADA councils, commissions and committees make recommendations on policy related to their specific areas of expertise.

483 DELEGATES Ada house of delegates

The members of the ADA HOD are chosen by the 53 constituent societies, the five federal dental services and the American Student Dental Association. The HOD meets once a year, during the ADA Annual Meeting, usually held in October. The officers of the HOD are the speaker and the secretary. The executive director of the ADA serves as HOD secretary.

The ADA has 10 councils. Most councils are composed of one member from each of the trustee districts of the association and one new dentist member recommended by the New Dentist Committee and nominated by the ADA BOT. Most councils meet twice a year, either at the ADA headquarters office in Chicago or the Washington, D.C. office. Council on Advocacy for Access & Prevention

Council on Ethics, Bylaws & Judicial Affairs

Council on Communications

Council on Membership

Council on Dental Benefit Programs Council on Dental Education & Licensure

Council on Members Insurance & Retirement Programs

Council on Dental Practice

Council on Scientific Affairs

Council on Government Affairs

4 commissions

3 committees

Commission for Continuing Education provider Recognition

New Dentist Committee: providing the board with expertise on issues affecting new dentists

Commission on Dental Accreditation

Advisory Committee on Annual Meetings: conducts the annual meetings of the ADA

Joint Commission on National Dental Examinations National Commission on Recognition of Dental Specialties & Certifying Boards

American Dental Political Action Committee: voluntary nonprofit unincorporated committee of dentists and others

updates for members *PLEASE NOTE THAT FDA MEMBERS HAVE THEIR NAMES LISTED IN BOLD.

Your Dues Statement is on its Way — Now with Auto-renew! Never worry about making a late payment or forgetting to renew your membership! You can now set your mandatory dues to automatically renew each year when you select to pay in either one lump-sum with auto-renew or nine monthly installments with autorenew. Also, by selecting the monthly installments, adding the recommended contributions is easier on your budget! There are two auto-renew options available: n Lump-sum payment with auto renew: Your card will be charged the full amount at the time of enrollment. n Nine monthly installments with auto-renew — you must enroll by Jan. 4, 2019 for this option! Your first payment will not be charged to your card until January 2019 and the last payment will be charged to your card in September 2019. Both options will allow your membership to automatically renew in 2020 at the same terms that you indicate and will be charged to the credit card you provide for auto-renewal. Using your American Dental Association (ADA) number as your username, log on at floridadental.org/dues and choose the auto-renew option during Step 3, and cross this off your list!

TODAY'S FDA

Renewing your membership for life is that easy! Contact the Member Relations department at 850.681.3629 with any questions you may have about these new payment options.

Join us for the 2019 Florida Mission of Mercy! The 2019 Florida Mission of Mercy (FLAMOM) will take place March 22-23 in Orlando. Since 2014, the FLA-MOM has made an impact across the state — more than 49,000 procedures were provided to 8,140 patients, resulting in $7.37 million in donated care! Volunteer registration for the 2019 FLA-MOM is now open, and we need your help to make an impact in Central Florida and treat at least 2,000 patients. Please visit flamom. org to sign up to volunteer and donate today!

FDA Foundation Emerald Club Are you ready to create a legacy for oral health in Florida? Did you know that the easiest way to make an impact and support the FDA Foundation is with your annual Emerald Club membership? Please be sure to check the “Emerald Club” box on your dues statement or when paying your dues online to include your $125 donation to the FDA Foundation. Want to increase your giving to support programs like the FLA-MOM, Donated Dental Services and Project: Dentists Care? Visit emeraldclub.floridadental.org or call the Foundation team at 850.681.3629 to enhance your level of giving.

NOVEMBER/DECEMBER 2018

Learn “The Power of the Complete Team” at FDC2019! Plan to attend the 2019 Florida Dental Convention (FDC) on June 27-29 at the Gaylord Palms Resort & Convention Center in Orlando! Hot topics include Dawson Seminar I, Botox and dermal fillers, body language, insurance coding, minimally invasive dentistry, pedo pearls, All-on-4 and much more! Take advantage of FREE registration and many FREE continuing education (CE) courses available to you as an FDA member during pre-registration. Registration opens March 2019. For more information, visit floridadentalconvention.com.

FDA and Colgate Oral Health Network Partner for Online CE The FDA is proud to recognize its partnership with Colgate Oral Health Network as its preferred online CE provider. Go to floridadental.colgateoralhealthnetwork.com to create an account today and receive unlimited access to more than 250 CE units and more than 110 live and on-demand webinars.

Patients, Dentists Can Report Issues with Direct to Consumer Dentistry Devices to Food and Drug Administration Patients and dentists can report issues with medical devices to the U.S. Food WWW.FLORIDADENTAL.ORG

and Drug Administration (US-FDA), including any problems they have had with devices related to direct to consumer (DTC) dental laboratory products. The use of these products is sometimes referred to as do-it-yourself (DIY) dentistry. The US-FDA’s MedWatch voluntary reporting form, which can be found at bit.ly/2JGkDxC, can be used to inform the US-FDA about problems patients encounter with DTC products, such as aligners, partial dentures and snoring appliances. The ADA’s House of Delegates recently adopted a resolution, which “strongly discourages the practice of direct to the consumer (DTC) dental laboratory services because of the potential for irreversible harm to patients.”

No Change to Statute or Rule Governing the Delivery of Nitrous The FDA is aware that CE companies are sending postcards that imply you may not be compliant with the Board of Dentistry (BOD) rule governing the delivery of nitrous. There has been no change to the statute or rule. If you were compliant before (you had adequate training while attending an accredited dental school), then there is no need to take an additional course. The FDA notified the BOD and it has been in contact with the CE provider about the misleading information. For more information, please contact FDA Director of Third Party Payer and Professional Affairs Casey Stoutamire at 850.350.7202 or cstoutamire@floridadental.org.

Today’s FDA Online Did you know that Today’s FDA is on our website? Make sure to check out the online version at floridadental.org/publications. WWW.FLORIDADENTAL.ORG

FDA Member is Small Business of the Year Finalist The Greater Tampa Chamber of Commerce held their Small Business of the Year Awards in September, which were presented in three categories based on the number of employees, with a fourth category specifically for startup companies. Companies were evaluated on financial success, community involvement and ethical business practices. FDA member Dr. Randy Feldman, a partner at Blue Wave Orthodontics, was a finalist in the Outstanding Leader category. He has dedicated his 35+ year career to helping people find the smile of their dreams through orthodontic care. Congratulations on this recognition, Dr. Feldman!

Welcome New FDA Members These dentists recently joined the FDA. Their membership allows them to develop a strong network of fellow professionals who understand the day-to-day triumphs and tribulations of practicing dentistry.

Atlantic Coast District Dental Association Dalia Al-Azzawi, Palm Beach Gardens Suneetha Atluri, Weston Anoushirvan Baghaei, Coral Springs Maryann Bailey, Stuart Tiffany Brady, Delray Beach Amanda Buscemi, Plantation Andrea Cardoso, Deerfield Beach Jaroslaw Cegielski, Port St. Lucie Dannit Chen, Deerfield Beach Ann Cipriani, West Palm Beach Peter Coletti, Plantation Tamisha Denis, Coral Springs Sava Estanboliah, Palm Beach Gardens Matthew Fox, Port St. Lucie Marina Gikher, Palm Beach Gardens Christina Hernandez Bonnet, Hallandale Beach

In Memoriam The FDA honors the memory and passing of the following members:

Donald B. Dolan Holmes Beach Died: Sept. 12, 2018 Age: 90 Robert L. Edgerton Orlando Died: Oct. 16, 2018 Age: 86 Heather Hosseini, Weston Jennifer Kocher, Davie Paul Korus, Highland Beach Lauren Kramer, Palm Beach Gardens Mark Kubiliun, Jupiter Katherine Lorenzo-Machado, Weston Juan Marcos, North Lauderdale Marcela Matamoros, Palm Beach Gardens Thomas Morris, Pompano Beach Michael Paisner, Plantation Tousant Plunkett, Lake Worth Neelam Shah, Miami Dale Smith, Boynton Beach Liliem Socarras Diaz, Palm Beach Gardens Luisa Tchou, Boca Raton Jordan Tomalty, Boynton Beach Andrew Turke, Palm City Peter Wohlgemuth, Boca Raton Michelle Yang, Davie

Central Florida District Dental Association Edwin Acosta, Clermont Adriana Albite, Orlando Robair Aldaya, Mount Dora Ulan Aliev, Daytona Beach David All, Deltona Paola Berrios Merced, Orlando Paula Bielak, Indian Harbour Beach Russell Bienias, Viera Rene Brignoni, Gainesville Stacey Chan, Oviedo Derek Chenet, Melbourne Kaianne Conibear, Orlando Alejandro Delgado, Gainesville SEE PAGE 20

TODAY'S FDA NOVEMBER/DECEMBER 2018

updates for members Ross Smith, Melbourne Mark Sperling, Orlando Nadia Sulieman, Orlando Miguel Tabares, Kissimmee John Tawadrous, Apopka Gina Torres Marín, Clermont Estela Truzman, Gainesville Hang Van, Winter Garden Nga Vu, Clermont Anthony White, Winter Garden Veronica Yu, Melbourne

FROM PAGE 19 Buddy Denison, Ocala Daniel Eley, Melbourne John Farah, Deland Junaid Farooqui, Orlando Connie Feng, Orlando Carol Fiola, Gainesville Kristina Galligan, Palm Bay Emmanuel Gavua, Titusville Harrison Gollob, Leesburg Sweta Gunnell, Satellite Beach Amal Hamdi, Lake Mary Imran Hameedi, Longwood Kenneth Jainandan, Kissimmee Deborah Jerrells, Clermont Carly Joehl, St. Cloud Stephanie Jones, Lake Butler Shovon Kasem, Clermont Anne Kencos-Hajek, Orlando Brenna Kever, St. Cloud Shanna Kim, Orlando Z. Paul Kossak, Satellite Beach Catherine Koubek, Gainesville Ramy Labib, Lake Mary Utumporn “Penny” Laowansiri, Winter Garden Lam Le, Orlando Sharon McCrary, South Daytona Stephanie McRae, Tavares Misty Melillo, Orlando Thai Nong, Palm Coast Luz Ospina, Windermere Alba Pena, Winter Springs Edna Perez, Gainesville Denise-Joy Perras, Debary Scott Perras, Debary Bradley Pinker, Ormond Beach Shauna Pittman, Melbourne Danielle Price, Gainesville Kaitlyn Purcell, Doral Alec Raiken, Orlando Jamie Reiter, Orlando Ross Reiter, Winter Springs Carlos Rivero, Orlando Grissel Rosario-Aristy, Sanford Shalia Santana Pagan, Altamonte Springs Juliana Sardenberg, Gainesville Katrina Schroeder, Apopka Kevin Sessa, Winter Garden Surendra Sirivolu, Orange City Egle Skruodyte, Apopka

TODAY'S FDA

Northeast District Dental Association

Aruna Avanti, Jacksonville Christine Bojaxhi, Jacksonville Kathryn Cardenas, Macclenny Amber Cook, Perry Toni-Ann Mayembe, Orange Park Daya Muguercia Gonzalez, Jacksonville Anita Nahar, Jacksonville Melissa Nixon, Jacksonville Khalil Orsborn, Jacksonville Anuhar Pal, Jacksonville Reshma Patel, Jacksonville Liset Perez, Jacksonville Yanisis Romero, Jacksonville Erik Roos, Jacksonville Arthur Sollee, Jacksonville Sawsan Tabbaa, Jacksonville Donald Tigchelaar, Jacksonville

NOVEMBER/DECEMBER 2018

Northwest District Dental Association

J. Benito, Tallahassee Joseph Booker, Gulf Breeze Jordan Cherkinsky, Quincy Gregory Digby, Pensacola Christopher Laing, Tallahassee Barbara Leadbeater, Tallahassee Michael Marcantonio, Niceville Thuy Nguyen, Pensacola Paul Quinlan, Gulf Breeze Nageen Rak, Gulf Breeze Michelle Ward, Niceville Jacinta Watkins, Pensacola

South Florida District Dental Association

John Addison, Miami Dennis Amores, Palmetto Bay

Mark Berger, Coral Springs Arley Betancourt, Miami Raquel Brentson, Honolulu Michael Brody, Miami Diana Bronstein, Davie Rosa Bueno, Opa Locka David Cabanzon, South Miami Vianca Cabrera, Coral Gables Joaquin Camejo, Tavernier Irving Carvajal, Miami Mabel Coro, Miami Erick Crespo, Miami Antonio Cruz, Boca Raton Andres Cuartas, Doral Janice Defelice, Hallandale Beach Julia Dison, North Miami Beach Veronica Felipe, Hialeah Yeny Fernandez, Miami Mitchell Feuer, Hollywood Joan Flores, Miami Carlos Fors, Miami Jeffrey Friefeld, Miami Lakes Johanna Gallego Eckstein, Miami Hansel Gonzalez, Miami Ana Gonzalez Caceres, Hallandale Beach Norma Gonzalez Lopez, Miami Ana Gonzalez-Cayon, Miami Dmitry Gorbatov, Hallandale Beach Beverly Green, Sunrise Victoria Herrera, Miami Cesar Hurtado, Miami Maria Irizarry Ortiz, Miami Beach Sergio Jacas, Fort Lauderdale Chris Keane, Southwest Ranches Aida Lopez, Miami Anabelle Lopez, Miami Michelle Luis, Miami Beach Madelyn Luzardo, Coral Gables Mega Margapuram, Davie Rocio Martinez Saroza, Cutler Bay Jorge Menendez, Miami Jose Montero, Miami Marcela Newman, Hollywood Francisco Oliver, Weston Eli Oppenheimer, Surfside Ana Ospina, Davie Juan Packer, Miami Beach Danny Pena, Miami Jorge Perez, Miami Nelly Perez Rodriguez, Miami Hector Perez-Marti, Doral Tatiana Rey, Miami Eric Rieger, Hollywood Libia Rios, Miami Gretell Rodriguez, Miami Roxana Rodriguez, Hialeah WWW.FLORIDADENTAL.ORG

Liliam Rodriguez Castro, Coral Gables Gabriela Rolland-Asensi, Miami Ashley Rosenbaum, Palmetto Bay Milton Ruiz, Pembroke Pines Germaine Santiago Tua, Doral Isis Sosa, Hialeah Luviana Soto Martinez, North Miami Beach Wayne Stephens, Miami Alyne Tendero, Hollywood Marie-Joelle Thevenin, Miami Shari Witkoff, Coral Gables Ali Yazback, Pembroke Pines Cynthia Yu, Miramar

West Coast District Dental Association

Frederick Anderson, Lithia Monika Aneja, Bradenton Mark Angeloni, St. Petersburg Gemayel Aquino, Cape Coral Richard Ballentine, North Port Kristina Beg, Tampa Jason Blundell, Palm Harbor Lisa Brooks, Land O’ Lakes Matthew Byars, Englewood

Edgar Castellanos, Safety Harbor Gabriel Chamorro, Winter Haven Terryl Crawford, Lakeland Lilyann Cubero, Naples Elio D’Amico, Naples Arina Doroshenko, Lithia Shane Eckels, Sarasota Azita Eskandari, New Port Richey Mounika Falemban, Riverview Daisy Fatjo, New Port Richey Robert Ferrera, Tampa Kara Ford, Temple Terrace Stephen Gardner, New Port Richey Jon Gesicki, Bradenton Martin Giacobbi, St. Petersburg Joseph Gulle, Lithia Christel Haberland, St. Petersburg Lawrence Hale, Englewood Kelly Harris, Bradenton Kristyn Healey, Palm Harbor Kimberly Henwood, Tampa Brian Hoffman, Sarasota Darlene Jean, Tampa Elias Josephs, Fort Myers Jeongyun Kim, Tampa Lawrence Klein, St. Petersburg Filadelfo Larios, Naples

Brian Leeson, Tampa Jody Maiden, St. Petersburg Manav Malik, Sarasota Shazia Malik, Tampa Andrew Mikhail, Wesley Chapel Lori Morgan, Bradenton Chi Nguyen, Pinellas Park Thuy Nguyen, Brandon Ronald O’Neal, St. Petersburg Ulysses Patalinghug, Fort Myers Asha Patel, Palm Harbor Stevy Raju, Seffner Anson Rhodes, Hudson Santos Robinson Maita, St. Petersburg Jose Roque, Sarasota Kenneth Ross, Lakewood Ranch Fanny Rovira, St. Petersburg Richard Sable, New Port Richey Ray Santa-Cruz, Land O’ Lakes Scott Scheps, Lakeland Meenachi Sellappan, Sarasota Maykel Sierra, Fort Meade Greg Stoici, St. Petersburg Yaritza Viamonte Montes De Oca, Tampa Carter Waller, Dade City

THE FDA WELL-BEING COMMITTEE OFFERS YOU CONFIDENTIAL, PROFESSIONAL ASSISTANCE Alcoholism and drug addiction can touch any of us. ADA statistics have shown that almost 20 percent of all dentists will have problems with drugs or alcohol sometime during their careers! The FDA Well-Being Committee is a group of dental professionals with personal experience with these problems who can give complete confidential assistance to members of the profession, their staff and spouses.

FDA Well-Being Committee

For more information and/or help, contact Dr. Barton Blumberg anonymously at 352-446-7910. (Private Cell #)

PROBLEMS

WITH DRUGS OR ALCOHOL? WWW.FLORIDADENTAL.ORG

Support the FDA Foundation when you shop! Amazon will donate 0.5% of the purchase price to the FDA Foundation! Go to smile.amazon.com/ch/59-2019148 for all your Amazon purchases.

TODAY'S FDA NOVEMBER/DECEMBER 2018

FDA Services Cyber Liability Coverage

RECENT THREAT TO FLORIDA DENTISTS ... If you are a Florida Dental Association (FDA) member, you may have received the following email from us in July 2018, warning of a possibly malicious spam email targeting Florida dentists. Emails like this can put your practice files at risk!

]

NOT an Official BOD Complaint!

]

Many members have notified the FDA that they have received spam email indicating that a complaint against them has been initiated from the following email address: â&#x20AC;&#x153;reportmydr.org.â&#x20AC;? Additionally, the FDA reached out to the Florida Board of Dentistry (BOD) to confirm that this is NOT an official complaint by the BOD and should be deleted. If you received an email from this email address indicating a complaint has been filed, it is NOT an official complaint and should be deleted.

YOUR DIGITAL PRACTICE FILES MAY BE AT RISK. FDAS Strongly Advises Adding Cyber coverage to your insurance profolio. The Doctors Company includes $50K in Cyberguard coverage on all malpractice policies because it’s a real risk. You can upgrade to $1 million in coverage starting at $50 per month with Cyberguard Plus.

Call us at 800.877.7597 to discuss your practice’s cyber liability coverage.

Member Milestones 24

TODAY'S FDA

The Florida Dental Association (FDA) would like to recognize its life members and those who have belonged to the association for 60, 50, 35 and 25 years. The FDA congratulates these members and thanks them for outstanding personal commitment to the association and the dental profession. Please note: The names listed below are those who have reached the milestone during the current membership year.

Life Members Joseph Abid Pamela Adams Scott Ames Jacob Armanious Dale Batten Otis Beck William Bell Joseph Briggle Clark Brown Robert Burks Susan Caddell John Capriccio Dennis Carmody Francis Chaney Josef Chencin Robert Christ Robert Chuong Steven Clark Lawrence Copenhaver Jorge Coro Joyce Cosby Edward Cronauer Jose Delacruz Edward Delbrook Frank Delgado Matthew Dennis Luis Diaz Glenn DuPont Marion Eldridge Steven Ellen John Ellis Donald Elsman Randy Feldman Carlos Fernandez Robert Ford Ralph Fortson Marie Gale Faustino Garcia Charles Hambrook Michael Harper Gary Herbeck James Holloway Jeffrey Holzinger Steven Hook James Hoyle Joseph Jackson T. Jacobs Walter Janson Nicholas Kaleel Michael Kanter Mohammad Kasem

NOVEMBER/DECEMBER 2018

Cesar Keathley Scott Klareich Robert Klement Dan Knellinger Gary Kodish Anthony Kopczyk John Krueger Sivathanu Kumar Michael Langan Idalia Lastra Mark Levinsky Julio Llera Deborah Lubell Richard Lubell Bruce Manne Buddy McAlpin Robert Miller Cindy Moore Charles Moses Arturo Mosquera Steven Muckey Marsha Mullett James Mulligan Raymond Nahmad Stephen New Arthur Nimmo Stephen Page Gene Patch Bhasker Patel Edward Penza Michael Pikos Louis Popiel James Powell Raj Rawal Thomas Reinhart Henry Richmond Randall Rigsby Stephen Rimer Carolyn Ritter Oliver Roberts Rose Rosanelli Barry Rosenthal Enrique Rovira-Sabater Michael Ruelf Gerard Rumberger Paul Saari Jack Saban Jayashree Sapre Michael Schenkman Stephen Seidler Robert Selwitz G. Edward Shehee Michael Siegel Robert Smith

Richard Soven Gary Stevens Doyle Summerlin Millie Tannen Charles Thomas Marcia Timson Marc Tindell Joseph Walsh Douglas Webster Peter Weisbruch Mark Weissman John Whitsitt Keith Wolfe Edwin Yee Kirk Young

60-year Members Richard Andrews Richard Arnold John Ashby Joseph Bodo Laurence Brody Ward Cole Howell Cox Donald Dolan Alfred Duda Richard Dyer Lewis Earle Leon Frush Richard Gaines Richard Georgiades Bertram Goodhart Charles Graham Zade Gross Charles Hall Robert Hazel Albert Hodges Norwood Hoecker John Kreher Cornelius Link Lamar MacNutt James McKnight Barry Meiselman Daniel Meister Richard Moss Paul Richman Monroe Ruda Robert Sabra Gerald Sammons Irwin Schwartz Jerry Sewell

WWW.FLORIDADENTAL.ORG

Joseph Spoto Carl Taylor Alfred Underwood Louis Vodila William Wells Claude Whatley Paul Witten

50-year Members Edward Amley Herbert Baughan Jon Baxter John Bembry Terrell Berryman Alan Burch Edwin Carlson John Carter Melvin Cohen Allin Crouch Mark Davis Robert Duby Jack Duckstein Robert Ferdinand Harry Geiger Steven Greenberg Wm Hutchinson Gilbert Jacobson Steven Krischer Bradley Kvittem Jesus Lastra William Murray Robert Northrop Gordon Norton Clifford Prince Robert Rapp Melvin Rappaport Raymond Reid Van Riley Robert Salisbury Stephen Samson Stephen Schwartz Robert Selz Anthony Silla Gerald Skinner Thomas Stone Frank Szot James Vogt Franklin Ward Ridley Ward Robert Westman

35-year Members Deep Agee Steven Alman James Aurelio William Balanoff Richard Balick James Barsamian

WWW.FLORIDADENTAL.ORG

Nicomedes Berasain Effie Blue Thomas Blue Mark Braxton Thomas Brick Solomon Brotman Andrew Brown Richard Brown John Canal Jim Cherry Mark Civin Daniel Cohen Michael Crovatt James Crowther Robert Daniel Alberto De Cardenas James Dee John Dietrich Joseph Dotson Nicholas Dundee Bruce Elkind Juan Erro Jacques Esclangon James Etling Richard France John Galberry Joseph Gerlecz Franklyn Gober Howell Goldberg Bradley Halper James Hancock Michael Hards Jeffrey Heilig David Hinton Jack Hirschfeld W. Howard Gary Kaplan Jeffrey Karp Gary Kaufman Chrissy Koval Jay Lerner W. Roger Long Angel Lopez William Maras Albert Mattia Oscar Menendez Paul Miller Steven Miller Rosario Molina James Morrish Daniel Mullett Lawrence Mund William Myers John Nelson Bruce Ouellette Stephen Parker Sonia Pena David Plank Stephen Pyle Edmund Rahal Steven Reddick Mark Roberts Suellen Rodeffer Raymond Rogers

Enrique Romeu Howard Rosa Donald Sammarco Edward Sheinis Edward Staudt Alfred Tortorelli Monte Tredway Undavadi Vasudev William Von Sick Kerry Waldee Bruce Weisbrot Paul Werner Michael Winter David Zelin

25-year Members Edgar Acuna Andrew Adler Kathie Allen Gary Altschuler Terri Andrews Yolanda Baez Brian Baker Terence Barnes Jose Barros Carlos Bertot David Bitchatchi Craig Broome Lawrence Brown Lisa Browning Kristin Burch Robert Burns Jose Calvo Pedro Castro Theodore Chekan Dhiraj Chotai Van Cogley Kenneth Cohrn Rafael Cordero Carlos Coro Brian Crosby Juan Curci Christian Davila Ed de la Paz Michael DeGrood Cynthia Deragon Kimberly Dettori Slavoljub Djuric Stephen Dunn Enrique Escofet Alfredo Fanelli David Ferlita Robert Fields Michael Fowler John Gallardo Bobby Garfinkel R. Gilleland Eileen Golway David Gulotte Danilo Hernandez Gredell Hernandez

Angela Hilton Foley Dennis Horanic Carol Horkowitz Kevin Huaman Kenneth Irigoyen Jeffrey Joffe Ian Jones Jeffrey Jones Kathy Karpinia Michael Kessler Gregory Klym Alan Krantz Gregory Langston Miguel Lopez Lois Lunderman Selena Marchan Michael Marfori Andrew Martineau Emilio Martinez Shannon Mate Elizabeth McKenna Pfent John Mengelberg Steve Milios Farid Moghadasi Vivian Morad Jacqueline Moroco Rhonda Nasser Bryan Oeth Gregory Parker Gaurangi Patel Denise Pieczynski Robert Reid Deborah Royse Gregory Rutherford Armando Sanchez Pamela Sandow Gerardo Santiago Roberto Santiago Gary Selby Kim Shaw Michael Sheffield Steven Slavkin Maria Souto Tracie Starling Manuel Stefan Richard Steinfeld Carl Steinkamp Dorothy Thomsen Patricia Webb Paul Weinstein Christopher Wigley Christopher Williams David Williams Stephanie Williams Jean Woo David Woods Thomas Zurfluh

TODAY'S FDA NOVEMBER/DECEMBER 2018

membership concierge

DID YOU KNOW THAT YOUR MEMBERSHIP CAN DO THIS? TIPS FROM YOUR MEMBERSHIP CONCIERGE

“

CHRISTINE TROTTO FDA MEMBERSHIP CONCIERGE

Ms. Trotto can be reached at ctrotto@floridadental.org or 850.350.7136.

Every day is an opportunity to experience the benefits of being a Florida Dental Association (FDA) member. It will prove to be one of your most powerful and valuable tools when you put it to work for you!

”

Concierge Tip: Make sure that your office staff knows that you are an American Dental Association (ADA) and FDA member! Often, staff disregard mailings and phone calls that are critical to your membership. We will never call you with a sales pitch or send you junk mail.

Just like phone apps, there’s a member benefit for that! Together, the ADA, FDA and your district dental association provide a variety of opportunities to make a difference in your community, develop your career, reach your goals and even simplify your office staff ’s day-to-day tasks. Of course, some benefits may stand out more than others — there may even be some benefits that you didn’t know existed! Concierge Tip: Keep your contact information and email up to date, add us to your safe sender list and do not unsubscribe from our email. The FDA and ADA communicate most of your member benefits by email. Many of the email messages contain information about new Florida Board of Dentistry laws and rules, licensure requirements, continuing education (CE), as well as opportunities to make the most of your membership. It’s the FDA’s policy to never sell or volunteer your personal information to any third-party vendors! Here are some benefits you might have forgotten about, as well as a few new benefits that you (and your staff) need to use now!

TODAY'S FDA

NOVEMBER/DECEMBER 2018

WWW.FLORIDADENTAL.ORG

v Continuing Education: The FDA is proud to recognize its partnership with the Colgate Oral Health Network as its premier source for Florida dental professionals to receive complimentary CE credits, access more than 250 FREE CE units, and more than 110 live and on-demand webinars for you and your staff! Create your FREE account at floridadental.colgateoralhealthnetwork.com. v NEW! Online Opioid Course: All Drug Enforcement Administration-registered prescribers of controlled substances must complete this course no later than Jan. 31, 2019. Find answers to the most frequently asked questions about HB 21, the Prescription Drug Monitoring Program (E-FORCSE) and access the online opioid course offered by the Florida Medical Association at floridadental.org/ opioidlaw. v ADA Find-a-Dentist Campaign: Market your practice and get more patients by updating your Find-a-Dentist profile. Updating your profile is easy and only takes five minutes. Completed profiles with a photo appear at the top of the search results and get 11 times more clicks than those without, so make sure to include your photo and fill out all fields. Create or update your profile by going to ADA.org/MyADA then click on “Update Profile.” v FDA Supplies.com: Save money on dental supplies with FDASupplies.com. Shop online for more than 50,000 products from more than 300 dental brands, plus FREE SHIPPING direct from the manufacturer or authorized distributors — no gray market, expired or counterfeit items! Send us your current dental supply invoice. We’ll send you an estimate with your projected savings. For more information, call 888.325.2808 or email us at support@fdasupplies.com. v FDA Career Center – for Job Seekers and Employers: Build and manage your career using the professional services offered through the FDA Career Center. Job seekers can search for free, get assistance with reference checking, resume writing, mentoring and career coaching. Employers can post jobs using an online management system, with resume search included. Members receive discounted rates! Visit our Career Center at careers. floridadental.org.

WWW.FLORIDADENTAL.ORG

v Required Posters: There’s no need to spend hundreds of dollars to purchase forms and posters from an outside group. Download the list of required posters and access printable posters by going to floridadental.org/posters. v HIPAA-compliance Forms: Don’t pay monthly fees for HIPAA-compliance services! The FDA saves you time and money by placing all the required forms in one place. Go to floridadental.org/hipaa for the Florida and HIPAA-compliance forms, which can be customized to fit your specific needs. Concierge Tip: We’re not just an association and you’re not just a member. Consider us an extension of your staff. Always call the FDA first with any questions you may have. We’re happy to find the answers for you! Visit the FDA website at floridadental.org/member-center/faq for more information on the following topics and many more! v reduced dues and benefits for recent graduates v retired membership and other dues reductions v FDA legislative issues v opportunities to pay it forward or volunteer We’re only a phone call away — call us at 800.877.9922. We’re here to help members succeed!

TODAY'S FDA NOVEMBER/DECEMBER 2018

alliance

The Alliance of the Florida Dental Association (FDA) is an organization of the spouses and partners in life and dentistry of FDA member dentists, and we are committed to YOU and the success of your practice. Alliance members come from many different backgrounds with a wide array of careers, hobbies and JERILYN BIRD personalities; yet, we all share a common bond — we are FDA member dentists’ spouses and significant others. We have a vested interest in your success. We are not an adjunct organization with its own agenda — your agenda is our agenda. Our most recent national project in conjunction with the American Dental Association (ADA) and Henry Schein Cares is Healthy Smiles from the Start, a prenatal/postnatal dental health care education program for mothers and caregivers of newborns. It was created to address the nation’s growing dental health issues during pregnancy and throughout early childhood. Healthy Smiles from the Start is a free kit that is filled with helpful information and is available in both English and Spanish. For more information, please email info@allianceofthefda.com.

TODAY'S FDA

NOVEMBER/DECEMBER 2018

You may have seen the Alliance at Dentists’ Day on the Hill in Tallahassee. The Alliance of the FDA sponsor’s this event each year during the legislative session and the next Dentists’ Day on the Hill event will be held on Tuesday, March 12, 2019. We work directly with the FDA Governmental Affairs Office to bring refreshments during the Monday evening Legislative Update and provide a delicious luncheon during the day of visits with our legislators. You also will see Alliance of the FDA members working in Florida Mission of Mercy (FLA-MOM) events throughout the state. We support the FLA-MOM with our time, talent and a substantial sponsorship check! We are there with you to provide wonderful people with quality dental care in an atmosphere of caring and respect. The Alliance is active at the local, state and national levels, and like the ADA, we are a tripartite membership. Our mission places us in the legislative arena, oral health education and wellness of the dental family. We encourage you to get your significant others involved as members of the Alliance of the FDA. Our goal is to make the dental profession SHINE! Please support us and join the Alliance of the Florida Dental Association on your next FDA dues statement. Learn more or join the Alliance of the FDA at allianceofthefda.com. Ms. Bird can be reached at JRBird23@aol.com.

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FDA - Alliance

FDA: Awards Luncheon

CONGRATULATIONS TO THE 2019 FDA AWARD RECIPIENTS!  PRESIDENT’S AWARD

Dr. Jolene O. Paramore



FDA DENTIST OF THE YEAR Dr. Gerald Bird

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J. LEON SCHWARTZ LIFETIME SERVICE AWARD Dr. Terry Buckenheimer

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JOIN IN THE RECOGNITION OF YOUR COLLEAGUES. FRIDAY • JUNE 28, 2019 11:30 AM-1 PM

FDA LEADERSHIP AWARDS Dr. Eva Ackley Dr. Leo Cullinan



NEW DENTAL LEADER Dr. Angela McNeight

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FLORIDA DENTAL CONVENTION Gaylord Palms Resort & Convention Center Orlando, Florida

DENTAL TEAM MEMBER Ms. Dianne Parisi

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FDA PUBLIC SERVICE Mr. Clay Archer Ms. Beth Burwell Dr. Michael Pikos

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HELPING MEMBERS SUCCEED TEAM IMPACT AWARD Ms. Brooke Martin

Awards Luncheon

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TODAY'S FDA NOVEMBER/DECEMBER 2018

2018 fla-mom

SOMETHING NEW UNDER THE (FLORIDA) SUN ONE-HOUR DENTURES AT THE 2018 FLA-MOM DR. LAWRENCE WALLACE

Through the Florida Dental Association Foundation (FDA Foundation), the Florida Mission of Mercy (FLA-MOM) has provided much needed dental care to those with few financial resources and problems with access to dental care. This year, in a spirited effort by Dr. Reza Iranmanesh and the FDA Foundation, the FLA-MOM was able to offer complete dentures for the first time. Traditional dentures take multiple visits, so they weren’t previously offered at the FLA-MOM. However, that all changed this year. The Larell One-step Denture was added to the services offered by volunteer dentists at the two-day clinic in Fort Myers in March. Edentulism and lack of dentures has many deleterious effects. From a health standpoint, the edentulous patient has a higher incidence of obesity, diabetes, gastrointestinal disease, cardiovascular disease and even an increased incidence of breast cancer. The effects on general health are huge, and the social effects also are important to note. Quality of life is impacted greatly. Edentulous patients have problems with employment (even fast food restaurants do not hire edentulous workers), tend to not socialize as much and tend to be more isolated. The barriers to care for edentulous patients have always been cost and access. Conventional dentures typically need four to five visits for fabrication and can cost anywhere from $3,0005,000. The Larell One-step Denture proved to be a better method requiring only a single visit to fabricate the dentures from start to finish. The Larell technique was first introduced to Dr. Reza Iranmanesh through a lecture at the FDA’s Florida Dental Convention. He was enthusiastic about the ability to offer complete dentures in a single visit at the FLA-MOM and was instrumental in including dentures this year. The advantages are the ability to fabricate a complete set of dentures in a single visit of about an hour and to be able to complete them without the need of an outside lab. They are ideal for complete dentures, immediate dentures and even one-visit implant overdentures. Though implants are not offered at the FLA-MOM, complete dentures and immediate dentures are now offered. Even though private practice is where the Larell dentures are most used, charitable clinics and nursing

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NOVEMBER/DECEMBER 2018

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homes are the most common sites for these one-visit dentures. The FLA-MOM received a lot of visibility due to this immediate life-changing process (Fig. 1). The Larell One-step Denture is based on a pre-formed thermoplastic denture template with the teeth individually set and fully customizable. Multiple sizes are available and no special equipment is needed. They follow the basic principles of denture construction and provide the fit, form and function requisite of all dentures. The one-visit process eliminates multiple visits for those who have transportation difficulties, are homebound or are in nursing home settings.

Fig. 1: Drs. Wallace and Masoud (far left and far right) gather with TV reporters and a denture patient.

Fig. 2: Dr. Iranmanesh smiles with a patient.

One patient, a disabled woman, travelled two hours by bus and wheelchair to come to the clinic in the hope of getting dentures. We were able to deliver those dentures that day and she was thrilled. Her first comment after 10 minutes of crying and smiling was that she was able to eat Fritos for the first time in 17 years (Fig. 2). It doesnâ&#x20AC;&#x2122;t sound like much to us, but for her it was a significant event. There were many more stories like this in those two days. Another patient had his teeth removed unnecessarily due to inability to afford treatment (Fig. 3). Since this was the first year using the Larell denture, the expectation was to do about 20 dentures. The doctors fabricating the dentures were well-trained but had not done this technique previously. With its intuitive, easy-to-learn steps, the four doctors were able to complete 44 dentures in the two days. Now that we have shown how easy the Larell dentures can be integrated into the FLA-MOM, we anticipate having them available at next yearâ&#x20AC;&#x2122;s FLA-MOM in Orlando in March. We wish to thank Drs. Iranmanesh and Zack Kalarickal and the entire FDA Foundation for bringing this exciting new process to the FLA-MOM. Dr. Wallace is the developer and CEO of the Larell One-step Denture. He is a board-certified oral and maxillofacial surgeon with 25 years of private practice. He can be reached at Lawrence.Wallace@larell.com or 831.659.9300.

Fig. 3: Patient with pre- and post-dentures, completed in one hour.

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Seattle Study Club

FDA: Get Involved!

rent

ARE YOU PAYING TOO LITTLE

IN RENT?

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NOVEMBER/DECEMBER 2018

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Conventional wisdom tells us that spending less money is the most effective approach to saving money. After all, a penny saved is a penny earned, and the more you save, the more you have left over. That logic is hard to argue with, but it’s not always foolproof. Saving money for your practice the wrong way can lead to diminished patient care, outdated equipment, the wrong location for your practice and additional negative results. There are several critical factors often overlooked when a health care practice’s primary focus is paying the lowest rent versus achieving the best combination of overall terms. Let’s look at three factors where paying higher rent could actually increase your profitability.

1. The Cost to Build Health care buildouts often cost two-to-three times more than a typical commercial real estate space. This is attributed to many factors that are unique to health care, including: n more durable finishes n millwork and cabinetry n plumbing and sinks in exam rooms, sterilization centers and laboratories n increased electrical and HVAC (heating, ventilation and air conditioning) requirements n and several more Three of these costs alone — HVAC, electrical and plumbing — drive up the cost considerably for health care buildouts when compared to non-health care uses. With buildout being such a costly expense, many health care professionals get themselves into trouble when they only focus on the lowest lease rate. Because landlords often care most about maximizing the property’s income, primarily the lease rate, this can be a costly mistake.

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The net operating income (NOI) is the main number an appraiser or investor looks at when valuing an investment property, which again, is derived from the lease rate. Savvy landlords recognize this and often would rather invest more money into their space while providing other concessions such as free rent, lower annual escalations and tenant improvement allowance as opposed to lowering their lease rates. To a landlord, lower lease rates devalue capitalization potential should they decide to sell the property. For example: n A landlord has a 2,000-sq. ft. vacant space listed for lease at $4,000 per month on a 10-year lease term. n A doctor wants to lease the space for the lowest lease rate possible. n The doctor offers the landlord $3,250 per month to get the lowest monthly rent. n The landlord proposes keeping the rent at $4,000/month but is willing to give the tenant $100,000 and five months of free rent to buildout the space, plus three months of free rent upon opening for business. In this instance, the doctor would be spending $90,000 more in rent over the 10-year lease term (assuming the landlord would agree to the lower proposed monthly rent). However, the doctor would benefit more by accepting the landlord’s higher rent offer. They would save $100,000 on the buildout loan, receive $12,000 in free rent (plus a free buildout period) and save an additional $27,000 on loan interest expense, assuming a 10-year loan term at a 5 percent interest rate. In this instance, the lower rent would have cost the doctor almost $50,000 more in total expenses!

KEN JORGENSON, CARR HEALTHCARE REALTY

Carr Healthcare Realty is the nation’s leading provider of commercial real estate services for health care tenants and buyers. Every year, thousands of health care practices trust Carr to achieve the most favorable terms on their lease and purchase negotiations. Carr’s team of experts assist with startups, lease renewals, expansions, relocations, additional offices, purchases and practice transitions. Health care practices choose Carr to save them a substantial amount of time and money, while ensuring their interests are always first. Visit CARRHR.com to find an expert agent representing health care practices in your area.

Additionally, with the higher lease rate/ monthly rent, the doctor would receive a SEE PAGE 38

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rent FROM PAGE 37

higher level of tax deductions, as rent is 100 percent deductible. Conversely, some of the additional loan costs are not deductible and a portion of the items purchased with the loan would need to be depreciated over a longer period to account for the buildout. From the landlord’s perspective, this deal is more appealing with the higher lease rate and more concessions because the $112,000 tenant improvement and free rent allowance today will be primarily recaptured through rental income over the lease term. More importantly, it saves the landlord from devaluing the property by more than $128,000 when compared to lowering the lease rate, assuming a 7 percent cap rate, which is a conservative rate in today’s commercial real estate market. This same approach and value carried over the entire property could save the landlord $500,0000 to $1,000,000 on an average-sized property at the time of sale. In this scenario, the landlord is much more likely to perform the transaction while the doctor would save well over $50,000 compared to negotiating exclusively for a lower monthly rate. Both the landlord and doctor win.

2. Your Location Another overlooked factor that could make paying a higher lease rate a better financial decision is a property’s location. If you have ever worked with a commercial real estate agent, you have likely heard them say, “Location, location, location.” This is the most clichéd term in real estate for a reason. Location is one of the most important factors in a health care practice’s success. There are two factors regarding your location that need to be considered: the first involves demographics, visibility, access, signage, etc. and the second is the quality of neighboring or anchor tenants. Having a strong anchor tenant, such as a leading grocery store or large national retailer can significantly impact the rate you pay. However, higher rent premiums can be worth the increased expense when you consider the number of potential

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new patients a strong anchor tenant can attract. A space with a better location and higher rent has the potential to increase the number of new patients per month to the point where the increased profit would be greater than the cost of the higher rent. Thus, the value of your practice would arguably be worth more upon a sale, as most practices are valued and sold based upon a percentage of annual revenue. If you can take home more money and increase the value of one of your largest assets, paying higher rent could be a strategic investment versus simply an expense. The same logic can be used paying more for increased visibility, traffic count, accessibility, signage, etc.

3. The Condition of the Space The condition of a space makes a large impact on the overall cost of a deal and often is overlooked when the primary focus is to achieve the lowest rent. When was the building built or remodeled? When was the HVAC last replaced? Is there sufficient electrical service for your equipment and technology? Is the building up to code and compliant with the American with Disabilities Act? Has there been any recent roof leaks? What type of deferred maintenance is present? And the list goes on … Any of these items could cost you thousands of dollars to remedy over the term of your tenancy. Whether the issue needs to be fixed on the front end, like installing new HVAC, or something else that adds up over time, like poor energy efficiency, the extra costs of leasing an older space or poorly maintained property need to be carefully considered. Paying higher rent upfront to avoid the above costs should be thoroughly evaluated prior to committing to a new lease. You should determine potential expenses and liabilities over the long run. You can make the most informed decision for your practice when you have thoroughly evaluated the property and no stone is left unturned. There is a significant amount of money on the line when it comes to your health care practice real estate — and the majority of it is negotiable. It’s vitally important to consider more

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than just lease rate and length of the term when evaluating your real estate options. Oftentimes, landlords are only willing to move slightly off the lease rate when they would be willing to give significantly more concessions. The best strategy to achieve maximum profitability with your commercial real estate needs is to have professional representation with every transaction. One of the best parts — as a tenant, your representation does not cost you anything. Landlords and sellers pay real estate fees in commercial real estate, just as in residential real estate. Beyond having professional representation, it’s equally important you have an agent on your side who only works with health care tenants and buyers and does not represent land-

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lords or sellers. You want someone who understands and specializes in health care and is only on your side of the transaction — an agent who understands the nuances of health care real estate can easily make a six-figure impact in your real estate negotiations. Additionally, having an expert agent who doesn’t have a single listing improves your ability to have an approach with no conflicts of interest. Your agent’s specific strategy for maximizing your practice’s profitability through real estate should take all the guesswork out of the process and bring peace of mind in every commercial real estate transaction in which you are involved in.

TODAY'S FDA

NOVEMBER/DECEMBER 2018

Hinman

FDA RX Checklist

FDA: Opioid Basics

TODAY'S FDA

NOVEMBER/DECEMBER 2018

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FDA: Opioid FAQS

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FDA: BOD Rule

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NOVEMBER/DECEMBER 2018

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TODAY'S FDA NOVEMBER/DECEMBER 2018

Doctor's Choice

E-VAC INC.

Superior Upholstery

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NOVEMBER/DECEMBER 2018

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HOW CONSUMERS FIND & SELECT PRACTITIONERS Consumer behavior is evolving and your website has become a valuable marketing tool! Publishing ratings and reviews provides information to patients and promotes patient loyalty.

WHAT DRIVES CONSUMER LOYALTY?

WORD OF MOUTH Patient recommendations are nearly

EXPERIENCE A patient’s most recent care experiences are

MORE IMPORTANT

MORE INFLUENTIAL than traditional marketing media.

than traditional marketing media.

CONSUMERS DO THEIR RESEARCH — EVEN WITH A REFERRAL. ONLINE MORE THAN

73%

of consumers check out the internet when selecting a provider.

STARS

REVIEWS

MORE THAN

of consumers look for patients’ feedback & ratings when seeking a new practioner.

63%

of consumers value both positive & negative reviews.

CONSUMERS READ — AND HEED — COMMENTS!

69%

of consumers

select or avoid practioners based on reviews. SOURCE: Press Ganey Associates Inc., 2018

a to z

MEMBERSHIP FROM

Advocacy The Florida Dental Association (FDA) is your advocate for legislative issues that impact you, your patients and the dental profession. Each year in Tallahassee, the FDA advocates for legislative policies that help protect your patients and support initiatives that help FDA members succeed! You can join the FDA’s advocacy efforts by attending Dentists’ Day on the Hill (March 12, 2019) in Tallahassee and participate as a legislative contact dentist. For more information, go to floridadental.org/advocacy.

Board of Dentistry Liaison The FDA’s Florida Board of Dentistry (BOD) liaison represents the interests of the FDA, its members and staff in front of the board. While it’s frequently misunderstood, the liaison doesn’t have a seat on the board. Rather, the liaison has a collaborative role and lobbies the FDA’s policies and positions to educate the BOD members, with the goal of getting them to vote along with the FDA. The FDA and BOD have a strong working relationship because the FDA has built good relationships with individual members of the BOD. Floridians are well represented by the committed, intelligent and ethical members of the BOD.

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Convention With three days of continuing education (CE) courses, more than 300 exhibitors, plus social events and meetings, there’s something for everyone at the annual Florida Dental Convention (FDC) in Orlando! FDA members receive FREE pre-registration and access to up to 18 hours of free CE. Go to floridadentalconvention.com for course and registration information. Join us for FDC2019 on June 27-29!

Discounts FDA Services (FDAS) has researched and vetted business solutions so FDA members can take advantage of exclusive deals and discounts offered through the Crown Savings program. Members who participate will save time, money and hassle — putting the focus back on patient care. Crown Savings benefits members and the association. The program produces revenue for the FDA, which adds value to your membership. For more information, go to fdaservices. com/crown-savings. In addition, dentists can purchase all their dental supplies through FDASupplies.com. FDASupplies.com keeps dental

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supplies affordable by making it easier than ever before to price-shop efficiently, and as an FDA member, you receive exclusive member pricing! They only offer products directly from manufacturers or authorized distributors and ship exactly what a dentist orders, with FREE ground shipping! Go to FDASupplies.com to start shopping for all your practice’s dental supplies.

Emerald Club As the philanthropic arm of the FDA, the FDA Foundation has been committed to promoting dental health for all Floridians for more than 38 years. The Emerald Club is the Foundation’s premier giving society and supports its philanthropic programs. As a member of the Emerald Club, you are distinguishing yourself as a champion and steward for oral health. Your donation is vital to ensuring that the FDA Foundation can continue to grow and supports everything we do to advocate, assist people and build awareness. Our programs — Florida Mission of Mercy (FLA-MOM), Project: Dentists Care (PDC) and Donated Dental Services (DDS) — improve patient care and emphasize the role of oral health in overall health. Your tax-deductible donation to the Foundation supports these life-changing programs. For information or to donate, visit donate.floridadental.org/emeraldclub.

Florida’s Action for Dental Health In February 2015, the FDA launched Florida’s Action for Dental Health to help improve access to oral health for all Floridians. This comprehensive initiative is focused on three primary objectives: promote attainable dental care for the uninsured and underserved; collaborate to maximize use and capacity of the current dental workforce to optimally serve Floridians with dental care; and, expand opportunities for public health dentistry to serve Floridians.

Graduated Dues Program The American Dental Association (ADA) and FDA offer new dentists an opportunity to experience the exclusive benefits of membership at reduced rates. As a recent graduate, you receive membership at no cost for the remainder of your graduation year and your first full calendar year of practice! After that, you’ll continue to receive a discount each year until you have reached your fifth year out from completion of your dental education. Here’s how it works: graduation

year — $0; first year out $0; second year out — 75 percent discount; third year out — 50 percent discount; and, fourth year out — 25 percent discount.

Hot Topics Check out a new section on the FDA’s website, Now You Know, which features the latest news from the FDA about major topics that affect dentistry in Florida: opioids, dental therapists, student debt, the Florida BOD and Medicare/Medicaid. With one click, everything you need to know about that topic is right there at your fingertips. Visit floridadental.org/nyk.

Impact Study In 2016, the FDA Foundation Board of Trustees decided to conduct a scientific research study about the FLA-MOM, a large-scale, two-day, professional dental clinic that provides care to any patient at no cost to them, with the goal of serving the underserved and uninsured in Florida. The Impact Study’s goals are to identify the characteristics, reasons for seeking care, dental needs, dental use patterns and barriers to access for people who seek care at a FLA-MOM clinic. This data will help local community partners develop strategies to address the unmet oral health care needs in their community. The researchers for this project included Drs. Jolene Paramore, Andy Brown and Jill Herndon. The Impact Study was the May cover story of The Journal of American Dental Association (JADA), “Mission of Mercy Patient Characteristics and Dental-related Emergency Department Use,” and can be found at bit.ly/2JMoLuP.

Journal Today’s FDA is the FDA’s award-winning bimonthly journal and has been one of members’ top tangible benefits for several years in a row. The journal features 80 pages of dental case studies, scientific abstracts, member features, BOD reports, legislative updates, dental industry news, practice management and patient care articles. Did you know that Today’s FDA is online? Go to floridadental.org/publications to catch up on past issues!

Knowledgeable Staff The FDA’s mission is helping members succeed and our dedicated staff provides optimal service to SEE PAGE 56

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Networking

a to z FROM PAGE 55

guide you through your member benefits and the important issues that affect the dental profession in Florida. The staff directory is located on page 3 of every Today’s FDA. Not sure who does what? Check out page 50 of this issue for who’s who, and what they do to help members succeed.

Legal Resources The FDA website is packed with legal resources exclusive to members! Some of the resources available are legal FAQs, HIPAA-compliance forms, contract analysis, required workplace posters and informed consent documents. You’ll also find comprehensive handbooks created specifically for the Florida dentist: prescription, controlled substance and pain management laws; managed-care contracts; and, the BOD licensure discipline process. Visit floridadental.org/legal-resources to access this member-only content.

MouthHealthy.org MouthHealthy is the premier patient resource for all things dental! The ADA’s patient-centered website provides information on dental care throughout all life stages, ADA Seal products, nutrition, dental visit FAQs, activity sheets and games for children, and more. Direct your patients to MouthHealthy.org as an additional resource outside of their dental visit. In addition, MouthHealthy is home to the ADA’s Find-a-Dentist search tool, which is part of the ADA’s three-year campaign to help members keep busier by reminding adults about the importance of seeing an ADA dentist regularly. The digital campaign, now in year two, predominately features paid searches on Google to drive potential patients to the members-only Find-a-Dentist tool. Have you updated your ADA Find-a-Dentist profile so new patients can find you? Go to ada.org/myada to update your profile in just five minutes! Don’t forget to add your picture — profiles with photos bring you to the top of the search results and get 11 times more clicks that those without!

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Florida has six district dental associations that represent the interests and activities of dentists in those areas: Atlantic Coast, Central Florida, Northeast, Northwest, South Florida and West Coast. Meet your colleagues at FDC and district and affiliate meetings. It’s smart business and you also can form friendships that last a lifetime! To view upcoming events visit floridadental.org/calendar.

Online CE The FDA is proud to recognize its partnership with the Colgate Oral Health Network as its premier source for online CE. FDA members receive FREE CE, including more than 250 CE credits, 110 live and on-demand webinars and 50 articles. Find this valuable resource at colgateoralhealthnetwork.com/floridadental. In addition, the FDA offers online CE credit for Legal CE and the popular Today’s FDA column, “Diagnostic Discussion.” Take advantage of this free member benefit at floridadental.org/online-ce.

Peer Review This FDA member-only free service is provided by colleagues to help mediate problems and, most of the time, avoid costly and emotionally draining litigation or BOD complaints. When the evaluators review a case, it is in strict confidence; they treat the situation as if they were the ones who had the complaint against them. Peer Review is only possible when members work together to support each other, with the patient’s best interest as the focus.

Questions? For personalized service, the FDA staff is always just a phone call, online chat or email away. FDA Membership Concierge Christine Trotto can help you take advantage of the many benefits designed for your success. Contact Christine at 850.350.7136 or ctrotto@floridadental.org.

Risk Experts FDAS is a full-service agency that offers dentists a complete insurance portfolio designed for their dental practices. They’re here to be your advocate with insurance carriers and to get the best service and coverage at the most competitive rates. By choosing FDAS for your practice needs, you also support the FDA! Revenue generated from WWW.FLORIDADENTAL.ORG

insurance income goes directly toward funding FDA programs and lobbying efforts that are important to members. FDAS keeps member dues at their lowest possible level. For more information, go to fdaservices.com.

Student Mentorship Program The FDA Mentorship Program is a resource to help dental students gain a practical, professional perspective of dentistry from established member dentists. The mentors are FDA members who volunteer their time and experience to provide professional guidance to dental students. A select number of dental students from the three Florida dental schools (LECOM, Nova and UFCD) will be able to participate as protégés. To volunteer, complete and submit a profile by visiting careers.floridadental.org/ementor.

Third-party Payer Services The FDA created a new position to focus resources on third-party payers in Florida and their impact on our members. Working closely with the various insurance plans, Medicaid managed-care plans, the Agency for Health Care Administration (AHCA), Department of Health, BOD and other state and federal agencies, the FDA Director of Third Party Payer and Professional Affairs Casey Stoutamire addresses issues relating to third-party payers. Contact Casey at 850.350.7202 or cstoutamire@floridadental.org with any issues and concerns you may have.

Unified voice (Power of 3) When you join organized dentistry, you become a member of three remarkable organizations — the ADA, FDA and your district dental association. The three parts of ADA membership complement each other, and each level offers valuable benefits and resources to members. Our strength comes from individual dentists — more than 161,000 members make up the ADA. A strong ADA means more resources for members and a powerful voice in Washington, D.C. and state capitals. The ADA, FDA and district dental associations enhance your ability to achieve success and excellence as a dentist and ensure a strong future for the profession.

advance its mission, “Helping Members Succeed.” Your personal success also will be enhanced as you gain experience in leadership and benefit from networking opportunities with your colleagues. We have many volunteer opportunities that range from quick to short term to long term — there’s something for everyone! For ideas on how to get involved, turn to pages 34-35. Also, the FDA Foundation provides opportunities to give back and make an impact on the community. The Foundation promotes dental health for all Floridians by providing lifechanging programs, such as the FLA-MOM, PDC and DDS, which provide dental care and improve the oral health of the public. Visit floridadental.org/foundation for more information on these programs or call 850.681.3629.

Water fluoridation As Florida’s advocate for oral health, the FDA helps educate community leaders on the benefits of fluoridation and provides expert testimony before commission meetings, when needed. The FDA works with state agencies and the ADA to promote fluoridation and to increase education efforts. Visit the FDA’s fluoridation-specific website, floridafluoridation.org.

X-ray Training Coming soon! An online radiography program through the FDA to fulfill the Florida BOD requirements for your dental assistants.

You! YOU make up organized dentistry — the FDA wouldn’t be here without our members!

Zero excuses! Already a member? Go to floridadental.org/dues to renew today! Want to join? It’s easy! Go to floridadental.org/join. Have questions or need more information? Give us a call at 800.877.9922.

Volunteer Opportunities Get involved and get more out of your membership! Did you know the FDA is led by volunteer members? As a volunteer, you help the FDA WWW.FLORIDADENTAL.ORG

TODAY'S FDA NOVEMBER/DECEMBER 2018

IS A SELF-FUNDED GROUP HEALTH INSURANCE PLAN RIGHT FOR YOUR DENTAL OFFICE? What are they?

BY CARRIE MILLAR, FDA SERVICES DIRECTOR OF INSURANCE OPERATIONS

Ms. Millar can be reached at 850.350.7155 or carrie.millar@ fdaservices.com.

Self-funded plans are health insurance plans that are funded by the individual dental practice but are administered by a health insurance carrier. Self-funded plans were only considered by larger companies in Florida until recently, when the stop-loss funding laws changed. Now, self-funded plans are more stable. Monthly payments are based on the employees’ health trends. And, when health care costs are lower than expected, you get back a percentage of your funds. If health care costs are higher than expected, there is stop-loss coverage in place. These plans are centered around creating a wellness program for your employees to save money on health care costs. To your employees, it will look and feel like a traditional insurance plan. The plan will have a network of providers; each employee will get an insurance card; and, claims will be submitted to the carriers.

For the right small business, self-funded plans can save up to 25 percent on upfront health insurance fees, save long term with the surplus-sharing benefit, save on taxes and fees, and create a wellness benefit for employees.

How do they work? The dental practice picks a plan to offer employees that fits their office’s needs and budget. Your total monthly payment covers your claims funding, terminal reserve, stop-loss premium and an administrative fee. Each month, the number of employees enrolled is used to determine the claims fund.* The monthly fees remain stable and are based on the number of employees enrolled. If claims are higher than anticipated, you’re protected by the stop-loss insurance. If claims are lower than anticipated, then a portion of the claims-fund surplus is refunded back to the dental practice owner.

Flow of Claims Funds Example:

How can you save? There are three ways you can save:

1. Tax savings — Self-funded plans are exempt from the health insurance providers’ fee that is required under the Affordable Care Act of traditional-funded plans. In addition, self-funded 3. plans generally are not subject to state premium taxes.

2. Surplus — With self-funded plans, if you renew your plan and your total claims during the plan year are lower than expected, you get money back. 3. Benefits design — Self-funded plans are not subject to benefits design mandates, allowing for less costly benefits levels.

Which office is the best fit? The simple answer is healthy offices. I get calls all the time from practices that are unhappy with their insurance premiums’ costs increasing and state that they never use their plan — those are the offices that self-funded plans work best for. • Practices with five or more employees enrolled: There needs to be a pool of at least five employees to create a big enough claims-funding pool. • Practices without employees with chronic conditions: A practice won’t see savings from a surplus if they have employees who have frequent and high claims. • Practices willing to start a wellness plan: Implementing and rewarding active living is the key to reducing health insurance claims. Most self-funded plans come with fitness incentive goals, well-visit incentives and e-visits for employees.

TRADITIONAL FUNDING

SELF-FUNDING

• subject to state mandates • limited plan design options • no money back • financial protection • community rated

• generally not subject to state mandates • more flexible benefit designs • opportunity to get money back • financial protection • monthly costs reflect expected claims

Does everyone qualify and how do you apply? Groups are medically underwritten, so not every office will qualify for coverage. If a group’s medical history would prevent them from saving any money compared to a traditional-funded plan, then the carrier will decline to sponsor the group. However, once accepted, the plans are guaranteed renewable. To apply, call one of FDA Services’ insurance advisors at 800.877.7597 to discuss which option is best for you. Once a plan is picked, each employee fills out a medical questionnaire and the group is submitted to underwriting. Underwriting will then determine the claims-funding pool needed for the group and a final monthly payment will be determined. At the end of the plan year, there will be a run-out period of three months for claims; if there is a surplus in the account, then a percentage will be returned to the practice.

Name: Address: City, State, ZIP: Office contact: Email:

Phone:

Name of present insurance company: RELATIONSHIP (employee, spouse/

Number of Employees: NAME

DATE OF BIRTH

GENDER

partner, or child/dependent

1. 2. 3. 4. 5. 6. 7.

Complete this form and fax or email to FDAS for a group health insurance quote. P: 800.877.7597 ∞ F: 850.681.9782 ∞ insurance@fdaservices.com ∞ fdaservices.com

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dental school deans

LECOM School of Dental Medicine Builds Bridges to the Future MATHEW BATEMAN, PH.D., D.H.ED. LECOM DEAN

The Lake Erie College of Osteopathic Medicine School of Dental Medicine (LECOM SDM) continues to build a bridge between the present and the future of dentistry throughout Southwest Florida and across the nation. With its commitment to providing quality education at an affordable cost, LECOM remains dedicated to preparing dentists who can deliver the best health care outcomes for the communities they serve. The evidence-based LECOM dental education program trains students to provide patient-centered care that ensures optimal therapeutic and economic outcomes, promote disease prevention, and enhance patient and provider education. “The evidence-based decision-making skills that we learn in the classroom prepare us for practical conversations with patients in our clinics. Being equipped with the latest information makes navigating difficult choices in the clinic easier for us and for our patients,” said Ashley Maus, Class of 2021. LECOM’s comprehensive mission prepares students to become proficiently trained, expertly skilled dentists by providing programs steeped in educational excellence, encouraging and developing research, deepening clinical care, and fostering an abiding commitment to community service. These objectives are linked through a unique and innovative curriculum. The doctor of dental medicine (DMD) degree at the LECOM SDM is earned by completing a full-time, four-year pathway at the Bradenton campus. The curriculum consists of two years of pre-clinical education that covers the majority of didactic information as well as providing scholarly experience in skills-based simulation laboratories. During this phase of the

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NOVEMBER/DECEMBER 2018

curriculum, students encounter most of the basic and medical sciences through a pioneering problem-based learning (PBL) curriculum that focuses on problem solving by introducing a team approach to learning and life. During the pre-clinical curriculum, students gain clinical experience working with D3s and patients from the Bradenton community. For example, students who were supervised by licensed faculty provided dental examinations and spoke to baseball players from the Pittsburgh Pirates Minor League teams about the importance of oral hygiene to their overall health. “Treating the baseball players was a gratifying experience for me because two of the three patients that I met had never been to the dentist before. They spoke Spanish, as do I, and our exchanges made them feel more comfortable in the dental chair. I was able to explain to them the importance of oral hygiene and treatment. Our visit to their training facility was rewarding,” said Priscilla Sosa, Class of 2020. The clinical aspect of practice, undertaken as a D3 and D4, is primarily comprised of hands-on experiences conducted at LECOM clinical sites. The D3s remain at the Bradenton campus where they work with skilled dental preceptors to provide comprehensive care directly to patients. The D4s’ curriculum is completed in DeFuniak Springs, Fla., or in Erie, Pa., where they train in LECOM community-based practices. The exposure of these community sites provides the D4s with an invaluable experience that greatly aids them in advancing to the next step of their careers, whether as general dentists, in residencies or in specialty-training programs. LECOM recognizes that dentists have become integral team players in improving the health of their patients. The curriculum’s programs empower students with the knowledge and skills necessary to work effectively in interprofessional, interdisciplinary and multicultural environments. The dentist’s role in preventive medicine complements the osteopathic principles of total health care as taught by the College of Osteopathic Medicine and the School of Pharmacy. Dentists often are the first health care professionals to recognize and identify a wide variety of diseases, ranging from hypertension to cancer. Many oral diseases reveal other health issues that may require a follow-up with the patient’s primary physician.

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Zack Viens, Class of 2020, noted, “People are becoming more aware of the importance of dentists in the arena of health care as more people come to understand the role of the dentist.” Sosa explained, “I am gaining so many experiences during my clinical time. The patients are everything. I find it very rewarding to help them recognize the vital importance of their oral health while I provide treatments they can afford. Educating patients and extending their repertoires of healthful knowledge and practices is an essential part of my desire to become a dentist. Oral hygiene is a major component of the overall health of the body, so we, as dentists, are on the front lines to provide this knowledge to all our patients.” Students who graduate from the LECOM SDM have been exposed to organized dentistry through their American Student Dental Association chapter, which works closely with representatives of the Florida Dental Association. LECOM’s dental students have benefited greatly from these interactions. Once students graduate and enter the dental profession, it’s our hope that they will affiliate themselves with local and state dental associations. LECOM’s unremitting commitment to provide excellent dental training to its students has brought not only great success to them as practitioners in the field, but also has furthered a fuller understanding of the important place that dentistry holds in the medical arena of the community at large. For the value of these achievements, the many thousands who it has touched and for the lives that it has improved through the provision of outstanding health care education, LECOM proudly stands prepared to educate the next generation of dentists.

UFCD – A Leader in Education DR. ISABEL GARCIA, UFCD DEAN

The University of Florida College of Dentistry (UFCD) is a leader in education, clinical care and research. A state-funded college, UFCD’s multi-faceted service mission includes patient care, community outreach and education. We remain committed to providing excellent care — translating discoveries and the best science into practice. WWW.FLORIDADENTAL.ORG

UFCD students and residents benefit from the skills and experience of faculty in a collaborative environment as one of the six health colleges at the UF Academic Health Center. As we focus on developing exceptional dentists, specialists and researchers, we are mindful that academic excellence must be paired with compassion, integrity and professionalism — and that our future depends on producing clinicians and leaders in academia, the community and organized dentistry. Current Florida Dental Association (FDA) leadership includes 14 UFCD alumni who serve on the Board of Trustees, House of Delegates, councils and committees. One of our alumni, Dr. Jolene Paramore, is serving as president, Dr. Rudy Liddell is president-elect and Dr. Kim Jernigan is a past-president.

UFCD Strategic Plan 2019-2024 Our new strategic plan is mission-focused and capitalizes on key opportunities. It embraces the integrated nature of modern dentistry, oral health and overall health — underscoring essential support for research that informs and transforms patient care. The plan centers on five goals: n Education: Develop and sustain a learner-centered educational environment. n Patient care: Provide excellent, patient-centered health care grounded in evidence. n Research: Support and advance pre-eminent basic, clinical, translational and population-based research. n Infrastructure: Upgrade and expand teaching, research and clinical care facilities and infrastructure. n Environment: Enhance and maintain a supportive and humanistic environment. The plan is on our website at cod-strategic-plan.sites.medinfo. ufl.edu/.

University of Florida — Top 10 In 2017, UF became the first Florida school to make it in the list of Top 10 Best Public Universities, coming in at No. 9, according to the 2018 U.S. News & World Report Best Colleges rankings. The rankings are based on measures that capture various dimensions of academic quality in seven broad areas: undergraduate academic reputation; graduation and retention rates; faculty resources; student selectivity; financial resources; alumni giving; and, graduation rate performance. SEE PAGE 64 TODAY'S FDA NOVEMBER/DECEMBER 2018

dental school deans FROM PAGE 63

Research According to the Blue Ridge Institute for Medical Research, the UFCD research enterprise now ranks fifth nationally among all U.S. dental schools in National Institutes of Health funding. Illustrative of this success, the college’s Comprehensive Training Program in Oral Biology received the William J. Gies Awards for Vision, Innovation and Achievement during the American Dental Education Association Annual Meeting in March 2018.

DMD Program While applicants to all U.S. dental schools declined slightly in 2017, our college saw a 5 percent increase in DMD applicants with 1,526 during the most recent cycle. Our applicants continue to have impressive academic credentials, as well as research and volunteer experiences. The 2017 entering class’ average Dental Aptitude Test scores were: Academic, 21; Perceptual Ability, 20; and, Total Science, 21 — all at or above the national averages. Over the past five years, our DMD students achieved on average a 97 percent first-time pass rate on Part 1 of the National Dental Board Exam and a 98 percent pass rate on Part 2. We are proud of their continued success.

Clinical Care The college’s dental centers in Gainesville, Hialeah, Naples and St. Petersburg/Seminole completed 148,000 patient visits last year. Along with the clinics that comprise the UF Statewide Network for Community Oral Health located throughout the state, we provided care to patients from all 67 Florida counties.

UF Capital Campaign In 2017, UF launched Go Greater, a $3 billion campaign that builds on the university’s call to enlighten, lead and serve, and is set to end in 2022. The $3 billion goal was established so UF can “go greater” in our communities, state, nation and across the globe. The UFCD portion of that goal is $28 million to fund important initiatives, including endowed professorships, scholarships, centers focused on excellence in digital dentistry and children’s oral health, and college naming opportunities. We’re proud to continue to play a significant role in dental education in our great state and fortunate to have a supportive and growing network of alumni and friends who make an incredible difference in the lives of their patients.

Nova Helps Students Achieve Their Dreams LINDA C. NIESSEN, DMD, MPH, NOVA DEAN AND PROFESSOR

Advanced Education Programs UFCD is one of only three U.S. dental schools with residency training in every specialty recognized by the American Dental Association. Our programs continue to attract outstanding applicants, and most of our graduates earn a 100 percent pass rate on their board exams. The addition of a Master of Operative Dentistry program in 2016 expands the total number of UFCD degree and certificate programs to 12.

Lifelong Learning For 39 years, UFCD has offered continuing dental education courses for dental health professionals. The courses are continually updated to stay abreast of changing needs in dentistry and innovations in the field. Today, we offer more than 100 courses each year that assist more than 3,000 oral health providers in maintaining licensure, building their practices, and learning new techniques and executive management skills.

TODAY'S FDA

NOVEMBER/DECEMBER 2018

Dear Linda, I wanted to send a short note to tell you I teach at a residency program in New Jersey (Jersey Shore University Medical Center/Hackensack Meridian) and we have one of your graduates this year. His name is Michael DiSanto and he is an absolute gem. He’s well prepared clinically and is the consummate professional. I have worked with him on a few periodontal surgeries and his skills are very impressive. He is a real credit to Nova. The other attendings are impressed by him as well.

— Maxine Feinberg, DDS

This message arrived in my email inbox a few weeks ago. For more than 20 years, the outstanding faculty at the Nova Southeastern University College of Dental Medicine (CDM) has WWW.FLORIDADENTAL.ORG

been helping dental students achieve their dreams of becoming the best dentists they can be — so this message is music to my ears! Nova CDM welcomed 123 new students to the Class of 2022. These talented students consist of 71 women and 52 men, with an average science GPA of 3.6, an overall GPA of 3.6 and an average DAT science score of 22. Forty percent of the class comes from underrepresented minority groups, including 42 Hispanic-Americans, six African-Americans and two Native American students. Eighty-seven students are Florida residents, 31 are from throughout the U.S. and nine are international students, with Canada representing the largest contingent of international students. These outstanding new students will undertake a rigorous academic program. In addition, dental students have the opportunity to pursue joint degrees in business (MBA), public health (MPH) and our award-winning DO/DMD degree with the College of Osteopathic Medicine — the only joint degree in the U.S. Nova CDM’s clinical education program provides a core competency in special needs dentistry, medically complex patients and autistic patients, in addition to healthy children and adults. With approximately 120,000 patient visits in a given year and more than 20,000 unique patients, the dental students learn to provide general dentistry in a comprehensive care, team-based model. Under the leadership of Dr. Diane Ede Nichols, who directs the Henry Schein Special Needs Clinic in North Miami Beach, dental students learn to care for special needs patients from throughout the state. In addition, during dental students’ pediatric dental experience, the students learn to care for patients with autism spectrum disorder (ASD) funded through a U.S. Department of Health and Human Services Health Research and Services Administration (HRSA) grant. Department of Pediatric Dentistry Professor and Chair Dr. Romer Ocanto has made caring for children with ASD the passion of his career. His research has focused on learning more about ASD and applying new techniques to the process of dental care. He’s received funding from the HRSA for the past 10 years to accomplish his work. His efforts have resulted

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in educating graduate dentists, pediatric dentistry residents and predoctoral dental students about caring for children with ASD. During his career, he partnered with faculty from the Nova Mailman Segal Center and used their applied behavioral analysis for dental care. Together, the faculty developed task strips to help non-verbal children understand the steps in the process of dental treatment. To the parents’ delight, these task strips have helped many ASD children receive dental care in an outpatient setting like a dental office, rather than receive dental care in a hospital operating room. Our CDM curriculum is always evolving, as the science and technology underlying dental medicine evolves. CAD/CAM is an exciting new technology that students, faculty and patients alike are embracing. Integrating the basic science in the first two years with clinical dental sciences is a work in progress, particularly as the CDM prepares students to take the new Integrated National Board of Dental Examination. Nova also works closely with the Florida Dental Association (FDA) to ensure that our students understand the importance and value of membership in the association. FDA President Dr. Jolene Paramore provided a warm welcome and overview of the dental profession to the Class of 2022 during their White Coat Ceremony. Our dental students are active in the American Student Dental Association, and the FDA welcomes our students as members of various FDA committees. Thanks to Dr. Laurie Gordon Brown, the dental students attend Dentists’ Day on the Hill, and Dr. Nichols serves as faculty for our dental students to participate in the annual Florida Mission of Mercy. With more than 1,800 alumni, Nova CDM graduates are now taking their places among dental leaders in Florida. In June 2018, two alums were recipients of FDA awards: Dr. Jordan Harper, of Niceville, Fla., received the New Dentist Leader Award and Dr. Irene Marron-Tarrazzi, of Miami, received the Dentist of the Year Award. As our CDM alumni increases and our partnership with the FDA grows, it’s only a matter of time before a Nova alum serves as FDA president — perhaps, even ADA president!

TODAY'S FDA NOVEMBER/DECEMBER 2018

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all you need to know about hot topics Opioids  Dental Therapists  Student Debt  Board of Dentistry  Medicare/Medicaid

all in one place floridadental.org/nyk The latest news from the Florida Dental Association about major topics that affect dentistry in Florida. A members-only benefit! For more reading, you can view our latest journal, Today’s FDA; email blasts, News Bites; and, our blog, Beyond the Bite.

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SPEAKER PREVIEW

FDC2019

Medically Complex Patients and Preparation for Medical Emergencies in the Dental Office DR. DANIELLE FREBURGHOFFMEISTER

Dr. Freburg-Hoffmeister is a clinical assistant professor in the Department of Oral and Maxillofacial Surgery at the University of Florida Academic Health Center. She will be speaking at the 2019 Florida Dental Convention and presenting her course, “Managing Medical Emergencies in the Dental Office” on Saturday, June 29, 2019 at 8 a.m.

TODAY'S FDA

Medical emergencies are an unwanted complication in the dental office. Given the aging population with increased medications and medical complexity, careful evaluation of patients is necessary to prevent emergencies. While many medical conditions could be reviewed and will be covered at the 2019 Florida Dental Convention, this article will focus on two: angina pectoris and diabetes mellitus. Angina pectoris, a common finding in our aging population, is caused by myocardial ischemia and can be stable or unstable. Stability relates to changes in pattern, intensity, exacerbating factors, and alleviation with rest or nitroglycerine. Unstable angina carries a worse prognosis and increases the risk of an acute coronary event during dental treatment.5 This emphasizes the need for the general dentist’s office staff to be certified in basic life support (BLS). Monthly mock emergency drills will help prepare for and prevent adverse cardiac events including death, cardiac arrest and life-threatening arrhythmias. Early recognition is the most important aspect in prevention of adverse events. Complaints of pressure and/or retrosternal pain which can be accompanied with shortness of breath, nausea or diaphoresis should alert the dentist of an acute coronary event. Protocols should

NOVEMBER/DECEMBER 2018

be in place so when an acute coronary event occurs, emergency medical service (EMS) is alerted immediately. The practitioner should administer supplemental oxygen and aspirin after verifying there are no allergies or contraindications such as gastrointestinal bleeding. The patient should chew rather than swallow 160-325 mg of aspirin for faster absorption. The patient’s vitals should be obtained, repeated every three minutes and recorded until arrival of EMS. Sublingual nitroglycerine and morphine may be used to alleviate pain, but with caution — systolic blood pressure must be more than 90 and heart rate should be above 50 beats per minute. Nitroglycerine is contraindicated with use of phosphodiesterase within 24 hours.3 An automated external defibrillator (AED) should be available and prompts followed in the event of arrhythmia. Early recognition by the dentist and timely transfer to the hospital will decrease myocardium loss, prevent cardiac arrest and prevent patient death. Diabetes mellitus (DM) is the inability to metabolize carbohydrates resulting in hyperglycemia. Type 1 DM (insulin dependent diabetes) is caused by a lack of secretion of pancreatic insulin. Type 2 DM (non-insulin dependent) is insulin-resistant and more common. The patient’s hemoglobin A1c

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THE POWER OF THE COMPLETE TEAM results should be reviewed and will provide information on the patient’s glucose control over two to three months. Normal levels are <5.7 percent,1 diagnosis of DM >6.5 percent, and controlled DM <7-8 percent.2 A patient with poorly controlled DM is at an increased risk of surgical complications, including post-operative infection, poor wound healing and even coagulation abnormalities.8 For elective surgical procedures, a consultation to the physician should be considered for an A1c more than 8 percent. A blood glucose level should be obtained the day of elective surgery and should be below 180 mg/dL. If the patient is insulin-dependent and uses a sliding scale, they may medicate to lower glucose preoperatively.6 If the patient is not on sliding scale insulin and took their regular medications but have a glucose level above 180 md/dL, consider physician re-evaluation prior to elective surgery.4 Hypoglycemia should be avoided during dental surgery. Excluding sedation, a patient’s diet and drug regimen should not be altered for dental procedures. If a diabetic presents with diaphoresis, confusion, hunger, pallor, belligerence, altered consciousness, tachycardia or tachypnea, blood glucose should be checked to rule out hypoglycemia.5 Catecholamine release causes these clinical signs and progresses to convulsions or coma without adequate glucose delivery to the brain.6 Normal glucose should range between 60-110 mg/dL. If <60 mg/dL or displaying the above symptoms, glucose should be provided and may include juice, non-diet soda or 15 g carbohydrate glucose tablet. Vitals should be monitored, and glucose rechecked 15 minutes after carbohydrate administration. If the patient loses consciousness, then glucagon is injected subcutaneously or intramuscularly if IV access is not available.7 The general dentist should continue to monitor vitals and manage the airway following BLS guidelines while waiting for arrival of EMS. As discussed, medically complex patients and medical emergencies are part of the dental office. Angina pectoris and diabetes mellitus were reviewed but there are many additional emergencies the general dentist should feel comfortable with. Monthly drills should be conducted with staff covering a wide array of emergencies. Each staff member should know their job in the event of an emergency. The general dentist should

Medically complex patients and medical emergencies are part of the dental office.

be prepared for medically complex patients, so complications may be avoided and patients’ lives saved in the event of medical emergencies.

References: 1. Abbasi J. For patients with Type 2 Diabetes, What’s the Best Target Hemoglovin A1c? JAMA. 2018; 319 (23): 2367-2369. Doi:10.1001/ jama.2018.5420 2. American Diabetes Association. “Standards of Medical Care in Diabetes—2013.” Diabetes Care 36. Suppl 1 (2013): S11–S66. PMC. Web. 19 Sept. 2018. 3. American Heart Association (AHA). 2016. Advanced Cardiovascular Life Support: Provider Manual. Dallas, Texas. 4. Duncan, Andra E. “Hyperglycemia and Perioperative Glucose Management.” Current pharmaceutical design 18.38 (2012): 6195–6203. 5. Little J, Falace D, Miller C, Rhodus N. Dental Management of the Medically Compromised Patient. St. Louis (MO): Mosby Elsevier: 2008. 6. Morgan GE, Mikhail MS, Murray MJ. Clinical Anesthesiology. New York (NY): Lange Medical Books/McGraw-Hill Medical Publishing Division: 2006. 7. Muhlhauser L, Koch J, Berger M, ‘Pharmacokinetics and bioavailability of injected glucagon: differences between intramuscular, subcutaneous, and intravenous administration’ Diabetes Care. 1985 Jan-Feb;8(1):39-42. 8. Yoo, HK, Serafin BL. Perioperative Management of the Diabetic Patient. Oral and Maxillofacial Surgery Clinics of North America. 2006; 18(2): 255-260.

SPEAKER PREVIEW

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NOVEMBER/DECEMBER 2018

SPEAKER PREVIEW

FDC2019

Treatment Planning and Restorative Options for the Edentulous Patient CHRIS BORMES

Mr. Bormes is the president of PREAT Corporation and can be reached at chris@preat.com. He will be speaking at the 2019 Florida Dental Convention and presenting his course, “Treatment Planning and Restorative Options for the Edentulous Patient,” on Thursday, June 27, 2019 at 8 a.m.

References 1. Slade G, Akinkugbe AA, Sanders AE. Projections of U.S. Edentulism prevalence following 5 decades of decline. J Dent Res. 2014 Oct;93(10):959- 65. 2. Jacobs R, van Steenberghe D. Comparison between implant-supported prostheses and teeth regarding passive threshold level. Int J Oral Maxillofac Implants. 1993;8(5):549554. 3. Trulsson M, Gunne HS. Foodholding and -biting behavior in human subjects lacking periodontal receptors. J Dent Res. 1998;77(4):574-582. 4. Dhima M, Paulusova V, Lohse C, Salinas TJ, Carr AB. Practice-based evidence from 29-year outcome analysis of management of the edentulous jaw using osseointegrated dental implants. J Prosthodont. 2014;23(3):173-181. 5. May 2015, Survata online survey of 5000 denture wearers 6. Institute for Dental Implant Awareness, 2000

TODAY'S FDA

Treating an edentulous patient involves many factors and the goal of this article is to keep it as simple as possible. In the U.S., the percentage of edentulous patients is declining 10 percent each decade. However, this reduction is more than offset by the aging Baby Boomer population and the increase in life expectancy portending an increased number of edentulous patients. The removable market is growing at more than 5 percent per year.1 As early as 2030, almost one in five people in the United States will be over the age of 65 (Fig. 1). Table 4.3

Age Groups

Population Growth by Age Group

Percentage of Change 2010-2030

65 and older 40-64 years old 20-39 years old Less than 20 years Total

76.8 % 3.4 % 11.9 % 14.1 % 18.2 %

Source: U.S. Census Bureau

Table 4.4

Percent of Total Population by Age Group Percentage of Total Population

Age Groups 65 and older 40-64 years old 20-39 years old Less than 20 years Total

2010 13.1 % 33.2 % 26.8 % 26.9 % 100 %

2020 16.2% 31.0% 26.4% 26.4% 100%

2030 19.6% 25.4% 25.4% 25.9% 100%

Fig. 1 Initially, we need to recognize the difference between natural teeth and implants when treating the edentulous patient who will receive an implant-supported or -retained prosthesis. Natural teeth have periodontal ligaments, nature’s shock absorbers. When

NOVEMBER/DECEMBER 2018

patients come into occlusion, there may be up to 1 mm of movement between opposing natural teeth. Implants do not have these shock absorbers; therefore, we need to protect our implants. Further, natural teeth provide proprioception, which protects the teeth by providing neurological stimuli, letting the brain know if we are overloading or potentially damaging the tooth prior to completion of the destructive movement. Teeth are sensory organs, and the tactile sensory feedback coordinates chewing, swallowing and breathing. The only tactile sensation available to implant restorations comes from bone deformation, which results in a threshold level 50 times greater than that of the natural dentition.2 The absence of mechanoreceptors impairs fine motor control by a reduced feedback mechanism. Studies also show that subjects with dentures and implants are unable to position their jaws as precisely as those with natural teeth. This lack of positional control, coupled with increased tactile sensory thresholds, results in much greater force being applied to implant restorations versus tooth-borne prosthetics.3 Therefore, implant prosthetics are likely to experience a greater incidence of mechanical damage. Implant-supported fixed hybrid prostheses experience 3.8 times more prosthetic complications than biologic complications.4 It’s important to design a prosthesis that may be serviced and repaired as the patient ages and needs change.

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THE POWER OF THE COMPLETE TEAM Traditional denture wearers have reported that wearing dentures limits ability to live life to the fullest, impacts their love life, affects their career and contributes to a lack confidence in meetings.5 A two-implant overdenture can restore confidence, diet, health and overall quality of life for these patients. Not only will a two-implant overdenture improve the patientâ&#x20AC;&#x2122;s functional capacity from 10 percent to 60 percent, implants maintain bone. Seventy-five percent of denture wearers would have chosen implant treatment had they known about bone loss.6

An overdenture bar (Fig. 4) provides between 60 and 90 percent of functional capacity and is ideal for the patient who has a flatter (pancake) ridge and would not have sufficient stability with a stud attachment. Fig. 4

When weâ&#x20AC;&#x2122;re presenting treatment options to our patient, what variables indicate certain treatment modalities? How do we select the best patient specific treatment plan? A fixed detachable (Fig. 2) provides prosthesis stability, security of fixed teeth, abutment splinting, maintenance of bone, an open palette for comfort and taste, and high aesthetics. Fig. 2

An overdenture stud (Fig. 5) is the most inexpensive way to improve the quality of life for mandibular denture patients. It takes the patient from 10 to 60 percent functional capacity. Fig. 5

A fixed removable (Fig. 3) has all the benefits of the fixed detachable, with the added benefit of a flange, easy hygiene and servicing for the patient and the clinician. Facially inclined screw access channels are not an issue, and a fixed removable does not require an alveoplasty. Fig. 3 Within each prosthesis (fixed detachable, fixed removable, overdenture bar and overdenture stud) there are options for the various attachment systems: Locators, O-rings, Hader Bars, Universal Plunger Locs and more. Join PREAT at the 2019 Florida Dental Convention to learn more about when and how to select the optimal attachment system for your current and future patients.

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NOVEMBER/DECEMBER 2018

Officite

donated dental services

FDA MEMBER PROVIDES NEW SMILE TO DONATED DENTAL SERVICES PATIENT DENTAL LIFELINE NETWORK • FLORIDA

Paula, 63, lives in the Daytona Beach area and is involved with her community, often taking time out of her week to assist an elderly woman who has Alzheimer’s disease. Previously, Paula worked in the medical field but had to stop due to several health issues including diabetes, cardiovascular problems and joint problems that developed from the physical requirements of her job. Sadly, Paula’s dental health also was in poor condition, with teeth in various stages of decay. Paula survives on income from a social security disability that barely covers her expenses. She also receives Medicare, which has helped with her other medical problems, but does not provide coverage for dental treatment. Paula found Donated Dental Services (DDS), a program of Dental Lifeline Network • Florida, and was linked with two generous volunteers. Florida Dental Association (FDA) member Dr. Adriana Porter, a volunteer since 2011 in South Daytona, had the opportunity to help Paula. She extracted three teeth, provided two restorations, and with the help of Sun Dental Lab, donated upper and lower partial dentures. Thanks to the team of DDS volunteers, Paula can eat more foods and no longer has pain while chewing. “It was wonderful — the whole office was pleasant and accommodating,” said Paula. “I bought [Dr. Porter] a present — I couldn’t be more thankful!”

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Dr. Andriana Porter and Paula

“[The DDS program] has brought a feeling of camaraderie among [office staff], and patients have been very appreciative and grateful,” said Dr. Porter. “It is important to get involved because this will improve the chances to facilitate dental care to patients in need.” Since 1997, Florida DDS volunteer dentists and labs have provided more than $8 million in treatment to more than 1,800 people with special needs. DLN • Florida thanks the FDA and the FDA Foundation for their longtime support of DDS. Will you see one patient this year? Visit willyouseeone.org to sign up online or contact Florida DDS Coordinator Megan Manor at 850.577.1466 or mmanor@dentallifeline.org.

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US Dental Transitions

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$235

FDAS CONTRIBUTION TO FDA DUES REDUCTION IN 2018

DUES REDUCTION FOR EACH FDA MEMBER

MALPRACTICE INSURANCE

WORKERS’ COMP. INSURANCE

25% WORKERS’ COMP DIVIDEND The Doctors Company Mission: Defend, Protect, Reward Benefits for FDA Members Eligible FDA members receive a 5 percent program discount and an additional claims-free credit of up to 10 percent. FDA members also receive automatic protection against privacy breach allegations and Medicare reviews, and have access to free web-based and live continuing education.

The Tribute® Plan The Tribute® Plan is an unrivaled financial benefit that rewards members for their loyalty and their dedication to superior patient care. More than $7 million is currently earmarked for Tribute Plan awards for Florida dentists. Eligible FDA members also participate in the company’s generous multiyear dividend program, which has returned more than $415 million in dividends since the program’s start in 1976.

Get and instant quote at bit.ly/tdcquote.

Practices with an annual workers’ compensation premium of $500 or more are now eligible (down from $1,000)! Available for dental offices that meet the following requirements: 1. annual workers’ compensation premium of $500 or more 2. claims-free the past three years (current year plus two prior years) The carrier will immediately apply a 25 percent dividend of your earned annual premium to all new and existing policies that meet the program guidelines starting July 1, 2018.

Explore The Zenith Solution Center: Zenith policyholders get free, 24/7 access to comprehensive risk management and safety resources specific to dentists at TheZenith.com: • • • •

assign, track and report employee training hundreds of downloadable forms hr guidelines and much more ...

FREE ACCESS TO: Call FDAS at 800.877.7597 to get a quote.

Driving Floridians to Find Their

FDA Dentist

The FDA is working to engage patients to find and see FDA member dentists. You can leverage your member status to drive your practice’s success. From September 2017 through September 2018, the FDA and The Moore Agency continued to successfully educate Floridians on the importance of oral health and drive Florida consumers to find their FDA dentist. FDA brand awareness was promoted through targeted digital advertising and media relations efforts. This year’s campaign succeeded in raising brand awareness and driving people to the primary tool to find an FDA dentist, including increasing landing page visits by more than 30 percent and achieving a clickthrough rate to the Find a Dentist search that is more than twice the industry average.

Digital Ad Campaign Highlights

Media Relations Highlights

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16 million+ views of FDA ads promoting member dentists

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2.5 million+ targeted Floridians reached on Facebook alone

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168,750+ clicks to the FDA webpage educating the public about the benefits and services of member dentists

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More than 100 positive media stories, including more than 20 stories supporting FDA policy initiatives

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25,000+ clicks to the FDA Find-A-Dentist search

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Featured in more than 35 media outlets across Florida, as well as national industry outlets Dentistry iQ and Dr. Bicuspid

Earned media engagement also helped to promote positive brand awareness of the FDA, our members and our commitment to improving oral health in Florida.

“Dentists are uniquely qualified to meet the needs of rural Floridians. After completing more than eight years of education and training, dentists are experts on how heart, kidney, gum and lung disease, as well as cancer and medications, affect the mouth and teeth and vice versa. They also are often on the frontlines of identifying a variety of undiagnosed conditions.” — DR. MICHAEL EGGNATZ, South Florida Sun-Sentinel

Leverage the Success by Promoting Your Member Status This year, we will continue to educate Florida consumers on the importance of oral health and engage them to find and see an FDA dentist through marketing and advertising efforts. As an FDA member, you can leverage these efforts by taking the following actions: •

Complete your ADA Find-a-Dentist member profile, including a professional photo. FDA ads drive Florida patients to find an FDA member dentist. A completed profile will elevate you in the member search directory, as well as engage prospective patients with you and your practice. To complete your profile visit ADA.org/MyADA and login with your ADA number, or contact fda@floridadental.org.

•

Promote your FDA member status by including your member logo on your website, social media platforms, email marketing and other marketing efforts. To download the FDA member logo, go to floridadental.org/marketing-toolkit to log in to the member-only section of the FDA website and select “Download member logo.”

•

Share FDA posts on your own social media channels. These posts provide you and your practice with ready-made content that will help keep oral health in mind for your current and prospective patients, as well as reinforce your status as an FDA member.

Connect with FDA Social Media Channels

Florida Dental Association @FDADental Florida Dental Association

tax savings

TOP TAX SAVING MOVES FOR THE REST OF 2018 As the end of the year approaches, it’s a good time to think of planning moves that will help lower your tax bill for this year and possibly the next. Year-end planning for 2018 takes place against the backdrop of the new law — the Tax Cuts and Jobs Act — that makes major changes in the tax rules for individuals and businesses. For individuals, there are new lower income tax rates, a substantially increased standard deduction, severely limited itemized deductions and no personal exemptions, an increased child tax credit and watered-down alternative minimum tax (AMT), among many other changes. In addition to shifting income and expenses, there are several other actions taxpayers can take before the end of the year to reduce their 2018 tax bills.

Valuable Year-end Planning Moves Include: n taking advantage of the new 20 percent deduction for qualified business income. n using expanded Code Sec. 179 expensing and 100 percent first-year bonus depreciation.

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n converting traditional IRAs to Roth IRAs. n planning moves for beneficiaries of IRAs and qualified retirement plans. n making year-end gifts of appreciated property to shift taxable gain to lower-bracket family members while taking advantage of the annual gift tax exclusion ($15,000 per taxpayer per donee). n disposing of passive activities to free up suspended passive losses.

Other Tax Strategies Fine-tune the W-4 Revise W-4s before year-end to more closely match remaining withholdings for the year to expected tax obligations. The savings that taxpayers anticipate might have already been given to them through withholding. You can perform a quick “paycheck checkup” by going to the IRS website at irs.gov/individuals/irs-withholding-calculator. WWW.FLORIDADENTAL.ORG

Recapturing AMT

Get Some Big Wheels

With the new higher income limits for individuals exposed to the AMT, more taxpayers will have the opportunity to recapture the AMT paid in prior years.

Buy an SUV or truck that is heavier than 6,000 lbs. for a business to take bonus depreciation up to 100 percent (or actual business percentage) for the cost of the vehicle.

Always, Always, Always Save

Pick the Right Date to Split

Maximize retirement plan contributions before the end. This is a perennial suggestion, as far too many taxpayers fail to make the most of their 401(k)s, Roth IRAs, traditional IRAs and other savings accounts.

If the taxpayer is in the middle of a divorce, finalize the divorce before the end of 2018 so they will be able to deduct alimony paid to their spouse. If the taxpayer will be the recipient of the alimony, they might want to put off finalizing the divorce or cut a deal to increase payment — after 2018, they won’t pay tax on the alimony.

Loss Harvesting Sell stocks that may produce a loss. Taxpayers can deduct up to $3,000 of their excess losses, which reduces overall income. If the taxpayer sold stocks that resulted in a gain, selling stocks that produce a loss will offset the gain.

Managing Itemizing Compare reduced itemized deductions to which the taxpayer might be entitled this year to the new standard deduction ($24,000 if married filing jointly and $12,000 if single). If they won’t benefit from increasing itemized deductions such as charitable contributions (because the standard deduction will be greater), they can consider bunching charitable contributions into every other year, setting up a donor-advised fund, or, if over 70 ½, making charitable contributions through IRA distributions. If they are taking the deduction this year, they can add to it by cleaning out closets, dressers and storage areas, and donating unused items to charitable organizations such as AMVETS, American Red Cross, Goodwill and the Salvation Army.

WWW.FLORIDADENTAL.ORG

You Can Still Deduct a Client’s Meal on a Night Out, IRS Says

DEBIE LEONARD TAX SERVICES DEPARTMENT DIRECTOR, SHAREHOLDER EMERITUS, THOMAS HOWELL FERGUSON P.A. CPAS

Ms. Leonard can be reached at DLeonard@thf-cpa.com.

The bill that President Donald Trump signed eliminated the deduction for so-called entertainment expenses — golf outings, cruises and concert tickets. Tax professionals also thought that ban included food purchased while taking clients out. The IRS said the costs of business meals while entertaining are still deductible as long as they’re reflected on a separate receipt. “Food and beverages that are provided during entertainment events will not be considered entertainment if purchased separately from the event,” the IRS said in a statement. For example, a meal purchased after a round of golf could be deducted. But tickets to a box to view a sporting event that includes food and drink would not be eligible for the tax break. Nevertheless, the best year-end tax planning strategy for many taxpayers may still be to follow the time-honored approach of deferring income and accelerating deductions to minimize 2018 taxes. TODAY'S FDA NOVEMBER/DECEMBER 2018

FDAS - Crown Savings

The Doctors Company

compleat dentistry

LIFETIME VALUE Would you like to take it for a ride?

DR. EDWARD HOPWOOD

Dr. Hopwood is restorative dentist in Clearwater and can be reached at edwardhopwood@gmail.com.

Compleat dentistry is a slower-paced, deliberate style of dentistry, espoused by Pankey, Dawson and so many others, in which the dentist knows the patient well, knows the work, knows their own abilities and limitations, and uses this knowledge to take care of the patients who trust them with their care. The world will change, but the principles of compleat dentistry will remain the foundation of an exceptional practice. The spelling is an homage to Isaak Walton, whose book, “The Compleat Angler,” was about so much more than fishing.

TODAY'S FDA

Should I p wrap it u for you?

uch How m ord u aff o y n a c nth? o m r e p What would it take to get you into this car?

Would you like to take it home for a day or two?

It’s the last one I have — so, no pressure — but if you want it, you better hurry because I have an appointment to show it to someone else this afternoon.

We’ve all heard these sales pitches so many times, it’s almost comical. I love to mess with salespeople by giving them all kinds of crazy answers: “We like to keep our car payments below $15,000 per month.” Or, “It would take a papal decree to get me into this car.” (That way, I can escape while they are Googling “how do I get a papal decree.”) It drives my wife crazy, but it keeps me entertained. Unfortunately, I’ve started hearing from new patients that their previous dentist sounded like a used car salesperson and that’s why they’re transferring to my office. I find this embarrassing because I am proud to be part of a trusted and respected profession, and I worry that our reputation is being tarnished. However, as dentists, we must be proficient at selling — otherwise, we’ll be forced to practice the simple, reactionary dentistry that’s so frustrating to both dentists and patients. So often, books I’ve read or the advisors I’ve listened to simply apply conventional aspects of selling to dentistry. But it’s absurd for a professional to come off as a salesperson: “What would it take to get you into that crown today?”

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As often is the case, we can look to our medical colleagues for help. But medicine is so different than dentistry. The payer often is the insurance company, so cost is a separate discussion based on what the insurance will “allow.” The treatment often reacts to an urgent problem, so there aren’t a lot of other options: “What would it take for me to remove that tumor for you?” To be sure, there are certain aspects of dentistry that are urgent and easy to sell. Fillings are treatment for urgent problems and they’re covered by insurance. Extracting a broken tooth is an easy thing to explain and accomplish. But, we must understand why the tooth broke, eliminate the cause, explain the options to fill that space and then direct our patients to the best treatment for them. That’s where sales in dentistry becomes important. And if we aren’t going to be effective at sales, then we’d all have to be endodontists. One of the surprising benefits of compleat dentistry is that it’s enabled me to shift my time horizon. Of course, there are certain parts of a treatment plan that must be completed quickly (active decay, infections). But there also are parts of a plan that can be spread out over time. I’ve found it helpful to stage treatment into three steps: (1) infection control; (2) occlusal control; and, finally, (3) rebuilding. I work hard to treat the infections quickly, then I wait until the patient is ready before completing occlusal control. But, I only begin rebuilding when they ask for it. What happens if they aren’t interested in occlusal control? I place them on recall and I work hard to keep educating them. This is distinctly different than selling — it’s explaining to them what I see and why it’s occurring. Only when they ask how to fix it, do I offer a solution. The difference is looking at the short-term value of a patient versus looking at the lifetime value of a patient. When we look at short-term value, the exam tends to be short and directed at finding what is broken and offering a solution, where periodontal probings are a means of evaluating the need for quadrant scaling. When we shift to lifetime value, the exam looks to determine what is healthy and what is not. Here, periodontal

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probings are a means of assessing health or disease. Treatment is not offered immediately. The exam is a means of gathering information that needs to be processed before treatment can be offered. Now, the knee-jerk reaction is that corporations are the chief culprits, pushing their employees to be the used car salespeople of dentistry. I’m not so sure that’s the case. Our patients (consumers) are becoming wise to the corporate tactics and they aren’t falling for the “everyone gets a quadrant scaling” pitch. I’m hearing about sales pitches from private practitioners in our area just as often as corporate practices. In fact, patients are surprised by the sales pitches from a private practitioner, whereas they expect it from the corporation. When we look at corporations outside of dentistry, they’ve already come to appreciate the lifetime value of their customers. A computer company may estimate the lifetime value of their user to be about $10,000. Grocery stores may think that the lifetime value of a customer is about $50,000. These companies work hard to build and maintain customer loyalty. That’s why Publix will buy and maintain scales in the front of their stores and the reason why there are “free” ATMs at every location. Regular readers of this column will be surprised when I say that there’s something we can learn from the large corporations — that is, we can appreciate the lifetime value of our patients. In fact, each of our patients has an enormous lifetime value to our practices. Unfortunately, we may never realize this value if we scare them off by acting like salespeople. When we keep the long-term perspective, we can shift from trying to sell dentistry into providing our patients with the services they want. And if they never need or want anything more than a cleaning every six months? Then maybe they’ll appreciate our relationship enough to send a friend or family member in to see us. Even if they never refer anyone to us, then at least we will have formed a nice relationship based on trust. To me, that is well worth the effort.

TODAY'S FDA NOVEMBER/DECEMBER 2018

FDA: Eiagnostic Discussion: Read, Learn & Earn!

Paragon

TODAY'S FDA

NOVEMBER/DECEMBER 2018

WWW.FLORIDADENTAL.ORG

DRS. REKHA REDDY*, NADIM M. ISLAM, INDRANEEL BHATTACHARYYA AND DONALD COHEN

A 33-year-old Caucasian male presented to Dr. Reinaldo Claudio of Clearwater Oral Surgery with a history of an abscess facial to Nos. 11-12 and facial swelling. Cone beam computed tomography (CBCT) imaging demonstrated a welldefined radiolucent lesion apical to Nos. 11-12 that perforated the lingual cortex (Figs. 1a-d). The patient also had a lesion on the left parietal bone. The patientâ&#x20AC;&#x2122;s medical history is significant for hypertension, radiation therapy and chemotherapy. He smokes one pack of cigarettes per day. His medications include lisinopril, lorazepam, oxycodone, methadone and flexeril. The periapical lesion was biopsied, and the specimen was submitted to the University of Florida College of Dentistry Oral Pathology Biopsy Service. Microscopic examination revealed subacutely inflamed connective tissue with zones of necrotic debris. An intense inflammatory infiltrate (Fig. 2a) composed of eosinophils, neutrophils, lymphocytes, plasma cells and peculiar cells with kidney bean-shaped nuclei (Fig. 2b) also was seen. The immunohistochemical stains CD-1a (Fig. 2c) and S-100 (Fig. 2d) were ordered to confirm the diagnosis. Both stains were diffusely and strongly positive in lesional cells.

Fig. 1: Histology and immunohistochemical stains. (a) Mixed inflammatory infiltrate composed of eosinophils, neutrophils, lymphocytes and plasma cells; (b) Arrow is pointing to a kidney bean-shaped (reniform) nuclei; (c) CD-1a showing strong membranous positivity in lesional cells; (d) S-100 demonstrating cytoplasmic and nuclear positivity in lesional cells.

Question: What is the most likely diagnosis? A. Periapical cyst B. Odontogenic keratocyst C. Central giant cell granuloma D. Multiple myeloma

Fig. 2: CBCT imaging of a radiolucent lesion apical to Nos. 11-12. (a) Axial view showing perforation of the lingual cortical plate; (b) 3D reconstruction of the patientâ&#x20AC;&#x2122;s left maxillary arch; (c) Reconstructed panoramic view showing a well-defined radiolucent lesion encircling the apices of Nos. 11-12; (d) Sagittal view demonstrating buccal cusp fracture on No. 12.

E. Langerhans cell histiocytosis

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diagnostics cases, with a marked predilection for the posterior body and ramus.

FROM PAGE 97

Diagnostic Discussion A. Periapical cyst Incorrect, but a great choice given the radiographic presentation of a retained root. Periapical cysts present as a rounded radiolucency that encircles the apex of the affected tooth. Significant growth is possible, and as the cyst enlarges, the radiolucency flattens out as it approaches adjacent teeth. The root demonstrates a loss of lamina dura and resorption is commonly seen. Patients with periapical cysts usually have no symptoms unless there is an acute inflammatory exacerbation. Furthermore, if the cyst reaches a large size, then swelling, mild sensitivity and mobility of adjacent teeth are possible. The tooth that the cyst originates from is unresponsive to thermal and electric pulp testing. Histologically, periapical cysts are lined by stratified squamous epithelium. The cyst lumen is usually filled with fluid and cellular debris. The cyst wall consists of dense fibrous connective tissue with an inflammatory infiltrate containing lymphocytes, neutrophils, plasma cells and histiocytes. Treatment consists of extraction or conservative nonsurgical endodontic therapy. If the radiolucency fails to resolve, then nonsurgical endodontic retreatment is recommended. Periapical surgery is usually reserved for lesions exceeding 2 cm and those associated with teeth that are not suitable for conventional endodontics. Because any number of odontogenic and nonodontogenic cysts and tumors can mimic the appearance of a residual periapical cyst, biopsy is indicated to rule out other possible pathologic processes. B. Odontogenic keratocyst Incorrect, but a good guess given that root resorption is not seen. Odontogenic keratocysts (OKC) arise from the cell rests of the dental lamina. About 60 percent of cases are diagnosed in people between 10-40 years old and there is a slight male predilection. The mandible is involved in 60-80 percent of

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Radiographically, OKCs demonstrate a well-defined radiolucent area with smooth and corticated margins. Larger lesions may appear multilocular. In 25-40 percent of cases, an impacted tooth is involved. The radiographic findings may simulate those of a dentigerous cyst, a radicular cyst, a residual cyst and a lateral periodontal cyst. Root resorption, however, is less common in OKCs when compared to dentigerous and radicular cysts. Additionally, unlike dentigerous and radicular cysts, OKCs grow in an anteroposterior direction within the medullary cavity of the bone without causing obvious bone expansion. If multiple OKCs are seen on a radiograph, the patient should be evaluated for nevoid basal-cell carcinoma (Gorlin) syndrome. Because OKCs can appear very similar to other odontogenic and inflammatory cysts radiographically, histopathologic confirmation is required for definitive diagnosis. Microscopically, OKCs show a uniform layer of stratified squamous epithelium that is six to eight layers in thickness with a hyperchromatic and palisaded basal cell layer. Similar to other odontogenic cysts, treatment consists of enucleation and curettage. However, complete removal of the cyst in one piece is difficult because the cyst wall is very thin and friable. Furthermore, because of the thin and friable nature of the cyst wall, OKCs have a higher recurrence rate than other odontogenic cysts (approximately 30 percent recur). Multiple recurrences are not uncommon, and recurrences are encountered more often in the mandible. It is unclear whether recurrences are due to residual fragments of the original cyst that were not removed during the initial operation, or the development of a new cyst from dental lamina rests in the same area. Although many OKCs recur within five years of the original surgery, recurrences have been reported to occur more than 10 years after the original surgical procedure. Therefore, long-term clinical and radiographic follow-up are necessary. C. Central giant cell granuloma Incorrect, but a good differential due to the patientâ&#x20AC;&#x2122;s young age. More than 60 percent of central giant cell granuloma (CGCG) cases occur before the age of 30. However, unlike WWW.FLORIDADENTAL.ORG

our case, there is a female predilection and approximately 70 percent of cases arise in the mandible. Lesions are more common in the anterior region of the jaws and mandibular lesions frequently cross the midline. Radiographically, they appear as unilocular or multilocular radiolucencies with well-delineated, but non-corticated, borders. The lesion may vary from a small, incidental radiographic finding to a large, destructive lesion. Small unilocular lesions may be confused with periapical granulomas or cysts, and multilocular lesions may look like ameloblastomas. Microscopically, CGCGs demonstrate multinucleated giant cells in a background of spindle-shaped mononuclear stromal cells. CGCGs are usually treated with thorough curettage. Recurrence rates range from 11-49 percent and recurrent lesions may require further curettage with peripheral ostectomy or en bloc resection. Alternative treatments include intralesional corticosteroid injections, subcutaneous or nasal calcitonin, subcutaneous interferon alpha-2a, imatinib and bisphosphonates. Overall, long-term prognosis is good. D. Multiple myeloma Incorrect, but a crucial entity to include in the differential diagnosis given that the patient has lytic lesions on his skull and jaw. Multiple myeloma (MM) is a relatively uncommon malignancy with an unknown cause. Men are slightly more affected than women, but unlike our case, it typically affects older adults between 60-70 years old. The disease occurs twice as often in African-Americans than Caucasians. The most characteristic symptom is bone pain, especially in the lumbar spine. Some patients experience pathologic fractures caused by tumor destruction of bone. Radiographically, multiple welldefined, punched-out radiolucencies or ragged radiolucencies may be seen, especially on a skull film. Although any bone may be affected, the jaws are involved in 30 percent of cases. Approximately 10-15 percent of patients with MM show deposition of amyloid. Amyloid deposits are due to the accumulation of abnormal light chain proteins. Intraorally, the tongue may show diffuse enlargement and firmness, or may have a nodular appearance that is sometimes ulcerated. Another area that is affected is the skin, with amyloid deposits appearing as waxy, firm, plaque-like lesions. Renal failure also may be a presenting sign, as the kidneys become overburdened WWW.FLORIDADENTAL.ORG

with excessive circulating light chain proteins of the tumor cells. Histologically, diffuse, monotonous sheets of neoplastic plasma cells are seen. Chemotherapy is initially used to control multiple myeloma. Radiation therapy is only useful as palliative treatment for painful bone lesions. A bisphosphonate medication is typically prescribed to reduce the possibility of myeloma-related fracture. Prognosis ranges from six to seven years for patients who are categorized as “standard risk” and two to three years for patients who are categorized as “high risk.” E. Langerhans cells histiocytosis Correct! Great job! Langerhans cell histiocytosis (LCH) is encountered in patients over a broad age range, but more than 50 percent of cases are seen in patients younger than 15. The most common clinical presentations are bone lesions. Almost any bone can be affected, but children younger than 10 years old often have skull and femoral lesions, whereas patients older than age 20 have lesions in the ribs, shoulder girdle and mandible. Dull pain and tenderness often accompany the bone lesions. The jaws are affected in 10-20 percent of cases. Similar to multiple myeloma, the lesions appear as sharply punchedout radiolucencies without a corticated rim. Occasionally, an ill-defined radiolucency is seen. A characteristic “scooped out” appearance may be apparent when the alveolar bone is destroyed. The resulting bone destruction and loosening of teeth can clinically resemble severe periodontitis. Extensive alveolar involvement causes the teeth to appear as if they are “floating in air.” Microscopically, a diffuse infiltration of large, pale-staining cells with indistinct cytoplasmic borders and rounded or indented vesicular (reniform) nuclei are seen. Various numbers of eosinophils, plasma cells, lymphocytes and multinucleated giant cells are seen, and areas of necrosis may be present. Immunohistochemical stains are used to identify lesional Langerhans cells. Immunoreactivity with antibodies directed against CD-1a and CD-207 (langerin) are specific for LCH.

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diagnostics FROM PAGE 99

Accessible bone lesions, such as those in the maxilla and mandible, are usually treated by curettage. Low doses of radiation may be used for less accessible bone lesions. Intralesional injection with corticosteroid agents in localized bone lesions also has been reported to be effective. The prognosis for bone lesions in the absence of significant visceral involvement is good. However, progression or dissemination of the disease may occur, especially for patients who have three or more bones affected. In such a scenario, chemotherapy is indicated.

References: Bansal S, Garg A, Khurana R. Langerhans Cell HistiocytosisA Challenge for the Dental Professional. J Cutan Aesthet Surg. 2017;10(4):215-218. Peters SM, Pastagia J, Yoon AJ, Philipone EM. Langerhans Cell Histiocytosis Mimicking Periapical Pathology in a 39-year-old Man. J Endod. 2017;43(11):1909-1914. Yu Q, Wang PZ, Shi HM, Wang L, Sun DX. Radiographic findings in Langerhans’ cell disease affecting the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(2):251-254. Lee SH, Yoon HJ. Intralesional infiltration of corticosteroids in the treatment of localized Langerhans cell histiocytosis of the mandible: report of two cases. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(4): e255-260.

Clinicians are invited to submit cases from their own practices. Cases may be used in the “Diagnostic Discussion,” with credit given to the submitter. Drs. Islam, Bhattacharyya and Cohen can be reached at oralpath@dental.ufl.edu. DR. ISLAM

Conflict of Interest Disclosure: None reported for Drs. Cohen, Islam and Bhattacharyya.

The Florida Dental Association is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP DR. BHATTACHARYYA does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at ada.org/ goto/cerp.

DR. COHEN

*Senior resident in oral and maxillofacial pathology at the University of Florida College of Dentistry

Diagnostic Discussion is contributed by UFCD professors, Drs. Nadim Islam, Indraneel Bhattacharyya, and Don Cohen, who provide insight and feedback on common, important, new and challenging oral diseases. The dental professors operate a large, multi-state biopsy service. The column’s case studies originate from the more than 12,000 specimens the service receives every year from all over the United States.

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PSC Group, Inc.

FDA FDC: Exhibitor Marketplacae

PNC Bank

FDA: Career Center

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career center

The FDA’s online Career Center allows you to conveniently browse, place, modify and pay for your ads online, 24 hours a day. Our intent is to provide our advertisers with increased flexibility and enhanced options to personalize and draw attention to your online classified ads! As an added benefit, we will continue to publish the basic text of paid, online Career Center ads in Today’s FDA, at no additional cost to you. All ads posted to the online career center will be published during the contracted time frame for which you have posted your online classified advertisement. Today’s FDA is published bimonthly; therefore, all active ads online will be extracted from the Career Center on roughly the following dates of each year: ISSUE

EXTRACTED DATE

JAN/FEB MARCH/APRIL MAY/JUNE

JAN. 10 MARCH 10 MAY 10

JULY/AUG SEPT/OCT NOV/DEC

JULY 10 SEPT. 10 NOV. 10

Please visit the FDA’s Career Center at careers.floridadental.org.

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F/T or P/T Associate General Dentist. Want a great work-life balance and great earning potential? Want to work, live and play just a few steps from the best beaches and outdoorenthusiast’s paradise? Established private, dental practice is seeking an experienced general dentist for an immediate associate position in Panama City Beach, FL. The practice is mostly fee-for-service and performs many aspects of general dentistry including molar endo and oral surgery with an emphasis on quality restorative treatment and cosmetics. The office uses Dentrix and is modern, clean and fully digital, with intraoral cameras and TV monitors in every op. Owner practitioner is also interested in expanding office technology and treatment options. The ideal candidate would have a minimum of 3 years’ experience, be able to work autonomously and have excellent communication and leadership skills. Must also excel in customer relations, clinical expertise and treatment planning. Position is F/T or P/T, given the candidate’s needs and situation. Option to partner/buy-in may be offered to the right person. Send CV and references to beachdentistcareers@gmail.com. DDS or DMD degree from U.S. accredited dental program. Active Florida Dental License. Associate Dentist – Naples. Do you love your practice? Are you growing in your field? We have an exciting opportunity for a passionate, driven dentist to join our team in Naples, FL at the end of the year. This modern office is fully digitized and equipped with SiroLaser, CEREC® CAD/CAM, intraoral cameras, VELscope®, and digital X-rays. You will have full clinical autonomy to focus on creating patients for life without worrying about the operation of the office. Benefits: Competitive earning potential, with no earning cap. Potential for partnership; Benefits, including: Medial, Dental, Vision, 401K; Fully paid Lab & Supply fees, malpractice insurance, and any CE credits taken through the PDS institute®; Great location/professional marketing; Great working environment, with a fun, friendly, and supportive team! Please choose REPLY to send a CV for immediate consideration! rooneya@pacden.com. Associate Dentist - Mount Dora, FL. Do you love your practice? Are you growing in your field? Dr. Imran Hameedi is looking for a passionate, driven dentist to join his team at Mount Dora Modern Dentistry. This modern office is fully digitized and equipped with SiroLaser, CEREC® CAD/CAM, intraoral cameras, VELscope®, and digital X-rays. You will have full clinical autonomy to focus on creating patients for life without worrying about the operation of the office. Benefits: Competitive earning potential, with no earning cap; Benefits, including: Medial, Dental, Vision, 401K; Fully paid Lab & Supply fees, malpractice insurance, and any CE credits taken through the PDS institute®; Great location/professional marketing; Supportive working environment, with a fun, friendly, and experienced team! Please choose REPLY to send a CV for immediate consideration! If you prefer to apply directly online, you can follow this link: bit.ly/2QiUWpm. Associate Dentist – Daytona. Associate Dentist – Port Orange. Do you love your practice? Are you growing in your field? We are looking for a passionate, driven dentist to join our team in Port Orange. This modern office is fully digitized and equipped with SiroLaser, CEREC® CAD/CAM, intraoral cameras, VELscope®, and digital X-rays. You will have full clinical autonomy to focus on creating patients for life without worrying about the operation of the office. Benefits: Competitive earning potential, with no earning cap. Potential for partnership; Benefits, including: Medial, Dental, Vision, 401K. Fully paid Lab & Supply fees, malpractice insurance, and any CE credits taken through the PDS institute®; Great location/professional marketing; Great working environment, with a fun, friendly, and supportive team! Please choose REPLY to send a CV for immediate consideration! If you prefer to apply directly online, you can follow this link:

NOVEMBER/DECEMBER 2018

bit.ly/2JHXuef. Additional Salary Information: Paid lab fees, malpractice insurance, full benefits, and AGD certified CE. General Dentist - Naples, Florida. Are you an individual that is meticulous, patient, upbeat and have a love for dentistry? Do you want to be part of a growing practice in sunny Naples, Florida? Looking for a part time associate to help in a growing relationship-based practice with buy in potential for the right individual. For more information, send your resume and inquiries to: DMDMMG@gmail.com. Established General Private Practice seeking Associate Dentist. Established private dental practice is seeking a general dentist for immediate transition opportunity. 30 years in practice with a solid reputation as caring, patient centered practice located in Tallahassee, Florida. Practice is open 4 days a week M-Th. Modern office with digital technology, IO cameras, 4 fully equipped operatories and highly experienced staff. DDS OR DMD degree, licensed in the state of Florida. Current BLS and CPR certificate. southerndental1@ yahoo.com. General Dentist. General Dentist needed for our growing high end private dental practice. Candidate must have a minimum 3+ years’ experience. General Dentist must be able to perform molar endodontics, oral surgery, cosmetic dentistry, implant restoration as well as having excellent patient communication skills. P/T 3 days per week. nycdentalpsl@yahoo.com. Established Private Dental Practice seeking Associate Dentist. Established General Private Practice near The Villages seeking a Dentist Associate with potential for Partnership or buyout. Full time or part time consideration; Great working environment, with an experienced, fun, friendly, and supportive team; Health Insurance; Current Technology. DDS OR DMD degree, licensed in the state of Florida. Current BLS and CPR certificate. jennifer@cohrn.com. GENERAL DENTIST ASSOCIATE. FEE FOR SERVICE GENERAL PRACTICE. Come and enjoy doing dentistry in a practice that has all the technology you could want, and you will not have to reduce your fees. Comprehensive dentistry with an emphasis on restorative; Current technologies in the practice include: Cerac, Digital, CT imaging, etc.; Clinical autonomy, great work life balance, great earning potential, and good experienced team for support. Go where you are needed and enjoy the nice small-town community in a beautiful setting to live and work and not a bad commute into ATL for all the things a big city has to offer. Send resume to Colleen@dmacares.com to be considered. DDS/DMD, GA Dental License. General Dentist – Sarasota. What’s most important to you? If it’s providing excellent patient care, earning a great living, and getting home in time for dinner, then we invite you to join our Coast Dental team in our office. We are currently hiring full-time and part-time Associate Dentists. And, Coast Dental makes the path to practice ownership easy if you are interested in becoming a Managing Partner Dentist. When you join our group practice, it’s your name on the door, so you maintain 100% clinical autonomy. You are placed into an office where you as the dentist diagnoses and delegates. Your patients are your own from diagnosis to treatment completion. General dentists typically see 8 – 12 patients per day and we value quality patient care with compassionate friendly service. You focus on your patients; our team will take care of staffing, payroll, purchasing, insurance, and the other administrative functions that keep a practice running smoothly. We also feature specialty care provided by skilled endodontists, oral surgeons, orthodontists, pedodontists, and periodontists providing an in-house services to your patients. Contact us today at to find out about our excellent

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compensation plans including: $215,000 annual average full-time general dentist earnings; Health benefits & 401(k) plan; Free group professional liability insurance; Continuing education programs; Life and AD&D insurance. Own your own practice? Coast offers a part-time schedule to supplement your own dental office. With almost 30 locations in a growing Florida and Georgia markets, we have opportunities for dentists at every stage of their career. Whether you want to live close to big-city amenities or prefer a family-friendly community, we invite you to call us today. As a licensed dentist, a general dentist provides general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures. Duties and Responsibilities: Perform all general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures; Examine patients to determine the nature of the condition affecting the patient, utilizing x-rays, dental instruments and other diagnostic procedures; Provide preventive dental services and education in oral and dental hygiene; Adhere to safety protocols and processes including but not limited to ensuring protective equipment is utilized and OSHA/Bloodborne pathogen requirements are followed; All other duties and responsibilities allowed under applicable state laws and regulations. Knowledge, Skills, and Abilities: Commitment to quality patient care and enjoy educating patients on dental health; Effective communication skills; demonstrates professional and courteous demeanor with patients. Qualifications (Experience, Education, Licensure, Certification): DDS or DMD degree, licensed in state in which practicing or have the ability to obtain licensure upon graduation; Current Basic Life Support (BLS) and cardiopulmonary resuscitation (CPR) certificate; Completion of a general practice residency (GPR) or advanced education general dentistry residency (AEGD) preferred. ashley.rigsby@ coastdental.com. General Dentist – S. Lakeland. What’s most important to you? If it’s providing excellent patient care, earning a great living, and getting home in time for dinner, then we invite you to join our Coast Dental team in our office. We are currently hiring full-time and part-time Associate Dentists. And, Coast Dental makes the path to practice ownership easy if you are interested in becoming a Managing Partner Dentist. When you join our group practice, it’s your name on the door, so you maintain 100% clinical autonomy. You are placed into an office where you as the dentist diagnoses and delegates. Your patients are your own from diagnosis to treatment completion. General dentists typically see 8 – 12 patients per day and we value quality patient care with compassionate friendly service. You focus on your patients; our team will take care of staffing, payroll, purchasing, insurance, and the other administrative functions that keep a practice running smoothly. We also feature specialty care provided by skilled endodontists, oral surgeons, orthodontists, pedodontists, and periodontists providing an in-house services to your patients. Contact us today at to find out about our excellent compensation plans including: $215,000 annual average full-time general dentist earnings; Health benefits & 401(k) plan; Free group professional liability insurance; Continuing education programs; Life and AD&D insurance. Own your own practice? Coast offers a part-time schedule to supplement your own dental office. With almost 30 locations in a growing Florida and Georgia markets, we have opportunities for dentists at every stage of their career. Whether you want to live close to big-city amenities or prefer a family-friendly community, we invite you to call us today. As a licensed dentist, a general dentist provides general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures. Duties and Respon-

sibilities: Perform all general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures; Examine patients to determine the nature of the condition affecting the patient, utilizing x-rays, dental instruments and other diagnostic procedures; Provide preventive dental services and education in oral and dental hygiene; Adhere to safety protocols and processes including but not limited to ensuring protective equipment is utilized and OSHA/Bloodborne pathogen requirements are followed; All other duties and responsibilities allowed under applicable state laws and regulations. Knowledge, Skills, and Abilities: Commitment to quality patient care and enjoy educating patients on dental health; Effective communication skills; demonstrates professional and courteous demeanor with patients. Qualifications (Experience, Education, Licensure, Certification): DDS or DMD degree, licensed in state in which practicing or have the ability to obtain licensure upon graduation; Current Basic Life Support (BLS) and cardiopulmonary resuscitation (CPR) certificate; Completion of a general practice residency (GPR) or advanced education general dentistry residency (AEGD) preferred. ashley.rigsby@coastdental.com. General Dentist – S. Fort Myers. What’s most important to you? If it’s providing excellent patient care, earning a great living, and getting home in time for dinner, then we invite you to join our Coast Dental team in our office. We are currently hiring full-time and part-time Associate Dentists. And, Coast Dental makes the path to practice ownership easy if you are interested in becoming a Managing Partner Dentist. When you join our group practice, it’s your name on the door, so you maintain 100% clinical autonomy. You are placed into an office where you as the dentist diagnoses and delegates. Your patients are your own from diagnosis to treatment completion. General dentists typically see 8 – 12 patients per day and we value quality patient care with compassionate friendly service. You focus on your patients; our team will take care of staffing, payroll, purchasing, insurance, and the other administrative functions that keep a practice running smoothly. We also feature specialty care provided by skilled endodontists, oral surgeons, orthodontists, pedodontists, and periodontists providing an in-house services to your patients. Contact us today at to find out about our excellent compensation plans including: $215,000 annual average full-time general dentist earnings; Health benefits & 401(k) plan; Free group professional liability insurance; Continuing education programs; Life and AD&D insurance. Own your own practice? Coast offers a part-time schedule to supplement your own dental office. With almost 30 locations in a growing Florida and Georgia markets, we have opportunities for dentists at every stage of their career. Whether you want to live close to big-city amenities or prefer a family-friendly community, we invite you to call us today. As a licensed dentist, a general dentist provides general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures. Duties and Responsibilities: Perform all general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures; Examine patients to determine the nature of the condition affecting the patient, utilizing x-rays, dental instruments and other diagnostic procedures; Provide preventive dental services and education in oral and dental hygiene; Adhere to safety protocols and processes including but not limited to ensuring protective equipment is utilized and OSHA/Bloodborne pathogen requirements are followed; All other duties and responsibilities allowed under applicable state laws and regulations. Knowledge, Skills, and Abilities: Commitment to

quality patient care and enjoy educating patients on dental health; Effective communication skills; demonstrates professional and courteous demeanor with patients. Qualifications (Experience, Education, Licensure, Certification): DDS or DMD degree, licensed in state in which practicing or have the ability to obtain licensure upon graduation; Current Basic Life Support (BLS) and cardiopulmonary resuscitation (CPR) certificate; Completion of a general practice residency (GPR) or advanced education general dentistry residency (AEGD) preferred. ashley.rigsby@coastdental.com. General Dentist – Tallahassee. What’s most important to you? If it’s providing excellent patient care, earning a great living, and getting home in time for dinner, then we invite you to join our Coast Dental team in our office. We are currently hiring full-time and part-time Associate Dentists. And, Coast Dental makes the path to practice ownership easy if you are interested in becoming a Managing Partner Dentist. When you join our group practice, it’s your name on the door, so you maintain 100% clinical autonomy. You are placed into an office where you as the dentist diagnoses and delegates. Your patients are your own from diagnosis to treatment completion. General dentists typically see 8 – 12 patients per day and we value quality patient care with compassionate friendly service. You focus on your patients; our team will take care of staffing, payroll, purchasing, insurance, and the other administrative functions that keep a practice running smoothly. We also feature specialty care provided by skilled endodontists, oral surgeons, orthodontists, pedodontists, and periodontists providing an in-house services to your patients. Contact us today at to find out about our excellent compensation plans including: $215,000 annual average full-time general dentist earnings; Health benefits & 401(k) plan; Free group professional liability insurance; Continuing education programs; Life and AD&D insurance. Own your own practice? Coast offers a part-time schedule to supplement your own dental office. With almost 30 locations in a growing Florida and Georgia markets, we have opportunities for dentists at every stage of their career. Whether you want to live close to big-city amenities or prefer a family-friendly community, we invite you to call us today. As a licensed dentist, a general dentist provides general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures. Duties and Responsibilities: Perform all general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures; Examine patients to determine the nature of the condition affecting the patient, utilizing x-rays, dental instruments and other diagnostic procedures; Provide preventive dental services and education in oral and dental hygiene; Adhere to safety protocols and processes including but not limited to ensuring protective equipment is utilized and OSHA/Bloodborne pathogen requirements are followed; All other duties and responsibilities allowed under applicable state laws and regulations. Knowledge, Skills, and Abilities: Commitment to quality patient care and enjoy educating patients on dental health; Effective communication skills; demonstrates professional and courteous demeanor with patients. Qualifications (Experience, Education, Licensure, Certification): DDS or DMD degree, licensed in state in which practicing or have the ability to obtain licensure upon graduation; Current Basic Life Support (BLS) and cardiopulmonary resuscitation (CPR) certificate; Completion of a general practice residency (GPR) or advanced education general dentistry residency (AEGD) preferred. ashley.rigsby@coastdental.com.

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General Dentist – Crystal River. What’s most important to you? If it’s providing excellent patient care, earning a great living, and getting home in time for dinner, then we invite you to join our Coast Dental team in our office. We are currently hiring full-time and part-time Associate Dentists. And, Coast Dental makes the path to practice ownership easy if you are interested in becoming a Managing Partner Dentist. When you join our group practice, it’s your name on the door, so you maintain 100% clinical autonomy. You are placed into an office where you as the dentist diagnoses and delegates. Your patients are your own from diagnosis to treatment completion. General dentists typically see 8 – 12 patients per day and we value quality patient care with compassionate friendly service. You focus on your patients; our team will take care of staffing, payroll, purchasing, insurance, and the other administrative functions that keep a practice running smoothly. We also feature specialty care provided by skilled endodontists, oral surgeons, orthodontists, pedodontists, and periodontists providing an in-house services to your patients. Contact us today at to find out about our excellent compensation plans including: $215,000 annual average full-time general dentist earnings; Health benefits & 401(k) plan; Free group professional liability insurance; Continuing education programs; Life and AD&D insurance. Own your own practice? Coast offers a part-time schedule to supplement your own dental office. With almost 30 locations in a growing Florida and Georgia markets, we have opportunities for dentists at every stage of their career. Whether you want to live close to big-city amenities or prefer a family-friendly community, we invite you to call us today. As a licensed dentist, a general dentist provides general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures. Duties and Responsibilities: Perform all general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures; Examine patients to determine the nature of the condition affecting the patient, utilizing x-rays, dental instruments and other diagnostic procedures; Provide preventive dental services and education in oral and dental hygiene; Adhere to safety protocols and processes including but not limited to ensuring protective equipment is utilized and OSHA/Bloodborne pathogen requirements are followed; All other duties and responsibilities allowed under applicable state laws and regulations. Knowledge, Skills, and Abilities: Commitment to quality patient care and enjoy educating patients on dental health; Effective communication skills; demonstrates professional and courteous demeanor with patients. Qualifications (Experience, Education, Licensure, Certification): DDS or DMD degree, licensed in state in which practicing or have the ability to obtain licensure upon graduation; Current Basic Life Support (BLS) and cardiopulmonary resuscitation (CPR) certificate; Completion of a general practice residency (GPR) or advanced education general dentistry residency (AEGD) preferred. ashley.rigsby@coastdental.com.

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General Dentist – Venice. What’s most important to you? If it’s providing excellent patient care, earning a great living, and getting home in time for dinner, then we invite you to join our Coast Dental team in our office. We are currently hiring full-time and part-time Associate Dentists. And, Coast Dental makes the path to practice ownership easy if you are interested in becoming a Managing Partner Dentist. When you join our group practice, it’s your name on the door, so you maintain 100% clinical autonomy. You are placed into an office where you as the dentist diagnoses and delegates. Your patients are your own from diagnosis to treatment completion. General dentists typically see 8 – 12 patients per day and we value quality patient care with compassionate friendly service. You focus on your patients; our team will take care of staffing, payroll, purchasing, insurance, and the other administrative functions that keep a practice running smoothly. We also feature specialty care provided by skilled endodontists, oral surgeons, orthodontists, pedodontists, and periodontists providing an in-house services to your patients. Contact us today at to find out about our excellent compensation plans including: $215,000 annual average full-time general dentist earnings; Health benefits & 401(k) plan; Free group professional liability insurance; Continuing education programs; Life and AD&D insurance. Own your own practice? Coast offers a part-time schedule to supplement your own dental office. With almost 30 locations in a growing Florida and Georgia markets, we have opportunities for dentists at every stage of their career. Whether you want to live close to big-city amenities or prefer a family-friendly community, we invite you to call us today. As a licensed dentist, a general dentist provides general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures. Duties and Responsibilities: Perform all general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures; Examine patients to determine the nature of the condition affecting the patient, utilizing x-rays, dental instruments and other diagnostic procedures; Provide preventive dental services and education in oral and dental hygiene; Adhere to safety protocols and processes including but not limited to ensuring protective equipment is utilized and OSHA/Bloodborne pathogen requirements are followed; All other duties and responsibilities allowed under applicable state laws and regulations. Knowledge, Skills, and Abilities: Commitment to quality patient care and enjoy educating patients on dental health; Effective communication skills; demonstrates professional and courteous demeanor with patients. Qualifications (Experience, Education, Licensure, Certification): DDS or DMD degree, licensed in state in which practicing or have the ability to obtain licensure upon graduation; Current Basic Life Support (BLS) and cardiopulmonary resuscitation (CPR) certificate; Completion of a general practice residency (GPR) or advanced education general dentistry residency (AEGD) preferred. ashley.rigsby@ coastdental.com. General Dentist – Gainesville. What’s most important to you? If it’s providing excellent patient care, earning a great living, and getting home in time for dinner, then we invite you to join our Coast Dental team in our office. We are currently hiring full-time and part-time Associate Dentists. And, Coast Dental makes the path to practice ownership easy if you are interested in becoming a Managing Partner Dentist. When you join our group practice, it’s your name on the door, so you maintain 100% clinical autonomy. You are placed into an office where you as the dentist diagnoses and delegates.

NOVEMBER/DECEMBER 2018

Your patients are your own from diagnosis to treatment completion. General dentists typically see 8 – 12 patients per day and we value quality patient care with compassionate friendly service. You focus on your patients; our team will take care of staffing, payroll, purchasing, insurance, and the other administrative functions that keep a practice running smoothly. We also feature specialty care provided by skilled endodontists, oral surgeons, orthodontists, pedodontists, and periodontists providing an in-house services to your patients. Contact us today at to find out about our excellent compensation plans including: $215,000 annual average full-time general dentist earnings; Health benefits & 401(k) plan; Free group professional liability insurance; Continuing education programs; Life and AD&D insurance. Own your own practice? Coast offers a part-time schedule to supplement your own dental office. With almost 30 locations in a growing Florida and Georgia markets, we have opportunities for dentists at every stage of their career. Whether you want to live close to big-city amenities or prefer a family-friendly community, we invite you to call us today. As a licensed dentist, a general dentist provides general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures. Duties and Responsibilities: Perform all general dentistry services, including the diagnosis and treatment of diseases, injuries, and malformations of teeth, gums and related oral structures; Examine patients to determine the nature of the condition affecting the patient, utilizing x-rays, dental instruments and other diagnostic procedures; Provide preventive dental services and education in oral and dental hygiene; Adhere to safety protocols and processes including but not limited to ensuring protective equipment is utilized and OSHA/Bloodborne pathogen requirements are followed; All other duties and responsibilities allowed under applicable state laws and regulations. Knowledge, Skills, and Abilities: Commitment to quality patient care and enjoy educating patients on dental health; Effective communication skills; demonstrates professional and courteous demeanor with patients. Qualifications (Experience, Education, Licensure, Certification): DDS or DMD degree, licensed in state in which practicing or have the ability to obtain licensure upon graduation; Current Basic Life Support (BLS) and cardiopulmonary resuscitation (CPR) certificate; Completion of a general practice residency (GPR) or advanced education general dentistry residency (AEGD) preferred. ashley.rigsby@ coastdental.com. Associate Dentist – Lakeland, FL. Pacific Dental Supported Offices are currently looking for a full-time Associate Dentist to join our successful and growing practices in Lakeland, FL. This office is fully digitized and equipped with SiroLaser, CEREC® CAD/CAM, intraoral cameras, VELscope®, and digital X-rays. Our offices offer: Competitive earning potential, with no earning cap; Benefits, including: Medial, Dental, Vision, 401K; Our doctors pay all lab & Supply fees, malpractice insurance, and any CE credits taken through the PDS institute®; Mentorship and training; Great working environment, with a fun, friendly, and supportive team. If you would like to discuss the opportunity in more detail, please reach out directly by clicking REPLY. If you prefer to apply directly online, you can follow this link: bit.ly/2yQ9WEA. ASSOCIATE PLACEMENT SERVICES – Doctor’s Choice. Need an Associate? Need a job? General Dentist or Specialist? Call Melanie Aranda 561-310-0599 @ Doctor’s Choice e-mail: melanie.aranda@doctors-choice.com.

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Lead Dentist ($60-70k Production) - Lee County, FL. Are you a Fort Myers, FL based General Dentist seeking a patient focused practice? Our Lee County neighborhood office has a full-time opportunity for a seasoned, talented General Dentist to join our growing team! Enjoy a rewarding career with a full office staff (including Hygienist), a strong schedule and the ability to focus on quality patient care. Aggressive compensation/benefit package, dedicated staff, with a strong consistent patient schedule! Compensation: Strong Six Figure Annual Amount vs. Percent of Production; Possible Sign-On ($$$)! Benefits/Perks: Clinical Freedom and Treatment Autonomy; Patient Focus: Established and Growing Patient Foundation; Partnership Model – Doctor Care Path/Investment Opportunities; Full Benefits Offered – Healthcare & Dental Benefits, 401K, Short Term/Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues; Group Practice Camaraderie – Study Clubs, Chairside Mentoring, GEDC University Courses. Please view our Doctor Career Path video: screencast.com/t/M3xWM5CYN. For Questions, Please Contact: Ross Shoemaker, MBA | Doctor Recruiting Manager | Great Expressions Dental Centers. phone 678-836-2226 | fax 678-836-2144 |web www.greatexpressions.com. email Ross.Shoemaker@greatexpressions. com. Must have a DDS/DMD from an accredited University and active State Dental Board license. General Dentist & Specialist Opportunities in Central FL. Dental Care Alliance is a Dental Support Organization that was established in 1991 to provide comprehensive dental care to patients in 16 States. All DCA offices pride themselves on satisfying patient needs, providing high quality general and specialty dental services, and offering patient comfort that is second to none. DCA believes in providing a positive professional experience so that your goals can be achieved. We are one of the nation’s largest and most successful dental practice management companies because we understand that when you succeed, we succeed. We are currently recruiting General Dentist’s throughout Central Florida, with opportunities in Orlando, Clermont, Ocala, & Rockledge areas. We are recruiting FT Periodontists in the greater Orlando/Ocala area. We are recruiting FT Endodontists in the greater Orlando areas. Be chair side and make money from day one. Highly trained and dedicated staff to support you. No Day-to-Day headaches of Managing a Practice. Excellent compensation pkg. with performance-based incentives. Well-established and growing patient base. Full Time Dentist Benefits Package: Company paid professional liability insurance; DCA sponsored continuing education; Medical Insurance; Dental Plan; Life Insurance; Vision Insurance; Long Term Disability; Section 125 - Flexible Spending Account; 401K; EAP Program; DCA Voluntary Supplemental Insurance Products. Experienced providers or newly credentialed providers welcome! Licensed to practice in FL. Email resume to bames@dentalcarealliance.com. Learn more @ www.dentalcarealliance.com. NOTES: 5 openings. General Dentist Needed in Tallahassee, Florida. High quality private dental practice seeking a full-time associate. Our three doctors have an excellent practice with an exceptional staff and state of the art equipment. We are seeking a doctor with experience in all phases of dentistry. Our mission is to provide the highest quality care for each patient. Our professional staff is dedicated to our philosophy of quality care and team work. We do not participate in capitation plans. The doctors are experienced in all phases of general dentistry with an emphasis on implant placement and restoration and aesthetic procedures. They will provide an excellent mentorship opportunity. We are located in beautiful Tallahassee Florida. Tallahassee has a plethora of cultural opportunities with two major universities and a very large community college. It is located a short distance to the Gulf of Mexico. We offer benefits including health, professional liability and

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disability insurance. We also provide a 401k plan. We pay your continuing education expenses and professional dues. Please fax or mail your resume to: (850)386-8181. Drs. Chichetti, Torgerson and Hartley, 1305 Thomaswood Drive, Tallahassee, Florida 32308. Tallahasseedentists.net. General Dentist with current Florida License. Experience preferred but will consider recent graduate who is a team player. Must be available for 4.5-day workweek. Endodontist. Florida, Fort Lauderdale - Established, private endodontic multi-location practice in the Fort Lauderdale and Hollywood area seeking a motivated, compassionate, quality-driven endodontist for associateship. A Full-time position will be available in a modern CBCT and Microscope equipped practice. Our goal is to find a doctor who will provide our patients with exceptional care and will grow with us. There is an unlimited upside potential. We have been in practice for over 20 years, have an excellent reputation with our referrers and treat our patients, doctors and staff with great care. The doctors and a staff have the knowledge and experience that will help you make a seamless transition into your position with us. Please fax all inquiries and curriculum vitae to (978) 477-2671. Pediatric Dentist -Tampa, FL. Position availability — Spring/ Summer 2019. Private Pediatric dental practice - Noncorporate. Two office locations in the Tampa bay area. Newly renovated office has 15 chairs and is 5 days a week. 2nd office has 7 chairs and is a currently 2 days per week, with potential for growth. The ideal candidate I am seeking is full time, 5 days per week and will work at both office locations. PPO insurance and fee-for-service patients in both practices, no government plans or HMO plans. High-income potential, guaranteed $225K ++ in the first year with our compensation structure and patient volume. Both offices have digital radiographs and digital charting. In office IVsedation provided on a regular basis with a certified Pediatric Anesthesiologist group. Fully trained and certified pediatric dental staff in place. Orthodontic treatment is provided in both locations by an orthodontist in our practice. Full autonomy over treatment plans. Must have a current Florida dental license, previous experience in private practice is preferred but not necessary. Must be a certified pediatric dentist. Candidate should have excellent communication skills and enjoy a fast pace, fun work environment. We are now interviewing qualified candidates, if interested please email current CV to: sugarbugdude@gmail.com. We look forward to speaking with you. Kind Regards, CV to — sugarbugdude@gmail.com. Requirements: Must have a current Florida dental license. Previous experience in private or corporate offices is preferred. Must be a pediatric dental specialist. General Dentist’s, limited to children only, need not apply. Excellent communication and people skills. Endodontist OPPORTUNITY!! 25+ year, multi-doctor, privately owned family practice seeking a highly motivated and high character Endodontist to help treat our great patients and work with a wonderful and experienced team, in the Greater Orlando area. With nearly 2,000 5-Star reviews, join a successful practice and jump right in to a strong schedule with over 100 new patients a month waiting for quality, comprehensive care. Enjoy a high percentage-based compensation and an already established patient base. Please forward CV to Holly Strempel at hollymdmg@gmail.com.

percentage-based compensation and an opportunity for a stake in ownership. Please forward CV to Holly Strempel hollymdmg@gmail.com. Associate Dentist. Dr. Minh Pham, Owner of Dentists of South Naples, is currently looking for a full-time Associate Dentist to add to his successful and growing practice in Naples, FL. This office is fully digitized and equipped with SiroLaser, CEREC® CAD/CAM, intraoral cameras, VELscope®, and digital X-rays. Dr. Pham offers: Competitive earning potential, with no earning cap. Benefits, including: Medial, Dental, Vision, 401K ; Dr. Pham pays all lab & Supply fees, malpractice insurance, and any CE credits taken through the PDS institute®; Mentorship and training; Great working environment, with a fun, friendly, and supportive team. If you would like to discuss the opportunity in more detail, please reach out directly by clicking REPLY. If you prefer to apply directly online, you can follow this link: bit.ly/2yQ9WEA. Seeking Orthodontist- Tallahassee- FL. As a licensed dentist, an orthodontist examines, diagnoses, and treats abnormalities in development of jaws, position of teeth, and other dental-facial structures. Duties and Responsibilities: Examines, diagnoses, and treats abnormalities in development of jaws, position of teeth, and other dental-facial structures; Designs and fabricates appliances, such as space maintainers, retainers, and labial and lingual arch wires, to alter position and relationship of teeth and jaws, and to realign teeth to produce and maintain normal function; Examine patients to determine the nature of the condition affecting the patient, utilizing x-rays, dental instruments and other diagnostic procedures; Provides education in oral and dental hygiene; Supervise office staff, including hygienists, dental assistants, receptionists and other office staff; Adheres to safety protocols and processes including but not limited to ensuring protective equipment is utilized and OSHA/Bloodborne pathogen requirements are followed; Participate in morning huddles, chart reviews and routine office meetings; All other duties and responsibilities allowed under applicable state laws and regulations. Knowledge, Skills, and Abilities: Commitment to quality patient care and enjoy educating patients on dental health; Effective communication skills; demonstrates professional and courteous demeanor with patients. Qualifications (Experience, Education, Licensure, Certification): DDS or DMD degree, licensed in state in which practicing or have the ability to obtain licensure upon graduation; Completion of an orthodontic residency program; Current Basic Life Support (BLS) and cardiopulmonary resuscitation (CPR) certificate. Working Conditions: Orthodontists work in areas that are highly visible and designed and furnished to make a good impression. PART-TIME ORTHODONTIST. Our team is searching for a part-time ORTHODONTIST for 1500 DENTAL’s brand new, state-of-the-art facility located near downtown Fort Lauderdale. The practice is a 4,000 sq-ft Center for Complete Dentistry. It is conveniently situated approximately one mile from the ocean and adjacent to Nordstroms and Trader Joe’s, 1500 DENTAL offers partnership opportunities, continuing education, and a chance to work with South Florida’s most highly qualified multidisciplinary dental and administrative team. Please email CV and direct inquiries to: ADF@1500dental.com or (888) 800-4955 (facsimile). We look forward to hearing from you!

General Dentist OPPORTUNITY!! 25+ year, multi-doctor, privately owned family practice seeking a highly motivated and high character dentist to help treat our great patients and work with a wonderful and experienced team, in the Greater Orlando area. With nearly 2,000 5-Star reviews, join a successful practice and jump right in to a strong schedule with over 100 new patients a month waiting for quality, comprehensive care. Enjoy a base salary with

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off the cusp

IT'S THAT TIME OF YEAR Winter is coming. I think that has meaning for fans of Game of Thrones. For me, it means we’re entering the mean season. The weather won’t change, but attitudes do. It seems most folks are trying to get everything they can and if something is left over, maybe you can have it.

JOHN PAUL, DMD FDA EDITOR

Dr. Paul can be reached at jpaul@bot.floridadental.org.

The Publix nearest to the one where I shop has been torn down for remodeling, so traffic has doubled and people are fighting for parking places, nearly running over pedestrians. This year — earlier than ever — little old ladies I’m not used to shopping with are ramming my ankles with their carts, trying to get to that last box of Nutter Butters that’s on sale. It wouldn’t take a lot of work to start feeling sorry for myself, but I don’t have time for that. Have I told you I have two young daughters? Both will tell you, “We need constant supervision.” The younger is a daddy’s girl and if you give her a stick, she can tear up an anvil. They are in the photo above and you may note my elder has Down syndrome. We don’t keep it a secret and we don’t allow it as a reason for failures in basic citizenship. After I made a presentation to her class on Down syndrome, she has tried to make the excuse, “You know I have an extra chromosome.” Trisomy 21 has given my daughter an interesting gift. She simply does not process many of the things that make the rest of us feel sorry for ourselves. My beautiful 10-year-old daughter can put on designer clothes, high heel shoes and walk a New York runway in front of 1,500 strangers among bright lights and flashing cameras. She walks with confidence, flips her hair, turns and blows a kiss, and wins the hearts of the entire audience. I avoid cameras because of how I look in photos. All the snarky comments that we know people throw

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at her — about her looks, her intelligence, the future they are certain she is bound for or the one she will never have, for whatever reason — have no impact on her attitude. She’s a kid, so everything is not rainbows and unicorns, but a lot of the psychological things kids do to each other aren’t our problem. Her gift to us. This fall she was invited to New York and she walked in a show with people who are differently abled. The number of arms, legs and chromosomes did not average out to what we were taught is typical. She makes friends everywhere, including a young lady from Australia who also has Down syndrome and is widely known in the fashion industry. Her theme: When given the chance to do amazing things, we did so without hesitation. I thought about that when I watched one of the models cross the finish line of the New York marathon on crutches. I can’t imagine myself entering a marathon. I’ve been given great gifts. I’m allowed to practice the greatest profession in the world blending mental and physical skills to relieve pain, aid healing and create art. I hope I can live up to that young lady’s motto as well as she. P.S.: Look up the Runway of Dreams Foundation on the interweb. It’s a marvelous organization that focuses on making fashionable clothes for folks that might not be able to dress themselves in a typical manner. You can see photos of my daughter and all the friends she made one fall in New York doing good for folks who may not be as fortunate as themselves.

JOHN PAUL, DMD, EDITOR, TODAY'S FDA

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