Nov/Dec 2022 Issue of Today's FDA

Page 29

FDA Services FDA Foundation
Membership Leadership
FDC GAO
2 S C OTT RUTHSTROM • GeneralManager/COO scott.ruthstrom@fdaservices.com•850.350.7146 C A R R I E MI Director Of Insur erati o n s carrie.millar@fdaservices.com•850.350.7155 R I CK D ’ANGELO • WEST FLORIDA rick.dangelo@fdaservices.com •813. 475. 6 9 4 8 dennis.head@fdaservices.com•407.359. 9 7 0 0 DENNISHEAD • CENTRAL FLORIDA J OE PERRETTI • SOUTH FLORIDA joe.perretti@fdaservices.com•305. 665. 0 4 5 5 D A N ZOTTOLI•ATLANTIC COAST dan.zottoli@fdaservices.com•561. 791. 7 7 4 4 M I KE TROUT• NORTH FLORIDA mike.trout@fdaservices.com •904.254. 8 9 2 7 THE FDAS TEAM IS FOCUSED ON YOU AND YOUR PRACTICE MALPRACTICE • OFFICE INSURANCE • CYBER INSURANCE • WORKER’S COMP • DISABILITY Came for the insurance ... Stayed to support my profession.

Recap of the 2022 ADA House of Delegates

The Dentists Supply Company: Dental Supplies as a Member Benefit

2022 FDA President Dr. Jerry Bird

FDC2023: A Look at What’s to Come at FDCC2023 with FDC General Chair Dr. Becky Warnken

FDC2023 Speaker Preview: Your Patient, Your Duty

FDC2023 Speaker Preview: Have You Noticed Changes in Your Coverage for Dental Billing?

FDC2023 Speaker Preview: The 10 Financial Strategies to Succeed in Dentistry

Helping Members Succeed Throughout Florida!

1 | TODAY'S FDA november/december 2022 TABLE OF CONTENTS NOVEMBER/DECEMBER 2022 floridadental.org
7 46 CHECK OUT TODAY’S FDA ONLINE! IN EVERY ISSUE The Florida Dentist’s Guide to Peer Review 19 2 Staff Roster 4 Contributors 7 President’s Message 13 Did You Know? 19 Legislative 20 Preventive Action 22 news@fda 96 Diagnostic Discussion 100 Career Center 103 Advertising Index 104 Off the Cusp 8 |
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42 |
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56 |
58 |
60 |
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66 |
72 |
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MEMBERSHIP issue
But We Agreed They Were Independent Contractors
Massachusetts Ballot Question 2 Passed!
ADA and FDA Principles of Ethics and Codes of Professional Conduct
Stay Connected with the FDA
West Palm Beach 2023 FLA-MOM FAQs
What’s Your Why?
FDA Foundation Grants Aid to 209 Florida Dentists
Florida Dental Association By The Numbers!
The Florida Dentist’s Guide to Peer Review
So, You Want to Buy a New Computer?
Go Back-to-school for Radiography Certification
Highlighting FDA’s Event for Leaders Emerging Among Dentistry
Employment Agreements/Contracts
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84 | FDC2023 Exhibit Hall 86

545 John Knox Road, Ste. 200 • Tallahassee, FL 32303 • 800.877.9922 or 850.681.3629

EDITOR

Dr. Hugh Wunderlich, CDE • Palm Harbor

DIRECTOR OF PUBLICATIONS

Jill Runyan COMMUNICATIONS

PRESIDENT Dr. Gerald Bird • Cocoa

SECRETARY Dr. Dan Gesek • Jacksonville

AND

MEDIA COORDINATOR Kelsey Simmons

BOARD OF TRUSTEES

PRESIDENT-ELECT

• Miami

IMMEDIATE PAST PRESIDENT Dr. Dave Boden • Port St. Lucie

GRAPHIC DESIGN COORDINATOR

EXECUTIVE DIRECTOR Drew Eason, CAE • Tallahassee

Dr. Tom Brown • Orange Park | Dr. Christopher Bulnes • Tampa | Dr. John Coroba • Lake Mary | Dr. Bethany Douglas • Jacksonville Dr. Karen Glerum • Boynton Beach | Dr. Reese Harrison • Lynn Haven | Dr. Bertram Hughes • Gainesville | Dr. Mark Limosani • Weston Dr. Irene Marron-Tarrazzi • Miami | Dr. Eddie Martin • Pensacola | Dr. Paul Palo • Winter Haven | Dr. Mike Starr • Wellington Dr. Don lIkka • speaker of the house, Leesburg | Dr Rodrigo Romano • treasurer, Miami

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, to email Dr. Hugh Wunderlich, his email would be hwunderlich@bot.floridadental.org.

To call a specific staff member below, dial 850.350. followed by their extension.

EXECUTIVE OFFICE

Drew Eason • chief executive officer/executive director Greg Gruber • chief operating officer/chief financial officer Casey Stoutamire • director of third party payer and professional affairs Lianne Bell • leadership affairs manager Judy Stone • leadership affairs specialist Lywanda Tucker • peer review coordinator

ACCOUNTING

Breana Giblin • director of accounting

Leona Boutwell • finance services coordinator

Deanne Foy • finance services coordinator

Jamie Idol • FDAS support services coordinator

Mitzi Rye • fiscal services coordinator

Stephanie Taylor • membership dues coordinator

COMMUNICATIONS AND PUBLICATIONS

Renee Thompson

• director of communications and marketing

Jill Runyan • director of publications

AJ Gillis • graphic design coordinator

Kelsey Simmons • communications and media coordinator

FDA FOUNDATION

R. Jai Gillum • director of foundation affairs

Kristin Badeau • foundation coordinator

deason@floridadental.org • Ext. 7109 ggruber@floridadental.org • Ext. 7111 cstoutamire@floridadental.org • Ext. 7202 lbell@floridadental.org • Ext. 7114 jstone@floridadental.org • Ext. 7123 ltucker@floridadental.org • Ext. 7143

bgiblin@floridadental.org

• Ext. 7137 lboutwell@floridadental.org • Ext. 7138 dfoy@floridadental.org • Ext. 7165 jamie.idol@fdaservices.com • Ext. 7142 mrye@floridadental.org • Ext. 7139 staylor@floridadental.org • Ext. 7119

rthompson@floridadental.org • Ext. 7118 jrunyan@floridadental.org • Ext. 7113 agillis@floridadental.org • Ext. 7112 ksimmons@floridadental.org • Ext. 7115

rjaigillum@floridadental.org • Ext. 7117 kbadeau@floridadental.org

• Ext. 7161

2
AJ Gillis Dr. Beatriz Terry FIRST VICE PRESIDENT Dr. Jeffrey Ottley • Milton SECOND VICE PRESIDENT Dr. John Paul Lakeland

FLORIDA DENTAL CONVENTION AND CONTINUING EDUCATION

Crissy Tallman

• director of conventions and continuing education Mackenzie Johnson • FDC meeting assistant Brooke Martin • FDC marketing specialist Isabelle McCreless • FDC program coordinator

Lisa O’Donnell • FDC program coordinator Deirdre Rhodes • FDC exhibits coordinator

GOVERNMENTAL AFFAIRS

Joe Anne Hart • chief legislative officer

Alexandra Abboud • governmental affairs liaison Jamie Graves • legislative assistant

INFORMATION SYSTEMS

Larry Darnell

• director of information systems

Charles Vilardebo • computer support technician

MEMBER RELATIONS

Kerry Gómez-Ríos

• director of member relations

Megan Bakan • member access coordinator

Joshua Braswell • membership coordinator

Christine Trotto • membership concierge

FDA SERVICES

Scott Ruthstrom • chief operating officer

Carrie Millar • director of insurance operations

Carol Gaskins • commercial accounts manager Marcia Dutton • membership services assistant

Porschie Biggins • Central FL membership commercial account advisor Maria Brooks • South FL membership commercial account advisor

Davis Perkins • Atlantic Coast membership commercial account advisor Melissa Staggers • West Coast membership commercial account advisor Danielle Basista • commercial account advisor

Tessa Daniels • commercial account advisor Kelly Dee • commercial account advisor Liz Rich • commercial account advisor

ctallman@floridadental.org

• Ext. 7105 mjohnson@floridadental.org

• Ext. 7162 bmartin@floridadental.org • Ext. 7103 imccreless@floridadental.org • Ext. 7106 lodonnell@floridadental.org • Ext. 7120 drhodes@floridadental.org • Ext. 7108

jahart@floridadental.org • Ext. 7205 aabboud@floridadental.org • Ext. 7204 jgraves@floridadental.org • Ext. 7203

ldarnell@floridadental.org

• Ext. 7102 cvilardebo@floridadental.org • Ext. 7153

krios@floridadental.org • Ext. 7121 mbakan@floridadental.org • Ext. 7100 jbraswell@floridadental.org • Ext. 7110 ctrotto@floridadental.org • Ext. 7136

545 John Knox Road, Ste. 201 • Tallahassee, FL 32303 • 800.877.7597 or 850.681.2996

scott.ruthstrom@fdaservices.com • Ext. 7146 carrie.millar@fdaservices.com • Ext. 7155 carol.gaskins@fdaservices.com • Ext. 7159 marcia.dutton@fdaservices.com • Ext. 7148 porschie.biggins@fdaservices.com • Ext. 7149 maria.brooks@fdaservices.com • Ext. 7144 davis.perkins@fdaservices.com • Ext. 7145 melissa.staggers@fdaservices.com • Ext. 7154 dbasista@fdaservices.com • Ext. 7156 tessa.daniels@fdaservices.com • Ext. 7158 kelly.dee@fdaservices.com • Ext. 7157 liz.rich@fdaservices.com • Ext. 7171

• Boat

YOUR RISK EXPERTS

Dan Zottoli, SBCS, DIF, LTCP

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 cell: 407.927.5472 dennis.head@fdaservices.com

Mike Trout

director of sales • North Florida cell: 904.254.8927 mike.trout@fdaservices.com

Joseph Perretti, SBCS

director of sales • South Florida 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

3 | TODAY'S FDA november/december 2022
Group & Individual Health • Medicare Supplement • Life Insurance • Disability Income • Long-term Care • Annuities Professional Liability • Office Package • Workers’ Compensation • Auto
4 november/december 2022
GUEST CONTRIBUTORS
FDA
INFORMATION SYSTEMS
Page 56
Page
LARRY SANGRIK, DDS ljsangrikdds@aol.com Page 74 MADISON SCHWARZ TDSC.COM Madison.Schwarz@tdsc.com Page 64
WARNKEN, DDS rwarnkendds@gmail.com Page 72
R. PITTS, DMD james.pitts@jwcemail.com Page 80 CHRISTIN TAXIN ctaxin@links2success.biz Page 78
CASEY LYNN, DMD cclynn09@gmail.com Page 34 DEBORAH S. MINNIS AUSLEY MCMULLEN dminnis@ausley.com Page 8
LARRY DARNELL, MBA, CAE
DIRECTOR OF
ldarnell@floridadental.org
JOHN PAUL, DMD FDA SECOND VICE PRESIDENT jpaul@bot.floridadental.org Page 28 BRYAN T. MARSHALL, DDS, MBA btmarshall@msn.com
62 ANGELA MCNEIGHT, DMD, MS angela.mcneight@gmail.com Page 60
BECKY
JAMES

SAJA ALRAMADHAN, BDS oralpath@dental.ufl.edu

Page 96

JERRY BIRD, DDS FDA PRESIDENT gbird@floridadental.org 850.681.3629

Page 7

CASEY STOUTAMIRE, ESQ.

FDA DIRECTOR OF THIRD PARTY PAYER & PROFESSIONAL AFFAIRS cstoutamire@floridadental.org 850.350.7202

Page 13

INDRANEEL BHATTACHARYYA, DDS oralpath@dental.ufl.edu Page 96

JOE ANNE HART

FDA CHIEF LEGISLATIVE OFFICER jahart@floridadental.org 850.350.7205

Page 19

NADIM M. ISLAM, DDS oralpath@dental.ufl.edu Page 96

RENEE THOMPSON

FDA DIRECTOR OF COMMUNICATIONS AND MARKETING rthompson@floridadental.org 850.350.7118

Page 46

HUGH WUNDERLICH, DDS, CDE FDA EDITOR hwunderlich@bot.floridadental.org 850.681.3629

Page 104

5 | TODAY'S FDA november/december 2022
november/december 2022
CONTRIBUTORS

FLORIDA DENTAL CHATTER

6
This Facebook group
Join us at
is designed for dentists to interact with other members, receive the latest updates and information, and engage with FDA leaders and sta . This is the place to be in the know!
facebook.com/groups/floridadentalchatter.
ARE YOU A MEMBER OF FDAPAC CENTURY CLUB? Join now: floridadental.org/centuryclub A portion of your required dues is transferred to the Florida Dental Association Political Action Committee (FDAPAC). FDAPAC provides campaign contributions to dental-friendly candidates. FDAPAC Century Club members provide additional financial support of $150 or more for state campaigns. FDAPAC dues and contributions are not deductible for federal income-tax purposes. “Your support of the PAC helps the FDA build relationships with leaders who will be making important decisions in Tallahassee that will impact our profession and our patients.” — Dr.
Dr. Rudy Liddell FDAPAC Chair
Rudy Liddell

Why is Membership in the FDA Important?

Helping members succeed and supporting the health of the public are goals of the Florida Dental Association (FDA). As our professional organization, the FDA helps us from the beginning of our careers to the end and remains focused on our success as dentists and in our personal lives.

When I opened my practice in 1985, the FDA helped me navi gate the business side of dentistry. I have gained many friends, colleagues and mentors through the FDA. But what does mem bership in an organization really mean? There are many organi zations that we will join. Some we join to get something tangible in return. Organizations like AARP or clubs like Costco and Sam’s save us money by buying a membership; but that is about it. There are other organizations that we join because they fulfill us in some way – our church or synagogue. We join a family or a group that supports what we believe. Maybe it’s a volunteer club like Rotary, Kiwanis, Moose or Junior League. We give money and participate in their activities, but it may just be for a time or a season in our lives.

Then there are organizations like the FDA that are there to help make the road easier for us and have tangible benefits that are worthwhile to our business and profession. This is where we, as professionals, can make a difference in our chosen field of den tistry. This is more than a commitment – this is our career. We invested a lot of time, energy and money into our education and made many sacrifices along the way. Now we are in a practice, and we would like it to be productive, fulfilling and have longev ity. In addition, we may have a family and a home now, so there are more reasons to protect our investment.

As a dentist in Florida, you need to decide: Do I want to be a bystander, or do I want to be involved? Do I want to see what’s happening that can affect me, my profession and my family? What are the new advances, how can I improve what I do and make it better? What are the threats that linger out there that could affect my practice? That’s why we as dentists organized into an association – many voices make the best decisions and make the biggest difference.

The FDA has an amazing team of professionals at the ready to help us navigate the challenges of practice. They help us in ad vocacy by supporting dental-friendly candidates and legislation, helping our patients get access to quality dental care, purchasing insurance products for our office and team members, providing us with the best continuing education at the best dental meeting ever – the Florida Dental Convention – and so much more. The FDA, together with the American Dental Association, delivers programs, services, and advocacy to maximize value and service at every level.

As a member dentist of the FDA, you are ensuring that your investment in your profession is protected. As dentists in Florida, our strength and voice make a difference in our profession and comes from the unity of our member dentists. Encourage your friends who are not members to join and remember to invite that new dentist who just moved into your community to a local meeting or to coffee. A personal ask is the best recruitment tool for membership. It takes all of us and we cannot do it without YOU!

Join us today and let’s succeed together!

7 | TODAY'S FDA november/december 2022
president’s message

But We Agreed They Were Independent Contractors

Many companies and individuals attempt to maintain flexibility in their work relationships by entering into independent contractor agreements. However, these agreements can create serious tax and employment problems for companies. The fact that the parties have agreed to an independent contractor arrangement, have acted on that agreement, and have signed a document titled “independent contractor agreement” is not binding on the Internal Reve nue Service (IRS) or the agencies enforcing employment laws or the courts interpreting those laws.

Misclassifying an employee as an independent contractor can often result in unpleasant surprises for the company. By way of example, Company A terminates a contract with an individual working as an independent contractor. The disgruntled “independent contractor,” believing he/she was really treated as an employee, goes on the internet to the U.S. Depart ment of Labor Division of Wages and Hours (USDOL) to complain. (This is the division that enforces the federal overtime laws.) Based on the information provided to them, the agents of the USDOL decide that the individual was really an employee and not an independent contractor, resulting in the company possibly ending up owing the person overtime pay for two to three years.

” ”

8
Misclassifying an employee as an independent contractor can often result in unpleasant surprises for the company.

human resources

Three major areas where I most often see these types of issues are when former alleged independent contractors are audited by the IRS, have filed discrimination claims with the Equal Employ ment Opportunity Commission (EEOC), or have claimed overtime with the USDOL under the Fair Labor Standards Act (FLSA). The IRS, the EEOC and the USDOL each consider slightly different factors in determining the existence of an employer/employee relationship. Please see a brief overview of each.

IRS FACTORS: As a general rule, the IRS considers whether the company controls the method of work and not just the final out come. The more control the company exercises over the method of the work, the more likely the relationship will be determined to be that of employer/employee.

The IRS considers several factors broken into three categories: (1) behavioral control; (2) financial control; and (3) type of relationship.

1. Behavioral Control

a. Whether the company controls when and where the work is done.

b. Whether the company controls what tools or equipment are used.

c. Whether the company controls in what order and sequence the work is to be done.

d. The degree of instruction provided by the company – the more detailed the instructions the more control is being exercised.

e. Whether the company evaluates the individual on how the work is being performed, i.e., not just the end result.

f. Whether the company provides training on how to do the job. This demonstrates that the business wants the job done in a particular way and is strong evidence of an employer/employee relationship.

2. Financial Control

a. Does the individual have a significant investment in the equipment she/he uses? True independent contractors have a significant investment in equipment.

b. Are there unreimbursed expenses? Independent contractors have no unreimbursed expenses.

c. Is there is an opportunity for profit or loss by the individual providing the service?

d. Are the individual’s services generally available to the market?

e. How is the individual compensated? Independent contractors have a flat fee versus employees, who are paid a regular amount based on an hourly, weekly or monthly pattern.

3. Type of Relationship

a. Is there a written contract? However, note the IRS guidance specifically states that it is not required to follow the language in the contract.

b. Does the individual receive benefits, i.e., insurance, pension, vacation, sick leave and disability benefits?

c. How permanent is the relationship? If the relationship continues indefinitely, this indicates an employer/ employee relationship.

d. Are the services provided a key activity of the business? If so, the business is more likely to have the right to direct and control the person’s activities in how the services are performed.

FAIR LABOR STANDARDS ACT FACTORS: In its Fact Sheet #13, the USDOL sets out the factors it considers in determining what type of relationship exists. The following are among the factors considered:

l The extent to which the services rendered are an integral part of the company’s business.

l The permanency of the relationship.

l The amount of the alleged contractor’s investment in facilities and equipment.

l The nature and degree of control by the company.

l The alleged contractor’s opportunity for profit and loss.

l The amount of initiative, judgment, or foresight in open market competition with others required for the success of the claimed independent contractor.

9 | TODAY'S FDA november/december 2022
t

human resources

l The degree of independent business organization and operation engaged in by the claimed independent contractor.

While there is some overlap between these factors and the IRS factors, each agency has authority to interpret its factors indepen dent of the others.

In addition, the USDOL factors used to determine the existence or non-existence of an employer/employee relationship are also regularly interpreted by the various federal and state courts. The courts, in making their determinations on this issue, do not consider one factor over the others but have held that the total activity or situation controls. In its Fact Sheet #13, the USDOL also specifically states, among other factors not considered, the fact that the alleged independent contractor is licensed by state/local government does not have a bearing on its determination.

EEOC INDEPENDENT CONTRACTOR CHECKLIST: The EEOC administers most discrimination laws, such as Title VII, the Age Discrimination in Employment Act, the Pregnancy Discrimination Act, and the Americans with Disabilities Act. The EEOC considers the following factors:

l Does the company have the right to control when, where and how the work is performed?

l Does the work require a high level of skill or expertise?

l Does the company furnish the tools, materials and equipment that are used?

l Is the work performed on the company’s premises?

l Is there a continuing relationship between the company and the individual?

l Does the company have the right to assign additional projects to the individual?

l Does the company set the hours of work and the duration of the job?

l Is the individual paid by the hour, week or month rather than an agreed upon cost for performing the particular job?

l Does the individual hire and pay assistants?

l Is the work performed by the individual a regular part of the company’s business?

l Is the company in business?

l Is the individual engaged in his/her own distinct occupation or business?

l Does the company provide the individual benefits such as insurance, leave, or workers’ compensation?

l Is the individual considered an employee for tax purposes?

l Can the company discharge the individual?

l What type of relationship do the company and the individual believe they are creating?

This is not an exhaustive list; the EEOC and the courts can con sider other factors and circumstances they deem relevant to de termine the issue. No one factor is controlling. Answering “yes” to some or all of these factors generally indicates that the individual is an employee and not an independent contractor.

CONCLUSION: In conclusion, my previous statement bears repeating: the fact that the parties have agreed to an independent contractor arrangement, have acted on that agreement, and have signed a document titled “indepen dent contractor agreement” is not binding on the IRS or the agencies enforcing employment laws or the courts interpreting those laws. To the extent you currently have individuals you believe to be independent contractors, those agreements and your relationships with those individuals should be carefully reviewed. To the extent you are considering entering into such agreements or relationships in the future, you should carefully review and analyze the agreement and the specifics of the rela tionship before the provision of services begins.

This article is for informational purposes only and is not intended to be a substitute for professional legal advice. If you have a specif ic concern or need legal advice regarding your dental practice, you should contact a qualified attorney.

11 | TODAY'S FDA november/december 2022

OPIOIDS

SUMMARY: HEALTH CARE PROVIDER CHECKLIST:

INFORM

Non-opioid alternatives for pain treatment, which may include non-opioid medicinal drugs or drug products are available

Non-opioid interventional procedures or treatments, which may include: acupuncture, chiropractic treatments, massage, physical or occupational therapy, or other appropriate therapy are available.

DISCUSS

A dv an t ages an d d isa dv an t ages o f n o n- o pi o i d a lt erna t i v es Pa t ien t ’s risk o r h is to r y o f c o n t r oll e d s u bs t ance ab u se o r mis u se , an d pa t ien t ’s pers o na l preferences .

DOCUMENT IN PATIENT’S RECORD

N o n- o pi o i d a lt erna t i v es c o nsi d ere d . PROVIDE

“Alternatives to Opioids,” an educational information pamphlet created by the Florida Department of Health printed or in electronic format (required, available at bit.ly/2KXvZ2h). Also, a checklist and poster.

All health care providers must include non-opioid alternatives for pain and pain management electronically or in printed form in their discussions with patients before providing anesthesia, or prescribing, ordering, dispensing or administering a schedule II controlled substance for the treatment of pain. Effective July 1, 2021.

FOR THE LATEST ON OPIOIDS, GO TO: FLORIDADENTAL.ORG/NYK

12
NON-OPIOID ALTERNATIVES LAW: GO TO bit.ly/2KXvZ2h Exclusive Member Benefit!

Dentists May Delegate

Remedial Restorative Functions

Did you know that effective June 26, 2019, a den tist may delegate remedial restorative functions to a dental assistant or to a dental hygienist who has completed the mandatory training offered by an accredited dental or dental hygiene program?

What restorative functions are delegable? Look at the top of the following page for a current list. What are the prerequisites for dental assistants as well as what training is required? Look on the following page for information.

What are the responsibilities of the delegating dentist? Look on page 14 and 15 for a list.

13 | TODAY'S FDA november/december 2022 did you
know?
” The delegating and supervising dentist shall remain fully responsible for all delegated tasks and for ensuring that the dental assistant or dental hygienist meets the training requirements of this rule.
t

New! DENTISTS MAY DELEGATE REMEDIAL RESTORATIVE FUNCTIONS

What restorative functions are delegable?

All functions delegated shall be performed under direct supervision.

The delegating and supervising dentist shall remain fully responsible for all delegated tasks and for ensuring that the dental assistant or dental hygienist meets the training requirements of this rule

After a dentist has prepared a tooth, a dentist may delegate to a dental assistant or hygienist the task of placing, packing and con touring amalgam and composite restorations, and the fitting and contouring of stainless steel crowns (tasks).

Does not include permanently cementing stainless steel crowns. The tasks shall only be performed using a slow-speed handpiece and hand instruments.

FOR DENTAL ASSISTANTS

What are the prerequisites?

To be eligible to be admitted into the mandatory training course required by rule, a dental assistant (candidate) shall meet the following conditions:

Be at least 18 years of age

Be a high school graduate or have a High School Equivalency Certificate

Have a current Basic Life Support for Healthcare Provider certifi cate

Be a graduate of a dental assisting program that is accredited by a dental accrediting entity recognized by the United

What training is required?

The training course shall be offered by a dental or dental hygiene school or program that is accredited by a dental accrediting entity recognized by the United States DOE.

At a minimum, the training shall include and contain the following: 105 clock hours, including a minimum of 10 hours dedicated to preclinical didactic hours (may be offered online).

• At the completion of the preclinical didactic hours, the course shall require the passing of an initial written exam ination prior to the clinical portion of the training. A passing score shall require a score of 75% or above

A clinical portion consisting of a minimum of 70 hours dedi cated to simulated lab, minimum of 25 hours dedicated to live patients.

A clinical and lab session for Amalgam Restorations Class I, II, and V, which shall include live patients.

A clinical and lab session for Composite Restorations Class I, II, III, and V, which shall include live patients.

A clinical and lab session to size, fit and contour, but not per manently cement, stainless steel crowns, which shall include live patients.

States Department of Education (DOE) or shall have received formal training in expanded duties.

Never had a dental assisting license suspended or revoked in any jurisdiction.

Within 24 months prior to being admitted to the mandatory training course, the candidate must have documented proof of 2,400 hours of clinical work experience in either a dental office or as an educator of dental assisting.

The training program shall ensure that the candidate meets all the qualifications before accepting the candidate into the training program.

The training program shall verify competency by requiring an exit or final written examination and clinical examination that includes live patients.

The written portion of the examination shall include a section covering the Laws and Rules of Dentistry in Florida.

A passing score shall require a 75% or above on both the writ ten and clinical examination, and the examinations shall not be weighted to achieve an overall score of 75% or better

The clock hours dedicated to the exit or final written and clini cal examination shall not count towards the required minimum 105 total clock hours required by the course

Upon the successful completion of the training course, a certifi cate of successful completion of the Restorative Function Course shall be issued. The delegating dentist shall ensure that a copy of this certificate is immediately available at the location where tasks are delegated, and the certificate shall be produced by the dentist when requested by the Board of Dentistry (BOD) office or any authorized inspector

14
did you know?

Effective June 26, 2019, a dentist may delegate remedial restorative functions to a dental assistant or to a dental hygienist who has completed the mandatory training offered by an accredited dental or dental hygiene program.

What are the responsibilities of the delegating dentist?

Shall not supervise more than four dental hygienists or dental assistants in combination who are simultaneously performing the tasks.

Shall ensure that the patient’s dental chart is annotated to reflect the initials of the dental assistant who performed the tasks.

Shall ensure that the patient’s dental chart reflects that the final restoration was verified by the delegating dentist and the result of the verification also shall be documented.

FOR DENTAL HYGIENISTS

What are the prerequisites?

To be eligible to be admitted into the mandatory training course required by rule, a dental hygienist (candidate) shall meet the following conditions:

Be at least 18 years of age

Be a high school graduate or have a High School Equivalency Certificate

Have a current Basic Life Support for Healthcare Provider cer tificate

Have an active unrestricted dental hygiene license from any U S. state or territory.

Never had a dental hygiene license suspended or revoked in any jurisdiction.

What training is required?

The training course shall be offered by a dental or dental hygiene school or program that is accredited by a dental accrediting entity recognized by the United States DOE.

At a minimum, the training shall include and contain the following: 85 clock hours, including a minimum of five hours dedicated to preclinical didactic hours (may be done online), and a clinical portion consisting of a minimum 55 hours dedicated to simu lated lab and a minimum of 25 hours dedicated to live patients.

• At the completion of the preclinical didactic hours, the course shall require the passing of an initial written exam ination prior to the clinical portion of the training. A passing score shall require a score of 75% or above

A clinical and lab session for Amalgam Restorations Class I, II, and V, which shall include live patients.

A clinical and lab session for Composite Restorations Class I, II, III, and V, which shall include live patients.

A clinical and lab session to size, fit and contour, but not per manently cement, stainless steel crowns, which shall include live patients.

Within 24 months prior to being admitted to the mandatory training course, the candidate must have documented proof of 2,400 hours of clinical work experience in either:

• a dental office

• as an educator of dental hygiene

• is a graduate of a dental hygiene program, accredited by a dental accrediting entity recognized by the United States DOE, within 24 months prior to being admitted to the man datory training course

• The training program shall ensure that the candidate meets all the qualifications before accepting the candi date into the training program.

The training program shall verify competency by requiring an exit or final written examination and clinical examination that includes live patients.

The written portion of the examination shall include a section covering the Laws and Rules of Dentistry in Florida.

A passing score shall require a 75% or above on both the writ ten and clinical examination, and the examinations shall not be weighted to achieve an overall score of 75% or better

The clock hours dedicated to the exit or final written and clini cal examination shall not count towards the required minimum 85 total clock hours required by the course

Upon the successful completion of the training course, a certifi cate of successful completion of the Restorative Function Course shall be issued The delegating dentist shall ensure that a copy of this certificate is immediately available at the location where tasks are delegated, and the certificate shall be produced by the dentist when requested by the BOD office or any authorized inspector

15 | TODAY'S FDA november/december 2022
did you know?

IN THE KNOW WITH GAO

Webinar series for FDA members to stay informed on legislative and political issues.

The Florida Dental Association’s Governmental Affairs Office (GAO) would like to invite you to join in on our listening sessions to learn about legislative issues that may have an impact on the dental profession, political issues that could affect the dental industry, and a number of other hot topics that may be of interest to you!

The listening sessions will be scheduled for mid-afternoon, 30-minutes long and will allow you to ask questions of the speakers. These sessions are meant to give you a quick update on issues and topics during your lunch hour, without interrupting the flow of your day.

POTENTIAL GUESTS:

• Elected officials (federal, state and local)

• Candidates running for office

• State agency and department heads

• FDA Members

• National dental leaders/experts

GOVERNMENTAL AFFAIRS TEAM:

Chief Legislative Officer

jahart@floridadental.org

Governmental Affairs Liason aabboud@floridadental.org

Legislative Assistant jgraves@floridadental.org

18
ALEXANDRA ABBOUD

Addressing the Dental Workforce Shortages

It is no secret, workforce has become an issue for many indus tries, including dentistry. Not only did the pandemic create a hes itancy for dental hygienists and dental assistants to come back to the dental office, but it also exposed other workplace dilemmas that will have to be addressed in order to drive and keep dental hygienists and dental assistants in the dental profession. The Florida Dental Association (FDA), through its Workforce Innova tion Task Group, has been engaging with interested stakeholders on how to address this issue. The ideal solution would involve a quick fix to remedy the dental workforce issue, but because it is important to maintain the standards of educating and training qualified dental auxiliary, we must look to other options before compromising standards.

The American Dental Association’s (ADA) Health Policy Insti tute (HPI) recently released a report that took a deep dive into researching the parameters around the issues driving dental workforce shortages. In addition to concerns involving the pandemic, dental hygienists and dental assistants noted several issues they feel haven’t been sufficiently addressed within the dental workforce culture. Many have concerns about benefits and compensation packages and have expressed a desire for more inclusion in the dental office, to be seen as a part of the dental team. It is important for dentists to evaluate the status of the labor market in order to remain competitive. The pandemic

opened the doors for employees to demand more flexibility in their work schedules, heightened the desire for work-from-home options, negotiate for more compensation and paid-time-off, and the list goes on. Not all of these demands will be viable or met within the dental industry, but they can’t be ignored. The HPI report states that even if these demands are met, there will still be an ongoing dental workforce shortage that will take long-term solutions to adequately address. To access the HPI report titled “Dental Workforce Shortages: Data to Navigate Today’s Labor Market,” go to bit.ly/3D6XHFi.

In the meantime, the FDA hosted a webinar on addressing the dental workforce shortages. Dr. James Younger, owner and cre ator of TempStars, is a practicing dentist in Canada, who has en tered the market with a new spin on temporary staffing services. As a dentist, he truly understands the unique challenges a dental office faces when dental auxiliary is not dependable. TempStars just may be a temporary solution that could help address the need now in dental offices as long-term solutions are implement ed. To view the webinar about TempStars, go to bit.ly/3VMMWiK

The FDA’s Workforce Innovation Task Group will continue to meet to address the dental workforce issues and we would love to hear directly from you. If you have any information you would like to share, please contact Joe Anne Hart at jahart@floridadental. org

19 | TODAY'S FDA november/december 2022
legislative

Now is the Time to Make Sure You Are OSHA Compliant!

OSHA — just four letters, but a word that holds so much importance in health care. The four-letter acronym is short for Occupational Safety and Health Administration and was given life by the OSH Act of 1970, with the ultimate goal of reducing on the job injuries, illnesses and deaths across America. And, because we’re big believers in data and the occasional name drop, we will share this little tidbit: since the introduction of the OSH Act, workplace fatalities have been cut by more than 60%, and occupational injury and illness rates have declined by 40%.

20 preventive action

Now, we hope that your practice isn’t stuck in the Stone Age with some bulky paper binder that houses your OSHA program. We are here to tell you it’s time to dust it off and toss it in the dumpster. Between all the policies, forms and laws, there are more than 40 policies and pro cedures that are required for you to be compliant. While they are tedious and require a ton of knowledge to pull them together, OSHA is in place to promote a safe and healthful work environment — not to mention that state and federal regulations are always changing. And, when your focus should be on your patients, who really has time to keep up with that?

Did you also know that all employees should be complet ing training on an annual basis? From hazard communi cation to bloodborne pathogens and everything in be tween, there are more than a handful of topics that your employees should be knowledgeable and comfortable with to best perform their jobs. Unfortunately, it doesn’t seem like Netflix is adding OSHA training to their new releases anytime soon — although, we would probably give it five stars.

Even though we could chat about this for days, we will just leave you with this piece of advice. In addition to the rights you have as an individual employee, there also comes responsibilities in protecting yourself, your

co-workers, visitors and patients. Your workplace might have their own specific requirements, but general OSHA guidelines for employees include:

Reading and following all health and safety postings. Following safe work practices.

Helping to reduce work hazards.

Reporting all occupational injuries and illnesses. Reporting hazardous conditions.

Cooperating during an OSHA inspection. Exercising rights under the OSH Act in a responsible manner.

Whether you’re a newbie or an expert, Abyde is here to help you make sense of all the mumbo jumbo that comes along with OSHA. As your Crown Savings partner, it is our job and our passion to ensure you’re well equipped to take on any OSHA (and HIPAA!) challenge that comes your way. Since we’re all proud residents of the Sunshine State and never get the chance to truly embrace wearing the added layers of scarves and mittens in the winter, we do have some options for you to “bundle up” with our HIPAA and OSHA solutions – we encourage you to check them out!

21 | TODAY'S FDA november/december 2022
Since the introduction of the OSH Act, workplace fatalities have been cut by more than 60%, and occupational injury and illness rates have declined by 40%.

Volunteer Registration is OPEN for the 2023 Mercy is 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 under-served and uninsured in Flori da – those who would otherwise go without care.

The Atlantic Coast District Dental Association and the FDA Foun dation will be hosting the 2023 FLA-MOM in West Palm Beach Feb. 24-25 at the Expo Center at the South Florida Fairgrounds. With a goal of treating 2,000 patients – we need You!

Visit FLAMOM.org today and register to volunteer! Clinical volun teers including dentists of all specialties, dental hygienists and as sistants, and medical professionals such as physicians, EMTs and nurses are needed. In addition, general volunteers are needed to assist with registration, clinic setup, data entry, escorting patients, translating and more.

Questions? Please email foundation@floridadental.org or call 800.877.9922.

Freedom to Smile — Register for the 2023 Dentists’ Day On The Hill!

All Floridians deserve the “Freedom to Smile!” It shouldn’t matter where you live or how much money you make, everyone de serves to receive quality dental care from a licensed dentist. As an FDA member, you know and can help ensure this by coming to Tallahassee to advocate for the FDA’s legislative priorities.

During the 2023 Dentists’ Day on the Hill (DDOH) on Tuesday, March 28, FDA members, along with spouses and dental students,

2023 DENTISTS’ DAY ON THE HILL

Tuesday, March 28, 2023

FREEDOM TO SMILE!

Monday, March 27, 2023 Legislative Briefing 6 p.m. at Hotel Duval Complimentary dinner to follow

Tuesday, March 28, 2023 Capitol Visits Lunch provided

will meet with legislators and advocate for policies that will help better the oral health of patients in the state.

Register today at bit.ly/3hqDy4v to keep a healthy smile on all Floridians’ faces!

Hotel Room Block Hotel Duval - $209 a night Click here to reserve

A legislative briefing will take place on Monday, March 27, at 6 p.m. at Hotel Duval with a complimentary buffet dinner to follow. If you plan on attending the briefing and dinner, please add both items during your registration.

850.224.1089 or gao@floridaental.org.

The FDA has a room block at Hotel Duval for $209 a night. To book your room, please call 850.224.6000 and reference “Florida Dentists’ Day on the Hill” or go to bit.ly/3fOi94X. Rooms for this event fill up quickly so reserve your room today!

Please note: Room reservations should only be made for yourself/ parties staying in the same room. Multiple rooms reserved under one name for any affiliate or district may be subject to cancellation by the FDA. Thank you for your cooperation.

Information regarding DDOH will be sent periodically to regis trants throughout the year and up until the event. Register as soon as possible to receive timely information! If you have any questions, please contact Governmental Affairs Liaison Alexandra Abboud at 850.224.1089 or aabboud@floridadental.org

Flood Insurance is Available!

FDA Services recommends that ALL dental practices carry a flood insurance policy, especially since this is NOT covered on an office insurance policy. Practices can write a policy with the national flood program or a private flood carrier. Keep in mind a standard 30-day waiting period applies. Call or text 850.681.2996 to get a quote today!

22 news@fda
For
Click here or scan the code above to register
more information, please contact the FDA Governmental Affairs Office at

Get Ready for Stellar Education to Keep “Launching Dentistry

Forward” at FDC2023!

Save the dates for FDC2023, June 29-July 1, at the Gaylord Palms Resort & Convention Center in Orlando where you can attend courses on the latest trends, technologies and techniques to keep “Launching Dentistry Forward.” Course highlights include Dawson Seminar 1, clear aligner therapy, platelet-rich fibrin therapy, crown lengthening, implant advancements, geriatric and spe cial needs care, salivary diagnostics, and much more. Go to bit. ly/3UBXwaE to check out the full list of course offerings and their details. As always, FDA members can take advantage of free reg istration, free course options and discounted registration fees for team members. Go to to bit.ly/3UBXwaE to search all FDC2023 courses and speakers.

Captain Samira Meymand, DDS, MPH

Captain Samira “Sam” Meymad serves as the Captain of 14th Dental Company, 4th Dental Battalion lead ing the dental readiness of Marines and Sailors along the East Coast. Capt. Meymand quickly climbed the ranks of leadership, most recently to Captain in October 2022.

After completing her Oral and Max illofacial surgery residency, Capt. Meymand deployed on the USNS Comfort (TAH-10) Navy ship in 2009 where she performed oral surgery and even served as Chief of Oral Maxillofacial Surgery. She also served side-by-side with plastic surgeons assisting in cleft lip and palate treatment with Operation Smile.

With her most recent rank promotion, Capt. Meymand continues to look for opportunities to mentor sailors coming up through the ranks, as she knows the challenges and sacrifices that come with being a military officer, surgeon and mother.

Health Care Practice Stays Compliant with Coalition’s Included Employee Security Training

Dental care may be the biggest concern and goal when it comes to a practice and the service it provides. But privacy and security are two of the biggest elements that help determine just how safe a company really is — for both patients and those who work there. New regulatory frameworks, including the General Data

The FDA House of Delegates Will Consider Bylaws Changes

The Council on Ethics, Bylaws and Judicial Affairs will perform it’s annual review of the FDA bylaws and propose changes if necessary.

The Next House of Delegates Meeting Will be Held

Jan. 21, 2023 at the Tampa Airport Marriott Hotel

Protection Regulation (GDPR) and California Consumer Privacy Act require companies to adhere to high standards of data and privacy compliance. Many companies need guidance on how to comply, as well as insurance protection if an incident arises.

Following is an example of one company who turned to Coalition for coverage: number of employees: less than 25; company’s main duty: provides dental are for patients across two offices; and, highly regulated industry.

Under the heavy burden of increasing regulation and following a less than stellar claims experience with a traditional insurer after a previous data breach, a Michigan-based health care organi zation turned to Coalition for superior coverage and help with regulatory compliance both nationally and on a global scale. The organization was looking for an insurance policy that: provided broad coverage for privacy regulations including local, state, federal and foreign laws such as GDPR; included coverage for voluntary notification (which wasn’t covered in their last policy) with no caps on the number of individuals notified; and, went beyond just insurance — they needed help with compliance and cybersecurity to protect their patient data

After reviewing options with their insurance broker, they chose Coalition. And, in addition to receiving superior coverage, they’ve re-written their security policies with help from Coalition’s Secu rity Incident Response Team and are using Coalition’s included employee security training and simulated phishing emails with every single member of their staff.

Coalition’s included security tools can reduce an organization’s costs to detect, recover and contain a breach more than 40%, and are available to all policyholders at no additional cost.

23 | TODAY'S FDA november/december 2022

Welcome New FDA Members

The following dentists recently joined the FDA. Their memberships allow them to develop a strong network of fellow pro fessionals who understand the day-to-day triumphs and tribulations of practicing dentistry.

Atlantic Coast District Dental Association

Dr. Alejandro Baez Gutierrez, Davie

Dr. Andre Barbisan de Souza, Boca Raton

Dr. Beau Byers, Davie

Dr. Anna Katrina Canta, Sebring

Dr. Alexander Cardounel, Plantation

Dr. Saba Dolatshahi, Plantation

Dr. Carlos Espinal Mercado, Jr., Dania Beach

Dr. Vanessa Franks, Pompano Beach

Dr. Lisset Garcia Alonso, West Palm Beach

Dr. Mitchell Hong, Fort Lauderdale

Dr. Lavina Jagtiani, Boca Raton

Dr. Isha Khullar, Tamarac

Dr. Venkata Manda, Plantation

Dr. Sheldon Sacks, Palm Beach Gardens

Dr. Nathaniel Soto Rosado, Sebastian

Dr. Cao-Minh Tran, Boynton Beach

Dr. Kevin Vernet, Delray Beach

Dr. Michael Ybern, Miami

Central Florida District Dental Association

Dr. Andikan Akpabio, Jacksonville

Dr. Lara Bachour, The Villages

Dr. Anika Batta, Orlando

Dr. Alla Bizanti, Kissimmee

Dr. Alexandra Brown, Gainesville

Dr. Cody Dazen, Gainesville

Dr. Timothy DeSanto, Melbourne

Dr. Andra Hayward, Saint Cloud

Dr. Hannah Houghtaling, Apopka

Dr. Alena Kvashenka, Tampa

Dr. Inaia Leibovitch, Gainesville

Dr. Danielle Lombardi, Orlando

Dr. Julianna Masabni, College Station, TX

Dr. Alberto Noguera, Oviedo

Dr. Shivani Rajkumar, Maitland

Dr. Laura Santos, Saint Cloud

Dr. Vanessa Schussler da Silva, Gainesville

Dr. David Wertz, Milwaukee, WI

Dr. Karli Wilson, Gainesville

Northeast District Dental Association

Dr. Elizabeth Amoff, Jacksonville

Dr. David Elsharouny, Jacksonville

Dr. Woo Sang Hwang, Jacksonville

Dr. Christopher Klekamp, Jacksonville Beach

Dr. Stephanie Labib, Jacksonville

Dr. Hy Le, Jacksonville

Dr. Kirkland Maples, Ponte Vedra

Dr. Scott Poortinga, Jacksonville

Dr. Loveena Rastogi, Jacksonville

Dr. Matthew Radwanski, Chalfont, PA

Dr. George Rubin, Jacksonville

Dr. Tyler Sanders, Fernandina Beach

Dr. Emory Spradlin, Saint Augustine

Dr. Adam Tarboush, Orange Park

Dr. Cole Washington, Fernandina Beach

Northwest District

Dental Association

Dr. Jeremy Brown, Santa Rosa Beach

Dr. Matthew McNally, Shalimar

Dr. Dixie Mobley, Milton

Dr. Aarti Parmar, Tallahassee

Dr. Jacob Zellner, Tallahassee

South Florida District

Dental Association

Dr. Guianella Cala Balmaseda, Miami

Dr. Ana Blain Abdala, Miami

Welcome new members to the

24 news@fda

Dr. Carlos Arango, Miami

Dr. Elissabet Banega, Coral Gables

Dr. Livet Boffil, Miami

Dr. Matthew Breglio, Miami

Dr. Venus Salazar Castrillon, Miami

Dr. Elizabet Cedeno, Miramar

Dr. Francisco Chapman, Pembroke Pines

Dr. Dened Vega Delgado, Miami

Dr. Adrian Gonzalez, Miami

Dr. Angely Hernandez Jose, Miami

Dr. Angelica Machin Hernandez, Miami

Dr. Ahmad Jumaa, Davie

Dr. Franziska Klostermyer, Plantation

Dr. Lieny Padron Giraldino, Davie

Dr. Maria Zelaya Gomez, Miami

Dr. Arash Goshtasby, Hollywood

Dr. Grace Guzman Lavandera, Miami

Dr. Megan Leyva, Miami

Dr. Andrea Lima, Plantation

Dr. Alexandra Martin, Miami

Dr. Hajir Mohammed, Hialeah

Dr. Yusmila Ochoa, Tampa

Dr. Ana Karina Perez, Miami

Dr. Susana Barrios Pinera, Naples

Dr. Mayumi Harada Rodriguez, Davie

Dr. Alexandra Romero, Miami

Dr. Ramon Sanchez, Fort Lauderdale

Dr. Justin Schneider, Miami

Dr. Sujit Shakya, Miami

Dr. Tejaswi Singana, Davie

Dr. Yohanny Solorzano Monaca, Doral

Dr. Ana Martins Wright, Davie

Dr. Irina Zarichny, Miami

Dr. Karen Zapata, Davie

Dr. Manelys Zapata, Hialeah

West Coast Dental Association

Dr. Islam Abusalum, Tampa

Dr. Elizabeth Alabi, Fort Myers

Dr. Vladyslava Barylyak, Wesley Chapel

Dr. Hunter Bennett, Bonita Springs

Dr. Jeffrey Bourne, Fort Myers

Dr. Yilian Laborde Chang, New Port Richey

Dr. Paige Collins, Venice

Dr. Taylor Dietl, Palm Harbor

Dr. Michelle DiMonte, Bradenton

Dr. Oghenerukevwe Erhenede, Tampa

Dr. Ashley Eugenio, Tampa

Dr. Aashin Gokal, Riverview

Dr. Gregory Grabowski, Nokomis

Dr. Timothy Jernberg, Naples

Dr. Michelle Jordan- Gonzalez, Tampa

Dr. Leigh Klein, Lakeland

Dr. Anyeley Lopez, Plantation

Dr. Armando Lopez, Plantation

Dr. Nicholas Lynch, Clearwater

Dr. Radhika Malhotra, Spring Hill

Dr. Fernando Martinez Escobar, Cape Coral

Dr. Yuniesky Martinez Lopez, Naples

Dr. Huda Niwash, Tampa

Dr. Andrew Pakchoian, Wesley ChapelDr. Rachel Patenaude, Brandon

Dr. Heydi Perez Reyes, Fort Myers

Dr. Dominik Rokita, Hudson

Dr. Albert Rophie, Bradenton

Dr. Natalie Schmidt, Sarasota Dr. Michael Snyder, Dunedin

Dr. Anabel Valdivia Del Campo, Naples

Dr. Brittany Valledor, Bonita Springs

Florida Dental Association!

25 | TODAY'S FDA november/december 2022

In Memoriam

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

Marshall B. Berger

Hollywood

Died: 9/21/2022 Age: 86

Joseph J. Meyer

Saint Petersburg Died: 9/12/2022 Age: 74

Robert E. Karol

Ponte Verdra Beach

Died: 10/22/2022

Age: 68

Thomas A. Parker

Hollywood Died: 9/30/2022 Age: 89

Joe M. Wright

Bradenton

Died: 9/18/2022 Age: 90

26

Passed!

The Florida Dental Association (FDA) is pleased to share excellent news about a major victory for dental patients and their families in Massachusetts. Massa chusetts Ballot Question 2 — requiring most of the premium dollars collected by dental insurers to be spent on actual dental care — has passed overwhelmingly with 71% of the vote.

This decisive landmark victory means better dental benefits and better access to dental care for patients, period. It also means more families will be empowered to seek the dental care they need. The FDA contributed $50,000 to the campaign; the American Dental Association (ADA), other state dental associations, dental spe cialty groups and individual dentists also contributed.

The passage of Question 2 ensures that what patients in Massachusetts pay in premiums ultimately goes to the actual care they receive, rather than to insurers’ bottom line. If dental insurance companies spend less than 83% of patient premiums on actual dental care, they must refund the difference to covered individuals and groups.

This sets an important precedent for dental care pro viders and their patients across the country. Despite dental insurers spending millions to defeat Question 2, ultimately voters considered the facts and support ed these important consumer protections for dental patients and their families.

The ADA now hopes to work toward bringing these important reforms in dental insurance to other states throughout the country. There is momentum and now is the time for dental care providers and their patients, as well as health care and consumer advocates across the nation, to work together to ensure that these important pro tections are implemented for dental patients and their families in every state.

The ADA is always a resource for dental providers in advocating for important insurance reforms to benefit dental patients and their families as well as the future generation of dental care providers to ensure better access to dental benefits and oral health care for everyone.

27 | TODAY'S FDA november/december 2022
Massachusetts Ballot Question 2
This decisive landmark victory means better dental benefits and better access to dental care for patients, period. It also means more families will be empowered to seek the dental care they need.

Recap of the 2022 ADA House of Delegates

ADA in Houston.

October 18 saw the close of the 158th American Dental Association (ADA) House of Delegates and the culmination of the presidency of Dr. Cesar Sabates, the first president of the ADA from the state of Florida.

The 17th District Delegation to the ADA (Florida is one of five single-state delegations) traveled to Houston for the meeting. Your delegation was successful in making and passing two resolutions: Resolution #517 closed a loophole allowing prospective members to receive services from the ADA. An important benefit when it took months to process an application, it was obsolete now that member ship can be confirmed in less than a week. Some individuals were taking advantage of benefits without completing memberships, but the practice will now stop.

Important to all members of the ADA, Resolution #305 adopted as ADA policy that when third party payers (insurance companies) request any changes to existing contracts between dentists and the third

28
ADA in Houston
If a third party payer seeks to lease its network or start a new network, it should provide notice to the dentist 90 days in advance and obtain the dentist’s written consent to include the dentist in the new network.
The 17th District Delegation attending the 158th

party payer, it must be noticed at least 90 days before they are enacted and require the signature of the dentist to opt-in to agree to the new changes. Also, if a third party payer seeks to lease its network or start a new network, it should provide notice to the dentist 90 days in advance and obtain the dentist’s written con sent to include the dentist in the new network.

While the resolution will not create a new law, it will set the stan dard for best practice and will serve as a guide for determining policy and future action.

The ADA House also voted in a new form of governance, the

Strategic Forecasting Committee. Florida’s Dr. Tom Brown was integral in developing this group and will serve on the commit tee during its inaugural year. This, coupled with a new view on accounting called Mission-based accounting where expenses are reported as they relate to programs of the ADA, should help the association direct its spending to programs members find most important and useful.

*Photo by EZ Event Photography, courtesy ADA News. © 2022 American Dental Association. No copyright information is necessary for photos printed for personal use.

If you have questions about what is permitted use, please contact Kelly Ganski, Editor, ADA News, ganskik@ada.org, 312.440.2792.

The ADA name should not be used in connection with a product or other commercial entity without specific, written permission from the ADA. Thank you for your cooperation.

29 | TODAY'S FDA november/december 2022
Dr. Cesar Sabates addresses the 158th House of Delegates during the October ADA annual meeting in Houston, TX.*

ADA and FDA Principles of Ethics and Codes of Professional Conduct

I have elected to be a PROUD MEMBER OF

THE FLORIDA DENTAL ASSOCIATION,

Because the dental profession holds such a special position of trust within society, the profession makes a commitment to society that its members will adhere to high ethical standards of conduct. These standards are embodied in the American Dental Association (ADA) and Florida Dental Association (FDA) Principles of Ethics and Codes of Professional Conduct (ADA & FDA Codes). The ADA & FDA Codes are essentially a written expression of the obligations arising from the implied contract between the dental profession and society.

which demonstrates an individual commitment to the American Dental and Florida Dental Associations’ Principles of Ethics & Code of Professional Conduct.

Members of organized dentistry voluntarily agree to abide by the ADA & FDA Codes as a condition of membership; they recognize that continued public trust in the dental profession is based on the commitment of individual dentists to high ethical standards of conduct. The full ADA code can be found online at bit.ly/3SJDWIu

I VOW TO:

The full FDA code can be found online at floridadental.org/coe. The main difference between the two is that the FDA requires for members to participate in the peer review process.

HONOR a patient’s role as an integral member of the treatment planning process.

I also will honor their right to confidentiality. (Autonomy)

The ADA & FDA Codes have three main components:

PROTECT patients from harm, using current knowledge and adept skill; and providing proper referrals to optimize treatment. (Nonmaleficence)

The Principles of Ethics — The Principles of Ethics are the aspirational goals and firm guideposts of the profession. They provide guidance and are made up of the five fundamental principles of patient autonomy, nonmaleficence, beneficence, justice and veracity.

ACT for the benefit of the patient and the public at large, through competent and timely delivery of dental care. (Beneficence)

DELIVER care with fairness and without prejudice, promoting access for all. (Justice)

The Code of Professional Conduct — The Code of Professional Conduct is an expression of specific types of conduct that are either required or prohibited. It’s a product of the ADA’s legislative system and all of its elements result from resolutions adopted by the ADA’s House of Delegates.

COMMUNICATE as clearly and honestly as I can. (Veracity)

I welcome questions and open discussion regarding these principles and your health care.

The Advisory Opinions — The Advisory Opinions are interpretations that apply the code to specific fact situations. They are ad opted by the ADA’s Council on Ethics, Bylaws and Judicial Affairs to provide guidance to membership about how the Council might interpret the code in a disciplinary proceeding.

floridadental.org ada.org/about/principles/code-of-ethics

Members, please consider displaying the poster, which was polybagged with this issue, in your office to reinforce to patients, staff and members of the public that you’re a dentist who is personally committed to exercising the ADA & FDA Codes. If you would like additional copies, please go to bit.ly/3TG70Rl, to print out the poster.

33 | TODAY'S FDA november/december 2022
standard of conduct
I
PROUD
have elected to be a
MEMBER OF THE
34 THREE EASY WAYS TO PAY: PAYMENT PLAN: Choose from a variety of monthly installment plans. AUTO-RENEWAL: Set it and forget it! Your membership will automatically renew each year with the credit card you put on file. Online: Visit floridadental.org/dues. Mail: Return blue envelope with statement and payment. Phone: Dial 850.681.3629 to speak to our friendly membership team. RENEW YOUR MEMBERSHIP FOR 2023 TODAY! HELPING MEMBERS SUCCEED We have your back. Always.
Chair,
Dr. Casey Lynn
FDA Council on Membership
Pediatric
Dentist – Apollo Beach, FL

membership

The dental world can be a lonely place when you are isolated from your colleagues and working daily in a single office. Leading a team, managing a business and navigating a minefield of things outside of your control can be daunting sometimes! The good news is, the Florida Dental Association (FDA) can help with the day-to-day challenges as well as your overall career. Organized dentistry can be intimidating to those not involved, but the main thing we work on at the FDA is our members and how we can help them succeed. The FDA community is dedicated to helping our members in all aspects of dentistry.

The advocacy aspect of the FDA is one of the largest “silent” ben efits our members have. Our team works tirelessly to make sure any legislative issues that can affect the dental profession are ad dressed, lobbied on and controlled before they affect members. Each year, our team navigates the political world, and we make sure they advocate on your behalf!

FDA Council on Membership Pediatric Dentist – Apollo Beach,

Are you looking to meet other dentists, build connections and open doors that can catapult your career? We have many net working events designed to make this easy and fun. The FDA also provides numerous resources to help members succeed. Our Member Benefits Guide is a one-stop shop to see everything the FDA has at your fingertips. If you have a question and can’t find the answer online, call our headquarters in Tallahassee and our amazing team can connect you to the right resource! Some of the biggest challenges facing our industry are not discussed in public forums. Difficult patients and a litigious world can lead to frivolous complaints to the Board of Dentistry (BOD); as an FDA member, Peer Review is available to help settle any issues before they get to the BOD — a huge benefit for any practicing dentist.

We have your back. Always.

I have been an FDA member since dental school, and proudly stay involved so I can have a seat at the table as a “younger” dentist. It’s helped me stay connected, provided numerous opportuni ties to better my career and facilitated the growth of my startup practice. All of which I feel are invaluable. For newer dentists, the career outlook is vastly different than our more seasoned mem bers. It’s imperative that we all support our organization so we can keep this amazing profession what it is, and work to make it better every day. As an organization, we make a significant impact on the future of our profession!

For those looking to get a more in-depth look into what the FDA does, I recommend reaching out to any component of organized dentistry, as we are always looking for members who want to make a difference. For those who are not interested in dedicating time or energy to the FDA, your membership has a powerful im pact on what the organization can do for YOU and all our member dentists. Although many of us work in an isolated environment, the FDA can help you connect, manage you career

35 | TODAY'S FDA november/december 2022 THREE EASY WAYS TO PAY: PAYMENT PLAN: from a variety of monthly installment plans. AUTO-RENEWAL: and forget it! Your membership will automatically renew each year credit card you put on file. Visit floridadental.org/dues. Return blue envelope with statement and payment. Dial 850.681.3629 to speak to our friendly membership team. RENEW YOUR
FOR 2023 TODAY! HELPING MEMBERS SUCCEED
MEMBERSHIP
THRIVE.
questions
stay connected with the THREE EASY WAYS TO PAY: PAYMENT PLAN: Choose from a variety of monthly installment plans. AUTO-RENEWAL: Set it and forget it! Your membership will automatically renew each year with the credit card you put on file. Online: Visit
Mail: Return blue envelope with statement and payment. Phone: Dial 850.681.3629 to speak to our friendly membership team. RENEW YOUR MEMBERSHIP FOR 2023 TODAY! HELPING MEMBERS SUCCEED We have your back. Always. Dr. Casey Lynn Chair, FDA Council on Membership Pediatric Dentist – Apollo
FL
and
Please contact me or anyone at the FDA if you have any
or would like to get more involved.
floridadental.org/dues.
Beach,

VOLUNTEER FOR FLA-MOM 2023!

February 24-25, 2023 • West Palm Beach Expo Center

at The South Florida Fairgrounds

THE FLORIDA MISSION OF MERCY

Florida Mission of Mercy (FLA-MOM) is a large-scale, two-day, professional dental clinic that provides care to any patient at no cost, with the goal of serving the underserved and uninsured in Florida — those who would otherwise go without care.

With a goal of treating 2,000 patients, FLA-MOM seeks to have a positive impact by providing important access to dental care.

Treatments o ered at FLA-MOM include: cleanings,

fillings, extractions, root canals, pediatric dentistry

YOU CAN MAKE A DIFFERENCE!

Help us provide dental care to those in greatest need. We need the following types of volunteers:

dentists, hygienists, dental assistants

dental lab technicians

physicians, nurses, EMTs medical assessments of health history vital signs glucose testing

general community egistration endants and more!

SIGN UP TODAY AT FLAMOM.ORG
   

FDA Foundation

What’s Your Why? FDA Members Share Why They Give to the FDA Foundation

“I volunteer [with the Florida Dental Association (FDA) Foundation] because the Florida Mission of Mercy (FLA-MOM) is a place where you use your greatest expertise and passion to provide the greatest gift to mankind,” shares Dr. Sam Elias, FDA member and FLA-MOM prosthodontics co-manager.

As the philanthropic arm of the FDA, the FDA Foundation brings member dentists together to provide dental care to the under served and uninsured in Florida — those who would otherwise go without care.

With guidance from the FDA Foundation, members hearing the call to Give, Volunteer and Lead can best use their time and skills to provide quality dental care to those in need. FDA member donations, time and leadership help create the success of the FDA Foundation.

“I’m involved [in the FDA Foundation] to give back to those in need and to show that dental professionals have a giving heart!” said Dr. Terry Buckenheimer, FDA Foundation board treasurer and FLA-MOM consultant.

Give

Volunteer

Lead

Emerald Club

• Annual membership supports FDA Foundation programs.

Giving Tuesday

• Annual giving opportunity in November to support the FDA Foundation.

Planned Giving

• Pledge a donation in your estate plan or donate with an annual IRA distribution charitable donation.

Florida Mission of Mercy

• Annual two-day dental clinic with care provided at no cost for those in need.

Donated Dental Services

• Provide care in your office for disabled, elderly or medically fragile patients who cannot afford treatment.

Project: Dentists Care

• Volunteer at a local dental access clinic that provides preventive and restorative care.

FDA Foundation Board

• Serve on the Board of Directors or one of their committees. Florida Mission of Mercy Leadership Team

• Volunteer to lead a committee or department on the FLA-MOM planning team.

FDA President Dr. Jerry Bird and his wife, Jerilyn, have been long-time FDA Foundation supporters and say, “Our why is to bless others!” The Birds have been involved in many FLA-MOM clinics and say that the clinic “is an amazing weekend spent blessing others and getting back more than you can imagine.”

“I volunteer at FLA-MOM because I am happy to use my skills and experience to help people that have difficulty affording dental care,” explains Dr. Julia German, who volunteers along with her husband, Dr. Igor German, and their two daughters. “I came to this country as a very poor immigrant from the former Union of Soviet Socialist Republics, and I had the privilege of studying at the University of Florida and learning my great profession.” t

39 | TODAY'S FDA november/december 2022

Come and join the FDA Foundation with our call to action – Give, Volunteer and Lead – and discover your Why!

As the philanthropic arm of the association, we are committed to promoting dental health for all Floridians, and our volunteers and donors help us make a difference in the lives of thousands of people each year. Former FDA Foundation president and longtime volunteer, Dr. Robert Payne, coined the phrase, “The FDA Foundation is the heart of the FDA.” Your support of the FDA Foundation is the beat that enables our “heart” to provide life-changing dental programs.

Please visit donate.floridadental.org to show your support today.

How

Your Why Has an Impact in the Community

2022 Florida Mission of Mercy Patient Spotlight

“First and foremost, I’d like to thank the staff and volunteers for their time, work and sincerity through the entire process. But even more than that, I’d like to thank them for fixing my smile, my oral health and restor ing my confidence. I used to live every day in fear of judgment for my [previously] poor dental hygiene. It wasn’t only affecting me. I have three stepdaughters with beautiful smiles, and they were hiding their teeth in photos and at events because they’d watched me do it for so long. Now I’m not afraid to show them how to smile with their teeth and how beautiful it is. I no longer avoid talking, smiling or laughing so people won’t see my teeth. No longer will I have to stay up at night in throbbing pain due to tooth aches because I don’t have the insurance to take care of it. I feel like I didn’t just get my smile and confidence back, I got my life back. Thank you again.” – 2022 FLA-MOM patient

41 | TODAY'S FDA november/december 2022
FDA Foundation

FDA Foundation Grants Aid to 209 Florida Dentists

Recipients, including the dentist who gave the quote at the right, have been thanking the Florida Dental Association Foundation’s (FDAF) Emergency Disaster Assistance Program for grants that assist with immediate personal needs such as food, water, clothing, emer gency shelter or medications.

To date, in response to the impacts of Hurricane Ian, the FDAF has processed 209 applica tions for emergency disaster assistance and provided $313,500 in grant funds

In addition to the negative effects of the storm — damage to practices and homes, loss of records and personal mementos, and more — it’s important to note the positive response. Members of organized dentistry and others came together to offer support to Florida den tists hit by the hurricane through donations to the FDAF Emergency Disaster Assistance Program.

42
Thank you for your quick assistance on this matter. I appreciate the generosity of the FDA Foundation to support a member during this difficult time.

Donations from individuals: $17,470

Donations from FDA Components, other state dental associations and other entities: $149,000

l Alabama Dental Association Foundation

l Arizona Dental Association

l Atlantic Coast District Dental Association

l Brevard County Dental Association

l California Dental Association

l Central Florida District Dental Association

l Florida Section – American College of Dentists

l Florida Section – International College of Dentists

l Henry Schein Cares

l Kansas Dental Charitable Foundation

l Louisiana Dental Association Foundation

l Massachusetts Dental Society Foundation

l Mississippi Dental Association

l Missouri Dental Association Foundation

l Missouri Dental Association

l Northeast District Dental Association

l New York State Dental Association

l Northeast Missouri Dental Society

l Oklahoma Dental Relief & Disaster Grant Program

l Pennsylvania Dental Foundation

l South Carolina Dental Association

l South Florida District Dental Association

l Texas Dental Association

43 | TODAY'S FDA november/december 2022
FDA Foundation
PEDIATRIC PERIODONTICS GENER AL ENDODONTICS OR AL & MAXIL LOFACIAL SURGERY ORTHODONTICS & DENTOFACIAL ORTHOPEDICS by the numbers! florida dental association BOARD OF TRUSTEES OVER AL L MEMBERSHIP HOUSE OF DELEGATES AVER AGE YEARS IN PR ACTICE AVER AGE AGE - 54 MEDIAN AGE 54 28 A ICAN AMERIC HIS NIC W E 73 % 8% 7% 6% 3% 54% 13% 11% 7% 4% 3 % 7% 3% 2% 5% 5% 4% 4% 6% 73% .4% 66% 11% 12% 2% 7% 2% .1% 1% 47% 15% 12% 12% 9% 6% 21 OTHER .4% 4% .1% 5 2 70% % 4%
45 | TODAY'S FDA november/december 2022 NEED HELP WITH PATIENT COMPLAINTS? The Peer Review program is designed to help Florida Dental Association member dentists. Avoid costly legal fees, malpractice suits and Board of Dentistry complaints by using this free service exclusively for members. Learn more online at FloridaDental.org/PeerReview or by contacting FDA Peer Review Coordinator Lywanda Tucker at 850.350.7143 or ltucker@floridadental.org

The Peer Review program is designed to help Florida Dental Association (FDA) member dentists avoid costly legal fees, malpractice suits and Board of Dentistry complaints.

Designed to assist members with resolution of patient disputes before they become law suits or complaints to the Florida Board of Dentistry (BOD), the FDA’s Peer Review program is an incredible member benefit that’s both free and confidential. The process can be initiated by a patient or an FDA member dentist.

FDA’s peer review coordinator, Lywanda Tucker, works with both the patient and the dentist to negotiate a compromise when there are differences in opinion about the care provided. If she is unable to successfully find a compromise, the case will be referred to the appropriate component peer review chair (a volunteer dentist) for additional media tion or a formal review.

The Florida Dentist’s Guide to Peer Review ” ”

— Florida Dentist

The peer review process is not designed to handle every type of situation or problem that may arise between dentists and patients. Only cases involving problems with actual dental treatment and procedures are eligible. Cases not qualified for peer review include: those already in malpractice litigation; those already being investigated by the BOD; disputes that are only about dental fees; treatment that occurred more than 12 months before the patient’s last appointment; and cases involving nonmember dentists. The current peer review system is also not intended to handle a complaint initiated by one dentist against another.

Why Start with Mediation?

Mediation is the initial step in peer review and is one of the most important steps in the process. During mediation, the disputing parties, with the assistance of Ms. Tucker as a mediator, identify disputed issues, discuss alternative ways to resolve the issues, and

46
Thank you so much for your profession alism and handling of my recent peer review case. I greatly appreciate your responsiveness and patience while achieving an amicable result for all parties.

peer review

potentially reach a settlement that is satisfactory to both parties. If mediation is successful, cases are concluded at that stage and do not need to proceed on to formal peer review.

The crux of the mediator’s work is to help the parties think through the issues and generate ideas for resolving the dispute. Ms. Tucker begins by gathering information about the dispute and asking each party to explain what the dispute is about in his or her own terms and hears each party’s initial position on the matter. Sometimes, it seems patients just want to be heard. Even if there are differences in the versions of the events, it is not always necessary to resolve them. Ms. Tucker focuses more on finding out what needs each party wants to satisfy and how to best resolve the dispute. Ms. Tucker’s experience, dental knowl edge and personality aid in problem-solving and finding com promise.

In fact, Ms. Tucker has more than 16 years of dentistry experi ence in varying positions including work at periodontal, general and orthodontic offices. She has been a chairside assistant, a treatment coordinator and a member of the front office staff. This training and experience are of great benefit and allow her to properly conduct mediation as an impartial — but knowledge able — third party. She works to establish communication, build trust and resolve problems expeditiously. Mediation can result in resolution of many cases initiated in the peer review system and can be a very valuable tool in resolving dental disputes.

A Brief History

Peer review provides an impartial, easily accessible and generally expedient means for resolving misunderstandings regarding den tal treatment. It benefits the patient and the dentist; however, it hasn’t always been in existence.

The American Dental Association (ADA) first established policy on peer review in 1970, with the adoption of the statement on Dental Society Review Committees. That statement outlined the purpose and functions of review committees and clearly speci fied that such committees were to be established for prepayment programs. Other committees, such as patient grievance, patient relations or patient counseling, dealt with disputes between patients and dentists.

FDA’s Peer Review Program:

 Maintains high dental standards.

 Aids in mediation efforts.

 Meets the needs of the public regarding the quality and appropriateness of dental care.

Since its establishment in 1970, the peer review program has grown and changed through adoption of policies:

 1971 — peer review committees got the right to review radio graphs and other treatment records.

 1972 — third parties were encouraged to use the peer review process.

 1973 — constituent societies were urged to seek statutory ex emption from civil damage liability for peer review committee members.

 1975 — the prerogative and duty of the dental profession to conduct all necessary review of dental services through its established mechanisms, including peer review was acknowl edged.

1977 — the responsibilities for grievance and peer review committees were combined under the auspices of a single “peer review committee.”

 1979 — constituent societies were urged to cooperate in the resolution of inter-jurisdictional cases.

 1980 — the Bylaws definition of member in good standing was amended to include, among other things, cooperation with dental society peer review bodies.

 1987 — policies were revised to reflect the current practices in peer review and the changing nature of the various relation ships that exist in the delivery of dental care.

Most of the remaining peer review policies were modified where necessary and incorporated into a statement, “Guidelines on the Structure, Functions and Limitations of the Peer Review Process.”

 Assists parties in avoiding litigation. t

47 | TODAY'S FDA november/december 2022

peer review

For questions or additional information, please visit FloridaDental.org/PeerReview or contact Peer Review Coordinator

Lywanda Tucker at 850.350.7143 or ltucker@floridadental.org.

That statement was revised and adopted in 1992, by the ADA House of Delegates.

Peer review continues to grow, change and improve. For exam ple, in Florida, there was a shift to moving administrative duties to the FDA’s headquarters rather than at each of the components. This was done, in part, to ensure consistency in intake of cases throughout the state. Having a qualified and trained staff person dedicated to peer review will benefit all members. And, parts of the process remain consistent with prior systems so cases will still be referred to the appropriate component peer review chairs as appropriate and necessary.

In all, peer review is a valuable tool to help FDA member dentists succeed.

Section 466.022(1), Florida Statutes, states (among other things) that “a professional organization or association of dentists which sponsors, sanctions, or otherwise operates or participates in peer review activities is hereby afforded the same privileges and immunities afforded to any member of a duly constituted medical review committee by s. 766.101(3).”

Section 766.101(3)(a), Florida Statutes, provides that “[t]here shall be no monetary liability on the part of, and no cause of action for damages shall arise against, any member of a duly appointed medical review committee, or any health care provider furnishing any information, including infor mation concerning the prescribing of substances listed in s. 893.03(2), to such committee, or any person, including any person acting as a witness, incident reporter to, or investigator for, a medical review committee, for any act or proceeding undertaken or performed within the scope of the functions of any such committee if the committee member or health care provider acts without intentional fraud.” These statutory protections are intended to encourage good faith participation in the peer review process without fear of liability.

However, it is important to remember that records generated in the peer review process may be subject to disclosure in response to a subpoena or other legal process, and the original records (patient’s chart and dental records) and underlying facts of a matter submitted to peer review are almost always discoverable.

48

Peer Review Cards to Give to Patients

Dentists are encouraged to have this card handy for front desk staff to give to patients who may be good candidates for Peer Review. Cut out these 10; print more at bit.ly/3UWTMRe

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals dentists is to attention and problems occur. or believe your care possible, mediated

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you satisfactorily resolve or dentist has provided best possible, there options. You may have the mediated through the Review

One of the goals dentists is to attention and problems occur. or believe your care possible, mediated

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and But, problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals dentists is to attention and problems occur. or believe your care possible, mediated

One of

have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One goals of Association dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you satisfactorily resolve or dentist has provided best possible, there options. You may have the mediated through the Review

One of the goals dentists is to attention and problems occur. or believe your care possible, mediated

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One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

Peer Review Coordinator Lywanda Tucker 850.350.7143 or ltucker@floridadental.org

One of the goals dentists is to provide attention and problems occur. or believe your care possible, mediated

Peer Review 850.350.7143

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

Peer Review Coordinator Lywanda Tucker 850.350.7143 or ltucker@floridadental.org

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

Peer Review Coordinator Lywanda Tucker 850.350.7143 or ltucker@floridadental.org

Peer Review 850.350.7143

One of the goals dentists is to provide attention and problems occur. or believe your care possible, mediated

One of the goals dentists is to provide attention and problems occur. or believe your care possible, mediated

Peer Review 850.350.7143

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

Peer Review Coordinator Lywanda Tucker 850.350.7143 or ltucker@floridadental.org

One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.

Peer Review 850.350.7143

One of the goals dentists is to provide attention and problems occur. or believe your care possible, mediated

50
peer review

peer review

Peer Review Case Studies

Case Study #1:

A patient called and wanted to file a complaint against a dentist he saw in 2021 to have a crown replaced that fell off a front tooth. Patient was told the crown could not be saved and it would have to be replaced with a new crown. According to the patient, the tooth was filed down too much when being prepped for the first crown and a new crown. The permanent crown later fell off again and this time there was not enough tooth left for another crown. The tooth had to be extracted. The patient went to another den tist and had treatment and wanted to receive a refund from the previous dentist.

Peer Review Results:

The case was forwarded to the peer review chair dentist for the patient’s area since the case was not able to be resolved with simple mediation. Upon full review of all records and talking to both the patient and the treating dentist, the case was closed. The treating dentist had done everything within the standard of care and the patient was looking for a refund since he needed to have additional treatment for the tooth. Case Closed!

Case Study #2:

A patient called to file a complaint about an FDA member dentist whom she said had done a filing for her that later came out. The patient stated she’d already spoken to the dentist about a refund, and he agreed to refund her, but she wanted to file a complaint about the amount to be refunded. The patient sent in her state ment from the dental office.

Peer Review Results:

Peer Review Coordinator Lywanda Tucker called and spoke with the treating dentist about the patient’s complaint. He agreed to refund the patient and wanted to know the amount to refund her. After looking over the patient’s statement the dentist agreed to refund her the amount she paid out of pocket as well as her insurance. Case Closed!

Case Study #3:

A patient called and stated she went to a dentist to have two lower implants placed for permanent dentures. According to the patient, the implants were causing her a lot of discomfort and the permanent dentures would not fit. The patient went for a second opinion and was told that one of the implants had not been placed directly in the bone; it was in the gum and had to be extracted.

Peer Review Results:

Peer Review Coordinator Lywanda Tucker called and spoke with the treating dentist to discuss the complaint and he agreed to refund the patient. No need for a more formal complaint with the Florida Board of Dentistry or a lawsuit. Case Closed!

Case Study #4:

A patient called and stated that she went in for treatment, but had a lot of discomfort and temporary crowns keep breaking. The patient went to another dentist to have a second opinion and de cided to have treatment with him. The previous dentist refunded the patient the amount she paid for the permanent crowns but, the patient wanted more to cover the expenses she’d accrued with the current dentist.

Peer Review Results:

After speaking with the dentist about the complaint, Peer Review Coordinator Lywanda Tucker determined that the dentist had already refunded the patient. The patient understood, but was insisting that she should have received more from the treating dentist. Ms. Tucker forwarded the case to the peer review chair doctor for the patient’s area. After looking over the records and speaking to both the patient and the dentist, the peer review chair doctor decided that the refund the patient received was sufficient for what she had paid out. Case Closed!

51 | TODAY'S FDA november/december 2022
52 Division of Medical Quality Assurance Enforcement Process Department Probable Cause Prosecution Attorney Review Mediation Case Disposition Findings: Complaint Receipt and Analysis Closure/Referral to other agencies as Non-Jurisdictional OR Closure as legally Non-sufficient Mediation Investigation Non Disputed Final Order Prosecution Formal Hearing Before DOAH (Contest Charges) Informal Hearing Before Board (No Dispute) Complaint Closed Settlement by Licensee to Board for Approval Dismissal/ Closure No Probable Cause Found Probable Cause Found Election of Rights by License Consumer Services (CSU) Investigative Services (ISU) Prosecution Services (PSU) State Surgeon General Boards Compliance Management (CMU) Courts of Appeal Confidential Public Citation Issued Administrative Complaint Filed With Department of Health Appeal Procedures To District Courts of Appeal Compliance Monitoring Final Order Imposing Discipline Filed with Department of Health Hearing Waived Before Board (No Dispute) Disputed Settlement Rejected Draft Emergency Action State Surgeon General Review and Signature Full Board Action and Disposition Revised 11/2019 peer review
The Florida Dental Association (FDA) basically provides you with a liaison to navigate the process. It’s fair. It’s free and it’s the finest FDA benefit. Oh, not a member of the FDA? The next three pages give you some insight to the legal morass you might be facing. I mean it’s only your license! Join the FDA. We are here to help YOU succeed! Peer Review is Simple

peer review

A Quick Guide to the MQA Disciplinary Process Probable Cause Panels

The division of Medical Quality Assurance’s (MQA) Bureau of Enforcement fields and investigates complaints against health care practitioners and facilities/establishments regulated by the Florida Department of Health.

The path of a complaint:

• Consumer Services Unit (CSU): Where the complaint process begins.

• Investigative Services Unit (ISU). Legally sufficient complaints are forwarded here.

• Prosecution Services Unit (PSU). Conducts legal review of ISU-generated investigative reports.

• Probable Cause Panel. Determines what becomes of the case.

Cases are ultimately decided by a Probable Cause Panel (PCP). It is not bound to go along with the recommendation PSU attorneys give upon legal review. *456.073(2) & 456.073(4), Florida Statutes

A Probable Cause Panel…

• reviews all evidence and information gathered during the investigation.

• is made up of 2 or 3 board members – usually 1 or 2 licensed health care professionals and a consumer member. (*A consumer member represents the public interest. He or she does not necessarily have specialized medical knowledge/training and does not practice medicine.)

• can feature different members from meeting to meeting.

The PCP will issue one of the following recommendations: (1) Escalation to the Formal Administrative Complaint phase. (2) Closure, with a letter of guidance (3) Dismissal.

FAST FACTS

Florida Statutes outline the parameters by which probable cause panels operate, especially its strict disclosure policy. (Example: The only time a case will be made public is if an administrative complaint is approved by the PCP – 10 days after such a finding.) *456.073(10)

True or False?: The person(s) whose complaint initiated an investigation of a health care professional is given unlimited access to the PCP and its conducting of official business.

Answer: False. Even the complainant in the case is not privy to what happens at PCP meetings. Furthermore, he or she cannot sit in on PCP discussions, receive transcripts of the proceedingsor obtain copies of the case evidence presented. *456.073(9)(a),(b), and (c)

True or False?: The licensee whom the complaint was filed against has the overriding expectation of confidentiality.

Answer: True. If a case is closed without an administrative complaint being issued – either with a letter of guidance or a regular dismissal ‒ no one gets to know anything about it, including who was on the PCP or what the alleged violation was. That is, unless, the licensee waives his/her right, in writing, to keep everything confidential. *456.073(10)

53 | TODAY'S FDA november/december 2022
1 2

A Quick Guide to the MQA Disciplinary Process Discretionary Emergency Orders – 3 Things to Know

The Emergency Action process is applicable to any licensed Florida health care professional who poses an immediate, serious danger to the public health, safety or welfare.

*456.073(8); 120.60(6), Florida Statutes

What that means:

• Immediacy is necessary. If an incident occurred too long ago to be considered immediate anymore, it will not qualify for Emergency Action. (Determination of “too long ago” is made on a case-by-case basis.)

• The allegation(s) need to rise to a sufficient level of seriousness to warrant the emergency order.

Emergency Restriction Orders (EROs) and Emergency Suspension Orders (ESOs) are exclusively issued by the State Surgeon General. As with Probable Cause Panels, the Surgeon General can either accept or disregard the preceding investigation-based recommendation made by Prosecution Services Unit attorneys.

In addition to immediacy, the DOH is only permitted to use the “least restrictive means” to stop the danger. *120.60(6)(b)

What that means:

The Emergency Action must be in line with what danger is posed to the public – whether it be just a portion, or, the public as a whole. (Example: If a male licensee accused of sexual misconduct against females will only be restricted to not treating females.)

The distinction between orders:

• ESOs – For licensees deemed to be a threat to the public at large

• EROs – For licensees considered a threat to a segment of the population

The Emergency Order process is carried out without a hearing. Restricting someone’s right to work without the benefit of a hearing, the balancing act dictated by appellate law calls for it be done by the least restrictive means.

An ESO or ERO is not considered final agency action.

What that means:

• Orders can be appealed within 30 days of issuance. The appeal can play out while the normal disciplinary process – toward administrative complaint and regular prosecution – runs its course. *120.60(6)(c)

• The accused health care practitioner is entitled to a hearing before final action is taken by a regulatory board or by the Department of Health. He or she can request an expedited full evidentiary hearing, which requires the presentation of evidence that is admissible in court and witnesses to testify to prove the alleged violation.

• Complaints have to be filed within 20 days of an ERO/ESO – *Rule 28-106.501(3), Florida Administrative Code.

The violation posing the public danger must be a viable charge listed under the Practice Acts or the rules regulating the Department of Health, including: commission of crimes; violations of standards of care; drug use / impairment; drug diversion; sexual misconduct; and student loan defaults.

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1

I hear you. You are a dentist — a highly educated professional who works with a lot of technology day in and day out at your practice. So buying a new computer/laptop should be easy for you, right?

I just participated in Amazon Prime Days. It is like Black Friday sales a month early. You know what I never buy on Black Friday or Amazon Prime Days? Computers/laptops. Why? For the most part, retailers will put models and fea tures on ridiculous sales that have almost none of the features you really want or need. However, who can turn down a $300 laptop though, right?

I call this time of the year silly season for technology because you have people who want a new “something”, and you mostly have retailers who want to sell you the technology they cannot sell at other times of the year. It is a match made in technology heaven.

Let me ask you a few questions and provide you with some suggestions that can help you make wise purchases (or even no purchase) at this time of year.

First, who is this computer/laptop for? Will it need to be mobile — like travel with you? That rules out a desktop. In fact, I will say there are very few specific cases where a desktop is going to be the best option because laptops and even tablets are just as powerful as desktops these days.

Next, are you tied to a particular brand or maker of a device? If you are an Apple user (like an iPhone), MacBooks and iPads make great options to buy. Why? Because information can so easily be shared between them with built-in apps.

56
You Want
Buy
New
Despite what seems like light-speed development, newer is not always better. No need for the pricy upgrade. ” ”
So,
to
a
Computer?

Likewise, if you are an Android or Google user, there are op tions that work well in that arena, too. I would caution you to steer clear of a Chromebook unless you only want it for limited Internet access. Chromebooks are single-purpose laptops with limited power and functionality but are also very cheap.

On occasion, a Microsoft Surface might be a good option no matter the phone you use because it is like a hybrid laptop/ tablet that works on the familiar Microsoft Windows operating system. Familiar is good.

The other thing you will notice is a dizzying array of features, acronyms, and letter/number combinations. Here is an actual advertisement on Amazon for a $650 laptop: 2022 Newest HP 17.3” HD+ Display Laptop, 11th Gen Intel Core i3-1115G4 (Up to 4.1GHz, Beat i5-1030G7), 16GB DDR4 RAM, 1TB PCIe SSD, Blue tooth, HDMI, Webcam, Windows 11, Silver, w/ 3in1 Accessories.

Let’s break that down. Intel Core I3 is an older and slower pro cessor (even an 11th generation one); you want I5, I7 or I9, the higher the number the better. 17.3-inch screen means it could be monstrously heavy for a laptop. Check the weight if you want it to be portable.

16GB of RAM should be a standard today. You might get by with 8 or 12, but you will want more in a laptop than that. RAM is where the work on a computer can bog down. A 1 Terabyte (TB) SSD is a solid-state drive which is really good. The drive is where you store your applications and data. 1 TB is 1024 GB (Gigabytes). Most of your cheaper models will push a 256 GB SSD which is NEVER enough.

If you are buying a desktop/laptop, you want Windows 11. Most of the other features listed come standard on just about anything you buy. You definitely want to pay attention to the number and types of ports like USB, HDMI and other video ports. In my opinion, this laptop is worth $400 not $650.

If you are wanting to purchase a desktop or laptop, here are some suggestions to follow.

Go look at what you are interested in at a store locally. Want to buy a computer/tablet/laptop/phone, you name it? Go get the look and feel at the store. You do not have to buy it there. Any time I go to a city with an Apple store, I go in and put my hands on all the test models. Best Buy and club warehouses have the ability for you to test out anything, so do it. Find what you like.

Make a note of it and the features. Take a picture of the specs with your fancy phone…that’s what it’s for. Then shop around both in stores and on the Internet paying close attention to get the specs and features you want for the price you want too.

3. 2.

Is the extended warranty or Geek Squad stuff worth it? Proba bly not, but it depends on your level of expertise. I get Apple Care on my phone because a lot of bad things can happen with a phone. My laptops? Never.

If you are shopping online, make sure it is with a reputable retailer. On Amazon, look at the stars, read a few customer re views and be careful of some 3rd party resellers. Doing so might save you some headaches later.

5. 4.

Despite what seems like light-speed development, newer is not always better. Case in point, except for the camera, an iPhone 13 is just like an iPhone 14. No need for the pricy up grade. Wait for the iPhone 16 to get more value for your money.

I also tend not to purchase really off-brand of technology. Generic may work for groceries but it’s not as helpful with technology. It really comes down to service and support after you have made the purchase. The off-brands may not provide you with the best options here. Sometimes you really do get what you paid for.

6.

Be critical of those things that are put on sale at the high-pres sure times of the year. The only exception I might make to that is back-to-school sales because good deals can be found then, but they are usually found at office supply stores not big box retailers or online.

Most computer people like me will also never buy from certain manufacturers. Often that is based on personal experience. I have a list just like that. I do not care if they are giving them away, I am not taking it. Making the wrong decision can have long-term consequences so do some research. Be patient. What seems like the best deal today will likely be available again.

Happy computer/laptop shopping. As a guy who just properly disposed of 15 years’ worth of old computers/laptops, it pays to pay more, take your time, and get what you want/need the first time.

57 | TODAY'S FDA november/december 2022 7.
1. technology

Go Back-to-school for Radiography Certification

Education opens so many doors and can help people grow personally, in their careers and in their earning capacities. Dental assistants can join the back-to-school movement by seeking certification in radiography. The easiest way to become certified to expose radiographs is to take the Flor ida Dental Association’s (FDA) online radiography training course.

Why is it easy?

l It’s completely online! You can study at your conve nience, at home or in the office, on a desktop, tablet or smartphone, any time, any day, and for as long as you want.

l No travel, no classroom, no health risks.

l Enroll at any time and work at your own pace.

l It’s affordable for your employer. Online tuition is only $285 for FDA member dentists.

l Once you’ve earned your FDA radiography certificate, you simply apply to the state of Florida for your license. Once licensed, you will have new skills to contribute to your team, greater job satisfaction and more diverse tasks.

How to get started

A dentist who wishes to make the FDA’s radiography training available to employees first needs to create an account at mydentalradiography.com/FDA and complete a short tu torial that explains the supervising dentists’ responsibilities. By state law, only dentists without any current or historical licensing actions are allowed to be supervising dentists for this training. When the tutorial is completed, the supervis ing dentist is assigned an identification number and can

purchase and assign vouchers to staff members. The dental assistant who is to take the training receives a “welcome” e-mail and can create an account and get started learning right away.

About the course

The training consists of nine modules, each with a quiz to test the student’s learning in preparation for the final test. The final test covers the online course material and must

receive value for their membership.

For more information about the radiography program, contact the FDA at 850.350.7114 and speak with Lywanda Tucker or email her at ltucker@floridadental.org How’s this for an amazing back-to-school experience for your staff? No travel. No time away from work. They train online, at their own pace. The Florida Dental Association (FDA) Online Radiography Training Program provides your team the formal training they need, with the professional development they want. Enrich career paths while contributing a vital service to your patients and dental team. It’s the most convenient and economical way to get the radiography training required by Florida law. It’s affordably priced, too — just $285 per student* for FDA members!

58
TRAINED RADIOGRAPHY? TO FIX THAT. RADIOGRAPHY TRAINING THAT MAKES BACK TO SCHOOL COOL AGAIN FOR YOUR DENTAL TEAM CALLING ALL DENTAL ASSISTANTS

RADIOGRAPHY TRAINING THAT MAKES BACK TO SCHOOL COOL AGAIN

How’s this for an amazing back-to-school experience for your staff? No travel. No time away from work. They train online, at their own pace. The Florida Dental Association (FDA) Online Radiography Training Program provides your team the formal training they need, with the professional development they want. Enrich career paths while contributing a vital service to your patients and dental team. It’s the most convenient and economical way to get the radiography training required by Florida law. It’s affordably priced, too — just $285 per student* for FDA members!

59 | TODAY'S FDA november/december 2022
*Non-members pay $385.
YOUR DENTAL TEAM CALLING ALL DENTAL ASSISTANTS PRINT AD_0291_ Radiography_Target DENTIST_back to school_F_2022_2.indd 1 8/31/2022 2:13:35 PM
FOR

LEADERS EMERGING AMONG DENTISTRY

LEAD

JAN. 20, 2023 • TAMPA, FLORIDA

An organization’s ability to thrive is largely determined by the quality and effectiveness of its leadership. Great leaders can create tremendous success, but leadership skills don’t always come naturally. At the Florida Dental Association we believe that great leaders are developed through learned skills and practices. LEAD, Leaders Emerging Among Dentistry, is an FDA program that provides participants with training to enhance leadership and interpersonal skills as well as a backstage pass to FDA offerings and experiences. LEAD features speakers from around the country with a focus on providing ideas and tools to help member dentists succeed in their leadership pursuits.

LEARN MORE AND REGISTER AT FLORIDADENTAL.ORG/LEAD

Highlighting FDA’s Event for Leaders

Emerging Among Dentistry

The Leadership Development Committee of the Florida Dental Association (FDA) is excited to announce its annual Lead ers Emerging Among Dentistry (LEAD) event taking place Friday, Jan. 20, 2023, at the Tampa Airport Marriott. This half-day program, from 1-5 p.m., provides leadership training to enhance your abilities and interpersonal skills to help you become a stronger leader in your practice and your community. The first half of the program will focus on discovering your communica

60

tion style and conflict resolution through interactive leadership coaching by renown leadership consultant, Velma Knowles. She will provide a new perspective on your communication style and give tools to adapt your style for greater connection, leading to greater team collaboration and increase in employee morale. The second half of the LEAD event will include in teractive, round-table discussions focused on real-life leadership challenges and current trends in the dental landscape. The day will also be sprinkled with informational presentations on FDA governance, advocacy and Foundation programs to share what is being done at all levels of the organization.

So, you’ve been to leadership events before and you’ve received training on some of the above-mentioned topics, and you may be thinking … why should I go to this particular event? What makes this event different? While all methods of self-im provement should be applauded, the fact remains that leaders change over time. As you grow in your practice and become more confident in your leadership skills, it is important to re-evaluate your strengths and receive additional training on areas of your skill set that may be a struggle. As much as leaders change, teams and their needs change as well. The challenges dentists face today are different than the challenges faced even a few years ago. Through the self-reflection and goal-setting portions of this event, you will receive tangible skills that you can incorporate into your day-to-day life. Investing time in your self will bring invaluable insight to your interactions with your team, your community and your colleagues. After the event, attendees have the opportunity to attend a leadership reception with FDA House of Delegates members to network and learn more about the behind-the-scenes of the FDA.

If you are looking to get more involved in dental leadership, become a more effective leader, or just learn more about orga nized dentistry, this is the event for you. LEAD is a free event for FDA member dentists as well as Florida dental students. The FDA has a limited number of grants available to assist with travel costs. For more information, access to the hotel room block, and to register, please visit floridadental.org/lead.

Registration is limited to the first 50 registrants.

61 | TODAY'S FDA november/december 2022 lead
event
” If you are looking to get more involved in dental leadership, become a more effective leader, or just learn more about organized dentistry, this is the event for you.

Employment Agreements/Contracts

You’ve successfully graduated and passed your boards – what’s next? For many of you, it’s getting that first job out of dental school. Almost all those jobs will involve an employment agree ment of some kind. The first question that should come to mind is – “What should I expect?” In truth, most employment contracts are 90% boilerplate – meaning it is standard wording that will appear in every contract. The major elements are as follows:

Restrictive Covenant – Basically this will have two elements: time and distance. The typical time is two years, the distance will vary depending on the practice location. If you are in a high-den sity urban area, it could be one to three miles; if you are in a suburban area, it could be three to five miles. This is something that you may be able to negotiate a bit, but you will have some thing in place.

Non-Solicitation – This is an absolute. No negotiation here. Basically, it says that you cannot solicit staff nor patients directly if you leave the practice.

Benefits – Things like insurance (health, malpractice, life, disabil ity), continuing education, paid rime off, etc. Keep in mind that if your employer is supplying malpractice, when you leave, you will be responsible for purchasing “tail” insurance. Although you may be tempted to try to negotiate here, many of the benefits are covered by federal regulations (ERISA) and, as such, must be the same for everyone. Doesn’t hurt to ask, but don’t be disappointed if there is no room here for negotiation

Compensation – This is the most important part. Usually, it is a percentage of collection calculated on a monthly basis. Many also include a deduction for lab fees incurred. An example would be 30% collection, less 30% lab fees. The reason for the lab fees is to ensure that you have some skin in the game and won’t be un

reasonable about to whom you send you lab cases. Many times, there will be a daily minimum guarantee as well. Sometimes that guarantee go es away after 90 days. You may be able to negotiate this, but keep in mind that you will have to be able to earn your keep and if you are consistently producing less than your mini mum, you will probably be looking for another job.

Notice – Usually the contracts require a 30-day notice. Trying to negotiate a lesser time frame will raise alarm bells for the employ er. Remember that if you decide to leave, the employer will need time to find a replacement and you should allow time to finish your cases.

Attorneys – Many of you will want an attorney to look over the contract before signing. There are two important things to note. One is that the contract will be weighted in favor of the employer. The reason for this is that all you have to lose is your job; your employer could, in theory, lose the practice. So, please remem ber that when your attorney tells you that the contract is not in your favor. Second, it is important that if you use an attorney you choose someone who has experience in health care employment agreements. An attorney that does real estate closings and wills is not a good choice. Ask the FDA for help and guidance with this.

In order to have a good experience after signing on, it is vitally im portant to keep the lines of communication open. Be sure to ask whom you speak with if you have any questions and/or problems. Everyone involved wants the experience to be a positive one, so open and constructive communication is vital. Almost all prob lems are the result of misunderstandings or miscommunication. Being aware of that will make your first employment experience a positive one.

Bryan T. Marshall, DDS, MBA is currently the CEO of Pioneer Dental Services based in Denver, CO. He has served as Chief Dental Officer for several Regional DSO’s throughout the United States. Dr. Marshall also served as a past FDA treasure. He can be reached at btmarshall@msn.com.

62

The Dentists Supply Company:

Dental Supplies as a Member Benefit

Each and every day, shoppers at TDSC.com can save 24% on supplies; however, members of the Florida Dental Association save an additional 7% more on average, equating to greater than 31% savings on supply spends. Additional benefits to members of organized dentistry include:

l Competitive pricing on dental supplies.

l Free shipping on orders more than $99.

l Next day delivery on over 95% of in-stock items*.

l Commitment to supporting state dental associations.

Monitoring Your Supply Overhead

When the Florida Dental Association (FDA) was looking for innovative ways to help its members be more competitive and efficient in the business side of dentistry, they found TDSC. com. The FDA’s group purchasing partnership provides mem bers with dental practices of every size competitive prices on supplies from leading brands. Additionally, TDSC.com equips its shoppers with:

l Savings guides that act as your own personal formulary.

l A dental supply overhead calculator to help you stick to your budget.

l Ability to create shopping lists and save favorite items.

l An educational blog to keep shoppers up to date on trends and best practices.

64
tdsc

Why Shop at TDSC.com?

Florida dentists and their staffs can save time by shopping at their convenience 24/7 with TDSC.com and there is no need to negotiate. TDSC.com offers supplies at competitive prices to all dental practices – large or small. New dentists can take advan tage of great prices, even if they’ve just opened their practice. Supply pricing can be confusing. We practice price transpar ency so it’s easy to see the price you’ll pay with TDSC.com.

TDSC.com offers additional savings opportunities for all customers throughout the year with promotional events. Whether it’s a Flash Deal or Sitewide Event, dental practices will have the option to save even more. Sign-up for our emails to learn about all the promotional events when you create an account.

TDSC.com makes it easy to buy dental supplies online and receive them quickly, too. With next-day delivery* on leading brands, you can feel confident in knowing your products will arrive fast!

Visit TDSC.com to see for yourself!

Our wide selection of products is consistently growing. TDSC. com has recently added a larger variety of lasers, sterilizers and scanners, making our equipment and technology offering larger than ever before! TDSC.com is an authorized source for the

best, top-quality dental supplies you love from brands you trust including:

When you shop with TDSC.com, you can be sure you’re pur chasing only top-quality dental brands at the best prices. TDSC.com’s knowledgeable customer care team offers product information and shopper support before, during and after the sale. Want to learn more? Give us a call at 888.253.1223 or send an email to support@tdsc.com.

Disclaimer: Exclusions apply. Next-day delivery is provided for over 95% of line items, dependent on inventory levels and time of order placement. Orders may ship from separate locations and may arrive at different times. Please refer to product detail pages for delivery estimates and exclusions. See tdsc.com/disclaimers for details.

65 | TODAY'S FDA november/december 2022
” Supply pricing can be confusing. We practice price transparency so it’s easy to see the price you’ll pay with TDSC.com.
l
l
l
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l
l
l
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3M ESPE
Cranberry
Clinician’s Choice
Colgate
DenMat
Dentsply Sirona
Fluoridex
GC America
Henry Schein Inc.
Kerr Corporation
Ortho Technology
Plasdent Corp

2022 FDA President Dr. Jerry Bird

Dr. Bird was born in Chicago, IL while his dad was going to chiropractic school. The Bird family migrated in the early years to Holland, Mich. and Platte, S.D. The family eventually settled in Marne, Mich. to be close to relatives. Dr. Bird is the eldest and has a sister, Carol, in Michigan, a brother, Keith, in Georgia and his youngest sister, Teresa, in North Carolina.

While in 6th grade, Dr. Bird knew he wanted to be a dentist. Once in dental school, he fell in love with oral surgery. Dr. and Mrs. Bird married in 1984, and moved from Michigan to Florida in 1985, where they built a thriving oral surgery practice. They have two chil dren, Kevin (34), a surgical nurse who lives in Naperville, IL with his wife, Taylor, and their son Carter. Stephanie (32) works at Lock heed and lives in Denver with her soon-to-be fiancé, Anthony.

The Bird family is a sports family. Running, soccer, basketball, cycling and triathlons were all part of busy weekends. The kids went to many dental meetings with mom and dad and, probably like your kids, they began to think the meeting hotel was THEIR hotel. In his spare time, Dr. Bird was an assistant varsity men’s soccer coach at Holy Trinity Academy in Melbourne for several years and still attends games.

Dr. Bird has been involved in the Brevard County Dental Society, Central District Den tal Society, the Florida Dental Association 1.

fda president

Photos:

1. Dr. and Mrs. Bird in D.C. at Dentist and Student Lobby Day.

2. Dr. Bird with grandson Carter.

3. Mrs. Bird, Florida State Representative Tyler Sirois and Dr. Bird.

4. Drs. Matt Sheldon, Jerry Bird and Jim Antoon.

5. Dr. Bird sporting his Michigan gear.

6. Dr. Bird, Mrs. Bird and their surgical assistants (l to r) Shelley, Ashley and Ellery

7. Dr. Bryan Bergens, Past Central Florida Distrist Dental Association (CFDDA) President, Marlinda Fulton, executive director for the CFDDA, and Dr. Bird celebrate 100 years of association excellence!

8. At Ironman Alaska this summer - Dr. and Mrs. Bird with their daughter, Stephanie, after she finished Ironman Alaska, and her beau, Anthony.

9. Kevin (son), Carter (grandson), Taylor (daughter-in-love).

67 | TODAY'S FDA november/december 2022
4.
3. 2. ”
5.
His goal for the Florida Dental Association is to be a unified force for the dental profession. The FDA already is the “Go To” place for all things dental.
Expect More With NDX 50% off of your first order Offer only valid for Clinicians based in Florida. Case value not to exceed $299. Coupon must be enclosed with case. No copies accepted. If submitting the case via IOS, please put the promo code in the notes section Cannot be combined with any other offers. PROMO CODE: FL50FIRST22 - Expiration Date: 12/31/22 THE POWER OF THE NETWORK FUEL THE SUCCESS OF YOUR PRACTICE NDX is the largest dental lab network in the country... with more than 60 labs providing the most advanced technology for all aspects of dentistry. We focus on your practice... whether it’s digital technology, crown artistry or the most aesthetic implant restoration for your patient. But don’t take our word for it…try us out for yourself. To get started with NDX... please visit us at nationaldentex.com and request a Welcome Kit. Feel the difference of a nationwide network. Scan the code to submit an inquiry and your local representative will connect with you. MKT00336.RevA © 2022 National Dentex, LLC. All Rights Reserved.

(FDA) and American Dental Association (ADA) since 1985. He has always thought it was important to give back to the profession to make it better for those who will come after him. His most loved arena is legislative, and his favorite job has been chair of ADPAC. He had a great legislative mentor, Dr. Robert Downey, who taught him much of what he knows. In their early office years, a team member’s dad who was their friend, realtor and part-time babysitter became a congressman. The rest is history.

Dr. and Mrs. Bird have been vegetarians since 1983, and they love Mexican food. They also love Michigan football and Tom Brady. His favorite guilty pleasure is a Ghirardelli dark chocolate brown ie with vanilla ice cream topped with whipped cream. Anything chocolate is #1. Although Jerry is not a fan of candy, many of his Board of Trustee friends like to share their chocolate buckeyes with him at meetings. Hmmm? But he really loves his University of Michigan Wolverines.

Dr. Bird loves to dance. 70’s and 80’s songs are favorites. He needs a new hip from the cycling accident, but once he gets the new total hip in December, watch out ... he will be back on the dance floor!

Dr. Bird loves his family, his profession, dogs, babies, all of his pa tients and many friends. His favorite drink of choice is water, and it is with him everywhere he goes. His favorite movie is “Shaw shank Redemption,” which he has watched at least 10 times and lives the “Get busy living or get busy dying” quote every day. His goal for the FDA is to be a unified force for the dental profession. The FDA already is the “Go To” place for all things dental. During the COVID-10 pandemic, the FDA was a leader in getting the latest information. Whether providing the safest conditions for patients and teams, helping dentists secure Paycheck Protection Program loans, and grants, the FDA had us covered. Now it is hurricane season, and the FDA is checking on us and making sure we are ready. The FDA is an amazing organization!

69 | TODAY'S FDA november/december 2022 fda president 8. 7. 9.
6.

A LOOK AT WHAT’S TO COME AT FDC2023 WITH FDC GENERAL CHAIR, DR. BECKY WARNKEN

Q. A.

As the new General Chair of Convention and Continuing Education (C-CCE), what can we expect for you to bring to the Florida Dental Convention (FDC)?

First, I want to say that I am beyond excited to be the new C-CCE General Chair. During my six years on the committee, I have served in every aspect on the committee. I know how much this group pours into FDC every year, and we cannot wait to continue to showcase the innovation this group delivers each year. While education is – and will always be – our focus, we will also continue to offer new events for the whole dental team, as well as the dental family. I want your experience at FDC year after year to be the cutting-edge dental meeting you have come to expect, with a few surprises here and there to keep you guessing “what’s next?!”

I, myself, am a practicing dentist in a multispecialty office with a diverse team and a young family. I intend to continue to bring this unique perspective to C-CCE, pushing the envelope on our events and FDC to continue to expand our offerings to fit every aspect of your team, family, and practice! I intend for FDC to continue to be the premier educational AND fun meeting for our Florida dentists and beyond!

Q. A.

What do you look forward to most in attending FDC?

are top notch; the vendors are excited to meet, connect and help attendees accomplish their goals; and the attendees are all eager to learn. “Come for the CE, stay for the fun” isn’t just something we say – it truly happens every day of FDC!

Q. A. Q. A.

We know there are many outlets to get your continuing education. Why would you recommend your colleague get continuing education (CE) at FDC?

There is nowhere else in Florida that you can get all that FDC offers: 130+ amazing courses to choose from, education for you AND your team, top-notch social events for all attendees, and an incredible resort for your family to enjoy, all at an affordable price with FREE registration for FDA members!

Beyond the obvious, the FDC Scientific Program is phenomenal. There are 90+ distinguished speakers — experts in their fields who offer everything from advanced dentistry and hands-on workshops to communication and administrative courses. Bring your team and learn cutting- edge skills that can be implement ed in your dental office on Monday morning.

Why do you choose to bring your team to FDC and what type of skills/knowledge have they brought back to the office?

I absolutely love the energy and comradery of FDC. There is nothing like it. Everyone who attends is excited about dentistry, ready to gain skills, learn something new, and continue to serve their patients better when they return home. The speakers

My team attends FDC because there is something in the pro gram for every single one of them. My business assistants have gained communication and conflict management skills. My hygiene team has gained knowledge in everything from instru mentation and ergonomics for more efficient calculus removal

FDC2023 SPEAKER PREVIEW

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to oral pathology to additional adjuncts for disease manage ment. My clinical team has learned 3D printing applications for the general practice, tips and tricks for efficiency throughout their day, better lab case management, and implant pieces and parts to name a few! They also rave year after year about the Friday night party and are very much already looking forward to the “Out of this World” theme this year!

What kind of perks can FDA members expect to receive at FDC?

First and foremost, FDA members receive free registration and CE. All members receive free pre-registration, up to 19 CE cours es for free, and discounted course fees with pre-registration.

There are also motivational keynotes on Thursday and Friday that are FREE for all attendees during pre-registration.

You can also discover and test drive the latest products, services and dental technologies from 300+ industry leading exhibitors in the FDC Exhibit Hall. Access to the Exhibit Hall is included in FDA members’ FREE pre-registration.

And, of course: Come for the CE, Stay for the Fun! There are endless opportunities to connect with colleagues, make new friends and enjoy your time during FDC. Enjoy alumni recep tions, specialty meetings, family-friendly social events and all the fun Gaylord Palms has to offer all under one roof. As always, the legendary FDC Thursday and Friday parties are included for free in your registration.

The 2023 Florida Dental Convention will be held June 29-July 1 at the Gaylord Palms Resort and Convention Center in Orlando. You can view courses and make your hotel reservation at floridadentalconvention.com. Registration opens March 1.

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My team attends FDC because there is something in the program for every single one of them.
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Q.

YOUR PATIENT, YOUR DUTY:

Legal Issues Surrounding Medical Emergency Preparedness

Following continuing education programs, participants often come forward and ask a question about which everyone is wondering but too timid to ask publicly. When I speak on medical emergency preparedness, the question is, “What must I do to legally protect my office from litigation after a medical emergen cy?” While the question is a mere 15 words, the answer is far more complex.

Is There Really a Problem?

The dental profession has no mechanism to track or quantify medical events occurring during dental treatment. Regardless, there are five risk factors that point to medical emergencies during dental treatment increasing in frequency, intensity and diversity.

1. Demographics: As the baby boomer generation continues to age, the percentage of the general population in the upper age brackets continues to increase. Aged patients have an increased risk for undiagnosed or under-diagnosed medical problems.

2. Complex Medical Histories: Paradoxically, improvements in medical care mean that today’s dentist is faced with patients who have far more complex medical conditions than our predeces sors. Patients that in past generations were homebound (or dead) are now able to live full, active lives, including receiving dental care.

3. Increase Sophistication: As dental treatment becomes more complex, appointments are becoming longer with an increased emphasis on surgical treatment.

4. Use of Sedation: Today’s dental patient expects not only clinical excellence but also freedom from both pain and anxiety during treatment. Dentists are responding by offering wider rang es of sedation during treatment.

5. Dropped Dental Devices: While foreign objects blocking the airway have always been a concern to the dental profession, the increased reliance on dental implants, many with small instru mentation or components, only serves to heighten this issue.

The public does not expect the typical dental office to be a “mini emergency room;” nor does it expect that a typical dentist be capable of all the services a paramedic could offer.

However, a 2019 white paper published by the American Associa tion of Dental Boards found that patients expect a dental office to serve as a “first responder to the level to which they are trained.” Contained within these ten words are two important concepts.

l First Responder: The public identified six tenets that they felt were important for a dental office to function as an adequate ly prepared first responder.

l Dentist training: The dentist needs to periodically train to respond to a wide array of medical problems beyond basic CPR.

l Staff Training: The dentist should see that the entire staff has been trained to assist the doctor in the management of a medical emergency.

l Mock Drills: The dental team should practice together responding to various medical situations they may encoun ter.

l Emergency Manual: Because medical emergencies are relatively infrequent, the dental team should have a quick reference manual with signs/symptoms and response algorithms for a variety of medical situations.

l Medications: The office should stock emergency medica tions as recommended by the American Dental Association (ADA).

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l Emergency Equipment: The office should stock and main tain basic equipment to manage a medical emergency, specifically the ability to deliver oxygen to both a breathing patient needing supplemental oxygen and a non-breathing patient.

• To the level to which they have been trained. The public cares little about what local community standards are. Instead, they tend to focus on what is being taught in dental school, residencies and continuing education courses.

What’s Expected of Dental Offices

Many dental offices feel they have a legally defensible position against malpractice litigation if they merely fulfill the require ments of their state dental board. Unfortunately, this leads to a false sense of security.

For example, many dental boards require that dentists and dental team members maintain basic life support skills. Other boards require that dental offices stock an automated external defibrilla tor (AED). While neglecting a dental board’s mandate is inherently negligent, fulfilling the mandate does not imply that a dental office has met the standard of care.

The legal system has long established that it is impossible for the law to cover every possible situation. Consequently, the courts instruct juries to follow a legal doctrine of the reasonable man standard

As it pertains to medical emergencies during dental care, the jury seeks to determine what a reasonable dentist would do in a similar situation. They will pay little, if any, consideration to what the colleagues of a dentist are doing. Instead, they will define a reasonable dentist’s response as being what he/she should have done in the situation ... and to answer

that, they will likely look at the areas outlined earlier.

So When Does Malpractice Occur?

For malpractice to have occurred the plaintiff’s attorney must prove four things. If the defense can trip up the plaintiff’s case in any one area, it is like the baseball player who fails to touch second base. The batter may have hit a home run, but no run is scored.

The four pillars of a dental malpractice case are:

1. Duty: The dentist has an obligation to the patient.

2. Breach: The dentist failed to fulfill that obligation to the patient.

3. Damage: The patient suffered an adverse consequence.

4. Cause: The breach of duty was the direct reason for the damage suffered by the patient.

One More Legal Principle

One area in which dentists can find themselves in trouble is the legal principle of mitigation of damage. In short, in any situation, the involved parties have a mutual obligation to not make the situation worse than it would normally be.

Imagine a driver gets confused at an intersection, makes an illegal turn and causes a collision with another car. The driver of the second car, the victim, who was not wearing a seat belt in a state with a seat belt mandate, sustains a fractured pelvis and a concussion from his head hitting the windshield. Who pays for the victim’s medical expenses?

Clearly, the driver that caused the accident is financially responsi ble for the fractured pelvis and any other negative consequences

There is such a need for pediatric OSA services that once you overcome your reservations and start having these conversations, your program will grow with very little work from you!
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such as loss of mobility. However, concussion is a different situ ation. The concussion was caused by the victim hitting his head against the windshield. The victim, merely by following the law and wearing a seat belt, could have avoided hitting his head.

Consequently, the victim, while not being responsible for the accident as a whole, is responsible for the portion of the accident that he made worse.

Putting it All Together...

Let’s take the following hypothetical situation and examine the dentist’s responsibilities. A patient presents for a standard pre ventive maintenance appointment in the hygiene department. During the prophylaxis, the patient begins having chest pains. The dentist comes to the treatment room, assesses the situation and directs that EMS is called. After reviewing the patient’s med ical history, he administers aspirin. However, because the office only has supplemental oxygen for a non-breathing patient, no oxygen is available.

After 20 minutes, a reasonable response time, EMS arrives, administers oxygen and begins transport to a hospital. While transferring the patient to the ambulance, the patient goes into full cardiac arrest. The paramedics attempt to defibrillate the patient, but he ultimately dies.

Will there be litigation? Probably. Plaintiffs usually consult an attorney if something unusual has a serious negative outcome. Now it becomes the plaintiff’s attorney’s to prove the four pillars of a malpractice case.

Damage is self-evident. The patient died.

Did the dentist have a duty to the patient? In a jury trial, a jury will likely conclude that, “Yes,” there was a duty. The dental team should respond as a properly prepared first responder.

Did the dental team breach that duty? Despite doing most things right (promptly calling EMS and administering aspirin) the dental team did not have equipment to oxygenate the patient while waiting for EMS. Consequently, there was a breach. That’s three of four. The case now hinges on causation

Did the dentist cause the heart attack? It will be almost impossi ble to prove that the dental treatment was the direct cause of the patient’s myocardial infarction. Consequently, it would superfi cially appear that the case lacks causation and the dental office did not commit malpractice.

However, the plaintiff’s attorney will likely use the concept of mitigation of damage to prove the case. Did the dentist’s failure

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to oxygenate the patient make the patient’s existing heart attack worse and directly cause the patient’s death?

This is a far simpler challenge for the plaintiff’s attorney to prove. If it can be shown that providing supplemental oxygen while wait ing for EMS could have made the heart attack survivable, then the dentist is responsible for the difference between the competing scenarios. Unfortunately, this difference is the difference between life and death.

In all likelihood, the dentist’s malpractice carrier will seek to avoid going to trial and attempt to protect the dentist’s dental license and personal financial assets.

Back to Our Original Question...

Legally speaking, how can a dentist best prepare a dental office for a medical emergency?

The ADA recommends following the six principles sited earlier.

1. Dentists should periodically take medical emergency courses beyond CPR. Every two years is a reasonable interval.

2. Dentists should train their staffs to assist the dentist in re sponding to a medical emergency in a coordinated manner.

3. Dental teams should periodically practice responding to a variety of medical scenarios.

4. Dental offices should have a quick reference manual available featuring signs/symptoms and a series of response algorithms to medical events a dentist is likely to encounter.

5. At minimum, dental offices should stock the seven emergency medications recommended by the ADA.

6. Dental offices should maintain basic medical emergency equipment with an emphasis on supplemental oxygen.

Dr. Sangrik will be offering the courses “Impact of Personality on Patient Behavior Deep Dive,” “Medical Emergencies in the Dental Office: Why CPR is Not Enough” and “Understanding Dental Fear: Successfully Treating the Apprehensive Patient” at the 2023 Florida Dental Convention. Learn more about Dr. Sangrik’s FDC2023 cours es at floridadentalconvention.com.

This article is for informational purposes only and is not intended to be a substitute for professional legal advice. If you have a specif ic concern or need legal advice regarding your dental practice, you should contact a qualified attorney.

FDC2023

HAVE YOU NOTICED CHANGES IN YOUR COVERAGE FOR DENTAL BILLING?

Third party payer policy changes happen all the time since they are running a business and not practicing on a real patient. The company feels it is up to the purchaser of the policy to under stand what is covered and why.

Many plans have what is called Integrated Benefits for Hygiene Visits. What these do for patients with systemic issues such as diabetes, kidney, arthritis and many more medical conditions allows them to have four covered visits with many codes that are not normally covered on the six-month visits since they have a medical condition, and they need to stay in remission. I use the word remission since hygiene is about stemming the infection of the oral cavity, so the patients’ medical condition does not have other infections traveling through the body.

We have said for years that patients who have a diagnosed condi tion need to stay as healthy as they can since their body is already compromised. This was a hard lesson that the world was told for the past three years during the COVID-19 pandemic. What hap pens when a patient has a compromised system? They are not able to fight back as hard as needed since they’re already fighting.

This has changed the entire way we have traditionally diagnosed patients for treatment, the treatment plans we offer and why learning how to use diagnostic codes is necessary.

An example many of the dental plans that have added to the extra visits are all patients that have a medical diagnosis, and then we must add our diagnosis to have the patient covered.

We must learn that a periapical radiography (PA) alone is a diag nostic tool, so it must be documented ordered and then what was seen on that x-ray that is causing a problem. Very few den tists take this step, and with the many changes in codes for differ ent types of x-rays from PA to cone beam computed tomography

(CBCT), we must learn how to use them to back our treatment up.

If you are using the updated 2023 coding book by the American Dental Association (ADA), the dental diagnostic codes are in the book. The big problem is never being trained officially to use them correctly.

1. How to choose the diagnosis we are performing for the work we are billing.

2. How to communicate with the medical provider what his diagnosis is for treatment of the patient.

3. How to put them together for both dental extra benefits and medical benefits for patients who are not covered in dental or who have no benefits for a treatment such as bone grafts that are no longer covered in dental.

Let’s give you an example of how to bill for a bone graft for a patient who is diabetic.

21210 – Graft, bone; nasal, maxillary, or malar areas (includes obtaining graft). The physician utilizes a bone graft to augment or aid in the healing of the nasal, maxillary, or malar regions. Under general anesthesia, the physician obtains bone grafts from the patient’s rib, skull, or hip. An incision is made over the defective area, and the physician plants the graft into the ap propriate region. Wires, plates, or screws may be used to hold the graft to the recipient site. All incisions are closed.

Lesson 1. If you do not use the bone from the patient, then you must use a modifier to show the insurance company you are purchasing bone. Use modifier 52 which states you are not utilizing the patient’s bone.

Lesson 2. Put the lab bill on the claim for the purchase of the bone.

Your diagnostic codes are going to depend on the patient’s medical history and the primary medical doctor who is treating this patient. The medical issues can come from the following areas in the example provided below:

E13.638 – Other specified diabetes mellitus with other oral com plications

E11.630 – Type 2 diabetes mellitus with periodontal disease

We then also need to learn how to ask the provider what treat ment is being provided for this patient so we can add that.

This patient is using insulin (Z79.4) adverse effect, which is a side effect of a substance correctly prescribed and administered. The nature of the adverse effect (e.g., dizziness, hives) would be coded before the T code.

T38.3X1A – Poisoning by insulin and oral hypoglycemic [antidia betic] drugs, accidental (unintentional), initial encounter.

After you choose these codes, which are only able to grow the medical doctor’s code, you have given the medical plan the rea son why you are performing treatment on any patient with these conditions.

Notice that many of your patients have diabetes and one of the biggest reasons systemic issues are used is that the patient’s sali va is not healthy and continues to infect the patients’ body. That is the big reason dental added the additional hygiene visits and why you can do work to help the atrophy, decay or other issues in the oral cavity including oral cancer screenings.

In hopes you want to continue to grow your practice both for the benefit of the patients, but also to the benefit of your financial ability to continue your journey without wondering how to cover your overhead and pay everyone in your office.

P.S: The use of AI is helping staff use treatment plans better and provide the information needed for both dental and medical for payments. Don’t let them use it to ask for overpayments; you use it to protect your office.

Ms. Taxin is the founder and president of Links2Scuccess and Dental Medical Billing University. She will be offering the course “Dental to Medical Billing Deep Dive,” on Friday, June 30, 8 a.m. - 12 p.m. at the 2023 Florida Dental Convention. Learn more about Ms. Taxin’s FDC2023 courses at the 2023 Florida Dental Convention at floridadentalconvention.com.

We must learn that a PA alone is a diagnostic tool, so it must be documented ordered and then what was seen on that x-ray that is causing a problem.
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THE 10 FINANCIAL STRATEGIES TO SUCCEED IN DENTISTRY

As dentists we are blessed with having a great profession. There is no other career I know of where you can be your own boss, work in the manner that you choose and create a great life for your family.

Dentists also have an opportunity to earn a tremendous amount of money by working as hard as they choose.

Over the course of an average 35-year career, a dentist can easily collect over $30,000,000 in his or her office. Many dentists will do far more than this.

A dentist can also easily average $250,000 - $350,000 in take home pay yearly. Why is it then that only about 10% of dentists can afford to retire and stay at the same standard of living? It’s not that we don’t make enough money. As the saying goes, we don’t plan to fail. We just fail to plan.

In this article, I will share 10 financial strategies to help dentists reach their goals. By using these proven, highly effective strat egies, we can move confidently towards becoming financially independent.

Develop a Written Financial Action Plan. Create this plan as early as possible and don’t stop. Having a written plan that spells out exactly what you will accomplish and how you will do it, greatly increases the chances of success. Keep the plan in var ious places where you can easily see it every day. By constantly reminding yourself of your objectives, success comes more easily. If you need help in creating a plan, work with a financial professional. It will be money well spent.

Live Below Your Means. Human nature causes us to try to live at or above our means. When we first start our careers, we have to be more frugal with our spending. We typically aren’t making as much money, so we don’t get into as much trouble. As we earn more, we justify the increased spending by saying

we deserve it. There is always a tug of war between our current desires and our future needs. Most of the time, the current de sires win. One way to help prevent this is to visualize your future self. What will your financial situation be like in 15-20 years if you keep doing what you are now? In the fourth strategy, I will show how dentists can provide for their future without sacrificing their present.

3.Maximize the Collections in Your Dental Practice. By working at an increased level, you create more production and collection. Most dentists are working at close to half their pos sible capacity. The problem is we don’t usually know how to fix our issues. Some type of change is needed. This change could be in your facility, your staff, your skills, or even in yourself. Many times, in a dentist’s career, they will reach a point where the practice hits a plateau. The dentist feels like they are working as hard as they can, in their current office, with the staff they have and the systems in place.

It feels like they have hit a wall. Usually, a fundamental change is needed. Typically, the dentist will need help making these changes. Consultants that help with practice management is sues are not inexpensive. They are however, worth every penny if they can facilitate the needed change.

4.Invest Automatically. This is a key to becoming wealthy. Your financial life should run on systems, just like your dental practice. By scheduling saving and investing to occur auto matically every month, you are accomplishing many great objectives. First, the money goes directly from your business account to your investments. It doesn’t get sent home where it will be spent. The prescribed funds go automatically into the investments every month. By doing this, you are dollar cost averaging into the market. When the market is down, you are buying in more shares with the money. When the market is up, you are buying less shares with the same amount of money. By using this principal, you are being smart without having to try.

By saving and investing automatically over the years, you will create wealth. The money will arrive exactly where it should be, and you won’t ever miss it.

Always Have Your Money Working. As dentists, we work hard for our money. It should work as hard for us. No one can effectively time the market. In order to do so, one must be right twice. Once when you take the money out of the market and then again when you put the money back in. This is impossible. However, by developing a sound investment strategy and a good long-term plan, and by keeping your money invested, you can benefit from good markets and rebounds in bad markets. Studies show us that the best days in the market usually occur right after the worst days. By keeping your money invested, you won’t be tempted to pull the funds out at the worst time. Most dentists tend to hoard cash in their business accounts, all the while earning next to nothing from their bank. While it is prudent to keep an emergency amount of cash on hand to take care of any unforeseen events, most dentists have way too much cash on hand. They never realize the lost opportunity of having that money working for them. With inflation running high, money in the bank could be losing up to 8-9% in spending power.

Rebalance Your Portfolio Quarterly or Yearly. This is how the principal works. For example, initially your investment portfolio is created with a 60% stocks and 40% bonds asset mix, based on your particular risk tolerance. Then, over the course of a year, if stocks do well, by the end of the year your portfolio would look like 70% stocks and 30% bonds. In order to rebal ance to your original asset allocation model, you would sell some stocks that have appreciated and buy some bonds that are lower. By doing this, you are returning to your original 60/40 model. More importantly, you are selling high and buying low

which is the smart way to invest. Having your portfolio rebalanced automatically ensures it will happen.

7. 8.

Reduce Your Taxes Constantly. The effect that taxes have on the ability to build wealth is enormous. By regularly participating in pretax retirement plans in your dental practice one can save a tremendous amount on taxes. Money is saved pre-tax and grows tax deferred within the plan. Retirement plans come in many types and sizes. Examples can include 401k plans, SIMPLE plans and SEPs. Consult with a financial professional to help evaluate which plan is right for your dental practice. Also, knowing which type of investments to hold in various types of accounts is important. For example, in non-qualified accounts where you are taxed yearly on any gains it is vital to hold appropriate investments. Possibili ties could include municipal bonds that give fed tax free income, growth stocks that you want to hold for a long time and dividend producing stocks. Furthermore, working with a dental specific Certified Public Account (CPA) is very important. The CPA can help save you on taxes every year. One of the biggest tax issues that can occur is when a dental practice is sold. It is extremely important to structure the sale properly. This is very complicated topic which should be dealt with in another article.

Working with A Financial Professional to Help You Optimize Your Outcome. Studies show that people who work with a finan cial advisor can potentially improve up to 2-3% better annually in investment performance over those who don’t. Sometimes getting advice when facing various financial and business issues can help dentists avoid mistakes. Find an advisor who has knowledge and experience with dental practices. By sharing ideas and befitting from experience, you can shorten the learning curve significantly.

It’s not that we don’t make enough money. As the saying goes, we don’t plan to fail. We just fail to plan.
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9.Reverts to strategy 1, Review and Adjust Your Financial Action Plan Periodically. Even a well thought out plan needs evaluation and adjustments occasionally. Time, changing issues in dental practices and circumstances of life will dictate periodic adjustments. As the saying goes, most plans don’t survive first boots on the ground. Communication and flexibility help you to continue to benefit from the plan and move towards the ultimate goal of financial independence.

10.

Maintain Your Focus on Your Long-Range Goals. We are bombarded everyday with news, noise in the media and mean ingless babble. Markets will go up and down, but the prudent dentist knows to filter out most of the daily noise. Over time, a well thought out and followed plan increases the chances of success. The daily rantings and ravings of media announcers and daily market moves don’t mean much in the long term.

Keep your focus on what’s important in your life. Your family, faith, long-term goals and your dental practice should be the focus. By maintaining this focus, you move confidently in the direction of your dreams.

Dr. James Pitts II, is a licensed financial advisor, registered invest ment advisor representative, professional financial strategist, and a dental consultant connection. He will be offering the following two courses “Your Best Year Ever!,” on Friday, June 30, 2:00 - 4:00 p.m. and “The Long and Winding Road: A Dentist’s Guide to Financial Independence” on Saturday, July 1, 9:00 a.m - 12:00 p.m at the 2023 Florida Dental Convention. Learn more about Dr. Pitts course being offered at the 2023 Florida Dental Convention beginning January 2023 at floridadentalconvention.com.

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Read, Learn and Earn! Visit floridadental.org/online-ce for this FREE, MEMBERS-ONLY BENEFIT. You will be given the opportunity to review the “Diagnostic Discussion” and its accompanying photos. Answer five multiple choice questions to earn one hour of CE. Contact FDC Marketing Coordinator Brooke Martin at bmartin@floridadental.org or 800.877.9922.

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Free preregistration for FDA Members!

A-C

A-DEC

A1 HANDPIECE SPECIALISTS

ABYDE

ACTEON NORTH AMERICA

ADIT

ADS DENTAL SYSTEM INC.

ADVANTAGE DENTAL

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AIR TECHNIQUES

ALPHAEON CREDIT AMERITAS

ARGEN

ARTCRAFT DENTAL INC.

ASEPTICO INC.

ASPEN DENTAL MANAGEMENT INC.

ATLANTIC DENTAL SOLUTIONS

AUGMA BIOMATERIALS USA INC.

AVALON BIOMED

AVZ BENEFIT SOLUTIONS

BANK OF AMERICA PRACTICE SOLUTIONS

BAYSHORE DENTAL STUDIO

BENCO DENTAL

BEST INSTRUMENTS USA

BEUTLICH PHARMACEUTICALS

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Kathy Corrado l Executive Director l k.corrado@acdda.org l 561.968.7714 l acdda.org 10380 SW Village Center, #408 l Port St. Lucie l FL 34987

The Atlantic Coast District Dental Association (ACDDA) delivers even more benefits for success! The ACDDA offers continuing education (CE) to members during their annual conference, which will be held Friday, April 28, 2023. Affiliates provide local meetings and events throughout the year that offer the opportunity to obtain additional CE credits. Bonus: Three meetings are included in your membership dues!

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Counties: Miami-Dade, Monroe, South Broward Yolanda Marrero l Executive Director l ymarrero.sfdda@gmail.com l 305.667.3647 l sfdda.org 420 S. Dixie Highway, Ste. 2-E l Coral Gables l FL 33146

The South Florida District Dental Association (SFDDA) gets creative providing members more ways to succeed! Check out SFDDA’s “Ain’t That the Tooth” podcast where you get a glimpse into members’ lives and their perspectives on dentistry and other topics. Make sure you are a member of SFDDA and interact with your colleagues at 15 different affiliate CE dinner meetings throughout the year, which are included with your membership. Receive high-quality CE courses that fulfill licensure requirements at a re duced rate with automatic reporting of course attendance to CE Broker.

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Read, Learn and Earn!

Visit floridadental.org/online-ce for this FREE, MEMBERS-ONLY BENEFIT. You will be given the opportunity to review the “Diagnostic Discussion” and its accompanying photos. Answer five multiple choice questions to earn one hour of CE.

A 17-year-old Hispanic female presented to Dr. Deck Couch, a Periodontist in Florida, with a chief complaint of swollen gums that interfered with eating. The patient appeared completely healthy with no complaints of spontaneous hemor rhage or bleeding upon brushing. Clinical examination revealed a generalized and diffuse gingival hyperplasia involving both maxillary and mandibular quadrants, especially in the anterior facial aspects (Fig. 1, A-B). The gingiva was swollen and erythematous. Bone loss was not evident in the panoramic radiograph. The patient was completely asymptomatic. A gingivectomy procedure was performed for a cosmetic reason (Fig. 2), however, 14 days later the gingival overgrowth recurred (Fig. 3, A-B). Dr. Couch performed an incisional biopsy. This was then submitted to the University of Florida Oral Pathology Laboratory biopsy service for microscopic examination.

Question:

Based on the above history and clinical presentation what is the most likely diagnosis?

Contact FDC Marketing Coordinator Brooke Martin at bmartin@floridadental.org or 800.877.9922.

A. Chronic hyperplastic gingivitis

B. Orofacial granulomatosis

C. Drug-induced gingival overgrowth

D. Plasma cell gingivitis

E. Leukemia-associated gingival hyperplasia

Fig. 1 (A-B): Diffuse gingival erythema with significant overgrowth.

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Fig. 2: Appearance immediately after gingivectomy.

Fig. 3 (A-B): Relapse of gingival overgrowth two weeks postoperatively.

97 | TODAY'S FDA november/december 2022
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A. Chronic hyperplastic gingivitis

Incorrect. Chronic hyperplastic gingivitis occurs from persistent and long-term gingivitis due to lack of proper oral hygiene, which leads to the accumulation of dental plaque and calculus; howev er, many other factors can affect the gingiva’s susceptibility to the oral flora. Gingivitis could be due to hormonal (puberty, pregnan cy and oral contraceptive), stress, substance abuse, poor nutrition and medications. Establishing an effective oral hygiene regimen should be the goal for these patients. In our case, the oral hygiene appeared to be fair.

B. Orofacial granulomatosis

Incorrect. Orofacial granulomatosis (OFG) is an uncommon entity where oral lesions characterized by persistent and/or recurrent lip enlargement, oral ulcers, and other orofacial features such as mucosal tags, gingival enlargement, and fissured tongue may be noted. The etiology of this rare but perplexing condition is un known. There is a slight female predominance. Most authorities believe an abnormal immune reaction is the root cause. Before calling it OFG, we need to exclude other granulomatous lesions such as chronic granulomatous disease, foreign body reactions and allergies. Typically, biopsy of these lesions reveals lymphoe dema and non-caseating granulomatous inflammation, these features were not seen in the biopsied specimen of the present case. The enlargement of the lips is the most common presenting complaint. Local causes of OFG can be an allergic reaction to cos metics, foods, flavorings, oral hygiene products (e.g., toothpaste, mouth rinses), and dental restorative materials.

C. Drug-induced gingival overgrowth

Incorrect. Gingival overgrowth is a well-documented side effect associated mainly with several medications. The pathogenesis of drug-induced gingival overgrowth is uncertain, and there appear to be no unifying theories that link the three main categories of drugs such as Phenytoin sodium (anticonvulsants), cyclosporine (immunosuppressive), and nifedipine (antihypertensive). Up to 50% of individuals receiving phenytoin exhibit gingival over growth. Phenytoin induced overgrowth tends to respond well to good oral hygiene practices and responds directly to improve ments in oral plaque levels.

Cyclosporine is a widely used immunosuppressive drug used to prevent organ rejection in solid organ transplant patients and has gingival overgrowth induction effect.

Calcium channel blockers especially nifedipine, may also induce gingival enlargement in a certain group of patients. Drug-induced gingival hyperplasia may regress after discontinuation of the offending medication(s) or substitution of one medication for another in the same class by the attending physician. However, the patient in the present case reported no medications.

D. Plasma cell gingivitis

Incorrect. Plasma cell gingivitis typically presents with a rapid onset of sore gingiva that may be intensified by spicy or hot foods. The entire free and attached gingiva demonstrates diffuse enlargement with bright erythema and loss of normal stippling. Erythematous areas may extend onto the palate, tongue or buccal mucosa. Plasma cell gingivitis is most often the result of contact stomatitis associated with food flavoring agents, tooth paste and preservatives. One of the more common offenders is cinnamon where the patient displays a hypersensitivity reaction to usually cinnamon-flavored candies, foods or chewing gum. Microscopically, large numbers of plasma cells are noted in the gingival tissue biopsy which was not noted in our case. The best way to treat plasma cell gingivitis is to prevent its occurrence, hence a careful and complete dietary history is essential. Allergy testing may be helpful along with an elimination diet. Topical corticosteroids have been used in some cases with success.

E. Leukemia-associated gingival hyperplasia

Correct. A very important diagnostic consideration when evalu ating patients with generalized or localized gingival hyperplasia with episodes of bleeding. However, in the present case, no spon taneous gingival bleeding was reported and the patient appeared otherwise healthy. The clinical signs and symptoms such as anemia and infections seen in leukemia are related to the marked reduction in normal white and red blood cells. The patient may also present with a fever associated with an infection which is often the initial presenting sign.

Commonly reported oral manifestations of leukemia include a diffuse, edematous, boggy and nontender gingival enlargement with unusual ulcerations that tends to bleed either sponta neously or on provocation. The gingival tissue is most severely

98 quiz

affected than any other oral mucosal tissue mainly due to the large numbers of bacterial flora normally present around teeth. Although gingival involvement has been reported in all variants of leukemia, it is most commonly seen with acute myeloid leuke mia. Petechial hemorrhages of the posterior hard and/or soft palate may be also observed. Differentiating leukemic infiltration from inflammatory and reactive conditions can be challenging. However, a comprehensive clinical evaluation is important. Den tal clinicians should be aware of the oral manifestations that may be the first, earliest or only indication of leukemia. Moreover, they are often the first sign of relapse from remission achieved through chemotherapy. Awareness of oral manifestations ultimately helps dentists to facilitate early diagnosis and timely referral to a hematologist for appropriate treatment, thereby helping to reduce disease-related morbidity and mortality. A confirmatory diagnosis is usually made by testing patient’s blood and bone marrow. Remission of leukemic gingival overgrowth is expected after chemotherapy along with corresponding normal peripheral blood values. However, remission depends in part on the pa tient’s oral hygiene status because higher levels of dental plaque are directly proportional to an increase in gingival hyperplasia in duced by systemic diseases. Thus, to ensure successful remission of gingival hyperplasia, plaque control with dental prophylaxis is recommended.

Reference:

Neville, BW, et al. Oral and Maxillofacial Pathology. Elsevier, 2016. Lourenço SV, Lobo AZC, Boggio P, Fezzi F, Sebastião A, Nico MMS. Gingival Manifestations of Orofacial Granulomatosis. Arch Dermatol. 2008;144(12):1627–1630. doi:10.1001/archderm.144.12.1627

Tungare S, Paranjpe AG. Drug Induced Gingival Overgrowth. [Updated 2022 Sep 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/ books/NBK538518/

Barros P, Islam MN, Fitzpatrick SG, Cohen DM, Bhattacharyya I, Alra madhan SA. Essentials of oral manifestations of leukemia for the dental practitioner. Gen Dent. 2022;70(2):33-36.

Negi BS, Kumar NR, Haris PS, Yogesh JA, Vijayalakshmi C, James J. Plas ma-Cell Gingivitis a Challenge to the Oral Physician. Contemp Clin Dent. 2019;10(3):565-570. doi:10.4103/ccd.ccd_776_18

López-Valverde N, López-Valverde A, Gómez-de Diego R, Ramírez JM, Flores-Fraile J, Muriel-Fernández J. Gingival hyperplasia as an early manifestation of acute myeloid leukemia. A retrospective review. J Clin Exp Dent. 2019;11(12):e1139-e1142. Published 2019 Dec. 1. doi:10.4317/ jced.56214

Agrawal AA. Gingival enlargements: Differential diagnosis and review of literature. World J Clin Cases. 2015;3(9):779-788. doi:10.12998/wjcc. v3.i9.779

Ellegaard B, Bergmann OJ, Ellegaard J. Effect of plaque removal on patients with acute leukemia. Journal of Oral Pathology & Medicine: Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. 1989 Jan;18(1):54-58. DOI: 10.1111/j.1600-0714.1989.tb00734.x.

Diagnostic Discussion is contributed by University of Florida Col lege of Dentistry professors, Drs. Indraneel Bhattacharyya, Nadim Islam and and Saja Alramadhan who provide insight and feed back 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 14,000 specimens the service receives every year from all over the United States.

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. Bhattacharyya, Islam and Alramadhan can be reached at oralpath@dental.ufl.edu.

Conflict of Interest Disclosure: None reported for Drs. Bhattacha ryya, Islam and Alramadhan.

The Florida Dental Association is an ADA CERP Recognized Pro vider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of con tinuing dental education. ADA CERP 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.

99 | TODAY'S FDA november/december 2022

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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 at tention to your online classified ads!

Post an ad on the FDA Career Center and it will be published in our journal, Today’s FDA, at no additional cost! Today’s FDA is bimonthly; therefore, the basic text of all ac tive ads will be extracted from the Career Center on roughly the 5th of every other month (e.g., Jan. 5 for the Jan/Feb issue, March 5 for the March/April issue, etc). Please note: Ads for the Nov/Dec issue must be placed no later than Nov. 1.

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

Dental Office for Sale in Margate. Great Opportunity to start your own practice or add an additional location. Dentist is relocating and selling the current Set-Up. Low investment to become the owner of your own prac tice. Office has 4 Ops., all equipped with dental chair, LED light and intra-oral xray. All major equipment also included: compressor, vacuum, amalgam separator, autoclave. All wired and ready for digital xrays. Tile through out, great condition. Aprox 1,200 sf. Located in a Shopping Center in a highly transited intersection. No intermediaries. The suite has been a dental practice for more than 25 years, anchoring one successful dentist after another. Please, call or text if inter ested: (786) 303-1732. Visit careers. floridadental.org/jobs/17686791/.

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Associate Positions Available Now, Panama City. Bay Dental Center and Dr John Collias encourage you to call if you are interested in a position with maximum growth potential. We are located in Panama City on the Bay. We are currently in the process of opening two additional locations between Panama City and Destin. My

Cell phone is 850-501-0761 (Dr. John Collias). Visit careers.floridadental. org/jobs/17585923/.

Dentist, The Villages. Established multi office, private practice is look ing for a full-time associate dentist to provide quality comprehensive general dental services, someone who is an excellent communicator, and is compassionate with patients. Our dentists have clinical freedom in their treatment plans, and mentoring is available on the job for newer gradu ates. We offer employee or indepen dent contractor arrangements with competitive per diem or percentage of production-based compensation. Four day a week work schedules are available. Our experienced team of doctors, hygienists, assistants and ad ministrative staff strive to make every patient feel comfortable and confident that their dental care needs are being met with the highest standard of treat ment. They are loved by our patients, who truly appreciate them. Our North Central Florida offices are in a fast growing, treatment compliant, tight knit community and our reputation is top notch. We are serious about what we do, care about our employees, and are looking for the same commitment from others. If you are looking for a new chapter in your dental career, with massive opportunities, and think you could be a great fit don’t hesitate to contact us. DMD or DDS required. Visit careers.floridadental.org/ jobs/17567273/.

Dentist, Lake Mary. Come grow with us! Our high-end practice in Lake Mary, FL is looking for a full-time/parttime associate. After two years, the right candidate will have the opportu

Seeking Qualified Dental Radiographer?

Train your dental assistants to expose radiographs using the FDA’s MyDentalRadiography online course that combines self-paced learning with clinical proof of competency. Call Lywanda Tucker at 850-350-7143 for details or visit mydentalradiography.com/FDA to create a supervising dentist account and complete the necessary tutorial on how the program works.

nity to buy into our thriving practice. We are proud of our excellent patient base, superb staff and latest equip ment. Our practice is fee-for-service, accepting only out of network benefits from PPO plans. Full-time candidates can expect to work four days a week. Good communication skills and three years experience are required to have basic skills mastered so that advanced dentistry can be learned and applied. Please send resumes to timtiralosi@ tiralosidental.com or call/text us at 321.320.3128. Visit careers.floridaden tal.org/jobs/17495779/.

Practice in HIGH & DRY Florida! Fee For Service in North Central Florida. Are you tired of evacuating for hurri canes? Tap into the market of CASH PAYING retirees of The Villages, Del

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FDA november/december 2022 career center

Webb, and Stonecrest 55+ communi ties, many who have relocated from coastal Florida. There is also an untapped population of hundreds of young families moving into new homes in the immediate area! The only other dentist in the immediate vicinity is a Heartland office. Two fully equipped operatories are in free-standing 950 sq. ft. building built in 2008 plumbed for three operatories. It is situated on one beautiful acre of land on busy US 301 just north of THE VILLAGES. Practice grossed 150K taking no insurance at 30% overhead in 2021 on 20-25 patients/week with dentist doing all hygiene. 4-5 inter nally referred new patients per week are being referred to a colleague. All surgery, endo, and pedo have been referred out. Immediate two full days of hygiene are scheduled and will keep the buyer busy with a loyal patient base. Modern chartless office is equipped with digital sensors and Patterson Fuse cloud-based software. There is plenty of room to expand existing building or even build a new office and then rent the current space. Please message me for more pics or to arrange a visit. Office is a 1 hour commute from either North Orlando/ Winter Garden/Clermont or Gaines ville, 1.5 hours from Tampa. It is an easy drive off of I-75 Exit 341 or off the Turnpike on US 301. $450k includes practice and building/property. I will consider owner financing with ade quate down payment. Visit careers. floridadental.org/jobs/13686503/.

General Dentist, Lake Wales. Opportunity to work in high quality, ethical digital practice. Minimum five years experience, short term part time with unlimited growth potential. Highly experienced and talented team with awesome reputation. License to practice in Florida. Visit careers. floridadental.org/jobs/17715632/gen eral-dentist.

General Dentist, Naples. Naples Family Dentist, a private, non-corpo rate, practice in North Naples is look ing for a Part-Time General Dentist to join our team of awesome dental pro fessionals! This is a great opportunity for a Dentist who wants to work part time without all of the responsibilities of practice ownership. Compensation is based on experience and collections and can be discussed with Dr. Mabe in person. Please submit your CV or Resume for review to Smile@naples familydentist.com. We look forward to meeting you and welcoming you to our team! Learn more about our practice at www.naplesfamilydentist. com. Visit careers.floridadental.org/ jobs/17733586/.

Experienced General Dentist, Palm Beach Gardens. This is a rare oppor tunity to be mentored by a doctor with internationally recognized creden tials in cosmetic dentistry, full mouth reconstruction, dental implant surgery & sedation. Senior doctor is preparing to reduce his busy schedule allowing a new doctor to grow into a leader ship role. Qualified doctor should be capable of producing at least $1M-

$1.5M their first year in our practice. Seeking a highly experienced general dentist looking for a long-term oppor tunity to join an extremely productive cosmetic & restorative practice in Palm Beach Gardens. Strictly fee for service. No HMO’s or PPO’s. Our impeccable reputation for exceptional care has been well known in our community for 35 years. Integrity & good interper sonal skills are a big part of our culture where open and honest communica tion with patients and team is a top priority. Our state of the art facility is fully equipped with advanced technol ogies including CBCT scans. Our highly trained team maintains very organized systems that are proven to be very effi cient & effective, allowing our doctors to focus on delivering quality dentist ry. You will have the opportunity to perform all forms of dentistry includ ing crown & bridge work, cosmetics, complete smile makeovers, endodon tics, implant surgery as well as full mouth reconstruction at fees that are commensurate with the quality work you provide. Must have a minimum of 5 years clinical experience deliv ering quality dentistry. Proficiency in molar endo preferred. Cosmetic training through a recognized cos metic dentistry institute is preferred. Applicant must be personable with excellent communication skills. Posi tion involves excellent compensation package + bonus package based on production with a guaranteed daily base salary. Medical insurance is in cluded. Visit careers.floridadental.org/ jobs/17779424/.

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

Peer Review is Paintball All Grown Up

If you think about it, your whole life is a series of disputes that are settled in increasingly complex ways. When I was a young kid in Ohio, we would settle our differences with the “did so … did not … did so … did not” method. The kid to say it last won. This technique had its limitations, so we advanced to “army.” Later forms of this game used hand-propelled dirt clods that exploded on the loser. If the dirt was dry, it would never leave a mark until a bruise developed three days later.

Naturally, we elevated the game to BB guns with two limitations: an eight-pump maximum and no shooting in the head. Howev er, when your opponent wears two pairs of jeans and his older brother’s band jacket, the game once again was reduced to “did so … did not.”

From this, I believe, was born paintball and … Peer review, in its simplest form, is a mechanism by which the dental profession demonstrates the appropriateness and quality of the case it renders. It provides an expert and credible system for resolving disagreements that cannot otherwise be resolved regarding patient complaints about clinical care.

It is the dental “did not … did so” method. Ideally, both patient and doctor win, especially if you can avoid the Florida Board of Dentistry (BOD) and/or civil litigation. Trust me, trial attorneys do not always play fair. I learned this in …

Paintball has only two rules. If you are within 5 feet of your cor nered cowering targets, you yell, “surrender, surrender!” They are “dead” for that game. When you are hit with paint on any part of the body, you are dead. On this day at a Bay area paintball park, my dental staff was assaulting a fortress defended by (oh, joy!)

trial attorneys. Each team member had been issued a protective mask and a semi-automatic paintball gun. Our mission was to capture a flag held in a plywood “Alamo” guarded by an equally equipped league of lawyers.

As we approached the fort quietly, I spied a gun barrel protruding about 6 inches off the ground. That meant some attorney would be on his belly and unaware of my stealthy flanking maneuver. I stood over him and yelled, “surrender, surrender!”

Failing to do so, I had no choice. I fired six rounds from 6 feet into his best side. Startled and stung, he spun to his feet. Looking down at his paint-free chest, he whined, “Hey, I have to see the paint to be dead!” His legal-esque argument had reduced the game to “did not … did so.” If only we had …

The Peer Review Manual of the Florida Dental Association (FDA) establishes a reference for resolving the most commonly encoun tered problems of patient complaints. A separate publication, the Ethics Manual, sets forth minimum acceptable procedures to safeguard rights of members accused of unethical conduct.

Peer review is intended to be a membership benefit. It is not intended to be an adversarial process. It is designed to preserve the doctor/patient relationship and resolve disputes that already have occurred, so patients do not file malpractice lawsuits or BOD complaints against members. The BOD is limited by the law when dealing with discipline cases.

I doubt the sum of dues paid to the FDA over a career would approach the cost of one litigation loss.

I believe peer review to be the best benefit in organized dentistry. Without peer review all you have is, “did so … did not … did so … did not.”

104 off the cusp
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