2016 - July/Aug TFDA by Florida Dental Association

Supported Candidates Insurance Solutions for the Dental Graduate Mentors Florida's Dental Schools Dental Specialties

VOL. 28, NO. 5 â&#x20AC;˘ JULY/AUGUST

TRY MY AGENT “

When we contacted Rick [D’Angelo], we advised him that time was an issue since our renewal date with previous insurance was within 30 days. He was quick to get back with responses/quotes/suggestions. He answered all of our questions. He was extremely professional and everything was completed in a matter of less than a week. Very pleased!

“

- Karen Hoeft, Office Manager Premier Dentistry of Sarasota, plc

800.877.7597 ∞ insurance@fdaservices.com ∞ www.fdaservices.com

OUR AGENT RICK D’ANGELO

Pictured: Dr. Jason Swartz (Left) and Karen Hoeft (Right) Photo courtesy of Premier Dentistry of Sarasota

contents Students & Mentoring

news

Refractory Odontogenic Infection Associated to Candida Albicans: A Case Report

news@fda

FDC2016 Recap

House of Delegates

Serving Up Smiles

Board of Dentistry

90 Maximize Your Profitability Through Real Estate

Political Action Committee Supported Candidates

HIPAA Audits

literary 93

Books on the Shelf

f e at u r e s columns

The FDA Says, “Thank You!“

The Results Are In ...

The LDC is on the Job!

Staff Roster

Insurance Solutions for the Dental Graduate

President’s Message — Hope and Change: FDA Style

42 Compleat Dentistry — Mentors

Legal Notes

44 Mentors and Protégés

Information Bytes

Giving Back

Diagnostic Discussion

Mentors: A Priceless Asset

Off the Cusp

Florida's Dental Schools

ASDA Presidents and Their Role in Leadership

Dental Students: The Importance of Being Involved

A Career in General Dentistry

60 Choosing Your Career Path 61

My Path to Oral Surgery

My Journey into Prosthodontics

Why I Chose Pediatric Dentistry

To Specialize, or Not to Specialize ...

Why I Became a Periodontist: Good Mentors!

Read this issue on our website at:

www.floridadental.org.

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classifieds 86 Listings

*Cover photo courtesy of Mike Copeland On the cover (left to right) from Nova Southeastern University College of Dental Medicine: Joel Rosenfeld (D4), Preston Hansen (D4), Lizette Garcia (D4), Alexis Otero (D4) and Dr. John Aylmer.

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

July/August 2016

Today's FDA

FLORIDA DENTAL ASSOCIATION

L A C LO Y L E V I &L GATHER FOR FUN & CONTINUING EDUCATION IN YOUR DISTRICT. WCDDA SUMMER MEETING

Aug. 5-7, 2016 • The Ritz-Carlton, Naples Speakers: Dr. DeWitt Wilkerson – Integrative Dental Medicine / The Complete Health Dental Practice; Dr. David Seaman – Nutrition & Inflammation www.wcdental.org • 813.654.2500 • kelsey@wcdental.org

WCDDA ANNUAL MEETING

FRIDAY, FEB. 3, 2017 • CAMLS, Tampa

Speakers: Dr. John Burgess — Dental Materials & Current Restorative Techniques; Dr. John Kalmar – You Make the Diagnosis www.wcdental.org • 813.654.2500 • kelsey@wcdental.org

NWDDA ANNUAL MEETING

Friday & Saturday, Feb. 17-18, 2017 The Grand Sandestin Speakers: Dr. Tarun Agarwal, Dr. John C. Flucke, Ms. Pamela Smith www.nwdda.org • 850.391.9310 • nwdda@nwdda.org

WCDDA PRESIDENT’S TRIP

Friday, April, 28, 2017 Disney Cruise• Port Canaveral to Bahamas

CE will be provided. www.wcdental.org • 813.654.2500 • kelsey@wcdental.org

CFDDA ANNUAL MEETING

May 11-13, 2017 • Rosen Shingle Creek, Orlando

More info soon! www.cfdda.org • 407.898.3481 centraldistrictdental@yahoo.com

For a complete listing: www.trumba.com/calendars/fda-member.

Today's FDA

July/August 2016

JULY/AUGUST 2016 VOL. 28, NO. 5

EDITOR Dr. John Paul, Lakeland, editor

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

BOARD OF TRUSTEES Dr. William D’Aiuto, Longwood, president Dr. Michael D. Eggnatz, Weston, president-elect Dr. Jolene Paramore, Panama City, first vice president Dr. Rudy Liddell, Brandon, second vice president Dr. Andy Brown, Orange Park, secretary Dr. Ralph Attanasi, Delray Beach, immediate past president Drew Eason, Tallahassee, executive director Dr. James Antoon, Rockledge • Dr. Steve Cochran, Jacksonville Dr. Richard Huot, Vero Beach • Dr. Jeannette Pena-Hall, Miami Dr. George Kolos, Fort Lauderdale • Dr. Jeffrey Ottley, Milton Dr. Paul Palo, Winter Haven • Dr. Howard Pranikoff, Ormond Beach Dr. Barry Setzer, Jacksonville • Dr. Beatriz Terry, Miami Dr. Stephen Zuknick, Brandon • Dr. Ethan Pansick, Delray Beach, speaker of the house Dr. Tim Marshall, Spring Hill, treasurer • Dr. John Paul, Lakeland, editor

PUBLISHING INFORMATION Today’s FDA (ISSN 1048-5317/USPS 004-666) is published bimonthly, plus one special issue, by the Florida Dental Association, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914. FDA membership dues include a $10 subscription to Today’s FDA. Non-member subscriptions are $150 per year; foreign, $188. Periodical postage paid at Tallahassee, Fla. and additional entry offices. Copyright 2016 Florida Dental Association. All rights reserved. Today’s FDA is a refereed publication. POSTMASTER: Please send form 3579 for returns and changes of address to Today’s FDA, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914.

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

EDITORIAL CONTACT INFORMATION All Today’s FDA editorial correspondence should be sent to Dr. John Paul, Today’s FDA Editor, Florida Dental Association, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914. FDA office numbers: 800.877.9922, 850. 681.3629; fax 850.681.0116; email address, fda@floridadental.org; website address, www.floridadental.org.

ADVERTISING INFORMATION For display advertising information, contact: Jill Runyan at jrunyan@floridadental.org or 800.877.9922, Ext. 7113. Advertising must be paid in advance. For classified advertising information, contact: Jessica Lauria at jlauria@floridadental.org or 800.977.9922, Ext. 7115.

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CONTACT THE FDA OFFICE 800.877.9922 or 850.681.3629 1111 E. Tennessee St. • Tallahassee, FL 32308 The last four digits of the telephone number are the extension for that staff member.

FLORIDA DENTAL ASSOCIATION FOUNDATION

EXECUTIVE OFFICE

(FDAF)

Drew Eason, Executive Director deason@floridadental.org 850.350.7109

Meghan Murphy, Program Coordinator mmurphy@floridadental.org 850.350.7161

Greg Gruber, Chief Operating Officer/ Chief Financial Officer ggruber@floridadental.org 850.350.7111

FLORIDA DENTAL CONVENTION

Graham Nicol, Chief Legal Officer gnicol@floridadental.org 850.350.7118

(FDC)

Judy Stone, Leadership Affairs Manager jstone@floridadental.org 850.350.7123

Crissy Tallman, Director of Conventions and Continuing Education ctallman@floridadental.org 850.350.7105

Alex Lewis, Leadership Concierge alewis@floridadental.org 850.350.7114

Elizabeth Bassett, FDC Exhibits Planner ebassett@floridadental.org 850.350.7108

ACCOUNTING

Brooke Martin, FDC Meeting Coordinator bmartin@floridadental.org 850.350.7103

Jack Moore, Director of Accounting jmoore@floridadental.org 850.350.7137 Leona Boutwell, Finance Services Coordinator Accounts Receivable & Foundation lboutwell@floridadental.org 850.350.7138 Joyce Defibaugh, FDA Membership Dues Assistant jdefibaugh@floridadental.org 850.350.7116 Deanne Foy, Finance Services Coordinator Dues, PAC & Special Projects dfoy@floridadental.org 850.350.7165 Stephanie Taylor, Membership Dues Coordinator staylor@floridadental.org 850.350.7119

Jennifer Tedder, FDC Program Coordinator jtedder@floridadental.org 850.350.7106

GOVERNMENTAL AFFAIRS Joe Anne Hart, Director of Governmental Affairs jahart@floridadental.org 850.350.7205 Alexandra Abboud, Governmental Affairs Coordinator aabboud@floridadental.org 850.350.7204 Casey Stoutamire, Lobbyist cstoutamire@floridadental.org 850.350.7202

COMMUNICATIONS AND MARKETING

INFORMATION SYSTEMS

Jill Runyan, Director of Communications jrunyan@floridadental.org 850.350.7113

Larry Darnell, Director of Information Systems ldarnell@floridadental.org 850.350.7102

Lynne Knight, Marketing Coordinator lknight@floridadental.org 850.350.7112 Jessica Lauria, Communications and Media Coordinator jlauria@floridadental.org 850.350.7115

Will Lewis, Information Systems Helpdesk Technician/ Database Administrator wlewis@floridadental.org 850.350.7153

MEMBER RELATIONS Kerry Gómez-Ríos, Director of Member Relations kgomez-rios@floridadental.org 850.350.7121

Ashley Merrill, Member Relations Coordinator amerrill@floridadental.org 850.350.7110

Kaitlin Walker, Member Access Coordinator kwalker@floridadental.org 850.350.7100

Christine Mortham, Membership Concierge cmortham@floridadental.org 850.350.7136

FDA SERVICES 800.877.7597 or 850.681.2996 1113 E. Tennessee St., Ste. 200 Tallahassee, FL 32308 Group & Individual Health • Medicare Supplement • Life Insurance Disability Income • Long-term Care • Annuities • Professional Liability Office Package • Workers’ Compensation • Auto • Boat Scott Ruthstrom, Chief Operating Officer scott.ruthstrom@fdaservices.com 850.350.7146 Carrie Millar, Agency Manager carrie.millar@fdaservices.com 850.350.7155

Tessa Daniels, Membership Services Representative tessa.daniels@fdaservices.com 850.350.7158 Liz Rich, Membership Services Representative liz.rich@fdaservices.com 850.350.7171

Carol Gaskins, Assistant Sales & Service Manager carol.gaskins@fdaservices.com 850.350.7159 Debbie Lane, Assistant Manager – Service & Technology debbie.lane@fdaservices.com 850.350.7157 Allen Johnson, Accounting Manager allen.johnson@fdaservices.com 850.350.7140

Suzy Illum, Director of Sales – Southern Expansion suzy.illum@fdaservices.com 850.350.7141

RISK EXPERTS

Alex del Rey, FDAS Marketing Coordinator arey@fdaservices.com 850.350.7166

Dan Zottoli Director of Sales Atlantic Coast

Angela Robinson, Insurance Clerk angela.robinson@fdaservices.com 850.350.7156

561.791.7744 Cell: 561.601.5363 dan.zottoli@fdaservices.com

Dennis Head

Jamie Idol, Commissions Coordinator jamie.idol@fdaservices.com 850.350.7142

Director of Sales Central Florida 877.843.0921 (toll free) Cell: 407.927.5472 dennis.head@fdaservices.com

Marcia Dutton, Receptionist marcia.dutton@fdaservices.com 850.350.7145 Porschie Biggins, North Florida Membership Services Representative pbiggins@fdaservices.com 850-350-7149

Mike Trout Director of Sales North Florida 904.249.6985 Cell: 904.254.8927 mike.trout@fdaservices.com

Maria Brooks, SFDDA Membership Services Representative maria.brooks@fdaservices.com 850.350.7144 Eboni Nelson, CFDDA Membership Services Representative eboni.nelson@fdaservices.com 850.350.7151 Melissa Staggers, WCDDA Membership Services Representative melissa.staggers@fdaservices.com 850.350.7154

Joseph Perretti Director of Sales South Florida 305.665.0455 Cell: 305.721.9196 joe.perretti@fdaservices.com

Rick D’Angelo Director of Sales West Coast 813.475.6948 Cell: 813.267.2572 rick.dangelo@fdaservices.com

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

July/August 2016

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PRESIDENT’S MESSAGE BILL D'AIUTO, DDS

Hope and Change: FDA Style

It has been said that the only things in life that are inevitable are death and taxes, yet the undeniable truth really is that change is the only constant. Death, of course, is part of life. We are born, we grow up and reside on Earth, constantly changing along the way. Taxes are never static. They change and grow due to a myriad of whims both locally and nationally. So, therefore, the question isn’t, “What is inevitable?” But rather, “How do we influence the change that is constantly upon us, both for the individual and the good of the order?” It takes more than just reading tea leaves to understand the ongoing changes to our profession and practice life. The Florida Dental Association (FDA) relies on scientifically surveying its members, employing proven statistical methods in order to determine how to change, modify and grow its offered benefit programs to meet and exceed the ever-changing needs of our members in practice. This is no small feat. FDA Services (FDAS), the Board of Trustees (BOT) and the FDA Foundation (FDAF) use the membership survey information, which was most recently obtained in May 2016, to create the program and benefit offerings that our members desire to stay ahead of the curve in our businesses, while giving back to our communities in meaningful ways. FDAS has created the Crown Savings program in which each vetted business solution strives to enhance the competitive edge that members need to stay in business. It’s also been said that necessity is the mother of invention — if that’s so, then the forward, assertive thinking of our members (recorded in their surveys) aids us to forge new and competitive programs that inspire our portfolio. The FDAS Board of Directors has expanded their view of what is possible by aiding the FDA to create more non-dues revenue, which allows us to keep our membership dues among the lowest in the country. For the 2015-2016 fiscal year, FDAS has contributed more than $1.65 million to the FDA — a significant resource of non-dues revenue — which represents 20 percent of the FDA’s revenue budget. The out-of-the-box thinking that is employed has created programs that increase the economies of scale for our participating dentists. Purchasing supplies through the new FDASupplies.com program allows even the smallest practices to command the purchasing power that once was the territory of only larger practices and groups. FDASupplies.

“

Never underestimate the power of your time spent sharing your professional expertise for the good of the community.

”

Please see PRESIDENT'S, 7

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July/August 2016

Today's FDA

FDA Services would like to thank our 2015-2016 Student Advisors! Thank you for contributing your time and insights to FDA Services!

JOHN AYLMER

RAMZY LOTFI

JENNA PASCOLI

Nova Southeastern University College of Dental Medicine

University of Florida College of Dentistry

LECOM School of Dental Medicine

Visit www.fdaservices.com to learn more about our products and services. 6

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PRESIDENT’S from 5

com can save you up to 35 percent on your supply order. These are the innovative ideas that can super charge your practice experience. Now that’s the type of change that truly inspires hope in this ever-changing health care landscape! The banking relationship that FDAS has developed with Bank of America (BOA) gives hope to our newest dentists and soon-to-be graduates through innovative programs for first-time borrowers to purchase or start their own businesses. “Helping members succeed” is the FDA’s mission statement and is the thread that ties all of the FDAS programs together, and also has our evolving banking relationship with BOA benefit both the buying and selling dentist alike. A true win-win. Bringing hope and change to the lives of our member dentists and families would, of course, not be complete without bringing a measure of hope to the underserved in our state. Through the tireless efforts of the FDAF, a second Florida Mission of Mercy (FLA-MOM) was successfully completed in Jacksonville this past April, which afforded close to 3,000 patients in need of mainly emergent care to get the help they needed. Comprehensive dental care … no, but to a patient in pain or in need of getting a few front teeth restored in order to get a better job — it meant the world! Our member dentists have long been a philanthropic lot, performing pro bono or discounted dental services in their private practices as an ongoing endeavor. However, few concepts in treating the most vulnerable around us is more impactful to an entire community and mindful legislators than seeing 1,500 dental team members treat several thousand people in two days, donating millions of dollars in care while saving countless emergency room visits. Truly awe-inspiring!

nity. It is these efforts that will ensure we remain a respected profession well into the future. I ask that you consider generously giving your time and finances to support your FDAF — a foundation for good. The FDA is lead by member dentists through volunteer activities at the local, district and state level, and I humbly ask that you also consider “plugging in” and share in guiding the leadership directive of this association. It has made all the difference in my career. This is hope and change: FDA style. Helping members succeed while protecting the public trust. These are the ingredients of a healthy, vibrant profession.

Dr. D’Aiuto is the FDA President and can be reached at bdaiuto@bot.floridadental. org.

When we work together in mass, we show that the dental profession takes its articles of creation— for more than 170 years — to heart. The dental profession was created for one purpose: to protect the public trust. When you participate in a MOM event or volunteer in the other FDAF projects, such as Project: Dentists Care or Donated Dental Services, you are fulfilling that public trust beyond the limits of your own practices. Never underestimate the power of your time spent sharing your professional expertise for the good of the commu-

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July/August 2016

Today's FDA

Legal Notes

The Federal Government Has Changed How Much You Can Charge to Copy Records Graham Nicol, Esq., HEALTH CARE RISK MANAGER, BOARD CERTIFIED SPECIALIST (HEALTH LAW)

In yet another incursion by the federal government into the health care delivery system, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), recently announced it has changed its interpretation of the records copying rules. The reason? To make sure covered entities don’t stand in the way of patients who want to have electronic access to their personal health information (PHI). In short, the federal government wanted you to provide copies of electronic health records (EHR) for free. Now, they want you to charge a maximum $6.50 flat fee to provide electronic records unless you are prepared to document why you are charging more. Author’s Note: There was an outcry since OCR first posted on its website that covered entities should provide electronic copies for free. Since then, OCR has removed any reference to electronic records being provided for free and made it clear that the

Today's FDA

July/August 2016

$6.50 maximum flat rate is one of three options, with average and actual costs being the other two. I like that the federal government no longer suggests that electronic records be copied free of charge. But I still think the remaining interpretation is unfair to smallbusiness owners. It places an unnecessary record-keeping burden on doctors to justify how they calculated average and actual costs. A flat rate of $6.50 probably has no business impact when the patient simply wants you to copy pre-existing electronic records and email them or copy them to a flash drive. But there will be times when you want to use actual or average costs instead of the flat rate. So, my next article in Todays’ FDA will walk you step by step through how to calculate both average and actual costs. Further, I don’t like that OCR uses a standard of “reasonableness” for the calculation of wages paid to staff. This doesn’t give much concrete guidance and will always leave doctors with the anxiety that they have done the calculation incorrectly. In Florida, a per-page fee equivalent to the clerk’s office charges in the county where the practice was located used to be acceptable. That was objective and easily verified with a call to the clerk’s office. That’s no longer a viable option. I fear that doctors

will simply take the easy route and just charge the $6.50 flat rate because they don’t want to calculate and document actual or average charges. The next issue will walk you through how to do that. But let’s see how we got to this point. August marks the 20th anniversary of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and HHS’s ironically titled “Administrative Simplification” rule. Over the last two decades, HIPAA’s Privacy Rule was a shield to protect patients’ privacy — an honorable goal. But now, litigious patients use the Privacy Rule as a sword to control their records. And now, OCR is actively enforcing the rules and telling private businesses how much they can charge for copying records. For example, the internet now has a HIPAA “Wall of Shame” that lists data breaches and can be searched by anyone, including plaintiffs’ lawyers, other doctors, dental plans and curious patients. The Wall of Shame is not a Gawker website. It is actually required by section 13402(e)(4) of the HITECH Act and the federal government runs it. From the OCR website: These breaches are now posted in a new, more accessible format that allows users to search and sort the posted breaches. Additionally, this new format includes brief summaries of the breach cases that OCR has investigated and closed, as well as the names

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Legal Notes

of private practice providers who have reported breaches of unsecured protected health information to the Secretary. We are at the point where anyone can search for data breaches: v There are more than 100 entities in Florida alone listed on the Wall of Shame. v The Florida Department of Health is included twice, alongside major hospitals, health plans and private practices. v Private businesses include optometrists, podiatrists, anesthesiologists, pathologists, dermatologists, radiologists, business associates and the list goes on. v Incidents range from unauthorized access to a desktop computer, theft of a network server, hacking, improper disposal of a laptop, email violations, violations that involve paper records and radiographic films, and theft or loss of memory devices. Most of the breaches involve negligent — not intentional — conduct. v Incidents in Florida range in number of patients affected from 500 to several that involve more than 100,000 patients. v Four dental practices in Florida appear on the Wall of Shame. Before we get to the newest change to the records copying charge, let me review some basic compliance strategies that I see dentists get wrong: v Never condition the furnishing of the patient’s records upon payment of a fee for services rendered. v With patients having open access to your records, be careful about what

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you include and exclude from your chart notes. Include everything that you rely on to make your diagnosis and treatment plan. Have enough detail to justify the clinical treatment provided. Anything beyond that is probably best kept off the record. It is an exceptionally bad idea to include derogatory comments based on a patient’s demeanor, weight, disability, race, religion, etc. When patients look at their records and demand that you correct something, think through whether you should. One of the remaining rights left to doctors is that you may refuse a patient’s request to alter their records. Avoid an emotional reaction and let relevance to clinical decision-making be your guide. For example, are you asking about STDs because they are clinically relevant? If so, how are you going to respond when the patient refuses to answer? What will you do when they demand that you correct their medical history to insert something you believe to be incorrect? The ethical issues raised by such questions are outside the scope of this article, but if you decline the patient’s request, document your reasons in the chart. You may require that a patient’s request for access to or to copy records be in writing on a form that you have created. You must accept faxed or scanned copies of your form. You cannot force the patient to travel to your office and sign the form in your presence. If you accept records requests via your email account or web portal, you must have protocols in place to verify that the person/potential hacker who requests the records is actually your patient or their legal representative. For

example, require the requester to confirm the patient’s address before you release the records into the ether. As a dentist, you probably are unable to refuse to produce your records for a patient. Don’t try to fight against it, just accept it. There are therapeutic privileges that allow refusal of access to psychotherapy notes, but the only rule that even arguably applies to dental records is when the PHI was given by someone other than the health care provider (e.g., a family member) under a promise of confidentiality, and to allow access would reveal the source. Again, this exception is unlikely to occur in dental settings. You can — and probably should — politely ask patients why they want their records. This might allow you to refer the patient to the FDA Peer Review program and avoid an adversarial relationship. Of course, they may not tell the truth and they are under no legal duty to answer your questions, but it is not unusual for patients to request records because they are dissatisfied with your care. If so, it’s better to know early and handle the situation before it grows into a Board of Dentistry complaint. Never withhold the records if they won’t tell you why. You must, without unreasonable delay, provide patients their PHI in the format they request “if readily producible.” I cannot conceive of a situation where EHR would not be readily producible in an electronic format. Even if you only have paper records, or paper mixed in with EHR, you must scan the paper files into electronic format if you have a scanner. If not, then Please see LEGAL, 10

July/August 2016

Today's FDA

Legal Notes

LEGAL from 9

provide paper records in readable form. Also, the patient has the right to get records in paper even if you are using EHR. You must deliver the PHI in the way the patient asks. Usually, most are agreeable to pick up copies or look at the records in your office during regular business hours. If the patient wants an electronic version, they have the right to get it sent via email, web portal or storage device. Never require the patient to come to your office if they want the records mailed or emailed.

So how much can I now charge to copy records? This is the area of the law that OCR clarified. Forget all the old rules you’ve memorized. OCR has said that the Privacy Rule means a covered entity copying records either for the patient or their legal representative can lawfully bill for only three things: 1. Clerical labor for copying PHI into the format requested. To quote HHS/OCR: Labor for copying only includes labor to create and deliver the electronic or paper copy in the form and format

requested or agreed upon by the individual, once the PHI that is responsive to the request has been identified, retrieved or collected, compiled and/or collated, and is ready to be copied. Labor for copying does not include costs associated with reviewing the request for access; or searching for and retrieving the PHI, which includes locating and reviewing the PHI in the medical or other record, and segregating or otherwise preparing the PHI that is responsive to the request for copying. (Emphasis in original.) 2. Supplies to create the requested paper copy (e.g., paper and toner — not the cost of the copier) or electronic media if the patient requested EHR to be copied to portable media (e.g., what you paid for the CD or USB flash drive — not the cost of the computer and software). You cannot require the patient to purchase portable media and they have the right to have their PHI emailed or mailed to them upon request. 3. Postage when the patient requests that the records be mailed. That’s it: labor costs (but only to copy), supplies and postage if mailed. It has yet

to be litigated, but it appears — at least where EHR is involved — that the OCR’s interpretation of HIPAA pre-empts Florida law that allows a per-page maximum tied to what the county clerk charges in the county where you practice. See, e.g., BOD Rule 64B5-17.009(2): “A dentist may charge a fee for copying reports or records not to exceed the cost per page charged by the Clerk of the County Court where the dentist practices.” State laws that authorize higher or different fees than are permitted under HIPAA are pre-empted. State laws that provide patients with greater rights of access to their health information than the HIPAA Privacy Rule does are not pre-empted: Per-page fees are not permitted for paper or electronic copies of PHI maintained electronically. (Emphasis in original.) OCR is aware that in many cases, per-page fees have become a proxy for fees charged for all types of access requests — whether electronic or paper — and that many states with authorized fee structures have not updated their laws to account for efficiencies that exist when generating copies of information maintained

What Florida Dentists Need to Know about Prescription, Controlled Substance and Pain Management Laws (LC01) Patient Abandonment (LC02) Take these courses online to earn free CE credit. For links, go to floridadental.org/members. FDA Members Only!

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Legal Notes

electronically. This practice has resulted in fees charged to individuals for copies of their PHI that do not appropriately reflect the permitted labor costs associated with generating copies from information maintained in electronic form. Therefore, OCR does not consider per-page fees for copies of PHI maintained electronically to be reasonable for purposes of 45 CFR 164.524(c)(4). HHS/OCR states that a flat fee not exceeding $6.50, inclusive of labor, supplies and any applicable postage, is reasonable for providing electronic copies of PHI maintained electronically. But the $6.50 maximum is better than what OCR first said: Further, while the Privacy Rule permits the limited fee described above, covered entities should provide individuals who request access to their information with copies of their PHI free of charge. (Emphasis added.) While covered entities should forgo fees for all individuals, not charging fees for access is particularly vital in cases where the financial situation of an individual who requested access would make it difficult or impossible for the individual to afford the fee. We will continue to monitor whether the fees that are being charged to individuals are creating barriers to this access, will take enforcement action where necessary, and will reassess as necessary the provisions in the Privacy Rule that permit these fees to be charged. We note that as technology evolves and processes for convert-

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ing and transferring files and formats become more automated, we expect labor costs to disappear or at least diminish in many cases. (Emphasis added.) So, the federal government originally wanted you to provide records for free. Now, they say the maximum fee you can charge for EHR is $6.50 unless you want to document a higher fee. It bothers me that OCR never really explains how they came up with the $6.50 amount. It also bothers me that if you want to charge more, the burden is on you to prove the charge is “reasonable” (an undefined term that could be subjectively interpreted by OCR) via documentation of actual or average costs. To quote HHS/OCR: An example of an actual labor cost calculation would be to time how long it takes for the workforce member of the covered entity (or business associate) to make and send the copy in the form and format and manner requested or agreed to by the individual and multiply the time by the reasonable hourly rate of the person copying and sending the PHI. What is reasonable for purposes of an hourly rate will vary depending on the level of skill needed to create and transmit the copy in the manner requested or agreed to by the individual (e.g., administrative level labor to make and mail a paper copy versus more technical skill needed to convert and transmit the PHI in a particular electronic format). Charging a flat fee not to exceed $6.50 is therefore an option for entities that do not want to go through the process

of calculating actual or average allowable costs for requests for electronic copies of PHI maintained electronically. Other HHS/OCR interpretations include: v No fee is allowed when a patient uses an EHR web portal and downloads their own records. v No fee is allowed when a patient just wants to look at their records. This is true even where, for example, the patient brings their own scanning device, takes handwritten notes or takes picture of your records with their smartphone. v You may establish reasonable policies to assure that equipment or technology used by the patient doesn’t disrupt your business operations and that the patient only is copying the records to which they are entitled. v The patient has no right to connect a personal media device to your EHR system and you can prohibit them from doing so. v Per-page fees are prohibited unless the records (either electronic or paper format) are being copied and produced on paper. The OCR interpretation trumps state law that allows a per-page fee to be collected if it is more than that allowed under HIPAA. v Fees from an outside copying service (i.e., “business associate”) can’t simply be passed through to the patient. Quoting HHS/OCR: “Costs associated with outsourcing the function of responding to individual requests for access cannot be the basis for any fees charged to individuals for providing that access.” Please see LEGAL, 13

July/August 2016

Today's FDA

Legal Notes LEGAL from 11

Covered entities should post on their websites, or otherwise make available to individuals, an approximate fee schedule for regular types of access requests. v You should provide an estimate of the fee when a patient requests the records. OCR says that you ought to be able to provide a breakdown of the total fee charged if either the patient or OCR asks you to document it. Again, quoting HHS/OCR: When an individual requests access to her PHI and the covered entity intends to charge the individual the limited fee permitted by the HIPAA Privacy Rule for providing the individual with a copy of her PHI, the covered entity must inform the individual in advance of the approximate fee that may be charged for the copy …. (Emphasis in original.) The failure to provide advance notice is an unreasonable measure that may serve as a barrier to the right of access. v The fee limits apply when a patient/legal representative directs a covered entity to send the PHI to a third party. In other words, unless you want to justify actual or average charges, the $6.50 limitation for EHR applies regardless of whether the inv

benefit

dividual has requested the PHI be sent to them or a third party designated by the patient. You may require the patient/legal representative make the request in writing, sign it, and clearly identify the designated person or entity and where to send the PHI. See, 45 CFR 164.524(c)(3)(ii).

The federal government is changing the way dentists in Florida practice and specifying maximum records copying charges. It is publicly shaming dentists who, even unintentionally, violate patient privacy. I don’t like this trend and I think it is only going to get worse. This article is for informational purposes only and is not intended to be a substitute for professional legal advice. If you have a specific concern or need legal advice regarding your dental practice, you should contact a qualified attorney. Graham Nicol is the FDA’s Chief Legal Counsel.

Helping Members Succeed

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Information Bytes

Pokémon Go Crazy! By Larry Darnell DIRECTOR OF INFORMATION SYSTEMS

By now, you have either heard about or played the newest smartphone craze, “Pokémon Go,” a game for Android and iOS devices. “Pokémon Go” is an augmented reality game that uses your smartphone’s GPS and camera to make it seem like animated “Pokémon” creatures are in the real world. There are daily news stories about people playing this game. To some, it seems more than a game — it is an obsession. I have heard of people losing their jobs over it, being ticketed by police and even putting their lives in danger. Yes, I know — over a game. There are, however, some applicable business lessons for us from these kinds of things. First, it is new and exciting. The use of a smartphone to create an augmented reality sounds kind of cool, but also somewhat scary. I once was addicted to the game “Candy Crush.” (I admit I am a recovering video game addict.) I wonder how many still play “Candy Crush”? Remember “Angry Birds”? Same thing. Games have a tendency to come and go. However, “Pokémon” dips into the nostalgic. Many adults today grew up playing “Pokémon,” and can remember the cards and the Nintendo games, so it is familiar. We also remember the fun associated with “Pokémon.” This version is free, so that adds to the ease of playing it.

“

Do not be afraid to incorporate technology into what you do, but never lose sight of the purpose you have for doing it.

”

Hopefully, you can see the allure of it now. New, yet familiar. Exciting and fun. Free … yet it eats up our free time, and in some cases, our not-so-free time. Some will say it has its benefits, such as getting people outside and exercising. The other day I went to the park, and everyone was chasing the virtual “Pokémon” creatures around with their smartphones. I believe the bottom line is this: While it seems technology is changing our world, some things do stay the same. Examine what you are currently doing. See if there is a new, fresh or exciting perspective to the what, where, when, why and how you are doing it. Free is never really free. Do not be afraid to incorporate technology into what you do, but never lose sight of the purpose you have for doing it. I have to go chase down Pikachu now. Mr. Darnell can be reached at ldarnell@floridadental.org or 850.350.7102.

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July/August 2016

Today's FDA

*Please note that FDA members have their names listed in bold.

CORRECTION: Dr. Robert E. Watkins of Fort Myers was inadvertently listed with deceased FDA members in the May/June issue of Today’s FDA, and while we are profoundly sorry for this mishap, we are grateful and relieved that he is alive and well! We sincerely apologize for any confusion or distress this may have caused.

Thank You, CFDDA, for Supporting the FDA Foundation! The Central Florida District Dental Association (CFDDA) recently hosted a fundraiser, “Brews, Bites and Bids,” during their annual meeting on April 15. Attendees of the annual meeting were invited to the event, which included a silent auction and raffle, hors-d’oeuvres and drinks provided by local breweries. The CFDDA graciously donated the proceeds from the fundraiser to the FDA Foundation. These funds will be used to support Foundation programs such as the Florida Mission of Mercy, Donated Dental Services and Project: Dentists Care. Thank you again to our friends at the CFDDA!

Hurricane Proof Your Practice with the FDAS 2016 Hurricane Guide Get your dental practice ready for the 2016 Atlantic hurricane season with the FDA Services (FDAS) hurricane prepared-

Today's FDA

July/August 2016

ness guide, “Hurricane Proof.” This guide provides useful tips on insurance coverage, disaster planning, office preparation and digital resources that will help you keep your practice running in the event of a big storm. What’s Inside? • Office Inventory Guide • Before the Storm Checklist • Business Continuity Plan Guide • Flood Insurance 101 • Apps and Resources Go to http://bit.ly/29nWaJU to read “Hurricane Proof: 2016 Practice Readiness Guide.” Contact FDAS at 800.877.7597 or insurance@fdaservices.com for more information.

FDA Members Receive Lifetime Achievement Awards The Southern Academy of Periodontology recently granted Dr. Tyler Baldock the 2016 Lifetime Achievement in Periodontics Fellowship Award. The Hillsborough County Dental Association recently recognized Dr. Mohammad Reza Iranmanesh with its 2016 Life Achievement Award. Each year, the association recognizes one member for their outstanding leadership, dedication and devoted service to the dental profession and the association.

Third-party Payer Advocacy The American Dental Association (ADA) is excited to announce a new space on ada. org that is dedicated to dental benefits content. The ADA brought together all the resources it can offer to members to help them navigate the third-party payer world. Go to http://bit.ly/29zWqIf to access these resources.

What Are Your Fitness Hobbies? The theme for the September/October issue of Today’s FDA is “Wellness” and we’d like our members to share their fitness hobbies with us. Do you run, bike, golf, play tennis, do yoga, etc.? How did you get started? How have you benefited? Do you have any advice for others who may be looking for a new way to be active? Please email your answers to these questions to communications@floridadental.org.

Have a Tough Patient Question? Ask Dr. John Paul! Do your patients ever ask a question that you have a tough time answering? Most likely, you’re not the only one who has been asked that same question. Let Dr. John Paul help you frame a concise and effective response to your patients’ questions. Send your questions to Dr. Paul at jpaul@bot. floridadental.org, and we’ll post his answers on the FDA blog, “An Early Bite with Dr. John Paul” on Tuesdays.

Congratulations to Drs. Baldock and Iranmanesh!

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

Atlantic Coast District Dental Association Emmanuel Acheampong, Palm City Samin Eftekhari, Boynton Beach Andrea Lewis-McKenzie, Tamarac Mark McCawley, Fort Lauderdale Dario Rodriguez, Fort Pierce Stephen Rosenberg, Boca Raton Esther Shin, Pompano Beach Brian Sider, Wellington Dana Storch, Fort Lauderdale

Central Florida District Dental Association Alejandro Delgado, Gainesville Brandon Greenwalt, St. Johns Amal Hamdi, Orlando Christopher Latham, Orlando David Mantel, Orlando Clayton Miller, Winter Park Roger Montz, Melbourne Beach Anne Nguyen, Longwood Ankit Patel, Gainesville Matthew Rooney, Gainesville Anand Shah, Cocoa Sonia Simmonds, Orlando Jonathan Spenn, Dunnellon Kristine Vasquez, Orlando

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Northeast District Dental Association Mina Mikhail, Jacksonville Jennifer Mokris, Fernandina Beach Jeffrey Mokris, Fernandina Beach Jason Olitsky, Ponte Vedra Beach Puja Patel, Jacksonville

Northwest District Dental Association Matthew Fournier, Destin Elizabeth Huggins, Fort Walton Beach Rosie Kolokithas, Tallahassee Elizabeth Stamps, Panama City

South Florida District Dental Association Suheily Aponte-Rodriguez, Doral Rafael Balboa, Miami Stephen Boss, Miami Beach Jennifer Escobar, Hialeah Robert Evelyn, Miami Dalia Forero-Amaya, Pembroke Pines Luis Fornaris, Miami Abelardo Heredia Laurencio, Hialeah Ricardo Humaran, Hialeah Jose Mendigutia, Hialeah Luciana Molinari, Key Biscayne Paola Pellerano, Miami Victor Rodriguez, North Miami Beach Eduardo Rodriguez, Miami Gabriela Rolland-Asensi, Coral Gables Evan Rubensteen, Hollywood Dwight Salmon, Southwest Ranches Sharon Schmeiser-Rios, Miami Melissa Sedeno, Miami Javier Servigna, Pembroke Pines

West Coast District Dental Association Daniel Amyradakis, Fort Myers Harrison Black, Riverview Gianna De Simone, Winter Haven Raymond Dixon, Bradenton Fadi Fares, Spring Hill Anna Gayday, Spring Hill Saachi Goyal, Tampa Eric Heisser, Naples Jennifer Hughes, Naples Eugene Kulaga, Manasquan Viviana Mora, Valrico Donna Nichols, Tampa Gustavo Parajon, Valrico Madge Potts-Williams, Bradenton Theyyar Rangarajan, Naples Rachel Spicola, Palm Harbor Katharine Stringer, Naples Monica Tabbita, Cape Coral Corey Warrenbrand, Sarasota

In Memoriam The FDA honors the memory and passing of the following members: Rupert Q. Bliss Jacksonville Died: 4/9/2016 Age: 85 Andrew P. McKeveny Lakeland Died: 5/9/2016 Age: 68 Ricardo D. Dubois Miami Lakes Died: 5/25/2016 Age: 53

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Volunteers

The FDA Says, “Thank You!“ Outgoing 2015-2016 Council/Committee Volunteers The Florida Dental Association (FDA) would like to thank each of our council and committee members who have completed their terms with the groups listed below. Many of them are returning to continue their service with other FDA leadership groups. The FDA appreciates your time and dedication for serving in this capacity.

Committee on Conventions & CE m Dr. Sara Habashi – ACDDA m Dr. Clayton Roth – ACDDA m Dr. Ross Enfinger – CFDDA m Dr. Chandy Samuel – SFDDA m Dr. David Russell – NWDDA m Dr. Pat Lepeak – WCDDA

Council on Financial Affairs m Dr. Cecil White – NWDDA m Dr. Bill D’Aiuto, Trustee Liaison – CFDDA

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Council on Ethics, Bylaws and Judicial Affairs

FDAPAC

m Dr. Kris Scales, Chair – NEDDA

m Dr. Ralph Attanasi, GAC rep. – ACDDA m Mrs. Carol Nissen, Alliance rep.

Council on Membership

FDA Services

m Dr. Steve Zuknick, BOT Liaison – WCDDA

m Dr. Rick Stevenson – NEDDA m Dr. Jorge Centurion – SFDDA m Dr. Bill D’Aiuto – CFDDA

Council on the New Dentist m Dr. Michael Costabile, BOT Liaison – ACDDA m Ms. Desiree McMillen, LECOM ASDA Student Consultant m Mr. John Aylmer, Nova ASDA Student Consultant m Ms. Alison Novakovic, UF ASDA Student Consultant m Ms. Jennifer Quist, ASDA District 5 Trustee

Leadership Development Committee m Dr. Jeff Ottley – NWDDA m Dr. Orlando Dominguez – SFDDA m Dr. TJ Albert – WCDDA m Dr. Rick Stevenson – NEDDA

Governmental Action Committee m Dr. Vaugh Holland – NEDDA m Dr. Rick Stevenson, Immediate Past President – NEDDA

July/August 2016

Today's FDA

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House of Delegates

House of Delegates June 17-18, 2016 By FDA Staff

Election of Officers The following officers were elected and installed during the June HOD meeting.

President: Dr. Bill D’Aiuto

President-elect: Dr. Mike Eggnatz

First Vice President: Dr. Jolene Paramore

Second Vice President: Dr. Rudy Liddell

Secretary: Dr. Andy Brown

Speaker of the House: Dr. Ethan Pansick

Treasurer: Dr. Bryan “Tim” Marshall

Editor: Dr. John Paul

On June 17-18, the Florida Dental Association (FDA) House of Delegates (HOD) met in Orlando, at the Gaylord Palms Resort and Convention Center during the 2016 Florida Dental Convention (FDC). The HOD discussed many issues, including the following business. Dr. Ralph Attanasi, 2015-2016 FDA president, recognized Dr. Bert Hughes, the Council on Conventions and Continuing Education (C-CCE), and FDA staff with a standing ovation for their successful meeting. In addition, Ms. Joe Anne Hart presented former Sen. Alan Hayes with the FDA Legislative Award.

Report of the President Dr. Attanasi gave his final president’s address and acknowledged the sadness associated with the massacre at the Pulse nightclub. He reported that many FDA members were involved as first responders and grief counselors. Dr. Attanasi reflected over the past six months and talked about the FDA’s increased membership and recognition by the American Dental Association (ADA). He also mentioned that Dr. Irene Marron now is the ADA second vice president, Dr. Cesar Sabates serves as ADA trustee-elect and Dr. Terry Buckenheimer is running for ADA president-elect. Dr. Attanasi also remarked that the Florida Mission of Mercy (FLA-MOM) event in Jacksonville was a huge success and treated more than 2,800 patients.

17th District Trustee Report Dr. Buckenheimer recognized that this would be his last meeting as an ADA trustee. He thanked those who helped him throughout his career and stated that the FDA’s recognition has increased due to its recent membership success. Dr. Buckenheimer acknowledged that dentists in Florida still have a “busyness” problem, and mentioned that consumers need to be educated about the importance of oral health and the difference between insurance and dental benefits plans.

Report of the ADA President-elect Dr. Gary Roberts indicated that student loan debt continues to be a threat and reminded delegates of the ADA loan consolidation program, which features an 80 percent approval rate. He discussed how the dental specialty accreditation process is outdated and indicated that the ADA will take action soon. He mentioned that the ADA will offer a credentialing

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July/August 2016

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House of Delegates

service for free and a resolution will be presented to the ADA HOD to allow the ADA Board of Trustees to approve the budget with the HOD approving the dues amount.

Reports of the Florida Dental Schools Dr. Linda Niessen reported that the Nova Southeastern University College of Dental Medicine has a diverse class; the simulation labs have been completely refurbished; the Give Kids A Smile event was a success; and, Nova was one of six schools to participate in the Curriculum Integrated Format for testing. Dr. Isabella Garcia reported that she now has served as the dean of the University of Florida College of Dentistry (UFCD) for 16 months. UFCD is one of only two dental schools that teach every specialty, and also is one of the top 10 schools to receive funding from the National Institutes of Health. Aaron Susmarsky, Esq. represented the LECOM School of Dental Medicine and indicated that the search for a new dean is underway. He stressed that LECOM is extremely proud of its fourth-year dental students, with many of the graduating class set to go into military service or establish practices in rural areas.

Report of the Newly Installed FDA President Dr. Bill D’Aiuto stressed that change in the profession is constant and that the FDA’s job is to influence it to help members succeed. He said the membership survey results will guide the association in the next year. He commented that the FDA’s dues were among the lowest in the nation due to the success of FDA Services and other non-dues income programs. Dr. D’Aiuto said his view of his role as president is to listen and build coalitions. He would like the FDA to consider a dental service organization task group and the development of a dentists’ “Bill of Rights,” a program to help dentists with practice transitions. Last, he announced that the Central District Dental Association intends to sponsor the 2018 FLAMOM event.

Date of Next Meeting The next HOD meeting will be Jan. 27-28, 2017 at the Tampa Airport Marriott Hotel.

Examiners Licensed Outside of Florida The HOD adopted that the language in Section 466.006, Florida Statutes, which requires the practical or clinical examination given in Florida be graded by Florida-licensed dentists only, be revised to allow non-Florida licensed dentists to act as examiners. And, the HOD also adopted that language be added to Rule 64B5-2.020(3) to encourage the department to solicit Florida-licensed dentists from the pool of examiners first, before using out-of-state dentists as examiners.

C-CCE Chair Term Limits In regard the term limits of the C-CCE chair, the HOD adopted that the Workgroups Manual be clarified so that at the end of the chair’s term, under extenuating circumstances including, for example — but not by way of limitation — the lack of an experienced replacement, the FDA president may recommend to the BOT that the term limit be extended no more than two successive one-year terms. www.floridadental.org

July/August 2016

Today's FDA

Board of Dentistry

Board of Dentistry Meets in Jacksonville By Casey Stoutamire, FDA Lobbyist

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The Florida Board of Dentistry (BOD) met in Jacksonville on Friday, May 20. The FDA was represented by FDA BOD Liaison Dr. Don Ilkka and FDA Lobbyist Casey Stoutamire. Other FDA members in attendance included Drs. Andy Brown, Clive Rayner and Mark Romer.

For a CRNA to administer a general anesthetic he/she must be supervised by a dentist who has a general anesthesia permit and the office must be inspected for a general anesthesia permit.

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July/August 2016

All of the BOD members were present, which included Dr. Robert Perdomo, chair; Dr. Joe Thomas, vice chair; Drs. Joe Calderone, Naved Fatmi, Bill Kochenour, Claudio Miro and T.J. Tejera; hygienists, Ms. Catherine Cabazon and Ms. Angie Sissine, and consumer member, Mr. Tim Pyle. There is one consumer position open on the board that the governor has not yet filled. Ms. Nichole Geary, who was appointed in August 2015 to serve as general counsel at the DOH, gave the BOD an update on the backlog of discipline cases. She has worked with the DOH attorneys in the Prosecution Services Unit assigned to dental cases to come up with a plan to clear the backlog of discipline cases while keeping up with the current caseload brought forth by the Probable Cause Panel. The BOD can expect to see many more disciplinary cases during upcoming meetings. Mr. David Flynn, BOD attorney, gave a rules report and a hearing was held on Anesthesia Rules 64B5-14.002, Prohibitions and 14.003, Training, Education, Certification, and Requirements for Issuance of Permits. Mr. Glenn Thomas, on behalf of the Florida Association of Nurse Anesthetists, which represents Certified Registered Nurse Anesthetists (CRNAs), requested the hearing to clarify how recent changes to the rules affect CRNAs. Mr. Flynn and BOD Anesthesia Committee Chair Dr. Tejera explained the supervision requirements for CRNAs working in a dental office under Rule 64B5-14.002. For a CRNA to administer a general anesthetic he/she must be supervised by a dentist who has a general anesthesia permit and the office must be inspected for a general anesthesia permit. The CRNA does not need to get a permit and can only perform the same level of anesthesia as the supervis-

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Board of Dentistry

ing dentist. This rule only applies to anesthesia given in a dental office and not in a hospital setting. Dr. Tejera and Mr. Flynn explained that the changes in Rule 64B5-14.003 do not affect CRNAs; this rule is for dental anesthesiologists and those dentists receiving training to apply for a conscious sedation permit. Dr. Tejera asked BOD Executive Director Ms. Jennifer Wenhold to send a letter to the Board of Nursing stating the rules for conscious, deep and general sedation. Mr. Thomas and Mr. Flynn are going to meet to clear up any further confusion. A discussion also was held on Rules 64B5-14.009, Conscious Sedation Requirements: Operatory, Recovery Room, Equipment, Medicinal Drugs, Emergency Protocols, Records, and Continuous Monitoring and 14.010, Pediatric Conscious Sedation Requirements: Operatory, Recovery Room, Equipment, Medicinal Drugs, Emergency Protocols, Records, and Continuous Monitoring. The FAPD requested that the BOD extend the timeframe to allow conscious sedation and pediatric conscious sedation permit holders more time to comply with the new capnograph requirement. The BOD did not grant an extension of time and this rule is now in effect. Dr. Brown gave the BOD an update on the recent Florida Mission of Mercy (FLA-MOM) held in Jacksonville. The BOD enthusiastically congratulated the FDAF and FDA on a successful event. The BOD stated they would continue to support this program and the screening mechanism the FDAF has in place for volunteer dentists who are not licensed in Florida. Two internationally trained dentists appeared before the BOD asking for a waiver of Rule 64B5-2.0146(2), Licensure Requirements for Applicants from Non-Accredited Schools or College. One had completed a two-year pediatric residency program and the other had completed a two-year supplemental education program in prosthodontics. The waivers were granted because both of the applicants were in their programs when the law was changed in 2011 and thus fell under the grandfathering provision of this rule. However, after the waivers were granted, Mr. Flynn and the BOD spoke on the record to end the confusion on what qualifies as a general supplemental dentistry program. From this meeting forward, no waivers will be granted for specialty programs. The BOD agreed the plain meaning of the chapter 466.006(3)(b), Florida Statutes, is that a general supplemental dentistry program does not include specialty programs. This is the FDAâ&#x20AC;&#x2122;s position. Furthermore, Mr. Flynn stated on the record that from 2009-2012 the rule allowed specialties, but the Legislature specifically did not include that language when it amended the statute in 2011. The Legislature knew the BOD was allowing specialties to fulfill the supplemental education requirement and they purposely left the specialty program language out when they amended the statute. Thus, the inclusion of one is the exclusion of others, meaning the Legislature purposefully included general programs and excluded everything else, i.e., specialty programs. In addition, Dr. Tejera asked Mr. Flynn if the way the Legislature acted

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The next BOD meeting is scheduled for Friday, Aug. 26, 2016 at 7:30 a.m. in Gainesville at the Hilton University of Florida Conference Center upon this issue was meaningful oversight for FTC purposes and Mr. Flynn stated that it was. Finally, a hygiene and internationally trained dentist applicant for licensure both applied to sit for the exam through the Commission on Dental Competency Assessment (CDCA), which administers the ADEX exam in Florida, and not the BOD. The CDCA allowed them to sit for their exams without ensuring they were complying with Florida law. The BOD directed Ms. Wenhold and Mr. Flynn to work with the CDCA to close this loophole. There were five disciplinary cases and two voluntary relinquishments that dealt with failure to meet the standard of care, itinerate anesthesia and failing to keep proper dental records. If you have not yet attended a BOD meeting, it is suggested that you take the opportunity to attend and see the work of the BOD. It is much better to be a spectator than a participant in BOD disciplinary cases. Ms. Stoutamire can be reached at 850.350.7202 or cstoutamire@floridadental. org.

July/August 2016

Today's FDA

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SUPPORTED CANDIDATES

Primary Election: Aug. 30, 2016 Thanks to your FDAPAC membership and support, FDAPAC has contributed to many candidate campaigns for the 2016 Primary Election. Without the FDAPAC membership, FDAPAC Century Club members, FDAPAC Capital Hill Club members, and FDAPAC Capitol Step Club members, organized dentistry would not be as effective during the legislative session. Below is a list of FDAPAC-supported House and Senate candidates for the 2016 Primary Election.

CENTRAL FLORIDA DISTRICT

ATLANTIC COAST DISTRICT Lange Sykes, R-Vero Beach MaryLynn Magar, R-Hobe Sound Gayle Harrell, R-Stuart Larry Lee Jr., D-Fort Pierce Bill Hager, R-Boca Raton Lori Berman, D-Boynton Beach George Moraitis, R-Fort Lauderdale Bobby DuBose, D-Fort Lauderdale Kristin Jacobs, D-Coconut Creek Katie Edwards, D-Sunrise Evan Jenne, D-Hollywood Shevrin Jones, D-West Park Richard Stark, D-Weston Ritch Workman, R-Melbourne Joe Negron, R-Stuart Bobby Powell, D-West Palm Beach Jeff Clemens, D-Lake Worth Perry Thurston Jr., D-Lauderhill Jim Waldman, D-Fort Lauderdale

H-54 H-82 H-83 H-84 H-89 H-90 H-93 H-94 H-96 H-98 H-99 H-101 H-104 S-17 S-25 S-30 S-31 S-33 S-34

NORTHEAST DISTRICT Elizabeth Porter, R-Lake City Reggie Fullwood, D-Jacksonville Leslie Jean-Bart, D-Jacksonville Jay Fant, R-Jacksonville Dick Kravitz, R-Jacksonville Cyndi Stevenson, R-St. Augustine Travis Cummings, R-Orange Park Aaron Bean, R-Jacksonville Rob Bradley, R-Orange Park Audrey Gibson, D-Jacksonville

H-10 H-13 H-14 H-15 H-16 H-17 H-18 S-4 S-5 S-6

Clovis Watson Jr., D-Gainesville Chuck Clemons, R-Newberry Paul Renner, R-Palm Coast David Santiago, R-Deltona Jason Brodeur, R-Sanford Scott Plakon, R-Longwood Bob Cortes, R-Maitland Larry Metz, R-Groveland John Cortes, D-Kissimmee Eric Eisnaugle, R-Orlando Kamia Brown, D-Ocoee Bruce Antone, D-Orlando Mike Miller, R-Orlando Amy Mercado, D-Orlando Carlos Guillermo Smith, D-Orlando Rene Plasencia, R-Orlando Tom Goodson, R-Cocoa Thad Altman, R-Melbourne Rod Smith, D-Alachua David Simmons, R-Altamonte Springs Randolph Bracy, D-Ocoee Dorothy Hukill, R-Port Orange Victor Torres Jr., D-Orlando

H-20 H-21 H-24 H-27 H-28 H-29 H-30 H-32 H-43 H-44 H-45 H-46 H-47 H-48 H-49 H-50 H-51 H-52 S-8 S-9 S-11 S-14 S-15

SWITCHED TO HOUSE RUN! This candidate was supported by the FDAPAC for his Senate run, but has now switched to run for a House seat.

Joseph Abruzzo, D-Boynton Beach

H-81 (ACDDA)

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FDAPAC-SUPPORTED CANDIDATES (CONT.)

NORTHWEST DISTRICT

WEST COAST DISTRICT

Clay Ingram, R-Pensacola Frank White, R-Pensacola Jayer Williamson, R-Milton Jonathan Tallman, R-Niceville Brad Drake, R-Marianna Jay Trumbull, R-Panama City Halsey Beshears, R-Monticello Ramon Alexander, D-Tallahassee Loranne Ausley, D-Tallahassee George Gainer, R-Panama City Bill Montford, D-Tallahassee

H-1 H-2 H-3 H-4 H-5 H-6 H-7 H-8 H-9 S-2 S-3

SOUTH FLORIDA DISTRICT Joseph Geller, D-Dania Beach Manny Diaz Jr., R- Hialeah Carlos Trujillo, R-Doral Barbara Watson, D-Miami Gardens Cynthia Stafford, D-Opa Locka Jose Oliva, R-Hialeah Bryan Avila, R-Hialeah Nick Duran, D-Miami David Richardson, D-Miami Beach Daisy Baez, D-Coral Gables Michael Bileca, R-Miami Jose Felix Diaz, R-Miami Kionne McGhee, D-Miami Carlos Pria, R-Miami Jeanette Nunez, R-Miami Holly Raschein, R-Key Largo Oscar Braynon, D-Miami Gardens Rene Garcia, R-Hialeah Anitere Flores, R-Miami Dwight Bullard, D-Miami

H-100 H-103 H-105 H-107 H-109 H-110 H-111 H-112 H-113 H-114 H-115 H-116 H-117 H-118 H-119 H-120 S-35 S-36 S-39 S-40

SWITCHED TO SENATE RUN! These candidates were supported by the FDAPAC for their House run, but have now switched to run for a Senate seat.

Dana Young, R-Tampa Kevin Rader, D-Boca Raton Jose Javier Rodriguez, D-Miami

S-18 (WCDDA) S-19 (WCDDA) S-37 (SFDDA)

Blaise Ingoglia, R-Spring Hill Amanda Murphy, D-New Port Richey Richard Corcoran, R-New Port Richey Danny Burgess, R-Zephyrhills Colleen Burton, R-Lakeland Cary Pigman, R-Sebring Ben Albritton, R-Bartow Jake Raburn, R-Valrico Dan Raulerson, R-Plant City Ross Spano, R-Riverview Sean Shaw, D-Tampa Janet Cruz, D-Tampa Shawn Harrison, R-Tampa James Grant, R-Tampa Chris Sprowls, R-Clearwater Larry Ahern, R-Seminole Chris Latvala, R-Clearwater Ben Diamond, D-St. Petersburg Kathleen Peters, R-St. Petersburg Jim Boyd, R-Bradenton Julio Gonzalez, R-Venice Heather Fitzenhagen R-Fort Myers Matt Caldwell, R-Lehigh Acres Byron Donalds, R-Naples Bob Rommel, R-Naples Wilton Simpson, R-New Port Richey Jack Latvala, R-Clearwater Tom Lee, R-Brandon Bill Galvano, R-Bradenton Kelli Stargel, R-Lakeland Jeff Brandes, R-St. Petersburg Denise Grimsley, R-Sebring Lizbeth Benacquisto, R-Fort Myers Matt Hudson, R-Naples

H-35 H-36 H-37 H-38 H-40 H-55 H-56 H-57 H-58 H-59 H-61 H-62 H-63 H-64 H-65 H-66 H-67 H-68 H-69 H-71 H-74 H-78 H-79 H-80 H-106 S-10 S-16 S-20 S-21 S-22 S-24 S-26 S-27 S-28

Please note, those listed in PAC PURPLE are FDAPAC-supported candidates who were elected to office without opposition after the June 24 qualifying deadline. Their names will not appear on the election ballot. For additional information on FDAPAC-supported candidates, contact the FDA Governmental Affairs Office at 850.224.1089 or gao@floridadental.org.

FLORI DA DENTAL CON V E NT I O N: THE OF F I CI AL ME E T I NG OF T H E F DA

GET CONNECTED: Team to Technology

SAVE THE DATE

JUNE 22-24, 2017

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HIPAA Audits

HIPAA Audits: Why Dental Organizations Shouldn’t Ignore the Audits By Dr. Danika Brinda CEO, PLANET HIPAA

“ ” Don’t wait until a HIPAA audit comes to your dental practice to know that you are out of compliance.

Today's FDA

July/August 2016

2016 is going to be a monumental year for HIPAA compliance. The Phase 2 HIPAA audits will be starting, and increased HIPAA enforcement is a guarantee. So far in 2016, we have seen multiple fines and HIPAA compliance enforcement that are setting the stage for the remainder of 2016. For many years, HIPAA compliance has been pushed off and ignored; however, if the first two months of 2016 is telling the story, now is the time to ensure your dental practice has established proper policies, procedures and practices for HIPAA compliance. Don’t get tangled up in a HIPAA audit without confidence in your dental practice’s compliance with HIPAA! It is easy to think that your practice is too small to get selected for a HIPAA audit or that audits will focus on large, integrated health care systems. However, looking at the findings from the pilot audits indicate that dental practices are just as desirable for a HIPAA audit as any other type of organization.

Some key findings from the HIPAA Pilot Audits are: n Smaller organizations tended to struggle with HIPAA compliance more than larger organizations. n The most common finding was the entity was “unaware of the requirement.” n Of the total health care providers audited, NONE of them were 100 percent HIPAA compliant. n Incomplete implementation of the regulations was cited as a top finding from the audits. We are at a stage with HIPAA compliance that “I didn’t know” or “I was unaware” is no longer going to be an acceptable reason for non-compliance. In the past year, numerous data breaches were reported to the Department of Health and Human Services. In some of the dental data breaches reported, more than 500 individuals were impacted! n 2,000 individuals impacted when an unencrypted portable device was stolen from a dental provider. n 3,200 individuals impacted after an unencrypted server was stolen during a burglary of a dental office. n 7,400 individuals impacted when dental records at an offsite storage were released by the storage company to unauthorized individuals.

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HIPAA Audits

With proper oversight of HIPAA and appropriate physical, technical and administrative safeguards, these data breaches could have been avoided. Another common finding is false security that the vendor of your practice management system or electronic health record has all aspects of HIPAA compliance covered. Even when a third-party solution manages a system, not all aspects of HIPAA compliance are met. Additionally, you may find that some functionality of your systems does not actually meet HIPAA compliance. For example, your systems should be able to automatically log out after a specified time of inactivity. Your vendor may be the group responsible for creating the functionality, but you are responsible for the implementation in your dental organization. If your software system doesn’t have the functionality to automatically log out of the system with inactivity, you may be out of compliance with HIPAA. Don’t assume that compliance is met — verify it!

benefit

NUMBER

Don’t wait until a HIPAA audit comes to your dental practice to know that you are out of compliance. Immediate action is needed if you are not confident in your HIPAA compliance. HIPAA takes more than just putting a HIPAA manual on the shelf in your dental practice. Make sure your organization takes the steps NOW and prevents a bad outcome from a HIPAA audit or showing up on the HIPAA Wall of Shame. (https://ocrportal.hhs.gov/ocr/breach/ breach_report.jsf). This article was first published on PlanetHIPAA.com on April 18, 2016. Dr. Danika Brinda is the CEO of Planet HIPAA and has more than 12 years of experience in health care privacy and security practices. She also is a nationally recognized speaker on a variety of health care privacy and security topics, and specializes in helping dental organizations implement a HIPAA-compliance program.

Helping Members Succeed Other HIPAA products cost more than $400 and don’t comply with Florida law!

Florida and HIPAA Compliant Forms for 2013 Omnibus Rule As an FDA member, you now have access to forms that comply with both federal HIPAA and Florida confidentiality law. All of the documents are available on the FDA website and are free of charge to members only. They are uploaded as Microsoft Word documents, so that you may add your practice information to them.

LINK TO THE FORMS: www.floridadental.org/members/member-resource FOR MORE INFORMATION 800.877.9922 • fda@floridadental.org • www.floridadental.org

www.floridadental.org

July/August 2016

Today's FDA

The Results Are In ...

Member Survey

Today's FDA

By Larry Seibert, Ph.D

The Florida Dental Association (FDA) recently engaged the services of Association Metrics Inc. (AMI) to conduct a membership study, which replicated the membership study previously conducted in 2011. The purpose of this study, which was launched in April, was to determine the needs of FDA members, how well those needs are met and how the FDA is performing compared to the 2011 study. Hundreds of current members, former members and Florida dentists who have never been an FDA member completed the survey. The data have been analyzed and the results — along with AMI’s recommendations — have been reported to the FDA management team and Board of Trustees (BOT). What we learned — like other associations, the FDA has a diverse membership population who have a variety of personal and professional needs, and they belong to the FDA for a variety of reasons. In general, the top three reasons why members belong to the FDA are to support the dental profession; be a part of organized dentistry; and, support the profession’s advocacy efforts. Other top reasons include access to the FDA’s continuing education (CE) courses; access to the FDA’s member benefits; staying current on information about dentistry; and, networking and building professional relationships. These top reasons are the same now as they were in 2011.

July/August 2016

Additional analyses were conducted to determine where differences exist among member segments, such as by specialty, age, practice type, gender, race, number of years as a member, district and dues category. By understanding the needs of each member segment, the FDA is able to offer products, services and experiences tailored to meet each segment’s specific needs. This study also measured the strength of the relationships that members have with the FDA in a metric known as the Loyalty Profile. By analyzing the responses to three questions, respondents were classified as loyal, neutral or vulnerable. The FDA’s Loyalty Profile for 2016 is 53 percent loyal, 31 percent neutral and 16 percent vulnerable. This profile is within the range typically found among professional membership associations, and statistically is unchanged from the 2011 study. Further analyses also drilled down to determine which member segments had higher or lower Loyalty Profiles, which shows where the FDA is doing a better job of meeting the needs of those segments. The portion of the study that measured the performance of individual offerings of the association uncovered the areas within the FDA that have the greatest impact on members’ value of their membership. The key drivers of membership value are member benefits, the Florida Dental Convention (FDC), membership dues, publications, FDA staff, advocacy efforts and CE. Compared to the 2011 study, the performance ratings of the FDA staff, the convention, FDA Services (FDAS), CE and community outreach all went up significantly, while the perception of dues declined. In the benefits analysis section of the study, each current member benefit was rated to determine how well the benefit is meeting individuals’ needs. Additionally, the usage and awareness were tested to determine which benefits members are aware of but choose not to use, as well as which benefits members were unaware of prior

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Member Survey

to taking the survey. The typical next steps are to determine which benefits should be modified based on poor performance and/or low usage, and which benefits need to be promoted due to a low level of awareness. Since 2011, the performance of four benefits have improved (community outreach, volunteer opportunities, discounts on CE and practice assistance), while the performance of one benefit has declined (public Find a Dentist search/FDA public awareness). In the 2016 study, individuals were asked where they would like the FDA to allocate its time and resources. The top two areas that emerged as the primary focus were advocacy and CE, which are consistent with the top reasons why members belong to the FDA. As a result of your survey responses, the FDA management team and BOT have been provided with improvement priority matrices for FDC, publications, website, staff, CE, FDAS, FDA Foundation and each of the six FDA districts. These matrices provide a recommended course of action to improve each of these areas, should management and the BOT choose to improve one or more of these areas. In the months ahead, the FDA management team and BOT will be making strategic plans for the FDA’s future. While a number of factors will be used in their decision making, a major part of the strategic planning process will include the recommendations provided by this voice-of-the-member research. These research results would not have been possible without the time you took to fill out the survey. On behalf of the FDA management team and BOT, thank you for your time and your opinions. Dr. Seibert is the President/CEO of Association Metrics Inc. and can be reached at larry@associationmetrics.com.

www.floridadental.org

“

In general, the top three reasons why members belong to the FDA are to support the dental profession; be a part of organized dentistry; and, support the profession’s advocacy efforts.

”

July/August 2016

Today's FDA

http://pscsales.com/ http://pscsales.com/ http://pscsales.com/ http://pscsales.com/ http://pscsales.com/ http://pscsales.com/ http://pscsales.com/ http://pscsales.com/ http://pscsales.com/ http://pscsales.com/

VOLUNTEER TO BECOME AN EXAMINER FOR THE ADEX DENTAL LICENSURE EXAM IN FLORIDA ARE YOU: • actively engaged in the practice of dentistry in Florida for five years; • interested in continuing dental education; • and, not connected in any way with any medical or dental college?

IF YOU ANSWERED YES!

Contact the Board of Dentistry office at 850.245.4474 and tell them you want to volunteer as an examiner for the Florida dental licensure exam.

benefit

Membership NUMBER Concierge

Thanks, Christine. You are a very welcoming member of the FDA and made me feel happy to become associated with it. If there is anything I can do to help the FDA, please do not hesitate to ask. — Dr. Bob Finkelstein Hi Christine, Thank you so much! CHRISTINE I told the Dr., “I LOVE THE FDA!!” MORTHAM — Bibiana Escobar Billing Coordinator, Santos Dental Care

OUR MEMBERS!

Your suggestions and comments are welcome. THE COMMISSION ON DENTAL COMPETENCY ASSESSMENTS USES THE LIST FROM THE BOARD OF DENTISTRY TO FORM A POOL OF ELIGIBLE EXAMINERS.

IF SELECTED TO SERVE AS AN EXAMINER, you must attend every session of the pre-examination standardization exercise conducted by the Commission on Dental Competency Assessments..

4 ?

EXAMINERS MAY SERVE FOR FOUR CONSECUTIVE YEARS.

For additional information, contact Casey Stoutamire: 800.326.0051 • 850.224.1089 cstoutamire@floridadental.org

HELPING MEMBERS SUCCEED

800.877.9922 or 850.350.7136 cmortham@floridadental.org

Leadership Development

The LDC is on the Job! By Dr. Suzi Thiems-Heflin

“

The LDC is dedicated to “Helping Members Succeed!“

”

Have you ever wondered where to find information that can help you improve your leadership skills? The Leadership Development Committee (LDC) is on the job! One excellent source for leadership materials is the American Dental Association’s (ADA) website. So, to help you in your search, the LDC has reviewed everything that is available on the Center for Professional Success/ Leadership Institute on the ADA website. Then, we created an easy-to-read chart as a “shortcut” to help you determine which materials pique your interest, while allowing you to use your time more efficiently. The LDC presented this chart at the House of Delegates meeting in June, as well as to the component executive directors and incoming presidents. However, we felt that all Florida Dental Association (FDA) members would benefit from this “shortcut” to the ADA materials. A sample of the chart is pictured on the next page, which includes five out of the 23 materials that were reviewed for leadership training. To view the full chart, please go to www.floridadental.org/ldc. A new “Leadership” section on the FDA website is being developed, which will include other opportunities for leadership growth, so look for that in the near future. We hope this information will help enrich your leadership skills! In addition, the LDC also conducted a survey to gather current information from all of the FDA’s councils and committees, which includes the purpose, time commitment and terms for each position. In the past, this information wasn’t easy to find. So, here’s another little “shortcut” for you: simply type “councils and committees” in the search box on the FDA website and — voilà! — there’s the information. If you have any suggestions or ideas that you would like the LDC to research, please email me at drsuzi@cox.net. And remember, the LDC is dedicated to “Helping Members Succeed!” Dr. Thiems-Heflin is the Leadership Development Committee chair and can be reached at drsuzi@cox.net.

Today's FDA

July/August 2016

www.floridadental.org

Leadership Development

Recommended Leadership Development Materials Presented by the Leadership Development Committee The ADA has pertinent leadership materials available on the ADA Center for Professional Success, Leadership Institute website. The LDC has taken on the task of reviewing the materials on that website. This will help FDA members access the ADA materials and help determine applicability of the ADA leadership material. Recommendation Provided By

Recommended Material

Author

Type

Recommended for Leadership?

Dr. Jeff Ottley

Aspects of Leadership

Gene Wurth, Executive Director of the ADA Foundation

Video

Yes

Dr. Suzi Thiems-Heflin

Hit the Ground Running

William Pawlucy, CAE, MPA, MBNQA

Video

Yes

Dr. Liz Gesenhues

Practical Strategic Planning

William Pawlucy, CAE, MPA, MBNQA

Video

Yes

Dr. Rick Stevenson

Recipes for Success: Overview

Association Options, Inc.

Booklet

Yes

Mr. Drew Eason

Board Assessment Toolkit

Association Options, Inc.

Toolkit

Yes

www.floridadental.org

Why? The speaker covers many areas of leadserhip and development of leadership. In addition, he uses his experience to relate concepts to reality. This gives basic information for a good presidency.

Important to train individuals to create plans that allow an organization to grow, to support the pursuit of goals and define a means to measure their goals. Explains everyoneâ&#x20AC;&#x2122;s role in leadership, what is expected of them and how they can accomplish this.

This would be for Boards and how to evaluate effectiveness.

July/August 2016

Today's FDA

FDA Services

Insurance Solutions for the Dental Graduate By Dan Zottoli FDA SERVICES DIRECTOR OF SALES, ATLANTIC COAST

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It can be complicated to choose the right insurance solutions. Put your trust in FDAS and let us do the work for you.

”

Today's FDA

July/August 2016

Congratulations! You graduated from dental school! You made it! You earned it! You deserve it! So, doctor … what comes next? As a new graduate, there are a variety of topics you now must face. It’s our goal at FDA Services (FDAS) to help simplify the transition from dental student to dental professional and provide the insurance solutions you need to take the next step in life and your career. This simplification results in three major steps: disability insurance, malpractice insurance and health insurance.

Disability Insurance How many years have you devoted to your education and training? And for what purpose? We all dream and aspire to be successful. As a dentist, you have spent so much time, effort, and money to accumulate the skills and experience needed to perform at your best in your chosen profession. Now, what if you couldn’t work? On average, one out of four dentists will become disabled at some point in their career — what if it is you? Would you be able to pay your bills? Disability insurance is the only method available to insure your ability to earn income. There are many types and many different carriers, and no two policies are created equally. Ask your insurance professional: 1. What is the definition of disability in the policy? This will be the trigger that tells the policy to pay or not to pay. 2. Are there any new graduate programs or discounts? 3. Are there any association programs or discounts?

Malpractice Insurance In today’s litigious society, liability insurance is even more prevalent in the dental practice. In general, malpractice insurance will cover you for lawsuits related to alleged malpractice and alleged failure to diagnose. Different coverage limits exist and can be selected at the dis-

www.floridadental.org

FDA Services

cretion of each individual. The most common limit of coverage is $1,000,000 per occurrence and $3,000,000 aggregate. Your employer also may have their own requirements as to how much coverage you can select.

RISK EXPERTS Dan Zottoli Director of Sales Atlantic Coast

Ask your insurance professional: 1. Can the carrier settle claims on my behalf or do I need to provide consent? 2. Does the company cover legal defense for board investigations? 3. Does the policy include legal defense for alleged Medicare or Medicaid fraud? 4. Does the policy include any protection for cyberliability? 5. Are there any new dentist programs or discounts? 6. Are there any membership programs or discounts?

561.791.7744 Cell: 561.601.5363 dan.zottoli@fdaservices.com

Dennis Head Director of Sales Central Florida 877.843.0921 (toll free) Cell: 407.927.5472 dennis.head@fdaservices.com

Mike Trout Director of Sales North Florida

The need for strong malpractice coverage is incredibly important — ask anyone who has been through a lawsuit.

Health Insurance Many of you have had health insurance through your dental school. As you are aware, that coverage ends after graduation and you will need to seek out your own individual coverage. The Affordable Care Act has changed the way health insurance is sold. In the past, you could seek out an individual health insurance plan at any time throughout the year. Today, mandated by Federal Law, we have an open enrollment period. The open enrollment period is the only time throughout the year you can purchase health insurance without an extenuating circumstance. Typically, these open enrollment periods are at the end of the calendar year for a policy to start effective Jan. 1. You will have the opportunity to purchase health insurance now, because you are losing your group coverage provided by your school — known as a “qualifying event.” Another qualifying event would be if you moved from one county to another, got married, had a child, etc. It is important to remember that you only have 60 days to take advantage of a qualifying event. Failure to do so will result in having to wait until open enrollment to obtain coverage. Tax penalties also may apply. There are many different types of health plans with various levels of pricing. Beyond the normal questions about coverage, it is important to make sure that the plan you purchase has an extensive network of hospitals and doctors to ensure the providers you choose accept your insurance coverage. Each individual’s situation is different, so the important thing to take away from this is that it can be complicated to choose the right insurance solutions. It doesn’t have to be. Put your trust in FDAS and let us do the work for you. Best of luck as you venture into your new career. We look forward to working with you!

904.249.6985 Cell: 904.254.8927 mike.trout@fdaservices.com

Joseph Perretti Director of Sales South Florida 305.665.0455 Cell: 305.721.9196 joe.perretti@fdaservices.com

Rick D’Angelo Director of Sales West Coast 813.475.6948 Cell: 813.267.2572 rick.dangelo@fdaservices.com

About FDA Services Inc. FDA Services (FDAS) is the wholly owned, for-profit insurance agency of the Florida Dental Association. FDAS is a full-service insurance agency and takes pride in managing the insurance portfolios of each and every client. Last year alone, FDAS contributed more than $1,000,000 to the FDA to help reduce membership dues.

We know insurance, we know dentists. Mr. Zottoli is the FDA Services Director of Sales for the Atlantic Coast and can be reached at dan.zottoli@fdaservices.com or 561.791.7744.

www.floridadental.org

July/August 2016

Today's FDA

Dental Practice Financing Together, we’ll find the right financing solutions to help you reach your business goals As your practice financing experts, we’ll work with you to identify your unique business needs and find the right financing* solutions to help you reach your goals — like purchasing new equipment, expanding your operation and more efficiently managing your cash flow. ●

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For more information or to get started today, please contact us. We look forward to speaking with you soon. * All programs subject to credit approval and loan amounts are subject to creditworthiness. Some restrictions may apply. The term, amount, interest rate and repayment schedule for your loan, and any product features, including interest rate locks, may vary depending on your creditworthiness and on the type, amount and collateral for your loan. **Owner-Occupied Commercial Real Estate, 51% owner occupancy required. † Bank of America Practice Solutions may prohibit use of an account to pay off or pay down another Bank of America account. Bank of America is a registered trademark of Bank of America Corporation. Bank of America Practice Solutions is a division of Bank of America, N.A. ©2015 Bank of America Corporation | flyer-0715-den-rep2 | ARVYXDWV | Rev. 07/15

Jason Nunez 614.804.0627 jason.nunez@bankofamerica.com

Compleat Dentistry

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

“You really need three great teachers in dentistry: one technical, one managerial and one financial,” he said over a few glasses of beer and wine at the end of a full day of continuing education (CE). He was one of a group of dentists who were more than halfway through their careers as I was just starting out. I knew them before I applied to dental school, and after spending time in their offices, I decided to pursue dentistry instead of medicine. They enjoyed the profession, rabidly pursued CE courses and were everything I had hoped to become as a dentist. When they signed up for a great speaker they wanted to see, they would let me know and tell me I should come, too. Even when I had no money, I would borrow the money

Today's FDA

July/August 2016

just to go to the courses that they attended. They would tell me which programs were worthwhile and I would complete them. I remember when I finished my last Pankey continuum and had a beer with one of my mentors, I told him that the reason I took all the Pankey courses was because he recommended I take them. His response: “Boy, I wish I had gone to all of them.” Collectively, they are the fourth great teacher we need as dentists: mentors. I would argue that they are just as important as the technical, managerial and financial teachers. Simply put, a mentor is someone who has been in your shoes before, who you can trust and who you respect for where they are now. Mentors are distinctly different from other authority figures. Teachers seem to know everything about their subject; mentors often share your confusion. Parents (unless they are dentists as well) don’t quite understand the challenges you face; mentors face the same challenges. When your employer tells you to do something, you have to do it; when a mentor tells you to do something, you want to do it.

I was fortunate to find such a great group of mentors — one was a friend of my parents, another was my family dentist when I was growing up. When I graduated and joined the local dental society, it gave me such great pleasure to see them at the meetings and spend some time with them. I listened to what they had to say and I took it to heart. Because we worked in the same town, my mentors were a tremendous help to me with my practice. Once, a patient left my practice to go to one of theirs. I called him and asked what he thought I should do differently. His words stuck with me: “Be firm in your principle, flexible in your procedure.” It was a much needed dose of humility for a young dentist who thought he knew it all. In fact, when I saw these great men still avidly pursue new knowledge even late in their careers, I realized that I have so much to learn and I became comfortable with the fact that I need to plot a course for continual growth. One time, I was worried about some numbers in my practice and spoke with two of my mentors about my concerns. They laughed and explained that they have the same problems with the same numbers. They didn’t have the answer and they didn’t solve my problem. But, they brought me great comfort to know that perhaps I need to recognize that there are some things

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Compleat Dentistry

that I cannot solve. This freed me to work harder in other areas where I could make a difference. The biggest challenge of taking great CE courses occurs when you return to your office the following Monday and apply your new knowledge. One of the most important steps to become a compleat dentist is to overcome this challenge. You will reap the greatest benefits of excellent CE if you take a course, genuinely try to apply what you have learned, then fail and try again before you take the next level course. Mentors are a huge help with this process. They can help you negotiate the day-to-day failures that are so important to professional growth. A great mentor has been to the courses, implemented the material, failed and learned to overcome the reasons for their failure. There are a couple of opportunities once we recognize the value of great mentors. First, we can be a mentor. Recently, I headed to a break during a lecture and a young dentist pulled me aside and explained that he had worked for a corporate entity and had recently left to pursue private practice. The reason he started out at a corporation was that he really had no idea that this style of dentistry was even possible. For those of us who love our profession and do not want it to be devoured by corporations, we need to make sure young dentists know that there is a different way — they do not have to serve a corporate master. Those of us who are in the middle of our careers or beyond, need to serve as mentors to the newest generation of dentists.

www.floridadental.org

Second, we can find our own mentor. We can make ourselves better if we learn from the fourth category of great teachers. Experienced dentists can tap into the relationships they have formed with their older colleagues throughout their careers. Young dentists who may not have one and may be interested in a different practice than working for a large corporation. You will find it much easier if you have some mentors. The best way I know to find a great mentor is at the local dental society meetings. The bang for the buck at local dental society meetings is unbeatable: for about $40 you get an hour of CE, a dinner that resembles chicken and most importantly, an opportunity to have a beer with your mentors. If that doesn’t work, then head over to one of Dr. Pete Dawson’s lectures and look around for someone taking it for the second or third time — chances are, they are a pretty fantastic dentist who would make a great mentor. Finally, please remember to thank your mentors. My mentors have all retired, and fortunately for me, I am honored to treat several of them as patients. Hopefully, they recognize the profound influence they have had on me every time they walk into my office. Sadly, one passed away this spring and will miss this article, which he so greatly influenced. Ken, Fred, Harvey and David, thank you so much for all you have done for me, for my practice and for my life. Dr. Hopwood is a restorative dentist in Clearwater and can be reached at edwardhopwood@gmail.com.

“

When your employer tells you to do something, you have to do it; when a mentor tells you to do something, you want to do it.

”

July/August 2016

Today's FDA

Mentoring

By Dr. CJ Henley

In the earliest days of medical education, the primary teaching model for those who wished to pursue medicine was the mentorship model. Young men were to study medicine from a “good teacher,” one “whose precepts are sound, whose practical skill is widely approved, who is clever, dexterous, upright and blameless; one who also knows how to use his hands, has the requisite instruments and all his senses about him, is confident with simple cases and sure of his treatment in those which are difficult; of genuine learning, unaffected, not morose or passionate, and who is likewise patient and kind to his pupils.” The principals that originated in ancient medicine still are present in today’s dental education, as we all still take some variation of the Hippocratic Oath. A portion of the original oath reads: “To hold my teacher in this art equal to my own parents; to make him partner in my livelihood.” Surveys of accomplished individuals have reported that influential mentors were second in importance only to education as a factor in their career’s success. Mentoring during the early stages of an individual’s career has been associated with a higher level of career satisfaction and a higher rate of promotion, both in medical and non-medical fields. In my career, mentorship has been one of the best tools for fast-forwarding my understanding of both the clinical aspects and the business of dentistry. However, finding a mentor is a challenge. It takes time and perseverance to find the right person to help guide you. The mentor-protégé relationship can be difficult to cultivate because the involved parties need to be on similar ground morally, professionally and clinically. The mentor has to have the desire to enter into the relationship; likewise, the protégé has to be ready and willing to learn. Much of what we do on a daily basis is attempting to determine the best possible outcome for our patients. With little or no experience, it can be difficult to determine what is best for patients. It is easy to understand the statistics, failure rates and average lifespans of different restorative procedures, but each case is different, each patient is different and it often takes experience to put all of the pieces of the puzzle together to ensure excellent clinical outcomes. Years of excellent clinical practice cannot be read in a text book — it has to be both experienced and passed on. During your career, mentorship provides guidance clinically and morally. I continue to rely on my mentors to help me in clinical decision making and treatment planning to ensure that I treat my patients with the appropriate care. This is true in all facets of my practice

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Mentoring

from choosing materials to proper treatment of oral pathology. Mentorship also is critical with respect to ethical behavior. The dentist-patient relationship is based on trust. As practitioners, we are performing a treatment that our patients (usually) cannot fully understand and cannot correct without our help. Our careers and profession are reliant on dentists who practice independent ethical behavior. Good mentorship can be beneficial for dentists who work in isolation and can help them make decisions that are good for their careers, the profession and their community. Mentorship must be based on mutual respect, trust and friendship. I’ve had the good fortune to have a mentor who has not only helped me to perform the best dentistry I can, but also has become a dear friend. I deeply value the insight that I’ve gained from my mentor both professionally and personally. There is something inspiring when someone can help you become the practitioner and person you want to be by earnestly supporting you during your career. Hopefully, many of you have had similar relationships in your careers. Indeed, there is a facet of mentoring that is similar to a parent-child relationship. It often is for these reasons that the connection is an intensely personal experience. Additionally, time is essential to positive mentoring outcomes. What will be gained cannot be done so quickly. The longer the duration of the relationship, the more valuable the experience. Evidence suggests that those who are mentored early on in their careers later become mentors in higher numbers. In a survey of departmental chairs and residency and fellowship program directors at an educational hospital, 90 percent reported having had a mentor throughout their training; of these, 81 percent had become mentors at some point in their careers, suggesting that mentoring activity tends to be a self-perpetuating phenomenon. Today, it seems that mentorships have been on the decline. Lack of access to mentors has consistently been identified as a barrier to successful mentorships. This is a disservice to both clinicians and patients as we move forward. In a survey of faculty from 24 U.S. medical schools, faculty members with mentors had significantly higher career satisfaction scores than those without mentors. Medicine and dentistry always have had mentorship as a central part of their educational processes. I encourage both potential mentors and protégés to consider mentorship — not only is it mutually beneficial to both parties, but, more importantly, benefits the patients we treat. Dr. Henley is a general dentist in Jacksonville and can be reached at DrHenley@HenleyandKelly.com.

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There is something inspiring when someone can help you become the practitioner and person you want to be by earnestly supporting you during your career.

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July/August 2016

Today's FDA

Mentoring

By Dr. Robert Churney

How did you get started in mentoring? I guess it started when I first went into practice. The idea that I could help someone on their own journey intrigued me, and I truly enjoy the connection you can make.

How can members become involved in mentoring? There are so many ways. Meet a young dentist at your affiliate meeting and strike up a conversation — sometimes that is all it takes. Also, become a courtesy faculty member at any of the dental schools in our state. They need us, and we need to engage with the next generation of dentists.

What do students get from mentoring? I tell them they get real world answers. We all know that dental school prepares you as best as it can, but there is only so much you can learn in a short period of time. Having a mentor means having someone with years of practice under their belt to really show you a whole other world of practice.

How can students go about finding a mentor? Talk to people at your local affiliate or any other meeting. Ask other young dentists who they discuss cases with. Pick up the phone and call. Students can talk to faculty, especially in the areas they are interested in.

What have you gotten out of mentoring? Sheer joy. I get to meet so many passionate people in our field who strive to create something meaningful in their professional lives. Just the idea that I am able to help young dentists on their journey is worth more than anything else. I have been so fortunate to have people who have believed in me along my path that I want to share that with others.

Why do you feel it is important to be a mentor? First and foremost, it’s important to give back. To gain knowledge and not pass it on is criminal. We elevate the whole profession by standing on the shoulders of those before us. When we mentor others, we pass it on.

Did you have mentors? Absolutely — no one can say they didn’t have someone who they gained knowledge from. In dental school, it was the periodontal department faculty. In general practice, it was Dr. Gerald Marx in Louisville, Ky. In two short years, I learned more ethical standards to build upon for life than I would have on my own. In residency, it was Dr. Sam Low and for 20 years of periodontal practice, it was Dr. Danny Melker, with whom I was able to discuss cases and surgical techniques, which helped me to grow professionally. Dr. Churney is a periodontist in Clearwater and can be reached at drc@churneyperio.com.

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Mentoring

Mentors: A Priceless Asset By Dr. Alex S. Kim

My mentors are the people who look out for my best interests — they go above and beyond to help me thrive in my profession and in life. I have found my mentors to be an invaluable resource, and hope that many dental students and young dentists receive the opportunity to benefit from such mentor-mentee relationships. I strongly encourage experienced dentists to offer mentorship to those who need the advice and guidance, and for dental students and young dentists to seek out mentors early on. I found my mentors through the connections I made during my two years of residency at the University of Florida St. Petersburg Advanced Education in General Dentistry (AEGD) Clinic. I also developed many of my relationships with mentors when I attended various dental meetings and through my involvement in the national and local dental organizations. I sought out mentors because I believe that having the right guide to help you improve your clinical skills and develop your own dental philosophy is a priceless asset. Being a dentist means being a lifelong learner. We are members of a profession that constantly has new developments in dental technology and clinical skills, so continuing education www.floridadental.org

(CE) is a necessity. The training and advice I received from the experienced dentists who taught me the proper techniques early on in my career helped me improve at my job. My mentors at the Dawson Academy — including Dr. Peter Dawson himself — taught me the valuable principles and necessary skills for the practice of quality and complete dental care. Their mentorship also helped me learn how to pace myself and balance my life and career. Dr. Thomas Porter, the director of the AEGD Clinic, is a true model of a lifelong learner. He continuously has encouraged and motivated me to get involved in CE. There are many more mentors in my life that I cannot even begin to mention in this short article. I cannot thank them enough for their continued advice and support that has helped me become a better dentist. My mentors also helped me manage my dental career. During my two years at the clinic, I received tremendous help in figuring out where and how I will practice after the residency. They also helped with my job search and advised me on where to look and how to find the right person to work with. They were the ones who vouched for my ability as a dentist to others. For instance, Dr. Porter’s high recommendations of me to a former resident of the clinic helped me secure an associate position early on. I also would not have been given the honor of publishing this article in Today’s FDA if it had not been for Dr. Robert Churney’s recommendation. Young dentists should look for someone with a firm dental philosophy, knowledge of the practice and most importantly, someone with a deep interest to teach the future generation of dentists. Dental students who are still figuring out whether they want to specialize would benefit from advice from experienced dentists who have already gone through that decision-making process. Young dentists also should look for mentors who can show them tips on how to run a private practice and the different paths that they can take in their career. We depend on mentors to share the knowledge we do not yet have. Experienced dentists can help younger dentists simply by sharing what they have experienced during their own careers. I’ve received a lot of support and help from my mentors. They have given me advice that rang true throughout dental school and my residency. If an opportunity should arise for me to share what I learned from my mentors, I would do so in a heartbeat. It is an opportunity for both the mentee and mentor to initiate a meaningful relationship, which often develops into lifelong friendships. I encourage the dentists in our community to provide mentorship to those dental students and young dentists who would benefit immensely from such support. Dr. Kim is a general dentist in La Jolla, Calif. and can be reached at alexkimdmd19@gmail.com.

July/August 2016

Today's FDA

Dental School Deans

Florida's Dental Schools The Journey Continues By Mathew Bateman, Ph.D., D.H.Ed. INTERIM DEAN, LECOM SCHOOL OF DENTAL MEDICINE

As I prepare to step in as the interim dean of the School of Dental Medicine (SDM) at the Lake Erie College of Osteopathic Medicine (LECOM) Bradenton, Fla. campus, I’ve had the opportunity to reflect on LECOM’s growth in recent years. Thinking back over the past 10 years, I’ve had the pleasure of being part of much of that growth — perhaps, most importantly, the founding and recent expansion of the SDM. During the past few months alone, the LECOM SDM has undergone significant changes, from completing its final CODA inspection for accreditation and graduating its first class of dental students to its second dean retiring. This flurry of activity has prompted me to evaluate the core foundations essential to a LECOM education. I find myself considering the immediate future of the school as well as focusing on our ability to create a long-term impact through innovative strategic planning and constant evaluation and assessment. Moving forward, the focus during my tenure will be on the institution’s three core values, which are the very hallmarks of each student and graduate.

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First, there must be a foundation of knowledge within the dental discipline. Second is a devotion to professionalism. Third, there is an inculcation of the osteopathic philosophy within the school’s approach to dental medicine. These three values are the underpinnings to the decisions that are and will be made — from reviewing curricula to enhancing assessments. LECOM’s unique model of communitybased clinical training within the fourth year in Erie, Pa. and DeFuniak Springs, Fla. prepares bright young women and men who enter the workforce with superlative dental knowledge, skills and professionalism. We will continue to seek out and recruit the best candidates for the SDM, as we fulfill LECOM’s mission to prepare students to become osteopathic physicians, pharmacy practitioners and dentists through programs of excellence in education, research, clinical care and community service. Our dental students are highly motivated and accomplished, and are progressing through the rigors of the curriculum as well as being closely involved in community outreach projects providing invaluable services to their communities. The LECOM SDM has made inroads in establishing internal and external partnerships with the LECOM College of Osteopathic Medicine and School of Pharmacy, as well as various community organizations, respectively. These relationships have resulted in many diverse opportunities that have enriched the educational experience of SDM students, which allows them to participate in unique volunteer activities. We will continue to create new avenues

through which students can work to improve oral health care in our multiple communities, mutually benefitting the students as well as the patients whom they serve. Dr. Bateman is the interim dean of the LECOM School of Dental Medicine and the Director of Institutional Planning, Assessment, Accreditation and Research. He can be reached at mbateman@lecom.edu.

The Path Ahead By Dr. Isabel Garcia DEAN, UNIVERSITY OF FLORIDA COLLEGE OF DENTISTRY

Last month, the University of Florida College of Dentistry (UFCD) celebrated its 41st commencement. Proudly, 78 students earned a dental degree and 52 received master’s degrees or certificates in seven specialties and advanced education in general dentistry. For graduates, commencement is a time to look at the path traveled and contemplate with excitement what is to come. For UFCD, the academic year’s end marks a time of reflection and preparation for the path ahead, being mindful that continued success requires us to be innovative and adaptable, and constantly evolve to fulfill our vision.

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Dental School Deans Our college is known for excellent clinicians, skilled graduates, top-notch researchers and devoted community servants. UFCD is one of only two U.S. dental schools with residency training in every dental specialty. The breadth, depth and rigor of our programs were affirmed during our successful CODA accreditation visit last year. As we plan for the next five years, we will maintain balance in all parts of our mission while focusing on key areas of opportunity.

Transform Dental Education UFCD will lead the way to create innovative educational models for training future dentists and specialists. We will adopt a new predoctoral curriculum that features more critical thinking, earlier clinical experiences, fuller integration of basic and clinical sciences, increased small-group learning and less lecture time — while adapting to today’s and future learning styles. Greater links between the dental program, advanced education, UF Health teaching hospitals and the UF College of Medicine will create a truly unique interprofessional environment. For seven consecutive years, our dental students achieved a 100 percent first-time pass rate on Part I of the National Dental Board Exam. We will meld new technologies with time-tested approaches that have yielded this, and other measures, of student success. Embracing UF’s plans for graduate medical education, we will prepare postdoctoral fellows, MS, DMD/Ph.D. and Ph.D. students to succeed in a rapidly changing environment.

Invest in People, Programs and Infrastructure The heart and soul of UFCD are the faculty who inspire, shape and teach students, and the staff who support them. In the years

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ahead, our goals are to grow and diversify sources of revenue, and increase fundraising and efficiency, which allows us to invest in faculty recruitment, support and development. Key strategies for growth and support for the university's pre-eminent question to achieve a top-10 status among U.S. public universities include: v update plans for a building expansion v renovate and upgrade existing research space v develop new partnerships and strengthen existing collaborations between UFCD and other UF health professional schools

Drive Discovery and New Knowledge New insights and knowledge from research informs what we teach and how we provide care. UFCD currently ranks seventh and has placed among the top 10 dental schools in the National Institutes of Health funding for the past 15 years. Research funds increased by 15 percent last year to $15.4 million, the bulk of which came from federal grants. We will continue to support our many multidisciplinary programs that are using cuttingedge technologies, which change the way to prevent and manage oral diseases, and position our college to remain a world leader in oral health research. Renewed efforts in areas of historical strength — biomaterial sciences, epidemiology and clinical research — will round out our research program and afford greater opportunities for bench-tochairside translation.

Serve Florida’s Oral Health Needs For nearly 20 years, the UF Statewide Network for Community Oral Health has provided community-based learning for our dental students while offering urgently

Vision To be international leaders in research, education, patient care and service.

Mission To be known for innovative education, commitment to cultural diversity, discovery, transfer of scientific knowledge, superior skills of our graduates and the highest degree of patient care and service.

needed care to underserved communities. We provide high quality, comprehensive care to people in all 67 counties in Florida through our college-owned clinics and community partners. As Florida’s only state-supported dental school, our service mission is deeply ingrained in our institutional fabric — the statewide network is the backbone of future community service as we seek to grow partnerships and create a national model for service learning. Achieving these areas of focus will help ensure that the UFCD continues to be the flagship dental school in the state, an asset to the University of Florida and its Health Science Center, and an exceptional place in which to work, learn, study and teach. By further strengthening the close integration between education, clinical care and research, we will provide unparalleled opportunities to faculty, staff, students, residents and support for the citizens we proudly serve. Dr. Isabel Garcia is the University of Florida College of Dentistry dean. She can be reached at aigarcia@dental.ufl.edu. Please see DEANS, 51

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Ways to Get Involved

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CONTINUING EDUCATION

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Attend Dentists' Day on the Hill. Offer pro bono care through the FDA Foundation: PDC, DDS, and FLA-MOM.

Serve on an FDA or district council.

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Write articles for Today's FDA. Visit a school during Children's Dental Health Month. Volunteer for Give Kids a Smile. Train as an FDA spokesperson.

FDC 2017

Save the date — June 22-24, 2017 — for the Florida Dental Convention. Anyone can pre-register, but only FDA members pre-register for FREE, and only FDA members can earn up to 18 hours of FREE CE credits.

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QUESTIONS ABOUT YOUR MEMBER BENEFITS?

Find more information at www.floridadental.org.

Dental School Deans DEANS from 49

Innovation Continues By Linda C. Niessen, DMD, MPH DEAN, NSU COLLEGE OF DENTAL MEDICINE

Nova Southeastern University College of Dental Medicine (CDM) was founded in 1997 with a number of firsts. It was the first new dental school to open in the U.S. in 25 years, it was the first College of Dental Medicine to be affiliated with a College of Osteopathic Medicine and it was the first private dental school in Florida. The CDM’s vision is “to be the acknowledged leader in educating students for an enriched career in general or specialty practice, academia and/or research with special emphasis on underserved populations.” From a pool of more than 2,500 applicants, 126 dental students entered the Class of 2019, which included 66 female students and 60 male students. Fifty-seven percent are Florida residents. The last two months in 2015 saw a total renovation of the 19-year-old Dental Simulation Laboratory. The simulation units were designed by the Italian design firm, Pinon Ferrari (designer of Italian sports cars), and have a unique round footprint. While the D1 and D2 students enjoy working in the new simulation laboratory, it’s also proving to be a recruiting device for the future students when they tour the facility. Our dental students have a strong commitment to community service, with many who volunteer in charitable events. Nova was honored to be selected by the American

Dental Association Foundation (ADAF) as the national kickoff location for the ADAF’s Give Kids A Smile (GKAS) event. The event is student-run and this year included the College of Pharmacy and College of Osteopathic Medicine students. There were clowns, face painting and a DJ at the event to create a fun atmosphere for the children. Leaders from the ADA and the Florida Dental Association (FDA) joined our students and dental industry leaders that morning for the ribbon cutting. The CDM partnered with Broward County Public Schools and the Boys and Girls Clubs, and more than 700 children received treatment. For many of the children, this was their first visit to the dentist. Following the GKAS event, the Broward County Public School Board recognized Nova’s dental students for their efforts to improve access to oral health care for the children. Besides GKAS, our students participated in the Florida Mission of Mercy in Jacksonville, and found it to be an incredible event that truly made a difference for the 2,800 patients who received care. Students often don’t realize the gifts they have until they care for people who have so much less. The CDM students also held the “Swinging for Smiles Charity Golf Tournament,” an “Aceing Autism” tennis event and an Oral Cancer Awareness 5K, to name a few. This last event resulted in more than $8,000 raised to help a patient. This year, we participated in the new “patient-centered” Commission on Dental Competency Assessment Board Examination, nicknamed the “Buffalo model.” Nova was one of six dental schools in the nation to implement this new format, in which students take the board exam during a regular clinic session. Faculty and board examiners are on the clinic floor together. If the student does not pass the examination, the examiner informs the student, explains why the student failed the examination, advises the student to work with their faculty to correct the problem and provide the ap-

propriate care to the patient. The students’ feedback on this format was favorable and they found it was less stressful. The class achieved a success rate for this format that was about the same, if not a little higher, than the traditional format (more than 90 percent success). As a new dental school, Nova continues to grow its research enterprise and had many research successes this year. These include: an HRSA grant to improve education for dentists caring for autistic children and adults; an American Association of Oral and Maxillofacial Surgeons Foundation grant for stem cell research in cleft lip/palate; research funding to support clinical trials for various consumer oral health products; grants to support bone growth, stem cells and dental implant improvements; and, grants from several community foundations to support school-based oral health prevention programs in elementary schools in South Florida. Nova appreciates our partnership with the FDA and looks forward to continuing to work together to support the next generation of dentists. Each year, Nova’s American Student Dental Association (ASDA) student leaders participate with the FDA at Dentists’ Day on the Hill (DDOH). Dr. Laurie Gordon Brown serves as the faculty sponsor for this activity. The 2016 Legislative Session included the student debt issue, which enticed more students to participate in DDOH. ASDA members were engaged in the FDA’s legislative efforts, as this was one of the FDA’s key issues. The ASDA leaders also organized the FDA Signing Day event in which students meet with FDA leaders, network and learn more about the value of FDA membership. These events support FDA membership by demonstrating the benefits of organized dentistry. Dr. Niessen is the dean of the Nova Southeastern University College of Dental Medicine and can be reached at lniessen@nova.edu.

ASDA Presidents

ASDA Presidents and Their Role in Leadership By Sable Muntean LECOM ASDA PRESIDENT

Being a dental student at the Lake Erie College of Osteopathic Medicine (LECOM) is the greatest achievement and honor I could have imagined. After living in Southern California for 25 years, I was extremely thankful for the opportunity to start a new chapter in my life in a new state at an amazing school. And from the moment I received my acceptance letter, I knew that I would do my absolute best to make LECOM proud of their decision to welcome me into their family. I am now in my third year and work in the clinic on patients, earning a Master’s in Health Services Administration simultaneously with my courses, performing research, spearheading many projects and serving as president and first delegate of LECOM’s chapter of the American Student Dental Association (ASDA). In my first year of dental school, I really did not know much about ASDA — but one of my favorite professors demonstrated what

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a wonderful organization it was and I knew I had to learn more. I became one of the ASDA representatives for my class and little by little began to understand the principles of the association that represents 92 percent of dental students. What really opened my eyes was when I attended a House of Delegates meeting at the Florida Dental Convention in June 2015. I saw firsthand how practicing dentists and dental students worked together to make an impact on the matters discussed and how positive changes were made to improve the profession. I am amazed at how important the Florida Dental Association (FDA) and American Dental Association (ADA) finds the opinions of dental students. In the meantime, I was elected to serve as the membership officer for our ASDA chapter and had the opportunity to get to know my own colleagues better, as I recruited 88 percent of the school to join ASDA. I was able to network and meet many leaders and other dental students from around the country who share the same values I do. The more involved I became, the more I knew I wanted to make an even greater difference for my classmates. So, I decided to run for our chapter president. After having the privilege of being elected, I have taken the bull by the horns and work diligently with my remarkable executive council to

restructure our chapter and make it an “ideal” ASDA chapter. As president and first delegate, I serve as the chair of the Executive Council, lead our general ASDA member meetings, oversee our 11 committees, serve on the FDA Council on the New Dentist, represent LECOM on a state and national level, vote on topics that affect dental students, and attend various conferences to learn how to be an effective leader. I am driven to make our chapter and our school a tremendous success in the dental world and I will continue to deliver. ASDA’s mission statement, as stated on asdanet.org, is a “national student-run organization that protects and advances the rights, interests and welfare of dental students. It introduces students to lifelong involvement in organized dentistry and provides services, information, education, representation and advocacy.” It is most definitely not a solely political organization because it strives to instill the importance of not only the political aspect of dentistry, such as lowering the amount of student debt and improving the licensing examination process, but also wants to aid students in understanding what life as a practicing dentist is like and what opportunities there are to grow as an individual and a leader. There are sessions that discuss topics varying from residency programs to how to run

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ASDA Presidents

a successful dental practice at each conference and via webinars. Attendees gain knowledge that is not necessarily presented in dental school, but is imperative to know for the future. Through ASDA, members also are able to mentor pre-dental student members to guide them through the application process and more. I even had the privilege of having my remarks featured on LECOM’s page in the ASDA Pre-dental Student Handbook this past year. As you can see, ASDA makes an impact on much more than just the present, but also the future. I’ve been extremely fortunate not only to be a student at LECOM, but to take advantage of the leadership opportunities within our ASDA chapter, and now lead it as president. I am making a name for myself as a student and future dentist, and I cannot be more thankful for the relationships I have created and the values I continue to learn. During my fourth year, I aspire to have a role in National ASDA and look forward to seeing what I can achieve until then with the help of my supportive colleagues and mentors. As John Quincy Adams once voiced, “If your actions inspire others to dream more, learn more, do more and become more, you are a leader.” Every day, I diligently work to do just that because if I can help even one person achieve his or her aspirations, I am living the life I want to live. Sable Muntean is the LECOM ASDA president and can be reached at Sable.Muntean@ dmd.lecom.edu.

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By Neila Nicholson UF ASDA PRESIDENT

My leadership in the University of Florida College of Dentistry’s (UFCD) chapter of the American Student Dental Association (ASDA) began last summer when I was selected as the Loupes Fair director. I received positive feedback after the Loupes Fair, so I decided to become more involved with ASDA. As the year went on, I gained further exposure to the advocacy and legislative aspects of our chapter, as well as how important it is to foster dental students’ initial ties to organized dentistry. For example, the Florida Dental Association (FDA) worked with us to have our chapter’s first New Dentist Panel, where multiple FDA-member dentists spoke about their careers and how organized dentistry played such a vital role to shape them as professionals. My belief in the importance of our chapter’s mission continually grew, and I was honored when the UF ASDA’s former executive board chose me to take over the reins as chapter president for the 2016-2017 school year. I am excited to bring a fresh perspective, as well as enhance some of the thriving programs we host throughout the year. As president, I oversee 41 officer positions, which are distributed amongst five committees. Each member of our executive board

— which includes the two vice presidents, secretary and treasurer — spearheads one committee. As chair of the Special Events Committee, I will oversee some of our chapter’s larger events, such as Mighty Molar, which is a traditional class competition field day, the end-of-the-year gala, the business symposium, Loupes Fair, vendor fair and much more. With five committees in our chapter, there are many ways ASDA members can get involved. We encourage each of our officers to form subcommittees of their own. This allows other student members the opportunity to take on smaller leadership roles, such as organize Dinner and Dentistry events, make decorations for special events or communicate with guest speakers. Volunteering at some of our special events is another way for students to partake in our chapter activities as well as take on an active role. For example, many of our student members served as tour guides during our annual Pre-dental Conference. This event was so successful and recruited so many new members that we won a National ASDA award for having the third largest membership of pre-dental students out of all the ASDA chapters! Apart from our special events, ASDA brings in various speakers to educate dental students about dentistry in the “real world.” We’ve found it is more successful to host such events in a more casual setting offcampus, and we look forward to organizing Please see ASDA, 55

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Today's FDA

TIME FOR A CHANGE? Keep your ADA and FDA member profile up to date with any changes! Call the FDA at 800.877.9922 or email us at fda@floridadental.org.

Ready to retire as an FDA privileged member? Stay active and take advantage of special membership incentives — you’ve earned it! Contact us to find out if you are eligible for retired membership. * Florida licensed dentists: Don’t forget to notify the Florida Board of Dentistry with your new information by going to floridasdentistry.gov or calling 850.488.0595.

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YOUR FLORIDA DENTAL CONVENTION STAFF IS “HELPING MEMBERS SUCCEED” EVERYDAY!

PROFESSIONAL STAFF I HELP MEMBERS SUCCEED BY providing grassroots and political advocacy for our members. I assist volunteers for grassroots lobbying, fundraising and campaigning. We are always looking for new members to advocate on behalf of organized dentistry and I am happy to assist these member dentists. — Alexandra Abboud Governmental Affairs Coordinator

Have a question about governmental affairs? 800.877.9922 • 850.350.7204 • aabboud@floridadental.org www.floridadental.org

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TODAY’S FDA CLASSIFIED ADS

ADVERTISE OR SEARCH! Target your message at a dental audience.

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www.floridadental.co/classifieds Postions, equipment, office space available or sought — find it here! The Florida Dental Association classified website is convenient, fast and user-friendly. It’s simple and straightforward, and requires only a few keystrokes to place your ad! The FDA classified website has exciting features to enhance your ad: � You can upload up to four complimentary images and place up to 120 words. � You have more control of the layout of your ad: bold, italics, underline, bulleted/numbered lists. � Featured ads! $20 for seven days � Run your ad for 60 days, just $78. � In addition, we publish the basic text of your ad in Today’s FDA — at no additional cost! Questions about the classified ad site? Contact Jessica Lauria at 850.350.7115 or jlauria@floridadental.org

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ASDA Presidents

ASDA from 53

more mixers this upcoming year. Another program our chapter is excited about is further developing the student-faculty mentorship program we began last year, called the Hue Groups. Each faculty member was paired with a group of about 15 students from all class years, and encouraged to meet on a regular basis for friendly discussions. The goals of this program were to further open the lines of communication between faculty and students, offer students the chance to gain more informal advice and build relationships with fellow dental students with whom they might not have otherwise interacted. Another important aspect of ASDA is the simultaneous memberships in the American Dental Association (ADA) and FDA. This tripartite allows members to attend conferences such as the annual Florida Dental Convention. These conferences are a great way to be exposed to new technology and advances in dentistry, as well as opportunities to network. Also, the ADA sponsors a student disability and life insurance policy free of charge to ASDA members, which grants us all peace of mind. I feel blessed and humbled to serve as president of the UF ASDA chapter. As the year progresses, I have no doubt that I will exponentially grow through this unique experience. I hope to gain many friends, knowledge and wisdom through

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this process. I wholeheartedly believe that ASDA offers extraordinary opportunities to students — a lot of which is made possible through the help of the FDA. I look forward to an upcoming action-packed year and to continue the great relationship between the FDA and ASDA. Neila Nicholson is the UF ASDA president and can be reached at NNicholson@dental. ufl.edu.

By Preston Hansen NOVA ASDA PRESIDENT

To me, the best way for students to become involved in our local chapter is to attend events. We host many events each month ranging from Lunch n’ Learns and Loupe Fairs to social gatherings and meetings with potential employers. We encourage students who want to be more involved to take on a greater responsibility and run for one of our 30+ leadership positions. These experiences can change a student.

Students and Florida Dental Association (FDA) members should know that ASDA is the voice for all dental students at all dental schools. We speak and take action on behalf of the health and wellness of our students, and work to protect and advance the rights My experience of all dental students. ASDA also provides with my pre many resources to help dental students sucdental American ceed. For me, ASDA has been like a second Student Dental family. Being away from those we are close Association to can be stressful, but ASDA members (ASDA) chapter come together to help one another, which was the reason tremendously helps with the stress of dayI continued my to-day life in dental school. involvement in

ASDA once I began dental school. I joined Nova’s ASDA chapter and became a legislative liaison. This position gave me the opportunity to further my involvement in organized dentistry by advocating for dental-related legislation. When my term was over I still wanted to be involved, and through mentorship and a slight nudging, I ran for president-elect. I was elected and now I’m halfway through my presidency, and I can tell you, I love every aspect of what ASDA has to offer.

Through ASDA, I’ve learned to rely on others, how to work better as a team and how to delegate responsibility to achieve a goal. I’ve realized that everyone has something of value to offer, and I will always listen to the opinions of those around me. Most importantly, I will forever be grateful for the opportunities ASDA has given me. Preston Hansen is the Nova ASDA president and can be reached at ph516@nova.edu.

July/August 2016

Today's FDA

YOU are NUMBER

YOUR COLLEAGUES ARE “HELPING MEMBERS SUCCEED” EVERY DAY!

DEDICATED VOLUNTEERS HELP YOU SUCCEED I was fairly involved with ASDA in dental school, and knew that I wanted to remain involved after graduation. As oversight of our profession changes through the years, there will only be one constant voice of dentists to interact with those overseers. It's nice to have the chance to be a part of that voice. Fortunately, I practice in an area with great dentists who also care about the well-being of the profession. The camaraderie that comes with organized dentistry is an extra perk. I look forward to continuing to serve, to observe our profession as it changes, but also as it maintains its status as one of the best professional options for those who desire a life of service.

Clay McEntire, DMD

— Clay McEntire, DMD Member, FDA House of Delegates & Council on the New Dentist mcentch@gmail.com

Interested in opportunities to get involved? Simply email the FDA’s Membership Concierge and she’ll put you in touch with your local dental society. Contact Christine Mortham at cmortham@floridadental.org.

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Today's FDA

July/August 2016

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Dental Students

Dental Students: The Importance of Being Involved

(L to R): Ms. Novakovic, Dr. Ethan Pansick, Ms. Paula Cohen, Mr. Mahmoud Mona, Ms. Gabrielle Klatt and Mr. Will Baldock attend the 2016 Dentists' Day on the Hill.

By Paula Cohen UNIVERSITY OF FLORIDA COLLEGE OF DENTISTRY, D4

Any chance I get, I brag about how lucky I am to be a part of the Florida Dental Association (FDA) as a student member. From the moment I began dental school, I was always encouraged and mentored by the dentists and leaders of the FDA, and it has shaped my education and outlook on our profession in such a positive way. My journey started when I was selected to be the legislative liaison for my chapter of the American Student Dental Association as a D1. This immediately opened up a network of some of the most intelligent and motivated people I’ve had the privilege of working with: Ms. Joe Ann Hart, Ms. Casey Stoutamire, Drs. Jolene Paramore and Gerald Bird — the list goes on! They continue to encourage my growth as a student and to help develop my leadership skills and sense of professionalism. I’ve been to Dentists’ Day on the Hill (DDOH) three times, and each time I am more convinced of how important it is for us to have a strong voice on Capitol Hill. It’s tempting to isolate yourself in a bubble as you study away the four years of dental school, but the reward of being an active student member is absolutely incredible! I’ve been able to talk one-on-one

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with legislators, learn about the political process and provide input on issues that affect me. I encourage every student to attend DDOH, because you really see how hard the FDA works for you. This year, they lobbied for legislation that would help students who want to practice in a high-needs area receive funding to help with their student debt burden. This is just one of many ways that the FDA governmental affairs team continues to prioritize the issues of students, dentists and the profession! Ms. Paula Cohen is a D4 at the University of Florida College of Dentistry and can be reached at pcohen@dental.ufl.edu.

July/August 2016

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July/August 2016

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Choosing a Specialty

A Career in General Dentistry By Dr. Lawrence E. Weaver

In high school, I always thought I would pursue some sort of medical career. My family dentist, Dr. Ed Martin, was a good friend of my parents and always talked about how fulfilling his career in general dentistry was for him and his family. My roommate in college, Dr. Steve Coppes, attended dental school since his father also was a general dentist. I began to evaluate what a career in dentistry had to offer. To me, the best aspects were to work with and help people, be my own boss, make a nice living for me and my family, and choose the hours I work — which influenced my decision to apply to dental school. My four years at the Indiana University School of Dentistry were challenging, especially learning how to manage my time and dedicating a full eight plus hours a day to my chosen career. I enjoyed many aspects of dentistry and realized as a general dentist, I could pick and choose to practice the areas I enjoyed. Upon graduation, I was commissioned as a U.S. Naval dental officer and treated service members and their dependents for five years. This period of time allowed me to perfect my skills and decide on what I wanted to do for the majority of my career. I decided to buy the existing private practice of Dr. Joe Hughes in Tallahassee, Fla. I found I enjoyed restorative and cosmetic dentistry as well as minor oral surgery, including extractions. My honest and principled approach to treating my patients has allowed my practice to grow and maintain a loyal staff and clientele. I am excited to welcome my third associate to work with and mentor, just as Dr. Hughes did for me more than 20 years ago. My practice also welcomes many potential dental students from Florida State University and Florida A&M University, as well as students from local high schools to shadow, learn, and assist me and my staff on their path to become a member in the dental community. My career in dentistry now extends more than 30 years since I began my freshman year in dental school. I can say, without question, my journey as a general dentist was the right choice for me. I agree with what I learned from Dr. Martin: my life in general dentistry has been a fulfilling and worthwhile career choice for me and my family. I look forward to mentoring the next generation of young dentists, and I hope they find their dental path will be just as rewarding as mine.

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I can say, without question, my journey as a general dentist was the right choice for me.

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Dr. Weaver is a general dentist in Tallahassee and can be reached at Tina@weaverdds.comcastbiz.net.

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July/August 2016

Today's FDA

Choosing a Specialty

Choosing Your Career Path By Dr. Ilan Abramowitz

Choosing your career path is not something that comes easily. In fact, today I don’t refer to it as a career path, but following your passion! Settling for a career that you are not passionate about — no matter the financial success — will not bring you joy.

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Dentistry included aspects of all the professions that piqued my interest: engineering, medicine, surgery and business.

”

So how did I find my passion? It was an evolution that started in middle school with my exposure to orthodontic treatment — I had it for three years! My experience with treatment, combined with other interests, led me to search for potential careers in both medicine and engineering while in high school. In college, I came across an opportunity to regularly volunteer at my undergraduate school’s orthodontic residency, which played a big role! Toward the end of college and early after graduation, I sought out multiple medical doctors, surgeons, engineers and dentists to discuss what their life was like at work and home. The dental field came out as the premier career path for me. Dentistry included aspects of all the professions that piqued my interest: engineering, medicine, surgery and business. In dental school I invested time to further clarify what my specific passions were. I spoke with instructors and dentists in the private practice setting to learn the nuances of all aspects of dentistry. I had multiple face-to-face meetings and shadowed at general practices, oral surgeons’ and orthodontic offices. I created a list of my passions and linked them to the specific dental procedure that I enjoyed. Once combined, it to lead me to a career in orthodontics. It sounds very methodical, but I feel lucky to have taken this path and found a fulfilling career.

Step One: Find your soul purpose! Write a single statement that, when accomplished, does more than just satisfy you. Let it make you smile! Think about what you want to leave as your legacy. Can it be accomplished through a career in dentistry?

Step Two: adow various dental offices. Most of us have a team of primary care dentists and specialists who have treated us a patient. Give them a call. Sit in for a while and see how they interact with and treat their patients. Take them out to lunch and find out what they enjoy about their specific field. You will gain more insight on the pros and cons of specializing than you would in dental school. Dr. Abramowitz is an orthodontist in Bartow and Winter Haven and can be reached at dra@eaortho.com.

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July/August 2016

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Choosing a Specialty

My Path to Oral Surgery By Dr. Steven Bryan

How did I become an oral and maxillofacial surgeon? I’d have to go back to before my dental education even began. Growing up in a small town in Central Florida in the 1960s, there were only two dental specialists that I had even heard of: an orthodontist and an oral surgeon. You had to drive out of town if you had to visit one of them. How things have changed! I attended Florida State University and my interest in biology blossomed. Late-night roving through the scientific journal section of the Strozier Library introduced me to what was then called the Journal of Oral Surgery. Wow, the pictures were fascinating. How cool it would be to treat some of the conditions presented in those pages. My interest in surgery continued throughout my time at the University of Florida College of Dentistry. I was allowed to take a number of oral surgery-related electives, volunteer extra time in the oral surgery clinic and attend a two-week rotation in oral surgery at the University Hospital in Jacksonville. After a general practice residency and three years in the U.S. Navy, I was fortunate enough to be accepted into a residency program in the specialty. That is my story, but is specialty training right for you? It’s my opinion that the way we look at the “traditional” dental specialties will undergo radical changes during the next one to two decades. There are so many opportunities today for intensive, non-specialty education in areas of dentistry. These hands-on and distance learning opportunities will continue to multiply. The explosion of technology allows interested and well-trained general dentists to provide expanded services that have been historically provided by various dental specialties. If you find an area of interest in dentistry and are seriously considering specialty training, there are many factors to consider. You should not only obtain firsthand exposure to what the training is like, but also what the actual “practice” of the specialty is like. Today in oral and maxillofacial surgery, you are likely considering a five- to six-year postdental education commitment. Upon training completion, you’ll probably divide your time between practice in an office setting (most likely multiple office locations) and outpatient and inpatient medical facilities. Practice opportunities now abound in dentistry. Would you be more comfortable in a solo or multiple provider practice? Certain specialties may lend themselves more to a certain practice style than others. Going forward, a solo oral and maxillofacial surgery practice may be a difficult practice model to sustain due to the high cost of technology, oncall patient coverage requirements, and the need for expanded administrative staff to deal with medical and dental insurance and compliance issues.

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I cannot imagine not taking the specialty career path that I have chosen. I remain intensely interested in surgery and enjoy what I do.

”

In closing, I cannot imagine not taking the specialty career path that I have chosen. I remain intensely interested in surgery and enjoy what I do. As a specialist, I have fostered professional and personal relationships with other members of our great profession that may not have happened for me otherwise. If you find an area in dentistry in which you think you may want to specialize, do some self-assessment, do your homework, then go for it! Dr. Bryan is an oral surgeon in Tallahassee and can be reached at bryanosurg@gmail. com.

July/August 2016

Today's FDA

Choosing a Specialty

My Journey into Prosthodontics By Dr. Sundeep Rawal

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Sometimes we forget that the most important thing we do is not place a dental implant or gingival graft, but restore a patient’s dentition and dental health — and there is no other specialty that embodies this as much as prosthodontics.

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Today's FDA

July/August 2016

I knew from a very young age that I wanted to be a dentist. My father was a prosthodontist, so I always was surrounded by and excited about the profession. However, it wasn’t until my years in dental school that I truly appreciated the vast spectrum that being a dentist encompasses. There are so many different areas to focus our interest on and mine fell to prosthodontics. Even though my father tried to steer me toward orthodontics, I was intrigued by this specialty. Sometimes we forget that the most important thing we do is not place a dental implant or gingival graft, but restore a patient’s dentition and dental health — and there is no other specialty that embodies this as much as prosthodontics. That’s why I chose it, and I’m sure glad I did because that is just the tip of the iceberg. What I learned in residency still surprises me sometimes! I learned how to handle any clinical situation with confidence, philosophies that enable me to treat patients better and most importantly, along with the clinical expertise needed, I learned to embrace technology. In my opinion, this is the most dynamic time in dentistry with technological influences that change our daily practice and define, what it means to be a prosthodontist. It is a dentist who has knowledge and expertise to be able to heal patients in any restorative situation and do it in the most state-of-the-art way possible. And, it’s all bundled into three years of hard work to get there. Can the general dentist do it? Absolutely. However, knowing what I knew coming out of dental school, it would take 10 years or more and countless continuing education (CE) courses to gain the same skills that a dedicated three years of focus allows. In addition to the benefits of becoming a prosthodontist, residency allowed me to form relationships with mentors who are lifelong resources both professionally and personally. I credit Dr. Arun Sharma at the University of California, San Francisco who molded me into the clinician I am today. I can always count on him to help me with a case, give me guidance and impart wisdom from his experiences, even as I continue to gain experience myself. I feel that all dental students should be as lucky as I was, so I always counsel students to seek further knowledge. Whether it is specialization, general practice residency or simply further CE through organized curriculum at the local level, I always encourage new dentists to continue the learning process. There is simply too much that is required of all of us to learn in dental school and it is an impossible task to learn it all at the highest level of expertise. That doesn’t even count actual experience. So, the more new dentists can learn under the guidance of others, the better they, our profession and our patients will be. Dr. Rawal is a prosthodontist in Merritt Island and can be reached at srawal99@yahoo.com. www.floridadental.org

Choosing a Specialty

Why I Chose Pediatric Dentistry By Dr. Barry P. Setzer

For almost 40 years, people have asked me why I chose pediatric dentistry, and my response has always been: I love to work with children. I knew this to be true as young as 16 years old, when I spent my summer as a camp counselor teaching youngsters how to swim, water ski and perform life-saving techniques. Even as a teenager, teaching children came easily to me because I had an innate ability to talk to them on their level and make them feel confident in themselves. I kept my campers mesmerized with my crazy stories, self-deprecating humor and constant encouragement, and in return, I gained their friendship and respect. So, no, I didn’t go into pediatric dentistry for the money. In fact, it was one of the lowestpaying specialties when I graduated dental school in 1973. I chose pediatrics mainly because I felt comfortable with children, and they felt equally as comfortable with me. There were, of course, other factors that influenced my decision. While in dental school, I gravitated toward the pediatric dental professors because I found them to be much nicer than professors from other departments, many of whom were gruff ex-military dentists. Ironically, I became a dentist for the U.S. Air Force shortly after graduation. After I met so many young airmen who were afraid of the dentist, I asked myself, “Is there a better way?” As a pediatric dental resident at the Children’s Hospital of Philadelphia (CHOP), I learned that there definitely was a better way. Each medical department reinforced a humane approach to treat children, including my professors who believed all children deserved our utmost respect and compassion. At CHOP, there was no such thing as “funny-looking kids” — these were special children who needed merciful care and understanding. I can’t even begin to describe how wonderful it felt being surrounded by such caring medical professionals … I fit right in. The concept of integrated medical care recently has been all the rage, but I witnessed it years ago when the pediatric specialists at CHOP integrated pediatric dentistry into their overall medical team. Their emphasis on primary care influenced how I decided to run my practice. For the past 40 years, I’ve been affiliated with pediatric specialists, children’s hospitals and the Jacksonville Cleft Palate team. When I get a referral, the referring doctor gets a detailed letter of my findings and treatment plan, just as they would receive from any other medical specialist. Working with pediatric specialists, and keeping my patients and their parents happy, has built my practice into what it is today. In my last article in the “Children’s Issue” of Today’s www.floridadental.org

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People have asked me why I chose pediatric dentistry, and my response has always been: I love to work with children.

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FDA (January/February), I spoke of the hundreds of former patients who have now sent their children to our office. Not only is this extremely rewarding and humbling, but it continues to prove that there is a “better way” for pediatric dental care. My continued adoration for children also has shaped my practice and career as a whole. Don’t go into pediatric dentistry for the money — do it because you genuinely love children and you’re confident they feel the same way about you. This mutual admiration makes work extremely enjoyable — even after 40 years! Dr. Setzer is a pediatric dentist in Jacksonville and is an FDA Trustee. He can be reached at bsetzer@bot.florida.org.

July/August 2016

Today's FDA

Choosing a Specialty

To Specialize, or Not to Specialize ... By Dr. Jeannette Peña-Hall

Choosing a career path is always a stressful milestone. It is safe to say that many dentists have their own story regarding when and how they chose a career in dentistry. In my situation, my interest in a dental career began at a very young age. My grandfather was a dentist in Cuba who immigrated to Florida, where he became licensed to practice. Although he passed away when I was only 10 years old, by age 13 I knew I wanted to be a dentist. Soon enough, I had finished college and I was off to dental school. Once the curriculum had become more clinical and less didactic, I then was faced with the conundrum of whether to practice as a general dentist or to continue to a postgraduate program. I feel it was my personality that led me to choose to focus on becoming a specialist and not pursue general practice. Over the first three years I had considered orthodontics and oral surgery as possible postgraduate programs. Hmmm … so, how is it that I became an endodontist? Fortunately, I was accepted into an intense general practice residency (GPR). Without batting an eyelash, my first recommendation to students is to consider investing one year’s time to participate in a GPR. In one year, I was able to treat patients in a hospital clinic and take hospital calls for dental cases every third night. This experience was invaluable; it allowed me a trial run at practicing general dentistry, but with exposure to specialists in oral surgery, endodontics and periodontics. It was important to me to find a specialty that I not only enjoyed, but that I could excel in. Thanks to my residency attendings — who were amazing mentors — I decided to become an endodontist. My mentors began to point out areas where they felt I was talented, and areas where my bedside manner and skills were most evident. As a student, we are in a rush to finish so we can make a living and avoid debt accumulation, or we worry about which career decision will ultimately give us the most financial stability. Again, I strongly believe that if you are diligent enough to find what you are best at and what you can enjoy doing for a lifetime, the patients and/or referrals will come because your work will speak for itself. Should you have an opportunity to enter into a general practice residency, I highly recommend it.

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My first recommendation to students is to consider investing one year’s time to participate in a general practice residency.

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Dr. Peña-Hall is an endodontist in Miami and can be reached at jeannettephall@gmail.com.

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July/August 2016

Today's FDA

Choosing a Specialty

Why I Became a Periodontist: Good Mentors! By Dr. Joseph Barnett

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It really is a great time to be a dentist and especially a periodontist!

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I was lucky to have some great dentists share their love of dentistry with me as I grew up. In second grade, my classmate’s father, Dr. Powers, came to our class several times. Once, he pulled out a pocketful of dimes, shined each dime with pure mercury and gave them to us. I saved that dime for years! My family dentist, Dr. Godeking, would send me home with plaster animal casts to later paint. I loved watching his slow speed drill cables move as he leaned over doing his best to “drill” my cavities. When he left the room, I would immediately sit up and look at all of his great instruments. I was so fascinated with dentistry that I would bring my toothbrush with me to school. My friends noticed it back then and said, “You should be a dentist.” Later in high school, I attended the occupations program. Since I had won a bridge building contest, I explored architecture. But, I loved dentistry. Dentists were interesting and active and liked fixing things. Some had farms. One was a little league coach. Many liked to fish (my favorite hobby!). Ironically, fisherman’s tools are a lot like dental tools! During college breaks, I was lucky to have my future wife’s dentist as a mentor. I could tell that Dr. Flood loved his patients and dentistry. He taught me the reason for each procedure. He also told me that I had severe recession on tooth No. 3 from brushing too much! At Western Kentucky University I took extra courses and was named “Pre-dental Student of the Year.” At Ohio State University College of Dentistry, I tried all the specialties. I found Dr. Lewis Claman in the periodontics department to be an especially helpful mentor, and I took every elective course he taught. I learned that periodontics was the foundation for all of dentistry. I joined the Navy after dental school while my wife finished medical school. As a military dentist, I saw patients from every part of America. A long line of new recruits would sit in the hallway waiting to be treated — there was a restorative line, a cleaning line and a third molar line. Appointments were made for perio, endo and prosthetics. The dentists could take breaks if we finished the restorations, but I loved to use that extra time to clean the patients’ teeth, smooth old restorations and even bleach the teeth of the occasional Tetracycline-stained patient common in those days.

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July/August 2016

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Choosing a Specialty

My superiors noticed my interest in periodontics and transferred me to the “recruit side” of the periodontics department. I gained a lot of experience treating the long lines of young patients with partial dentures, enlarged gums, severe gingivitis and periodontitis. I was eventually moved to the “main side” of periodontics where Dr. Mellonig — eventually one of the world’s top periodontists — became another great mentor. Dr. Mellonig used to tease that a monkey can do periodontics. But, to be a good periodontist you had to find out the causes. Way back in the 1980s, he taught us the close relationship between periodontics and overall health. We carefully checked medical conditions and studied the drugs patients took. We also performed bone grafts, which was his research specialty. He offered to get me into periodontal school if I was in the top third of my dental school, which I was. I was sent to the Naval Postgraduate Dental School at the renamed, Walter Reed National Military Medical Center in Bethesda — the President’s clinic and one of the great clinical and research centers. They helped develop the ultrasonic handpiece, turbine high-speed handpieces, phase contrast microbial studies and tissue bank, bone grafts. Best of all, Dr. Mellonig became the department chairman. His staff included Dr. Towle, a gifted researcher, and Dr. Gray, who loved the students like family. Dr. Mellonig received about every award that a periodontist could receive, but his best accomplishment may have been when he brought implants to periodontics, as early as 1986. My classmates and I gave lectures and published research. We were expected to obtain our periodontics boards, which at that time was so difficult that only 35 percent were successful. During the board exam process, I met my current dental partner, Dr. John Dozier. He was one of the very few civilian dentists to take and pass the American Academy of Periodontology Board Examination.

who are considering dentistry or periodontics to spend time observing it in action. It is gratifying to see many of “our” students now successfully practicing dentistry. Many diseases affect the periodontium. We have a world diabetes epidemic, which can severely damage the periodontium. I read the Journal of the American Medical Association and obtain regular news alerts from the Centers of Disease Control and Prevention to stay abreast of medical news. Periodontists and their hygienists are able to spend quality time with their patients. We motivate our patients to improve their oral — and most importantly —overall health. If you love helping people, it really is a great time to be a dentist and especially a periodontist! Dr. Barnett is a periodontist in Tallahassee and can be reached at jdbarnettgums@hotmail.com.

I could not have been a dentist or periodontist without many good mentors. Mentors who love dentistry are incredibly motivating. Dr. Dozier and I have always encouraged students

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July/August 2016

Today's FDA

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Diagnostic

Diagnostic Discussion By Drs. Indraneel Bhattacharyya and Nadim M. Islam

A 48-year-old female presented to the University of Florida College of Dentistry’s St. Petersburg Advanced Education in General Dentistry Clinic in Seminole, Fla. and was seen by Dr. James Nguyen under supervision of clinic director, Dr. Thomas Porter. The patient presented for evaluation of a painful bump on the back of the upper jaw (Figs. 1 and 2). Patient has had complete upper denture for many years and complete lower dentures for the last three years. She reported that the dentures apparently did not fit well. The bump in her upper ridge hurts with or without the dentures in place. This growth has been present for a few months and has become larger and more symptomatic in the recent weeks. In addition, she had multiple skin lesions that were asymptomatic (Figs. 3 and 4). She also had a large movable asymptomatic bump on the skin of her right knee. Since she had her dentures made at this clinic, past medical and dental history was available. She did not have any prior history of similar oral lesions, dental anomalies or supernumerary teeth, or bone defects or growth. Medical history also was reviewed and was positive for depression and psychiatric issues. She takes topiramax, zolpidem, alprazolam, risperidone, bupropion and clonidine. She also has a history of asthma. The patient’s clinical history and photographs were sent over for consultation. A biopsy of the painful growth was planned.

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Fig. 1

Fig. 3

Fig. 2

Fig. 4

Question What is the most likely diagnosis based on the patient’s condition and nodule on the maxillary retromolar region? A. Multiple endocrine neoplasia type 2 B. Gardner syndrome C. Inflammatory fibrous hyperplasia/epulis fissuratum D. Heck’s disease/multifocal epithelial hyperplasia E. Neurofibromatosis

Please see DIAGNOSTIC, 70

July/August 2016

Today's FDA

Diagnostic

DIAGNOSTIC from 69

Diagnostic Discussion A. Multiple endocrine neoplasia syndrome type 2 Incorrect. Good and pertinent choice since multiple endocrine neoplasia syndrome type 2 (MEN 2) is defined as a disorder with multiple skin and oral mucosal â&#x20AC;&#x153;bumps.â&#x20AC;? However, these patients also have mucosal commissural neuromas and neuromas of the tongue and other oral tissues that appear as small bumps. Neoplasms in two or more different endocrine glands in several family members are common. There are two types, MEN type 1 (MEN 1) and MEN 2. MEN 1 also is known as Wermer syndrome and has a decreased life expectancy, with a 50 percent probability of death by age 50. It is characterized by parathyroid, pancreas and pituitary tumors. MEN 1 is rare with uncommon oral manifestations. MEN 2 encompasses MEN 2A and MEN 2B, caused by mutation of RET proto-oncogene. Both of these syndromes are associated with medullary thyroid carcinoma (MTC) and pheochromocytoma. Patients with MEN 2A are at increased risk for MTC (> 90 percent of patients), adrenal pheochromocytomas (50 percent of patients) and primary hyperparathyroidism (20-30 percent of patients). Patients with MEN 2B, in addition to MTC and pheochromocytoma, develop mucosal neuromas and a marfanoid habitus. Oral mucosal neuromas normally are the first sign of the condition, and usually are present on the lips, anterior tongue, buccal

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July/August 2016

mucosa, gingiva and palate. Bilateral neuromas of the commissural mucosa are highly characteristic, but were not present in this patient who had been seen in this clinic for several years. Early detection of this condition plays a role in prognosis because of the extremely poor prognosis for MTC. The thyroid gland should be removed as soon as possible. B. Gardner syndrome Incorrect, but another excellent choice given the multiple skin lesions seen on the patient. Patients with Gardner syndrome (GS) often have variable numbers of skin lesions that present as bumps or lumps. It is an autosomal dominant disorder caused by mutations in the adenomatous polyposis coli tumor suppressor gene on chromosome 5. About 30 percent of cases are a result of new mutations. This syndrome is highly penetrant and most affected individuals have a family history of the disease. Its incidence ranges from 1 in 4,000 to 1 in 12,000 in the general population. It is characterized by intestinal polyps, as well as varied abnormalities of the teeth, bones, skin, soft tissues and other sites. Intestinal polyps may be asymptomatic or may cause diarrhea, constipation, rectal bleeding, abdominal pain or bleeding. If untreated, polyps in the colon and rectum can ultimately develop to cancer (50 percent by age 30 and 100 percent by age 50). Most common skeletal abnormalities are osteomas. These become evident around puberty and most commonly involve the skull, paranasal sinuses and the mandible. They range between three and six in number, and are a few millimeters to several centimeters in diameter. Dental manifestations are seen in

approximately 30 percent of patients and include odontomas, supernumerary teeth and impacted teeth. Cutaneous involvements include epidermoid cysts of the skin, lipomas, fibromas, neurofibromas and leiomyomas. None of these lesions were seen in our patient and there were no reported dental/bony anomalies. GS patients usually undergo prophylactic colectomy. Dental manifestations involve removal of impacted teeth, odontomas, and orthodontic and prosthodontic treatment. C. Inflammatory fibrous hyperplasia/ epulis fissuratum Incorrect. Excellent choice given the clinical setting and the oral lesion is highly suggestive of this diagnosis. When combined with the skin lesions, however, this diagnosis is difficult to sustain. Inflammatory fibrous hyperplasia (IFH) is a reactive hyperplasia of fibrous connective tissue in response to irritation from the flange of an ill-fitting denture. The term epulis fissuratum is commonly used instead of IFH. Epulis is actually a generic term used for any tumor of the gingiva and alveolar mucosa. Typically, it presents as a single or multiple fold(s) of raised sessile or pedunculated redundant firm mass of soft tissue in the alveolar vestibule or other regions under trauma. The lesions range in size from a few millimeters to several centimeters, which encompasses large sections of the oral mucosa. IFH develops in older adults more often on the lower jaw and in the facial and anterior aspects, and is more common in women. A leaf fibroma often is seen on the hard palate in response to irritation from a denture. Treatment consists of surgical removal, and remaking or relining of the denture to prevent future irritation.

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Diagnostic

D. Heck’s disease/multifocal epithelial hyperplasia Incorrect. Heck’s disease consists of multiple papillomatous lesions throughout the oral mucosa, which arise in certain ethnic groups and races. Skin manifestation is rare. Lesions are seen in children and typically seem to resolve or fade away as the child ages; it rarely remains in adulthood. It is a rare epithelial proliferation caused by human papilloma virus 13 and 32. Initially described in Native Americans and Inuits, it subsequently has been reported in all ethnic groups. This condition often affects multiple members of the same family, and this tendency may be related to either a genetic susceptibility or to the close proximity between individuals of the same family. Heck’s disease is characterized by multiple well-circumscribed, sessile, soft, elevated nodules of the oral mucosa. Sometimes they form clusters. The color ranges from whitish to normal mucosa. Lesions are seen on the labial and buccal mucosa, lower lip and tongue, and less often on the upper lip, gingiva and palate. The condition usually occurs in children and has familial predilec-

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tion, and may last for several months — or years — before running its course. There is not a certain explanation for this feature, but some authors proposed that the less developed immunologic system in children can be related with the beginning of the disease and later, immunity development is responsible for the lesions vanishing. This may explain why lesions aren’t found in adults. Since the lesions can resemble other conditions, such as inflammatory fibrous hyperplasia, inflammatory papillary hyperplasia, verruciform xanthoma, verrucous carcinoma, Cowden disease, condyloma acuminatum and focal dermal hypoplasia syndrome (Goltz-Gorlin syndrome), diagnosis is made on the basis of clinical observations and biopsy. It usually requires no treatment. For aesthetic concerns or when traumatized, it has been reported that lesions may be removed using cryotherapy, electrocoagulation, or laser or systemic treatment.

diagnosis when she presented for denture construction. It is an autosomal dominant disorder with an incidence of approximately 1 in 2,600-3,000. Approximately half of the cases are familial, with the others as new mutations arising in patients with unaffected parents. The neurofibromatosis type 1 (NF 1) gene on chromosome 17 encodes a protein neurofibromin, a tumor suppressor protein. The mutation of NF 1 gene results in a large number of nervous system tumors, including neurofibroma. In addition to neurofibromas, cutaneous manifestations and various other tumors also may be seen. Characteristically, a patient may have the following symptoms: two or more neurofibromas; six or more café au lait macules on skin; freckling in the axillary or inguinal region (Crowe’s sign); optic gliomas; two to more iris hamartomas (Lisch nodules); distinct bone lesions (thinning of long bone cortex, sphenoid dysplasia); or, a firstdegree relative with NF 1. Diagnosis is con-

E. Neurofibromatosis type 1 (NF 1): Correct! The skin lesions are characteristic of this diagnosis. The patient had this

Please see DIAGNOSTIC, 72

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“DIAGNOSTIC DISCUSSION”

Visit the FDC & CE page on the FDA website and click the “Online CE” button for this free, members-only benefit. You will be given the opportunity to review this column and its accompanying photos, and will be asked to answer five additional questions. Questions? Contact FDC Meeting Coordinator, Brooke Martin at bmartin@floridadental.org or 800.877.9922. * These courses expire on 6/30/2017.

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Diagnostic

Diagnostic Discussion is contributed by UFCD professors, Drs. Indraneel Bhattacharyya, Nadim Islam and Don Cohen, and provides insight and feedback on common, important, new and challenging oral diseases.

DIAGNOSTIC from 71

firmed if a patient presents with two or more of these characteristic features. Oral manifestations are seen in 70-90 percent of patients. Soft tissue findings include enlargement of fungiform papillae or intraoral neurofibromas. Radiographic findings include enlargement or branching of mandibular canal, enlargement of the mandibular foramen, increased bone density, concavity of the medial surface of mandible and an increased dimension of the coronoid notch.

Dr. Bhattacharyya

Treatment usually is done for prevention of complications as well as for cosmetic purposes. Development of malignant peripheral nerve sheath tumor is the most feared complication and has been reported in 5 percent of cases. The average life span of patients is 8-15 years shorter than the average population. Genetic counseling is highly recommended.

References: Jouhilahti EM, Visnapuu V, Soukka T et al. Oral soft tissue alterations in patients with neurofibromatosis. Clin Oral Invest.16:551-558, 2012. Visnapuu V, Peltonen S, Tammisalo T et al. Radiology findings in the jaws of patients with neurofibromatosis I. J Oral Maxillofacial Surg.70:1351-1357, 2102. Ingham S, Huson SM, Moran A, et al. Malignant peripheral nerve sheath tumors in NF 1 ; Improved survival in women and in recent years. Eur J Cancer. 47: 2723-2728, 2011. D’Ambrosio JA, Langlais RP, young RS: jaw and skull changes in neurofibromatosis. Oral Surg Oral Med Oral Pathol. 66:391-396, 1988.

The dental professors operate a large, multistate biopsy service. The column’s case studies originate from the more than 10,000 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.

Dr. Islam

Drs. Bhattacharyya, Islam and Cohen can be reached at ibhattacharyya@dental.ufl.edu, MIslam@dental.ufl.edu and dcohen@dental. ufl.edu, respectively.

Dr. Cohen

Please see benefit #16 (on page 71) to learn how to get CE credit for reading this article. 72

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Jacksonville 2016

Thank you Thank you to our generous to our generous sponsor! sponsor! FDA Services welcomes our new 2016-2017 Student Advisors! Thank you for volunteering to provide the insights and perspective we need to serve the next generation of Florida dentists.

JAY GHIYA

ALISON NOVAKOVIC

JENNIFER QUIST

Nova Southeastern University College of Dental Medicine

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LECOM School of Dental Medicine

Visit www.fdaservices.com to learn more about our products and services.

Abstract

Refractory Odontogenic Infection Associated to Candida Albicans: A Case Report By Mikhail Daya A., DMD; Heidi Mederos, BS; and Shawn McClure, DMD, MD

“

Although multiple factors could have contributed to this patient’s vulnerability to odontogenic infection of fungal etiology, it still remains an infrequent finding in the literature.

”

Today's FDA

July/August 2016

Multifascial space infections from an odontogenic origin have been attributed to a different number of microorganisms. These infections can be serious, and involve multiple deep spaces in the head and neck, which potentially can compromise the airway. Fungal etiology has been reported in the past as a rare agent involved in multifascial space infections. We present an unusual case of a severe deep space infection associated with carious teeth Nos. 31 and 32 (Fig. 1). This specific infection proved to be resistant to multiple antibiotic therapies and required incision and drainage on two different occasions. After the initial surgery, the patient remained febrile with an elevated white blood cell count; thus, the patient was taken to the operating room again for a re-drainage and new cultures. Cultures obtained during the second surgery were positive for Candida albicans. The patient was responsive to antifungal therapy and his condition quickly improved. Infections that arise from C. albicans usually occur in immunosuppressed individuals and are not commonly seen in otherwise healthy patients. Though uncommon, there are a few studies in the literature on reported instances of C. albicans found in infected root canals.1 An important aspect to highlight in this case is the fact that at the time of the first surgical drainage, frank purulence was noted to be draining from the right external auditory canal (Fig. 2). A review of the literature revealed only two other reported cases of odontogenic infections that involved drainage from the external auditory meatus, though not associated to C. albicans.2 The patient’s past history of alcohol abuse could have played a role in his predisposition to the C. albicans infection. Molina et al.3 reported that alcohol abuse impairs various aspects of the human immune response, which gives way to an increased risk of infections. Additionally, the C. albicans infection could have resulted from the initial administration of broad-spectrum antibiotics, which lead to modification of the patient’s normal microbiota and increased susceptibility to fungal colonization. Although multiple factors could have contributed to this patient’s vulnerability to odontogenic infection of fungal etiology, it still remains an infrequent finding in the literature. This case illustrates the need to consider a fungal cause in patients with odontogenic infections who are not responsive to broad-spectrum antibiotics and surgical drainage.

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Abstract

References 1. Waltimo, T. M. T., Siren, E. K., Torkko, H. L. K., Olsen, I., and Haapasalo, M. P. P. (1997). Fungi in therapyâ&#x20AC;?resistant apical periodontitis. International Endodontic Journal, 30(2), 96-101. 2. Pepato, A. O., Yamaji, M. A. K., Sverzut, C. E., and Trivellato, A. E. (2012). Lower third molar infection with purulent discharge through the external auditory meatus. Case report and review of literature. International journal of oral and maxillofacial surgery, 4 3. Molina, P. E., Happel, K. I., Zhang, P., Kolls, J. K., and Nelson, S. (2010). Focus on: alcohol and the immune system. Alcohol Research & Health, 33(1-2), 97.

Fig.1: Panoramic X-ray showing malposition tooth No. 32 with gross carious Nos. 31 and 32.

Mikhail Daya A., DMD is an oral and maxillofacial surgery resident at Nova Southeastern University/Broward Health Medical Center and can be reached at mikhail.daya@gmail.com. Heidi Mederos is a D4 at Nova Southeastern UniversityÂ and can be reached at heidimederos@gmail.com. Shawn McClure, DMD, MD is an Oral and Maxillofacial Surgery Program Director at Nova Southeastern University/Broward Health Medical Center and can be reached at smcclure@nova.edu. Fig. 2: Frank purulence was evacuated from external auditory canal.

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July/August 2016

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FDC2016

On June 16-18, more than 7,000 dental professionals — including 1,500 Florida Dental Association members — gathered at the Gaylord Palms Resort & Convention Center for the 2016 Florida Dental Convention (FDC2016), “The Art of Modern Dentistry.” Featuring a robust Exhibit Hall with 315 industry-leading exhibitors, 125 courses taught by world-renowned speakers and nightly family-friendly social events, FDC2016 was an exceptional event where dental professionals could buy the latest products and learn the newest skills, all while building team morale and networking with colleagues. Make plans to join us for FDC2017 on June 22-24. The 2017 dates do not conflict with Father’s Day and will not through 2023! Go to Floridadentalconvention.com/hotel to reserve your hotel room today! Photos courtesy of: Mike Copeland, Brad Sapienza and Jill Runyan

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FDC2016

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Our dedicated volunteers! Volunteers created the amazing success of the Jacksonville Florida Mission of Mercy. Below we list the leaders who worked tirelessly for 2016 FLA-MOM.

LEADERSHIP Dr. Andy Brown  2016 Local Host Co-chair Dr. Rick Stevenson  2016 Local Host Co-chair Dr. Nolan Allen  Statewide Co-chair Dr. Leo Cullinan  Statewide Co-chair COMMITTEE CHAIRS Dr. Brandon Alegre  Manager, Anesthesia Department Mr. Clay Archer  Lead, Data Services Dr. Dayn Boitet  Co-lead, Local Clinical Liaison Dr. Sol Brotman  Consultant Dr. Tom Brown  Manager, Endodontics Department Mrs. Karen Buckenheimer  Lead, Patient Education Dr. Chris Bulnes  Co-lead, Clinical Committee Ms. Cindi Callahan  Manager, Volunteer Recruitment Dr. Mike Chanatry  Lead, Hospitality Committee Dr. Drew Clark  Co-manager, Dental Triage Dr. Stephen Cochran  Co-manager, Pediatric Department Mrs. Debbie DeVille  Manager, Local Arrangements Dr. Marcos Diaz  Co-manager, Oral Surgery Dept. Mr. Abe Dopazo  Lead, Facilities And Logistics Dr. Leandra Dopazo  Manager, Radiology Department Dr. Suzanne Ebert  Co-lead, Local Clinical Liaison Dr. Sam Elias  Manager, Prosthodontics Dept. Dr. Monica Franklin  Manager, Hygiene Department Ms. Heather Gioia  Statewide Executive Director Ms. Linda Harvey  Manager, Volunteer Registration Dr. Kim Jernigan  Co-manager, Routing Dr. Zack Kalarickal  Lead, Communications Committee Ms. Hazel Kerr  Coordinator, Volunteer Committee Dr. Steve Krist  Co-manager, Dental Triage Dept. Dr. Larry Leventhal  Manager, Medical Triage Dept. Ms. Jackie Mack  Co-manager, Sterilization Dept. Dr. Brian Maples  Manager, Donated Services/Supplies

Dr. Andy Maples  Co-manager, Donor Outreach Dr. Lindsey Maples  Co-manager, Donor Outreach Dr. Oscar Menendez  Co-lead, Clinical Committee Ms. Glenda Miller  Co-manager, Sterilization Dept. Ms. Deborah Mobbs  Manager, Patient Exit Dr. Rick Mullens  Manager, Finance Dr. Bill Nipper  Manager, Restorative Dr. Jolene Paramore  Lead, Impact Study Committee Dr. Michael Pikos  Co-,anager, Oral Surgery Dept. Dr. Roger Robinson  Manager, Media & Legislative Outreach Dr. Barry Setzer  Lead, Fundr.aising Committee Ms. Angie Sissine  Manager, Hotel Mr. Craig Smith  Manager, Food & Beverage Dr. Flavio Soares  Co-,anager, Pediatric Department Dr. Linda Trotter  Lead, Volunteer Committee Dr. Claudio Varella  Manager, Set-Up/Break-Down Ms. Cindy Wampler  Manager, Patient Education Dr. Cecil White  Lead, Patient Registration Ms. Theresa Wilcher  Manager, Central Supply Department Dr. Steve Zuknick  Co-manager, Routing DISTRICT EXECUTIVE DIRECTORS Ms. Debbie DeVille  Northeast District Dental Association Mr. Mike Dvorak  Atlantic Coast District Dental Association Ms. Angel Estep  Northwest District Dental Association Ms. Marlinda Fulton  Central Florida District Dental Association Ms. Yolanda Marrero  South Florida District Dental Association Ms. Lissette Zuknick  West Coast District Dental Association STAFF Ms. Megg Murphy  FDA Foundation Program Coordinator Ms. KC Lorenz  FDA Foundation Assistant Mr. Greg Gruber  Chief Financial Officer/Chief Operating Officer Mr. Drew Eason  FDA Executive Director

Florida Mission of Mercy April 22-23, 2016 Jacksonville, Fla.

2,800 PATIENTS RECEIVED CARE

VOLUNTEERS

2,465 589 70 250 432 21 115 988

Dentists Dental Students & Faculty Hygienists & Students Dental Assistants & Students Lab Techs Medical Professionals & Students Community Volunteers

$2.75 MILLION in oral health care services provided at no charge to patients who experience barriers to care.

16,228

TOTAL NUMBER OF PROCEDURES

Foundation

Serving Up Smiles 14, nearly 80 participants attended the “Serving Up Smiles” event at the Country Club of Ocala to raise money for the FDA Foundation (FDAF) and its programs.

Tell us about the “Serving Up Smiles” charity tennis tournament you organized.

By Jessica Lauria, as told by Sarah Perkins

Dr. Carter Perkins has done well both professionally and personally — he raised a thoughtful, caring young woman who is about to start her journey to college. Only a high school senior mere months ago, Sarah accomplished something most girls her age haven’t: she single-handedly pulled off a successful fundraiser for charity. Inspired by her father’s profession and its philanthropic efforts, Sarah decided to put her love of tennis to charitable use and organized a doubles tennis tournament fundraiser in her hometown, Ocala. On May

Today's FDA

July/August 2016

The tournament was a great success — we raised almost $5,000 for the FDAF through generous donations, entry fees and sponsorships! There were nothing but smiles throughout the entire day! It might not have been the biggest tournament, but it had a big impact. I was able to raise money for a wonderful cause, while also raising awareness of the FDAF throughout Ocala. Trophies were given out to six different divisions, and both the winning and runnerup teams received a trophy. All participants were given a T-shirt, snacks and drinks throughout the day, and a delicious lunch.

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Foundation How would you encourage others to hold their own fundraisers to help support the FDAF and its programs? 2.

What prompted the idea to hold a fundraiser? Why tennis? I’ve wanted to hold a doubles tennis tournament fundraiser since I began high school. I’m an extremely competitive tennis player, and I’ve been actively involved in the United States Tennis Association (USTA) since I was 12 years old. I was a leader on my high school tennis team as well. I plan to play tennis on the Club Tennis Team at the University of Florida. I absolutely love tennis; however, not much is better than helping people smile and laugh through healthy living and exercise! Through this fundraiser, I was able to combine my love for tennis and healthy living to support the FDAF and its programs, the Florida Mission of Mercy, Project: Dentists Care and Donated Dental Services. It was a wonderful feeling to know that, not only did the tournament participants smile and have fun, but we ultimately helped dentists provide dental care to those less fortunate as well.

How did you get people involved? What was your strategy? I did a variety of things to get people involved. I posted ads on Facebook regarding sponsorship and participation. I created sign-up fliers that I posted throughout Ocala at numerous locations, such as the Country Club of Ocala, Golden Ocala Country Club and Fort King Tennis Center. I also contacted local tennis professionals and USTA league captains to help spread the word. Originally, I had almost 40 teams signed up for the tournament. Unfortunately, Mother Nature did not cooperate and the tournament was rained out, so it had to be rescheduled. The new date for the tournament conflicted with a number of Florida tennis events, so we ended up with fewer teams. But we still had a good turnout — there were almost 80 participants in the tournament.

I would definitely encourage others to hold their own fundraisers for the FDAF. If you want to support a foundation that is true to its promise, then the FDAF is perfect. The FDAF and its staff have shown an extreme amount of gratitude for any support they receive. The FDAF programs and their volunteers put their heart and soul into what they do. They genuinely care about Floridians’ dental health and well-being. If anyone ever wants to give back to their own community — the FDAF is the way to go! Ms. Lauria is the FDA's Communication and Media Coordinator and can be reached at jlauria@floridadental.org. Ms. Perkins can be reached at sarahelizabethp36@gmail.com.

Photos: 1. Participants take a break and serve up some smiles of their own. 2. Fundraiser banner recognizes sponsors. 3. Participants take to the court.

Besides the charitable aspect, what else did you gain from this experience? The tournament helped me develop numerous skills including, but not limited to, communication, accounting and organizational skills, which will be beneficial throughout college and beyond. I also was introduced to the business world, as I had to talk with business owners, leaders and community members in order to receive sponsorships and get participants to sign up. Most importantly, I have learned that a successful fundraiser includes a tremendous amount of dedication and hard work. However, I can easily say that all of the hard work and time spent was well worth it. I met a lot of wonderful people and made a bunch of new friends.

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July/August 2016

Today's FDA

C lassified A dvertising

Opportunities

Today's FDA

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

Issue

Extracted Date

Jan/Feb March/April May/June July/Aug Sept/Oct Nov/Dec

Jan. 15 March 15 May 1* July 15 Sept. 15 Nov. 15

* The May/June issue is scheduled to be mailed out two weeks earlier than normal to reach members before the annual Florida Dental Convention.

Please visit the FDA’s classified website at www. floridadental.co/classifieds.

July/August 2016

Endodontist Opportunities - Tampa, FL. Great Expressions Dental Centers has select openings for Endodontists to join our Tampa, FL practices. Our specialists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. When considering a career with GEDC, specialists can expect: Compensation: Six Figure Annual Base vs. Percent of Production! Attractive Sign-on or Relocation possible as well. Benefits/Perks: Leader in the practice: Clinical Freedom and Treatment Autonomy; Patient Focus: Established and Growing Patient Foundation; Multi-Specialty office; Doctor Career Path – Partnership/Investment Opportunities; Full Benefits Offered – Healthcare & Dental Benefits, 401K, Short Term/Long Term Disability, Time Off; Malpractice Coverage Assistance. Apply Here: http://www.Click2Apply. net/wnjgk9hg3w. General Dentist (Full-Time) - Tampa, FL. Great Expressions Dental Centers has an immediate, select opening for a full-time General Dentist to join one of our established and highly productive practices located in Tampa, FL. Compensation: Competitive Six Figure Annual Draw with Percent of Production; Sign-on Bonus or Relocation Assistance possible as well. Benefits/Perks: Leader in the practice: Clinical Freedom and Treatment Autonomy; Patient Focus: Established and Growing Patient Foundation; Digital Office; Doctor Career Path – Partnership/Investment Opportunities; Full Benefits Offered – Healthcare & Dental Benefits, 401K, Short Term/Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues. Apply Here: http://www.Click2Apply. net/383x26g5tf. Orthodontist (Full-Time) - Tampa, FL. Compensation: Relocation or sign-on bonus possible as well. Benefits/Perks: Large, Internal Network of Referring Dentists; Leaders in the Practice: Clinical Freedom and Treatment Autonomy; Patient Focus: Established and Growing Patient Foundation; Multi-Specialty Practices with Dedicated Staffs; Hygiene/Fully Digital Offices; Doctor Career Path – Partnership/Investment Opportunities; Full Benefits –Healthcare & Dental Benefits, 401K, Short Term/Long Term Disability, Time Off; Malpractice Coverage Assistance; Continued Education Reimbursement, Invisalign Training, Whitening Opportunity, Paid ADA & State Society Dues; Mentorship – Study Clubs, Chairside Mentoring, GEDC University Courses. Please view our Doctor Career Path video: http:// www.screencast.com/t/M3xWM5CYN. Apply Here: http://www.Click2Apply.net/7r4zzrg8t3.

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Pediatric Dentist Opportunity - Treasure Coast, FL. Come join our team in the Treasure Coast as a Pediatric Dentist for our growing network of practices! Great Expressions Dental Centers has a current, select opening for a part-time (3 days/ week) Pediatric Dentist to join our multi-specialty, growing Treasure Coast practice(s). Dedicated staff, consistent schedule with a strong referral network of several local offices. Compensation: Compensation - Draw vs. Percent of Production. Apply via this ad to learn more about Great Expressions! For More Information, Please Contact: Ross Shoemaker, MBA | Doctor Recruiting Manager | Great Expressions Dental Centers 770 Holcomb Bridge Road Roswell, GA 30076 USA, phone 678-836-2226 | ext 72226 | fax 770-242-3251 |web www.greatexpressions. com. email Ross.Shoemaker@greatexpressions. com. Apply Here: http://www.Click2Apply.net/ xvmvrr5yb7. General Dentist needed-Partnership 50/50. I have a local Dental Practice (Name-Confidential) located in central Inverness. I’m searching for a FT General Dentist with at least 2 years’ experience, implant experience a plus. The practice has 3 DAs, adding a 4th, one P/T Associate and a hygienist. My clinic is completely remodeled with new equipment, very clean with great lighting, 8 OP and digital radiographs. This practice is located on the corner of an intersection with great traffic flow and expanding patient base (ave. 7 new patients daily-verifiable). We are FFS and take most insurances. Financials will be discussed in person. ***Please call my mobile for serious inquires*** 813.417.2156. Pediatric Dentist Opportunity - Tampa, FL. Great Expressions Dental Centers has an immediate, 3-5 days/week, Pediatric Dentist opportunity in Northeast Tampa, FL. For more than 35 years, Great Expressions Dental Centers has been exceeding patients’ expectations offering general dentistry, endodontic, periodontic, oral and maxillofacial surgery, orthodontic, and pediatric dentistry services in a comfortable, friendly environment. The Pediatric Dentist would receive referrals from our 20+ General Practice offices in the metro-Tampa, FL area! Please apply via this ad for consideration or via contact information below: Stacey Bruwer, M.A. | Clinical Recruiter | Great Expressions Dental Centers 29777 Telegraph Road, Suite 3000 | Southfield, MI 48034, phone 248-2376853 |Ext. 72468| fax 248-686-0118 | web www. greatexpressions.com. “Look for the Smile Above Our Name!” Apply Here: http://www.Click2Apply. net/v28rmypckv.

Part-time Endodontist - Page Field, FL. Great Expressions Dental Centers has a current opening for a Part-time Endodontist in our Page Field, FL practice (located at 5100 S. Cleveland Avenue, Units 315 & 316). **Please watch more about our Doctor Career Path and apply via this ad! Stacey Bruwer, M.A. | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 300 East Long Lake Rd Suite 311| Bloomfield Hills, MI 48304 USA, phone 248-237-6853 |Ext. 72468| fax 248-686-0118 | web www.greatexpressions.com. “Look for the Smile Above Our Name!” Must have a DDS/DMD from an accredited University and active State Dental Board license. Endodontist Dental License and certifications. Apply Here: http://www.Click2Apply. net/mbrj3tkchy. Full-time Dentist. Wexford Health Sources, one of the nation’s leading innovative correctional health care companies, provides clients with experienced management and technologically advanced services, combined with programs that control costs while ensuring quality. For nearly two decades, Wexford Health has consistently delivered proven staffing expertise and a full range of medical, behavioral health, pharmacy, utilization management, provider contracting, claims processing, and quality management services. Wexford Health has an exceptional opportunity for a full-time, 40 hours per week, Dentist to join our team of healthcare professionals at the DeSoto Correctional Institution in Arcadia, FL. rkokos@wexfordhealth.com 2 day/wk General Dentist Opportunity - Tampa, FL. Enjoy a rewarding role with a dedicated staff in this beautifully updated facility with an established patient base! Compensation: Annual Draw vs. Percent of Production! Benefits/Perks: Leaders in the practice: Clinical Freedom and Treatment Autonomy for Every Doctor; Patient Focus: Established and Growing Patient Foundation; Multidoctor office; Doctor Career Path – Partnership/ Investment Opportunities; Malpractice Coverage Assistance; Continued Education Reimbursement, Paid ADA & State Society Dues; Mentorship – Study Clubs, Chairside Mentoring, GEDC University Courses. Please view our Doctor Career Path video: http://www.screencast.com/t/M3xWM5CYN. Please apply via this ad for consideration! Stacey Bruwer, M.A. | Clinical Recruiter | Great Expressions Dental Centers. Apply Here: http://www.Click2Apply. net/3fbt23435y. Hygienist Wed & Thursday Dadeland Area. Hygienist needed 8:30 - 5:00 on Wednesdays & Thursdays. Email Resume to: gaes@bellsouth.net. Solo practitioner office. Private Insurance no HMO. Pinecrest/Dadeland neighborhood. Replacing our prior hygienist who is retiring after 25 years! Salary to be based on years of experience. Prefer someone with at least 3 years of experience.

Restorative Dentist for High End Group Practice-Part Time, Melbourne. Our practice is looking for a talented restorative dentist to help our patients with minor restorative dentistry one day a week, preferably Fridays. The opportunity for you would be to be a part of a well-managed, happy practice, with assistants and staff who are trained to do the best for the patient. If you are at all interested in exploring this opportunity, please contact Dr. Lee Sheldon directly. Office phone number is 321259-8000. Cell is 321-258-7467. I look forward to hearing from you. http://drleesheldon.com. General Dentist Opportunity - Pinellas County, FL. Great Expressions Dental Centers has an immediate opening for a full-time General Dentist to join one of our Tampa, FL practices in Pinellas County, FL. Enjoy a rewarding role with a dedicated and experienced staff! Please apply via this ad for consideration, Stacey Bruwer, M.A. | Clinical Recruiter | Great Expressions Dental Centers PSCNorth | 29777 Telegraph Rd| Southfield, MI 48034 USA, phone 248-237-6853 |Ext. 72468| fax 248686-0118 | web www.greatexpressions.com. Must have a DDS/DMD from an accredited University and active State Dental Board license. Apply Here: http://www.Click2Apply.net/y2gj83dyyc. Dentist. Looking to be an associate in an established practice with the possibility of becoming a partner or owner? We are paperless and digital office. Our practice is about 90% children. If you prefer adult dentistry we will be more than happy to accommodate. You can have your own practice within our practice. We pay a percentage of what is collected and you will be considered an employee with all the benefits provided to all the employees. Flexible schedule (part-time/full-time). We only want enthusiastic dentists who love practicing their profession to the fullest. You can be a seasoned dentist or a new graduate; there will always be room for you. Send your CV to DOFFC@AOL.COM or fax 407-322-4415. DENTIST - ADJUNCT (ON-GOING). Eastern Florida State College. The college is currently accepting applications for the following position: Dentist – Adjunct (On-going). Online applications are available on the Web site at http://www. easternflorida.edu/administration-departments/ human-resources/employment-needsopportunities/employment-opportunities.cfm and will be accepted beginning June 22, 2016; however, the College reserves the right to extend or conclude searches without notice. Eastern Florida State College is an equal opportunity employer.

Please see CLASSIFIEDS, 88

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July/August 2016

Today's FDA

Your Classified Ad Reaches 7,000 Readers! CLASSIFIEDS from 87 Opportunity for General Dentist. Exciting opportunity for a general dentist in Melbourne, FL. Great place to live and raise a family. Great beaches, 15 minutes from airport centrally located to Miami, Tampa and Orlando. We have a thriving practice, latest technology, a highly skilled support and dynamic staff and a commitment to ongoing training and education. You’ll have the opportunity to earn more income than a dentist in a traditional practice without the headaches of running a business. You’ll work with a state of the art technology and have valuable opportunity for continued education, training and mentor-ship. Join us in promoting excellent dentistry in the community and improving the quality of life for millions of people. wickhamdentalcare@gmail.com. General Dentist Opening (Jammes) - Jacksonville, FL. Great Expressions Dental Centers has an immediate opening for a full-time General Dentist to join our established and highly productive Jammes practice located in Jacksonville, FL at: 5218 Jammes Road, Suite D, Jacksonville, Florida 32210. Enjoy a rewarding role with a dedicated staff in this beautiful facility with an established patient base! Please apply via this ad for consideration, Molly McVay | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 29777 Telegraph Road. Suite 3000| Southfield, MI 48034 USA, phone 248430-5555 |Ext. 72467| fax 248-686-0170 | web www. greatexpressions.com. “Look for the Smile Above Our Name!” Must have a DDS/DMD from an accredited University and active State Dental Board license. Apply Here: http://www.Click2Apply.net/ cbhcnbqhkc. molly.mcvay@greatexpressions.com. The American Society for the Advancement of Anesthesia and Sedation in Dentistry. The most comprehensive IV sedation course ever offered by The American Society for the Advancement of Anesthesia and Sedation in Dentistry will be held at St. Joseph’s Medical Center, Paterson, New Jersey. ASAAD is the oldest organization in the United States teaching sedation to dentists since 1929. Includes exposure to I.V., Oral, Sub-mucosal and I.M. routes as well as non-traditional modalities including acupressure and acupuncture. Course dates for 2016 are: October 24th - November 4th. This program is designed to meet or exceed all ADA guidelines for teaching sedation in dentistry. Contact Dr. David Crystal, Executive Secretary (732) 469-9050. email: dacryst1@aol.com.

Sage Dental currently has opportunities for qualified General Dentists & Specialists at our South and Central Florida practices. Sage Dental offers you: Excellent Earning Potential; Ability to Focus on Patient Care; State-of-the-Art Facilities; Quality of Life. Apply today! Contact: Bradford Cabibi - Doctor Recruitment, Email: bcabibi@ mysagedental.com; careers@mysagedental.com. website: http://www.mysagedental.com/; https:// www.mysagedental.com/career-opportunities/. Phone: 561-999-9650 Ext. 6146. Fax: 561-526-2576. General Dentist Opening - Jacksonville, FL. Great Expressions Dental Centers has an immediate, select opening for a full-time General Dentist to join one of our established and highly productive practices located in Jacksonville, FL. Enjoy a rewarding role with a dedicated staff in this beautiful facility with an established patient base! Compensation: Competitive Six Figure Annual Draw with Percent of Production. Benefits/Perks: Leader in the practice: Clinical Freedom and Treatment Autonomy. Please apply via this ad for consideration, Molly McVay | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 29777 Telegraph Road. Suite 3000| Southfield, MI 48034 USA, phone 248-430-5555 |Ext. 72467| fax 248-686-0170 | web www.greatexpressions.com. “Look for the Smile Above Our Name!” Apply Here: http://www.Click2Apply.net/8dq8thk357. Full-time Dentist. Wexford Health Sources, one of the nation’s leading innovative correctional health care companies, provides clients with experienced management and technologically advanced services, combined with programs that control costs while ensuring quality. For nearly two decades, Wexford Health has consistently delivered proven staffing expertise and a full range of medical, behavioral health, pharmacy, utilization management, provider contracting, claims processing, and quality management services. Wexford Health has an exceptional opportunity for a full-time, 40 hours per week, Dentist to join our team of healthcare professionals at the Okeechobee Correctional Institution in Okeechobee, FL. rkokos@wexfordhealth.com. Pediatric Dentist-Multispecialty Group! Since 1997, Christie Dental has grown from our original Merritt Island location to 17 locations from coast to coast in Central Florida. We’re a community based, multi-specialty group committed to the traditional doctor-patient relationship and providing the highest quality care and service to our patients. Our mission is to be Florida’s premier dental provider of choice. We’re interested in speaking with Pediatric Dentists to join our team in Melbourne. This is a part time position working 2 day a week and can be a great supplement to an existing schedule and may offer future growth opportunity. Christie Dental primarily a fee-for-service and PPO provider. Contact kateanderson@amdpi.com. https://www. christiedental.com/. ENDODONTIST-TAMPA BAY AREA. Quality associate needed for busy, modern endodontic office. New graduates encouraged to apply. Send CV to julieh@aeoftb.com.

Today's FDA

July/August 2016

Pediatric Dentist - Jacksonville, FL. Great Expressions Dental Centers has a select full-time opening for Pediatric Dentist to join our team in Jacksonville, FL. For more than 35 years, Great Expressions Dental Centers has been exceeding patients’ expectations offering general dentistry, endodontic, periodontic, oral and maxillofacial surgery, orthodontic, and pediatric dentistry services in a comfortable, friendly environment. We are looking for a motivated and qualified pediatric specialist to join and lead our 20 plus practices spread across the Jacksonville, FL area! Job Requirements: Must have a DDS/DMD from an accredited University and active State Dental Board license. Pediatric Dental License and certifications. Apply Here: http://www.Click2Apply. net/ppvdjbjw2b. Full Time Dentist Opportunity: Stuart, FL. Great Expressions Dental Centers has an immediate, select opening for a full-time General Dentist to join our established, high production, digital Stuart, FL multi-specialty practice located at: 2410 NW Federal Highway Stuart, FL 34994! Enjoy a rewarding career with a full office staff (including HYG), a strong schedule and the ability to focus on quality patient care. Apply via this ad to learn more about Great Expressions! For More Information, Please Contact: Ross Shoemaker, MBA | Doctor Recruiting Manager | Great Expressions Dental Centers Practice Support Center - South | 1560 Oakbrook Drive, Norcross, GA 30093 USA, phone 678-836-2226 | ext 72226 | fax 770-242-3251 |web www.greatexpressions.com. email Ross. Shoemaker@greatexpressions.com. “Look for the Smile Above Our Name!” Apply Here: http://www. Click2Apply.net/w4j9xfsn6z. (Part Time) General Dentist - Jacksonville, FL. Great Expressions Dental Centers has select openings for (Part-Time) General Dentists to join our Jacksonville, FL dental team! For more than 35 years, Great Expressions Dental Centers has been exceeding patients’ expectations offering general dentistry, endodontic, periodontic, oral and maxillofacial surgery, orthodontic, and pediatric dentistry services in a comfortable, friendly environment. We are always looking for motivated and qualified dental professionals and with over 200 dental centers in ten states, the opportunities are unlimited. Please apply via this ad for consideration! Job Requirements: Must have a DDS/DMD from an accredited University and active State Dental Board license. Apply Here: https://careersclinical-greatexpressions.icims. com/jobs/5323/general-dentist-opportunities--jacksonville%252c-fl/login. FLORIDA - Orlando/Daytona Beach/Jacksonville/ Tampa/Sarasota regions: Join our 60 office group practice. Flexible schedule. Top salaries. General Dentists with 1-3 years’ experience average $228K. Training and mentoring for new/recent graduates. Both General Dentists & all Specialists needed. Fully digital offices. Call Dr. Andrew Greenberg (407) 772-5120 (confidential), fax CV to (407) 7868763, visit www.greenbergdental.com or e-mail to drgreenberg@greenbergdental.com.

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Periodontist. A private practice in Sarasota Fl seeking a part time periodontist. Please contact Dr Arshadi at 508-717-1251 or siestafamilydentistry@ gmail.com for more information. Dental Office and Dentist. GENERAL DENTIST wanted 1 (one) day, possibly 2 (two) days per week later in year. SEBASTIAN (32958). Also, equipped and furnished 1,000 sf DENTAL OFFICE, for LEASE, PALM BAY (32905). Business office, waiting room, 3 operatories, 4th used for storage, laboratory, bathroom, private office with exit door. Email best way to communicate, DDDOCTORRR@aol.com. General Dentist - Jacksonville, FL (Merrill). Come lead our team in Jacksonville, FL (Merrill) as our full time General Dentist! Great Expressions Dental Centers has an immediate, select opening for a full-time General Dentist to join our Merrill practice (located: 9119 Merrill Road, Suite 29 Jacksonville, Florida 32225). Enjoy a rewarding role with a dedicated staff in this beautiful facility with an established patient base! Compensation: Competitive Six Figure Annual Draw with Percent of Production; Sign-on Bonus or Relocation Assistance possible as well. Please apply via this ad for consideration, Job Requirements: Must have a DDS/DMD from an accredited University and active State Dental Board license. Apply Here: http://www.Click2Apply.net/3fffbfs33v.

For Sale/Lease Surgical Instruments/Implants for Sale Dentist retiring- For Sale: Seldom used- 22 Tatum Straight Universal Osteotome Instruments for Bone expansion- $1200. New- 19 Tatum Sinus Instruments, $900. Seldom Used In very good condition: Hu-Friedy Needle Holders: NH 5020$325, (2) NH 5074-each $115; Hu-Friedy Scalpel blade handles 360 degrees(3): K360- each $80; Imtec Bone Collector: 10-7094- $80; Oratronics, Tissue Punch- Stainless Steel, “gold” plated Handle -$152; Imtec Implants (14 Sealed, 1 unsealed- but never used) & accessories (O-rings, Analogs, Wax copings). Included Used Imtec Surgical Kit - $1505; Sealed, Osseous Scraper, Osseous Technologies of America - $40. Please contact smiledentistry29@ gmail.com for additional information and photographs. Fort Lauderdale-Davie practice for sale. Private practice -doctor wants to retire. 35 years established general practice. No HMO,s. Located on busy road in a free standing building 11 years old. Perfect for visual advertising. Five operatories. Doctor will stay on for smooth transition. Great opportunity for young doctor or doctor relocating. Send email to sandsurf1@bell south.net. KODAK/CARESTREAM & SCHICK INTRAORAL X-RAY SENSOR REPAIR. Specialize in repairing Schick CDR & Kodak/Carestream RVG 5100 & 6100 dental X-Ray sensors. Repair & save $1,000’s over replacement cost. We purchase old/broken sensors. www.RepairSensor.com/919-924-8559.

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GENDEX & DEXIS INTRAORAL X-RAY SENSOR REPAIR. We specialize in repairing Gendex & Dexis dental X-Ray sensors. Repair & save thousands over replacement cost. www.RepairSensor.com/919-9248559. Ponte Vedra Beach Dental Office. Beautiful 1500 sq ft 4 operatory full equipped dental office in prestigious community in need of an Orthodontist or Pedodontist. There are 2 elementary schools within 1.25 miles. Office has Pan and Ceph, staff lounge, sterization, and full lab. N2O and cable TV. 904.463.1952. Brandon, Fl. FOR LEASE Beautiful 2000 sf lakefront office space available for custom build out. Adjacent to Endodontist. Ideal for Oral Surgeon or Periodontist. Contact Julie at 813-654-3636 or julieh@aeoftb.com. DENTAL PRACTICE FOR DISCOUNTED SALE. This is an exceptional bargain for anyone interested in a one of a kind financial opportunity. $290K gross collection on 2 days/week. Prime location near mall, university, and new development. Completely computerized, paperless, with digital xray, intraoral camera, and many amenities. Has been valued by a broker but not currently listed. Willing to sell for far less than broker valued. Doctor must have immediate sale due to personal and medical reasons. Willing to discuss any terms. Contact Dale @ 813-833-6869. Brandon office. Brandon dental office and building for sale in a highly visible area, one block from hospital. 3 ops and 1 plumbed. Newly remodeled with a high traffic location. Owner retiring. Excellent opportunity for the right person. Contact Donna at 813-689-6491 bafdental@gmail.com. Gulf Coast General Practice: Minutes to Anna Maria Island. 4-Day General Practice FOR SALE. Three year Gross Collection Average: $582,867.00. Five digital operatories: Dentrix Program and Dexis. 1600 SQFT Stand alone Building For Sale. Practice Analysis/Cash Flow available. Excellent collection history. Financially approved Buyers preferred. Confidential contact: 941-224-9124 or Email: nperrondmd@gmail.com. Office for sale in Panama City, FL. For sale, Panama City, FL. 1933 sqft. Stand alone building. 4 equipped ops with room for 2 more ops; Lab, etc. Plenty of parking. Superb location in professional office park on major street on best side of town. Does not include practice, already sold that when dentist recently retired. 850-271-5612. Practice in paradise. Only full time periodontalimplant practice in Key West. Three operatories with spectacular views of the Gulf of Mexico and equipped with new ADEC chairs and delivery systems and digital x-ray. There is a small lab, private office and sterilization center. Practice is strictly fee for service with highly skilled referral base. Enjoy working, playing and living in paradise all year round. msgordondmd@gmail.com.

FLORIDA – SPECIALTY DENTAL PRACTICE SPACE FOR LEASE. Located in The Villages, Florida, a large senior retirement community in central Florida; Beautiful, completely built-out dental space with 6 operatories fully furnished with modern digital equipment (can be purchased). Looking for a dental specialist to lease the space located next door to general dentist; 2200 sq ft turnkey facility located in the heart of The Villages; golf cart-accessible. Contact: Mike Pederson, Grizzard Commercial Real Estate Group, (352) 408-0190. http://www.loopnet.com/Listing/19603384/11938CR-101-Suite-130-The-Villages-FL/. PRACTICE FOR SALE – MIAMI. Sunset Area Miami: Established productive, profitable, General Practice for Sale. Seller is seeking a Clinically and Financially pre-qualified buyer. Confidentially listed spacious 4 operatory facility with steady production/revenue. The practice offers a four day work week with a flexible owner willing to negotiate employment post sale to transition patients. Practice proforma with after tax cash flow analysis available. Contact: miamidentist2016@gmail.com. Excellent Dental Office Opportunity. Great Opportunity! Renovated space for sale or lease. Perfect for Medical/Dental or Paramedical Office. “IDEAL LOCATION” Single story with large attic space. Approx. 2000 square feet interior which includes: Waiting Room, Reception/Front Business Office, 2 professional offices, one with private bathroom with shower, 6 exam/treatment rooms, 2 additional bathrooms, Staff lounge/kitchen, supply room, 2 storage closets and Ample Parking in front of office. Walking distance to Capital Regional Medical Center. Low maintenance, all brick building with metal roof. Lease option available. http://tours. sunlightpc.com/148115. rongoldstein@kw.com. Downtown Fort Lauderdale Dental Practice for Sale. This established and flourishing dental practice of 12+ years is a dream come true for the right dentist. Located just 1 block from busy Las Olas Blvd. in the heart of Downtown Fort Lauderdale. Great Flow, recently remodeled with modern, spa-like design. Brand-New Website! Transaction: 1 Time Sale/Buy-Out Transitional Opportunities. Type of Practice: General/Cosmetic/Specialty. Reason for Sale: Doctor is Retiring. Description: 4 equipped ops with room for 5, PPO only, Digital X-rays & Pano, Open Dental Software. 2 hygienists work 4days/wk - doctor works 3days/wk - Specialty works 2-4days/mo. Square Feet: 1,280. Annual Collections: $1,200,000. Asking Price: $950,000. More info available. email: ft.lauderdalepractice4sale@gmail. com.

July/August 2016

Today's FDA

Profitability

Maximize Your Profitability Through Real Estate By Colin Carr, Carr Healthcare Realty

Let’s start with some basics: 1. Unless you own a mobile clinic, you will need an office space to see patients. 2. A practice’s office lease or mortgage typically is its second highest expense. 3. In today’s economy, maximizing profitability is not only a desire, but it’s also essential for most practices to stay in business.

“

If you are looking to maximize profitability, start by understanding how much is on the line with your lease or mortgage.

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Today's FDA

July/August 2016

Now let’s dig in further. If you own a practice, you most likely have an office. That office carries with it many expenses; the most obvious is the monthly rent or mortgage. With office space, also comes staff and payroll as well. These two items are not only needed to have a practice, but also are the two highest expenses for most practices. That being the case, only one of them really is negotiable. You may decide to cut staff, but when it comes to payroll, you either pay people what they are valued at or they’ll go somewhere that will. Real estate, however, is 100 percent negotiable. You can decide if you want to be in an office building, retail center or medical office building. You can decide if you lease or own. You can determine the size, location and amenities your space will offer. You can choose to be in a stand-alone or multi-tenant building. You can determine the length of lease, concessions you ask for, economic terms, business terms, etc. So, if real estate is your second highest expense behind payroll, and if there are so many options and choices to make when it comes to your office space, how can you maximize the opportunity? To start, you need to understand how the game is played. As a health care professional, the playing field is not level. You are a health care professional who might engage in two to six commercial transactions in your career; whereas, most landlords and sellers professionally negotiate for a living. You specialize in your field; they specialize in theirs. If the outcome was based upon understanding medicine or providing a health-related service, you would probably win.

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Profitability

However, the process and outcome are based upon comprehensive real estate market knowledge, authoritative posturing and negotiation expertise. Winning requires having more options, understanding the correct timing, and posture and negotiation tactics that landlords use. In many cases, it also requires being able to withstand the stress and conflict that many landlords and sellers use to exploit unsophisticated tenants and buyers. Let’s focus on a few of these concepts. If you start the transaction at the wrong time, you lose leverage and posture. If you don’t know the market, you are simply begging or bluffing. If you can’t handle conflict, you most likely will receive even more pressure and stress from the landlord or seller to make you uncomfortable and force you into making a decision you will regret. And, even if you could overcome all of these, without professional representation you are going to be viewed as a novice and are not going to receive the necessary respect to achieve the most favorable terms available to you. Nearly all landlords and sellers hire or consult with professional commercial real estate brokers to give them even more leverage so they can win. Why? Because they understand what is really on the table when it comes to each negotiation. For them, if they give up unnecessary concessions or go lower on rates than they need to, it costs them tens to hundreds of thousands of dollars of profit per lease. The reality is, those are the same items you are trying to maximize and capitalize on. Large national tenants and buyers understand this concept as well. If you polled Fortune 500 companies, you would find they either hire professional representation on every transaction or they have a team of in-house professionals who are trained and equipped to maximize the opportunity. They understand the potential upside or downside involved in every transaction, and they are committed to getting the best possible terms in every transaction. Most doctors and administrators don’t understand that commissions in commercial real estate typically are paid the same as they are in residential real estate: by the seller or landlord. This means representation does not cost the practice more money. Fees are set aside in advance and either is used to provide each party with representation, or the landlord or seller keeps that money or gives their broker a double commission.

negotiation that involves a lot of money. By doing so, you are positioning yourself to win. The bottom line is, there are tens to hundreds of thousands of dollars available to either be won or lost in every commercial real estate transaction — especially with health care real estate. Your profitability affects your patients, your staff, your family and many others. Maximize every commercial real estate opportunity by taking advantage of the best resources available to you. Winning on your next commercial real estate transaction can transform your practice! Carr Healthcare Realty is the nation’s leading provider of commercial real estate services for health care tenants and buyers. Every year, hundreds of medical, dental, veterinary and other health care practices trust Carr Healthcare Realty to help them achieve the most favorable terms on their lease and purchase negotiations. By not representing landlords or sellers, Carr Healthcare Realty is able to strongly advocate for health care providers and avoid conflicts of interest while saving their clients hundreds of thousands of dollars. Carr Healthcare Realty’s team of experts can assist with all types of real estate transactions, including lease renewals, expansions, relocations, startup offices, purchases and practice transitions. For more information, go to www.carrhr.com.

If you are looking to maximize profitability, start by understanding how much is on the line with your lease or mortgage. Then, make the choice to hire representation that is 100 percent free to you. Select a commercial real estate broker that understands health care, only works for you as the tenant or buyer, can help you find the most options, has the strongest game plan, and who can take and absorb the conflict and confrontation that is inherent in every

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For more info, contact Ken Jorgenson, CARR Florida Agent at ken.jorgenson@carrhr.com or 813.690. 9755.

July/August 2016

Today's FDA

Books on the Shelf

Books on the Shelf Books Available for Review If you are interested in reviewing one of the books listed here, please contact Director of Communications Jill Runyan by email at jrunyan@floridadental.org or by mail at 1111 E. Tennessee St., Tallahassee, FL 32308. Authors should review their books within four to six weeks and are given the books they review. 2013 QDT, Quintessence of Dental Technology, Vol. 36 Edited by: Sillas Duarte, DDS, MS, PhD 216 pages Published in 2013 by Quintessence Publishing Price: $128 2016 QDT, Quintessence of Dental Technology, Vol. 39 Edited by: Sillas Duarte, DDS, MS, PhD 224 pages Published in 2016 by Quintessence Publishing Price: $132 3-D Imaging in Dentistry: From Multiplanar Cephalometry to Guided Navigation in Implantology By: Giovanna Perrotti, Tiziano Testori and Massimiliano Politi 560 pages Published in 2016 by Quintessence Publishing Price: $210 Aligner Orthodontics: Diagnostics, Biomechanics, Planning, and Treatment By: Werner Schupp and Julia Haubrich 368 pages Published in 2016 by Quintessence Publishing Price: $228

Best Practices in Endodontics: A Desk Reference By: Richard Schwartz, DDS and Venkat Canakapalli, BDS, MDS 368 pages Published in 2015 by Quintessence Publishing Price: $134 Ceramics in Dentistry: Principles and Practice By: J. Robert Kelly, DDS, MS, DMedSc 128 pages Published in 2016 by Quintessence Publishing Price: $39 Color Atlas of Fixed Prosthodontics: Vol. 1 By: Yoshiyuki Hagiwara 196 pages Published in 2013 by Quintessence Publishing Price: $120 Communications Skills for Dental Health Care Providers By: Lance Brendan Young, Cynthia Rozek Oâ&#x20AC;&#x2122;Toole, Bianca Wolf 352 pages Published in 2015 by Quintessence Publishing Price: $78.00 Dancing Hands By: Herluf Skovsgaard, DDS 296 pages Published in 2013 by Quintessence Publishing Price: $198 Development of the Human Dentition By: Franz P.G.M. van der Linden, DDS, PhD 240 pages Published in 2016 by Quintessence Publishing Price: $99

Endodontics Review: A Study Guide By: Brooke Blicher, Rebekah Lucier Pryles and Jarshen Lin 264 pages Published in 2016 by Quintessence Publishing Price: $68 Evidence-based Dentistry for the Dental Hygienist By: Julie Frantsve-Hawley, RDH, PhD 376 pages Published in 2014 by Quintessence Publishing Price: $56 Foundations of Dental Technology: Anatomy and Physiology By: Arnold Hohmann and Werner Hielscher 300 pages Published in 2014 by Quintessence Publishing Price: $98 Global Diagnosis: A New World Vision of Dental Diagnosis and Treatment Planning By: J. Williams Robbins and Jeffrey S. Rouse 244 pages; comes with a CD-ROM Published in 2016 by Quintessence Publishing Price: $148 Medical Emergencies in the Dental Practice By: Orrett E. Ogle, DDS; Harry Dym, DDS; and Robert J. Weinstock, DDS 200 pages Published in 2015 by Quintessence Publishing Price: $69 Medical Microbiology and Immunology for Dentistry By: Nejat Duzgunes 306 pages Published in 2015 by Quintessence Publishing Price: $118 Please see BOOKS, 95

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July/August 2016

Today's FDA

SAVE THE DATE! MARCH 24-25, 2017

VOLUNTEER! PENSACOLA, FLA. WOODHAM MIDDLE SCHOOL

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ALL U.S. LICENSED DENTISTS MAY PROVIDE CARE IF REGISTERED BY JAN. 15, 2017.

Books on the Shelf

BOOKS from 93 Oral & Maxillofacial Surgery Review By: Din Lam, DMD, MD and Daniel Laskin, DDS, MS 440 pages Published in 2015 by Quintessence Publishing Price: $88 Oral Implantology Surgical Procedures Checklist By: Louie Al-Faraje, DDS 92 pages Published in 2013 by Quintessence Publishing Price: $68 Oral Implants: Bioactivating Concepts Edited by: Drs. Rolf Ewers and Thomas Lambrecht 536 pages Published in 2013 by Quintessence Publishing Price: $328 Orofacial Pain and Headache, Second Edition By: Yair Sharav, DMD, MS and Rafael Benoliel, BDS 664 pages Published in 2015 by Quintessence Publishing Price: $168 Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management By: Reny de Leeuw, DDS, PhD, MPH and Gary D. Klasser, DMD 312 pages Published in 2013 by Quintessence Publishing Price: $48 Periodontal Review: A Study Guide By: Deborah A. Termeie, DDS 296 pages Published 2013 by Quintessence Publishing Price: $68

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Principles of Design and Fabrication in Prosthodontics By: Arnold Hohmann and Werner Hielscher 408 pages Published 2016 by Quintessence Publishing Price: $128

Surgical Design for Dental Reconstruction with Implants: A New Paradigm By: Martin Chin 256 pages Published in 2015 by Quintessence Publishing Price: $172

Promoting the Oral Health of Children: Theory and Practice, Second Edition By: Aubrey Sheiham, Samuel Jorge Moyses, Richard G. Watt and Marcelo Bonecker 450 pages Published 2014 by Quintessence Publishing Price: $110

The Alexander Discipline, Vol. 3: Unusual and Difficult Cases By: R.G. “Wick” Alexander, DDS, MSD 192 pages Published in 2016 by Quintessence Publishing Price: $176

Reintervention in Endodontics By: Mario Luis Zuolo, Daniel Kherlakian, Jose Eduardo de Mello Jr., Maria Cristina Coelho de Carvalho and Maria Ines Ranazzi Cabral Fagundes 332 pages Published 2014 by Quintessence Publishing Price: $180 Sinus Floor Elevation: Avoiding Pitfalls Using Cone-Beam CT By: Dr. Yasuhiro Nosaka 120 pages Published 2014 by Quintessence Publishing Price: $120 Smile! Your Guide to Esthetic Dental Treatment By: Douglas A. Terry, DDS 54 pages Published 2014 by Quintessence Publishing Price: $29.50 Summitt’s Fundamentals of Operative Dentistry: A Contemporary Approach, Fourth Edition By: Thomas J. Hilton, DMD, MS; Jack L. Ferracane, PhD; and James C. Broome, DDS, MS 612 pages Published in 2013 by Quintessence Publishing Price: $128

The Biomechanical Foundation of Clinical Orthodontics By: Charles J. Burstone, DDS, MS and Kwangchul Choy, DDS, MS, PhD 608 pages Published in 2015 by Quintessence Publishing $180 The Oral-Systemic Health Connection: A Guide to Patient Care By: Michael Glick, DMD 312 pages Published in 2014 by Quintessence Publishing Price: $118 What’s in Your Mouth? What’s in Your Child’s Mouth? By: Douglas A. Terry, DDS 66 pages Published in 2013 by Quintessence Publishing Price: $29.50 What’s in Your Mouth? Your Guide to a Lifelong Smile By: Douglas A. Terry, DDS 48 pages Published in 2014 by Quintessence Publishing Price: $29.50

July/August 2016

Today's FDA

OFF THE CUSP

JOHN PAUL, DMD, EDITOR

Things They Didn’t Teach in Dental School When I first started practicing, we had a family friend who was an accountant and it seemed wise to speak with him. At the end of our chat, he stood, reached across his desk to shake my hand and said, “Congratulations, you have just become a non-compensated tax collector for the U.S. government.”

“

You have to know something about business — and a lot about relating to people.

”

Today's FDA

July/August 2016

Turns out, this and several other important pieces of information were not covered in dental school. About five years into practice, my assistant looked at me one day and said, “They never told you in dental school you’d spend your life working with a bunch of women, did they?” Since I am quoting a woman, this can’t be a sexist remark. And, if you think about it, it makes little difference whether it was said to a man or a woman. Research shows nearly every dental practice in the U.S. is run by women — if not exclusively, they are in an overwhelming majority. I think the only time I’ve ever heard of an allmale dental office was in the military. Why do you suppose we don’t brag that dentistry is the largest industry in America run by women?

In dental school, I thought I would learn the mysterious potions and sleight of hand that would let me save the world from tooth decay and make a satisfying living for my family. Judging by the attitude and grading system at my alma mater, fillings, crowns and dentures were the most important things I would do. Burnishing a margin impressed my classmates and makes my crowns and fillings last longer, but neither my patients nor my staff will appreciate it. It doesn’t stop me from polishing, but I’m the only one it satisfies. Dentistry’s rewards do not lie in making perfect line angles every time. It turns out, being able to do dentistry well is a bare minimum, and by itself won’t keep the doors open. You have to know something about business — and a lot about relating to people. Keeping the office clean, holding your patient’s hand, easing their pain and reassuring them on Sunday morning that you will see them Monday to fix their problem are what actually keeps people coming back and referring their friends. Dr. Paul is the editor of Today's FDA. He can be reached at jpaul@bot.floridadental.org.

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