2022 - March/April TFDA by Florida Dental Association

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TABLE OF CONTENTS

MARCH/APRIL 2022 floridadental.org

48 | 10 Reasons to Bring Your Team 52 | FDC2022 Speaker Preview: The Inner Game 54 | FDC2022 Speaker Preview: Obtain and Maintain Healthy Posture for Seated Professionals 58 | FDC2022 Speaker Preview: Talking TOTAL Patient Health!

62 | FDC2022 Exhibit Hall

64 | 3 Unfounded Fears That Will Cost You During Commercial Real Estate Negotiations

IN EVERY ISSUE 2 Staff Roster

18 news@fda

4 Contributors

69 Diagnostic Discussion

7 President’s Message 10 Did You Know? 12 Legislative

CHECK OUT TODAY’S FDA ONLINE!

74 Career Center 77 Advertising Index 79 Off the Cusp

14 Preventive Action

1 | TODAY'S FDA march/april 2022

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

EDITOR Dr. Hugh Wunderlich • Palm Harbor DIRECTOR OF PUBLICATIONS Jill Runyan

COMMUNICATIONS AND MEDIA COORDINATOR Jessica Lauria

GRAPHIC DESIGN COORDINATOR AJ Gillis

BOARD OF TRUSTEES PRESIDENT Dr. Dave Boden • Port St. Lucie

PRESIDENT-ELECT Dr. Gerald Bird • Cocoa

SECRETARY Dr. John Paul • Lakeland

FIRST VICE PRESIDENT Dr. Beatriz Terry • Miami

IMMEDIATE PAST PRESIDENT Dr. Andy Brown • Orange Park

SECOND VICE PRESIDENT Dr. Jeffrey Ottley • Milton

EXECUTIVE DIRECTOR Drew Eason, CAE • Tallahassee

To contact an FDA board member, use the first letter of their first name, then their last name, followed by @bot.floridadental.org. For example, to email Dr. Hugh Wunderlich, his email would be hwunderlich@bot.floridadental.org.

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

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

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

ACCOUNTING Breana Giblin • director of accounting Leona Boutwell • finance services coordinator Deanne Foy • finance services coordinator Jamie Idol • FDAS support services coordinator Mitzi Rye • fiscal services coordinator Stephanie Taylor • membership dues coordinator

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

COMMUNICATIONS AND PUBLICATIONS Renee Thompson • director of communications and marketing Jill Runyan • director of publications AJ Gillis • graphic design coordinator

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

FDA FOUNDATION R. Jai Gillum • director of foundation affairs Kristin Badeau • foundation coordinator

rjaigillum@floridadental.org • Ext. 7117 kbadeau@floridadental.org • Ext. 7161

FLORIDA DENTAL CONVENTION AND CONTINUING EDUCATION Crissy Tallman • director of conventions and continuing education Brooke Martin • FDC marketing specialist Deirdre Rhodes • FDC exhibits coordinator Jennifer Thomas • FDC program coordinator Mackenzie Johnson • FDC meeting assistant

ctallman@floridadental.org • Ext. 7105 bmartin@floridadental.org • Ext. 7103 drhodes@floridadental.org • Ext. 7108 jthomas@floridadental.org • Ext. 7106 mjohnson@floridadental.org • Ext. 7162

GOVERNMENTAL AFFAIRS Joe Anne Hart • chief legislative officer Alexandra Abboud • governmental affairs liaison Jamie Graves • legislative assistant

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

INFORMATION SYSTEMS Larry Darnell • director of information systems Charles Vilardebo • computer support technician

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

MEMBER RELATIONS Kerry Gómez-Ríos • director of member relations Megan Bakan • member access coordinator Joshua Braswell • membership coordinator Christine Trotto • membership concierge

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

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

Scott Ruthstrom • chief operating officer Carrie Millar • director of insurance operations Carol Gaskins • commercial accounts manager Marcia Dutton • membership services assistant Porschie Biggins • Central FL membership commercial account advisor Maria Brooks • South FL membership commercial account advisor Kelly Dee • Atlantic Coast membership commercial account advisor Melissa Staggers • West Coast membership commercial account advisor Danielle Basista • commercial account advisor Tessa Daniels • commercial account advisor Liz Rich • commercial account advisor Davis Perkins • commercial account advisor

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

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YOUR RISK EXPERTS Dan Zottoli, SBCS, DIF, LTCP director of sales • Atlantic Coast 561.791.7744 cell: 561.601.5363 dan.zottoli@fdaservices.com

Joseph Perretti, SBCS director of sales • South Florida 305.665.0455 cell: 305.721.9196 joe.perretti@fdaservices.com

Dennis Head, CIC director of sales • Central Florida 877.843.0921 cell: 407.927.5472 dennis.head@fdaservices.com

Rick D’Angelo, CIC director of sales • West Coast 813.475.6948 cell: 813.267.2572 rick.dangelo@fdaservices.com

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

3 | TODAY'S FDA march/april 2022

GUEST CONTRIBUTORS march/april 2022

MARSHALL BARRES

JOE CALDERONE

CARR REALTY

FDA LIAISON TO THE FLORIDA BOARD OF DENTISTRY

marshall.barres@carr.us Page 64

drcalderone@gmail.com Page 10

RANDY FOX

UCHE ODIATU, DMD

FOXPOINT, LLC

FDC2022 SPEAKER

OdiatuDMD@gmail.com

randy@foxpoint.net

Page 58

Page 52

STEPHEN PEREZ, DDS

DIANNE SAYWELL, RDH, ERYT500, YACEP

GENERAL DENTIST CLEARWATER, FL

FDC2022 SPEAKER

drstephenperez@verizon.net

yogadi77@yahoo.com

Page 35

Page 54

DAVE BODEN, DDS, M.S.

DONALD COHEN, DMD

oralpath@dental.ufl.edu

FDA PRESIDENT

oralpath@dental.ufl.edu

dboden@floridadental.org

Page 69

850.681.3629 Pages 7

NADIM M. ISLAM, DDS

JOE ANNE HART

oralpath@dental.ufl.edu

FDA CHIEF LEGISLATIVE OFFICER

Page 69

jahart@floridadental.org 850.350.7205 Page 12

CASEY STOUTAMIRE, ESQ. FDA DIRECTOR OF THIRD PARTY PAYER & PROFESSIONAL AFFAIRS cstoutamire@floridadental.org 850.350.7202 Pages 10 & 26

HUGH WUNDERLICH, DDS, CDE FDA EDITOR hwunderlich@bot.floridadental.org 850.681.3629 Page 79

5 | TODAY'S FDA march/april 2022

CONTRIBUTORS march/april 2022

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in the sulcus

the courage to change course By David F. Boden, DDS, M.S., FDA President

I like the Yogi Berra aphorism. “When you come to a fork in the road, take it.” Many times, we are afraid of choices: Will I make the right one or pay a price for a bad decision? Manager Berra’s point is that indecision often is the worst decision. We should have the courage to analyze — not agonize about — choices and make the best of our decisions. But what if we are wrong? I enjoy hiking, especially in the wilderness with friends. Sometimes the trail is clear and well blazed, but that’s not always the case. Then, here comes that unanticipated, but not inevitable, fork in the trail. Great. It was my turn to lead. I stop and try to figure out which to take. I look at my compass (GPS is cheating!), check the sun angle, look for landmarks and try to appear ever-so-wise. Sometimes, there is just not enough data and I have to make a best guess for my friends behind me, who are equally puzzled, and plunge on. Fortunately, I have never suffered a dangerous consequence, but if I later realize it is the wrong way, that often means backtracking several miles with a lot of grumpy friends with heavy packs going up and down already conquered hills and valleys. The only answer is to admit the error, keep a positive attitude and lead on regardless. Realistically, and sometimes privately, they all know they would have been just as likely to make the same choice. I’m guaranteed some ribbing later, but I know they respect my abilities and are grateful I recognized my error.

So, what happens if we make an “uh-oh” with a decision in dentistry? Should we hang on to our choice for dear life? Are we unnecessarily hurting others? The first step is to recognize we made a mistake. The next is to admit to those affected that we errored. And finally, change our course to the better path, apologize sincerely, and then learn what we did wrong to avoid the same error in the future. This process is humbling, and perhaps even embarrassing, but it is a sign of true leadership to demonstrate the courage to make an error, admit to it, fix it and then pursue the correct course. Errors are inevitable. Correcting them takes effort and no small degree of fortitude. Leaders gain (not lose) respect for their courage in this way. We are approaching many crossroads in our profession and all of you must decide which path to take. Not choosing means someone else will decide for you. Corporate, solo or small group practice? Continue insurance participation or drop it? Accept more government control or advocate to prevent it? Integrate with medicine or stay separate? Other people rely upon your decisions — your family, your staff and your profession. If you make an error, do you have the fortitude to admit you were wrong and change your path? Those in dental association leadership positions also encounter occasional (and hopefully rare) errors in judgement with their decisions. Leaders must be careful not to let egos fog judgements when we realize we led our trusting followers down the wrong path, especially when we were aware of t

7 | TODAY'S FDA march/april 2022

in the sulcus

”

We are approaching many crossroads in our profession and all of you must decide which path to take. Not choosing means someone else will decide for you.

that long ago. In doing so, when it becomes obvious to others that the error is real but unadmitted and uncorrected, respect is lost. In the end, that loss of respect inevitably removes the mantle of leadership.

Your Colleague,

Leadership means making tough decisions, but your courage shows when you are wise and willing enough to modify them later. So, when you encounter a fork in the road, take it. Don’t dread it — RELISH it!

Subscribe to our blog. Get entered into a monthly drawing for a $10 Starbucks gift card.

beyond the bite THE OFFICIAL BLOG OF THE FDA

blog.floridadental.org

9 | TODAY'S FDA march/april 2022

did you know?

You are Required to Provide 24-hour Emergency Care for All Patients By Dr. Joe Calderone, FDA Liaison to the Florida Board of Dentistry and Casey Stoutamire, FDA Director of Third Party Payer and Professional Affairs

Did you know that you are required, either personally, through another Florida-licensed dentist or a reciprocal agreement with another group, to provide 24-hour emergency care for all patients under your continuing care? If you do not provide this emergency care, then you are subject to discipline by the Florida Board of Dentistry (BOD). Emergency care also is listed in the American Dental Association’s (ADA) Dental Patient Rights and Responsibilities Statement. It states that a patient has the right to reasonable arrangements for dental care and emergency treatment. The full list of patient’s rights and responsibilities can be found at ada.org. There are no clear-cut parameters on what type of methods will be enough to satisfy this rule. For example, is a 24-hour number for patients to call you enough; do you have to be available to have patients come into your office 24 hours a day, seven days a week? The reasonableness standard will apply here: Is the access to emergency care you are providing to your patients reasonable under the circumstances? The BOD Rule on this issue is 64B5-17.004, Emergency Care: It is the responsibility of every dentist practicing in this state to provide, either personally, through another licensed dentist, or through a reciprocal agreement with another agency, reasonable twenty-four (24) hour emergency services for all patients under his [or her] continuing care.

”

The reasonableness standard will apply here: Is the access to emergency care you are providing to your patients reasonable under the circumstances?

OPIOIDS information from the FDA

HEALTH CARE PROVIDER CHECKLIST: INFORM Non-opioid alternatives for pain treatment, which may include non-opioid medicinal drugs or drug products are available. Non-opioid interventional procedures or treatments, which may include: acupuncture, chiropractic treatments, massage, physical or occupational therapy, or other appropriate therapy are available.

DISCUSS Advantages and disadvantages of non-opioid alternatives. Patient’s risk or history of controlled substance abuse or misuse, and patient’s personal preferences.

DOCUMENT IN PATIENT’S RECORD Non-opioid alternatives considered.

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

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

NON-OPIOID ALTERNATIVES r You FDA ve R lusi exc EMBE ! M EFIT BEN

LAW: FOR THE LATEST ON OPIOIDS, GO TO:

FLORIDADENTAL.ORG/NYK

11 | TODAY'S FDA march/april 2022

GO TO bit.ly/2KXvZ2h

legislative

Dentists’ Day on the Hill is Back! By Joe Anne Hart, FDA Chief Legislative Officer

Dr. Jolene Paramore. CFO Patronis was instrumental in getting legislation passed last year that provided protections for health care providers against frivolous COVID-19 lawsuits.

Thank you to all the dentists, spouses and dental students who traveled to Tallahassee for the 2022 Dentists’ Day on the Hill (DDOH)! We had an amazing time seeing everyone at the Capitol advocating for the Florida Dental Association’s (FDA) legislative priorities.

On Tuesday, Feb. 1, the Capitol was filled with blinking toothbrushes as everyone started meeting with their legislators. The hallways were filled with the buzz about the state allocating $773,000 for the Dental Student Loan Repayment Program and the Donated Dental Services program, with our DDOH attendees wearing their budget buttons.

The legislative briefing on Monday, Jan. 31 included visits from several legislators who expressed the importance of dentists traveling to Tallahassee during session and participating in the process. Legislators need to hear from the experts who are directly involved in dentistry.

Check out the DDOH highlight video at vimeo.com/673726439 and photos from the events at bit.ly/3gK9ZaC.

Also in attendance at the legislative briefing was state of Florida Chief Financial Officer (CFO) Jimmy Patronis, who was presented with an FDA Champion for Dentistry legislative award by

And the day ended with a meet and greet with Gov. Ron DeSantis as pictured above!

Save the Date:

The 2023 Dentists’ Day on the Hill will be Tuesday, March 28! 12

ARE YOU A MEMBER OF FDAPAC CENTURY CLUB? Join now: floridadental.org/centuryclub

A portion of your required dues is transferred to the Florida Dental Association Political Action Committee (FDAPAC). FDAPAC provides campaign contributions to dental-friendly candidates. FDAPAC Century Club members provide additional financial support of $150 or more for state campaigns. FDAPAC dues and contributions are not deductible for federal income-tax purposes. Dr. Rudy Liddell FDAPAC Chair

“Your support of the PAC helps the FDA build relationships with leaders who will be making important decisions in Tallahassee that will impact our profession and our patients.” — Dr. Rudy Liddell

13 | TODAY'S FDA march/april 2022

preventive action

Compliance and Security: A Match Made in HIPAA Heaven By Abyde

Peanut butter and jelly, macaroni and cheese, rock and roll — there’s really no mistaking that some things are just better in pairs. While these might be the obvious examples to tag along with the old ’80s hit, “It Takes Two to Make a Thing Go Right,” there’s another dynamic duo that plays an important role in your practice’s daily operations: compliance and security. Compliance and security go hand in hand, making the perfect team when it comes to protecting patient data. But falling into the trap of thinking that achieving one means meeting the other can mean double trouble for your practice, so it’s important to understand the differences between the two and how to ensure you’re checking both off your list.

What is compliance? Compliance is kind of like the bread and butter of your practice. It focuses on the regulatory requirements involved in the protection of sensitive patient data, meaning that you not only have a secure technical environment, but also have the know-how and documentation to prove it. Compliance is a comprehensive set of standards that practices must meet to avoid fines but should be viewed as more of a baseline when it comes to security, not the end all be all. Complying with HIPAA means meeting various requirements outlined in the HIPAA Security and Privacy Rule — but there’s more to the story when it comes to ensuring that patient data is fully protected.

What is security? Security is the complete system of policies, processes and technical controls specific to your practice. The goal of security is to ensure the best possible protection of the confidentiality, integrity and availability of patient data, which in the age of technology means constantly updating to mitigate the risk of ever-changing threats. When we think of security, we often think of locks on practice doors and passwords on computers, but those safeguards only brush the surface of true security. Having the proper technical safeguards in place and staying up to date on any new threats, such as the recent increase

in ransomware, knowing how to properly mitigate a potential threat and staying educated are just some ways to meet your practice’s security needs.

So, what’s the difference? While both are crucial in protecting patient data, security and compliance are not one and the same. The key distinction between the two is that compliance requirements are a bit more predictable, whereas security standards are rapidly evolving with current risks and threats. This, unfortunately, means that even if you check off each of the compliance requirement boxes, it doesn’t exactly mean that your practice is 100% secure — which is why you are still at risk for a cyberattack even if you have a complete HIPAA-compliance program in place.

Why you need both! Just like Batman and Robin, when you put the two forces together, they’re pretty unstoppable. And with cyberattackers playing the role of the modern-day villain, establishing strong compliance and security programs are the best, and perhaps the only, way to ensure you’re taking every measure to protect patient data. Just visit abyde.com/demo to see for yourself how Abyde’s revolutionary solution can be the perfect match for keeping your practice protected. Reprinted with permission from Abyde.

Even if you check off each of the compliance requirement boxes, it doesn’t exactly mean that your practice is 100% secure

15 | TODAY'S FDA march/april 2022

HAVE CONFIDENCE IN YOUR COMPLIANCE. As the FDA’s chosen compliance vendor, Abyde provides the solutions and support needed to ensure members have protection and peace of mind in their complete HIPAA program. But don’t just take our word for it.

100% Audit Pass Rate 95% Renewal Rate

“Every provider should have Abyde, they’re crazy not to!”

0% HIPAA Stress Rate

Dr. Oscar Menendez Comprehensive Dental Care FDA Member

SEE IT FOR YOURSELF. abyde.com/demo Looking for more education? Sign up for a one-on-one consultation at abyde.com/hipaaconsultation

800.594.0883 info@abyde.com abyde.com

PROUD PARTNER OF

17 | TODAY'S FDA march/april 2022

news@fda *PLEASE NOTE THAT FDA MEMBERS TALLAHASSEE MARCH HAVE THEIR NAMES LISTED IN BOLD.

UFCD Student Essay Recognized by ADA

11-12, 2022

The American Dental Association (ADA) awarded a certificate of recognition to University of Florida College of Dentistry (UFCD) student Ms. Fianna Shafirovich for her essay, “More Than Teeth: What Your Dental Team Wants You to Know About Health Misinformation.” Her essay was selected as UFCD’s submission for the 2021 National Health Literacy in Dentistry Essay Contest.

Welcome New FDA Members The following dentists recently joined the FDA. Their memberships allow them to develop a strong network of fellow professionals who understand the day-to-day triumphs and tribulations of practicing dentistry. Names listed in blue are members in dental residency.

Thank You, FLA-MOM Volunteers! The 2022 Florida Mission of Mercy (FLA-MOM) was a tremendous success, thanks to the more than 1,300 volunteers! Preliminary numbers show that 1,375 patients received more than $1.79 million in donated dental care! We couldn’t have done it with out you, and we are grateful to have such giving and wonderful members. Stay tuned for our FLA-MOM recap in the May/June issue of Today’s FDA.

Atlantic Coast District Dental Association Dr. Joshua Adametz, Wellington Dr. Augusto Lima, Port Saint Lucie Dr. Jaime Marquez, Boca Raton Dr. Claudia McDaniel, Boynton Beach Dr. Josie Nguyen, Tamarac Dr. Sharon Pollick, Port Saint Lucie Dr. Rafael Rodriguez, Jupiter Dr. Alejandra Romero, Fort Lauderdale Dr. Julio Salas, Pompano Beach

Central Florida District Dental Association Dr. Miralys Chardon Gesualdo, Orlando

The No. 1 New Threat to Dental Offices is Ransomware

Dr. Joel Eley, Melbourne Dr. Mark Fleming, Lake Mary

Ransomware attacks not only compromise patient data, but also can cost your practice hundreds of thousands of dollars in lost business and notification fees on top of the ransom. FDA Services (FDAS) strongly recommends that your practice carry at least $1 million in cyberliability coverage, and we recommend a policy from preferred carrier Coalition Insurance. Call or text FDAS today to learn more at 850.681.2996 or fill out an application today at bit.ly/3tdQmig.

Dr. Gary Gibson, Orlando Dr. Harrison Gollob, Melbourne Dr. Randy Mejias, Orlando Dr. Megan Phillip, Kissimmee Dr. Shauna Pittman, Melbourne Dr. Surendra Sirivolu, Edgewater

Dr. Linda Soper-Maier, Longwood Dr. Luis Veloz, Clermont Dr. Melissa Williams, Orlando Dr. Panagiotis Zoidis, Gainesville

Northeast District Dental Association Dr. Rami Al Saidi, Orange Park Dr. Richard Campbell, Jacksonville Dr. Tatiana Kalashnikova, Jacksonville Dr. Justin McDaniel, Jacksonville Dr. Raul Molina, Jacksonville Dr. Annie Vu, Callahan

Northwest District Dental Association Dr. Doron Bresler, Panama City Dr. Mark Harris, Panama City Dr. Fady Shaaban, Destin Dr. Herman Singh, Pensacola Dr. Lance Washburn, Pensacola

South Florida District Dental Association Dr. Akil Alexander, Pembroke Pines Dr. Mobeen Alvi, Fort Lauderdale Dr. Tomas Bello, Miami Dr. Monica Bonnin, Miami Dr. Asharie Campbell, Miami Dr. Natalie Cespedes, Miami Lakes Dr. James Clark, Miramar Beach Dr. Alfredo Contino, Miami

The FDA House of Delegates May Consider Bylaws Changes

The Next House of Delegates Meeting June 24-25, 2022 at the Gaylord Palms Resort & Convention Center in Orlando.

Dr. Patricia Nicklas, Summerland Key Dr. Anny Oliva, Aventura Dr. Lina Rivera, Juana Diaz Dr. Ashley Rosenbaum, Coral Gables Dr. Jordan Shapiro, Hollywood Dr. Edda Sidorova, Miami Dr. Yusleimys Torres, Homestead

West Coast District Dental Association Dr. Raqueline Bruno de Sousa, Sarasota Dr. Bernadette Delumpa, Naples Dr. William Garcia, Winter Haven Dr. Rose Gedeon, Naples Dr. Ivelisse Griffith, Fort Myers Dr. Jonathan Johnson, Plant City Dr. Abdul Khan, Hudson

Dr. Paula De Freitas, Miami Dr. Vivianne De La Camara, Miami Springs Dr. Maria Figueredo, Doral Dr. Maria Carolina Guia Rodriguez, Miami Dr. Harold Hui, North Miami Beach Dr. Shirley Kleiner-Arias, North Miami Beach Dr. Alberto Mantovani, Miami Beach

Dr. Hannah Lowe, Tampa Dr. Robert Musselman, Saint Petersburg Dr. Bryce Opps, Sarasota Dr. Maria Pardo, Bradenton Dr. Leonardo Saraiva, Sarasota Dr. Cecilia Sorelle, Seminole

19 | TODAY'S FDA march/april 2022

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

M. Paul Nestor

Raphael Greenfield

Gainesville

Stamford, CT

Died: 01/02/2022

Died: 02/01/2022

Age: 91

Age: 77

Joseph Zukoski

Delio Garcia Grandal

Panama City

Miami

Died: 01/21/2022

Died: 02/27/2022

Age: 80

Age: 61

FDA: Well-being program Tobacco Free Florida

HELPING MEMBERS SUCCEED

RENEW YOUR MEMBERSHIP FOR 2022 TODAY!

We have your back. Always. Dr. Joshua Golden Today’s FDA Guest Contributor 2022 FDA Instagram Takeover Host

THREE EASY WAYS TO PAY: Online: Visit floridadental.org/dues. Mail: Return blue envelope with statement and payment. Phone: Dial 850.681.3629 to speak to our friendly membership team.

PAYMENT PLAN: Choose from a variety of monthly installment plans.

AUTO-RENEWAL: Set it and forget it! Your membership will automatically renew each year with the credit card you put on file. 21 | TODAY'S FDA march/april 2022

Guest

Editorial Dear Dr. Boden, I read with great interest your article in the January/February Today’s FDA, “Skeptic Turned Supporter.” It is a discussion I have on a regular basis with my students. My background is that I am a retired captain in the United States Navy Dental Corps with just short of 27 years of service. I am Navy residency-trained in general/comprehensive dentistry and taught in Navy Advanced Education in General Dentistry and Advanced Clinical Residency programs. In 2004, I was recruited out of the Navy to run one of the University of Florida College of Dentistry (UFCD) Advanced Education in General Dentistry (AEGD) programs. In 2008, I was asked by the Extramural Programs Department at UFCD to help establish and run the Extramural Rotation Program in Jacksonville at the Sulzbacher Center. Since 2008, I have had roughly two-thirds of every UFCD graduating class rotate through my extramural rotation. UFCD very much depends on these extramural rotations for restorative experience for their students. I have had numerous students who can count on one hand the operative restorations they have placed in the school clinics before they come on rotation. Of course, that is another discussion for another time, and not the point of this letter. But my point is that many students have not had the restorative experience involving direct patient care. As one of my Navy residency instructors use to say, “You can teach a monkey to do the same task over and over, but when things go outside the repetitive nature, that is what makes the difference.” I tell my students that it is the application of ideal principals to situations that are not ideal and come out with a successful and lasting outcome that will make them successful dentists, and go on to say that sometimes decay does not read the rule book, and how they handle those situations will determine their success in dentistry. The Commission on Dental Competency Assessments’ CompeDontTM examination may show promise, but it does not take into account patient variables and unexpected issues in which live patients do. In other words, it does not take into account situations when the decay does not read the rule book. You and I both have been involved in direct patient care for quite some time, and both know that a flat two-dimensional radiograph does not tell the whole story, and we must rely on our clinical judgement and experience to treat those situations. These aspects are simply a part of live-patient board examinations which simply cannot be duplicated with a mannequin examination. As an educator in both residency and undergraduate level clinical education of over 26 years and based on my direct observations of dental students for the past 14 years, I feel that we will be doing both the students and the citizens of the state of Florida an injustice by proceeding to a non-patient-based dental licensure examination.

Sincerely, Roger D. Wray, DDS Captain, Dental Corps, USN(ret) Associate Dental Director, Community Health Centers, Inc. Adjunct Clinical Associate Professor, Community Based Programs University of Florida College of Dentistry

Guest

Editorial Dear Dr. Boden, I want to congratulate on your column in [the January/February 2022 issue of] Today’s FDA on the non-patient licensure [exam]. It takes an intelligent person to change his feelings when presented with the appropriate data. Although I retired from the practice of dentistry in Florida years ago, I still like to follow up on new trends in [the] delivery of health care. I think this new exam will be a step toward increasing dental access for the residents of Florida. I still remember the logistical difficulties to the old exam: Doing procedures on patients who had their treatment delayed for the purpose of the exam and being well paid for their pathology. Taking the exam in inadequate facilities with outmoded equipment and no assistants to suction or retract. Examiners who had no idea how to use a perio probe. An introduction from a member of the Board of Dentistry who said that the reason the exam was so difficult was “because you guys all cheat!” The actual procedures were not all that difficult, but it was extremely difficult and expensive for an out-of-state dentist like me to locate patients with the appropriate pathologies and transport and pay them to sit for the exam. Speaking frankly, it was obvious that the reason Florida was the last state in the nation to accept any reciprocity in licensure was not to protect the patients of Florida, but to protect the economic well-being of Florida dentists by restricting out-of-state dentists. I salute you for your progressive change of the licensure exam in Florida. Your colleague, Stephen Eingorn, DMD University of Pennsylvania SDM, ’74

Editor’s note: All editorials may be edited due to style and space limitations. Letters to the editor must be on topic and typically a maximum of 500 words. Submissions must not create a personal attack on any individual. All letters are subject to editorial control. The editorial board reserves the right to limit the number of submissions by an individual. Views and conclusions expressed in all editorials are those of the authors and not necessarily those of the editors, staff, officials, Board of Trustees or members of the Florida Dental Association. For full editorial policies, see page 77.

23 | TODAY'S FDA march/april 2022

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board of dentistry

BOD Meets in Gainesville By Casey Stoutamire, FDA Director of Third Party Payer and Professional Affairs

The Florida Board of Dentistry (BOD) met in Gainesville on Friday, Feb. 18, at 7:30 a.m. The Florida Dental Association (FDA) was represented by FDA BOD Liaison Dr. Joe Calderone and Director of Third Party Payer and Professional Affairs Casey Stoutamire. Drs. Andy Brown, Jim Haddix and Suzi Thiems-Heflin also were in attendance. In addition, many University of Florida dental students and Santa Fe Community College hygiene and assisting students attended the meeting. The BOD members present included: Dr. T.J. Tejera, chair; Mr. Fabio Andrade (consumer member), vice chair; Drs. Christine Bojaxhi, Brad Cherry, Tom McCawley, Jose Mellado, Claudio Miro and Nick White; and hygiene members, Ms. Karyn Hill and Ms. Angela Johnson. There is one consumer position open on the board that the governor has not yet filled. Ms. Hill gave the Council on Dental Hygiene report. The council proposed rule language allowing a portion of the CPR certification course to be done online. However, there still must be a hands-on component. The BOD unanimously approved this proposed language. This rule is not yet effective as it still must go through the rule-making process. The FDA will keep you updated on its status. Dr. Tejera postponed a discussion about many of the proposed changes to the Anesthesia Rules to allow the Anesthesia Committee to meet again. As a reminder, the committee is discussing the amounts of various drugs and equipment that sedation permit holders must have in the dental office. The current rules have led to some confusion and different inspectors requiring dentists to have different amounts upon inspection. The FDA will continue to monitor and update its members accordingly. However, the BOD did approve the following language:

64B5-14.004 Continuing Education Requirement. (1) Each biennium, all dentists who hold an active sedation permit of any level must complete a four (4) hour board-approved continuing education course in Medical Emergencies, four (4) hours of continuing education in airway management and four (4) hours of continuing education in medical emergencies, every four (4) years from the last date the dentist took the continuing education course. The four (4) hours in airway management must include two hours didactic training in providing dentistry on sedated patients with compromised airways and two hours must include hands-on training in airway management of sedated patients. The continuing education must be taken through a board approved continuing education provider. The continuing education required by this subsection will take effect on March 1, 2014. The continuing education required by this subsection may be included in the thirty (30) hours required by Section 466.0135, F.S. (2) To be approved by the board, the Medical Emergencies continuing education course must include a hands-on airway management component. During the licensure biennial renewal period that begins on March 1, 2020, and ever licensure biennial renewal period thereafter, all dentists who hold an active sedation permit of any level shall take the following continuing education instead of the continuing education required in subsection (1): A four (4) hour board approved continuing education course in Medical Emergencies that shall include airway management as a component of the course. (3) The Medical Emergencies continuing education course must be taken through a board approved continuing education provider. Finally, Dr. Tejera recognized Dr. Leonard Britten, who recently passed away, for his service on the BOD and to the citizens of Florida.

The next BOD meeting is scheduled for Friday, May 20, at 7:30 a.m. ET in Jacksonville. There were six disciplinary cases, three informal hearings, two determination of waivers and one voluntary relinquishment dealing with failing to meet the minimum standard of care especially with the placement of implants, practicing beyond the scope of practice for dentistry and failing to keep adequate records. One dentist had her case dismissed because her records were so detailed that the BOD felt she had acted properly under the circumstances.

Peer Review could keep you from BOD disciplinary action. Only FDA members have the benefit of Peer Review. 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.

FLORIDA DENTAL CHATTER This Facebook group is designed for dentists to interact with other members, receive the latest updates and information, and engage with FDA leaders and staff. This is the place to be in the know!

Join us at facebook.com/groups/floridadentalchatter.

27 | TODAY'S FDA march/april 2022

2022

Award Winners

President’s Award

Dentist of the Year

Dr. David Boden has been practicing periodontics and oral diagnosis in the Treasure Coast of Florida since 1986. He is a graduate of Oakland University in Rochester, Michigan, and received his dental degree from University of Michigan (UMich) in 1981, after which he was a lecturer in oral diagnosis and radiology. In 1982, he entered the UMich graduate residency in periodontics and received his Master of Science degree in 1985. He began teaching at UMich until he met and fell in love with his wife, Carmen, who was a dental resident at the time. Dr. Boden is a believer in giving back to organizations that have helped him. He is a past president of the Treasure Coast Dental Society and has served in many capacities throughout the years. Dr. Boden also has been active with the American Dental Association, (ADA) serving as past chair of the Council on Ethics, Bylaws, and Judicial Affairs, and as a member of the ADA Committee on Education and Ethics, and Council on Dental Education and Licensure. Dr. Boden has served as a trustee for the Florida Dental Association (FDA) and currently serves as president. In addition, he is a member of the Florida Association of Periodontists and the American Academy of Periodontics. Dr. Boden and Carmen have two children, Francisco and Maria, and they enjoy long-distance hiking, bicycling and tandem bicycle riding when they travel.

Dr. Daniel Gesek Jr. is a board certified oral and maxillofacial surgeon practicing in Jacksonville. Dr. Gesek grew up in Olean, New York, and received his undergraduate degree in chemistry from Alfred University in 1987. He then graduated from the University of Pennsylvania School of Dental Medicine in 1991 and went on to study oral and maxillofacial surgery at the Washing Hospital Center in Washington, D.C., completing his residency in 1995. He married his beloved wife, Stacy, in 1991, and they have three sons, who are now fully grown and in college.

Dr. David Boden

Dr. Daniel Gesek Jr.

Dr. Gesek has served as a delegate and alternate delegate to both the FDA and ADA House of Delegates (HOD), as well as the Florida and American Association of Oral and Maxillofacial Surgeons (AAOMS). He has been a member of multiple councils and committees for the ADA and FDA, as well as serving as the chair of the ADA Council on Dental Education and Licensure. He currently is the vice chair of the ADA Council on Governmental Affairs as well as member of the FDA Board of Trustees (BOT). Additionally, Dr. Gesek was a member of the Florida Board of Dentistry (BOD) from 2007-2015 and chair from 2012-2013. He has been heavily involved in anesthesia nationwide, having rewritten anesthesia guidelines for the state of Florida, the ADA and the American College of Emergency Physicians. Dr. Gesek served as the chair of the 2021 Florida Mission of Mercy (FLA-MOM) in Jackson-

ville, which treated more than 1,000 patients and provided $1.6 million in care for the underserved and uninsured in Florida. Dr. Gesek has actively coached baseball through the years in Ponte Vedra and Jacksonville, and he enjoys reading, golfing, raising his children and giving back to the community.

has led him to teach at dental colleges across the country and he currently serves on the Board of Governors for Tel Aviv University. He and Cheryl were married for 55 years until her death in October 2021. They have two grown children, Marra and Michael, and one granddaughter, Abigaile.

J. Leon Schwartz Lifetime Achievement Award

Leadership Award Dr. Lee Anne Keough

Dr. Howard Pranikoff

Dr. Lee Anne Keough received her dental degree from the University of Florida College of Dentistry (UFCD). She completed a post-graduate general practice residency at the VA Hospital in Gainesville and served as a junior faculty member in the UFCD Endodontic Department, where she obtained her Master of Science in endodontics. Prior to dental school, Dr. Keough worked as both a dental hygienist and a dental assistant. She is a past president of the Florida Association of Endodontists and a two-time president of the Central Florida District Dental Association. She has served as both a delegate and alternate delegate to the FDA, served on the FDA Governmental Action Committee and is currently the chair of the FDA Council of Financial Affairs. Dr. Keough has supported and participated in the past five FLA-MOM events, serving as the radiology lead for the past two years. In addition to her work at the state level, she was instrumental in coordinating advocacy for continued community water fluoridation in Ocala and remains active in the Marion County Dental Association as well as leading a multi-discipline dental study club. t

Dr. Howard Pranikoff was born in Syracuse, New York, and graduated from Syracuse University in 1964 with a B.A. in zoology. In 1966, he married his high school sweetheart, Cheryl, while attending graduate school at Syracuse University. During this time, he decided to pursue a career in dentistry and moved to Buffalo. He attended the State University of New York at Buffalo School of Dentistry and graduated in 1971, followed by a dental internship at Upstate Medical Center in Syracuse. After his internship, he moved to Daytona Beach where he practiced general dentistry for five years. In 1979, he attended Boston University (BU) Henry M. Goldman School of Graduate Dentistry and obtained his Master of Science in endodontics. He practiced endodontics in upstate New York and then in Ormond Beach, Florida, until his retirement in 2018. Dr. Pranikoff has a passion for organized dentistry and for leading and mentoring those around him. He was a leader in many organizations, including the ADA, Volusia County Dental Association and the Jewish Federation of Volusia & Flagler Counties. Dr. Pranikoff has served the FDA throughout the years as a member of the HOD and BOT, and as a member of the FDA Services Board of Directors, where he served as vice president in 2015-2016. In addition, he is a current BOT member for the Alpha Omega International Dental Fraternity and has served in many leadership positions including as international president in 2004. Dr. Pranikoff’s passion to mentor and teach others

Leadership Award Dr. Angela McNeight

Dr. Angela McNeight is an owner orthodontist at Caudill & McNeight Orthodontics with three locations in her hometown of Brevard County, Florida. Dr. McNeight currently serves as the president of the Brevard County Dental Society (BCDS) and the chair of the FDA Leadership Development Committee. With the BCDS, she created an annual Give Kids A Smile (GKAS) clinic event that has provided more than $80,000 of free dental care to more than 350 children during the past five years. When community water fluoridation was removed from the city of Mims’ water supply in summer 2021, she created and lead a task force of local and national health professionals who collaborated to advocate for the health of Brevard County residents. Dr. McNeight also serves as the new and younger alternate delegate to the Southern Association of Orthodontists and is extremely involved in her community with the Junior League of the Space Coast, Inc. She has been named a “Space Coast Business Under 40” award winner and a finalist for the LEAD Brevard’s “4 Under 40” award.

New Dental Leader Dr. Mariana Velazquez

Dr. Mariana Velazquez was born and raised in Caracas, Venezuela, where she pursued the same career path as her mother and 21 other family members. She completed dental school at the Universidad Central de Venezuela, where she graduated at the top of her class. Dr. Velazquez completed her oral and maxillofacial surgery internship and residency at Boston University (BU). She also served one year in general surgery and had extensive training in anesthesiology. Dr. Velazquez belongs to several professional organizations,

including the AAOMS, Florida Society of Oral and Maxillofacial Surgeons, ADA, FDA and South Florida District Dental Association (SFDDA). She currently serves as the SFDDA immediate past president. Dr. Velazquez is a Diplomate of the American Board of Oral and Maxillofacial Surgeons. She has hospital affiliations with Baptist Hospital, South Miami Hospital, Doctors Hospital and Nicklaus Children’s Hospital. Dr. Velazquez’s areas of interest are dentoalveolar surgery, implantology, anesthesia, pathology, and facial trauma and reconstruction.

Dental Team Member Award Mrs. Teresa Posada-Wilcher

Mrs. Teresa Posada-Wilcher is the youngest of six children and was born in Tampa while her father was stationed at MacDill Air Force Base. After moving to Delaware, the family returned to Tampa upon her father’s retirement. Mrs. Posada-Wilcher began her dental career in 1987 working in Dr. Terry Buckenheimer’s dental office, and it was there she learned what great dentistry looked like. She was inspired to be the best dental assistant she could and credits the culture of the office for her growth and confidence. In 2010, she earned her B.A. in social science. Mrs. Posada-Wilcher met her husband (another military kid), as a child and they married many years later. Together they have two children: a son, Angel, and daughter, Dominique. Angel and his wife, Maria, have given them two beautiful granddaughters, Mia and Michelle.

Dental Student Award Ms. Sophia Mohseni

Ms. Sophia Mohseni is a fourth-year dental student at UFCD, where she has been a leader throughout dental school and works as a tutor and teacher for dental students in pre-clini-

cal courses. She is passionate about doing her part to bridge the access-to-care barriers many patients face. Ms. Mohseni has worked with local and student organizations at UF to empower the local community with the knowledge and resources to make healthier choices. In addition, she focuses her work on patients with special health care needs. Ms. Mohseni was instrumental to restarting the American Association of Public Health Dentistry at UFCD. This organization was previously active on campus but had lost its presence over the years. Together with a group of her peers, she helped rebuild its foundation and went on to serve as the organization’s president. When she’s not busy with dental school and serving those in her community, she enjoys spending time with family and friends.

Public Service Award Dr. Greg Scott

Dr. Greg Scott was born in Grand Haven, Michigan, and moved to Pompano Beach, Florida, to complete high school. He attended UF for three years and transferred to Eastern Michigan University to complete a B.A. in English and B.S. in biochemistry in 1976. He received his dental degree from Georgetown University in 1985 and completed orthodontic residency at University of Detroit Mercy in 1987. Dr. Scott has been practicing orthodontics in Lakeland since 1987. He was married to his wife, Michelle, for 40 years until she passed away in 2019. They have three sons: Jonathan, Patrick and Paul. His oldest son, Jonathan, is his partner in their orthodontic practice in Lakeland.

Public Service Award Dr. Reza Iranmanesh

2021 Florida Mission of Mercy Hospitality Committee

Dr. Reza Iranmanesh graduated from Tehran University School of Dentistry. He later earned his master’s degree in prosthodontics at BU and has practiced comprehensive full-mouth rehabilitation since 1989 in Tampa. Dr. Iranmanesh held a part-time position as a courtesy clinical professor in the UF Prosthodontics Department. Currently, he lectures once a year for post-doctoral prosthodontics at BU. He is a past president of the Florida Prosthodontist Association, West Coast Dental District Association and the Hillsborough County Dental Association (HCDA). He has served as dental board examiner in Florida and has been delegate or alternative delegate in the FDA HOD since 2004. Dr. Iranmanesh served as chair for Access to Care in the HCDA where he has led and participated in GKAS for several years. Dr. Iranmanesh is passionate about FLA-MOM and has served at every event since 2014. His mission is that no person in the line should leave without receiving treatment.

Ms. Angie Brown, Ms. Stacy Gesek, Ms. Kathy Ilkka Ms. Angie Brown has been a dental hygienist for more than 27 years. Since 2015, she has been the office manager for an orthodontic practice in Jacksonville. Ms. Brown uses her dental knowledge in tandem with her managerial skills to ensure the practice runs smoothly and patients always feel welcomed. Ms. Brown’s care for the safety of the citizens of Florida has made her an integral part of the dental team and has extended outside the office in her role as a member of the Florida BOD. Appointed by Gov. Rick Scott, she served on the BOD for six years and was the chair of the Rules Committee in 2018. Thanks to her leadership in that role, the BOD passed rules allowing for expanded restorative t

functions for assistants and hygienists that went into effect in June 2019. Ms. Brown also has been a longtime volunteer with FLA-MOM using her skills and experience to help those Floridians most in need. When she is not at the office or volunteering in dental clinics, she enjoys spending time with her grandchildren.

Ms. Stacy Marie Gesek was raised in the Tampa Bay area of Florida and graduated from Gulf High in 1986. She married Dr. Daniel Gesek in 1991 and worked for JW Marriott while her husband finished his residency in Washington, D.C. In 1995, they moved to Jacksonville where they still reside. Together they have three children, all boys, who are currently in college. Ms. Gesek enjoys participating in philanthropic activities to help others succeed. In 2021, she was the FLA-MOM Hospitality Committee lead. Along with her colleagues, Ms. Angie Brown and Ms. Kathy Ilkka, she ensured that all the FLA-MOM 1,177 volunteers were well fed and taken care of so they could provide needed care for patients.

Ms. Kathy Ilkka was born in Baltimore, Maryland, and raised in Orlando with her sister and brother. She received her Bachelor of Design degree from the UF College of Fine Arts and worked in Orlando at a printer, then as a staff artist for Orlando Regional Medical Center (ORMC). She met the love of her life, Don Ilkka, on a blind date in 1983 and they married in 1985. Dr. Ilkka’s dental practice is in Leesburg, so after working at ORMC for several years, she began freelance work in Lake County to be closer to home. They have three wonderful children, John, Jacob and Anna. John and his wife, Jo, and their youngest child, Anna, volunteered at the FLA-MOM events in Orlando (2019) and Jacksonville (2021). In her free time Ms. Ilkka enjoys animals, especially horses, and enjoys riding dressage.

Special Recognition Award Dr. Yoshita Patel Hosking

Dr. Yoshita Patel Hosking attended Case Western Reserve University in Cleveland, Ohio, earning a B.A. in medical anthropology. She went to dental school at the University of Michigan in Ann Arbor, where she met her husband, Dr. Michael Hosking (an endodontist). Realizing that treating pediatric and special needs patients was her passion, she completed a one-year hospital-based residency in Madison, Wisconsin, followed by a two-year residency in pediatric dentistry at the University of Texas (UT) Health Science Center in San Antonio and concurrently completed a master’s in public health from the UT Houston. In her spare time, she enjoys spending time with her husband, their adorable son and daughter, going on walks with their fur baby (Nemo), cooking/eating international cuisine, dancing and running. She is classically trained in a few styles of Indian dance and loves supporting the arts, her Brevard community and cultural activities.

Helping Members Succeed Team Impact Award Mr. Rick D’Angelo

Mr. Rick D’Angelo graduated from Florida State University with a degree in risk management and insurance. He began working for FDA Services in August 2002 as a college intern. Twenty years later, he is now the director of sales for the West Coast. Mr. D’Angelo has continued his education in insurance, obtaining two designations over the years: certified insurance counselor (CIC) and certified risk manager (CRM). He is currently working on his third designation, which he will complete by the end of the year. He is married to his amazing wife, Jennifer, and they have two children, Ella and Ricky, whom they love to spend time with.

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FDC2022 | Q & A

fdc2022 scientific program chair q&a By Stephen Perez, DDS

When is FDC2022 and how do I register? The 2022 Florida Dental Convention (FDC) will take place June 23-25. Visit floridadentalconvention.com to register. Don’t forget: Registration is free for Florida Dental Association (FDA) members until June 10.

What can I expect on this year’s scientific program? FDC2022 will feature a comprehensive technology-rich scientific program with more than 130 continuing education (CE) courses and hands-on workshops for the entire dental team, including: Pankey Essentials 1: A 3-day Workshop (PE1), a 3D printing mini-residency, courses on whole-body health and wellness, sleep disorders and gingival grafting.

Should I bring my team? What is available for them? Of course, FDC2022 offers something for everyone on the dental team! There are many morning and afternoon sessions designed specifically for hygienists, dental assistants and business/admin team members.

What makes FDC unique? FDC is the premier educational and social dental event of the year, and it all takes place in one beautiful venue, the Gaylord Palms Resort & Convention Center in Orlando. Come for the CE, stay for the fun!

The speakers sound magnificent. Who are you particularly excited to hear from? I am really excited to hear Drs. George Merijohn, Jonathan Ng and Javier Vasquez — all of whom are phenomenal speakers and will bring their expertise for the first time to FDC this year.

What three things should FDC attendees be sure to do outside the education sessions and exhibit hall?

• • •

Attend Dueling Pianos on Thursday night. Attend the Sea Vibes party on Friday night. Enjoy the resort’s fabulous water park or attend a Disney World 50th Anniversary event nearby. Discounted tickets to Walt Disney World are available to FDC attendees.

FDC is unique in terms of its size, interactive nature and science focus. What advice would you give to someone attending their first convention? I would be sure to attend the opening sessions on Thursday and Friday mornings (NC01 and NC07), take in as much CE as you can, visit the Exhibit Hall, and leave some time to relax and enjoy Gaylord Palms.

Is there a virtual component? There is not a live virtual component, but you can purchase audio recordings of FDC courses at $20 each or the entire conference package for $199 at education.floridadental.convention. com.

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Buyer Seminar

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Seller Seminar

Friday, May 13th, 2022 9:00am-12:15pm

Gaylord Palms Resort Florida Dental Convention State Meeting 6000 W. Osceola Pkwy, Kissimmee, FL 34746 Greg Jones Doctor’s Choice Dental Praccce Broker

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Pankey Essentials 1: A 3 Day Workshop | PE1 Thursday, June 23-Saturday, June 25 | 8 AM-5:30 PM, All Days Aesthetic/Treatment Planning | CE Credit: 33.5 | Audience: Dentists

Transform your experience of practicing dentistry and REGISTRATION CATEGORY increase predictability, profitability and fulfillment. The DENTIST - FDA/ADA MEMBER Pankey Institute’s Essentials Series is the key, and aesthetic NON-MEMBER DENTIST and functional treatment planning is where your journey begins. Following a system of risk assessment, patient ownership and risk management creates technical excellence and predictability. Practicing dentistry the way you want, doing the procedures you enjoy most with patients who value and appreciate you and the exceptional care they receive. This course is built on an exam, diagnosis and treatment planning system based on five key areas: aesthetics, occlusion, restorative, biology and the patient. You will leave proficient with this process and ready to incorporate it into your practice the very next day. Lunch will be provided on Thursday through Saturday. Attendance is limited to 24. Register early to secure your seat before the course sells out!

March 1-May 23 $4,999 $5,199

P SAVE U00 TO $8 nkey

Pa g n i k a t by 1 at s l a i t n e Ess 2! FDC202

See the FDC2022 Registration Brochure for attendee online pre-coursework requirements.

Pankey Essentials 1 Speakers

DR. LEE ANN BRADY

DR. DEANNE BLAZEK

DR. MICHAEL CRETE

DR. MICHAEL MELKERS

DR. CHRISTINE SHIGAKI

ASSISTANTS CAN ALSO EXPERIENCE PANKEY AT FDC2022! The below courses by Dr. Edwin McDonald are aligned with The Pankey Institute’s learning philosophy. Deep dive into The Pankey Institute’s philosophy of personal and professional fulfillment. For more than four decades The Pankey Institute has been at the forefront of dentistry, changing the lives of dentists, technicians, team members and patients through their comprehensive advanced education and friendly community. Now is your chance to immerse yourself in these teaching at the Florida Dental Convention! Master Assistant Class: The Seamless Clinical Appointment | C11 Thursday, June 23 | 9 AM-12 PM CE credits: 3 Discounted price of $49 for assistants.*

Master Assistant Class: Building Clinical Competency | C23 Thursday, June 23 | 2-5 PM CE credits: 3 Discounted price of $49 for assistants. *

The Art and Science of Provisional Restorations for Assistants | C36 Friday, June 24 | 9 AM-12 PM CE credits: 3 Discounted price of $49 for assistants. *

Register for C11 and C23 on Thursday and get a $20 LUNCH VOUCHER for Exhibit Hall Concessions! The Art and Science of Provisional Restorations for Assistants Workshop | W15 Friday, June 24 | 2-5 PM CE credits: 3 Discounted price of $239 for assistants.*

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It’s a win-win! While the dentist is taking the Essentials 1 course, assistants can attend

DR. EDWIN MCDONALD

2.5 days of courses offered by Pankey Institute faculty, Dr. Edwin McDonald, for a parallel learning experience. Seating is limited. Register today! * Early Bird discounted course pricing ends on 4/15. 39 | TODAY'S FDA march/april 2022

FDC2022 HIGHLIGHT

THE PEEL TECHNIQUE

A New Paradigm in Pediatric Tongue-Tie Treatment: A Two-day Mini-Residency (MR01)

THURSDAY, JUNE 23 & FRIDAY, JUNE 24 | 9 AM-5 PM, BOTH DAYS PEDIATRIC | CE CREDITS: 14 | AUDIENCE: DENTISTS REGISTRATION CATEGORY

EARLY 4/15

REGULAR

ONSITE 6/10

DENTIST - FDA/ADA MEMBER

$849

$879

$899

NON-MEMBER DENTIST

$879

$909

$929

In this two-day mini-residency, attendees will be introduced to the concept of laser frenectomies, an increasingly popular method by which dentists and physicians can treat tongue- and lip-ties in their patients. Five percent or more of the babies born in the United States have such tight tongue-ties and frenum pulls that they cannot successfully latch onto their mother’s nipple and breastfeed. For the baby, serious consequences include loss of weight and the label of “failure to thrive.” For the mother, this results in sore and cracked nipples, mastitis, painful engorgement and post-partum depression due to an inability to nurse her baby. This has classically been treated by a physician taking a scalpel or a pair of scissors to the newborn’s mouth and cutting the attachment. The treatment of choice, however, is for a dentist to use laser technology to painlessly and bloodlessly remove the attachment, allowing the infant to immediately nurse. Though many practitioners perform tongue-tie release, few are trained in the PEEL Technique™. This technique ensures that the four movements the tongue must make in order to nurse successfully can be performed: peristalsis, elevation, extension and lateralization. Attendance is limited to 32. Participant Requirements: Loupes, tweezers/cotton pliers and periosteal elevators are recommended. Dentists who own diode lasers are encouraged to bring them if they want to be certified on their own units – otherwise lasers will be supplied for the attendees. Attendees who successfully complete MR01, as well as the online Course Examination, will be awarded a Certificate of Dental Laser Proficiency, recognized by the American Board of Laser Surgery. The Course Examination is not mandatory but is highly recommended. View the complete course description and participant requirements in the FDC2022 Registration Brochure.

Dr. Robert Convissar earned his dental degree from New York University College of Dentistry. He is a fellow of the American Academy of General Dentistry and American Society of Laser Medicine and Surgery and diplomate of the American Board of Laser Surgery. Dr. Convissar maintains a private practice in New York. Ms. Joy Funston is a registered nurse and international board certified lactation consultant. She is the founder and CEO of Joyful Start and board member of the International Affiliation of Tongue-tie Professionals. The equipment for this mini-residency is partially sponsored by

CORPORATE CLASSROOMS at fdc2022! THURSDAY, JUNE 23

FRIDAY, JUNE 24

CYBER SECURITY AWARENESS AND TRAINING FOR YOUR BUSINESS | C02

MAKING 2022 A BANNER YEAR: USING THE LATEST MARKETING TOOLS TO INCREASE EFFICIENCY, GROW YOUR PRACTICE AND INCREASE YOUR REVENUES | NC09

MR. CLAY ARCHER 9-11 AM | CE CREDITS: 2 Sponsored by DPC Technology.

PREPARING FOR PRACTICE OWNERSHIP: ASPIRING DENTISTS TO BECOME PRACTICE OWNERS | NC04

MR. PHILLIP DIDONATO, MR. JASON NUNEZ & MR. NILESH PATEL 9 AM-12 PM | CE CREDITS: 0 Sponsored by Bank of America Practice Solutions.

JUST HOW EASY IS IT TO FALL VICTIM TO A CYBERCRIMINAL? TOO EASY WHEN HACKERS SUCCESSFULLY ATTACK EVERY 39 SECONDS! | C22 MR. ROBERT MCDERMOTT & MR. DAVE FIDANZA 2-4 PM | CE CREDITS: 2 Sponsored by iCoreConnect.

CLINICAL APPLICATIONS OF BONE GRAFT CEMENT WORKSHOP | W06 DR. MICHAEL KATZAP 2-5 PM | CE CREDITS: 3 *COURSE FEES APPLY. Sponsored by Augma Biomaterials.

DR. JOSHUA GINDEA 9 AM-12 PM | CE CREDITS: 0 Sponsored by Doctors Internet.

COMPLETE HOLISTIC FINANCIAL AND WEALTH MANAGEMENT FOR YOUR DENTAL PRACTICE | NC11 MR. RIAD SHANAWANY 9 AM-12 PM | CE CREDITS: 0 Sponsored by Myriad Capital.

ARE YOU READY FOR OWNERSHIP OR RETIREMENT? START PLANNING TODAY! | NC13

MR. GREG JONES, MR. MICHAEL DEMEOLA & MR. JASON KAPLAN 2-5 PM | CE CREDITS: 0 Sponsored by Doctor’s Choice Practice Transitions LLC.

FINANCIAL SUCCESS FOR A PRACTICE OWNER’S BUSINESS & PERSONAL GAIN | NC19

MR. ERIC MILLER 2-4 PM | CE CREDITS: 2 Sponsored by Econologics Financial Advisors LLC.

REE F e r a s e s cour Lecture & ADA Members for FDA e-registration! r during p SATURDAY, JUNE 25 THE EPIDEMIC OF DENTAL EMBEZZLEMENT — DIAGNOSIS, TREATMENT AND PREVENTION | NC14 MR. MICHAEL DEMEOLA 9 AM-12 PM | CE CREDITS: 0 Sponsored by Getsee & DeMeola LLC.

MINI DENTAL IMPLANTS FOR LONG-TERM FIXED AND REMOVABLE PROSTHETICS | C64 DR. TODD SHATKIN 9 AM-12 PM | CE CREDITS: 3 Sponsored by Shatkin F.I.R.S.T. LLC.

SOCIAL MEDIA AND INTERNET MARKETING FOR DENTAL PRACTICES | NC17 MR. SHAY BERMAN 2-5 PM | CE CREDITS: 0 Sponsored by Digital Resource.

A PRACTICE OWNER’S GUIDE TO THE BUSINESS SIDE OF DENTISTRY | NC18 MR. CASEY HIERS 2-4 PM | CE CREDITS: 0 Sponsored by Four Quadrants Advisory.

TH AN KS TO OUR S P ON S OR S !

CE HIGHLIGHT

UTILIZING 3D PRINTING TECHNOLOGY IN GENERAL DENTISTRY: A TWO-DAY MINI-RESIDENCY (MR02) FRIDAY, JUNE 24 & SATURDAY, JUNE 25 | 9 AM-5 PM, BOTH DAYS TECHNOLOGY/OCCLUSION | CE CREDITS: 14 AUDIENCE: DENTISTS, ASSISTANTS, LABORATORY TECHNICIANS REGISTRATION CATEGORY

EARLY 4/15

REGULAR

ONSITE 6/10

DENTIST - FDA/ADA MEMBER

$1,595

$1,695

$1,795

NON-MEMBER DENTIST

$1,695

$1,795

$1,895

TEAM MEMBER

$1,595

$1,695

$1,795

The opportunities for 3D printing and scanning and integration into other dental office systems like Cone Beam CT imaging is expanding at an alarming rate. This twoday mini-residency will discuss the practical ways to incorporate this technology into the general dental office and the tremendous potential that it has for return on investment. Topics will include 3D printed study models, surgical guides, in-office aligners and occlusal guards. Particular emphasis will be placed on the workflow that team members can support. Attendance is limited to 30. Participant Requirements: PC laptop, if participant owns one. At the end of this mini-residency, participants will be able to: ■ understand the current printing technology and choose the best option for your practice. ■ explore opportunities for 3D printing in general dentistry. ■ create a printing workflow that has a strong ROI. ■ empower your team to perform digital tasks.

Dr. Mark Kleive earned his dental degree from the University of Minnesota School of Dentistry. He is a visiting faculty member of The Pankey Institute and fellow of the American College of Dentists. Dr. Kleive maintains a private practice in Black Mountain, NC.

ACT F A ONLY ST! REM 20 AINI

NG!

F LO RIDA DEN TAL CONV EN T ION P RES ENT S

DUELING PIANOS FEATURING HOWL AT THE MOON’S

THURSDAY, JUNE 23 8-11 PM

Featuring the biggest hits and the crowd’s best requested songs, Dueling Pianos will keep you rockin’ all night long. Name badges are required for attendees over 8 years of age.

FREE

FOR ALL ATTENDEES!

Get Free Course Tuition! Volunteer to be an FDC Speaker Host at FDC2022!

Volunteers provide an invaluable service to the Florida Dental Convention. Speaker Hosts will be responsible for introducing the speaker, making announcements in front of the course, passing out and collecting surveys, and contacting convention staff if AV assistance is needed. Volunteering has its perks!

• All Speaker Hosts receive a $20 lunch voucher for Exhibit Hall concessions.

• Lecture Speaker Hosts receive free course tuition for the hosted course. Volunteer today at education.floridadentalconvention.com

QUESTIONS?

Contact Mackenzie Johnson at mjohnson@floridadental.org or 850.350.7162.

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

Contact FDC Marketing Coordinator Brooke Martin at bmartin@floridadental.org or 800.877.9922. 46

FDC2022 HIGHLIGHT

ADVANCED APPLICATIONS OF BOTULINUM TOXIN WORKSHOP (W19) SATURDAY, JUNE 25 | 8 AM-5 PM BOTULINUM TOXINS | CE CREDITS: 8 AUDIENCE: DENTISTS, ASSISTANTS EARLY 4/15

REGULAR

ONSITE 6/10

DENTIST - FDA/ADA MEMBER

REGISTRATION CATEGORY

$1,799

$1,899

$1,999

NON-MEMBER DENTIST

$1,899

$1,999

$2,009

$199

$214

$229

ASSISTANT*

This intense one-day workshop will build on the fundamental knowledge of botulinum toxin and will expand the attendee’s scope of practice. Techniques learned in a hands-on botulinum toxin level one or equivalent course will be refined and comprehensive lower face treatments will be covered in detail. Attendees will have the unique opportunity to perform advanced techniques to improve results in upper and lower face botulinum toxin treatment, correct asymmetric smiles, expand neuromodulator portfolios and understand rationale for toxin choice. Upon completion of this full-day course, attendees will have the confidence and skills to grow their existing botulinum toxin practice even further. Attendance is limited to 20. *Paid team member learning is a co-learning experience with a paid doctor attendee. Participant Requirements: Attendees must (1) provide proof of course completion for a hands-on level one botulinum toxin course or other comparable introductory hands-on course two weeks prior to attend, (2) provide proof of current professional liability insurance two weeks prior to the workshop to attend, and (3) must bring their own model patient. View the full course description and participant requirements in the FDC2022 Registration Brochure.

Dr. Tracy Shaw-Blessing earned her dental degree from Tufts University School of Dental Medicine and completed a residency program Coler-Goldwater Specialty Care Hospital. She is the founder and CEO of Aesthetic Interface. Dr. Shaw-Blessing maintains a private practice in Palm Beach Gardens and Miami Beach, FL.

ACT F A ATTE NDA ST! LIMI NCE T I S ED T O 20 !

fdc2022 ... it’s a team thing!

10 REASONS TO BRING YOUR TEAM 1. Reward your team for “having your back” with a trip of learning, CE earning and networking! 2. Having fun with your coworkers = happier employees! 3. Create synergy and new ideas with team building courses. 4. Show your comradery in matching office T-shirts.

COME FOR THE CE, STAY FOR THE FUN AT FDC2022 JUNE 23-25, 2022 GAYLORD PALMS RESORT & CONVENTION CENTER ORLANDO, FLORIDA

5. Build team morale at the free keynote sessions. 6. Connect and unwind at the nightly social events. 7. Be [rock]stars with the VIP experiences. 8. Learn new skills to implement in the office. 9. Discover new products in the Exhibit Hall. 10. And most importantly, HAVE FUN with your team!

DON’T NEED CE?

VISIT THE EXHIBIT HALL FOR FREE! Connect with 300+ Exhibitors with a FREE Exhibit Hall Only Pass at FDC2022!

Exhibit Hall Hours

Thursday, June 23 | 11 AM-6 PM Friday, June 24 | 8:45 AM-6 PM Saturday, June 25 | 9 AM-2 PM

*Available for dentists, team members and guests/spouses. Not eligible for CE courses.

Register as “Exhibit Hall Only” to take advantage of this offer.* » BUILD RELATIONSHIPS with current and existing vendors. » NETWORK with colleagues and vendors at the Welcome Cocktail Reception in the Exhibit Hall Thursday, June 23, 4-6 PM. » DISCOVER new products, services and technologies in the Corporate Learning Corner sessions. » MAXIMIZE your time with industry-leading exhibitors. View the current list of exhibitors at exhibithall.floridadentalconvention.com.

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SPONSORED BY Name badges are required for all attendees over 8 years of age.

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FDC2022 | SPEAKER preview

The inner game By Randy Fox

Through decades of being inside thousands of games, watching teams win and lose every night and being a part of so many different NCAA officiating crews, there is one aspect of games that drives most of the successes and failures. This might even be something you haven’t given much thought to. It all starts with the six inches between your ears. Your inner game. I’ll summarize it for you like this: The inner game is the most important part of any game. It is the part of the game that protects the mind, fuels desire, controls behavior, guards the mouth, enhances actions for outcomes and ultimately, is the source of every successful person. In short, the inner game is all about what you think; it is the mental aspect of your game. In contrast to those outer skills that you see, the inner game is what you think. It is your thoughts, the little voice in your head that says so much more than your mouth ever does. Here are a few examples of your inner game:

• • • • • •

Your thoughts before and after you respond to someone. Your process when answering tough questions. Your mental approach to discussing important issues. Your response to failure. Your attitude and mood swings, through good and bad moments.

Your inner game is 100% based on how you choose to control your thoughts. The direction and level of success in your life is fueled, sustained and based on your inner game. Your inner game drives your outer game. Like anything else in life, the best thing to do if you want to be better at something is to practice. You need to take steps to be better, and in this case, steps to control your thoughts and not allow negativity and fear to control you. Here are several tools to improve your inner game:

1. Read. Don’t just read anything; read articles and books on communication, having a good attitude and positive thinking. Read about people in life who have established themselves in their field, find out how they think and approach each day. Read, read and read some more!

2. Watch videos. Similar to reading, find the right videos. Sign up to follow people with great content who focus on improving this part of your game. Make sure that insights from thought leaders are filling up your mind.

3. Live life close to and learn from others. Observe others with and without great thought processes; you can learn from both. Surround yourself with people who build you up and bring out your best attributes. Let these people act like mentors and fuel your mind with positive thinking. Oh, and avoid negative people, you can observe them from afar!

Your outlook: Is the glass half full, half empty or overflowing?

“

„

Your inner game is 100% based on how you choose to control your thoughts. The direction and level of success in your life is fueled, sustained and based on your inner game.

4. Be mindful of what you put in your mind .... what you watch on TV, the books you read, the music you listen to, the people you converse with often; all of this impacts your thoughts. You want to think in a positive way and stay strong, so seek out people who do the same. The expression of “garbage in, garbage out” applies. Put in great and get out great!

5. Think differently, live differently. Literally, choose to think differently. When negative thoughts or fears creep in, tell them to go away. As noted in No. 3, you can’t think positively if you are with people who are negative. Don’t waste your time with people who complain, speak negatively and never see anything positive. Walk away. Why?

The great part about your inner game is that you choose — and you need to choose to be better and remain positive. You need to choose to spend time on your inner game. This choice to practice will help you improve, but the focus to get better won’t mean a thing unless you have the right perspective. Your attitude matters. Your attitude is your choice. It’s about your attitude, win or lose, and you choose your inner game.

Mr. Fox is a keynote speaker at the 2022 Florida Dental Convention (FDC) and will be presenting “You’re Missing a Great Game: Life Lessons On and Off the Court” on Friday, June 24 at 7:45 a.m. For more information and to register for FDC2022, visit floridadentalcovention.com.

There’s no time for stinkin’ thinkin’! Negativity begets negativity. You need positive people, messaging and input for your brain to have a positive inner game. Similar to any weight loss program, financial planning system or anything in life, the system is only as good as your ability to use it. Practice, practice, practice. You need to work on these steps to improve your inner game.

53 | TODAY'S FDA march/april 2022

FDC2022 | SPEAKER preview

obtain and maintain healthy posture for seated professionals position. This curve is developed as an infant prior to taking our first footsteps. It is unique to humans as it allows the spine to remain balanced in a fully upright position for extended periods and gives us the ability to walk. The cervical and thoracic curves of the spine also are involved.

By Dianne Saywell, RDH, ERYT, YACEP

Do you love your job? Are you tired of the back pain and body aches that go with it? I sure was! There is a way to obtain and maintain balanced posture, beginning with awareness. Recognizing tight tissue in a sign of discomfort is a particularly important awareness to cultivate. We often are so busy with staff and patient interaction as well as our own internal dialogue that we scarcely remember to simply “tune in.” When we notice the annoyance of the edge of pain, perhaps increasing over weeks or months, we can apply yogic principles (simple principles that connect us to awareness of the body) and stop the cascade into chronic conditions and/or injury. Cultivating awareness is the first step that will help with overall body and spinal integrity in a comfortable full range of motion movement.

One of the most important elemental principles I acquired was the awareness of how to sit while treating patients. Consider your foot placement and leg position in the seated position. The pelvis, sacrum and lower back are immediately affected by their positioning and directly involved in full-posture balance. While working, also consider that the torso and weight of the arms may lean at yet another angle. Often, this position places the body both forward and twisted. It is easy to see how the potential for a stress-related injury is likely to occur. Tasks involving awkward and static postures generate continuous muscle activity. Muscle fibers fatigue as they can only fire for so long. It is imperative to

As many dental professionals and the entire office team can attest, the position we keep our bodies in while working contributes to body pain and can lead to limitation in movement. The repetitive motion combined with the same static positioning leads to imbalance, which may result in injury that often requires attention and treatment and can involve loss of work. Mindful practice of posture combined with breathing, stretching and strengthening key muscle groups regularly will balance the body.

become aware of discomfort in the body when it is a whisper before we hear and feel it scream. Chair seat height is especially important, as we want to be able to place the feet squarely on the floor, with the hips slightly higher than the knees. The slight height of the hips will foster an anterior tilt to the pelvis and maintain the extremely important lumbar curve. Avoiding the feet in a “10-and-2” angle in external rotation of the hips is key to keeping the hips and muscles aligned. The slight angle change and full-foot placement creates a cascade of healthy balance up the legs into the hips and spine. When the foot is placed firmly, we avoid the dysfunction of the other joints as the energy travels upward freely with support.

The Seated Spine Technique When treating patients, the dental professional is seated but also may be rotated at the hips and lower back. The natural curve of the lumbar vertebrae is the most compromised area in a seated

Other areas where pain and limitation can occur in the seated working body are the shoulder joints. They often are slouched as visibility and access issues can create this position in the upper back as well. The front body tends to close in a forward manner in general and as the shoulders round as well, the lungs get restricted. The fortifying action of the breath that delivers freshly oxygenated blood to the organs is compromised and the organs themselves do not receive enough of it. The diaphragm begins to come into habitual dysfunction due to shallow breathing as more fatigue can settle in. Taking a few moments to stand and open the front body with arms up and chest open will restore us in just three to four breaths.

Breathing in Awareness So, how exactly do you “tune in”? It is imperative to take the time to check in with your breath as we move in and out of our daily positions. Counting the breath in a “four-square breath” is a simple technique that brings in oxygen and tunes us into our physical body. This is done with an inhale to the slow, purposeful (and not forced) count of four, maintain the inhale for a count of four, then exhale to the count of four and pausing in the exhale t

“ „ It is imperative to become aware of discomfort in the body when it is a whisper before we hear and feel it scream.

55 | TODAY'S FDA march/april 2022

GOT FLOOD INSURANCE? DON’T GO UNDER! In preparation for hurricane season starting June 1, FDA Services wants to remind you to make sure you have flood insurance in place! If not, we strongly recommend that you look into this coverage NOW as it has a 30-DAY WAITING PERIOD to become active. Visit fdaservices.com or call us at 850.681.2996 to get a quote today!

Came for the insurance ... Stayed to support my profession.

FDC2022 | SPEAKER preview end for four. If this breath can be detected at any time during the day, we are centered and aware of any struggle/tension if this changes at all. More importantly, use the antidote of yoga poses with breath that stretches tension and strengthens weakness. Yoga does not require flexibility, but flexibility and strength can be gained by following one simple concept: observation of the breath in movement and static position. Once this becomes fairly routine, it will be hard to imagine we have lived without this connection to our bodies. Balanced bodies are necessary to support a healthy, pain-free spine. When we are in balance with our bodies, in any position

or range of motion, we create harmony. This sense of equanimity brings us into a more peaceful and freer place in which we move from. This can be felt within us throughout the workplace, with our patients and out into all of life.

Ms. Saywell is a speaker at the 2022 Florida Dental Convention (FDC) and will be presenting “Maintaining the Healthy Spine in the Seated Dental Professional: A Deep Dive into the Yoga Principles to Freedom!” on Friday, June 24 at 9 a.m. For more information and to register for FDC2022, visit floridadentalcovention.com.

FDC2022 | THURSDAY, JUNE 23 | 9-11 AM | $20 TICKET

Chat. Connect. Grow. A Speed Networking Event

Start your morning with coffee, pastries and networking with vendors! Sit back and relax with your colleagues while representatives from 10 leading dental companies rotate to your table. Each vendor will have 10 minutes to present information, update you on their latest products and answer your questions. In this fast-paced, fun networking environment, you are sure to leave with new connections and a growing knowledge of new products, services and technologies. This event is available to registered dentists only. Add your ticket within your FDC registration. Seating is limited, so register today!

Continental breakfast sponsored by

57 | TODAY'S FDA march/april 2022

event, e h t f o d At the en ts will receive a s ! all denti IFT CARD

$50 VISA

FDC2022 | SPEAKER preview

talking total patient health! By Uche Odiatu, DMD and Mahsa Bakhshandeh, RDH

Want to add some variety to your chairside conversations? Want to share cutting-edge scientific findings with your patients? Would you like to be seen as a person of influence with a broad knowledge of nutrition and healthy living strategies? Mahsa Bakhshandeh, RDH, reports, “Some patients still see us [hygienists] as teeth cleaners and aren’t aware of the scope of our education, which includes an intense nutrition component.” Caution: This article contains foundational strategies to support oral health and TOTAL patient health. “All disease begins in the gut.” – Hippocrates, 300 B.C. How did the first physician who the Hippocratic oath is named after have such insight into what has only been recently scientifically uncovered? He didn’t have a microscope or access to the National Institute of Health’s ground-breaking initial Human Microbiome Project findings, but he proclaimed, “Let food be

bacteria’s No. 1 choice of nutrition in which all other interactions depend, reported Justin Sonnenburg, Ph.D., assistant professor in the department of microbiology and immunology at the Stanford University School of Medicine “The human microbiome is only recently thought to influence health as powerful as your genes.” – S. K. Mazemanian, Ph.D., professor of microbiology at California Institute of Technology What is the number one influence on the human microbiome? What we eat, proclaims gastroenterologist Robynne Chutkann, MD. “The food we eat dictates what bacteria grow in our body. And our human microbiome is predominantly (99%) made up beneficial bacteria.”4 What does this have to do with dental patients? Why should we talk food and gut health in its relationship to oral health and overall health? Because the gut flora, our microbiome, play a major role in our immune system health, nutrient absorption, energy levels and emotional well-being.

your medicine and medicine be your food.”

Key Gut Players Mind your guts. Not the outer abdominals but the gut flora on the inside of your belly. We live in harmony with more than 100 trillion single-celled bacteria. Eighty percent of them live in your digestive tract1 and a recent groundbreaking article in Scientific American reported their influence on our health is shaking the very foundation of medicine and nutrition.2 The bacteria in your gut play an important role in immune system modulation. Three-quarters of the cellular constituents of your whole immune system are located in this area.3 If you want to build the strongest foundation for your immune system, you need to eat 25-30 grams of fiber each day to keep your gut flora in good shape. (The average North American consumes half that amount). Fiber is the gut

“Our gut microbiome guides our immune system, metabolism and even our mood and behavior.” – J. Sonnenburg, Ph.D., microbiologist Stanford University School of Medicine5 Now you know why food is so important. Our single-celled passengers have an intimate relationship with them. Their very survival depends on a regular supply of healthy food. And which health care industry professionals oversee the eating apparatus? Is it the chiropodist? Is it the optometrist? The cardiologist? The physiotherapist? No. It is the dental professional — the dentist, dental hygienist and dental assistant. We are the caregivers of the teeth, jaw and muscles of mastication. If people want to be able to break down food and digest it and absorb it (6,000 of our enzymes have bacterial origin),6 they need optimal masticatory function. Eating, digesting and absorption of nutrients is one of the most intimate things we do with our environment. MIC DROP.

“

Patients enjoy and welcome their dental professionals emphasizing total health along with focused attention on oral health. Talking nutrition is relevant to oral health and overall health, is within our scope of practice and lastly, our patients are hungry for it.

Questions from patients are a good opportunity to share our total health knowledge about the body-mouth connection. It also will feel less like we are lecturing patients, as they will have invited us to share once they have made an inquiry. And our answers can go beyond the usual “apples and cheese are healthy snacks and avoid juice and pop.”

What else can I do between hygiene visits to keep my gums healthy? In the days following a dental hygiene appointment — especially if it is a patient who has not been in for regular hygiene — their soft tissues may feel tender for 24 hours or more afterward. For adequate healing, their immune systems need to be in optimal health. We get calls sometimes from patients and they might ask, “Why were my gums tender after the last cleaning?” We can respond: Healing depends on the ability of your immune system to do its job in the healing and repair process. An impeccable diet provides you with the building blocks for healing. Did you know that only 5% of the population eats the recommended 25 g of fiber daily?7 Our gut flora needs a regular intake of fiber — this is a keystone foundational relationship — this is where our gut bacteria make short-chain fatty acids (SCFAs). Bob Hutchkins, Ph.D., food scientist at the University of Nebraska, claims these are some of the body’s most powerful anti-inflammatory agents. Ian Chapple stated most of the destruction of periodontal structures were from the host, and dental professionals need to include host factors when they are creating their treatment plans.8 Ninety-seven percent of the population does not eat the recommended amount of fiber. Without this keystone nutrient for the gut flora, there will be a poor supply of SCFAs. The body cannot put out the fires of inflammation burning in our patients’ bodies.

Roller coaster elevations in blood sugar from poor eating habits promote post-meal dysmetabolism, which supports inflammation and disease.9 Scientists now report that chronic inflammation is a major player in most modern degenerative diseases.

Isn’t once a year hygiene visit enough? Sixty percent of the population reports not getting sufficient sleep to feel rested each night. This raises a red flag, “poor sleepers are poor healers.”10 Seventy percent of the adult population doesn’t eat a single piece of fruit each day.7 Red flag: less phytonutrients, fiber and antioxidants to help douse the flames of inflammation. Only 5% of the population exercises regularly.11 Waving red flag: 95% of patients don’t enjoy the anti-inflammatory benefits of exercise. Anyone who doesn’t have healthy lifestyle habits needs to think about increasing their hygiene frequency to lower their inflammatory burden.

I am at a loss; my gums seem to bleed and be tender no matter what I do? Dental hygienists scale, root plane, debride, floss … our patients need to have a high-functioning immune system to recover and heal after our treatments. Seventy percent of our immune system is in our GI tract. Our gut flora influences our immune cells. They do this through the regulatory T cells. This communication can only work well if the gut bacteria are stable and diverse in variety and if they haven’t been recently decimated by a recent course of antibiotics. Antibiotics have been shown to disrupt one-third of a person’s good bacteria and it can take up to a year to bounce back.12 t

59 | TODAY'S FDA march/april 2022

FDC2022 | SPEAKER preview

My mouth has gotten drier over the last year. Should I be worried?

4. Make fitness friendships. Exercise scientists have reported that people who have more fit friends and live in a fit environment find it easier to keep from falling off the proverbial health wagon. Trying to do it on your own means you’re using will power — which has a finite store of energy. When we harness our environment, there are subtle, but powerful natural reinforcers that can keep our fitness efforts alive. Having fit friends and colleagues provide accountability partners by asking about your workout or participating with you. This supports you in your health and fitness goals.

Epidemiologist Tim Spector, Ph.D., said there are many reasons for the human body deteriorating, such as the loss of muscle and changing social circumstances, but also affirmed the loss of dental integrity and lower amounts of saliva.6 He reported that all other factors accounted for, nutrition and diet stood out as the major factor in influencing the microbiome and its impact on seniors’ health. How many times have you heard from patients as they sit down slowly in the chair, “Getting old is not for sissies,” or “The golden years aren’t so golden.” We can be their health champion by focusing on the importance of maintaining all their teeth and acknowledging the side effects of medicines that cause dry mouth. We can encourage them to preserve arch integrity and replacing missing teeth, stay hydrated and help them choose OTC products to prevent dry mouth.

TOTAL HEALTH TIPS FOR YOU AND YOUR PATIENT 1. Eat free-range, hormone-free meat. Eating hormone-free, antibiotic-free and free-range meat used to be a very expensive food choice. Gastroenterologist Emaran Mayer, M.D., reports that it is now seen as a good investment in our overall health and particularly our gut health. Antibiotics fed to animals as growth enhancers can disrupt our delicate gut flora.

5. Eat more fruits and vegetables. There is irrefutable scientific evidence that food and its macro and micronutrients can ramp up or dial down inflammation in the body. Vegetables and fruits are loaded with phytonutrients, antioxidants, polyphenols, and most of all, fiber — which our gut flora need to make SCFAs, one of the body’s most important anti-inflammatory agents. Health Canada’s new Food Guide makes it perfectly clear: Half of the plate ought to be fruit and vegetables to enjoy optimal health.16

2. Exercise regularly. Regular exercise makes your gut bacteria more diverse in their makeup. This adds to the stability and potency, and most of all, keeps pathogens in balance.13

6. Get good sleep. When you’re awake your body’s repair/recover/rebuild system is running on standby mode. It is only while you’re sleeping that your body launches into its powerful offensive mode, where close to 95% of resources regenerate. Without adequate sleep, opportunistic gut bacteria can get the upper hand and cause disruption.15 We encourage patients to reevaluate their sleep habits to ensure they are getting adequate quality and quantity for optimal GI function.

3. Manage stress. Unmanaged stress also decreases diversity in your gut flora and, therefore, hampers fabrication of the cellular constituents of your immune system. Poorly managed stress or life events that not only rock us emotionally can thin the mucus lining of our stomachs and bring pathogenic bacteria in closer proximity to the general circulation.14

7. Take a good probiotic. Probiotics are good bacteria and can be found in cheese, yogurt, kefir, sauerkraut, miso soup and assorted vegetables. If consumed regularly, they will support optimal gut health and the fortification of an empowered immune system. How about probiotic supplements? Great question, everyone seems to be interested in this popular supplement. There’s sound scientific evidence

for the value of probiotics helping prevent antibiotic-associated diarrhea. It is a developing science, and many different companies are vying for top of mind in the consumer. For everyday use? In a placebo-controlled, double-blind, random-assigned study in the Journal of Strength and Conditioning Research from January 2017,17 it looked at 30 hard-driving athletes and it showed that probiotic supplementation would help rebuild the first-line defense or humoral immune system that gets beaten up from intense training in the winter months. The athletes who took the probiotic had less respiratory illnesses. The authors went on to say the findings could make a case for the consumption by immunocompromised populations (the very young and the very old) who tend to get sick each winter. There are different formulations and numerous brands available in high-end health food stores, grocery stores and pharmacies. We prefer room temperature, stable varieties with multiple strains that are easy to swallow.

References: 1. Bermon S et al. “The microbiota: an exercise immunology perspective. Exercise Immunology Review 2015.

4. Chutkan R. MD., The Microbiome Solution 5. Sonnenburg J & Sonnenburg E., The Good Gut © 2015 Penguin Books 6. Spector T. Diet Myth: The Real Science Behind What we Eat © 2015 Weidenfeld and Nicolson 7. Greger M MD., How Not to Die © 2015 Flatiron Books 8. Chapple L., Potential Mechanisms Underpinning the nutritional modulation of periodontal inflammation” JADA 2009; 140(2): 178-184 9. O’Keefe J, Bell D., Postprandial hyperglycemia/hyperlipidemia is a cardiovascular risk factor. Am Journal Cardiology 2007;100(5):899-904 10. O’Brien M MD., The Healing Power of Sleep © 2009 Biomed General 11. Chek P., Can Fit Pro Annual Personal Trainer Summit. Toronto August 2018 12. Mayer E., The Mind Gut Connection. © 2016 Harper Collins 13. Clarke SF et al. “Exercise associated dietary extremes impact on gut microbial diversity.” Gut 2014 14. Enders G., Gut: The Inside Story of Our Body’s Most Underrated Organ © 2016 (audio) Brilliance Audio 15. Stevenson S., Sleep Smarter © 2016 Rodale 16. Canada Food Guide. https:/food-guide.canada.ca 17. Michalickova, D. M. et al. (2017). Lactobacillus helveticus Lafti L10 Supplementation Modulates Mucosal and Humoral Immunity in Elite Athletes: A Randomized, Double-Blind, Placebo-Controlled Trial. Journal of strength and conditioning research, 31(1), 62–70.

2. Scientific American 2015 Special report. Pp S1-S15 3. Campbell SC & Wisniewski P “Exercise is a novel promoter of intestinal health and microbial diversity” October 2016 American College of Sports Medicine Journal.

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3 Unfounded Fears That Will Cost You During Commercial Real Estate Negotiations By Marshall Barres, CARR

Fear can be a motivating factor but, often, it is baseless, misplaced and ultimately a thief of our desired outcome. Consider an analogy from nature: A tiger can run 30-40 miles per hour, but only in short bursts. A gazelle can sustain speeds of 30-40 mph with bursts up to 60 mph. Based on the numbers alone, a tiger should never be able to catch a gazelle. But with strategy, prowess and striking fear into its prey, a tiger’s pursuit results in the gazelle’s fatal end. This may seem like an extreme or irrelevant analogy to a real estate negotiation, but fear affects humans’ minds just as it does animals’ by clouding our thinking and leading to feelings of intimidation and poor decision-making. It is paralytic and results in an undesired end for one party. The following are three key fears that, once you’ve identified them, can be disarmed and defused to prevent you from losing.

1. Fear of Making a Premature Commitment Many people believe that submitting a letter of intent (LOI) or request for proposal (RFP) on a property commits them to the terms of the deal or to that specific property. This is just a misunderstanding. Negotiations performed via a non-binding LOI in commercial real estate are just that — non-binding — and it’s an acceptable practice to submit non-binding LOIs on more than one property at a time.

With the help of an expert real estate agent, a dental practice can navigate a lease or purchase negotiation at no cost and with confidence, strong posture and competitive options, all of which prevent fear from limiting any desired outcomes.

Submitting terms in the form of an LOI is not a premature commitment, instead it’s a way to address and negotiate the basic financial and business points of a deal before moving forward with the legal expense of drafting and signing a lease or contract. It’s not until a tenant (or buyer) and landlord (or seller) mutually execute a lease or purchase contract that the parties are legally obligated to perform the terms.

2. Fear of Acting Inappropriately There’s a common belief that it’s inappropriate to “shop” for the best offer on the market. This fear could apply to property locations, financing options, service providers, equipment vendors and more. This process of competitive procurement — which savvy business owners always employ — is sometimes labeled as “shopping,” which sounds unrefined or disreputable. However, it’s normal and accepted in the commercial real estate world. As a buyer or tenant, competitively procuring the best possible terms can only be achieved by securing multiple offers from multiple properties to find the best fit. Negotiating with a landlord or seller or requesting a service provider submit a quote does not commit you to that offer, nor is it inappropriate. Instead, failing to competitively procure solutions will surely end in a loss.

3. Fear of Confrontation Most people have this fear innately. It’s something that salespeople and real estate agents must quickly overcome if they’re going to make it in their field. At the root, it’s either a fear of rejection (“What if they think unfavorably of me?”) or a fear of loss (losing relationship status, losing a reputation, losing an argument or losing a good deal in pursuit of a better deal), or both. The truth is that confrontation is not a bad thing. It’s an inevitable path to clarity and a greater outcome for both parties; especially anytime you are dealing with a high-dollar negotiation. When handled professionally, confrontation is respectable and can strengthen a relationship. Leaning on a team of advisors and professionals also helps remove the personal confrontation a doctor feels when going up against a professional landlord and creates a competitive business scenario that drives greater concessions.

Think Like a Human, Not a Gazelle While a gazelle’s fear of a tiger is legitimate, a tenant’s fear of a lease or purchase negotiation, or dealing with a landlord or seller is not. Submitting to fear in a real estate negotiation can lead to a string of bad decisions that can result in six-to-seven-figure losses over the life of a practice. With the help of an expert real estate agent, a dental practice can navigate a lease or purchase negotiation at no cost and with confidence, strong posture and competitive options, all of which prevent fear from limiting any desired outcomes. CARR is the nation’s leading provider of commercial real estate services for health care tenants and buyers. Every year, thousands of health care practices trust CARR to achieve the most favorable terms on their lease and purchase negotiations. CARR’s team of experts assist with startups, lease renewals, expansions, relocations, additional offices, purchases and practice transitions. Health care practices choose CARR to save them a substantial amount of time and money, while ensuring their interests are always first. Visit CARR.US to learn more about our expert representation services.

65 | TODAY'S FDA march/april 2022

Books Books SHELF SHELF We need your help! bookshelf is overflowingand and we we are of of space! OurOur bookshelf is overflowing arerunning runningout out space! us make roomfor forthe thefuture future textbooks receive. HelpHelp us make room textbookswewe receive.

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Send the review to communications@floridadental.org and we’ll post your review on our website. Keep the book — at NO CHARGE — and add it to your own bookshelf!

By Drs. Sumita Sam, Neel Bhattacharyya, Donald M. Cohen and Nadim M. Islam

Read, Learn and Earn!

A 70-year-old male patient was referred to Dr. James Gift, an oral and maxillofacial surgeon in Tampa, for a gingival swelling. The Visit floridadental.org/online-ce for this FREE, MEMBERS-ONLY BENEFIT. You will be given the patient’s medical history was non-contributory, and the patient opportunity toThe review thea pigmented “Diagnostic Discussion” and its accompanying photos. Answer five was asymptomatic. lesion was soft-tissue mass on the right choice lower gingiva involving teeth Nos. 26-28 was first multiple questions to earn oneandhour of CE. noticed several months prior to the biopsy. The brown-grey pigmentation was seen diffusely throughout the lesion, and some pigmentation also was noted on the adjacent gingiva (Fig. 1). No Fig. 1: Gingival swelling with diffuse and irregular pigmentation findings were noted upon radiographic analysis. The clinician’s differential included melanotic macule and melanoma. An incisional biopsy was performed and submitted to the University of Contact FDC Marketing Coordinator Brooke Martin Florida Oral Pathology Biopsy Service for a diagnosis. t

at bmartin@floridadental.org or 800.877.9922.

Question: Based on the above history, clinical presentation and radiographic findings, what is the most likely diagnosis? A. Melanotic macule B. Non-Hodgkin lymphoma C. Melanoma D. Kaposi sarcoma E. Peripheral giant cell granuloma (PGCG)

69 | TODAY'S FDA march/april 2022

quiz A. Melanotic macule Incorrect. Melanotic macules are commonly seen in the oral cavity and appear as a flat, brown mucosal discolorations. The lip vermillion is the most common location, and frequent intraoral locations include the gingiva, buccal mucosa and palate. Though the lesion is observed over a broad age group, it is most frequently diagnosed during the fifth decade with a 2:1 female predilection. The lesion typically appears as a solid, well-demarcated macule that is less than 7mm in diameter. Brown pigmentation often is observed, though it may occasionally exhibit blue or black pigmentation. Once it develops, the macule remains consistent in size, a feature that helps distinguish it from melanoma. Though the current lesion is pigmented, the large swelling is not consistent with a melanotic macule. In addition, the pigment includes several colors and is irregular and diffuse. These unusual features should alert the clinician for further evaluation and biopsy. Microscopically, melanotic macules exhibit an increase in melanin in the basal layer of the epithelium. Some melanin pigmentation may be observed in the subepithelial connective tissue. Though benign, melanotic macules may mimic incipient melanomas, especially if observed on the hard palate or gingiva. The lesion should be observed for changes in size, shape and color, all of which would warrant a biopsy.

B. Non-Hodgkin lymphoma Incorrect, but great guess! Non-Hodgkin lymphoma (NHL) includes a broad group of lymphoreticular malignancies that primarily affect the lymph nodes. Most NHLs are of B cell lineage, but T cell and histiocytic malignancies are occasionally observed. Adults are usually affected, though aggressive subtypes may involve children. Extranodal involvement is not infrequent; 20-40% of all cases are seen in these sites. The oral cavity is a common extranodal site, and NHL is frequently observed in Waldeyer’s ring (nasopharyngeal tonsils, palatine tonsils and lingual tonsils). Intraorally, NHL often presents as soft-tissue swelling or mass exhibiting a red-purple hue and boggy consistency. The lesion also may occur centrally within the jaw and cause significant bone destruction. An ill-defined, “moth-eaten” radiolucency is commonly observed, though early lesions may not produce these characteristic changes. NHL may cause significant cortical destruction and perforation and emerge as a soft-tissue mass. Pain and paresthesia are not unusual findings and patients may complain of vague tooth pain. In the current case, a soft-tissue

swelling is observed with diffuse pigmentation. While a soft-tissue swelling is frequently observed in oral NHL, brown-speckled pigmentation is not a usual feature. Microscopic analysis reveals a proliferation of abnormal lymphocytic cells, often in varying stages of differentiation, which helps narrow the subtype of lymphoma. In the oral cavity, diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma observed. Treatment of NHL depends on the specific type, histologic grading and clinical staging. For DLBCL, most patients begin multiagent chemotherapy. The field of treatment continues to evolve with novel therapies that target immune checkpoints, signalling pathways and cellular immunotherapy, ultimately improving the prognosis and outlook for this disease.

C. Melanoma Correct! Primary oral mucosal melanoma is a rare entity and comprises less than 1% of all melanomas in the U.S. Though melanoma accounts for only 5% of total skin cancer cases, it accounts for nearly 75% of skin cancer deaths. Unlike cutaneous melanomas, UV radiation exposure is not a risk factor for mucosal melanoma. Though genetic mutations, tobacco, alcohol and environmental carcinogens have been implicated as risk factors for mucosal melanoma, the precise etiology is still unknown. Mucosal melanoma is most common between the fifth and seventh decades of life and is observed most frequently on the hard palate and maxillary alveolus. Melanoma often presents as an irregular pigmentation that may be flat or nodular. However, early lesions may emerge as a small macule and appear relatively inconspicuous. Most patients are asymptomatic, and the lesion often is discovered upon clinical evaluation. Radiographically, melanoma may invade bone and appear as an irregular or “moth-eaten” radiolucency. In the current case, a soft-tissue mass with diffuse pigmentation involving the gingiva of teeth Nos. 2628 is observed. The lesion is multi-colored and exhibits brown, grey and white pigmentation with granularity. Irregular pigmentation and swelling are consistent with intraoral melanoma. Some lesions, however, may contain minimal pigmentation or appear more vascular, which poses a diagnostic challenge. Accordingly, oral pigmented lesions of recent onset or unknown duration, irregular pigmentation, or enlargement should be biopsied for histopathologic examination. Upon microscopic examination for our case, atypical melanocytes forming disorganized nests are observed scattered along the basal cell layer of the epithelium

(Fig. 2). Though not always observed, another helpful finding for diagnosis is scattered pigmentation associated with malignant cells in the connective tissue (Fig. 2). Depth of invasion identified microscopically is an important prognostic indicator and helps guide clinical staging. Since melanoma is aggressive and metastasis is not unusual, surgical excision with wide surgical margins is the mainstay of treatment. The cervical lymph nodes are the most common site for oral melanoma metastasis, and lymph node dissection may be necessary for patients with clinically palpable nodes. Adjuvant radiation and immunotherapy may be necessary for patients at risk for metastasis or recurrence. The prognosis for oral melanoma is poor; studies report a survival rate of 10-25%, likely due to tendency for early metastasis. In the current case, the patient was referred to Moffit Cancer Center for definitive treatment.

over time. In sub-Saharan Africa, the endemic type is observed in young children and adults. This clinical type may present as skin lesions (similar to the classic type) or with more aggressive organ involvement. The iatrogenic type is observed in transplant recipients, likely a result of immunosuppressive therapy to prevent transplant rejection. The fourth clinical presentation is epidemic KS, which is the most common type observed in the U.S. Epidemic KS is associated with HIV infection and is considered an AIDS-defining condition. In fact, KS is one of the most frequent malignancies seen in patients with advanced HIV infection. Of the four clinical types, oral involvement most often is observed in epidemic KS. The hard palate and gingiva are commonly affected, but any intraoral site may be involved. Initially, the lesion may appear as painless erythematous macules that exhibit blue or purple coloration. Over time, the lesions develop into nodules that are frequently ulcerated. KS may invade bone and cause aggressive bone loss and tooth mobility. In reference to the current lesion, which exhibits a pigmented gingival swelling, KS is a great differential. The speckled-brown pigmentation, however, is more suggestive of melanocytic origin. For HIV/AIDS patients, treatment for oral KS include combination antiretroviral therapy (cART) if not yet established. This cocktail therapy usually results in regression of KS lesions and a reduced tendency to develop aggressive visceral lesions. Aggressive cases of epidemic KS may require additional systemic chemotherapy and immunomodulatory treatment.

E. Peripheral giant cell granuloma (PGCG) Fig. 2: Pale staining atypical melanocytes are observed throughout the epithelium with invasion into the superficial connective tissue (blue arrows). Scattered brown pigmentation is identified throughout the connective tissue (green arrows).

D. Kaposi Sarcoma Incorrect. Kaposi sarcoma (KS) is a hematologic malignancy that often is seen in immunosuppressed individuals, especially HIV-positive patients. It was first described by Moritz Kaposi as a cutaneous neoplasm of endothelial origin observed in elderly men. KS is caused by an infection with Kaposi sarcoma-associated herpesvirus (KSHV), also known as human herpesvirus 8 (HHV8). There are four clinical presentations of KS, which include the classic, endemic, iatrogenic and epidemic types. The classic type of KS is generally seen in elderly men of Italian, Jewish or Slavic ancestry. Indolent red-purple cutaneous plaques develop primarily on the lower extremities and may develop into tumor nodules

Incorrect. Peripheral giant cell granuloma (PGCG) is a benign hyperplastic lesion seen exclusively on the alveolar gingiva. The lesion can develop at any age with a mean age in the fourth decade and a slight female predilection. Gingival trauma can produce inflammatory lesions, which manifest as reactive gingival hyperplasia, and sources of irritation include extractions, plaque, calculus and ill-fitting dentures. Clinically, PGCG usually appears as a red to purple firm mass that may be ulcerated on the gingiva. Most PGCGs do not exceed 2 cm in diameter, though larger masses may occur, especially in the presence of poor oral hygiene. While PGCG develops in the soft tissue, “cupping” resorption of the underlying alveolar bone is sometimes observed, which may cause confusion with a central lesion. In the current case, though a swelling consistent with PGCG is noted, the diffuse pigmentation is not typical for this diagnosis. Although the presence of hemosiderin (a breakdown product of red blood cells) may impart a reddish-brown color in PGCG, the speckled-brown, white and grey pigmentation in the current lesion is more suggestive t

71 | TODAY'S FDA march/april 2022

quiz

of a melanotic lesion. Histologically, a proliferation of multinucleated giant cells dispersed within granulation tissue is essential for diagnosis of PGCG. Abundant hemorrhage is often seen with focal areas of hemosiderin pigment in the connective tissue. The lesion is indistinguishable from brown tumor of hyperparathyroidism, an osteoclastic tumor commonly seen in patients with hyperparathyroidism. Especially in the case of recurrence, careful evaluation of the patient’s medical history and further investigation may be merited to rule out brown tumor of hyperparathyroidism. Treatment of PGCG consists of surgical excision down to the periosteum to prevent recurrence (10-18%).

Diagnostic Discussion is contributed by University of Florida College of Dentistry professors, Drs. Indraneel Bhattacharyya, Don Cohen and Nadim Islam, who provide insight and feedback on common, important, new and challenging oral diseases. The dental professors operate a large, multi-state biopsy service. The column’s case studies originate from the more than 14,000 specimens the service receives every year from all over the United States. Clinicians are invited to submit cases from their own practices. Cases may be used in the “Diagnostic Discussion,” with credit given to the submitter.

References:

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

Buchner A, Hansen LS. Melanotic macule of the oral mucosa. A clinicopathologic study of 105 cases. Oral Surg Oral Med Oral Pathol. 1979;48:244-9.

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

Hiatt K, Nelson A, Lichy J. et al. Classic Kaposi Sarcoma in the United States over the last two decades: A clinicopathologic and molecular study of 438 non-HIV-related Kaposi Sarcoma patients with comparison to HIV-related Kaposi Sarcoma. Mod Pathol. 2008;21:572–582.

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

Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. 2016. 4th edition. WB Sauders, Elsevier. Shadman N, Ebrahimi SF, Jafari S, Eslami M. Peripheral giant cell granuloma: a review of 123 cases. Dent Res J (Isfahan). 2009;6:47-50. Symvoulakis EK, Kyrmizakis DE, Drivas EI, et al. Oral mucosal melanoma: a malignant trap. Head Face Med. 2006;2:7. Wang L, Li L-r, Young KH. New agents and regimens for diffuse large B cell lymphoma. J Hematol Oncol. 2020;13:175.

*Third-year resident in Oral and Maxillofacial Pathology University of Florida College of Dentistry.

AMATEUR PHOTOGRAPHY IS GREAT FOR VACATIONS (JUST NOT GREAT FOR RADIOGRAPHY) If you’re doing radiography without the proper training, it’s really more like amateur photography. There’s no room for amateurs in dentistry and it violates Florida law. The Florida Dental Association (FDA) Online Radiography Training Program provides you the formal training you need, with the professional development you want. This training enriches your career path while contributing a vital service to your patients and dental team. It’s the most convenient and economical way to get the radiography training required by Florida law. No travel. No time away from work. Train online, at your own pace. It’s affordably priced, too — just $285 per student for FDA members!

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Career Center

The FDA’s online Career Center allows you to conveniently browse, place, modify and pay for your ads online, 24 hours a day. Our intent is to provide our advertisers with increased flexibility and enhanced options to personalize and draw attention to your online classified ads! Post an ad on the FDA Career Center and it will be published in our journal, Today’s FDA, at no additional cost! Today’s FDA is bimonthly; therefore, the basic text of all active ads will be extracted from the Career Center on roughly the 10th of every other month (e.g., Jan. 10 for the Jan/Feb issue, March 10 for the March/April issue, etc). Please note: Ads for the Nov/Dec issue must be placed no later than Nov. 1.

Please visit the FDA’s Career Center at careers.floridadental.org. Fort Lauderdale, FL Periodontal Practice for Sale. Fort Lauderdale is famous for its beaches, arts, culture and events. New to the market is a well-established periodontal practice in the Ft. Lauderdale area. The current doctor has practiced in the community for decades and has built an excellent patient base. With limited marketing, the practice sees 45 new patients per month. Interested in retirement, the doctor is considering a straight buy-out or short-term affiliation with a group. FOR AN OVERVIEW OF THIS FORT LAUDERDALE, FL PERIODONTAL PRACTICE FOR SALE, READ BELOW: 7 operatories; Adjacent suites available for expansion; Collections of $1.1 million; SDE $377,000; 45 new patients per month; Over 2500 patients seen in the last 12 months; Growth opportunity with additional hours of operation. TO LEARN MORE ABOUT THIS FORT LAUDERDALE PERIODONTAL PRACTICE, PLEASE CONTACT PROFESSIONAL TRANSITION STRATEGIES: SAM@PROFESSIONALTRANSITION.COM OR GIVE US A CALL: 719.694.8320. WE LOOK FORWARD TO SPEAKING WITH YOU! Visit careers.floridadental.org/jobs/16426431. Full-time Associate dentist position – Tampa. Busy, private dental office is hiring an experienced (minimum 5 years’ experience) dentist for a full-time position leading an established practice. Guaranteed 1st year minimum salary of $250,000 plus benefits (full medical, 401k, malpractice insurance). Join our growing practice with unlimited potential. Openings coming in Pinellas and Manatee County. Highly trained staff and state of the art facility and equipment. Contact Dr. Monticciolo at vmonti@ happydentistry.com. Visit careers.floridadental.org/ jobs/16419651. Clinical Supervisor, Dental Hygiene – Miami. Miami Dade College, Medical Campus is now accepting applications for the Clinical Supervisor, Dental Hygiene position. This role is responsible for the management of clinical operations of the On-Campus Clinic. Duties and Responsibilities: Serves on campus and college wide committees, during non-clinic hours; Participates in the development

and implementation of College policies, procedures, and guidelines; Provides clinically related training for employees and supervises OSHA compliance; Identifies resources necessary for the successful operation of a Clinic; Examines and reviews records of all new and returning patients, and gives referrals when required; Manages clinical emergencies that may arise as result of treatment of patients in the clinic; Assists clinical instructors in the instruction and evaluation of students in all clinical courses; Consults with students and instructors regarding patients’ medical histories, examinations, and treatment; Reviews health histories of all students working in the clinic; Participates in the development and implementation of clinical curricula to meet accreditation standards; Reviews current literature for information on risk management; Supervises management of the clinic’s inventory and maintenance of the clinic equipment; Assists in the supervision of clinic staff and participates in faculty meetings; Assists in the Self-study for re-accreditation of the program and supervises students in the Dental Hygiene Clinic. Doctorate degree in General Dentistry and a current license to practice in the State of Florida, with a minimum of three (3) years prior clinical experience. Malpractice Insurance for the teaching environment must be kept current. Visit careers.floridadental.org/jobs/16406270. Prosthodontist – Oxford, FL. $150,000 to $200,000+ Yearly. Full-Time. Benefits: medical, 401K. OWNERSHIP OPPORTUNITY. 100% FFS office. Clinical (restorative and surgical), Leadership & Businesses mentorship and support. Hours are 8:00-6:00 Monday - Thursday. Job Types: Full-time, Contract. Job Description: Seeking an experienced and passionate restorative/surgical specialist to join our private practice team. The candidate must place an emphasis on the QUALITY of her/his dentistry over the quantity. They also must actively listen to patients with empathy and compassion to discern what treatment option will suit them best. Company Description: Our team is looking for a kind, happy, clinically talented PROSTHODONTIST who is passionate about dentistry. We are a compassionate dental specialist team

that enjoys providing exceptional comprehensive dental care to our very large retirement community. The candidate must have a passion for continuing education and have a desire to grow clinically and professionally. Our team of dental specialist also provide our referring community mentorship and continuing education opportunities to provide the best possible care to patients who put their trust in us. Our vision is to continue to transition this office into a multi-specialty dental center as we believe this is the dental practice model of the future. Our highly qualified management, leadership and clinical TEAM will support this vision. The right restorative specialist candidate has an amazing opportunity to realize her/his fullest potential both personally and professionally. Current Controlled Substance Registration Certificate; Current Florida Dental License; Certificate of completion of advanced education in Prosthodontics. Visit careers.floridadental.org/jobs/16386950. General Dentist – Summerfield, FL. Baylee Dental PA, Summerfield/ The Villages, FL. $150,000$200,000+ Annually. Full-Time. Benefits: Medical, 401K. OWNERSHIP OPPORTUNITY. 100% well established FFS office. Clinical (restorative & surgical), leadership & business mentorship and support. JOB DESCRIPTION: Seeking an experienced and passionate restorative dentist to join our private practice team. The candidate must place an emphasis on the QUALITY of his/her dentistry over quantity. They also must actively listen to patients with empathy and compassion to discern what treatment option will suit them best. Hours are 8:00-6:00 Monday – Thursday. COMPANY DESCRIPTION: Our team is looking for a kind, happy, clinically talented DENTIST who is passionate about dentistry. We are a compassionate dental team that enjoys providing exceptional dental care to our very large retirement community. The candidate must have a passion for continuing education and have a desire to grow clinically and professionally. To support this, our dual trained periodontists and prosthodontist will take an active role in mentoring and teaching the applicant to fulfill his/ her fullest potential. Our vision is to transition this of-

career center fice into a multi-specialty dental center as we believe this is the dental practice model of the future. Our highly qualified management, leadership and clinical TEAM will support this vision. The right restorative candidate has an amazing opportunity to realize his/ her fullest potential both personally and professionally. Current Florida Controlled Substance Registration Certificate; Current Florida Dental License. Visit careers.floridadental.org/jobs/16386575. Dental Hygienist – Brandon. I am a General Dentist who just purchased a practice in the Brandon, FL area less than 1 year ago (have been practicing for 32 years). It is a 5 operatory office that is open 4 days a week M-Thur. We are seeking a hygienist 3days/ wk 8 am-5 pm. The individual must be an outgoing and engaging person who enjoys his/her work. Our practice has a robust periodontal clientele. The office is equipped with digital records/x-rays (Eaglesoft). Candidate must have graduated from an accredited hygiene school and must be proficient in providing diagnostic and preventive care. Visit careers.floridadental.org/jobs/16355738. Periodontist – Part Time, Winter Garden, FL. We are looking to expand our periodontal practice team and hire another part time periodontist 2-3 days/ week to start. To give a brief summary, I practice with my wife and have been practicing in the community for 13 years, since graduating residency. We are both board certified periodontists. We have a new, 8 op, state-of the art office. We offer sedation, LANAP, PST and have a CBCT scanner a digital scanner, 3D printer, lots of other toys as well. Some experience preferred but would be willing to train the right candidate. Visit careers.floridadental.org/jobs/16344653. PT PERIODONTIST – Tampa. We are looking for a part time periodontist that can perform extractions, soft tissue grafting and implant placement. We are a general dental practice that does many cosmetic procedures and often needs clinical crown lengthening to accompany treatment. The practice sees anywhere from 40-50 new patients per month. There is a beautiful surgical suite awaiting you! You will find that our team is very well-trained, and the office is well appointed. Please send resume to Jen@bauerdentistry.com. Florida Dental/periodontal license. Visit careers.floridadental.org/jobs/16334056. Endodontist – Fort Myers. SW coast — Fast growing area with two modern offices needs an associate/partner to replace the senior retiring partner. Privately owned practice with 30+ year reputation. Excellent earning potential and benefits. Trained support staff in place. Recent graduates encouraged to apply. Send CV to endo7211@gmail.com. The candidate must be certified in Endodontics from an accredited program as well as a FL dental license. Visit careers.floridadental.org/jobs/16304455.

General Dental Office for Sale – Pembroke Pines, FL. 601 Dental Studio, P.A. is located within the 601 Medical Building at Memorial Hospital West in Pembroke Pines, FL, Suite 415. This is a unique and exciting opportunity to take on something really special! The affiliation and networking associated with such a reputable Hospital, allows for attractive upside growth within the practice as well as generous Hospital privileges, creating a community of support, security, and endless referrals as your patient base grows. 601 Dental Studio, P.A. is a General, Cosmetic, and Oral Surgery Practice that currently accepts major PPO/EPO insurances. It is important to note that a majority of the Good Will accumulates with the Hospital Staff and Personnel who hold a great Cigna PPO Plan offered by Memorial Hospital West. This 4-Op Dental Practice, which includes 2 Hygiene rooms, is fully digital, utilizes Open Dental Management Software on 7 workstations, including one designated for the Panorex X-Ray, a brand new Autoclave, and a new custom, SEO optimized website built in 2021. The space is around 1,000 square feet and houses, on average, between 5-7 employees. Just recently, in October, 601 Dental Studio purchased the iTero Digital Scanner. The ideal Dentist will benefit greatly if actively practicing Endodontics and Oral Surgery given that the current owner either refers out or contracts out such procedures. The current lease expires in 2023 with the option to renew for 5 more years. It is also important to note that this Suite has been a Dental Practice for over 20 years but has recently been remodeled and upgraded. 601 Dental Studio collected $528,000 in 2021. Prior to the Pandemic, this office saw collections in the $800,000+. Contact: Nadja A Horst, D.M.D. (954)-895-4398. Visit careers. floridadental.org/jobs/16259925. Greater Tampa, FL General Dental Practice for Sale. Tampa Bay is known as the heart of Florida’s Gulf coast. New to the market is a thriving general dental practice in the greater Tampa area. The current doctor has practiced in the community for nearly thirty years. They are therefore interested in exploring all transition options, including partnership, buy-out or affiliation with the right group! Currently equipped with seven new operatories (six equipped) there is also an expansion opportunity into additional adjacent space. Within thirty minutes of downtown Tampa, the practice is situated in a professional office park and the real estate is for sale as well. TO LEARN MORE ABOUT THIS GREATER TAMPA, FL GENERAL DENTAL PRACTICE FOR SALE, READ BELOW: 7 operatories; Expansion opportunity; Collections of $1.1 million; SDE over $500,000; 2025 active patients; Real estate opportunity. TO LEARN MORE ABOUT THIS TAMPA, FLORIDA GENERAL DENTAL PRACTICE FOR SALE, PLEASE CONTACT PROFESSIONAL TRANSITION STRATEGIES: SAM@ PROFESSIONALTRANSITION.COM OR GIVE US A CALL: 719.694.8320. WE LOOK FORWARD TO SPEAKING WITH YOU! Visit careers.floridadental.org/ jobs/16132322.

75 | TODAY'S FDA march/april 2022

Associate Dentist – Hobe Sound, FL. Great opportunity for full or part time Associate Dentist position. We are a successful, private practice providing all facets of dentistry, including implants. Located in the beautiful and rapidly growing Treasure Coast area of Florida. Great location, experienced staff and great income opportunity. Don’t miss out! Must be licensed in Florida. If interested, please email your C.V. at ccp1222@bellsouth.net. Visit careers.floridadental.org/jobs/16041919. Associate Dentist – Kissimmee. 25+ year, multi-doctor, privately owned family practice seeking a highly motivated General Dentist to help treat our great patients and work with a wonderful and experienced team. Join a successful practice and jump right into a strong schedule with over 100 new patients a month waiting for quality, comprehensive care. Enjoy a base salary with percentage-based incentive compensation. Visit our website: kissimmeefamilydental.com Please forward CV to Holly Lance: holly@kissimmeefamilydental.com. Visit careers. floridadental.org/jobs/15955560. Fee-For-Service General Practice Belleview/The Villages For Sale. 10 year Fee For Service/No Insurance Assignment General Dental Practice is centrally located among several 55+ communities including The Villages. Modern free standing building has two equipped operatories and is plumbed for 3. There is plenty of room for expansion. Area is underserved by dentists and is growing rapidly with new Publix, AdventHealth ER, and new homes in the immediate vicinity. Office has Patterson Fuse cloud-based software and digital sensors. This would be a great open slate for a mid-career practitioner looking for quality of life or for a young dentist wanting low overhead to develop into the dream practice. Please message for pics. Due to family health issues, dentist has been seeing 20-25 patients/week on 3-4 days with dentist doing hygiene and 5-6 new patients per week are referred out. 1000+ patients of record with over 300 scheduled for recare. Gross 2021 $160K with less than 30% overhead. Real estate including 1 acre of land could be available also. This would also be an excellent satellite office and great for Endo/Pros/Surgery. $175K sale price and start practicing right away! Visit careers.floridadental.org/jobs/13686503.

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ADVERTISING INFORMATION For display advertising information, contact: Deirdre Rhodes at drhodes@floridadental.org or 800.877.9922, Ext. 7108. For Career Center advertising information, contact: Jill Runyan at jrunyan@floridadental.org or 800.877.9922, Ext. 7113.

PUBLISHING INFORMATION Today’s FDA (ISSN 1048-5317/USPS 004-666) is published bimonthly by the Florida Dental Association (FDA), 545 John Knox Road, Ste. 200, Tallahassee, FL 32303. FDA membership dues include a complimentary subscription to Today’s FDA. Nonmember subscriptions are $150 per year; foreign, $188. Periodical postage paid at Tallahassee, FL and additional entry offices. Copyright 2021 Florida Dental Association. All rights reserved. Today’s FDA is a refereed publication. POSTMASTER: Please send form 3579 for returns and changes of address to Today’s FDA, 545 John Knox Road, Ste. 200, Tallahassee, FL 32303.

EDITORIAL AND ADVERTISING POLICIES Editorial and advertising copy are carefully reviewed, but publication in this journal does not necessarily imply that the FDA 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 FDA.

EDITORIAL CONTACT INFORMATION All Today’s FDA editorial correspondence should be sent to Dr. Hugh Wunderlich, Today’s FDA Editor, Florida Dental Association, 545 John Knox Road, Ste. 200, Tallahassee, FL 32303. FDA office numbers: 800.877.9922, 850.681.3629; fax: 850.561.0504; email address: fda@floridadental.org; website address: floridadental.org. Today’s FDA is a member publication of the American Association of Dental Editors and the Florida Magazine Association.

77 | TODAY'S FDA march/april 2022

off the cusp laboratory

FDA Approves Ef-dee-see®

Tablets

Mental Scotoma: Proper dosage of Ef-dee-see® has shown marked improvement in cognitive abilities and occupational efficacy with concomitant decreased trichotillomania.

By Hugh Wunderlich, DDS, CDE, FDA Editor

Ef-dee-see® (FDC) Tablets BRIEF SUMMARY of prescribing information: Before prescribing, please consult complete prescribing information and schedule of events.

CONTRAINDICATIONS: Ef-dee-see® is contraindicated in individuals with a known hypersensitivity to fun and/or self-improvement.

INDICATIONS AND USAGE

DESCRIPTION AND PHARMACOLOGY: Ef-dee-see® is a selective inhibitor of occupational dental lethargy belonging to a national class of dental conventions. It has the following structure:

Occupational Depression: The efficacy of Ef-dee-see® was established through 100 years of randomized, placebo-controlled, double-blind clinical studies. These studies coincide with the number of years the Florida Dental Association has provided this annual therapy. Decreased mortality has been shown in elderly attendees. Analyses of 620 placebo-controlled trials (modal duration of one week) in these attendees revealed a 10-fold improvement in stress-related and cardiovascular-negative outcomes. Pooled analyses of short-term studies also showed dramatic improvement in occupational psychoses and depression. Families and caregivers should be advised to observe the attendee for marked improvement in critical thinking and well-being. The average risk of improvement of attendees taking proper dosage of Ef-dee-see® tablets was 100% over the placebo group. [See WARNINGS and PRECAUTIONS for pediatric use.]

Mania: The effectiveness of Ef-dee-see® for acute and chronic mania, especially for out-of-town attendees, was systematically evaluated in clinical trials and cross comparisons to other conventions of this type. Hypertension: Annual administration of Ef-dee-see® is indicated for improving mild hypertensive attendees. Single, annual dosage to healthy volunteer attendees produced decreased supine blood pressure (mean maximum decrease of systolic/diastolic blood pressure of 8.4 mm/Hg). This is especially true of attendees who combine this medication with citrate salts of Sildenafil.

2/14/22, 11:14 AM

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Ef-dee-see® is not soluble in water but some nocturnal aspects of the compound are enhanced with ethyl alcohol. Ef-dee-see® is easily and rapidly absorbed. Most of the compound will be absorbed by the brain. Maximum observed plasma concentrations are reached within 30 minutes of mental dosing in the fasted state. When Ef-dee-see® is taken with a high-fat content meal at the Gaylord Palms, the rate of absorption is greatly reduced, and the attendee may require additional rest before second day dosing. There are no gender or race effects on the pharmacokinetics of Ef-dee-see®. t

79 | TODAY'S FDA march/april 2022

off the cusp laboratory from page 79

IQ in Humans vs. Rats @ FDC

The active ingredients in this years’ convention are the hands-on workshops:

• • • • • • •

•

180

Humans

•

170 160

•

150 140

•

130 120

•

110 0

Rats

DAYS

The Peel Technique™ – Dr. Robert Convissar 3D Printing Technology – Dr. Mark Kleive Pankey Essentials – Dr. Lee Ann Brady et al. Applications of Botulinum Toxin – Dr. Tracy Shaw-Blessing Exodontia Techniques – Dr. John Alonge Process of Data Integration – Dr. Javier Vasquez Exceptional Dental Hygiene Tx Plan – Ms. Marianne Dryer

DOSAGE AND ADMINISTRATION: Ef-dee-see® is supplied as a one-, two-, three- or four-day convention of nationally recognized speakers, exhibitors and workshops at the Gaylord Palms Resort in Orlando. Recommended annual dosage for adults is the four-day “blister pack” starting on June 22, 2022. The medication can be mixed with meals and small amounts of ethyl alcohol to potentiate the benefits of the convention. Maximum dosing frequency is one four-day “blister pack” per year. RECOMMENDED STORAGE: Store at 25°C (77°F); excursions are permitted at 15-30°C (59-86°F) [see USP Controlled Room temperatures].

Distributed by FDA Laboratories, Tallahassee, FL.

81 | TODAY'S FDA march/april 2022

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