Today's FDA May/June 2022 Issue by Florida Dental Association

The ADA — Looking Ahead in Dentistry

celebrating 100 years!

Artificial Intelligence in Dentistry

Open Your Eyes to 3D Imaging

FLA-MOM 2022 Recap

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TABLE OF CONTENTS HIRE for Today, MENTOR for the FUTURE

MAY/JUNE 2022 floridadental.org

FUTURE OF DENTISTRY issue 25 | FDC Things to Know Before You Go ... 26 | Hire for Today, Mentor for the Future: Finding the Perfect Associate 30 | Looking Ahead in Dentistry 34 | Are We Ready to Embrace a Bold New Vision for the Dental Profession?

Finding the Perfect ASSOCIATE

36 | Application of Artificial Intelligence in Dentistry 39 | Artificial Intelligence and the Future of Dentistry: A Brief Review 40 | Open Your Eyes to 3D Imaging 48 | FDC2022 Speaker Preview: The Dentist as Diagnostician: What You Don’t See Might Hurt You 51 | FDC2022 Speaker Preview: Sitting: Active Versus Static 52 | Exhibit Hall

56 | FLA-MOM 2022 Recap

60 | FLA-MOM 2022 - A Special Thank You to Our 2022 Benefactors

IN EVERY ISSUE 2 Staff Roster

18 news@fda

4 Contributors

67 Diagnostic Discussion

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

CHECK OUT TODAY’S FDA ONLINE!

72 Career Center 75 Advertising Index 76 Off the Cusp

14 Preventive Action

1 | TODAY'S FDA may/june 2022

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

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

COMMUNICATIONS AND MEDIA COORDINATOR Shey Loman

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 Lywanda Tucker • peer review coordinator

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

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 Shey Loman • communications and media coordinator

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

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 Davis Perkins • commercial account advisor Liz Rich • 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 davis.perkins@fdaservices.com • Ext. 7145 liz.rich@fdaservices.com • Ext. 7171

Group & Individual Health • Medicare Supplement • Life Insurance • Disability Income • Long-term Care • Annuities Professional Liability • Office Package • Workers’ Compensation • Auto • Boat

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

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

3 | TODAY'S FDA may/june 2022

GUEST CONTRIBUTORS may/june 2022

JOE CALDERONE

RAYMOND COHLMIA, DDS

ANDREW J. CORSARO, DMD, MS, FACD

FDA LIAISON TO THE FLORIDA BOARD OF DENTISTRY

ADA EXECUTIVE DIRECTOR

CLINICAL ASSISTANT PROFESSOR UNIVERSITY OF FLORIDA COLLEGE OF DENTISTRY

adacohlmiar@gmail.com Page 34

drcalderone@gmail.com

acorsaro@dental.ufl.edu

Page 10

Page 39

MATT DIBLASI

SUZANNE EBERT, DMD

ALAN FRIEDEL, DDS

SANJIE JACKSON, DMD

ABYDE PRESIDENT

VICE PRESIDENT, DENTAL PRACTICE AND RELATIONSHIP MANAGEMENT, ADA BUSINESS INNOVATIONS GROUP

aefriedel@gmail.com

eijnas81@gmail.com

Page 36

Page 30

MARKO VUJICIC, PH.D. ADA CHIEF ECONOMIST & VICE PRESIDENT, HEALTH POLICY INSTITUTE

RICK WILLIAMSON, BS, ACE, CPT

mdiblasi@abyde.com Page 14

eberts@ada.org Page 26

DALE A. MILES, DDS, MS, FRCD(C) DIPLOMATE, lea.almatny@csdental.com. AMERICAN BOARD OF ORAL Page 40 MAXILLOFACIAL RADIOLOGY

LEA AL MATNY, DDS, MS

FDC2022 SPEAKER miles.dale@gmail.com Page 49

adavujicicm@gmail.com Page 34

FDC2022 SPEAKER bodypraxis@aol.com Page 51

DAVE BODEN, DDS, M.S.

DONALD COHEN, DMD

oralpath@dental.ufl.edu

FDA PRESIDENT

oralpath@dental.ufl.edu

dboden@floridadental.org

Page 67

850.681.3629 Page 7

NADIM M. ISLAM, DDS

JOE ANNE HART

oralpath@dental.ufl.edu

FDA CHIEF LEGISLATIVE OFFICER

Page 67

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 Page 10

HUGH WUNDERLICH, DDS, CDE FDA EDITOR hwunderlich@bot.floridadental.org 850.681.3629 Page 76

5 | TODAY'S FDA may/june 2022

CONTRIBUTORS may/june 2022

INDRANEEL BHATTACHARYYA, DDS

DENTISTRY& SYSTEMIC HEALTH: MOUTH, MIND & BODY CONNECTION

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in the sulcus

Future of Dentistry By David F. Boden, DDS, M.S., FDA President

This issue is all about the future of dentistry and I have been asked to put on my prognosticator’s hat. Trying to predict the future is, well, unpredictable and certainly risky. Some of you are going to nod your heads saying, “Yep, I see that, too.” Others may feel irritated or offended. Well, that is the risk I am willing to take by writing my personal opinion based solely on my observations. Some of the trends are scary but you belong to an association of your peers that loves a challenge and is very good at solving problems.

• Education Education is always the most important key to the future. There is a perception among dentists in the field that the quality of education is declining, including dental education. While that perception is far too generalized and exaggerated, it must be addressed. Education is an exceedingly difficult business, particularly in the professions. Every year more knowledge is gained, and history becomes lengthier, but the time to cram all that information into our students’ heads does not increase (unlike tuition costs). Nevertheless, our institutions must continue to demand high expectations of their charges, our future colleagues, our patients’ future doctors. This will happen because it must. The pride of our universities’ faculty and alumni will demand it. To fix it, do not complain. Rather, step up and ask your alma mater how you can help. You can be our students’ bridge between the wonders of academia and the

practicality of practice. They are hungry for your wealth of hard-earned knowledge. Be their coach. Without our leadership, students have been vying for more control of their education in the past 10 years. There has been a huge push by today’s culture to not judge others. Judgment is a survival instinct and will never disappear. In healthcare, it is a critical part of every patient examination. Instead of stamping judgement out as part of some societal fad, it should be fine-tuned as a critical tool for improving a patient’s health. Unfortunately, the opposite has occurred by the push for non-judgmental Pass/Fail grading in all of education, including in dental education. In my experience, Pass/Fail is, well, failing. It is proper, no, it is critical to judge students. How can athletes run faster or score more often unless they have great judgmental coaches tracking their progress? How else can we excel as much as we have in the past 150 year of dentistry? Fortunately, there is a nascent undercurrent by many students that feel they are unable to excel if there is no judgement of the current level of their abilities. At their post-graduate level, they understand grading stimulates competition—not just between students, but within themselves. Nothing makes one strive more than a deserved low grade. Nothing makes one prouder than finally earning that higher grade from a tough but fair professor. In my opinion, the return to grading is inevitable as well as the insistence that professors be more demanding coaches. t

7 | TODAY'S FDA may/june 2022

in the sulcus

”

Be sure to stay optimistic, but to stay effective every one of us must work toward that better future with Relentless Positive Action.

Grading “equity” has absolutely no place in training doctors who will perform surgical procedures on patients.

and our profession held in high trust. Failure by individuals or organizations to uphold and call out those failures will not only affect our trust level but hurt our collective bottom line. It is crucial that each individual doctor strongly resist not only our own temptations, but also the pressures by non-dentist personnel and entities that lead to shortchanging our patients and our profession. The Golden Rule still rules. In my opinion, the future of this is tenuous. However, much lies in your hands and of our profession’s excellent honor societies, the American and International Colleges of Dentists and the Pierre Fauchard Academy. It is important all three, and you, become far more active and visible if we are to remain a self-regulated profession. Do not be afraid to speak up and lead.

• Licensure Licensure continues to evolve. As you know from my previous writings this year, the American Dental Association’s (ADA) policy is to have license portability across all states and to have all states accept all forms of licensure examination or alternatives. Many states resisted, including Florida, declaring that it’s a states’ right issue. Their argument is that control of licensure would reduce to the lowest common denominator; that local control enhances proper disciplinary procedures and rules for practice; and that there would be a resultant degradation of Boards of Dentistry. The ADA’s latest strategy has been to push for licensure compacts across multiple states and eventually the entire nation. This is a complicated topic that the FDA’s Council on Dental Education and Licensure, as well as the FDA Board of Trustees are studying very closely. I expect more publications in this journal about this topic. My prediction is that some regional compacts will form, but not necessarily in Florida for now.

• Technology Much has already been written, but truly it is cool that we dentists cannot resist salivating over the latest gee whiz technology. Dental cone-beam computed tomography systems are just the beginning of advancements in imaging. Resolutions will improve even further to the point robotics will soon assist hard tissue surgery. Regenerative procedures are the next big wave and will eventually eclipse and make implants and some endodontic treatments last resort procedures. Office management will and must become much more integrated. Home care devices will become easier and more effective—maybe no more flossing!

• Ethics I hear many worries about the erosion of ethics in dentistry. Please do not fall into the trap that ethical behavior is “relative” or “fungible” due to whims of the current popular culture. Proper professional behavior is what keeps our patients safe,

in the sulcus

• Practice models There are significant financial pressures causing a trend to more group practices and dental hospitals of specialists, but there will still be room for small practices where future innovation must originate in order to stay competitive, and many patients will still prefer long term personal care. Some large group practices are trending to retail walk-in models while others are striving for more comprehensive care. I am a little disappointed to see the future of dentists as employees rather than owners. Lack of skin in the game tends to reduce motivation and individual decision making. Solo practices will still exist in rural areas, but perhaps they will be franchises in order to afford the expensive new technology toys. However, as technology-assisted care increases there will be a great reduction in operative and surgical procedures. Auxiliaries are — and will be — increasingly assigned those duties but expect patients to still demand to see “the doctor.” Your charge in the future is to be the doctor.

• Economics of practice I foresee exponential increases in the costs of tertiary care, like in medicine. Costs will drive the growth of expanded home remedies as is already seen in orthodontics. The generation that demands everything be free will inevitably get federalization of taxpayer-borne “insurance” funded by Medicare. Be aware that the ADA is already gearing up for inevitability. Denticare, here we go! Just as Doctors are misnamed “providers,” patients are rapidly becoming labeled consumers and shoppers (our own fault, by the way). The solution is again to be the doctor and speak up. That leads us to:

standardization of licensure, standards of care and payments. Competitive debate of ideas results in best conclusions. I am not sure which philosophy will prevail but if you do not want to be just a cog in the wheel, please sound off regularly to your association representatives. During my and trustees’ talks and speeches with you, I am always amazed at the lack of questions. You must be the ultimate leaders.

• Patient expectations Finally, what about patient expectations? Patients will rapidly convert further as consumers, and they will soon have enough information to become the treatment planners. Costs will inevitably cause market driven shifts to prevention procedures and demands for tooth preservation rather than replacement procedures. As the expert, you will have to coach them toward their best care. This is where your psychology courses pay off. Whew! Do not be discouraged. As I previously wrote, we are all problem solvers who are capable of amazing adaptability when we have the courage to make decisions and change them when necessary. Let your incredible training and logic overrule the temptation to get emotional. Identify the problem. Solve the problem. Stay in touch with your colleagues and do this together. Be sure to stay optimistic, but to stay effective every one of us must work toward that better future with Relentless Positive Action.

Always Your Colleague,

• Dental Associations Associations of doctors are critical to the best shaping of the profession’s and our patients’ future. As a leader in all levels of dentistry I observe some drift in the ADA’s mission. This is driven by a persistent struggle between groups of state association delegations of the ADA as well as within the ADA. There are those who strongly guard the independence of individual doctors and those who prefer nationalized models for

David F. Boden, D.D.S., M.S.

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 75 .

9 | TODAY'S FDA may/june 2022

did you know?

What Do You Mean I Do Not Report Unlicensed Activity to the BOD? 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 if you want to report unlicensed activity in the state of Florida, you do not report it to the Board of Dentistry? Instead, you report it to the Unlicensed Activity and Fraud unit (ULA) at the Department of Health. This unit protects Florida residents and visitors from the potentially serious and dangerous consequences of receiving medical and health care services from an unlicensed person. It investigates and refers for prosecution all unlicensed health care activity complaints and allegations. The ULA unit works in conjunction with law enforcement and the state attorney’s offices to prosecute individuals practicing without a license. In many instances, unlicensed activity is a felony level criminal offense. For more information about unlicensed activity in Florida and to report unlicensed activity, visit flhealthsource.gov/ula/.

”

This unit protects Florida residents and visitors from the potentially serious and dangerous consequences of receiving medical and health care services from an unlicensed person.

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 may/june 2022

GO TO bit.ly/2KXvZ2h

legislative

2022 session delivers big wins for FDa NON-PATIENT-BASED FLORIDA DENTAL LICENSURE EXAM

By Joe Anne Hart, FDA Chief Legislative Officer

2022 SESSION DELIVERS BIG WINS FOR FDA

Changes Florida live-patient-based dental licensure exam to a non-patient-based exam (manikin).

The 2022 Legislative Session resulted in big wins for the Florida Dental Association (FDA). The Legislature approved funding for the FDA’s budget priorities, legislation passed to change Florida’s dental licensure exam to a non-patient-based exam, defeated legislation to carve dental into medical under the Medicaid program, defeated legislation to authorize dental therapy, and defeated legislation to assign a Medicaid provider number to dental hygienists for direct reimbursement. Legislation also passed to extend the COVID-19 liability protections for health care providers that was due to expire on March 29, 2022, and will now expire on June 1, 2023.

KEEP DENTAL SEPARATE FROM MEDICAL IN THE MEDICAID PROGRAM Maintains dental care separate from medical care in the Medicaid program to allow for funding to go directly towards dental care without being diluted for administrative costs.

DENTAL THERAPY NOT A SOLUTION FOR FLORIDA Legislation was not considered this session in the fifth attempt to authorize dental therapists in Florida. The proponents of this legislation failed to secure a House bill sponsor.

For a comprehensive report on the 2022 Legislative Session, read the Sine Die Edition of Capital Report, available here: floridadental.org/sine-die.

DEFEAT EFFORT TO ASSIGN MEDICAID NUMBER FOR DIRECT REIMBURSEMENTS TO HYGIENISTS

DENTAL STUDENT LOAN REPAYMENT PROGRAM AND DONATED DENTAL SERVICES

Legislation was not heard in committee to allow for dental hygienists to expand their scope of practice and be assigned a Medicaid provider number for direct reimbursements.

Funding of $1.773 million was allocated to the Dental Student Loan Repayment Program (dentists eligible for $50,000 per year maximum for five years as a Medicaid provider in a public health access setting) and Donated Dental Services (two full-time coordinators, plus operating expenses).

FDA 2022 CHAMPIONS FOR DENTISTRY

Rep. Tyler Sirois (R - Merritt Island)

Sen. Ben Albritton (R - Bartow)

This legislative session, the FDA supported changes to the dental licensure exam process and wanted to make sure the sponsors of this legislation would help keep the bills focused on just that. Rep. Tyler Sirois and Sen. Ben Albritton helped navigate bills through to the finish line that will change Florida’s live-patient dental licensure exam to a non-patient-based exam. During the 2021 June House of Delegates, the FDA passed a resolution supporting this position after receiving data showing the metrics tabulated from the dental licensure exams administered during the height of the pandemic. Because there were a lot of unknowns back in 2020, the governor issued several executive orders allowing for certain health care professions (including dentistry) to bypass the live-patient requirement

save the date! Mark your calendar to attend Dentists’ Day on the Hill Tuesday, March 28, 2023 in Tallahassee. More information coming soon!

and use a manikin instead. The FDA also would like to thank Rep. Sirois and Sen. Albritton for supporting the FDA’s budget priorities, as well as for their positions on scope of practice issues.

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 may/june 2022

preventive action

Dental Offices Are No Longer Flying Under the OCR’s Radar By Matt DiBlasi, Abyde President & Co-Founder

Attention all dental practices, listen up! Three of the four most recent U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) enforcement actions were against dental practices. Now that we have your attention, as your Crown Savings preferred vendor partner, Abyde, let’s break down what could happen to you without a strong and stable compliance program in place. The OCR just concluded its 27th enforcement action since the HIPAA Right of Access Initiative began in 2019. Totaling over $170,000 across four penalties, the announcement of the verdicts includes two cases as part of the HIPAA Privacy Rule. The additional actions relate to the disclosure of patients’ protected health information (PHI).

Here’s the highlight reel version of the three dental cases just released by HHS: The first dental action includes a $30,000 settlement against the initially cited $104,000 for failure to comply with the Right of Access provision stating covered entities must permit individuals to inspect and obtain a copy of their PHI. Nearly two-and-ahalf years from the time of citation, the practice has completed a package of action plans, creating a costly and lengthy resolution process. Something as simple as Google review responses can get you fined! One provider learned the hard way the dos and don’ts of reputation management. A patient filed a complaint with the OCR after the provider included the patient’s full name and PHI in a review response. This cost the practice a whopping $50,000! Not the usual politician slip-up, but a recent provider running for office learned not to mix business and pleasure. As part of his political campaign, the provider shared names and addresses of over 5,000 patients with both his campaign manager and third-party marketing partner to distribute letters and emails. This resulted in a final citation of $62,500 and surely put a roadblock on his campaign trail!

As the OCR cracks down through its HIPAA Right of Access Initiative across dental practices, we hope that your level of awareness around the importance of being HIPAA compliant has expanded. If you are not sure how to get started, let Abyde be your compliance guru. As your preferred vendor partner, we lead with education and share tools, training and other resources throughout the year to empower you to take positive action around your compliance program. With an hour of your time, we will get you everything you need. How much is an hour of your time worth? We bet it’s not $170,000!

Abyde is an FDA Crown Savings Endorsed Partner and the Abyde software solution is an easy way for any sized dental practice to implement and sustain comprehensive HIPAA-compliance programs. FDA members save 20% on Abyde services that help their practices meet government-mandated HIPAA standards that protect patient health information by identifying and correcting key security safeguards. Visit fdaservices.com/abyde or call 800.594.0883.

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Something as simple as Google review responses can get you fined!

This cost one practice a whopping $50,000!

15 | TODAY'S FDA may/june 2022

17 | TODAY'S FDA may/june 2022

news@fda Limit Cybercrime Access Points

Email Spear Phishing: A New Level of Scary

Protected Health Information should not travel in or out of your general email inbox (Gmail, Yahoo!, etc.). The safest HIPAA-compliant email: l Meets all five required HIPAA Safeguards. l Transmits across a private encrypted network. l Encrypts email in transit and ‘at rest’ in your inbox. l Requires you to initiate first email communication to those outside your network. Recovering from an attack is much more difficult and costly than preventing it in the first place. Provide ongoing staff education. Assess the security of your HIPAA-compliant email. And implement a plan to send the bulk of your emails through a truly secure HIPAA-compliant email.

You’ve probably heard of phishing, where cyber criminals use email as their gateway to your personal information. Spear phishing takes email targeting to an entirely new level of scary; your attacker gets to know you. Cyber attackers collect information relevant to you from across the internet so it seems like an email you should expect. Sometimes you may be asked to click a link or attachment, or to respond. If you do, you’ve potentially opened the door for malware to get into your practice management system, accounting and other important applications.

iCoreConnect, a Florida Dental Association (FDA) Crown Savings Endorsed Partner, specializes in comprehensive software that speeds up workflow for dentists. iCoreExchange, endorsed by FDA Services (FDAS), is an encrypted, fully HIPAA-compliant email. Not one iCoreExchange email has been hacked. Ever. FDA members receive substantial discounts on iCoreExchange. Book a demo or call 888.810.7706.

Dr. Jolene Paramore Receives Excellence in Action for Dental Health Award

Learn to Spot the Trick

Dr. Jolene Paramore is the recipient of the first Excellence in Action for Dental Health Award from the ADA Council on Advocacy for Access and Prevention (CAAP).

Be cautious when you receive an email from a bank, your information technology (IT) department or a vendor, for example, stating that you need to reset your password or go to a website to update information. Reach out to the sender separately to verify it really came from them.

Don’t Click the Link A quick way to see if the link is suspicious is to just hover your cursor over it. The URL should point to the site to which the email claims it will be going. If it doesn’t, or you have any doubts, alert your IT team.

The new CAAP award recognizes stakeholders who have advanced the ADA’s Action for Dental Health initiatives in their state. The Action for Dental Health Act became law in 2018 and was created to ad-

vance the ADA’s nationwide, community-based movement aimed at improving access to oral health care for people who suffer from untreated dental disease.

New Social Media Content The FDA is pleased to share our latest campaign to help engage Floridians to find and see their FDA member dentist. It features attention-catching videos showing the connection of critical overall health issues to oral health. Our primary target audience for this campaign is Hispanic families and individuals, with video spots and supporting ad copy in both English and Spanish languages as well as English video spots created to resonate with a broader audience. As our members, we want you to take advantage of this readymade content to share on your own social media platforms and encourage Floridians to take charge of their oral health and overall health. You can share campaign content from the FDA’s social channels or download these videos to make them your own and share them on your personal and/or business social channels. To access videos, go to vimeo.com/showcase/9495604.

Chat. Connect. Grow: A Speed Networking Event with Vendors at FDC2022 Start your day at the Florida Dental Convention (FDC) 2022 with coffee, pastries and networking with vendors on Thursday, June 23, 9-11 a.m. Leading dental vendors will rotate to your table to present you with their latest product information and answer your questions. You are sure to leave with new connections and knowledge of products, services and technologies. Go to floridadentalconvention.com to register and add SN01 to your registration to secure your seat. Participating companies include: Halyard Global Products, Weave, ReCallMax, Sunbit Inc., FDA Services and more to come. At the end of the event, all attendees will receive a $50 Visa gift card!

FREE Keynote Sessions for the Entire Dental Team Get motivated and have your morning huddle with us at FDC2022! FDC will feature morning keynote sessions on Thursday, June 23 and Friday, June 24 from 7:45-8:45 a.m. Thursday morning will feature Dr. Uche Odiatu’s course, “Maximize Your Energy: The Peak Performance Advantage (NC01),” and Friday morning will feature Mr. Randy Fox’s course, “You’re Missing a Great Game: Life Lessons On and Off the Court (NC07).” Courses are FREE for all attendees. Go to floridadentalconvention.com to register!

L.E.A.D VIDEOS Great leadership skills can create tremendous success in your practice and in life, but these skills don’t always come naturally, and they take time and training to develop. The FDA Leadership Development Committee, Leaders Emerging Among Dentistry (L.E.A.D), exemplifies our commitment to providing our emerging dental trailblazers with the tools they need to become inspiring leaders. Go to floridadental.org/leadtheway to check out LEAD videos.

UF Researchers Help Develop Highly Accurate, 30-second Coronavirus Test

Researchers at the University of Florida (UF) have helped develop a COVID-19 testing device that can detect coronavirus infection in as little as 30 seconds as sensitively and accurately as a PCR, or polymerase chain reaction test, the gold standard of testing. They are working with scientists at National Yang Ming Chiao Tung University in Taiwan. The device, researchers said, could transform public health officials’ ability to quickly detect and respond to the coronavirus — or the next pandemic. t

19 | TODAY'S FDA may/june 2022

FDA: Well-being program Tobacco Free Florida

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.

news@fda

The FDA would like to thank the following board members for their dedication and years of service.

OUTGOING TRUSTEES: Dr. Alana Humberson, ACDDA 2019-2022

UF has entered into a licensing agreement with a New Jersey company, Houndstoothe Analytics, in hopes of ultimately manufacturing and selling the device, not just to medical professionals but also to consumers. Like PCR tests, the device is 90% accurate, researchers said, with the same sensitivity, according to a recent peer-reviewed study published by the UF group. Go to bit.ly/3Jmmvc2 to read the article in its entirety.

Dr. Bernie Kahn, CFDDA 2012-2021

OUTGOING LINE OFFICER: Dr. Andy Brown, NEDDA 2015-2022

As outgoing trustees, they will be honored at the Awards Luncheon on June 24, 2022 in Orlando at the Florida Dental Convention.

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

21 | TODAY'S FDA may/june 2022

DID YOU KNOW ... Did you know FDA Services (FDAS) is overseen by a board of directors made up of Florida dentists who guide our mission to support FDA members throughout their dental careers? Did you know FDAS specifically negotiated the FDA dental professional liability program with The Doctors Company to get FDA members the best coverage, rates and benefits possible? Did you know revenue generated from FDAS insurance sales goes directly toward funding FDA programs and lobbying efforts that are important to members, as well as keeping member dues at their lowest possible level? Did you know FDAS contributed $2,131,188 to FDA dues reduction in 2020?

Getting your malpractice coverage through FDAS and our partners at The Doctors Company is a no-brainer. Members get expertly negotiated coverage while benefiting the FDA and keeping dues low!

Call or text us at 850.681.2996 to learn more and apply 22

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

RUN BY AND FOR DENTISTS Finding the right insurance and business resources to help you run your practice securely and efficiently can be a headache, but as an FDA member you can find all of your solutions in one place. FDA Services is overseen by a board of directors made up of Florida dentists who guide our mission to support FDA members throughout their dental careers.

or visit bit.ly/tdcquote to get an instant quote. 23 | TODAY'S FDA may/june 2022

THE FDA COUNCIL ON THE NEW DENTIST PRESENTS

THE

AFTER PARTY FRIDAY

JUNE

10 PM-1 AM

DANCE THE NIGHT AWAY @ EXHIBIT HALL A WHERE THE NIGHT COMES ALIVE! OPEN TO THOSE AT LEAST 18 YEARS OF AGE WITH A VALID FDC BADGE. 24

Things to Know Before You Go … 1. ON-SITE BADGE PICKUP HOURS & LOCATIONS

• • • • •

6. SOCIAL EVENTS INCLUDED IN YOUR REGISTRATION plans to attend the social events included in your • Make registration*

Wednesday, June 22 – 4-9 PM (Hotel Lobby) Thursday, June 23 – 7 AM-8 PM (City Hall Lobby) or 4-9 PM (Hotel Lobby) Friday, June 24 – 7 AM-6 PM (City Hall Lobby) Saturday, June 25 – 7 AM-3 PM (City Hall Lobby) If you are registered as “Exhibit Hall Only,” you will pick up your badge at the first-floor rotunda outside the Exhibit Hall on Thursday & Friday, 8 AM-5 PM and Saturday, 8-11 AM.

o Thursday, June 23 Cocktail Hour in the Exhibit Hall – 4-6 PM (drink ticket

2. FREE OFFSITE PARKING & SHUTTLE SERVICE

parking and shuttle service to the Gaylord Palms will • Free be available for attendees at ESPN’s Wide World of Sports

* Events are not included in the free “Exhibit Hall Only” registration.

(700 S Victory Way, Reunion, FL 34747). Shuttle Hours: o Thursday, June 23 – 7 AM-11:30 PM o Friday, June 24 – 7 AM- 11 PM o Saturday, June 25 – 7 AM-6 PM Please allow ample time (at least one hour prior to course start) for parking and shuttle service.

•

7. ATTENDEE LUNCH VOUCHERS

you have purchased a Thursday morning and afternoon • Ifcourse or have signed up to be a speaker host, you will

•

3. MOBILE APP

the mobile app by searching “FDC2022” in the • Download Apple App store or Google Play the beginning of June. To view

•

your personalized course schedule and course/event location you must be logged into the app with your registration ID and last name. You can also download handouts, search exhibitors, view the event schedule, access the Gaylord Palms maps and more with the app! Be sure to turn on your notifications.

the Florida Board of Dentistry, you must be present in • Per a course 50 of 60 minutes to receive 1 hour of CE credit.

• •

handouts will be available within your online • Course registration dashboard 2 weeks prior to FDC. an effort to “go green,” FDC will not provide handouts • Inonsite. Please print, download on your mobile device or

receive a $20 lunch voucher for Exhibit Hall concessions. Vouchers can be used in the Exhibit Hall on Thursday through Saturday, 11 AM-2 PM. Your lunch voucher will be automatically loaded onto your badge. Just tap and go during checkout to use.

8. CE VERIFICATION/REPORTING

4. COURSE HANDOUTS

•

• for this event will be loaded on your badge) • Dueling Pianos – 8-11 PM • Guitarist in Wreckers – 10 PM-1 AM Friday, June 24 • Alumni Receptions – 5-7 PM • Sea Vibes Party – 7:30-10:30 PM • The After Party – 10 PM-1 AM

Your badge will be scanned when you enter and exit a course to calculate your hours attended. Your CE certificate will also be emailed to you by Monday, June 27. CE certificate printing stations also will be available on-site on Thursday through Saturday from 7 AM-5:30 PM on the classroom level. CE credit will be reported to CE Broker for all Florida licensed attendees by July 23, 2022.

9. SPEAKER HOST ORIENTATION

you are a first-time Speaker Host volunteer, plan on • Ifattending the Orientation Meeting the first day of your

view in the mobile app on-site. Note: some handouts may be too large to view within the mobile app. Please download and save to your device or print ahead of time.

•

5. EXHIBIT HALL

• Exhibit Hall Hours:

assigned hosting position. Orientation Meetings are held 7-7:30 AM and 11-11:30 AM, daily. You will pick up your host packet and your $20 lunch voucher will be activated at this meeting.

10. COVID-19 ON-SITE PROTOCOLS

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

wearing is recommended, but not required. • Mask are not required to be vaccinated and proof of • Attendees vaccine status will not be required to attend. policies are subject to change. FDC will continue • On-site to follow CDC, Gaylord Palms, and state/local ordinanc-

the current exhibitor listing and find FDC-exclusive • View exhibitor coupons at exhibithall.floridadentalconvention.com.

es. Visit floridadentalconvention.com for health & safety updates.

JUNE 23-25, 2022

GAYLORD PALMS RESORT & CONVENTION CENTER

ORLANDO, FL

FLORIDADENTALCONVENTION.COM

HIRE for Today, MENTOR for the FUTURE:

Finding the Perfect ASSOCIATE By Suzanne Ebert, DMD Bringing in an associate can be intimidating. You’ve built your practice’s reputation on a certain style of care and may have known some of your patients for decades. You want to know that Mrs. Smith will get the same quality and level of care she has come to expect, regardless of which dentist she sees in your office. So what makes an associate “right” for your practice and patients?

Every week at ADA Practice Transitions (ADAPT), I speak with owners looking to hire an associate or sell their practice. Many insist that any associate coming to work for them must have at least two to five years of experience. Too often, this means that they refuse to even consider a dentist who would otherwise be a perfect fit. At ADAPT, we strive to connect doctors who can work well together and respect each others’ professional decision-making. While

future experience is important, skills can ultimately be trained. Underlying personality traits cannot.

This begs the question: Where do owners expect new graduates to gain that initial experience?

Sometimes it’s best to hire someone who has the right attitude, approach and personality for your practice, then help them gain experience under your tutelage.

The reality is that DSOs are generally eager to hire new graduates. DSOs can be a fantastic place for young dentists to build their skills while earning a steady paycheck. Owners need to either embrace this model or take matters into their own hands and hire (and train) a recent grad to their specifications.

Let’s explore why a doctor with a little less experience can be a great asset to your practice.

Train them to your best practices Recently graduated doctors often come with a clean slate. They haven’t learned any bad habits and are typically laser-focused on achieving perfection. Meanwhile, you have spent decades developing your own best practices. You know exactly what to do when conditions dictate that a crown margin must be placed in a somewhat “less than ideal” location, a canal is blocked out or a tooth is broken off at the gingival level. Young professionals crave opportunities to learn these things from an experienced doctor, and you can mold them to your best practices. Yes, they may initially take longer, but patience will pay off. And watching someone grow into their career — and themselves — can be incredibly rewarding.

Young dentists have to get hands-on experience somewhere. Why not in your practice?

Gain a new perspective — and revenue A new dentist can provide an outsider’s perspective and fresh energy that may enable you to grow your practice. They might offer a treatment you currently refer out, or be able to take over some of the “bread and butter” dentistry to free up your time for more complicated treatments. Be sure to discuss your intentions with any prospective hire to ensure you’re on the same page .

Plan ahead for your own retirement

Get up-to-date about the latest evidence and technology

Many dentists plan a long, gradual path to retirement. I have helped some create an “associate-to-owner” pathway, in which both sides agree to a timeline during which the senior dentist sells the practice to the junior dentist.

Even the most diligent doctor has limited time for continuing education.

Other owners find themselves scrambling to sell after an injury or illness. Too often, this leads to practice closures.

A recent graduate who has devoted the last four years to learning best practices and studying the research can help you stay current on providing evidence-based care and understanding new technologies.

Hiring an associate helps future-proof your practice as you’ll already have an in-house dentist who can provide continuity of care to your patients.

Support independent dentistry While 86% of graduating dental students say they want to own their own practice within 10 years, many turn to dental support organizations (DSOs) for their first dental jobs. Some owners bemoan this fact, stating that the training early-career professionals receive in DSOs is not ideal for developing the clinical skills owners value. Even so, many of these same owners refuse to hire anyone with less than five years of experience.

Think of hiring as a long-term endeavor. Seek the right person to work with your staff and care for your patients for years to come, rather than seeking someone with a preconceived amount of experience.

To create a free ADA Practice Transitions profile and be matched with dentists who share your approach, visit adapracticetransitions.com

27 | TODAY'S FDA may/june 2022

In this day and age, with things ever changing, it is so nice to be part of online groups. We all need information fast. It’s nice to have access to dentists from all areas of the country.

”

Looking AHEAD in Dentistry By Sanjie Jackson, DMD

This world is ever changing. To me, it’s never been more so since March 2020. As a practicing dentist for the past 15 years, I feel like the last two have been the most mentally and emotionally challenging. Since the middle of March 2020, I have had to be more flexible, understanding and open than I’ve ever been as a dentist and owner. When I think about the future of dentistry there a few things that come to mind: artificial intelligence (AI), dental hygiene and comradery. I know, these things are very different; however, they all can and will affect the way we practice dentistry. AI has made its way into medicine, and we now see an increasing amount of robotically assisted surgeries. I had surgery last year and my amazing surgeon used a robot to aid her during surgery. A surgery that once would have taken four or five hours was com-

future pleted in approximately two hours. And, as seen in an article in Dentistry Today published April 28, 2021, AI is making its way into dentistry in different avenues. No, AI is not going to replace us as dentists. But it does have the capacity to help us with treatment planning by leveraging information from clinical and surgical data. With the integration of AI as an adjunct, we expect improvement in long-term treatment prognosis and outcomes for our patients. Some areas where AI will be pretty useful for us — and may become routine — are in caries, periodontal disease and oral cancer detection. Being able to detect and diagnose these earlier will definitely improve the lives of our patients. Another area that seems to really be growing rapidly is AI-assisted orthodontic treatment planning. This technology can help clinicians determine whether better results will result from surgical intervention. This brings me to my next topic: our hygiene departments. There is a nationwide shortage of dental hygienists. With almost every dentist that I talk to, and in nearly every group I am a part of, the topic of this shortage is at the forefront of discussion. I, myself, am feeling the pinch as one of our hygienists recently retired at the age of 70. In interviewing May 2022 graduate hygienists, I’ve learned that some are now expecting to make more than some PPO’s reimburse for an adult prophy. This leaves a lot of doctors in a pickle. Doctors and owners want to take care of our teams and our patients, but it leaves in a deficit — especially if you contribute 50% of medical and vision, contribute to/match 401K and give paid time off as I do. What do we do? I have heard of two solutions to this problem over and over again and it makes me think that this may be the two new ways of treating patients while compensating our hygienists. 1. Hygienists being paid on a percentage of their adjusted production. This would cover costs of this team member, personal contributions for having this person as an employee, new instruments that may be needed, as well as toothbrushes and toothpastes given to patients. I can see how this could really help every hygienist be more active in the involvement of each patient’s periodontal health. 2. Assisted Hygiene. Since there is a shortage, we as dentists and owners have to adapt and find a solution. My concern

with assisted hygiene is that I love relationships. And, I know my patients adore the relationship they have with the hygienist who has been with us for 25 years and new ones being built with our newest hygienists hired in recent years. I don’t want to mess with that at all. But, this is something I know is being considered by more and more dentists throughout the country. If the rate of assisted hygiene continues, what additional expanded functions will dental assistants be granted in the future and will dental practices just need less hygienists? Who knows? What I do know is that like everything else in life, dentistry is changing and we have to be flexible and adapt. And, finally, comradery. I have always felt it within my dental community; however, from March to May 2020 we all needed it. At the beginning of the COVID-19 pandemic there were a plethora of emails sharing webinars about how to take care of your team, how to apply for assistance, how to deal with stress, how to do online schooling with the kids and the list goes on. I even remember a local dentist sharing information about filtration systems that aid in keeping the air cleaner in our offices. The sense of community and connection was really strong. During this time new friendships were formed as we were all trying to figure out what to do. We were inquiring from our then colleagues, now friends what they were doing in their respective offices. In this day and age, with things ever changing, it is so nice to be part of online groups. On Facebook alone, there are dozens of free private groups that we can join from Dental Disrupt Nation to Dental Clinical Pearls and, of course, Florida Dental Chatter. There are also groups, like the Dental Success Network, that have podcasts, webinars with a myriad of topics you can research and an entire training entity that can help you with your team. You can join private forums where you can ask any question without being judged. Comradery used to only look like meeting in a room with fellow dentists learning but that too is changing. We all need information fast. It’s nice to have access to dentists from all areas of the country. To be able to ask a group of dentists their opinions about payroll vendors, for example, and get 20 responses by day’s end is so helpful. That’s part of what community is about. And I love being a part of that. Whether you’re an introvert or an extrovert, there is no reason we have to do dentistry alone.

31 | TODAY'S FDA may/june 2022

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I started working with Linda Marek in 2014. She has since guided me through some extremely delicate and difficult decisions. She knows how to push and challenge me to be my best and make clear levelheaded decisions for my practice. She makes herself accessible whenever I need assistance and answers my questions timely. My practice has quadrupled in less than 3 years. Linda’s help, guidance and friendship has been an enormous gift on this crazy journey through dentistry!”

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33 | TODAY'S FDA may/june 2022

Are Are We We Ready Ready to to Embrace Embrace a a Bold Bold New New Vision Vision for for the the Dental Dental Profession? Profession?

We are at a critical moment for the dental profession. What we do now, or what we don’t do, will define the entire profession of dentistry for decades to come. The pandemic has brought unprecedented disruption to our personal and professional lives, but it’s really what comes next that is the game changer. What’s approaching us is not just a guess. We have seen and will continue to see major acceleration in several trends that will have a profound impact on the profession. The future is now being painted clearly and several factors once thought to be shortlived fads are now well established trends. From the patient’s perspective, we know that there is a shift in the mindset of how patients are perceiving health care overall. This includes dentistry and is particularly common amongst millennials. This phenomenon, coupled with intensified consumerism and public and private insurance replacing the self-pay market, is leading to a change in patient base. This will challenge our previous outlook when we analyze the future consumers of our dental care services.

”

By Raymond Cohlmia, DDS and Marko Vujicic, Ph.D

What we do now, or what we don’t do, will define the entire profession of dentistry for decades to come.

”

Furthermore, we know that practice modality is transforming at a dramatic pace. This is fueled by the transition of the dental workforce to a younger, more diverse generation that will soon assume their roles as the new recognized dental care providers in the next decade. A decreasing percentage of dentists own their practice. Most dentists in Florida and much of the U.S. now practice in groups, with solo practice slowly disappearing (Fig. 1). More and more dentists are joining dental support organizations (DSOs) and a conservative estimate is that 15 percent of Florida dentists practice in these models, much higher than the U.S. average. As millennial and Generation X dentists replace baby-boomers, these trends will continue to intensify.

Fig. 1

The educational format has also shifted to an integrated and holistic approach to patient care. Dentistry has been very successful in supporting the thought processes of wellness and prevention. This has become the main focus of the general public’s expectations for their individual wellness. However, we also need to acknowledge that our current system of dental care financing and delivery is not serving all Americans. We know that half of the U.S. population is not going to the dentist regularly and that cost barriers are the biggest cause why. Although we have made vast improvements over the last two decades in many aspects of children’s oral health, we have little progress to show when it comes to oral health for adults and seniors. In fact, income and race disparities are widening among adults and seniors for several indicators of oral health and access to care. What is all this leading to? It brings us to a critical point for our profession. What we do now, or choose not to do, is critical to our future. Are we ready to accept that practice models are evolving and, inevitably, dentistry will too, like all other health care professions? Are we ready to advocate for policies that will work toward finding a dental home for everyone? Are we ready to transition dentistry into a core component of primary care in order to align with the conversion to a holistic approach to patient care that we’re seeing within the educational format? Changes like these have the potential to grant access to primary care dental providers to millions of Americans. If the answer is ‘yes’ to these questions, then the American Dental Association and Florida Dental Association will need to shift priorities in terms of how we support dentists and what we emphasize in our advocacy efforts.

This is a time for bold and defined leadership. You have heard both of us say that what is in the windshield is much more critical than what is in the rear-view mirror. The scenery around us will continue to change whether we move or not. The question is, are we choosing to move forward, or stand by and watch it all happen? Our profession is at a crossroads and our view through the windshield is vastly different than what’s staring back at us in the rear-view mirror. We must ask ourselves: are we ready to embrace a bold new vision for the dental profession, or are we going to sit back and watch as change happens around us?

35 | TODAY'S FDA may/june 2022

”

AI has been utilized to improve the predictability of implant therapy and monitor orthodontic cases; now it is being used for dental radiology.

”

artificial intelligence

Application of Artificial Intelligence in Dentistry By Alan Friedel, DDS

We hear the words Artificial Intelligence (AI) applied to seemingly everything these days. What exactly does AI mean and how does it relate to the everyday practice of dentistry?

when the dentist reports back that the recommendation of the x-ray was incorrect. The computer uses that input to correct itself and, with time and more and more radiographs being run through the software, accuracy improves.

Artificial Intelligence is the term applied when computers are used to perform functions associated with intelligent beings. The concept is often used in conjunction with machine learning, which is the ability of computers to enhance performance based upon a feedback loop which improves outcomes.

By reading the entire view, a doctor focused on a lower right molar on a panorex will not miss a sinus problem on the left side because the software will poke him to look beyond the immediate emergency. The goal is to improve outcomes because we will find pathology with much greater efficiency. As use of these prod-

AI has been utilized to improve the predictability of implant therapy and monitor orthodontic cases; now it is being used for dental radiology. It is this area of radiology that has been most active lately, in part because of the acceptance of cone beam computed tomography (CBCT) scanning and the sheer volume of data on a CBCT image. Use of CBCT has improved outcomes in implantology and improved the ability to diagnose pathology. The concern with CBCT images is that they cover a large field which must be viewed in its entirety, not just the practitioner’s

ucts increases, models improve because of input from thousands of user dentists.

area of interest. Even when viewing traditional Two-Dimensional (2D) radiographs, conventional wisdom is that 30% of the information is missed by the doctor.

How does AI fit into this “picture?” Computers are now being trained to scan digital images — and read them. Through the use of AI, they can identify areas of concern and focus the eyes of the dentist on those specific areas. There are multiple products in various stages of development, but the standard is that the software directs the doctor to a place on the image and suggests a diagnosis. The actual diagnosis, and ultimately the treatment plan, are the sole responsibility of the dentist. The accuracy of these recommendations is a key factor in whether they are useful. AI and machine learning are engaged

What other developments are now available that will transform dentistry? There is now a product currently available that uses equipment no larger than a standard x-ray head to capture periapical-sized images that are three dimensional. Using the accompanying software, users can scroll through the body of a tooth from buccal to lingual and see things that 2D images compress. This means the possibility of navigating around overlapping teeth on bitewings and seeing many more cracks within teeth. During root canal therapy, there will be an ability to focus on individual canals within a tooth. It also allows a better perspective for the shape of periodontal bone loss and, in some cases, may give a better sense of where decay lies within a tooth. Obtaining accurate images, whether annotated by computer AI or allowing for 3-Dimensional perspective provides for vastly improved diagnostic capability by dentists. This will allow us to treat our patients with a greater degree of confidence and the opportunity for higher success rates.

37 | TODAY'S FDA may/june 2022

Artificial Intelligence

Artificial Intelligence and the Future of Dentistry: A Brief Review By Andrew J. Corsaro, D.M.D., M.S., F.A.C.D. There have been many developments in dentistry related to materials, techniques, office and patient management and education. Regardless of these improvements, further development will ultimately result in diminishing returns to the advancement of the profession due to a single limiting factor: the human dentist. Many talented professionals are able to balance hectic schedules, complex cases, staff concerns, financial issues and the myriad of other challenges dentists face on a daily basis. These mental gymnastics cannot overcome the barriers of only treating one patient at a time, looking at one chart at a time and being in one place at a time. This inability to multiply will always be a limiting factor in the advancement of dentistry in spite of the forever evolving motif of our practice. The field of artificial intelligence (AI) has experienced tremendous growth throughout health care. Recently, the University of Florida and tech giant NVIDIA announced a $70 million partnership aimed at advancement of AI research and application. The UF College of Dentistry will be participating in this partnership through the addition of faculty and facilities to explore how AI will contribute to the field of dentistry. Dental AI has tremendous potential to make a large, lasting impact on access to dental care, success of dental treatment and financial efficiency. Diagnosis and treatment planning of dental pathology are the first hurdles to overcome in the delivery of dental care on a large scale in underserved areas. Emerging AI models have been able to accurately diagnose dental caries and other dental pathology, without human input, based on data that do not need to be collected by a dentist such as radiographs, photographs and saliva samples. While there is much work to be done to develop this ability to a point where it can reliably diagnose oral pathology to the current standard of care, these observations have proven to

be very promising. Diagnosis, triage and treatment planning on a large scale have traditionally been very labor-intensive practices for a dentist, relying on physical presence and the necessity to review patient data individually. Communities with large populations (i.e. schools, military, rural or underserved areas) could benefit greatly by using AI to predict the resources necessary to deliver care by first identifying the extent of the problem without the presence of a dentist. Dental care could then be delivered on a much more efficient and cost-effective basis, improving access to care. Telehealth, including teledentistry, saw a drastic increase in utilization as a result of quarantine and isolation during the COVID-19 pandemic. The limiting factor in the efficient deployment of teledental services was again the availability of the dentist. Inquisitive patients often seek advice or information prior to visiting a dental office and frequently have questions or concerns that could be addressed by dental AI. AI in healthcare has proven to be effective in reading and analyzing patient charts to identify trends. This could be used by patients to help answer questions and provide guidance of when and how to seek dental care. Patients would arrive at the dental office better educated and prepared for dental treatment. There are dozens of other impressive advancements in the field of dental AI that will help dentists of the future treat patients more efficiently and effectively. Research and application partnerships — such as that between UF and NVIDIA — are likely to be the driving forces behind development until industry takes over, at which point these applications will scale to become the standard of care. There are many great resources including academic publications, conferences and presentations emerging at all levels of organized dentistry should you choose to explore this topic further.

39 may/june 39 | TODAY'S FDA 2022

”

Cone beam computed tomography (CBCT) has changed the way clinicians diagnose and determine the best course of treatment.

6. 40

3D Imaging

OPEN YOUR EYES TO 3D IMAGING By Lea Al Matny, DDS, MS

Abstract The intent of this article is to identify different applications that may benefit from an investigation with a cone beam computed tomography (CBCT) scan beyond implant planning. These indications include variations of anatomical landmarks, detection of periapical pathosis, radicular fractures, external cervical resorption and airway analysis. CBCT has changed the way clinicians diagnose and determine the best course of treatment. This can often mean the difference between solving the mystery of a patient’s pain or missing a vital indicator. CBCT has advanced from unique use to almost commonplace use in dentistry as cost decreases and access to the technology increases.1 Dental specialists quickly embraced three-dimensional imaging as a means by which they can distinguish their practices as being on the cutting edge of technology. Oral surgeons, periodontists and orthodontists valued the anatomical structures visible in a large field of view CBCT scan, whereas endodontists appreciated the extraordinary level of detail achieved in high resolution, focused field of view scans. Even maxillofacial prosthodontists have pointed out the advantage of not being bound by two dimensions in a three-dimensional world.2

Figures: 1-6 Fig. 1: High-resolution, focused field of view CBCT scan of the posterior left mandible. Fig. 2: Low-dose, large field of view CBCT scan on the same patient. Fig. 3: Coronal view of the anterior maxilla presenting the “s-shaped” canalis sinuosus on the right side. Fig. 4: Periapical radiograph of posterior right maxilla. Fig. 5: Sagittal view of a focused field of view CBCT scan on the same patient. Fig. 6: Coronal view showing a radicular fracture extending from the occlusal surface.

General dentists soon recognized the impact three-dimensional imaging can have on diagnosis. Today, patients expect their dentist to be contemporary and utilize the latest technology available in treatment. t

41 | TODAY'S FDA may/june 2022

3D Imaging As more clinicians adopt this technology, it is important for users as well as referring practitioners to understand the basic concepts of this imaging modality. The large field of view, low-dose CBCT scan acquired by the patient’s orthodontist does not help address the questions raised by the patient’s endodontist when a root canal treatment is warranted. Recognizing when CBCT is needed, why it can be beneficial and which imaging protocol provides more relevant information in each case is the key to benefiting from this technology.

Variations of normal anatomical structures. Knowledge of anatomical variations is extremely important for planning treatment and avoiding complications postoperatively. Precise imaging becomes especially important in surgical cases that might involve vulnerable structures, including sinus cavities, nerve channels or blood vessels. One of the variations rarely discussed is the canalis sinuosus, a neurovascular canal, nerve branch of the infraorbital canal, that passes the anterior superior alveolar nerve.4

Customize Imaging Protocols for Your Patients

Detection of periapical pathosis. Furthermore, 3D imaging identifies up to 40% more of previously undetectable lesions.5 Two-dimensional imaging modalities provide patchwork information of anatomic segments to represent three-dimensional anatomy. This diagnostic variability is noticed in endodontically treated and untreated teeth, especially in the posterior maxilla. Patel et al. also elaborate on the limitations of detecting periapical lesions using periapical radiographs in necrotic teeth.6 A

Every patient is unique, and every clinical situation requires a treatment plan customized to meet each patient’s needs. In the same way, CBCT imaging can and should be customized to each patient or diagnostic task to optimize image quality and increase diagnostic accuracy. It can be easy to “set it, forget it” and take the same scan on every patient who needs a scan, but tailoring the settings on a CBCT machine can significantly affect image quality and increase diagnostic accuracy.

visible radiolucency surrounding an apex depends on the size of the lesion, density and thickness of the cortical plate as well as the distance between the lesion and cortical plate.

Some of the configurable factors include field of view, voxel size,

Vertical root fractures. Vertical root fractures can be even more difficult to visualize on routine radiographic techniques. Long-standing fractures usually show changes in the surrounding bone pattern. However, a recently fractured tooth can be more difficult to identify radiographically, especially in the presence of metal artifacts caused by metal restorations, endodontic posts, root fillings and implants. Therefore, reconstruction algorithms such as metal artifact reduction can greatly enhance the quality of images and reduce the effect of beam hardening and scatter present.

patient positioning and metal artifact reduction (MAR) reconstruction algorithm. It would also be simple and straightforward to reduce radiation doses to extremely low levels, but such extreme low dose levels may render images diagnostically useless. In fact, imaging protocols have evolved in adapting the traditional ALARA (As Low as Reasonably Achievable) principle toward ALADAIP (As Low as Diagnostically Acceptable being Indication-oriented and Patient-specific).3 What constitutes adequate image quality depends on the modality being used and the clinical question being asked.

External cervical root resorption. Other times, incidental findings such as external cervical root resorption require dynamic navigation through the three axes provided on a focused field of view CBCT scan to determine prognosis and possible treatment plan options. The clinical presentation of external cervical resorption depends considerably on the size and extent of the resorptive process. Some cases classified as Heithersay class I or II, typically assigned with a “good” prognosis, could present with

Evaluate CBCT Scans in a Comprehensive Manner There is little dispute that CBCT provides superior representation of anatomy versus two-dimensional plain films. Three-dimensional imaging facilitates the localization of anatomical variations, relationships of structures and helps identify the origin of pathosis (untreated/unobturated canals, root resorptions or fractures).

up to 28% of the root structure affected by the resorptive defects.7

Airway analysis. Surely, there is more to CBCT imaging than endodontic diagnosis. The ultimate goal of imaging is to portray the anatomic truth to help in diagnosis and treatment planning. CBCT imaging for the primary evaluation of the airway has been greatly debated. Studies have shown that certain craniofacial patterns are related with smaller dimensions of the upper airway.8 Some of the most common qualitative factors include retrognathia, steep mandibular plane, hypoplastic maxilla and reduced transverse dimension of the maxilla. Quantitatively, the airway volume, minimum cross-sectional area and length of the airway can be automatically computed using the imaging software.9 t

10.

Figures: 7-12

11.

Fig. 7: Sagittal view of the same tooth presenting localized angular bone loss on the distal aspect. Fig. 8-10: External cervical resorption on thin CBCT slices varying in extent, location and occupying volume. Fig. 11: Airway analysis presented on the volume rendering of a large field of view CBCT scan. Fig. 12: Volume rendering merged with facial scan and digital impression for patient education.

12. 43 | TODAY'S FDA may/june 2022

3D Imaging Use of 3D Imaging Beyond Implant Planning Software capabilities permit visualization of a CBCT scan from any angle, and specific areas in a scan can be segmented for further analysis. The use of CBCT has partly intensified due to its advanced software tools. Three-dimensional imaging was not just used as a diagnostic tool, but rather a productivity tool that helps dentists treat patients more efficiently. Over the next few years, dynamic software applications based on 3D imaging will also mature and become more enriched. We have already witnessed the effect of computer-aided design/ computer-aided manufacturing technology and 3D implant planning. CBCT scans can be automatically merged with digital impressions within seconds without points matching. Then, virtual implants can be planned with the final restoration in mind. The communication between different platforms makes the entire process faster and more efficient, which is important for a busy practice with many implant surgeries on the schedule. Improvements in software technology will bring more capabilities — including virtual treatments, simulations and new possibilities for guided surgery — than are available now. CBCT will go beyond a static image to create something tangible. Some of the applications include the ability to incorporate a dynamic element to reproduce occlusion and the movement of the arches. These applications are driven by the idea that both static and dynamic parameters should be considered in order to achieve complete diagnostics. Other applications involve dynamic navigation systems that track the position of the tip of the implant drill and map it to a pre-acquired CBCT scan of the patient’s jaw to provide real-time drilling and placement guidance/feedback. Dynamic navigation is gaining traction in endodontics as well, especially in calcified canals. These advancements in software and static/dynamic guide partners have brought more proficiency, flexibility and precision to treatment planning.

Conclusion CBCT technology is becoming more integral in daily practice. The anatomic and diagnostic accuracy provided by three-dimensional imaging have enormous impact on the prognosis and reliability of treatment plan provided. Incorporating 3D imaging

will allow practitioners to approach cases in a comprehensive manner, beyond focusing on the tooth in question.

References 1. Whitesides L. Cone beam computed tomography: Is dentistry ready for a new standard of care? Cone Beam — International Magazine of Cone Beam Dentistry; No. 04/2014. 2. Rinaldi M, Ganz S, Motolla A. Computer-guided applications for dental implants, bone grafting, and reconstructive surgery. Elsevier Publications; 2016. 3. The use of cone-beam computed tomography in dentistry. Advisory statement from the American Dental Association Council on Scientific Affairs. Journal of the American Dental Association;143(8):899-902. 4. Arruda JA, Silva P, Silva L, et al. Dental implant in the canalis sinuosus: a case report and review of the literature. Case Rep Dent 2017;2017:4810123. doi:10.1155/2017/4810123. 5. Pope O, Sathorn C, Parashos P. A comparative investigation of conebeam computed tomography and periapical radiography in the diagnosis of a healthy periapex. J Endod 2014;40(3):360-365. doi:10.1016/j. joen.2013.10.003. 6. Patel, S et al. The detection of periapical pathosis using periapical radiography and cone beam computed tomography - part 1: pre-operative status. International Endodontic Journal 2012;45(8):702-10. 7. Matny, Lea E et al. A volumetric assessment of external cervical resorption cases and its correlation to classification, treatment planning, and expected prognosis. Journal of Endodontics 2020;46(12): 1929-1930. doi:10.1016/j.joen.2020.10.006. 8. Neelapu BC, Kharbanda OP, et al. Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: a systematic review and meta-analysis of cephalometric studies. Sleep Med Rev 2017;Feb;31:79–90. doi:10.1016/j. smrv.2016.01.007. Epub 2016 Jan 30. 9. Schendel SA, Jacobson R, Khalessi S. Airway growth and development: a computerized 3-dimensional analysis. J Oral Maxillofac Surg 2012;70(9):2174-2183. doi:10.1016/j.joms.2011.10.013.

Lea Al Matny, DDS, MS, is a licensed oral and maxillofacial radiologist at SeeThru Reports (seethrureports.com) and a clinical education specialist at Carestream Dental. She attended the University of Texas Health in San Antonio, where she received both a certificate in oral and maxillofacial radiology and a master’s degree in dental science. She is a reviewer for Oral Surgery, Oral Pathology, Oral Medicine, Oral Radiology and is actively involved in multiple committees at the American Association of Oral Maxillofacial Radiology. Reprinted with permission by the Michigan Dental Association.

45 | TODAY'S FDA may/june 2022

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.

47 | TODAY'S FDA may/june 2022

FDC2022 | SPEAKER preview

The Dentist as Diagnostician: WhAT you don’t see might hurt you By Dale A. Miles DDS, MS, FRCD(C) Diplomate, American Board of Oral Maxillofacial Radiology

Today, the average patient in the dental office is not young, healthy and suffering from dental caries and periodontal disease. They are more likely to be middle-aged, prescribed multiple medications and have systemic issues that can complicate dental care. The introduction of the radiology modality (CBCT) to the dental profession has been a very disruptive technology with both advantages and potential liabilities. It is an extremely useful tool for dentists when it comes to most of the tasks they perform in their offices. However, the first reaction of a dentist upon capturing their first data set in cone beam CT is commonly, “These images are great! But…what am I looking at?” Unfortunately, the technology always precedes the education, so working towards complete comprehension is key to operating the technology competently and usefully. I, like every other dentist, have had to educate myself to look at the volume data in an expert fashion, despite my advanced training in oral maxillofacial radiology. There are three anatomic planes of section in the scans and hundreds of slices in each of the three planes. That’s a lot of data!

Because I was a dentist first and practiced for many years before my graduate training, I understand the complexities of practicing dentistry and am trying to help my colleagues understand the technology that they are adopting. You must examine all the data in your cone beam scans, or those systemic changes that you miss may come back to haunt you. Having examined over 35,000 CBCT scans, I feel quite competent interpreting changes in the nasal cavity, paranasal sinuses, airway and cranial vault to help my colleagues “stay out of trouble.” Think of me as your risk reduction professional! However, given that dentists have to look at all of their own data, it is essential that they “retool” themselves in anatomy, pathology and image processing so that they do not miss an important finding. It’s equally important that they learn how to use the tools in their cone beam software to enhance the features of the disease process to make a better clinical decision. This is part of being a competent dental professional. There is no way around it, you must get additional training to use the technology expertly. Recently, I have noticed that there are patterns of calcifications in the internal carotid arteries through the neck and head that are a potential marker of undiagnosed or uncontrolled Type II Diabetes Mellitus. Imagine being able to examine your cone beam data

“

„

Imagine being able to examine your cone beam data and radiographic findings to help you detect and diagnose a patient with undiagnosed Diabetes Mellitus.

and radiographic findings and detect a patient with undiagnosed Diabetes Mellitus. The sooner the disease process is diagnosed in the patient, the faster they will enter into appropriate treatment. We have the technology to do this: CBCT. Your “Pathway to Success” in being an expert diagnostician will be enhanced by adopting CBCT technology. You just have to know what you’re looking at first!

Dr. Miles is an FDC2022 speaker and will be presenting his course, “Can You See Systemic Diseases on X-rays? New Diagnostic Markers on CBCT Images,” on Friday, June 24. Mr. Miles will be presenting “Radiographic Manifestations of Systemic Disease - From Periapicals to Cone Beam” on Saturday, June 25.

49 | TODAY'S FDA may/june 2022

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FDC2022 | SPEAKER preview

sitting: ACTiVE Versus static By Rick Williamson One contributing factor to pelvic and low back pain is the rigid and static nature of a traditional dental stool, resulting in sustained mechanical tissue loading and restrictive posture. The prolonged postural loading of the spine, while sitting without natural movement or mobilization of the spine, can increase pain and stiffness. Inhibition of the deep core musculature is paired with overuse of superficial hip and back muscles, leading to fatigue and pain. In contrast, an active sitting system allows equal resistance in 360 degrees of movement. Forward spine flexion and pelvic rotation are minimized in work postures. Natural movement and spine mobilization, not forced, fixed rotation, are allowed as you work and address the patient. Deep core, postural muscles (the marathon runners of the body) engage and support the body as intended. This eliminates overuse of superficial musculature (the body’s sprinters) so that they can be engaged when they are needed, without strain or fatigue. This improves posture, core stability and circulation. The Body Praxis program incorporates seated exercises on a stability ball to increase pelvic mobility and realignment, lumbar spine mobility, postural awareness and core strength. Learn more about the Body Praxis program at FDC2022.

“ „ Natural movement and spine mobilization, not forced, fixed rotation, are allowed as you work and address the patient.

Mr. Williamson is a certified personal trainer and nationally recognized certified Pilates practitioner for rehabilitation. He developed the Body Praxis system after successfully rehabilitating numerous dentists and hygienists from the pain associated with musculoskeletal disorders and common complaints experienced by dental professionals. He can be reached at bodypraxis@aol.com. Mr. Williamson is an FDC2022 speaker and will be presenting his course, “Body Praxis: Physical Rehabilitation Program for Dental Professionals: The Prevention and Reversal of Musculoskeletal Disorders in Dentistry,” on Saturday, June 25.

51 | TODAY'S FDA may/june 2022

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2022 FLA-MOM • 2022 FLA-MOM • 2022 FLA-MOM • 2022 FLA-M

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This March, more than 1,300 volunteers from across the state participated in the seventh Florida Mission of Mercy (FLA-MOM), presented by the FDA Foundation. FLA-MOM is a large-scale, two-day, professional dental clinic that provides care to any patient at no cost to them, with the goal of serving the underserved and uninsured in Florida. FLA-MOM seeks to have a positive impact on those who attend by relieving dental pain and infection, restoring smiles and dignity, and educating patients about the importance of obtaining and maintaining optimal oral health. Held March 11-12 at the Donald L. Tucker Civic Center in Tallahassee, the 2022 FLA-MOM safely provided 9,493 procedures to 1,375 patients — resulting in $1.79 million in donated care! Thank you to all our volunteers and benefactors who helped make the event a success! Please visit flamom.org to get information about the 2023 FLA-MOM taking place in West Palm Beach Feb. 24-25.

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FDC2022 CE HIGHLIGHT

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

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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.

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63 | TODAY'S FDA may/june 2022

florida dental convention Partners with the Student National Dental Association The Florida Dental Convention (FDC) is excited to announce its partnership with the Student National Dental Association (SNDA) at the 2022 Florida Dental Convention. SNDA will hold their 50th Anniversary Celebration and Meeting parallel to FDC2022 on Thursday, June 23 through Saturday, June 25 at the Gaylord Palms Resort & Convention Center in Orlando. Visit www.floridadentalconvention.com to learn more about FDC2022 and www.sndaonline.com to learn more SNDA's 50th Anniversary Celebration and Meeting. We hope to see you there!

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!

Drs. Lauren A. Ruddocks, Neel Bhattacharyya, Nadim M. Islam

Read, Learn and Earn! and Donald M. Cohen

A 50-year-old female presented to Dr. Hardeep Chehal in Omaha, Neb. Her chief complaint was a one-year history of a swelling Visit floridadental.org/online-ce for this FREE, MEMBERS-ONLY BENEFIT. You will be given the on the maxillary gingiva. Clinical examination revealed a pinkopportunity review thesessile “Diagnostic Discussion” and its accompanying photos. Answer five red, well-defined,to smooth-surfaced, nodule on the facial gingiva adjacent to teeth #9 and 10 (Fig. The lesion multiple choice questions to1).earn one measured hour of CE. 2.4 cm in largest dimension and the patient reported no symptoms. A periapical radiograph demonstrated a well-demarcated apical radiolucency between teeth #8 and 9 (Fig. 2). An excisional Fig. 1: Nodule on the facial gingiva biopsy was performed and tissue was submitted to the Oral Pathology Biopsy Service at University of Florida College of Dentistry in Gainesville. Microscopically, the lesion was composed of Contact FDC Marketing Coordinator Brooke Martin epithelium overlying loose fibrous connective tissue containing at bmartin@floridadental.org or 800.877.9922. fibroblasts and numerous islands of odontogenic epithelium (Fig. 3). t

Question: Based on the above history, clinical photograph and imaging findings, what is the most likely diagnosis? A. Peripheral giant cell granuloma B. Peripheral ossifying fibroma C. Pyogenic granuloma

Fig. 2: Apical radiolucency between #8 and #9.

D. Peripheral odontogenic fibroma E. Peripheral ameloblastoma

Fig. 3: Loose connective tissue containing odontogenic epithelial islands, surfaced by epithelium.

67 | TODAY'S FDA may/june 2022

quiz A. Peripheral giant cell granuloma Incorrect, but certainly among the differential diagnoses. Peripheral giant cell granuloma (PGCG) is believed to represent a reactive response to local trauma rather than a true neoplasm. In common with our case, PGCG presents as an asymptomatic nodular mass on the gingiva, with a female predilection. It can be seen in patients across a wide age range, with a mean age in the fourth to fifth decades. PGCG are reported to occur more often in the mandible, and, unlike the pink-red color of our lesion, PGCG more commonly appear red to blue-purple in color. Resorption of the underlying bone (“cupping” resorption) is seen in around one-third of cases of PGCG and can create the false impression of a central lesion that has eroded through the cortical bone. Microscopically, PGCG is characterized by aggregates of multinucleated giant cells in a background of spindled and ovoid cells, interspersed with abundant hemorrhage and hemosiderin deposition. Treatment is by excision down to periosteum, as well as curettage to remove any sources of irritation. Performing curettage or peripheral osteotomy in addition to excision is reported to reduce the likelihood of recurrence by 85% compared to excision alone; the latter being associated with recurrence rates of up to 18%.

B. Peripheral ossifying fibroma Incorrect, but great thought. Like PGCG, peripheral ossifying fibroma (POF) is also a reactive proliferation in response to irritation and is more common in females. POF arises as an asymptomatic nodule, usually on the maxilla, and typically presents in young patients, with a mean age of around 10 to 20 years. POF is clinically and radiographically indistinguishable from the lesion in our case; cupping resorption is occasionally noted. Histologically, POF is composed of cellular fibrous tissue exhibiting deposition of bone or cementum-like material. The hard tissue-producing cells are thought to originate from pluripotent cells of the periodontal ligament. Recommended treatment is the same as PGCG: local excision down to periosteum combined with peripheral osteotomy/curettage to reduce the probability of recurrence.

C. Pyogenic granuloma Incorrect, but also a good choice. Pyogenic granuloma (PG) is another reactive lesion, characterized by localized hyperplasia of vascular connective tissue, again seen more commonly in females. It is thought that hormonal imbalance accounts for

an increased incidence of PG in patients during pregnancy or puberty, or those taking oral contraceptives. However, the precise mechanism behind such an association remains to be elucidated; a recent study found no direct correlation between cutaneous PG and female sex hormones. Around three-fourths of PG arise on the gingiva, but they can also present on the lips, buccal mucosa and tongue. Children and young adults are most commonly affected. Clinically, PG can vary from a fiery red to the pink seen in our case; the latter is usually seen in more mature, sclerotic lesions. Surface ulceration is common and imparts a yellow to grey color. Microscopic examination reveals a proliferation of vascular connective tissue, often with an associated inflammatory infiltrate. Where possible, PG arising during pregnancy should be left alone until delivery, after which time the lesion may gradually resolve. Surgical removal, where necessary, should be performed as described above for PGCG and POF.

D. Peripheral odontogenic fibroma Correct! Peripheral odontogenic fibroma (POdF) is uncommon, and unlike the entities described above, it is a true neoplasm. POdF is believed to be the most common peripheral odontogenic tumor, again presenting most commonly in women, with an average age in the fourth decade. It arises exclusively on the gingiva as an asymptomatic, firm, slow growing mass and shows a predilection for the anterior region of the jaws. As with the previous lesions, cupping out of the underlying bone is sometimes seen radiographically. Histologic examination shows fibrous connective tissue supporting a variable number of inactive-appearing odontogenic epithelial islands, with or without areas of bone or cementum-like material. Studies have shown a high recurrence rate of around 50%, with patients frequently experiencing multiple recurrences. For this reason, post-excisional curettage is particularly important.

E. Peripheral ameloblastoma Incorrect, but a good consideration. The clinical features of peripheral ameloblastoma (PA) are similar to our case: an asymptomatic, slow-growing gingival mass presenting most commonly in patients in the fifth and sixth decade, with or without cupping of the underlying bone. However, PA shows an almost 2-to-1 male predilection. There is a distinctive histopathologic appearance of islands of odontogenic epithelium composed of peripheral palisaded ameloblastic cells and central stellate reticulum-like tissue

within a fibrous stroma. PA exhibits much more indolent behavior than its central counterpart and treatment should consist of excision along with a margin of normal tissue; there is currently no evidence regarding the dimension of such a margin. Continued follow-up is recommended for at least 10 years due to the recurrence rate of 16 to 19 percent and rare associated instances of malignant progression.

References

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.

Chrcanovic BR, Gomes CC, Gomez RS. Peripheral giant cell granuloma: An updated analysis of 2824 cases reported in the literature. J Oral Pathol Med. 2018 May;47(5):454-459. doi: 10.1111/jop.12706. Epub 2018 Apr 10. PMID: 29569293.

Clinicians are invited to submit cases from their own practices. Cases may be used in the “Diagnostic Discussion,” with credit given to the submitter.

Shrestha A, Keshwar S, Jain N, Raut T, Jaisani MR, Sharma SL. Clinico-pathological profiling of peripheral ossifying fibroma of the oral cavity. Clin Case Rep. 2021 Oct 13;9(10):e04966. doi: 10.1002/ccr3.4966. PMID: 34691463; PMCID: PMC8513507.

Drs. Bhattacharyya, Cohen and Islam can be reached at

Park SH, Lee JH, Tak MS, Lee HJ, Choi HJ. A Research of Pyogenic Granuloma Genesis Factor With Immunohistochemical Analysis. J Craniofac Surg. 2017 Nov;28(8):2068-2072. doi: 10.1097/SCS.0000000000004148. PMID: 29019819. Ritwik P, Brannon RB. Peripheral odontogenic fibroma: a clinicopathologic study of 151 cases and review of the literature with special emphasis on recurrence. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Sep;110(3):357-63. doi: 10.1016/j.tripleo.2010.04.018. Epub 2010 Jul 31. PMID: 20674403. Anpalagan A, Tzortzis A, Twigg J, Wotherspoon R, Chengot P, Kanatas A. Current practice in the management of peripheral ameloblastoma: a structured review. Br J Oral Maxillofac Surg. 2021 Jan;59(1):e1-e8. doi: 10.1016/j.bjoms.2020.08.084. Epub 2020 Aug 21. PMID: 33162201.

oralpath@dental.ufl.edu. Conflict of Interest Disclosure: None reported for Drs. Bhattacharyya, Cohen and Islam. 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.

Vezhavendhan N, Vidyalakshmi S, Muthukumaran R, Santhadevy A, Sivaramakrishnan M, Gayathri C. Peripheral ameloblastoma of the gingiva. Autops Case Rep. 2019 Dec 13;10(1):e2019127. doi: 10.4322/acr.2019.127. PMID: 32039059; PMCID: PMC6945308.

69 | TODAY'S FDA may/june 2022

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

FDAS Partners with Coalition to Bring You New Cyber Coverage Coalition policyholders experience less than one-third the frequency of claims when compared to other carriers in the market.

To request a quote, go to 2022 bit.ly/37ardcu. 71 | TODAY'S FDA may/june

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 5th of every other month (e.g., Jan. 5 for the Jan/Feb issue, March 5 for the March/April issue, etc). Please note: Ads for the Nov/Dec issue must be placed no later than Nov. 1.

Please visit the FDA’s Career Center at careers.floridadental.org. 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. Currently only open three days a week, there is tremendous opportunity for growth. 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 $1.172 million; SDE $453,000; 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. REFERENCE #FL112422. We look forward to speaking with you! Visit careers. floridadental.org/jobs/16785441. Southwest Florida General Dental Practice Seeking Affiliation. Perched on the Gulf of Mexico, Southwest Florida, is famous for its high-end shopping, world-class culture and sophisticated dining. New to the market is a successful general dental practice in Southwest Florida. Having practiced in the community for over twenty years, the current doctor loves seeing patients. They would therefore like to continue to practice for several years, while affiliating with a group. Currently equipped with five operatories, there is an opportunity for expansion into an adjacent suite. The practice is primarily FFS and sees an average of 35 new patients per month. FOR AN OVERVIEW OF THIS GENERAL DENTAL PRACTICE IN SOUTHWEST FLORIDA, READ BELOW: 5 operatories; Expansion opportunity into adjacent suite; Collections of $1.681; EBITDA (2021) $281,000; 1565 active patients; 35 new patients/month. To

learn more about this practice in southwest Florida and review the prospectus please contact Professional Transition Strategies. Email Sam Schoenecker at SAM@PROFESSIONALTRANSITION.COM or call: 719.694.8320. REFERENCE #FL112422. We look forward to speaking with you! Visit careers.floridadental.org/jobs/16785453. Orlando General Dentist Private Upscale Office FFS. General Dentist. Enjoy living in the City of Orlando, Florida. An Excellent opportunity for a General Dentist to join +10year Upscale Private Established Dental Office Near Downtown Orlando. 5-stars rating providing an excellent patient care with the latest State-of-the-Art technology including Digital paperless records, Digital x-rays, Intraoral Camera, TVs, Cerec, Laser, Invisalign, Implants. Our dental center offers ALL aspects of dentistry including Cosmetic, General, and Dental Implants Surgery. We are 90% FFS/with only few PPO. (No HMO/ No Medicaid). If you have GPR-AEGD Residency it is a Plus ...This is a Full Time position, but willing to discuss Part Time if requested. Skilled New-Graduates are encouraged to apply. If offer accepted, you can start the position immediately or within 4 months. Email Doctor@OrlandoDentalCenter.com. Visit careers.floridadental.org/jobs/16759838. Associate Positions Available Now on the Beautiful Gulf Coast – Panama City! Bay Dental Center is looking for associates that value long term relationships in life. Bay Dental Center is expanding operations in the Gulf Coast area. We have been a Family Private Practice for nearly 15 years. We provide all aspects of General Dentistry. We have one year positions, as well as positions that are geared towards eventual partnerships. DDS or DMD with or without MS. Visit careers.floridadental.org/ jobs/16759880. Dentist - Florida Department of Health, The Dr. Edward F. Zapert Dental Clinic - Molar Express – Tallahassee. This is an advanced level position preforming a full range of assignments. Employ-

ee independently performs work under minimal supervision from the Senior Dentist. This is a highly responsible position providing professional dental services for the Dental Clinic in the Leon County Area, treating clients ages 0-20. Position requires: independent judgement; initiative; advance knowledge of program; business practices and skill in applying instructions to accomplish various job functions; ability to weigh relative costs and benefits of potential actions; possesses problem solving and analytical skills; communicates effectively in writing and speaking; knowledge of the principles and processes of strategic planning, resource allocation, leadership techniques and behavioral competencies; licensed by Florida Board of Dentistry. Visit careers. floridadental.org/jobs/16760042. Multi-location Tampa, FL Periodontal Practice for Sale. Tampa Bay is known for its blue skies and sunshine, a sparkling waterfront, world-class chefs and family fun. New to the market is a multi-location periodontal practice in the Tampa, FL area. The practices are a staple of their respective communities. The current doctor-owner is interested in partnering with a group for the long-term growth of the practice. The Tampa area is one of the fastest growing metro areas in the United States. This periodontal practice opportunity is sure to go quickly and is certainly worth a review! FOR AN OVERVIEW OF THIS MULTI-LOCATION TAMPA, FL PERIODONTAL PRACTICE FOR SALE, READ BELOW: 11 total operatories; Collections of $1.742 million; EBITDA of $300,000; 3400 active patients; Average of 20 new patients/month. To learn more about this multi-location periodontal practice in the Tampa metro area, please contact Professional Transition Strategies. Email Sam Schoenecker: SAM@PROFESSIONALTRANSITION.COM or call: 719.694.8320. REFERENCE #FL42722. We look forward to speaking with you! Visit careers.floridadental.org/jobs/16755324. Associate Dentist, Today’s Dental Network (TDN) – Inverness. Gulf Coast Dental Associates is a state-of-the-art dental practice providing exceptional

career center care using the latest and best technologies. The advancements in dentistry allow us to give our patients beautiful smiles while maintaining perfect functionality. We are currently hiring a Full-Time Associate dentist in Inverness, FL. Great earnings opportunity! High Producing Practice. Offer: Lucrative compensation package: Revenue sharing based compensation with no cap; Yearly CE allowance; Paid professional liability; Group health/wellness plans. Opportunity: Work in a well-established and successful dental practice; Build valuable relationships with your patients and greater community of Inverness while providing top-notch dental care; Be a key player in a premier and growing full-service multi-specialty concierge dental partner network organization; Work with some of the leading clinicians in the state; High new patient count (100+) in a demographically growing and desirable marketplace; Favorable pay mix with majority being FFS, no Medicaid or HMO ever; 2+ years experience preferred, will consider someone finishing a strong GPR program. Licensed in the State of FL. Gulf Coast Dental Associates is a highly successful affiliated practice of Today’s Dental Network (TDN). Visit careers.floridadental.org/jobs/16733422 Looking for a change? Private practice in New Hampshire - Kenne. One incredible opportunity is available for the right provider. Life in New Hampshire provides a sense of purpose and community. Fantastic location for those that love the outdoors and is just 90 mins from Boston, MA. Partnership track available for the right candidate. Current associate doctors are making 250-550k working M-F, 8-4. Please contact dzhao@raynordental.com to continue the conversation. BENEFITS: Current associate doctor total compensation range 250-550k; Sign-on bonus; Relocation bonus; Deferred Cash Bonus; 401K; $4000 CE reimbursement; $5000 tax-free student loan repayment assistance; Senior doctor mentorship. Comprehensive insurance package includes: Medical; Dental; Work/Life and Wellness Benefits; Employee Assistance programs; HSA options; Vision; STD/LTD. DMD/DDS. Dentist position available in the Monadnock and Lakes regions of New Hampshire. Visit careers.floridadental.org/jobs/16745801. Dental Clinical Specialist – Tampa. LIBERTY Dental Plan is committed to building collaborative and innovative teams nationwide. As one of the nation’s fastest-growing dental insurance plans, LIBERTY is expanding and excited for the future. This position is Hybrid (Partial Remote / On-Site) from any of our FL offices: Tampa, FL; Sunrise, FL; Tallahassee, FL. The Dental Clinical Specialist will primarily be responsible for the Utilization Management and Utilization Review Programs and ensuring the timely oral health decision-making and adjudication of dental claims and prospective requests for dental services (referrals and pre-authorizations) across all lines of business including Commercial, Medicare Advantage and Medicaid programs. They will formulate reviews to Peer-to-Peer requests and conduct Peer-to-Peer calls. The Dental Clinical Specialist will be involved in state oral health programs of LIBERTY, other clinical review activities, Tele-dentistry, and Special Investigation Unit (SIU) activities. They will be an active participant on the National Peer Review, Utilization Management, Credentialing and Quality Management & Quality Improvement Committees. Education/Experience: DDS/DMD Degree required;

Active, unrestricted license or certification to practice dental or related health profession in the U.S.; Must pass credentialing; no probation or listed sanctions; 2+ years’ experience of training, processing, and policy experience preferred; 5+ years’ experience as a practicing dentist. Sponsorship and Relocation Specifications: LIBERTY Dental Plan is an Equal Opportunity Employer / VETS / Disabled. No relocation assistance or sponsorship available at this time. Visit careers.floridadental.org/jobs/16733015. Lead Associate Dentist, Today’s Dental Network (TDN), Wauchula. Wauchula Dental provides a wide range of dental services in Wauchula, Florida. From root canals to advanced implant dentistry. We pride ourselves on always listening to our patients and providing them with the best possible service at the most reasonable cost. We are currently recruiting an experienced Dentist Full-Time. Great earnings opportunity! High Producing Practice (Wauchula Area). Offer: Lucrative compensation package: Revenue sharing based compensation with no cap; Sign-On Bonus; Up to $10,000 Relocation Assistance; Yearly CE allowance; Paid professional liability; Group health/wellness plans. Opportunity: Lead a well-established and successful dental practice; Build valuable relationships with your patients and greater community of Wauchula, while providing top-notch dental care; Be a key player in a premier and growing full-service multi-specialty concierge dental partner network organization; Work with some of the leading clinicians in the state; High new patient count (100+) in a demographically growing and desirable marketplace; Favorable pay mix with majority being FFS, no Medicaid or HMO ever; 2+ years experience required. Licensed in the State of FL. Wauchula Dental is a highly successful affiliated practice of Today’s Dental Network(TDN). Visit careers.floridadental.org/ jobs/16733201. West Palm Beach, FL Area General Dental Practice for Sale. The biggest city in one of Florida’s most desirable counties is a cultural hotspot for art, nightlife and water sports. New to the market is an incredibly profitable general dental practice near West Palm Beach, FL! The current owner doctor has been caring for patients for nearly two decades. They are interested in exploring all available options in the years leading up to retirement. The practice supports both the owner doctor as well as an associate. Within thirty minutes of downtown West Palm Beach, the practice is in a desirable area with easy access to beautiful beaches, luxury amenities and an easygoing lifestyle. FOR AN OVERVIEW OF THIS INCREDIBLY PROFITABLE DENTAL PRACTICE NEAR WEST PALM BEACH, READ BELOW: 8 operatories; Collections of $2.277 million; EBITDA (2021) $600,000; 8260 active patients; 55 new patients/month; Supports multiple doctors. To learn more about this incredible opportunity near West Palm Beach, FL please contact Professional Transition Strategies. Email Sam Schoenecker: SAM@PROFESSIONALTRANSITION. COM or call: 719.694.8320. REFERENCE #FL31622. We look forward to speaking with you! Visit careers. floridadental.org/jobs/16699235. Dental Lab for Sale – Dania. Impact Dental Lab manufactures the Power Up Mouth Guards for teams like the 76’ers, Panthers, Canadiens and the Sharks as well as many other professional teams. The lab

73 | TODAY'S FDA may/june 2022

also produces a TAG Appliance for the treatment of Tourette Syndrome. Impact Dental Lab is a division of Smile Perfected (www.smileperfected.com). The sale includes all the equipment as well as a robust customer list. Visit careers.floridadental.org/ jobs/16711685. Dentist - General Dentist – St. Augustine. Oxford Dental Associates now hiring a General Dentist in St. Augustine, Florida! Schedule: Full-Time 3 days per week (Tuesday-Thursday 8:00am-5:00pm). Advantages: Career Growth; Work/Life Balance; Complete Operational and Business Support; Strong Patient Base; Established Practice/Modern Facility. Competitive Compensation and Benefit Offerings: Continuing Education Investment; Annual Professional Expense Reimbursement; Vacation Time ; Paid Malpractice Insurance; Employee Assistance Program (EAP) for all employees and their household; 401k Retirement Plan; Paid $25k Basic Life & AD&D Insurance; Medical, Dental, and Vision; Short Term Disability; Voluntary Life & AD&D Insurance; Pet Insurance; Accidental Injury, Critical Illness, and Hospital Indemnity plans with Wellness Incentives. Qualifications: DDS/DMD degree from accredited dental school or residency program; Active Florida dental license; Active Federal DEA and applicable certifications; 2 or more years professional clinical experience. Visit careers.floridadental.org/jobs/16675577. General Dentist – Auburndale. Escape the rat race of the city and enjoy the subdued ambiance of Central Florida in Auburndale, located 45 minutes from both Orlando and Tampa. Live a short 5–10-minute drive to work and a short drive to all that either Orlando or Tampa offer. 5-stars rating providing exceptional patient care with the latest State-ofthe-Art technology including ExoCAD, 3D printers, intraoral scanning for restorations, aligner therapy, guided implant placement, digital paperless records, digital x-rays, as well as intraoral and extraoral cameras. Our practice offers all aspects of dentistry including cosmetic, general, and dental implants surgery and restorations. We are 100% FFS. (No PPO/ HMO/Medicaid). In addition to a deep commitment to the highest ethical standards and attention to detail, the ideal candidate would have good computer skills and be interested in a heavily digitally focused workflow. A GPR-AEGD residency would be a plus with surgical and restorative skills. Another advantage would be Dawson/Pankey training. This is a essentially a full time (4 day per week) position, but we could discuss a more part time arrangement if desired. This could lead to a buy out agreement in 4-5 years’ time frame or long term association if practice ownership is not in your immediate plans. Visit careers.floridadental.org/jobs/16633966. Dental Hygienist – Brandon. Busy Brandon, FL dental office seeking an outgoing, positive individual for a full time dental hygienist position. Our practice operates 4 days week (Mon-Thurs) 8am-5pm. Competitive salary with bonuses and 401k option. Individual must be a graduate of an accredited dental hygiene school. Experience not necessary. Visit careers.floridadental.org/jobs/16601755. t

career center Melbourne, FL Area General Dental Practice for Sale. Central East Florida is home to the space industry, top-notch birding, verdant parks, and the state’s top surfing. This general dental practice near Melbourne is sure to impress! The current doctor has practiced in the community for nearly a decade and would love to continue practicing and seeing patients. They are therefore most interested in establishing a growth partner for the long-term management of the practice. Currently equipped with five operatories, there is room for expansion into adjacent suites. Speaking of expansion, there is growth potential with additional hours of operation. FOR AN OVERVIEW OF THIS GENERAL DENTAL PRACTICE NEAR MELBOURNE, READ BELOW: 5 operatories; Expansion opportunity into adjacent space; Collections of $1.097 million; EBITDA nearly $200,000; 1300 active patients; 15 new patients/month. To learn more about this Central East Florida general dental practice for sale, please contact Professional Transition Strategies. Email Sam Schoenecker to receive the prospectus: SAM@PROFESSIONALTRANSITION.COM or call: 719.694.8320. We look forward to speaking with you! Visit careers.floridadental.org/ jobs/16595475. 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. Florida dental License, background check. Visit careers.floridadental.org/jobs/16419651. Prosthodontist – Oxford. $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. Current Controlled Substance Registration Certificate. Current Florida Dental License. Certificate of completion of advanced education in Prosthodontics. Visit careers.floridadental. org/jobs/16386950.

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. 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. Tap Into THE VILLAGES Market! Perfect SATELLITE office! Do you practice in the over-saturated Orlando, Tampa, or Gainesville areas and would like to tap into the market of CASH PAYING retirees of The Villages, Del Webb, and Stonecrest 55+ communities who prefer a private dentist over a DSO? There is also an untapped population of hundreds of young families moving into new homes in the immediate area! The only other dentist in the vicinity is a Heartland office. Two operatory, free-standing 950 sq. ft. building was built in 2008 and is plumbed for three operatories. It is situated on one beautiful acre of land on busy US 301 just north of THE VILLAG-

ES. Practice grossed 150K taking no insurance at 30% overhead in 2021 on 20-25 patients/week with dentist doing all hygiene. 4-5 internally referred new patients per week are being referred to a colleague due to family health issues. Immediate two full days of hygiene are scheduled and will keep the buyer busy with a loyal patient base. Modern chartless office is equipped with digital sensors and Patterson Fuse cloud-based software. There is plenty of room to expand existing building or even build a new office and then rent the current space. Office is a 1 hour commute from either North Orlando/Winter Garden/ Clermont or Gainesville, 1.5 hours from Tampa. It is an easy ten minute drive off of I-75 Exit 341 or twenty minutes off of the Turnpike on US 301. $450k includes practice and building/property. Will consider owner financing with adequate down payment. Visit careers.floridadental.org/jobs/13686503 to message owner for pics or to arrange a visit. Associate Dentist - Kissimmee Family Dentistry. 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 in to 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: https://www.kissimmeefamilydental.com Please forward CV to Holly Lance: holly@kissimmeefamilydental.com Associate Dentist – Port Charlotte. Full time Associate/owner-option Dentist position open at Soul Dental. This is what sets us apart! We are focused on using dentistry to invest in the lives of others. We are a private family business, with an environment that allows you to spend time with your patient. Come let us invest in you! Do you want to own your own practice someday but just need someone to teach you “How?” Join us! Maybe you want to become a “Super Doc” and dental school just scratched the surface for you. We will make you ready! We will also tailor your compensation to best fit your needs! Contact us to learn more and then send your CV to: Carol@souldentalpc.com.

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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.

75 | TODAY'S FDA may/june 2022

off the cusp

the future of dentistry Read it top to bottom and then reverse your future and read it bottom to top. By Hugh Wunderlich, DDS, CDE, FDA Editor

I am part of the dim future of Dentistry and I reject the notion that I can transform the profession I understand this may be a revelation but satisfaction comes from affiliation is a deception, and volition will make me auspicious so, in thirty years I will tell my colleagues they are not the most important thing in my life my government will know that I have my priorities straight because personal gains are more important than ethics I tell you this once upon a time dentists joined an association but this may not be true in my era this is a stopgap society pundits inform me thirty years from now organized dentistry will be irrelevant I do not concede that I will live in a dental association of our own making in the future totalitarianism will be the norm no longer can it be said that my colleagues and I care about this profession It will be evident that my generation is indifferent and lazy it is foolish to presume that there is optimism And all this will come true unless we reverse it.

(Inspired by the “Lost Generation” by Jonathon Reed)

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Today's FDA May/June 2022 Issue

Articles inside

FLA-MOM 2022 Recap

Exhibit Hall

FDC2022 Speaker Preview: Sitting: Active Versus

Looking Ahead in Dentistry

Artificial Intelligence and the Future of Dentistry A Brief Review

Are We Ready to Embrace a Bold New Vision for the Dental Profession?

FDC2022 Speaker Preview: The Dentist as

Open Your Eyes to 3D Imaging

FDC Things to Know Before You Go

Application of Artificial Intelligence in Dentistry

Hire for Today, Mentor for the Future Finding the Perfect Associate