2014 - Nov/Dec TFDA by Florida Dental Association

Helping Members Succeed Medicare "Opt-out" Florida Dental Schools ASDA President's Crown Savings

However you define success, organized dentistry makes it easier to achieve!

Working together, the ADA, the FDA and your district dental association help dentists accomplish their goals.

HELPING MEMBERS SUCCEED MEMBERSHIP ISSUE

B e Tre a t e d L i k e R o y a l t y

Save yourself time, money and the hassle of researching solutions to run and grow your practice. FDA Services has researched and vetted business solutions so you can easily take advantage of deals and discounts offered through the Crown Savings program. For your membership privileges, visit www.FDAServices.com/CrownSavings today.

Members can now save $500 to $4,000 on the purchase or lease of a new Mercedes-Benz. Imagine yourself behind the wheel of a sporty C-Class Coupe, the flagship S-Class luxury sedan, a stylish SL-Class roadster or a fun and eco-friendly Smart car.

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TODAY'S FDA

Medicare "Opt-out" Florida Dental Schools ASDA President's Crown Savings

However you define success, organized dentistry makes it easier to achieve!

VOL. 26, NO. 7 NOVEMBER/DECEMBER 2014

Helping Members Succeed

cover story

Helping Members Succeed All Year Long

Working together, the ADA, the FDA and your district dental association help dentists accomplish their goals.

UARY 15

enroll in a for 2015. "MEMBERSHIP" ISSUE

ers! 7

contents

HELPING MEMBERS SUCCEED MEMBERSHIP ISSUE

news

literary

news@fda

Letter to the Editor

13 House of Delegates to Consider Bylaws Changes

Book Reviews

13 Next House of Delegates Meeting Notice

Books on the Shelf

16 The Basics of "Medicare Opt-out" for Florida Dentists

f e at u r e s 19

Dentistry is a Team Sport

columns 3

Staff Roster

President’s Message

20 What's In It For You?

Legal Notes

Crown Savings Brings Business Solutions and Peace of Mind to Members

Information Bytes

Helping Members Succeed All Year Long

Diagnostic Discussion

FDC2015 Speaker Preview – Dr. Lawrence Wallace

80 Off the Cusp

42 FDC2015 Speaker Preview – Dave Weber 44 FDC2015 Exhibitor List 56

2014-2015 FDA President Dr. Rick Stevenson

60 Florida Dental Schools Create Future Colleagues 63

ASDA LECOM

ASDA UFCD

ASDA NOVA

UF's Executive Practice Management Program for Dentists

Read this issue on our website at:

www.floridadental.org.

www.floridadental.org

classifieds 74 Listings

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

November/December 2014

Today's FDA

FLORIDA DENTAL ASSOCIATION NOVEMBER/DECEMBER 2014 VOL. 26, NO. 7 EDITOR Dr. John Paul, Lakeland, editor

STAFF

Accelerate YOUR PROFESSIONAL GROWTH

NEDDA FALL CE COURSE

FRIDAY, DEC. 12, 2014 SHERATON JACKSONVILLE HOTEL Speaker: Dr. Alfonso Pineryo www.nedda.org • 904.737.7545 • ddeville@nedda.org

WCDDA ANNUAL WINTER MEETING

FRIDAY, JAN. 16, 2015 HILTON ST. PETERSBURG BAYFRONT Speakers: Dr. Henry A. Gremillion & Dave Weber www.wcdental.org • 813.654.2500 • wc.dental@gte.net

ACDDA ANNUAL WINTER MEETING FRIDAY, FEB. 13, 2015 EMBASSY SUITES HOTEL, WEST PALM BEACH Speaker: Dr. Tyler Lasseigne www.acdda.org • 561.968.7714 • acdda@aol.com

Jill Runyan, director of communications • Jessica Lauria, publications coordinator Lynne Knight, marketing coordinator

COUNCIL ON COMMUNICATIONS Dr. Thomas Reinhart, Tampa, chairman Dr. Roger Robinson Jr., Jacksonville, vice chairman Dr. Matt Henry, Vero Beach • Dr. Scott Jackson, Ocala Dr. Marc Anthony Limosani, Miami • Dr. Bill Marchi, Pensacola Dr. Jeannette Hall, Miami, trustee liaison • Dr. John Paul, editor

BOARD OF TRUSTEES Dr. Richard Stevenson, Jacksonville, president Dr. Ralph Attanasi, Delray Beach, president-elect Dr. William D’Aiuto, Longwood, first vice president Dr. Michael D. Eggnatz, Weston, second vice president Dr. Jolene Paramore, Panama City, secretary Dr. Terry Buckenheimer, Tampa, immediate past president Drew Eason, Tallahassee, executive director Dr. David Boden, Port St. Lucie • Dr. Jorge Centurion, Miami Dr. Stephen Cochran, Jacksonville • Dr. Richard Huot, Vero Beach Dr. Don Erbes, Gainesville • Dr. Don Ilkka, Leesburg Dr. Rudy Liddell, Brandon • Dr. Beatriz Terry, Miami Dr. Ethan Pansick, Delray Beach, speaker of the house Dr. Tim Marshall, Weekiwachee, treasurer • Dr. John Paul, Lakeland, editor

PUBLISHING INFORMATION Today’s FDA (ISSN 1048-5317/USPS 004-666) is published bimonthly, plus one special issue, by the Florida Dental Association, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914. FDA membership dues include a $10 subscription to Today’s FDA. Non-member subscriptions are $150 per year; foreign, $188. Periodical postage paid at Tallahassee, Fla. and additional entry offices. Copyright 2014 Florida Dental Association. All rights reserved. Today’s FDA is a refereed publication. POSTMASTER: Please send form 3579 for returns and changes of address to Today’s FDA, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914.

EDITORIAL AND ADVERTISING POLICIES

FRIDAY, FEB. 20, 2015 • JUNGLE ISLAND, MIAMI Speakers: Drs. Ethan Pansick & David Feinerman www.sfdda.org • 305.667.3647 • sfdda@sfdda.org

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

NWDDA 2015 ANNUAL MEETING

EDITORIAL CONTACT INFORMATION

SFDDA MIAMI WINTER MEETING

FRIDAY & SATURDAY, FEB. 20-21, 2015 THE GRAND SANDESTIN Speakers: Drs. Russell Baer & Stanley Rye www.nwdda.org • 850.391.9310 • nwdda@nwdda.org

CFDDA ANNUAL MEETING

FRIDAY & SATURDAY, APRIL 24-25, 2015 Speakers: Drs. Mark Hyman & Ethan Pansick www.cfdda.org • 407.898.3481 centraldistrictdental@yahoo.com

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

ADVERTISING INFORMATION

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

For a complete listing, go to www.trumba.com/calendars/fda-member.

Today's FDA

November/December 2014

www.floridadental.org

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

FLORIDA DENTAL ASSOCIATION FOUNDATION

EXECUTIVE OFFICE Drew Eason, Executive Director deason@florid adental.org 850.350.7109 Greg Gruber, Chief Financial Officer ggruber@floridadental.org 850.350.7111 Graham Nicol, Chief Legal Officer gnicol@floridadental.org 850.350.7118 Judy Stone, Leadership Affairs Manager jstone@floridadental.org 850.350.7123 Brooke Mills, Assistant to the Executive Director bmills@floridadental.org 850.350.7114

ACCOUNTING Jack Moore, Director of Accounting jmoore@floridadental.org 850.350.7137 Leona Boutwell, Finance Services Coordinator Accounts Receivable & Foundation lboutwell@floridadental.org 850.350.7138 Joyce Defibaugh, FDA Membership Dues Assistant jdefibaugh@floridadental.org 850.350.7116 Deanne Foy, Finance Services Coordinator Dues, PAC & Special Projects dfoy@floridadental.org 850.350.7165 Tammy McGhin, Payroll & Property Coordinator tmcghin@floridadental.org 850.350.7139

(FDAF)

Ashley Merrill, Membership Relations Assistant amerrill@floridadental.org 850.350.7110

Health Gioia, Director of Foundation Affairs hgioia@floridadental.org 850.350.7117

Kaitlin Alford, Member Relations Assistant kalford@floridadental.org 850.350.7100

Christine Mortham, Membership Concierge cmortham@floridadental.org 850.350.7136

Stefanie Dedmon, Coordinator of Foundation Affairs sdedmon@floridadental.org 850.350.7161

FDA SERVICES

FLORIDA DENTAL CONVENTION

800.877.7597 or 850.681.2996 1113 E. Tennessee St., Ste. 200 Tallahassee, FL 32308

(FDC) Crissy Tallman, Director of Conventions and Continuing Education ctallman@floridadental.org 850.350.7105 Elizabeth Bassett, FDC Exhibits Planner ebassett@floridadental.org 850.350.7108 Ashley Liveoak, FDC Meeting Assistant aliveoak@floridadental.org 850.350.7106

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

Mable Patterson, Accounts Payable Coordinator mpatterson@floridadental.org 850.350.7104

INFORMATION SYSTEMS

Stephanie Taylor, FDA Membership Dues Assistant staylor@floridadental.org 850.350.7119

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

COMMUNICATIONS AND MARKETING

Lisa Cox, Help Desk Technician/ Database Administrator lcox@floridadental.org 850.350.7163

Jill Runyan, Director of Communications jrunyan@floridadental.org 850.350.7113 Lynne Knight, Marketing Coordinator lknight@floridadental.org 850.350.7112 Jessica Lauria, Publications Coordinator jlauria@floridadental.org 850.350.7115

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

Stuart Williams, Information Systems Assistant swilliams@floridadental.org 850.350.7180

Group & Individual Health • Medicare Supplement • Life Insurance Disability Income • Long-term Care • Annuities • Professional Liability Office Package • Workers’ Compensation • Auto • Boat Scott Ruthstrom, Chief Operating Officer scott.ruthstrom@fdaservices.com 850.350.7146 Carrie Millar, Agency Manager carrie.millar@fdaservices.com 850.350.7155 Carol Gaskins, Assistant Membership Manager carol.gaskins@fdaservices.com 850.350.7159 Debbie Lane, Assistant Membership Services Manager debbie.lane@fdaservices.com 850.350.7157 Allen Johnson, Support Services Supervisor allen.johnson@fdaservices.com 850.350.7140 Alex del Rey, FDAS Marketing Coordinator arey@fdaservices.com 850.350.7166 Angela Robinson, Customer Service Representative angela.robinson@fdaservices.com 850.350.7156 Jamie Idol, Commissions Coordinator jamie.idol@fdaservices.com 850.350.7142 Marcia Dutton, Administrative Assistant marcia.dutton@fdaservices.com 850.350.7145 Maria Brooks, Membership Services Representative maria.brooks@fdaservices.com 850.350.7144 Nicole White, Membership Services Representative nicole.white@fdaservices.com 850.350.7151 Pamela Monahan, Commissions Coordinator pamela.monahan@fdaservices.com 850.350.7141

Porschie Biggins, Membership Services Representative pbiggins@fdaservices.com 850-350-7149

RISK EXPERTS Dan Zottoli Director of Sales Atlantic Coast 561.791.7744 Cell: 561.601.5363 dan.zottoli@fdaservices.com

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

Joe Dukes Director of Sales Northeast & Northwest 850.350.7154 Cell: 850.766.9303 joe.dukes@fdaservices.com

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

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

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

November/December 2014

Today's FDA

F LO R I D A D E N TA L CO N V E N T I O N : T H E O F F I C I A L M E E T I N G O F T H E F D A

KEYNOTE SESSIONS UCHE ODIATU, DMD Living Your Dreams DAVE WEBER Overcoming Life’s Goliaths

SAVE THE DATE J U N E 1 1 -1 3 , 2 0 1 5

MORRIS MORRISON Lead-ur-ship Starts With You! FREE FOR ALL MEMBER DENTISTS AND TEAMS!

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PRESIDENT’S MESSAGE RICK STEVENSON, DDS

Membership is Our Focus The Florida Dental Association (FDA) continues to work toward making membership more relevant to our members. Our volunteer leaders are engaged at all levels of organized dentistry and upholding the “Power of Three” concept by attending meetings at the local, state and national levels. I encourage you to attend as many of your affiliate meetings as you can and invite a new dentist to go with you, even if they aren’t a member yet. Make them feel welcome and introduce them to the member dentists that you know. They are the lifeblood of our organization and our future. On the state level, our workgroups are busy and we had a Board of Trustees meeting in November to continue the work on the FDA Strategic Plan. They also interacted with the Sub-council on the New Dentist while there. The American Dental Association (ADA) Trustee liaison is our own Dr. Terry Buckenheimer, and he is encouraged by the enthusiasm of the sub-council. Our 17th District delegation to the ADA attended the House of Delegates in San Antonio during the ADA’s annual meeting to determine the policies for the future and to continue our role as the one voice for oral health. These members spent a lot of time away from their practices and families, and we thank them for their dedication in working on our behalf. Because of their hard work, your membership dues will not increase next fiscal year. Membership and our declining market share are going to be our focus at all three levels of membership. We need everyone to be a recruiter — to bring in the newest dentists and also those who have failed to rejoin for whatever reason. Let’s keep organized dentistry as the one voice for oral health on the local, state and national levels. The influence we build with our legislative leaders depends on the strength of our membership numbers. Let’s make sure we don’t become irrelevant and allow outside forces to determine who the leading authority is on dentistry and the way we practice. Encourage your colleagues to become members and get engaged in the political process at all levels to ensure that you can continue to practice dentistry the way you want, and not how someone else thinks you should practice.

“

“Let’s make sure we don’t become irrelevant and allow outside forces to determine who the leading authority is on dentistry and the way we practice.”

”

Dr. Stevenson is the FDA President. He can be reached at rstevenson@bot.floridadental.org.

www.floridadental.org

November/December 2014

Today's FDA

Legal Notes

If “Pedigree Papers” Makes You Think About Your Dog, Please Read This! Graham Nicol, Esq., HEALTH CARE RISK MANAGER, BOARD CERTIFIED SPECIALIST (HEALTH LAW)

In 1971, the government enacted the federal Controlled Substances Act (CSA) and passed HMO legislation; Walt Disney World opened in Orlando; and FedEx started. Now, 40 some years later, we have: n ACOs, PLHSOs, EPOs, PPOs, DMPOs and HMOs n PRN, board-certified pain management specialists, PDMP and E-FORCSE n pedigree papers, audit trails and HCCE permits n NPI numbers and NDC codes, DEA numbers, US-FDA schedule changes and TIN numbers n DOH authorized prescribers, dispensing practitioner permits, controlled substance prescribing practitioners and DBPR prosecutions. Pill mills, face-eating zombies on bath salts, K2, spice and date-rape drugs are old news. Floridians just voted against medical marijuana, and FedEx stands accused of drug

Today's FDA

November/December 2014

trafficking and money laundering. Times have changed, and they keep on changing. Not sure what all these acronyms mean? Check out the list at the end of this article. Most recently, the U.S. Food and Drug Administration moved hydrocodone combination analgesics from Schedule III to Schedule II. While hydrocodone and oxycodone have been Schedule II since the 1970s, now drugs that contain hydrocodone in combination with ibuprofen or acetaminophen (e.g., Vicodin® and Lortab®) are Schedule II. Schedule II means a maximum 90-day prescription and no refills without an office visit, compared to Schedule III, where a maximum six-month prescription (i.e., 30-days with up to five refills) is allowed. The schedule shift means even more federal scrutiny of Florida dentists with regard to controlled substances. At the same time, Florida now prosecutes dentists with regard to prescription drugs. The point is both federal and state government, as well as several different governmental enforcement agencies (US-FDA, DEA, DOH/BOD, DBPR, DOJ, Florida AGO, etc.) are watching controlled substances and prescription drugs closer than ever, while at the same time thinking about decriminalizing other types of drugs. So now is a good time for Florida dentists to ask themselves some questions:

n Do I know what these acronyms mean? n Is Botox Cosmetic® the same as Botox®? What’s the difference and why does it matter? n What is an “unapproved new drug?” n What should I do when I first receive prescription drugs in my practice? n What are the minimum acceptable requirements for me to store, handle and quarantine prescription drugs? n Are pedigree papers the same thing as audit trails? n What exactly are “pedigree papers” and can I throw them away? n How long must I keep them? What can happen to me if I don’t? n Can I make a charitable donation of prescription drugs? n What’s the difference between “counterfeit” and “contraband” drugs? n Do Chapters 499 and 893 apply to dentists? What do they say that dentists need to know? n Do I need to register with the Florida Department of Business and Professional Regulation (DBPR) as a Heath Care Clinic Establishment (HCCE) in order to buy prescription drugs? n When will the Board of Dentistry (BOD) prosecute dentists for prescription drug violations? n When will DBPR prosecute dentists and does it matter that, as a dentist, I don’t even have a DBPR license?

www.floridadental.org

Legal Notes n When and what must I report to the Florida Prescription Drug Monitoring Program (PDMP)? n What is E-FORCSE (Electronic-Florida Online Reporting Controlled Substance Evaluation)? n Am I a “dispensing practitioner” or an “authorized prescriber”? n What is the minimum standard of care when I prescribe pain medication? n If I prescribe controlled substances, do I need to register with the Florida Department of Health as a “controlled substance prescribing practitioner”? n What exactly is a “controlled substance” and is it the same thing as a “scheduled drug?” n What’s the difference between dispensing, administering, prescribing and distributing, and why does it matter? If you’re not confident about your answers, don’t worry — the Florida Dental Association (FDA) is here to help you succeed! Go to the FDA website at www.floridadental. org, log in as a member and go to “Member Resources.” You’ll find “Legal Resources” under “Member Benefits,” where there’s a free, members-only FDA Legal FAQ guide to the basics that answers all of these questions. In addition, complete the online exam and get an hour of free CE credit for learning about laws and rules related to the practice of dentistry.

Oh, and those acronyms? They mean: n ACOs – Accountable Care Organizations under the Affordable Care Act. n PLHSOs – Prepaid Limited Health Services Organizations under the Florida Department of Financial Services, Office of Insurance Regulation. n EPOs – Exclusive Provider Organizations. n PPOs – C’mon, you know that one! n DMPOs – Discount Medical Plan Organizations. n HMOs – Really? n PRN – Professionals Resource Network or the Impaired Practitioners Program. You have been reading these articles, haven’t you? n PDMP – Florida Prescription Drug Monitoring Program. n E-FORCSE – PDMP’s Electronic Florida Online Reporting Controlled Substance Evaluation database. n DBPR – Florida Department of Business and Professional Regulation. n K2 – Street name for a type of synthetic cannabinoid that can cause psychotic breaks, similar to bath salts and spice. n DOH – Florida Department of Health. n BOD – Florida Board of Dentistry, an entity under DOH. n HCCE – Health Care Clinic Establishment (a type of permit required by Florida DBPR). n CE – Continuing Education. n NPI – National Provider Identification numbers .

n NDC – National Drug Control codes. n DEA – You need to watch more television! n US-FDA – United States Food and Drug Administration, not to be confused with our FDA. n TIN – Taxpayer Identification Number, used to determine whether you need to register with DBPR as a HCCE. n DOJ – United States Department of Justice. n Florida AGO – Florida Attorney General’s Office. n OK – I’m getting tired of these SSAs. n SSAs – Sarcastic, stupid acronyms. It’s a joke … not necessarily a good one. Seriously, if you want a “legal” discussion and the opportunity to earn two free continuing education credits, go to http:// fda.peachnewmedia.com/store/seminar/ seminar.php?seminar=32109. There you’ll find “What Florida Dentists Need to Know about Prescription, Controlled Substance and Pain Management Laws.” This article is for informational purposes only and is not intended to be a substitute for professional legal advice. If you have a specific concern or need legal advice regarding your dental practice, you should contact a qualified attorney. Graham Nicol is the FDA’s Chief Legal Counsel.

What Florida Dentists Need to Know about Prescription, Controlled Substance and Pain Management Laws: An FDA Legal FAQ Guide Take this course online to earn two free CE credits. For link, go to floridadental.org/members. FDA Members Only! www.floridadental.org

November/December 2014

Today's FDA

Information Bytes

The Art of Web Redesign For the third time in three years, the Florida Dental Association (FDA) has had to change our website. Our website, floridadental. org, now is integrated with our membership management system. Three years ago that was not the case; we embarked on a grand redesign and retooled our entire website.We wound up with a lot of information and no easy way of finding it. The menus were thoroughly developed, but it proved difficult to use in practice. In fact, analytics suggested that people visiting our website were mainly the general public. This time around, we decided to change things. We worked on a few basic principles: keep it simple; make it visually appealing; and, make sure it’s responsive in design, meaning it should look and work the same across all devices. We also wanted to provide our members with more information to help you in your dental practice. From concept to implementation, the redesign took a little more than three months and was developed in-house. You may have some questions about creating your own website, and I’ve answered a few here to get you started.

www.floridadental.org

Do I Need a Website? Absolutely! You need a full-fledged web presence with some social networking (like Facebook and Twitter) and email access thrown in. The Internet has replaced the Yellow Pages as the go-to place to look for services, including physicians, dentists and specialists. The more information you have out there, the easier it is for prospective patients to find you and your practice.

How Often Should it be Updated? That depends upon what you do. If you include hours of operations, procedures you perform, and other practice related information, then, maybe not very often. If you want to include a blog on relevant topics, then you should update your website frequently. I suggest making your information as easy to access as possible without a lot of clutter. Don’t make it hard to find the important information on your website. Nowadays, people seem to prefer passive research as opposed to just picking up the phone and calling your office. It’s important to provide as much information as you can about who you are and what you do so they can make an informed decision.

Can I Do it Myself? Do you or your staff have the time or technical ability to do it well and efficiently? If the answer to either of these is no, then I suggest you look to a company that understands dentistry to create your website. Officite, one of our merchants in

the FDA Services Crown Savings program, gives FDA members access to a complete, turnkey Internet solution at a discounted rate. FDA Services has researched and vetted business solutions so FDA members can take advantage of exclusive deals and discounts offered through the Crown Savings program. More information on this program can be found at http://www.fdaservices.com/crownsavings/. I encourage you to check out the new www. floridadental.org and let me know what you think. Email me your thoughts, ways you think we can improve it and what you would like to see it do for you. Mr. Darnell can be reached at ldarnell@ floridadental.org or 850.350.7102.

November/December 2014

Today's FDA

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

FDA Representatives on ADA Councils/Committees 2014-2015 ADA Political Action Committee (ADPAC) Dr. Jerry Bird Council on Access, Prevention, and Interprofessional Relations Dr. Cesar Sabates Council on Annual Sessions Dr. Neil E. Torgerson Council on Communications Dr. John H. Paul Council on Dental Benefit Programs Dr. Charles W. Hoffman Council on Dental Practice Dr. Andy Brown Council on Ethics, Bylaws and Judicial Affairs Dr. Don Ilkka Council on Governmental Affairs Dr. Rick Huot Council on Members Insurance and Retirement Programs Dr. Paul R. Miller Council on Membership Dr. Rodrigo Romano

Today's FDA

Committee on the New Dentist Dr. Irene Marron-Tarrazzi Commission of Dental Accreditation No slot in 2014-2015 Council on Scientific Affairs No slot in 2014-2015 Council on Dental Education and Licensure No slot in 2014-2015

Director of the Florida Dental Association Foundation Named The Florida Dental Association (FDA) is pleased to announce the hire of Heather Gioia as Director of the Florida Dental Association Foundation (FDAF), the charitable arm of the FDA. In this role, she will oversee the FDAF’s administration and its efforts to generate and direct resources for charitable and educational oral health programs in Florida. Ms. Gioia brings noteworthy experience in charitable strategic planning, governance, fundraising and grant writing to FDAF. Her professional background is in long-term fund development initiatives for non-profits and professional sports team foundations, such as the St. Louis Cardinals and St. Louis Rams. Additionally, she has managed charitable events for Nike at the Superbowl

November/December 2014

and the NCAA Men’s Final Four, as well as for Fox Sports at the MLB National League Playoffs and the U.S .Open. “We are thrilled to have Ms. Gioia join the Florida Dental Association Foundation,” says Drew Eason, Executive Director and CEO of the FDA. “She brings a great deal of experience to this role and will be a tremendous asset in leading this organization’s efforts to provide critical care and oral health education and resources to Floridians.”

Bradenton Orthodontist Receives SAO Oren Oliver Distinguished Service Award Dr. Steven Tinsworth, a Bradenton orthodontist, is this year’s recipient of the Oren Oliver Distinguished Service Award from the Southern Association of Orthodontists (SAO). This award was established in 1978 to recognize an individual member of the Southern Association Orthodontists who has given “above and beyond” the normal commitment to the SAO and has helped the association to accomplish its mission. The recipients are individuals who have helped guide the SAO through the years with dedication and selfless service for the good of the organization. This is the highest award the SAO bestows upon its members.

American Dental Association Installs Dr. Maxine Feinberg as New President Dr. Maxine Feinberg, who practices periodontics in Cranford, N.J., was recently installed as president of the American Dental Association (ADA) during a recent meeting of the ADA House of Delegates

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(HOD) in San Antonio. Dr. Feinberg is the third female to serve as the president of the 158,000-member organization. Prior to becoming the ADA’s president, Dr. Feinberg served as president-elect from 2013–2014. A longtime ADA member, Dr. Feinberg’s previous positions in organized dentistry have included serving as 4th District Trustee to the ADA HOD and as president of the New Jersey Dental Association, the first woman to serve in that position. She also served as president of the New Jersey State Board of Dentistry and as a delegate in both the ADA and New Jersey Dental Association’s HOD. Dr. Feinberg is a fellow in the American College of Dentists, the International College of Dentists and the Pierre Fauchard Academy. A graduate of New York University and the New York University College of Dentistry, Dr. Feinberg lives in Westfield, N.J., with her husband, John Wynne, and daughters, Haley and Rebecca.

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

Atlantic Coast District Dental Association Magda Abdelfattah, Boca Raton Mark Berger, Pompano Beach Melissa Bowers, Plantation

Alexis Carey, Fort Lauderdale Makepeace Charles, West Palm Beach Scott Ehlers, West Palm Beach Mohamad Elazizi, Fort Lauderdale Maureen Ghattas, Lake Worth Mariam Haroun, Fort Lauderdale Michael Hennessy, Parkland Marissa Matthews, Fort Lauderdale Queanh Phan, Lake Worth Melanie Rothberg, Pompano Beach Scott Spencer, Boca Raton Diana Torres, Pompano Beach Jelena Vathielil, Parkland Joshua Woodruff, Boca Raton Hayley Woolfson, Fort Lauderdale Ehsan Zariffard, Plantation

Central Florida District Dental Association Andrew Brown, Gainesville Maritza Garcia, Orlando Caroline Gordy, Orlando Robert Kalifeh, Gainesville Allison Miller, Winter Garden Maryam Moarechipour, Orlando Robert Pellosie, Lady Lake Behzad Rajaei, Ocala Swetha Reddy, Palm Bay

Northwest District Dental Association Amjad Heidami, Panama City Lauren Kovaleski, Panama City Allison Metzler, Pensacola Lara Sackheim, Pensacola William Sackheim, Pensacola Neil Simmons, Pensacola

South Florida District Dental Association Moghaddam Bahmadi, Miami Brittany Dickinson, Weston Grisell Gomez, Miami Angel Junquera, Miami Jessica Junquera, Miami Kamran Kiani, Miramar Rizwan Lalani, Miramar Carlos Llapur, Miami Victor Lubin, Hialeah Ileana Moya, Miami Omar Osman, Miami Shores Indira Perez, Miami Beach Jamie Saltz, Fort Lauderdale Sasan Sani, Miami Laura Taiman, Miami Shores

West Coast District Dental Association Monika Aneja, Saint Petersburg Anna Auletta, Saint Petersburg Christian Becker, North Port Brian Bernier, Land O Lakes James Bloom, Fort Myers Amir Daoud, Clearwater Caroline Dau, Seminole Mira Dudek, Apollo Beach Maria Elkhoury, Cape Coral Jhony Espinoza, Fort Myers Gregory Feldman, Palm Harbor Lucia Greer, Tampa George Mantikas, Naples Tach Pham, Lakeland Vani Prabakaran, Fort Myers Maryam Rostami, Lakeland Jason Snyder, Largo Dorothy Theogene, Tampa Toby VanLandschoot, Lithia Please see NEWS, 12

www.floridadental.org

November/December 2014

Today's FDA

NEWS from 11

In Memoriam The FDA honors the memory and passing of the following members: Angelo Amato Orange Park Died: 5/29/14 Age: 81

Enwood Ashmore Tallahassee Died: 9/08/14 Age: 89

V. Paul Bruno Pensacola Died: 4/27/14 Age: 88

Ernest Visco Deerfield Beach Died: 9/19/14 Age: 86

James C. Yeargin Port Orange Died: 8/7/2014 Age: 77

Peter Ramko Fort McCoy, FL Died: 10/12/14 Age: 80

IT’S NOT A MATTER OF IF BUT WHEN MAKE SURE YOU’RE

CYBERSECURE

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3% OTHER ENTITIES

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Call 800.877.7597 to speak to a licensed agent about cyber liability insurance 12

Today's FDA

November/December 2014

www.floridadental.org

House of Delegates

House of Delegates to Consider Bylaws Changes Pursuant to the bylaws of the Florida Dental Association (FDA),

The FDA’s Articles of Incorporation allow the FDA Bylaws to be

all members are hereby notified that the FDA House of Delegates

amended by a two-thirds affirmative vote of the HOD, provided the

(HOD) may be asked to consider amending the FDA bylaws to:

proposed amendments are sent in writing to the membership of the

m Increase in graduate student dues from $3.50 to $25.00 for

association and postmarked at least 30 days in advance of the HOD

dentists working toward a specialty designation or postdoctoral

session or at any HOD session by a three-fourths affirmative vote

degree

provided the amendments were presented in writing to a previ-

m Sub-council on the New Dentist proposal to become Council on the New Dentist

consideration.

MAKING CHANGES? LET US KNOW! MOVING?

Don’t miss out on any of your member benefits. Contact the FDA with your new office address or email address. Remember to contact the Board of Dentistry directly about your move. Go to floridasdentistry.gov to make the change.

RETIRING?

We want to make sure you receive the forms for retired membership. You can save money! Contact us to find out more!

FOR STATUS OR ADDRESS CHANGES, CONTACT THE FLORIDA DENTAL ASSOCIATION. 800.877.9922 • fda@floridadental.org

www.floridadental.org

ous session of the HOD and unanimous consent is given for their

Next HOD Meeting The secretary of the FDA announces that the House of Delegates will meet Friday and Saturday, Jan. 23-24, 2015, at the Tampa Airport Marriott, 4200 George J. Bean Parkway, Tampa, Fla. 33607. The FDA encourages all members to seek information about these important matters from their component’s delegates to the HOD and trustees to the BOT. The agenda for the HOD also will be available electronically at http://www.floridadental.org/FDA/house-of-delegates-0.aspx.

Dr. Jolene Paramore, FDA Secretary

November/December 2014

Today's FDA

WHEN IT COMES TO PROTECTING YOUR LIVELIHOOD AND YOUR REPUTATION, WE ARE YOUR MOST POWERFUL ALLY.

Only one medical malpractice carrier can give you the assurance that today’s challenging health care environment demands: The Doctors Company.

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RELENTLESS

WE RELENTLESSLY DEFEND, PROTECT AND REWARD THE PRACTICE OF GOOD MEDICINE.

ALLY

Medicare

The Basics of “Medicare Opt-out” for Florida Dentists BY CASEY STOUTAMIRE, FDA LOBBYIST

Effective June 1, 2015, Medicare Part D will no longer reimburse patients (assuming they have purchased Part D coverage) or pharmacies for prescriptions dentists write unless the dentist opts in and enrolls, or opts out and enters into a private contract with the patient. Confusing? To simplify, use the types of patients you see and the services you provide as a guide. First, Medicare is different than Medicaid. Both Medicare and Medicaid are government programs paid for primarily through taxes. In general, Medicare is for patients over age 65, and Medicaid is for patients who are financially needy. The opt-out issue has nothing to do with Medicaid reimbursement. In Florida, all Medicaid services are reimbursed through managed-care organizations. As a dentist, you opt in or opt out of Florida’s Medicaid program by, respectively, signing a participating provider agreement or not. Second, if you don’t have Medicare patients in your practice, then you don’t have to do anything. Since Medicare pays for few dental procedures, many Florida dentists (e.g.,

Today's FDA

pediatric specialists) are in this group and may be unaffected by the new rule.

services and are administered by the government and paid for via taxes.

Third, if you have Medicare patients (e.g., extractions, sleep apnea devices, prescription drugs), then you need to choose whether to enroll or opt out. Public health dentistry and oral and maxillofacial surgery provide Medicare services and therefore need to choose.

Part C, also known as Medicare Advantage, consists of the basic coverage under Parts A and B, but adds optional or supplemental dental and vision plan benefits not otherwise covered. Part C plans are administered by private health plans (not the government) and the supplemental coverage is paid for via premiums (not taxes) typically deducted from enrollees’ Social Security checks.

Next, consider the ramifications before you choose to enroll or opt out. For example, if you enroll as a Medicare treating provider, then you are subject to increased liability risks for false claims; the minimum records retention period increases from four to five years; you have to be careful about denying services to Medicare recipients; you can’t charge Medicare for missed appointments; you may have a percentage of your Medicare reimbursement withheld beginning next year if you don’t have electronic health records; etc. On the other hand, if you opt out of one part of Medicare, then you opt out of other parts as well, which can directly cause loss of revenue and patient dissatisfaction. When choosing, know that Medicare consists of four parts, and while you may not provide services covered under Parts A and B, you may provide services covered under Parts C or D. In general, Medicare Parts A and B provide basic coverage for hospital and physician

November/December 2014

Part D plans are like Medicare Advantage plans for prescription drugs only. They provide supplemental optional coverage for prescription medication used in dentistry (e.g. antibiotics, anti-inflammatory or pain medications), are administered by private health plans and are paid for via premiums. Your decision to enroll in or opt out of Medicare should be guided by the types of patients you treat and the services you provide. If you practice in The Villages, Medicare coverage is likely to be part of your practice. If you practice in a college town and all of your patients are under 65, then you may be entirely unaffected. If you have Medicare patients, then contact the ADA Center for Professional Success at 312.440.2500 for help on what to do next. Ms. Stoutamire can be reached at 850.350.7202 or cstoutamire@floridadental. org.

www.floridadental.org

Medicare

Guest Editorial

Dentistry is a Team Sport — Let Your Association be Your Wingman By Dr. Rick Huot

During my 30 years of U.S. Air Force active and reserve duty, I’ve seen numerous fighter jets take off in tandem, and I never grew tired of seeing the lead pilot and wingman streak down the flight line — sometimes with full throttle and afterburners ablaze — both in real time or during exercises. To this day, I still consider it an honor and a privilege to have served with a remarkable group of dedicated individuals that supported their mission. The traditional definition of a “wingman” refers to the pattern in which fighter jets fly. There’s always a lead aircraft and another which flies off the right wing of and behind the lead. This second pilot is called the wingman because he or she primarily protects the lead by “watching his back.” Modern technology has made this position a little less vital, but nobody can forget the 1986 movie “Top Gun,” when actor Val Kilmer chides fellow actor/naval pilot Tom Cruise about never flying without his wingman in tow. The classic ending puts it all in perspective.

Air Force reserves at a base not too far north from where we practiced. John (not his real name) was always a good mentor, and was admired by his patients in both private practice and military settings for his skill and great chairside manner. When I was promoted to colonel, I didn’t hesitate to ask him to attend and participate in the pinning promotion ceremony, and he gladly obliged. It was a good time to be with family, colleagues and fellow airmen on that special day. In the past few months, John was diagnosed with some medical conditions that forced him to close his practice. He was a private and humble man, so it was done quickly, and his current patients were efficiently taken care of by him and his staff. My wife was the first to notice the retirement announcement in the local paper, and I called him to wish him well and to please contact me if he needed any help at all. I was a little too late … John had taken his life at home sometime that same afternoon. This was the second time in six months that this type of tragedy personally affected me. A dental school classmate just two hours south had passed in the same manner, but it’s still a mystery as to why. Events such as these really drive home the fragility of life, and dentists are not exempt.

tions, continued competence and business demands make it more difficult to see all of the obstacles in the way of practice success. Your professional dental association should be your “wingman” in all aspects, and you should feel that you are not “flying alone” in this airspace we practice in. John was a lifetime member of the American Dental Association (ADA) and his specialty organization, and I will never forget the kindness that he extended to my patients and my family. Later that week at his memorial service, it was comforting to me to see many of the local dentists there to honor him for his service to his country and his patients. The pastor presiding at the service commented on how he had a new appreciation for how closely knit the dental profession seemed to be, after we memorialized him in the best way we knew how and paid our respects. Let’s promise to each other as dentists that we are uniquely qualified to understand the stressors of life, particularly when it comes to dental practice. Let’s also make certain we can mentor and guide the next generation of dentists by ensuring they know the value of belonging to the profession and the value of having a common source to inform them, guide them and watch their “wing” as they go about their daily lives. Let the ADA be your wingman.

Recently, I attended the funeral of a colleague who practiced nearby and had served with me for almost a decade in the www.floridadental.org

Dentistry is a challenging and rewarding profession, but it’s no longer healthy to “strike it alone,” as the complexity of regula-

Dr. Huot can be reached at drhuot@bellsouth.net.

November/December 2014

Today's FDA

Membership

Dr. Oldham CHAIRMAN OF THE COUNCIL ON MEMBERSHIP

Q. A.

What’s the number one reason you belong to the Florida Dental Association (FDA)? The best reason to belong to the FDA is advocacy for our profession. We need help to limit regulations that are unnecessary or expensive. Dentists and association staff evaluate unfair rules or unintended consequences that will weaken our profession and present solutions. These discussions occur at local, regional districts across the state and, on a larger scale, within the FDA’s councils.

Q. A.

The biggest benefit for a new dentist is networking and fellowship with colleagues — the opportunity for mentorship and friendly advice is priceless. Feeling that you belong to the profession and have support from your colleagues is critical to personal happiness.

Today's FDA

Q. A.

What is the most important part of membership that has made a difference in your life? I’ve found FDA Services Inc. to be truly beneficial. I received all the information I needed to make an informed decision from an honest insurance representative who guided me like a friend. I needed insurance and investment advice as a young doctor. He provided the insurance, friendship and guidance that was critical in my early career. The current most significant benefit of FDA membership for me is the Florida Dental Convention (FDC) in Orlando. Members receive free preregistration to the convention, which includes state-

What do you think new dentists need to know about membership?

YOU

November/December 2014

of-the-art continuing education courses and workshops, access to the Exhibit Hall and great quality social events to network with your colleagues and friends. Dr. Oldham is Chairman of the Council on Membership for the FDA. He can be reached at coldham2x2@gmail.com.

www.floridadental.org

Letter

Letter to the Editor Dear FDA Leadership, I was notified by our component leaders of the resolution recently discussed, voted upon and passed at the last FDA House of Delegates meeting in Orlando, and I believe this is the type of news that should and needs to be disseminated to all Florida dentists, so they realize that the FDA is tirelessly working for the dental profession. I would like to take this opportunity to applaud our delegates, officers and other leaders of the FDA on the recent decision to advocate for all Florida dentists against the latest proposed rule change by the Florida Board of Dentistry — by opposing any addition of new language to the existing rule for Written Dental Records, Minimum Content, Retention (Rule 64B5-17.002).

benefit

NUMBER

This is the reason organized dentistry should be important to all of us, and it encourages me to continue renewing my FDA membership. All too often, we hear others who may criticize organized dentistry — especially from those who have chosen to drop out of membership. However, this is only one of many examples of why all dentists should take pause, wake up to and be thankful for the benefits of belonging to our three-tiered dental organizations. Thank you again for acting on our behalf, and for taking such an important stand to protect our profession! Sincerely, Dr. Alexandra Botero Proud and very appreciative FDA Member

Helping Members Succeed It’s the best reason to join the FDA! PR is a very friendly, low-key, nonadversarial process that looks out for the best interests of the dentist and the patient. — Dr. Edward Daniel

The Peer Review Mediation Program settles disagreements between patients and dentists more economically and efficiently than the legal system and is available only to FDA members. This program is free of charge.

FOR MORE INFORMATION 800.877.9922 • fda@floridadental.org www.floridadental.org/peer-review

WE KNOW DISABILITY INCOME PROTECTION. WE KNOW DENTISTS.

Insuring your most valuable asset, your ability to earn income. What would happen if you became disabled? Disability insurance protects your income and provides an important benefit for your financial future.

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Member Benefit

Crown Savings Brings Business Solutions and Peace of Mind to Members Membership Working for You “I would recommend it. I do my website through them, and so far everything has been great.” ~ John Brodner, DMD, PA, of Tequesta

m apparel

m credit card processing

m debt collection

When FDA member

“I’ve been working with Officite for more

m dental supplies

Dr. John Brodner

than a year now,” said Dr. Brodner. “Any

of Tequesta, Fla.,

time there have been any issues or anything

m electronic dental claims

m financial

m luxury auto

m office supplies

decided it was time for his dental practice to

I wanted to change, they’ve been right on it.

have a Web presence, he didn’t have to look

I’ve had a great experience.”

far. That’s because FDA Services (FDAS) offers an assortment of deals and discounts

He added that he likes using the companies

m patient communication

as part of the Florida Dental Association

that have been researched by FDA Services.

m practice financing

m practice management

(FDA) membership package. “It makes me feel comfortable that the assoDr. Brodner purchases his insurance

ciation has recommended these companies,”

m payroll processing

through FDA Services, so it gave him added

said Brodner.

m scrap metal refining

m shipping

m website development

peace of mind knowing that FDAS had already done a lot of homework to ensure the

Whether you are planning to open your

company he selected to create his website

own dental practice or are looking for ways

would provide a good value for his practice.

to grow your existing business, you should know that FDAS has researched and vetted

Officite, the company Dr. Brodner hired to

business solutions to save you money, time

create his website, is one of 18 companies

and the hassle of doing your own research.

that offer exclusive privileges to dentists

Crown Savings offers rewards to assist you

who belong to the FDA. The program,

in the following areas of your business:

FDAS Chief Operating Officer Scott Ruthstrom shared insight into the thorough process for selecting Crown Merchants — the companies selected to participate in the Crown Savings program.

through which FDA Services offers the savings opportunities to association members now has a new name: Crown Savings.

www.floridadental.org

Please see SAVINGS, 27

November/December 2014

Today's FDA

Member Benefit

SAVINGS from 25

So what are some of the Crown Merchants that participate in Crown Savings and what

“Programs are vetted to make sure that they provide something that could lower overhead or produce more productivity in a

value do they bring to member dentists? Officite’s Jason Zib had this to say about

dental office,” said Ruthstrom.

the services his company provides to Dr.

Ruthstrom added that numerous companies

been providing dental professionals with

pitch ideas to him, but before they become a Crown Merchant, he conducts several interviews to evaluate the company and its products or services. After FDAS does its due diligence, he submits the program to the Council on Financial Affairs, where members weigh in, make sure the product or service is something they would want to use in their own practices, and verify it brings excellent value or benefits to a dental

Brodner and other members, “Officite has the best value in practice websites for more than a decade, and we deliver the design and development expertise that is crucial to online success.”

the FDA, but by more than 20 other state dental associations. We lead the pack in

Emerald Jones of Demandforce and Intuit

FDA Executive Director Drew Eason

bers experience with her company, “We’re

program, “FDAS offers programs that have been vetted by member dentists for member dentists, so you’re going to get the best product possible. The advantages are a less expensive product and money coming back to the FDA, which means your dues dollars are lower. It’s a win-win situation and a

commented on the monetary savings mema growth engine, and we help to communicate more effectively with patients. With our product specifically, it saves members about $299 off of the setup fee.” In addition to providing products and services for your business, there are perks you can enjoy outside of the office, such as

great opportunity for all member dentists.”

a discount when you purchase or lease a

Dr. Rudolph Liddell, chairman of the

advantage of this special offer save an aver-

Council of Financial Affairs, provided a summary of how the program lowers members’ dues, “Every time you use the Crown Savings programs, there is a bit of money that comes back to the FDA in the form of a residual or a check. Those checks add up over time to reduce our dues.”

Average Crown Savings on purchase or lease

online practice marketing solutions.”

practice.

shared his thoughts on the Crown Savings

$2,800

Zib added, “Officite is trusted, not only by

new Mercedes-Benz. Members who take age of $2,800. If you are an FDA member who wants to be treated like royalty, you can experience your membership working for you through the Crown Savings program. Simply visit www. FDAServices.com/CrownSavings to find specific information on what the program has to offer or call toll-free at 800.877.7597.

www.floridadental.org

November/December 2014

Today's FDA

HELPING MEMBERS SUCCEED

ALL YEAR LONG

LOOKING FOR SOLUTIONS? The America Dental Association (ADA), Florida Dental Association (FDA) and your district dental association are working together to empower you. Our mission: Helping members succeed Our vision: Florida’s advocate for oral health

Recharging your FDA!

 TRANSFORMATION At its annual convention in June 2014, the FDA introduced its rebranding program with a bright, unified look for all entities under the FDA umbrella. The FDA Foundation, the FDA Political Action Committee and FDA Services adopted new logos to identify them more closely with the FDA. All of our district and many affiliate associations also adopted the new logo. New logos were part of an ongoing project to recharge the association, including an increase in media coverage for dental events and developing a marketing toolkit for dentists. The FDA and local dental societies have integrated their technology to better serve members and avoid duplication of effort. We also have added a Member Concierge to help members take full advantage of all their benefits — call Christine Mortham at 800.877.9922.

 LEGISLATION THAT PROTECTS

In 2014, the FDA passed three important bills to protect Florida patients and practitioners.

SB 86: NON-COVERED SERVICES – Prohib-

its insurance companies from dictating charges for non-covered services in the contract. This legislation is not retroactive and does not change the current terms of a dentist’s contract; however, an insurance plan may amend a current contract to comply with the new law.

HB 97: SOVEREIGN IMMUNITY – Allows

patients to voluntarily contribute toward their dental lab costs without it being considered compensation for the dentist or jeopardizing the dentist’s sovereign immunity coverage when they volunteer with the Department of Health’s (DOH) Volunteer Health Care Provider Program (VHCPP).

SB 520: DENTAL WORKFORCE SURVEY PUBLIC RECORDS EXEMPTION

Provides a public records exemption for the personal identifying information of dentists and dental hygienists when completing the biennial voluntary dental workforce survey.

 COMMUNITY ACTION What happens when more than 1,600 volunteers wake up at 4 a.m. and work together to provide dental care to anyone who shows up? ■ ■ ■ ■ ■

More than 8,000 procedures More than $1 million in care 1,660 patients treated 1,100+ support volunteers 350+ Dentists and Registered Dental Hygienists

In March, the FDA Foundation held its first Florida Mission of Mercy event in Tampa. This event showcased Florida dentistry at its finest in local, state and national media. The FDA Foundation is planning another FLAMOM event, tentatively set for Spring 2016.

Delivering Deals and Discounts to Help You

Sav ing sb as ed

1 . 80 0. 87 7.7597

nc rie

QUE S TIONS ?

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es .Y ou rs av ing sm ay diff er.

 MONEY IN YOUR POCKET MEMBER BENEFITS ADD UP! $485 FLORIDA DENTAL CONVENTION PRE-REGISTRATION $150 TODAY’S FDA $173 JOURNAL OF THE AMERICAN DENTAL ASSOCIATION (JADA) $96 ADA NEWS $904 TOTAL PAID BY NON-MEMBERS $0 TOTAL PAID BY MEMBERS

LEGAL RESOURCES MEMBER-ONLY BENEFIT

PEER REVIEW/PATIENT DISPUTE MEDIATION AVOID PUBLIC LITIGATION & ATTORNEY FEES (EST. $300 PER HOUR)

ADA CONTRACT ANALYSIS ATTORNEY FEES (EST. $300 PER HOUR)

FLORIDA LAWS & RULES & LEGAL FAQS NEW! LEGAL CE FREE ONLINE CE

MEMBER-ONLY BENEFITS SAVE TIME AND MONEY! ■■ 30 HOURS FREE ANNUALLY FDA ONLINE CONTINUING EDUCATION ■■ FDA NEW DENTIST WEBINAR SERIES ■■ ADA ETHICS HOTLINE ■■ CAPITAL REPORT E-NEWSLETTER PACPOWER E-NEWSLETTER ■■ FDA MARKETING TOOLKIT FOR DENTISTS AND MEMBER LOGO ■■ ADA CENTER FOR PROFESSIONAL SUCCESS ONLINE BUSINESS RESOURCE ■■ FREE CONTINUING EDUCATION COURSES AT FLORIDA DENTAL CONVENTION ■■ ADA’S NEW DENTIST BLOG, “NEW DENTIST NOW” ■■ PEER REVIEW: NON-MEMBERS PAY ATTORNEY FEES ■■ NEWS BITES E-NEWSLETTER AND ALERTS ■■ FLORIDA AND HIPAA COMPLIANT FORMS FOR OMNIBUS RULE (REVISED 2013)

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A million reasons to call FDAS! In 2013-14, FDA Services provided more than $1 million to the FDA. Revenue generated from insurance sales goes directly toward helping fund FDA programs that are important to members, and to keep member dues at their lowest possible level.

The FDA offers more than 20 hours of “live” free CE at the annual convention and up to 30 hours of free online CE courses per year.

During the 2013-2014 fiscal year, 388 new dentists became FDAS professional liability policy holders, bringing our total number of policies with The Doctors Company to nearly 4,000.

insurance@fdaservices.com  800.877.7597 www.fdaservices.com

The Florida Dental Convention (formally the FNDC) is the largest CE program and dental exhibit in Florida, boasting more than 6,500 attendees and 300 dental exhibitors. In 2014, the convention held its first awards luncheon, offered exhibitor appointments, highlighted New Dentists and began automatic reporting to CE broker.

800.877.9922 www.floridadentalconvention.com

Help keep organized dentistry strong. Join us — there is power in numbers. Already a member? Please renew — dues statements were mailed in early November. Pay online at floridadental.org/dues.

benefit

Membership NUMBER Concierge

CHRISTINE MORTHAM

As Membership Concierge, Christine helps new and current members take advantage of all the benefits the FDA and ADA offer, and with a personal touch. Just like a hotel concierge, she has a wealth of information to help you navigate your association. Call her with your questions!

800.877.9922 or 850.350.7136 cmortham@floridadental.org

benefit

NUMBER

TIME TO RENEW! We offer four convenient ways to pay your member dues: 1. Credit card online 2. Credit card by mail, fax or phone 3. Check by mail 4. Dues installments by credit card Questions? Link to our “frequently asked questions” at www.floridadental.org/dues or contact your FDA Member Relations Department.

Statements were mailed in November. Call us if you didn’t receive yours. Phone: 800.877.9922 Fax: 850.201.5013 membership@floridadental.org

Helping Members Succeed NEW! MEMBER CERTIFICATES

ORDER YOUR FREE CERTIFICATE NOW! ■

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Online: floridadental.org/members/ member-resource

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Questions? Call the FDA Membership Services Number: 800.877.9922.

MEMBER IN GOOD STANDING

FLORIDA DENTAL ASSOCIATION

Richard A. Stevenson, DDS 2014 Florida’s Advocate for Oral Health N O R T H E A S T

D I S T R I C T D E N TA L A S S O C I AT I O N A COMPONENT OF THE AMERICAN & FLORIDA DENTAL ASSOCIATIONS

Not a member? Send your application to the FDA or apply online. Proud member? Share this application with a potential member.

FDC2015 Speaker Preview

Complete Dentures in One Hour:

An Alternative Denture System Fabricate complete dentures in a single one-hour office visit without the use of an outside dental lab. Read about this breakthrough technique for full dentures, immediate dentures and implant overdentures. By Dr. Lawrence N. Wallace

There are approximately 37 million fully edentulous people in the U.S. Several million more become edentulous each year. In a difficult economy, the number of people who cannot afford dentures or who do not have easy access to care is continuously increasing1,2. The average fee for a full set of upper and lower dentures in the U.S. is $3,4003. The effects of not having a functional occlusion directly impacts general health, as well as overall health care expenses. Lack of teeth increases the incidence of chronic disease in areas such as cardiovascular disease, gastrointestinal disease, obesity and diabetes. In addition, it also affects quality of life, self-esteem and employability (Fig. 1).

Dentures have been made nearly the same way for more than 100 years. The traditional technique typically encompasses four to five dental office visits with laboratory time in between. The process generally takes about six weeks. Adjustments often are necessary and add more visits to the series of treatment. The Larell One-step Denture is an innovative approach to complete dentures. There are many indications for its use in denture prosthetics, described below. The Larell denture is an alternative technique offering several advantages: the ability to be fabricated in one hour or less; the technique is intuitive and easily learned; and, no outside dental laboratory time is needed. For those patients who must travel distances or have difficulty with mobility, the ability to fabricate dentures in one visit is important. While traditional dentures are almost always made in the dental office, the one-hour denture is able to be made anywhere, including nursing homes, assisted living residences, mobile dental clinics and outreach dental missions.

Fig. 1: The effects of edentulism

Today's FDA

November/December 2014

www.floridadental.org

FDC2015 Speaker Preview

Indications for the Larell Onestep Denture: Private Practice

Fig. 2: Final dentures in place

Fig. 3: Upper implant-retained denture, attachments in place

The indications for the Larell denture are similar to traditional dentures. They are used for fully edentulous patients (Fig. 2), single upper or lower dentures, and for immediate placement dentures following extractions. The use of implant-retained dentures is increasing rapidly (Figs. 3 and 4). The doctor now has the opportunity to fabricate a complete set of dentures, place immediate load implants and have the entire implant-retained dentures completed in a single office visit, usually less than two hours. It’s profitable for the dentist, affordable for the patient and is a real practice builder. The Larell denture also can be used for an all-on-four dental implant fixed provisional appliance (Fig. 5), saving both time and money in the process.

Indications for the Larell Onestep Denture: Philanthropic

Fig. 4: Upper implant-retained denture in mouth

Fig. 5: Provisional for all-on-four dental implant reconstruction

Due to lack of affordability and access to care, thousands turn to free dental clinics, such as the Mission of Mercy (MOM), sponsored by state dental associations. Many states hold these free dental clinics; Florida held their first MOM event this past March. Held over a weekend, MOM events treat thousands of patients who will be seen for all types of dental treatment. Complete dentures are done infrequently due to the multiple steps, and those completed over a weekend are delivered months later. But now, being able to create full dentures in a single one-hour visit is a service that can be offered, allowing patients to have their dentures on the spot. In a typical weekend clinic, with three to five dentists, one

“

Difficult economic times and dentists’ lack of busyness mandate efficient cost-effective treatment options in all areas of dentistry, including developing dentures.

”

Please see DENTURES, 36

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hundred dentures are able to fabricated and delivered4.

Fig. 6: Adapted template on model, frenum relieved

Fig. 7: Occlusal plane plate in position with template

Fig. 8: Template marked for trimming from model

Fig. 9: Template modified to palate

Fig. 10: Template tried in mouth for proper reline thickness

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Though there is great need for philanthropic dental work in the U.S., there also is great need worldwide. Without the resources for dental treatment available here, it’s virtually impossible to provide dentures through mission work in other countries. Many countries don’t have dental lab facilities to process dentures and even if they did, the time frame would preclude full dentures. However, the need is still there. Due to its portability, the Larell One-step Denture system is addressing this worldwide need. We’ve been involved with different groups, helping provide dentures in Honduras, Nicaragua, Peru and other countries. As long as there is electricity to charge batteries and boil water, the Larell dentures can be made anywhere. The nutrition and health benefits are amazing, not to mention the instant smiles and increase in self-esteem.

One-hour Denture Technique The one-hour denture technique is predicated on a set of prefabricated thermoplastic denture templates with the teeth in place and finished on the outer surface. To determine the sizes of the denture templates, more than 1,000 consecutive edentulous models were evaluated with predetermined measurements such as ridge thickness, intertuberosity distance, etc. The measurements were then evaluated through mathematical formulae and categorized into five groups that encompassed all but the extreme outliers of the measured models. The thermoplastic template can conform to all but the extreme edentulous ridge structures by heating in boiling water for about 40 seconds then becoming malleable and adapting closely to the model (for immediate dentures the impression and model are

November/December 2014

done following the extractions). The process is efficient due to the fact that the template comprises the custom tray, wax rims and wax try-in. There’s room for tooth movement, tooth segments, flanges, palate and mylohyoid extensions within the templates due to their thermoplastic ability. Because there’s no memory, the templates can be reheated many times to achieve the proper fit on the model. If extreme movement is needed, the template can be notched and expanded, or contracted as needed. All this is completed on a quick-set stone model taken during the visit (Fig. 6). The upper denture is done first, with the template being tried in the mouth and positioned properly with an occlusal plane plate (OPP). The OPP is used to determine the ala-tragal line and the Frankfort horizontal plane (Fig. 7). The anterior posterior position (lip support) and the tooth show are determined visually. There best method to determine lip support and tooth show is directly in the mouth. The flanges are then trimmed (Fig. 8) to allow approximately 2-3 mm of space between the flange and the height of the vestibular fold and 1-2 mm of space (Fig. 9) between the template and the model to allow sufficient room for the reline material (Fig. 10). The ability to easily modify the template before reline is a key factor in the denture’s success. Once the template has been prepared with the flanges adjusted and the template adapted to the ridge, it’s ready for an in-themouth functional reline. The recommended reline material is Flexacryl (Lang Dental Manufacturing Co., Wheeling, Ill.). Many reline materials have been tested, and working qualities such as mixability, low porosity, low exothermic reaction and cost-effectiveness of the Flexacryl make it the ideal (Fig. 11). Though most dentures will use the Flexacryl hard reline material, Flexacryl soft reline also can be used. This

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Anal

Local thetic

lgesics

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FDC2015 Speaker Preview is indicated where there is an undercut present or additional retention areas for a resorbed ridge are desired, such as the mylohyoid ridges in the mandible. If necessary, the hard reline and soft reline material can be used in the same denture to combine retention and comfort. If desired, stops composed of the reline material can be placed in the anterior and bilateral posterior areas of the template. This will allow exact placement at the predetermined position during the reline process. The template is removed from the mouth when the reline material hardens. Should the dentist desire a darker gingival color for darker-skinned patients, tinting can be added to the reline material monomer to obtain the desired color (Fig. 12). The final finish and polish is accomplished at a later step in the standard fashion. For the upper denture, a post dam is placed after the initial reline and painted in with the reline material. The lower denture is then relined in a similar fashion. It’s placed in the mouth to be certain the occlusal tables are aligned and the flanges are in good position. The teeth can be moved and the flanges can be adjusted to allow for a proper fit. When the lower template with reline material is placed, the patient slowly closes their mouth. The teeth line up with the upper template and the ridge closes into the template. Vertical dimension is checked at this time to ensure proper freeway space (1-2 mm closure past the previously marked distance). After rough trimming, both dentures are placed into the mouth once again. Pressure-indicating paste is used a minimum of three times to check for any high spots on the mucosal surface (Fig. 13), and articulating paper is used to fine-tune the occlusion. The dentures are then finished and polished in the standard fashion with pumice and high-polish material (Figs. 2, 14 and 15).

Discussion The advantage of fabricating dentures in one hour is that there isn’t any waiting or lab time necessary before extracting the teeth and placing the denture. This is significant for immediate dentures. Contrary to conventional technique, the denture impression is taken after the teeth have been removed and the alveoplasty performed. This is a real benefit, as the denture is fit to the exact post-extraction position, not an approximation of what the ridge will look like after surgery. With an exact fit, the denture will be more comfortable, have an accurate fit and likely cause less post-placement bone resorption due to its increased stability. They are useful for spare or emergency dentures and can be used for interim surgical obturators for cancer surgery patients. Future uses will include intermediate dentures for children with ectodermal dysplasia who are missing some or all of their teeth. A one-hour technique will eliminate more chairtime as the children grow, outgrowing their dentures like they outgrow their shoes. Though not meant to replace traditional dentures as a patient service, current economic conditions are making it more difficult for many to afford and have access to complete dentures. Dental practices are not growing, and dental incomes are flat. An alternative technique for complete denture fabrication is demonstrated in this article. It meets the dentist’s needs by increasing the patient base and the profit margin, and meets the patient’s needs, who can now have full dentures that are affordable and convenient. It also addresses the uninsured and economically challenged patients’ needs, as well as those with difficulty accessing denture care.

Please see DENTURES, 39

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Fig. 11: Reline material being placed into modified template

Fig. 12: Template color modified with tinting ink in monomer

Fig. 13: Pressure indicating paste on inside of upper template

Fig. 14: Final upper and lower dentures, tissue side

November/December 2014

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FDC2015 Speaker Preview DENTURES from 37

The significant factors for success in dentures are fit, form and function. Achieving these factors meets the standard of care for denture treatment. A denture must have the best retention and support possible based on the patient’s mouth condition. It must have the appropriate appearance with regard to lip support, tooth show, occlusal planes and natural look of the teeth. It also must function well for the patient, allowing proper mastication and digestion. These all are achieved in a properly constructed denture. The Larell One-step Denture follows the denture fabrication scientific principles, meets the standard of care and is accepted by the patient, dentist and the profession. A comparison of a series of conventional dentures5 to a similar series of Larell dentures demonstrated an overall satisfaction rate of the conventional dentures of 76.7 percent. The overall satisfaction in the Larell series was 83.6 percent, with a 98.4 percent satisfaction of appearance and 80.3 percent able to chew comfortably6. The Larell One-step Denture technique achieves the necessary factors for denture success. Tooth position over the ridge, proper posterior extension of the occlusal table, natural-appearing lip support and tooth show, and the ability to retain the denture’s stability in function are classic prosthodontic principles7-15 that are present in the Larell denture. Additional factors are built in to assure the most retentive lower denture possible, such as concavities in the posterior lingual flanges to allow space for the tongue to prevent unseating the denture through tongue movement. In difficult economic times, it’s imperative that the dental profession develops methods to treat patients in a cost-effective expeditious manner. The Larell One-step Denture technique is one such offering. It’s not

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meant to completely replace conventional dentures, but is an effective treatment alternative that addresses many current needs. With a one-hour time frame for fabrication and no laboratory time or expense, the patient is able to have dentures almost immediately. This is significant when dentures are lost or broken and time is a factor. A less expensive method for complete dentures also allows the patient to possibly allocate more funds to implants, thus making the dentures even more stable and functional. The technique is intuitive and easy to learn. A basic knowledge of occlusion and oral anatomy is the basis for the Larell and any other denture. As stated previously, patient satisfaction meets or exceeds the satisfaction levels of conventional dentures, whether new or replacement. Difficult economic times and dentists’ lack of busyness mandate efficient cost-effective treatment options in all areas of dentistry, including developing dentures. Complete edentulism continues to represent a tremendous global health care burden, and will for the foreseeable future16. The unique Larell One-step Denture system focuses on the issue of complete dentures in both private practice and in philanthropic use for the ongoing domestic and global denture needs.

References: 1. Douglass CW Shih A Ostry L Will there be a need for Complete Dentures in the United States in 2020? J Prosthetic Dentistry 2002 Jan; 87(1):5-8 2. US Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville MD: US Department of Health and Human Services, NIDCR, National Institutes of Health: 2000:2-3 3. National Dental Advisory Service Comprehensive Fee Report 2012 p.26 4. Virginia Dental Association Foundation, California Dental Association Foundation, 2012 5. Roberta L.Diehl, Ulrich Foerster, Venitta Sposetti, and Teresa Dolan Journal of Prosthodontics, Vol 5, No2 (June), 1996, 84-90 6. Evaluation of Denture Patients: Virginia Department of Health Denture Program Miller SM Personal communication 2012

7. Boucher’s Prosthodontic Treatment for Edentulous Patients (ed 11) 1997 8. Complete Denture Prosthodontics: Modern Approaches to Old Concerns Joseph J. Massad, DDS, et al. 9. Effect of complete denture impression technique on the oral mucosa El-Khodary, et al. JPD 1985; 58: 543-549 10. The neutral zone and polished surfaces in complete dentures Schiesser, F.J. JPD; 1964; 14: 854-865 11. The monoplane occlusion for complete dentures Phillip M. Jones; JADA 85: 94-100, 1972 12. Testing of Occlusal Patterns on The Same Denture Base Vincent Trapozzano, JPD 1959: 53-69 13. The Effect of Denture Factors on Masticatory Performance Part III. The Location of the Food Platform Krishan K. Kapur and Sham Soman JPD, 1963: 451-463 14. Vertical Dimension of the Face Olsen, E. S.: Dental Clinics of North America 1964; 611-622 15. Clinical Measurement and Evaluation of Vertical Dimension Toolson, L.B., Smith D.E. Journal of Prosthetic Dentistry, 1982 16. Felton DA Texas Dental Journal Apr 2010 (Doctor Felton is the editor of the Journal of Prosthodontics and the dean of the West Virginia University School of Dentistry)

Disclosure: The author has a financial interest in the Larell One-step Denture as its developer and founder. The author wishes to thank Drs. Stephen Alouf and Scott Miller for the pictures used in this article. Dr. Lawrence N. Wallace is a board certified oral and maxillofacial surgeon who has maintained a private practice for 25 years in the Chicago area. He developed the Larell One-step Denture in 2007. He can be reached at larry@larell.com. He will be speaking at FDC2015, and presenting three courses: on Friday, June 12, 2015 he will present the lecture, “Larell One-step Dentures in One Hour,” at 9:00 a.m.; and the accompanying workshop at 2 p.m. Saturday, June 13 will be a repeat of his workshop at 9:00 a.m.

November/December 2014

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Some Days You’re the Pigeon, Some Days the Statue: Discovering Your Seven Me’s By Dave Weber

Everyone wants strong, positive, mutually beneficial relationships. So why are they so

I travel around the country to speak at

hard to develop? Why do so many spouses

conferences, and many times I’ll divide the

have such a hard time communicating

crowd into groups by job titles: doctors,

with each other? Why does the generation

hygienists, assistants and front office. Then

gap feel more like the Continental Divide?

I ask, “What is the one thing that drives

It’s because we don’t realize how complex

you crazy at work?” Virtually every group

relationships are … and how many different

comes up with the same answer: “The

“people” are involved.

people.” I believe that there are actually seven verWhether it’s getting along with co-workers,

sions of ourselves living inside of each and

patients, labs or vendors, it seems our inter-

every one of us. Let me clarify: I’m NOT

actions with others can be quite challenging

talking about multiple personalities or a de-

at times. The same thing can be said about

monic possession (I’ll leave those topics to

our personal lives as well.

trained psychologists and Stephen King). It might sound a little off the wall at first, but I

I believe that when you boil everything

think we all have seven concepts of self that

in life down to the barest essentials, the

together help define who we are as a person.

only thing that truly matters is relation-

I call them the “Seven Mes.”

ships — whether it’s parent/child, husband/ wife, doctor/staff, teacher/student or any

Now, they look different in every one of us

other relationship. What we say has a great

because we’re all different, but every person

impact on those relationships.

reading this article has the following seven people residing in them:

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November/December 2014

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1. The Me I Think I Am

speak words that are uplifting and affirm-

2. The Me I Really Am

ing to others. There’s so little of that being

3. The Me I Used to Be

modeled in today’s society, where around

4. The Me Others See

every curve we are being bombarded with

5. The Me I Try to Project

in-your-face-confrontation and downright

6. The Me Others Try to Make Me

ugliness coming out of everyone’s mouth.

7. The Me I Want to Be

From reality TV to radio talk shows to road rage, we rarely see healthy communica-

Here is where relationships get crazy — not

tion. Here’s the bottom line: words clearly

only does every person have these “Seven

matter. They are powerful, and what matters

Mes” in them, but each one of the “Mes”

most is how we use them. We can use them

wants to be in charge and influence the in-

to tear down and destroy, or we can use

teraction. So here’s the challenge: when two

them to build up, encourage and affirm.

two people, there are seven in one person

Whichever “Me” is in charge determines

and seven in the other — a whopping 14

what words we use … and that determines

people are trying to interact! It’s no wonder

the trajectory of the relationship.

relationships are tough! Mr. Weber is president and CEO of Weber So who’s in charge?

Associates Inc., a training and speaking firm in Atlanta, and is a national motivational

Ahh! That’s the fun part! Most people have

speaker. He can be reached at jill@weberas-

never thought about these “Seven Mes”

sociates.com.

“

I think we all have seven concepts of self that together help define who we are as a person.

people are communicating, there’s not just

running around inside them like a bunch of rowdy kindergartners. But each individual

Mr. Weber is one of the keynote speakers

can determine which of the “Mes” should

at FDC2015, and his keynote presentation,

be handed the reins. Believe me, one of

“Overcoming Life’s Goliaths,” will be on Fri-

those “Mes” is in control of every situation

day, June 12, 2015: at 8 a.m. He is scheduled

… but is it in control by default (because

for two additional courses that day: “The

you are not realizing what is going on) or

Winner in You” at 9:30 a.m. and “Sticks and

is it in control intentionally? I want folks

Stones Exposed: The Truth about Words and

to discover a whole new way of looking at

Relationships” at 2 p.m.

”

themselves and their interactions with others — at work and at home. The skill of “frog kissing” is the key to making progress on purpose in all of your relationships. It means to intentionally

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FDA SERVICES INC. IS A MAJOR SPONSOR OF THE FLORIDA DENTAL CONVENTION.

Diagnostic

Diagnostic Discussion By Drs. Indraneel Bhattacharyya and Nadim Islam

A 13-year-old male was referred to the Oral and Maxillofacial Surgery Department at the University of Florida College of Dentistry (UFCD). His chief complaint was swelling on the left side of his face with some pain. The patient and his family reported recent onset of symptoms and some pain in the posterior left side of the face. He complained of inability to open his mouth completely. He was evaluated by Dr. Esther Oh, an oral surgeon and oral pathologist who was consulted during the initial presentation. The patient did not report any fever, difficulty swallowing or breathing. Examination revealed a large left mandibular firm swelling. The area was tender to palpation and the patient had a mild fever of 99.3 degrees F. Blood workup, specifically differential blood cell count, revealed a high white cell count at 18.2 {neutrophils 12.85 (H), lymphocytes 4.25 (H), basophils 0.11 (H)}. His medical history was otherwise noncontributory. A decision to biopsy the mandibular lesion was made with consent from his parents, along with incision and drainage (I & D) to relieve discomfort (Fig. 1). Multiple images were obtained, including panoramic radiographs (Fig. 2) and CT scans (Fig. 3). Both procedures were performed at the oral surgery clinic under nitrous sedation. An incisional biopsy was done and two areas of bone were sampled from the expansive mandibular buccal lesion in the molar and premolar area. A raised, pink soft tissue lesion 2 mm in diameter adjacent to tooth No. 19 also was removed for microscopic examination. He was given 300 mg clindamycin four times a day along with advice to use chlorhexidine rinses. The patient returned one week later for further treatment. Persistent drainage from I & D site was noted, but the site appeared to be healing well. The mouth opening had increased significantly and no fever, difficulty swallowing or breathing was noted. Pulp testing of teeth Nos. 18-21 revealed mild sensitivity to heat and slight discomfort to percussion on teeth Nos. 18 and 19. No periapical pathology was observed. Pericoronitis associated with tooth No. 18 was observed extending into full bony impacted No. 17. Extraction

benefit

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Diagnostic

Fig. 1

of impacted No. 17 was planned with curettage of the No. 18 area under general anesthesia. Antibiotics were continued for seven additional days. Tissue from both the initial exam and later from the extraction of tooth No. 17 were submitted for microscopic examination to the UFCD Biopsy Service. Microscopic examination revealed “finger-like” proliferation of bony trabeculae parallel to each other associated with inflamed granulation and fibrous connective tissues. The bone was haphazardly laid down and rimmed by prominent osteoblasts. Replacement of marrow with loose, mildly inflamed fibrous connective tissue was seen.

Question: What is the most likely diagnosis? A. Fibrous Dysplasia

Fig. 2

B. Osteosarcoma C. Cemento-osseous Dysplasia D. Hemifacial Hypertrophy E. Proliferative Periostitis (Garré’s sclerosing osteomyelitis)

Please see QUIZ, 50

Fig. 3

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Diagnostic QUIZ from 49

Diagnostic Discussion A. Fibrous Dysplasia Incorrect. Excellent guess, since this is a condition affecting the bones of the head and neck and typically seen in young individuals often under 20 years old. But fibrous dysplasia (FD) of bone involves the cortical bone itself and rarely grows on the outside of the main body of the mandible, especially when there is minimal evidence of significant change in the mandibular bone. Generally, the patient has no discomfort or symptoms with FD unless there is secondary inflammation. The main radiographic features are fine “ground glass” opacification that results from formation of poorly calcified bone trabeculae arranged haphazardly. The lesions are ill-defined with blending of margins into adjacent normal bone. These features were absent here (see Fig. 2, periapical view). FD is considered to represent a developmental bone lesion, which usually affects one bone (monosototic disease) in about 80 percent of the patients. The skull is commonly involved, and etiology is unknown. The disease is diagnosed in the first and second decade of life and produces a painless swelling of the affected area. The maxilla is involved more commonly than the mandible. Maxillary lesion often involves adjacent bones such as the zygoma, sphenoid and occiput. Polyostotic FD is relatively uncommon and mostly associated with multiple areas of cutaneous pigmentation and endocrine abnormalities. This is known as McCune Albright syndrome, which is more common in females. Microscopically, normal bone is replaced with a cellular fibroblastic stroma containing variable amounts of randomly arranged irregular — usually delicate — bone trabeculae that evolve directly from the stroma. The trabeculae often assume curvilinear forms resembling Chinese script letters. The treatment is exclusively surgical but it isn’t always indicated. Solitary small lesions may remain asymptomatic and static, and thus, require no treatment. Simple contouring of facial or skull bones back to normal dimensions has proved quite effective. In this case the patient has pain as well as swelling and the lesion involves the mandible. Microscopically, no irregular trabeculae of bone were seen but elongated “finger-like” osteophytic proliferation of bone was noted. B. Osteosarcoma Incorrect — again a great guess! Swelling and pain are the most common symptoms associated with osteosarcoma of the jaws. The short duration rapid growth history, location (posterior mandible) and presence of paresthesia should favor this diagnosis. Osteosarcoma may involve the periphery of the bone (parosteal) and is seen

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November/December 2014

in young individuals such as this patient. The average age of the patient with osteosarcoma of the jaw is about 33 years old and is less frequent in children. Again, lack of signs within the mandibular body itself, expansion limited to the periphery of the bone and concurrent increase in white cell count, and mild fever all point to a reactive or infectious lesion rather than neoplastic. Radiographically, osteosarcomas most often are present as a mixed radiolucent and opaque area with “moth-eaten” or ill-defined indistinct borders, which wasn’t noted in this case. Importantly, osteosarcomas characteristically show opacification/calcification of the surrounding soft tissue. Often a spiking resorption of the teeth roots involved by the lesion is noted. An important early radiographic change consists of symmetric widening of the periodontal ligament space around an involved tooth or multiple teeth. A classic “sunburst” appearance caused by osteophyte bone production on the lesion’s surface is seen only in a quarter of the jaw cases. While osteosarcomas are the most common type of primary malignant bone tumor, the vast majority of these tumors occurs in the distal femur and proximal tibia. These tumors are rare in the oral cavity and only 5-10 percent of all osteosarcomas occur in the jaws. Older patients can occasionally develop jaw osteosarcoma if they have concomitant Paget’s disease of the bone or have been irradiated previously. Microscopically, osteoid or bone tumors formed by malignant-appearing stromal cells are noted, which was absent in this case. Treatment includes radical excision. C. Cemento-osseous Dysplasia Incorrect. This entity almost never is associated with swelling or any other symptoms, and usually is discovered during routine examination. This condition rarely is reported in children and has completely disparate radiographic and clinical presentation. Cemento-osseous dysplasia (COD), especially the more common focal cemento-osseous dysplasia (FCOD), is seen in middle-aged women and often in the African-American race. It typically presents as a well-defined, somewhat round “bull’s-eye” opacity near the apical region of the mandibular first or second molar intermixed with irregular zones of radiolucency. Some cases may be more lucent than opaque on radiographic examination. No expansion or constitutional symptoms such as fever, lymphadenopathy or elevated white cell count are reported unless the area is secondarily inflamed. The other variants of COD — namely, periapical and florid — have striking predilection for middle-aged African-American women and are rare in children. These entities may involve the posterior mandible but usually are seen in association with the apical regions of teeth. FCOD is the most common fibro-osseous lesion encountered in the oral pathology laboratory. Lesions occur in dentulous and edentulous areas. On surgical exploration, the tissue occupying

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Diagnostic the bone defect consists of fragmented gritty “grainy or sand-like” tissue. Microscopically, lesions exhibit multiple variably sized and shaped trabeculae of cementum-like material and bone distributed in a loose cellular fibrous stroma. COD should ideally be identified clinically and radiographically, and should not be subjected to surgical intervention. The patient in this case is an African-American child with recent onset of symptoms and pain. The radiographic presentation shows a solid, smooth periosteal reaction at the inferior border of the mandible, as well as well-defined areas of rarifying osteitis adjacent to the impacted third molar. No cementum-like material was seen microscopically. D. Hemifacial Hypertrophy Incorrect. This is a rare congenital malformation characterized by marked unilateral overgrowth of hard and soft tissues of the face. Though the condition is termed as “hypertrophy,” it actually represents hyperplasia of the tissues. It may be an isolated finding or it may be associated with a variety of malformation syndromes. The condition usually is noted at birth and produces obvious facial asymmetry and becomes more pronounced as the child ages, especially increasing growth around puberty. The affected side grows at a rate proportional to the non-affected side so that the disproportion is maintained throughout life. The etiology of this condition is poorly understood and multiple theories have been proposed such as heredity, chromosomal abnormalities, atypical forms of twinning, altered intrauterine environment and endocrine dysfunctions. However, no single theory explains the etiology adequately. This condition affects all facial tissues, including the jaw, teeth and related soft tissues. If the enlargement is confined to one side of the face, the term hemifacial hypertrophy may apply. There is a female predilection with the involvement occurring more often on the right side of the body. This patient had recent onset of jaw enlargement with pain and inability to open his jaw completely, which points to a more reactive inflammatory etiology. One of the most significant features with hemifacial hypertrophy is an increased prevalence of abdominal tumors, especially Wilms’ tumor, adrenal cortical carcinoma and hepatoblastoma. Unilateral macroglossia is a common feature. The microscopic features show increase in thickness of the epithelium with hyperplasia of the underlying connective tissue and bone, but the tissue is rarely proliferative or inflamed as seen here. In this case, there has been a recent onset of jaw enlargement with pain and the inability to open the jaw completely. These signs and symptoms rule out the above diagnosis E. Proliferative periostitis (Garré’s sclerosing osteomyelitis) Correct! Proliferative periostitis, or Garré’s sclerosing osteomyeli-

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tis, is a specific variant of chronic osteomyelitis that mainly affects children and young adults. It’s a well-described condition in dental literature and is commonly associated with an odontogenic infection resulting in stimulation of the periosteum and new osteophytic bone formation. This condition is seen almost exclusively in children or young adults, though rare cases in older individuals have been reported. The mandible is much more commonly affected than the maxilla. The etiologic factors include dental caries with associated periapical inflammation, periodontal infections, fractures and non-odontogenic infections. The typical clinical presentation includes mandibular swelling, followed by pain and symptoms. Many patients may be completely asymptomatic even upon palpation. Constitutional symptoms such as fever, lymphadenopathy and purulence may be absent, and in such cases diagnosis is challenging. The finding of an impacted tooth with pericoronitis in this case is helpful in making the diagnosis. In this case, the patient had purulence, trismus and a mild fever, further indicating presence of a possible dental source of infection. The word “osteomyelitis” originates from the ancient Greek words osteon (bone) and muelinos (marrow) and means infection of medullary portion of the bone. It can be classified as acute, subacute or chronic, depending on the clinical presentation. Garré’s sclerosing osteomyelitis is a distinctive type of chronic osteomyelitis characterized by new bone formation over the surface of the involved bone. This condition represents an exaggerated response of the periosteal tissue to persistent low-grade inflammation. Garré’s osteomyelitis is named after Carl Garré, a Swiss surgeon who was a student of Robert Koch. Microscopically, aggregates of densely inflamed granulation and fibrous connective tissues, numerous trabeculae and columns of reactive bone are noted. Dilated blood vessels, aggregates of inflammatory cells are seen. Notably, numerous finger-like trabeculae of viable and reactive bone exhibiting osteoblastic rimming and plump osteocytes within lacunae are noted within this specimen. There are parallel rows of highly cellular and reactive woven bone in which the individual trabeculae are frequently originated perpendicular to the surface. These trabeculae occasionally form an interconnecting meshwork of bone. Uninflamed fibrous connective tissue also may be seen. Eversole et al. proposed the criteria for the differentiation of Garré’s osteomyelitis from other periostoses. The necessary features included: 1) facial asymmetry from localized osseous enlargement; 2) histologic findings of a benign periosteal fibro-osseous lesion; 3) Please see QUIZ, 53

November/December 2014

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Your Sustaining Membership funds the FDA Foundation & it’s tax deductible! Dr. Terry Buckenheimer Tampa

Smile and check that “Sustaining Member” box! Dr. Ralph Attanasi Delray Beach

The FDA Foundation provides much needed programs like FLA-MOM. Dr. Nolan Allen Clearwater

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ays w l a t ’ I don e $, donat do – en I but wh e FDAF. th it’s to Dr. Hugh Wunderlich Palm Harbor

The Florida Dental Association Foundation is a non-profit, charitable organization approved by the Internal Revenue Service as a 501(c)(3) tax-exempt corporation. The FDHF is registered with the Florida Department of Agriculture and Consumer Affairs(#SC-02435). The FDAF receives 100 percent of charitable contributions. No portion of contributions are retained by a professional solicitor. A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL FREE, (800) 435-7352, WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.

Diagnostic QUIZ from 51

a source of infection, trauma or other irritation, not necessarily of odontogenic origin; and 4) complete or partial remodeling of excess bone after elimination of the cause. Radiographic imaging studies have proven to be consistently superior to conventional radiographs in demonstrating proliferative periostitis. On plain films, the alterations are typically seen best on a lateral oblique or panoramic radiographs. Radiographic features include convex radiopaque laminations roughly parallel to each other (“onion-skinning”) and the underlying cortical surface. These laminations vary from one to 12 in number. Radiolucent zones also may be seen. The adjacent jaw bone usually appears normal. Elimination of the cause of persistent infection, with or without resection of new bone, is the main treatment modality. This patient failed to appear for follow-up appointments but communications from the family indicated almost complete resolution.

Useful References: 1. Neville BW, Damm DD, Allen CW, Bouquot JE. Oral and Maxillofacial Pathology, 3rd ed. 2009. Saunders Elsevier. 2. Tong et al. Osteomyelitis with proliferative periostitis: an unusual case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102:e14-e19 3. Lincoln et al. An Extremely Unusual Case of Garré’s Osteomyelitis of the Mandibular Condyle After Surgical Removal of Third Molars. J Oral Maxillofac Surg. 2012 70:2748-2751. 4. Lichty G, Langlais RP, Aufdemorte T. Garré’s osteomyelitis. Literature review and case report. Oral Surg Oral Med Oral Pathol. 1980; 50(4):309-13.

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. Stevenson

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President Richard Stevenson was born in Bay City, Mich. He attended Western Michigan University for his undergraduate studies and received his dental degree at the University of Detroit Dental School. Upon graduating in 1975, he became an American Dental Association (ADA) member. Soon after, he served in the U.S. Air Force for three years before establishing his general dentistry practice in Jacksonville, Fla. He has been a Florida Dental Association (FDA) member since 1979 and has been in practice for 36 years. Dr. Stevenson has worked tirelessly in his district and at the state level to ensure the highest standards are met in patient care, as well as ensuring that dentistsâ&#x20AC;&#x2122; interests are represented. In addition to becoming the FDA president in June 2014, Dr. Stevenson serves on the Florida Dental Association Foundation (FDAF) Board of Directors, Florida Dental Association Political Action Committee (FDAPAC) Board of Directors and is a delegate at large for the Northeast District Dental Association (NEDDA). He is the past president of the Florida Academy of Dental Practice Administration, a past president of the NEDDA, a consultant to the FDA Governmental Action Committee, a liaison to the Leadership Development Committee, a representative to the Council on Dental Health and a current delegate to the ADA.

As if that is not enough, Dr. Stevenson has a passion for the underserved in Florida. He is a representative to the Oral Health Florida Coalition, the Oral Health Improvement Plan for Disadvantaged Persons and a member of the Woehler Research Group. He also is a member of the American College of Dentists, the Pierre Fauchard Academy and the International College of Dentists. He is co-chairman with Dr. Andy Brown for the next Florida Mission of Mercy, to be held in Jacksonville in April 2016.

Please see PRESIDENT, 59

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November/December 2014

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Helping Members Succeed www.floridadental.org: your go-to site for all things FDA, all things Florida dentistry

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Questions about floridadental.org? Call 800.877.9922

President Presidential Favorites Music: Rock and Roll Artists: Moody Blues, followed by The Beatles Movie: “The World’s Fastest Indian” and “Secondhand Lions” Book: “The Pillars of Earth” by Kenneth Follett Vacation destination: any of the National Parks north and west of here where it’s cool. Food: raspberries Memory: being there for my granddaughter’s birth Leisure activity: hunting, fishing, road trips in my Austin Healey and traveling with friends PRESIDENT from 57

Please tell us about your family, staff, etc. Marilynn and I have been married for 43 years, and we have two children: Ashley and Ryan. Ashley is a home health care nurse for psychiatric patients and has a daughter, Kyla. Ryan recently graduated from the American Academy of Golf and is newly engaged. I have four full-time employees and three who are part time. Three of my staff members have been working for me for more than 30 years, and my rookie has been with me for eight years. I collect British sports cars and enjoys golf, hunting and fishing.

How long have you been restoring old sports cars? How did you get started? I purchased my first sports car in 1970, a 1962 MGA 1600 MkII, and I’ve been working on them ever since. I currently own a 1956 Austin Healey 100M, a 1966 Austin Healey 3000 MkIII and a 1967 Austin Healey 3000 MkIII. When time allows, I like to help other club members work on their cars.

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yourself with family and good friends, and you can keep a good balance.

What advice would you give to new dentists? Take your time to build your practice the way you want. Also, to be successful, remember your people skills are just as important as your clinical skills.

The FDA’s mission statement is “Helping Members Succeed.” What does this mean to you? Organized dentistry is here to help you succeed in your practice and your life. We are your extended family.

You’ve been a member for your entire dental career. What are your two most important reasons for belonging? I believe that you’re not a part of the dental profession unless you are a member of organized dentistry, the entity which represents you to others. The rewards of belonging are the people you meet at all levels and the long-term relationships you establish.

What reasons would you give to non-members for joining and staying a member?

Is there anything you want members to know about your presidency or the FDA? It’s an honor to represent you as president. I follow in the shadow of many great leaders, and I’ll do my best to keep their legacies going.

Photos:

We need to have a unified voice to represent us on the national, state and local levels, as we have many outside forces trying to encroach on our profession to determine who and how dentistry will be practiced.

The theme for FDC2015 is “Career and Life in Balance.” Do you feel you’ve accomplished this, or is it always a work in progress? What helps you maintain this balance? My life is kept in balance by having a loving family, a supportive staff who I consider family and various outside activities. I belong to car clubs and dental study clubs, which both have diverse members with similar interests who I can travel with. I have great support from the staff at the FDA and the Northeast District Dental Association (NEDDA) and a good relationship with the Board of Trustees (BOT) to keep my leadership duties balanced. I was raised in a strongly religious family and attended parochial grade school, high school and dental school. That continues to help me stay focused and on the correct path. So surround

1. A family photo from FDC2014, (left to right) Dr. Rick Stevenson, wife Marilynn, son Ryan and fiancé Tracy, daughter Ashley and granddaughter Kyla. 2. Attending a Florida Academy of Dental Practice Administration meeting in Bermuda. From left to right: Dr. Chris Berdy, Marilynn Stevenson, Dr. Rick Stevenson, Kathy Haeussner and Dr. Ted Haeussner. 3. Dr. Stevenson’s garage featuring his Austin Healey’s and MGB’s. 4. Dr. Rick Stevenson’s staff (left to right): Joyce, Bonnie, Carla, Tracy, Marie and Shirley.

What is Your Goal for This Year? My goal this year is to streamline our systems. We’re almost finished with simplifying our strategic plan to a one-page document, which will direct what we do in the future. Currently, we’re refining the FDA’s bylaws and have a number of workforce groups working to position us for the future.

November/December 2014

Today's FDA

FLORIDA’S DENTAL SCHOOLS CREATE FUTURE COLLEAGUES The University of Florida College of Dentistry is one of a handful of dental schools housed on the same campus as a major teaching and research university. As such, the college and our students enjoy the benefits of being a part of a major, thriving university, including the cultural activities and other activities offered at the university. Being co-located at the UF Health Science Center (with a major teaching hospital and five other health colleges: medicine, nursing, pharmacy, public health and health professions, and veterinary medicine) broadens our student’s interdisciplinary learning opportunities through teaching collaborations as well as research and patient care collaborations. Through the college’s School of Advanced Dental Sciences, we offer a complete range of advanced education opportunities in all dental specialities. Yet, because we are a relatively small college, we are able to maintain a close community within our college and provide individual learning strategies and personalized mentoring to our students and residents. Founded in 1997, Nova Southeastern University College of Dental Medicine has the distinction of being the first private dental college established in the state of Florida, and the first College of Dental Medicine established in partnership with a College of Osteopathic Medicine in the United States. The College of Dental Medicine is part of a dynamic Health Professions Division that includes osteopathic medicine, pharmacy, optometry, nursing and medical sciences. NSU’s dental students take classes and interact with these other health professional students. One of the most selective dental schools in the United States, the College of Dental Medicine boasts distinguished faculty, advanced technology, and innovative curriculum that have allowed the college to create a uniquely rich learning environment for its students while earning the respect of the dental profession and dental educators throughout the world. Students of the college benefit from our state-of-the-art educational and clinical facilities, which feature the latest in computer and video technology, and distinguished professors. LECOM School of Dental Medicine offers students a four-year, 48 week DMD curriculum including approximately 3,500 hours of clinic. Our third year students do not share operatories and practice in the new LECOM Student Dental Group Practices in one of ten self-contained, ten-chair group practice clinics, complete with dispensary, wet lab, conference room, and radiography. D-4 students relocate, with their families, for a year of practice in DeFuniak Springs, Fla. and/or Erie, Pa., in a wholly owned LECOM offsite group practice clinic. Our goal is to acquaint students with general practice, offering primary oral health care to a disadvantaged patient population and to encourage them to practice in these types of access-to-care areas. First and second year students study pre-dental sciences in our modern patient-based Simulation Clinic and basic sciences with a problem-based learning approach. As part of our mission to provide treatment to those most in need, they work in the patient clinic to fabricate complete dentures for the local indigent population.

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November/December 2014

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Florida Dental Schools BY THE NUMBERS

150

TOTAL STUDENTS WHO GRADUATE

120

30 FIRST GRADUATES IN 2016 0

NOVA DMD

UFCD DMD

UFCD GRADUATE

LECOM

Advocating for the oral health and the resulting overall health of Floridians

PERCENTAGE OF MALE AND FEMALE STUDENTS 60

NOVA

UFCD

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FEMALE

TUITION PER ACADEMIC YEAR

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BRIEFING

$60,000

Tuesday, March 24, 2015 Aloft Hotel

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LEGISLATIVE VISITS

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NOVA

UFCD FLA. RESIDENT

LECOM NON-FLA. RESIDENT

ENROLLMENT TRENDS

NOVA: flat UFCD: up by 10 slots LECOM: rising

TUITION TRENDS

NOVA: up slightly UFCD: flat LECOM: up slightly

Wednesday, March 25, 2015 Capitol in Tallahassee SPONSORED BY

Aloft Hotel Room Block: $154.00 per night (with a $5.00 per night parking fee). The block closes on March 1, 2015.

ASDA LECOM

ASDA Presidents Share Their Views By Jasmine R. Shafagh, MBS LECOM ASDA PRESIDENT

Serving as the LECOM School of Dental Medicine’s American Student Dental Association (ASDA) chapter president is both an honor and an opportunity for me. Being involved in ASDA has national importance, as the organization represents the unified voices of more than 90 percent of dental students in this country, and it opens the door to connections and networking with other leaders in organized dentistry. At the local level, ASDA allows me to manage our chapter’s goals and activities, including political, ethical, philanthropic, educational and social matters. As a dental student, my goal was to become involved in ASDA early to help protect the profession, and to encourage and instill in other students the importance of advocacy and involvement. I feel empowered knowing that I’m working with other motivated student leaders to ensure decisions affecting our education and profession have meaningful student input. While my leadership involvement in ASDA is the most significant and rewarding undertaking in my life thus far, being a student leader always has been something to which I aspired. From my high school

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days, I secured leadership roles, such as editor-in-chief of our school’s student newspaper and Spanish newspaper, and as president of the Community Service Board. I continued in college as a board member of the Health Center Advisory Committee and actively participated in the Pre-Medical/Dental Club. Through adopting greater leadership responsibilities over the years, I’ve been inspired by my successes and yet humbled by my failures, forcing me to learn from my mistakes. Both types of experiences have contributed to the role I play as a leader today. Being a woman, I’ve never felt threatened or intimidated by society or my peers in voicing my concerns. Although I attended an all-women’s college, I don’t consider myself a feminist nor have I given much thought to calling myself the “female president” of ASDA at LECOM. Instead, I consider myself an individual leader who happens to be a female. Though theories and research suggest we all are subject to gender bias in the professional world, I believe the challenges I face as a female leader are similar to challenges any leader faces. I’ve never felt disadvantaged due to my gender, and my personal focus has always been on my own growth and the development of my strengths and capabilities in an effort to be better equipped to accomplish the tasks at hand. I’ve honed my vision and goals for our ASDA chapter, and together with the executive board and committee chairs, continually train for success and work to achieve our goals. I’m driven by the ability to evoke positive outcomes with maximum impact to my organization. My work and perseverance extends outside of ASDA, where I strive to be a caring and gentle provider to my patients, always bearing in mind that their needs supersede my own ambitions. Looking to the future, I see myself staying actively involved in ASDA and the American Dental Association (ADA), and I see the potential for my leadership to mature. Leadership at any level should continue to be developed based on needs and experience. I’d like to encourage all of my peers and colleagues in any field of dental medicine to strive to achieve their personal best and to never have reluctance about pursuing an idea or goal. Seize opportunities that come your way, keep learning, be patient and advocate for your beliefs. If you are proud of and enjoy what you do as a leader, it will shine through. You will gain the trust and respect you deserve, and you will achieve your goals. Make the choice to be a leader every day! Ms. Shafagh can be reached at Jasmine.Shafagh@dmd.lecom.edu.

November/December 2014

Today's FDA

ASDA UFCD

By Ramzy Lotfi UNIVERSITY OF FLORIDA ASDA PRESIDENT

What does it mean to be an American Dental Association (ADA) member today? It means you are a part of an association that is: 1. an integral player in forming and protecting the standards of our profession. 2. a formidable force in dispensing oral health information and education to the public. 3. an organization that serves as a network of like professionals in an organized and constructive manner. As chapter president of the student affiliated group, the American Student Dental Association (ASDA) at the University of Florida, my goal is to reflect these same principles on the student level. Over the past several decades, dentistry’s standards have progressively evolved due to research of treatment application, technological advances and a better understanding of patients’ needs. However, many times these concepts develop quicker than standards are actually set to address them. For real changes to occur, this generally requires advocacy and legislation, and even as students we understand this concept well. Through both past and present ASDA leadership, we’ve done our best to ensure that University of Florida College of Dentistry (UFCD) students are informed about any issues affecting the dental profession, as well as dental students. We keep them

Today's FDA

informed about important bills going through the House and the Senate, and the impact it would have on us and our profession. Students are encouraged to attend state and national lobby days to promote these causes. In recent years, National ASDA created the automated system, “Engage,” that offers students an easy way to contact their state representatives on these issues with just a few clicks on their computers. Even as students, we believe that our voices can have an impact on how the future of our profession is shaped. The UFCD ASDA chapter strives to develop a strong public presence by volunteering in the community. Throughout the year, we attend a number of local events and set up an oral hygiene booth to teach people proper oral health techniques. Additionally, our chapter hosts an annual battle of the classes competition called Mighty Molar. The proceeds help support Smile Train, a charity providing corrective surgery for children with cleft lips and palates. We have been very vocal about the benefits of working together for the greater benefit for our profession. Within our chapter, we believe in nurturing those who are interested in pursuing a career in dentistry and providing them with the resources necessary to be successful as they prepare for their careers. Undergraduate pre-dental students are invited to visit UFCD for our annual Pre-dental Conference, which gives them a taste of the dental school experience. During the conference, attendees tour our facilities, practice in the simulation lab, meet with administrators and receive advice from a dental student panel, among other things. Similarly, our chapter also has created the Dental Business Symposium — the first of its kind in the country — for current dental students. The symposium features many outstanding lectures and breakout workshops that teach a wide variety of topics, including: practice management, acquisition and financial planning, loan applications, marketing, malpractice, purchasing dental equipment, job interview preparation and much more. This year, we are excited to announce that the courses in the symposium will be eligible for continuing education (CE) credit! We encourage our members to attend the various opportunities to network with Florida dentists, dental corporations and vendors in order to build relationships that will provide more options for success after graduation. Our chapter also hosts other events to get members involved and stay informed. We partner with our local Student Professionalism and Ethics Association (SPEA) chapter to promote ethical awareness. In addition, we are starting a legislative debate this year. Renowned speakers, along with other school representatives from our district, will hold a round table discussion to raise awareness and understanding of the critical issues that affect our profession. As you can see, our UFCD ASDA chapter ensures that our members take the initiative to be active in their future careers in every aspect that we can. We look forward to the day that we not only graduate from dental school, but from ASDA members to FDA members. Go Gators! Mr. Lotfi can be reached at rlotfi@dental.ufl.edu.

November/December 2014

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ASDA NOVA

By Casey Lynn NOVA SOUTHEASTERN UNIVERSITY ASDA PRESIDENT

One of the most rewarding experiences I’ve had throughout dental school has been stepping outside of my comfort zone and running for president of Nova Southeastern University’s (NSU) American Student Dental Association (ASDA) chapter. Representing NSU and more than 400 student members on the local, state and national levels has helped me grow both as a person and as a professional. I consider myself extremely lucky for the opportunity. It has allowed me to gain invaluable insight into our profession and the direction in which it’s heading. When I started as president-elect, my goal was to develop more leaders in our school and leave NSU ASDA as a stronger chapter. Over the past two years, our chapter has continuously grown by increasing the support and benefits offered to our members and pre-dental students. We also have increased our chapter leader numbers by raising funds to send 12-15 people to each national ASDA conference. I feel that NSU ASDA will continue to grow and become one of the top chapters nationally. I cannot wait to continue my service with organized dentistry once I graduate and begin practicing.

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NSU’s ASDA members have great expectations for the future of dentistry. We feel privileged to learn the profession and are excited to embark on our post-graduation journeys. Young students also know that when it comes to the younger generations, they are always on the lookout for instant gratification and smart consumerism. This can be an issue for graduating students who think they can go out and practice dentistry the way their dad or grandfather did. Successful young practitioners are looking to embrace the changing market and grow with it. I feel that many of our students have begun this transition in thinking. They’re willing to look into working for or owning the multi-specialty offices that many patients are seeking. Most people today want a one-stop shop, and this is something that offices can offer without sacrificing patient care. Our chapter works to teach this to our members; I feel it’s important to educate our members on matters that are not taught in school. We want them to understand the differences between working as a corporate employee and being a business owner. The corporate option is enticing to young students with so much student debt. We don’t completely discourage the option, but explain the many pitfalls if you ever leave, such as patient management and practice restrictions. Many of our students do have that entrepreneurial spirit and are planning on opening practices after residency or associateships. They understand it will be difficult in the beginning, but know they will benefit tremendously in the long run. The future of organized dentistry lies in young practitioners’ hands. The ADA is working constantly to gain and keep younger dentists as life-long members. In order to do so, they must understand that graduates today are faced with tremendous obstacles that dentists of the past never dealt with. These include high student loan levels, health care reform and new licensure policies. If the ADA, along with the state and local levels, can continually educate and advocate for younger dentists, I feel they will retain a strong market share. Most young dentists are looking for the guidelines to success. The more tools the ADA has for new practitioners, the more value they will perceive from their membership. With organized dentistry’s recent success during this past legislative session, I feel the future generations of dentists who will represent the ADA will continue to advocate keeping dental separate. As dentists, we know what is best for our patients and it’s crucial that it remains that way. As a soon-to-be-graduate, I’m excited to see what the future holds for me as a dental professional. I look forward to many years of service to my community and hope to always have a voice in organized dentistry. Mr. Lynn can be reached at cl988@nova.edu.

November/December 2014

Today's FDA

Practice Management

UF’s Executive Practice Management Program for Dentists: An Alternative Model of Incorporated Dentistry By Annelise Ydstebo Driscoll, MBA, PhD

When the University of Florida College of Dentistry (UFCD) began our first cohort group in 2012, now commonly referred to as the Executive Practice Management (EPM) Program, our goal was to provide a comprehensive business curriculum based on sound business concepts, principles and theories applicable to the executive dental practice owner. Our goal is to help dentists develop the business acumen and skills necessary to be profitable, efficient and effective leaders, so they could provide affordable dental services to their community. What we didn’t expect was the emergence of a different type of practice model that is now referred to as “incorporated dentistry.” As dentists decoded the mysteries of the business aspects of dental practice, they embraced their management styles and enjoyed working on their practice, instead of just working in their practice. They learned that changing the practice’s legal status, such as becoming an LLC or PLLC, helps reduce personal risk to a sole proprietor’s assets. Sole proprietors, who then became incorporated, began spending more time on their executive responsibilities and shifted away from clinical activities more and more.

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Before we knew it, these “incorporated dentists” hired and mentored more associates, and focused on the clinical and administrative sides of their practice. This allowed them to ensure the practice’s business and clinical systems were maintained and working like a well-oiled machine, while reaping the financial rewards arising out of the associates’ mentored work in the practice. Some of our incorporated dentists have gone on to expand their practices by adding operatories, step further away from the clinical chair and bring in associates not just in their original practice, but to “cut and paste” their maintained practice systems (business and clinical) into a second practice — all while reaping the rewards of executive oversight as a sort of chief administrative officer for more than one practice. We discovered that dentists enjoy having and maintaining consistent systems within their practice(s). They enjoy mastering both clinical and business skills, and the structure and measurability that those systems provide for them and their employees. Corporate dental practices have consistent business systems in multiple practices so they can be easily measured and maintained, but typical sole proprietors don’t operate that way. As sole proprietors, many dentists struggle to keep their practices running efficiently and clinically productive. They can lack the administrative systems that contribute significantly to a practice’s ability to be consistently efficient and profitable. That’s one of the most noticeable differences between private and corporate practices. Having strong business systems

in place, which can be duplicated and easily measured while managed, is an empowering concept for private practice dentists; protecting personal assets through incorporation brings a sense of peace as well. Combining the two concepts gives dentists confidence and opens doors to possibilities for practices that were not previously evident. The “incorporated dentistry” model in private practice opens a future for dentists that might include owning one, two or three practices where they mentor associates and reduce their clinical time, yet reap the financial rewards of a well-run organization. We believe this dynamic model of private practice offers a new option for retiring dentists as well. We learned that dentists are thirsty for the business knowledge and systems that help them run their practices with new operational efficiencies. As we launch our third cohort group, many of our participants find they actually like the business side of dentistry, rather than viewing business management as a necessary evil for success. They want to learn more business concepts, principles and theories, and they want to implement them in their growing practices. They enjoy maintaining those systems and take the time needed to work on their practices. What an exciting and dynamic time to be in dentistry today — the opportunities are endless! Dr. Driscoll can be reached at adriscoll@ dental.ufl.edu.

November/December 2014

Today's FDA

Book Reviews

Book Reviews Powerful Practice: Leading Consultants, Vol. 2 Academy of Dental Management Consultants James and Brookfield Publishers

If you are looking for an inexpensive way to bring management topics from a thirdparty perspective to your staff members to review and adapt your everyday procedures,

Reviewed by Dr. Rick Huot

Dr. Huot is a general dentist and has a practice in Vero Beach. He can be reached at drhuot@bellsouth.net.

This is the second volume in a series of books that the Academy of Dental Management Consultants has rolled out featuring members of their organization. There are 17 different consultants contributing to this book, and each chapter is individually written by a consultant in their particular area of expertise or passion. The book is written is an easy-to-read format and can be finished in a matter of days. Its content is beneficial for all staff members and can be used to prompt discussion during staff meetings. The chapters on dental marketin g, ergonomics, practice success, and monitoring and scheduling were easy reads, and perfect examples to discuss with employees at a staff meeting.

In my opinion, the only drawback was the lack of information on the VSP concept. However, knowing that VSP is just a tool to add on to the principle extensively covered in this book made up for it. I particularly liked the following chapters: Chapter 2, “Systemic Patient Evaluation;” Chapter 3, “Diagnosis and Treatment Planning;” and Chapter 4, “Basic Guidelines for the Diagnosis and Treatments of Specific Dentofacial Deformities.” Collectively, these three chapters could be used as a reference guide in the VSP era. VSP is the best option as a final tool. However, those oral and maxillofacial surgeons that have been trained in cephalometric analysis, paper surgery and model surgery will find this book handy to precisely diagnose and plan the case before the final VSP meeting on your computer.

Essentials of Orthognathic Surgery, Second Edition Author: Johan P. Reyneke, BChD, MChD, FCMFOS (SA), PhD Published by Quintessence Reviewed by Dr. Takashi Koyama

I particularly enjoyed the chapter on emotional intelligence versus IQ, which is an ongoing debate in the management/ leadership world, and how it relates to why more “EQ” is needed these days, as opposed to “IQ.”

As an oral and maxillofacial surgeon in private practice who is still performing orthognathic surgery, this second edition by Dr. Reyneke has been a long-awaited addition to virtual surgical planning (VSP).

I found that the most helpful chapter in the book was written by Leonard Schwartz, CHCB. He has included a 100-question efficiency survey — which you can physically fill out in the book — on areas of practice management, such as: appointments, billing and collections, practice income and profitability, patient records, human resources, dental hygiene, marketing, office procedures and financial management.

There were two objectives: First, to meet oral and maxillofacial surgeons’ and orthodontists’ needs; and second, for experienced oral and maxillofacial surgeons to find valuable ways to improve the management and treatment outcomes for their patients. This book certainly meets these objectives. “Essentials of Orthognathic Surgery” contains the author’s clinical experience, accumulation of scientific knowledge and develop-

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ment of esthetic acumen, as well as updates. In this second edition, many sections have been added, revised and expanded.

Finally, for the technically savvy oral and maxillofacial surgeons, Chapter 5 has it all. This chapter contains practical and technical pearls for the most common surgical modalities, including intraoral vertical ramus osteotomy and intraoperative diagnosis of condylar sag. In closing, I would like to quote Dr. Reyneke: “It is essential to remember that we do not treat teeth but rather a person who has teeth, and that in changing the faces of our patients we also are certainly changing their lives.” Dr. Koyama is an oral and maxillofacial surgeon and practices in Fort Pierce. He can be reached at info@fioms.com.

November/December 2014

Today's FDA

Book Reviews BOOKS from 69

Books on the Shelf Books Available for Review If you are interested in reviewing one of the books listed here, please contact Director of Communications Jill Runyan by email at jrunyan@floridadental.org or by mail at 1111 E. Tennessee St., Tallahassee, FL 32308. Authors should review their books within four to six weeks and are given the books they review.

Books on the Shelf: 2010 QDT, Quintessence Publishing of Dental Technology Edited by: Sillas Duarte, DDS, MS, PhD 224 pages Published in 2010 by Quintessence Publishing Price: $84 2012 QDT, Quintessence of Dental Technology, Vol. 35 Edited by: Sillas Duarte, DDS, MS, PhD 236 pages Published in 2012 by Quintessence Publishing Price: $118 2013 QDT, Quintessence of Dental Technology, Vol. 36 Edited by: Sillas Duarte, DDS, MS, PhD 216 pages Published in 2013 by Quintessence Publishing Price: $128 2014 QDT, Quintessence of Dental Technology, Vol. 37 Edited by: Sillas Duarte Jr., DDS, MS, PhD 212 pages Published in 2014 by Quintessence Publishing Price: $128

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At the Forefront: Illustrated Topics in Dental Research and Clinical Practice By: Hiromasa Yoshie, DDS, PhD 108 pages Published in 2012 by Quintessence Publishing Price: $98 Atlas of Dental Rehabilitation Techniques By: Drs. Romeo Pascetta and Davide Dainese 416 pages Published in 2013 by Quintessence Publishing Price: $298 Challenging Nature: Wax-up Techniques in Aesthetics and Functional Occlusion By: Paul Kano Published in 2011 by Quintessence Publishing 371 pages Price: $280 Color Atlas of Fixed Prosthodontics: Vol. 1 By: Yoshiyuki Hagiwara 196 pages Published in 2013 by Quintessence Publishing Price: $120 Cone Beam Volumetric Imaging in Dental, Oral, and Maxillofacial Medicine: Fundamentals, Diagnostics, and Treatment Planning, Second Edition By Jörg Neugebauer and Joachim E. Zöller 288 pages Published in 2014 by Quintessence Publishing Price: $228 Controversial Issues in Implant Dentistry Edited by: Prof. Hernandez Alfaro, MD, DDS, PhD, FEBOMS 264 pages Published in 2013 by Quintessence Publishing Price: $168 Dancing Hands By: Herluf Skovsgaard, DDS 296 pages Published in 2013 by Quintessence Publishing Price: $198

November/December 2014

Dental Materials and Their Selection By: William J. O’Brien, PhD, FADM 425 pages Published in 2008 by Quintessence Publishing Price: $68 Endodontology: An Integrated Biological and Clinical View By: Domenico Riucci and Jose F. Siqueria Jr. 440 pages Published in 2013 by Quintessence Publishing Price: $258 Evidence-based Dentistry for the Dental Hygienist By: Julie Frantsve-Hawley, RDH, PhD 376 pages Published in 2014 by Quintessence Publishing Price: $56 Foundations of Dental Technology: Anatomy and Physiology By: Arnold Hohmann and Werner Hielscher 300 pages Published in 2014 by Quintessence Publishing Price: $98 High-strength Ceramics: Interdisciplinary Perspectives By: Jonathan L. Ferencz, DDS; Nelson R.F.A. Silva, DDS, MSc, PhD; and Jose Manuel Navarro, DDS, MS 296 pages Published in 2014 by Quintessence Publishing Price: $158 Immediate Dentoalveolar Restoration: Immediately Loaded Implants in Compromised Sockets By: Jose Carlos Martins da Rosa 372 pages Published in 2014 by Quintessence Publishing Price: $228 Inspiration: People, Teeth and Restorations By: Luis Narciso Baratieri, DDS, PhD, MS 482 pages Published in 2012 by Quintessence Publishing Price: $228 www.floridadental.org

Book Reviews Interdisciplinary Treatment Planning: Comprehensive Case Studies, Vol. II Edited by: Michael Cohen, DDS, MSD Published in 2012 by Quintessence Publishing 503 pages Price: $378 ITI Treatment Guide, Vol. 7; Ridge Augmentation Procedures in Implant Patients: A Staged Approach Edited by: Stephen Chen, MDSc, PhD; Daniel Buser, DDS; and Daniel Wismeijer, DDS, PhD 232 pages Published in 2014 by Quintessence Publishing Price: $98 Lingual Orthodontics By: Giuseppe Scuzzo and Kyoto Takemoto 885 pages Published in 2010 by Quintessence Publishing Price: $230

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One Stroke, Two Survivors By: Berenice Kleiman, with comments by Herb Kleiman 208 pages Published in 2006 by Cleveland Clinic Press Price: $24.95 Oral Implantology Surgical Procedures Checklist By: Louie Al-Faraje, DDS 92 pages Published in 2013 by Quintessence Publishing Price: $68 Oral Implants: Bioactivating Concepts Edited by: Drs. Rolf Ewers and Thomas Lambrecht 536 pages Published in 2013 by Quintessence Publishing Price: $328

Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management By: Reny de Leeuw, DDS, PhD, MPH and Gary D. Klasser, DMD 312 pages Published in 2013 by Quintessence Publishing Price: $48 Orthodontic and Surgical Management of Impacted Teeth By: Vincent G. Kokich, DDS, MSD and David P. Mathews, DDS 188 pages Published in 2014 by Quintessence Publishing Price: $106

November/December 2014

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C lassified A dvertising

Opportunities

The FDA’s online classified system allows you to 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! The FDA online classified ad model is for “paid online advertising.” Effectively, the advertising rate you pay will entitle you to online classified ads with increased exposure. As an added benefit, we will continue to publish the “basic text” format of paid, online classified ads in our bimonthly printed journal, Today’s FDA, at no additional cost to you. All ads posted to the online classified system will be published during the contracted time frame for which you have posted your online classified advertisement. Our magazine is published bimonthly, and therefore, all ads currently online will be extracted from the system on roughly the following dates of each year: Jan. 15, March 15, May 15, July 15, Sept. 15, Nov. 15. The ads extracted at this time will then be published in the following month’s issue of Today’s FDA. Please view the classified advertising portion of our website at http://www.floridadental.biz/.

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ANNOUNCING: Hands On Extraction Classes. Remove Teeth on Live Patients, including impacted wisdom teeth, and receive 40 hours of AGD PACE accepted CE Credit. Learn how to remove teeth and handle complications. Learn how to elevate flaps and suture properly. Classes July 27-31, Sept. 26/27, Oct. 24-30, and January 17-22, 2015. For more information contact Dr. Tommy Murph 843-4884357, drtommymurph@yahoo.com. A blockbuster opportunity. Full or part time for General Dentists, Endodontists, Orthodontists, Pedodontists, Periodontists, and Oral Surgeons. Generous compensation with unlimited potential. Guaranteed referrals. Join our group specialty care practice with a significant general dental component. Established in 1975 in Aventura, Coral Springs, Delray Beach, Boynton Beach, Stuart, Ft. Pierce and Melbourne. Call: Kelly Oliver 954.461.0172. Fax resume to: 954.678.9539. Email: careers@dentaland.net. Part time Dentist. Private practice in Sun City Center needs licensed part time general dentist with strength in endodontic and restorative dentistry. Must have excellent communication skills with comprehensive approach to dentistry. Please send us your resume via fax to 813.655.9945. POSITION DESIRED: Specialist. Part-Time Permanent. johnmaria7@yahoo.com. POSITION DESIRED: Endodontist. Board certified endodontist with many years of private practice experience and an active Florida license is looking for an endodontic position. If you’re interested, contact me at rcttoday@gmail.com. Pediatric Dentist Opening: Ft. Myers. Great Expressions Dental Centers has a current opening for a full time Pediatric Dentist in Fort Myers, FL. Our Specialists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. When considering a career with GEDC, Specialists can expect unlimited production based earnings, full benefits, malpractice coverage, a stable patient base, and long-term practice or regional career growth with possible investment opportunity. **Please watch more about our Doctor Career Path and apply via this ad! Apply Here: http://www. Click2Apply.net/3xbfvyz. POSITION DESIRED: Experienced General Dentist recently retired dentist. Proficient in placing and restoring implants, Extensive C & B, cosmetic dentistry, Oral Surgery and Perio surgical skills, Molar endo. Interested in f/t associateship in a quality setting. Prefer southern FL location. jspingarn@aol.com.

November/December 2014

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General Dentist Opening — Southwest, FL. Great Expressions Dental Centers has a current opening for a full-time General Dentist in our office located in Fort Myers, FL. Our dentists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. When considering a career with GEDC, Dentists can expect unlimited production based earnings, full benefits, paid time off, malpractice coverage, a stable patient base, and long-term practice or regional career growth with possible investment opportunity. **Please watch more about our Doctor Career Path (http://www. screencast.com/t/M3xWM5CYN) and apply via this ad! General Dentist. Full-Time Permanent. jhokamp@ ddpgroups.com. A traditional fee for service general practice seeking full or part time associates, as well as Endodontists and Oral Surgeons. Seven locations on Florida’s West Coast including Tampa, Clearwater, St. Petersburg, Port Richey and Bradenton. Immediate income, paid vacation, health insurance, 401k, flexible days. Established in 1981. NO CAPITATION. Please contact Carolyn Mallory 727.461.9149, Fax 727.446.8382 or www. FloridaDentalCenters.com. Experienced General Dentist Needed Full time. Experienced General Dentist Needed for fast growing practice in New Port Richey, Florida. Guaranteed salary plus percentage. Medical and mal-practice paid for you. High-tech office with experienced staff. No nights or week-ends. Excellent opportunity for experienced clinician. Please email resume (vjmnlm@gate.net) or fax(727.945.9661). Immediate opening. Looking For Associate Destin, FL. By way of introduction, my name is Dr. Olivier Broutin and I practice in the Destin area. We’re looking for a doctor to work in our practice. We have a thriving practice and we need help! We are creating a great opportunity for someone who wants to treat people. We’ll handle the marketing, new pt generating and management hassle. We offer great income potential, excellent working conditions and training. We have all the latest high tech equipment, including CEREC and CBCT. We think we have it all! If you would be interested please email us your resume to OBDMD1@gmail.com. Oral surgeon wanted. Longstanding oral surgery practice with excellent reputation seeks associate leading to partnership in Southwest Florida coastal community on the Gulf of Mexico. Great school systems in family oriented community with a large network of referral dentists. All phases of oral surgery available to BCBE surgeon. Contact gatormom143@me.com.

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Endodontic Position Available. Florida, Tampa Bay Area — Full time endodontist wanted to join established multi-specialty practice. Great opportunity for a self-starter to build a career practice with the possibility of a future partnership. Close to the beaches, excellent leisure activities available, and three pro sports teams in the area. Salary, bonus, 401K. Please call 727.460.8268. Associateship Leading to Ownership. I am looking for the right candidate as an associate for my wellestablished pediatric dental practice who wants to become a practice owner in 2 years. Hours would include Mondays, Fridays, and one Saturday per month. Please reply to this ad ONLY if practice ownership is in your short-term plans. babytth@ aol.com. ASSOCIATE LEADING TO PARTNERSHIP — BRADENTON, FLORIDA. Well-established high quality, fee for service, restorative/prosthodontic and aesthetic practice looking for a highly skilled and motivated associate. Excellent opportunity for the right person. scarlett@zkjvdental.com. DENTIST. Consulting firm seeking Practice Transition Consultant. Full Training and support. Unlimited earning potential. careers@paragon. us.com 866.898.1867. Endodonitst. Our multidisciplinary team in South Florida is seeking a motivated ENDODONTIC associate. The center is located in an upscale area near Gulf Stream Plaza. Approximately one mile from the ocean. Please visit us online at www. ThePremierSmile.com. Our team coordinates and provides continuing education courses. We employ a wonderful and highly trained staff that focuses on providing high quality care in a state of the art environment. We will provide the practice support needed for your success. Partnership opportunities are available. Please email CV to Mr. Howard Corbeau: howardcorbeau@gmail.com or fax to 888.800.4955. Professional Placement, Doctors per Diem. Professional practice coverage during personal, maternity or disability leave. Emergencies, short notice OK. That’s why we’re here. All inquiries treated with absolute confidentiality. Keep the cash flowing, your staff busy, overhead covered, and patients treated. Join us! Florida-based, DOCTORS PER DIEM needs Florida providers. No cost, no obligation, ever to join the team. Work only when and where you wish. Negotiated daily minimum guarantee, plus percent of production. Bread and butter procedures. DOCTORS PER DIEM INC. Since 1996. We know how. Register: www.doctorsperdiem.com/register. Email: docs@ doctorsperdiem.com. 800.600.0963.

Endodontist wanted PT/FT. Wanted: Endodontist, part-time or full time for growing Endo practice. Great Area and referral base. Buy in potential. Please call 813.374.2290 or email CV or questions to chris@cpendo.com. General Dentist Opening — Brandon, FL. Great Expressions Dental Centers has a current opening for a full-time General Dentist in our Brandon, FL and Tampa, FL office(s). Our dentists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. When considering a career with GEDC, Dentists can expect unlimited production based earnings, full benefits, paid time off, malpractice coverage, a stable patient base, and long-term practice or regional career growth with possible investment opportunity. **Please watch more about our Doctor Career Path (http:// www.screencast.com/t/M3xWM5CYN) and apply via this ad! Apply Here: http://www.Click2Apply. net/74sr8h6. General Dentist Opening — Treasure Coast. Great Expressions Dental Centers has a current opening for a full-time General Dentist in our Treasure Coast, FL office. Our dentists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. When considering a career with GEDC, Dentists can expect unlimited production based earnings, full benefits, malpractice coverage, a stable patient base, and long-term practice or regional career growth with possible investment opportunity. **Please watch more about our Doctor Career Path (http://www.screencast.com/t/ M3xWM5CYN) and apply via this ad! Apply Here: http://www.Click2Apply.net/42yh72w. General Dentist Needed – Jacksonville. Current opportunity for a full-time General Dentist DDS/ DMD in our metro-Jacksonville, FL office with Great Expressions Dental Centers! Our dentists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. When considering a career with GEDC, Dentists can expect unlimited production based earnings, full benefits, malpractice coverage, a stable patient base, and long-term practice or regional career growth with possible investment opportunity. Possible relocation assistance as well! **Please watch more about our Doctor Career Path ( http://www.screencast.com/t/ M3xWM5CYN ) and apply via this ad!

Please see CLASSIFIEDS, 76

November/December 2014

Today's FDA

Your Classified Ad Reaches 7,000 Readers! CLASSIFIEDS from 75

For Sale/Lease Beautiful Lakefront Property. Brandon, FL. Beautiful 2000 sf lakefront office space available for custom build out. Adjacent to Endodontist. Ideal for Oral Surgeon or Periodontist. Contact Julie 813.654.3636 or julieh@aeoftb.com BRAND NEW MEDICAL RETAIL FRONTING W. HILLSBOROUGH AVE. Under Construction – Brand new 2 Story Office/Medical Retail Building. Downstairs — 3,300 sq. ft. total that can be divided into two units. Upstairs – (3) Three 1,100 sq. ft. Executive Office Suites. Frontage on W. Hillsborough Ave. Average traffic counts 55,000+/ day. Largest LED display sign on W. Hillsborough Ave. Built with SIPS panels to save you 50% on electric. Pavilion, Future Nature Trails. katie@ tlhuntinc.com. http://www.unitedbusinesspark. com. University Health Park (website: universityhealthpark.net) is a $15,000,000 80,000 square foot “one stop shop” medical office park with 3,000 patient/week patient flow. We have need for the following: general dentist/pediatric dentist/endodontist/periodontist/prosthodontist/ oral surgeon/orthodontist. A large $300 million development (including Starbucks, Dunkin Donuts, Culvers, Tire Kingdom, Firehouse Subs) and 200 acres of homes are being built all around us. We have office space ranging from 1,200 to 6,000 square feet. Some of the suites have equity options. Please call Don Harvey, MD if interested at cell 941.724.3259. Dental office for sale, lease, or lease/purchase. Excellent opportunity at minimal expense. Centrally located in an attractive 10 unit condominium complex with two general dentistry practices, a chiropractic office, and other professional businesses. Fully furnished/equipped for the practice of dentistry. 3 operatories wired/ plumbed for water, suction, compressed air and nitrous oxide/oxygen. Suitable for general dentistry, periodontics, endodontics, prosthodontics or oral surgery. A) Purchase includes all equipment/ furnishings. B) 3Year Lease includes use of all equipment/furnishings. C) Lease/purchase: to be consummated anytime during 3 year period for appraised value at that time. Photos, inventory of equipment/furnishings and floor plan available. Contact Dr. Roger Lee 941.349.1352, royroddyboy@ gmail.com. http://fortmyers.craigslist.org/chl/ bfs/4689461245.html.

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Specialty office 1500 sq ft., 5 operatory, large waiting room, 2 pvt. offices, central sterilization, reception. Class A office space. Assume lease equipment negotiable. Assume remaining 2 year lease. osurgoffice@aol.com. Buyers and Sellers. We have over 100 Florida dental practice opportunities; and the perfect buyer for your practice. Call Doctor’s Choice Companies today! Kenny Jones at 561.746.2102, or info@ doctorschoice1.net. Website: doctorschoice1.net. Practice Sale Tampa, FL. **PEDODONTIST PRACTICE SALE!!!!** 3,000 sq/ft space. 6 Ops incl 2 Quiet rooms. Equipment includes intra oral Cameras, Digital X-rays, Panographic X-ray unit, Digital Panoramic unit, Lasers, Nitrous and I.V. Sedation System. Family friendly community within minutes of Raymond James Stadium and Busch Gardens. #FL104. Please contact: Henry Schein Professional Practice Transitions, Heather Brown – Licensed Sales Associate. Cell: 727.844.8588. Email: Heather.Brown2@henryschein.com. Sarasota Practice. Sarasota, FL — The #1 Beach Destination in the USA! Established 30 year old practice with $200,000 Gross and 95% collection rate – 25% PPO. 1100 sq. ft. business condo unit also for sale. Owner retiring. Contact Dr. Rotole at: rotoleswimsgood@verizon.net or 941.922.0111. Well-Established Practice For Sale (Miami-Dade County). GENERAL DENTAL PRACTICE: 2013 Gross $232K, Established 21 Years, 1,350 Sq. Ft., 3 Ops, 2 Open Bay Chairs, Waiting Room, Private Doctor’s Office, 1 Hygiene Chair, Manager/Business Office, Consultation/Education Office, Lab, Sterilization Room, Intra-Oral Camera, Central Tray Prep Area, 2,000 Charts, X-Ray System and Much More. 100% FINANCING AVAILABLE, Call ProMed 888.277.6633 or Email info@promedfinancial.com [Ref#D100]. Weston, FL GP. For Sale. Weston, Florida. Small general practice located in best medical building in area. 4 operatories, room for 5th, 2 X-rays ,pan, ceph 1200 sq ft. Great potential for rapid growth for individual or multi center group. Priced at only $375,000 for quick sale. Contact 305.498.1406, goofy596@aol.com. Seeking Partner. General Dentist for Partner and/ or Associate needed for paperless practice with an option to buy in immediately or in future as partner, or outright practice purchase. F/T or P/T. Offices available in Naples, Port St. Lucie or Coral Springs. Please email: pbfloridadentist01@aol.com.

November/December 2014

Practice in Largo. 3 Ops – 1,200 Square Foot Office-Expandable Office Space Available!! Largo, is centrally located under 15 minutes from Clearwater Beach and 30 from Tampa. Local beaches provide activities such as fishing, boating, swimming, kayaking, and more. Tampa Bay offers amenities such as the Hard Rock Cafe and Casino and unlimited restaurants and night life venues. #FL108. Please Contact: Henry Schein Professional Practice Transitions, Heather Brown – Licensed Sales Associate. Cell: 727.844.8588. Email: Heather. Brown2@henryschein.com. Practice Sale — Clearwater. 7 Op General practice – Updated Equipment, New Computers – 3,800 Sq. Ft. Office Space – Real Estate Included! Clearwater is known for its award-winning, white sandy beaches and beautiful blue waters. The city offers world-class entertainment including championship golf courses. #FL110. Please contact: Henry Schein Professional Practice Transitions, Heather Brown – Licensed Sales Associate. Cell: 727.844.8588. Email: Heather.Brown2@henryschein.com. Orthodontic/Pediatric dental office space conveniently located off Federal Highway. 5 chair open bay with window views. Private new patient consultation/quiet room and records room. Traditional panoramic and cephalometric radiograph machines and developer/processor included. Flat screen TV's and audio equipment throughout. Private elevator access to 2nd story. Parking lot with ample parking. braces53@yahoo. com. Dental practice in Key Biscayne, for sale or lease, 1050 sf, great opportunity to take over established practice with key money only, 4 plumbed operatories, 3 in use, each room with computer and double monitors, 6 computers total, potential for expansion, capacity to include Spa Dentistry. Dentrix dental system, lab area, spacious living room style front desk, back staff office, one full steam bath, staff half bath, equipment room with new washer/dryer. Superb location in the only shopping center on the Key with major supermarket, facing Crandon Blvd. Opportunity to obtain real estate is available. For information Gloria Gutierrez 305.232.7198 from 11 am to 6 pm. LEASE OPTION: Sarasota- new office ready to occupy. This is a fully equiped dental office with new buildout, modern design for efficiency. Fully newtorked, four operatories, sterilization, lab, phone, chairs and more. Great for start up as it requires no bank financing, planning, or effeort. Everything has been done for you. Just show up to work. Photos can be seen at :http://sarasota. craigslist.org/off/4764813472.html. schweizer@ juno.com.

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November/December 2014

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OFF THE CUSP

JOHN PAUL, DMD, EDITOR

The List Faithful followers of this column know I have two young daughters and one young (looking) wife. Given that there are varying levels of ability to communicate, a new question tops the list as most commonly asked in our house: “What do you want?” This question often is heard while the littlest is screaming, though it has a popular seasonal variation: “What do you want for Christmas?” When you are young that is a tough question to answer. There are the things you’ve wanted all year and then there are so many new things that come out just in time for gift giving. Judging from my patients, it doesn’t get any easier when you get older. How many people in your chair say, “You’re the doctor, you tell me what I should have.” We all know this is a cop-out, so they can complain if you fall for the trap and give them what they truly need. Knowing what you want is a very useful piece of information. It provides focus for your limited resources. It lets you stop struggling when you actually get what you want. This knowledge is best when shared. You’d be surprised how many people are willing to help you succeed, but you have to tell them how to help you. So here’s the list of things I want for Christmas. Remem-

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“ ”

Knowing what you want is a very useful piece of information.

bering that several of you took me to task last year for mentioning Christmas, my list includes eight things to recognize Hanukkah, which always seemed cool to a kid who only celebrated one day of Christmas. 1. A cordless laser with a holster like Han Solo would wear, and it has to make a cool noise. 2. A new knife: lightweight, not too big, right-side clip for tip-up carry, thumbhole for opening. 3. Another small high-powered tactical flashlight, because there’s no such thing as too many flashlights. 4. A safe, because I have some cool things and I don’t always like to share.

November/December 2014

5. Something that will make my wife smile every time she looks at it, because she deserves it for putting up with me every day. 6. One more hour at home every day while the kids are awake. They’re so cute when they’re asleep, but they’re more fun when they’re awake. 7. A dozen or so patients, whom I have well-pleased, to sing my praises to all of their friends. 8. A sarcasm font so you’ll all know when I’m serious or when I’m trying to be funny, rather than assuming I’m an insensitive jerk. Think about what you really want and don’t forget to tell others — it makes them feel good to help. If I left your holiday out this year, just send those comments and letters to jpaul@bot. floridadental.org.

Dr. Paul is the editor of Today's FDA. He can be reached at jpaul@bot.floridadental.org.

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