2015 - March/April TFDA by Florida Dental Association

Change is Good Speaker Previews Exhibit Marketplace Cyberliability

CE PROGRAM HIGHLIGHTS

JUNE 11-13, 2015

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WE KNOW INSURANCE. WE KNOW DENTISTS. Call us today to speak to a licensed agent about your insurance needs. “Excellent relationship with FDA [Services] and The Doctors Company. Nothing but praise for the FDA on its leadership in dentistry for the State of Florida and its dentists. Keep up the good work and thanks for caring about our profession.” — Dirk Fleischman, DDS

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news 12

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news@fda

columns 3

Staff Roster

17 House of Delegates Announcements

President’s Message

18 House of Delegates

Legal Notes

20 Board of Dentistry

Information Bytes

Diagnostic Discussion

f e at u r e s

80 Off the Cusp

Dr. Yvette Godet Creates a Balanced Program at FDC2015

Take Your Entire Team to FDC2015!

classifieds

Change is Good

72 Listings

FDC2015 Speaker Preview — Dr. Lozano

FDC2015 Speaker Preview — Dr. Hayes

44 FDC2015 Speaker Preview — Dr. Gottlieb 48

Exhibit Marketplace

59 Setting the Stage for a Successful Employment Relationship 65

Cyberliability

Shift Happens — Will You be Ready?

The Future of Dental Consulting

Payers Using Credit/Debit Cards for Payment

Do You Want That Mouthwash Straight Up or on the Rocks?

Read this issue on our website at:

www.floridadental.org.

www.floridadental.org

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

March/April 2015

Today's FDA

FLORIDA DENTAL ASSOCIATION MARCH/APRIL 2015 VOL. 27, NO. 3 EDITOR Dr. John Paul, Lakeland, editor

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

COUNCIL ON COMMUNICATIONS Dr. Thomas Reinhart, Tampa, chair Dr. Roger Robinson Jr., Jacksonville, vice chair 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

YOUR PROFESSIONAL GROWTH SFDDA ANNUAL BUSINESS MEETING Wednesday, April 15, 2015 Kovens Conference Center, North Miami

Speaker: Dr. Maxine Feinberg, President, ADA www.sfdda.org • 305.667.3647 • sfdda@sfdda.org

CFDDA ANNUAL MEETING

FRIDAY & SATURDAY, APRIL 24-25, 2015 Hammock Beach Resort, Palm Coast

Speakers: Drs. Mark Hyman & Ethan Pansick www.cfdda.org • 407.898.3481 centraldistrictdental@yahoo.com

SIXTH ANNUAL ACDDA CRUISE

THURSDAY, APRIL 30, 2015-MONDAY, MAY 4, 2015 LIBERTY OF THE SEAS – Royal Caribbean Speaker: Henry Schein Dental; Dr. Stuart Auerbach www.acdda.org • 561.968.7714 • acdda@aol.com

WCDDA 2015 SUMMER MEETING FRIDAY-SUNDAY, AUG. 7-9, 2015 The Ritz-Carlton, Naples

Speakers: Dr. Gerard Kuge & Dr. William Robinson www.wcdental.org • 813.654.2500 • wc.dental@gte.net

NEDDA PRESENTS TRIAGING THE OROFACIAL PAIN PATIENT Friday, Oct.30, 2015 Sheraton Jacksonville Hotel

Speakers: Dr. Henry Gemillion www.nedda.org • 904.737.7545 • ddeville@nedda.org

NWDDA 2016 ANNUAL MEETING

FRIDAY & SATURDAY, FEB. 19-20, 2016 The Grand Sandestin www.nwdda.org • 850.391.9310 • nwdda@nwdda.org

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. James Antoon, Rockledge • Dr. David Boden, Port St. Lucie Dr. Jorge Centurion, Miami • Dr. Robert Churney, Clearwater Dr. Richard Huot, Vero Beach • Dr. Kim Jernigan, Pensacola Dr. Rudy Liddell, Brandon • Dr. Howard Pranikoff, Ormond Beach Dr. Barry Setzer, Jacksonville • 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 2015 Florida Dental Association. All rights reserved. Today’s FDA is a refereed publication. POSTMASTER: Please send form 3579 for returns and changes of address to Today’s FDA, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914.

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

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

ADVERTISING INFORMATION

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

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

Today's FDA

March/April 2015

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@floridadental.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 Blair Fowler, Assistant to the Executive Director bfowler@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

MEMBER RELATIONS

(FDAF)

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

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

Meghan Murphy, Program Coordinator mmurphy@floridadental.org 850.350.7161

FLORIDA DENTAL CONVENTION (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 Program Coordinator aliveoak@floridadental.org 850.350.7106 Brooke Mills, FDC Meeting Coordinator bmills@floridadental.org 850.350.7103

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

Deanne Foy, Finance Services Coordinator Dues, PAC & Special Projects dfoy@floridadental.org 850.350.7165

Joe Anne Hart, Director of Governmental Affairs jahart@floridadental.org 850.350.7205

Tammy McGhin, Payroll & Property Coordinator tmcghin@floridadental.org 850.350.7139

Alexandra Abboud, Governmental Affairs Coordinator aabboud@floridadental.org 850.350.7204

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

Casey Stoutamire, Lobbyist cstoutamire@floridadental.org 850.350.7202

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

INFORMATION SYSTEMS

Marcia Dutton, Administrative Assistant marcia.dutton@fdaservices.com 850.350.7145

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

Sarah Beall, Membership Services Representative sarah.beall@fdaservices.com 850.350.7171

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

Maria Brooks, Membership Services Representative maria.brooks@fdaservices.com 850.350.7144

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

Nicole White, Membership Services Representative nicole.white@fdaservices.com 850.350.7151

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

RISK EXPERTS

Debbie Lane, Assistant Membership Services Manager debbie.lane@fdaservices.com 850.350.7157

GOVERNMENTAL AFFAIRS

COMMUNICATIONS AND MARKETING

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

Carol Gaskins, Assistant Membership Manager carol.gaskins@fdaservices.com 850.350.7159

Joyce Defibaugh, FDA Membership Dues Assistant jdefibaugh@floridadental.org 850.350.7116

Dan Zottoli

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

Pamela Monahan, Commissions Coordinator pamela.monahan@fdaservices.com 850.350.7141

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

Carrie Millar, FDAS Agency Manager Northeast & Northwest 850.350.7155 carrie.millar@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

March/April 2015

Today's FDA

EXHIBIT HALL HOURS Thursday, June 11 Friday, June 12 Saturday, June 13

9 AM - 5:30 PM 9 AM - 6 PM 9 AM - 2 PM

DEDICATED EXHIBIT HALL HOURS Each day from 12-2 PM

W I SH

O Y

JOIN US IN THE EXHIBIT HALL!

H E ERE R E !



BOOTHS 315 & 415

• Use the ADA Find A Dentist Photo Booth to update your webVisuallisting. Identity System ADA Signature • Toss for a bottle ofThe wine with FDAS. • Meet your local FDAS insurance agent. • Sit down and relax! parent brand signature is the most visible component • Access free Wifi. The of the brand identity system and serves as the foundation for all other pieces of the visual identity system. The signature distinguishes the organization from other dental • Order ADA products. organizations through color, emphasis on the name of

American Dental Association

the organization and typography, and reinforces the brand positioning message.

MEMBER CENTER @ HELPING MEMBERS SUCCEED WITH THE POWER OF THREE! This year, FDA and ADA membership experts Signature will staff the Member Center together. The signature is made up of two elements: the symbol Symbol Typography Signature Elements

and the typography. Since the acronym (ADA) exists for other organizations, the full name is emphasized in the signature. The two elements that comprise the signature complement each other visually while clearly identifying the organization.

•For Guidelines on using the symbol alone, see page 9. •Never alter the spatial relationship between the symbol and typography.

& YOUR DISTRICT DENTAL ASSOCIATION

FDA Services is a major sponsor of the Florida Dental Convention

New Dentist activities at FDC2015 are supported by a grant from the American Dental Association.

Style M

PRESIDENT’S MESSAGE RICK STEVENSON, DDS

The Journey Continues A lot is being accomplished during this last segment of my presidential journey. I’ve made numerous trips to Tallahassee, and I’m proud to say we’ve had great success with many dentists participating in the Legislative Contact Dentist (LCD) Visits. We introduced Florida’s Action for Dental Health (FADH), a comprehensive undertaking to provide quality dental care to all Floridians. This was developed by the Workforce Innovations Task Force under Dr. Jolene Paramore’s guidance, and introduced to the Legislature at a press conference at the Capitol in early February. The FADH provides an outline — now the hard work starts with implementing it. We are looking forward to interacting with other stakeholders to accomplish this goal. The Florida Dental Association (FDA) had yet another successful turnout at the annual Dentists’ Day on the Hill (DDOH)! It means a great deal to have so many of our members present, and it’s a critical step in getting our message to your senator or representative. They do take notice when you visit them in Tallahassee as well as at home. This year, one of our objectives is to pass SB606, by Sen. Don Gaetz (R-Destin), and HB 657, by Rep. Cummings (R-Orange Park), which will create dental care access accounts. In addition, we are seeking funding for community water fluoridation and an additional Donated Dental Services coordinator. Make sure to look for Capital Report in your inbox for weekly updates on these and other issues that might surface. Your staff at the FDA’s Governmental Affairs Office are ever vigilant in keeping us aware of any changes that might affect how you practice dentistry. During session, the Governmental Action Committee meets every Monday morning to discuss what is happening and to make recommendations on these issues, so there is no surprise presented to us. I thank them for their dedication and time. Take time to get involved in the legislative process — the more representation we have, the more influence we get.

“

Take time to get involved in the legislative process — the more representation we have, the more influence we get.

”

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

March/April 2015

Today's FDA

Legal Notes

An FDA Legal Grab Bag: Severe Weather, a U.S. Supreme Court Slip Opinion, Working Interviews, Board of Pharmacy Fines and Patient Abandonment Graham Nicol, Esq., HEALTH CARE RISK MANAGER, BOARD CERTIFIED SPECIALIST (HEALTH LAW)

This article is a potpourri of hot topics based on last month’s calls to the Florida Dental Association’s (FDA) legal staff. In no particular order:

Severe Weather Where snow days are the norm, employers usually have written policies giving a specific number of paid days off so employees don’t risk the commute into work. In Florida, we had a few hard freezes but this issue also arises during our upcoming favorite time of the year — hurricane season! — or what the rest of the country calls “summer.” When your practice (also known as “the worksite” in legalese) has to close its doors because of severe weather, here are the rules on paying staff. Non-exempt versus exempt employees may be treated differently, as follows: Non-exempt employees (i.e., hourly, nonprofessional staff): Under the Fair Labor Standards Act (FLSA), which applies if you

Today's FDA

March/April 2015

have one or more employee(s), non-exempt employees are not entitled to pay for workdays when the office is closed for weather. However, the employer’s written policies (you do have an employee manual, don’t you?) can change this result. For example, in order to keep a happy worksite, some dentists choose to pay non-exempt employees for severe weather days by allowing them to use accrued paid time off (“PTO”), also known as vacation/sick time benefits. Really generous dentists also can voluntarily choose to pay non-exempt employees who don’t have accrued PTO, but if you do so it must be done in a nondiscriminatory manner. Also, time paid, but not actually worked, does not count as part of a weekly overtime calculation for non-exempt employees. Exempt employees (i.e, dentists and other skilled professional health care workers): Under FLSA, exempt employees are to be paid their entire salary if the worksite officially closes. Barring an employee handbook or independent contractor agreement that varies from the FLSA norm (even if the worksite remains open during severe weather), an exempt employee who does not work is considered off work just like any other personal day and their wages are not docked. If the practice remains open, no exempt employee salary deductions should be made for an employee who arrives late or leaves early.

Dental offices with written policies on severe weather are at an advantage. They will be prepared and everyone will have clarity on what will and will not be paid; how your employees are to give notice that they will miss work due to weather; to whom that notice must be given for payroll purposes; and how you, as their employer, will give your employees notice that the office is closed due to severe weather. Oh, and by the way, unless your office was located directly on a Panhandle beach, the BP oil spill doesn’t count as a weather-related absence. If patients are not cancelling their appointments, then it probably was not a severe weather day!

Supreme Court Slip Opinion on North Carolina Board of Dental Examiners North Carolina’s Board of Dental Examiners (NCBODE) regulates the practice of dentistry like Florida’s Board of Dentistry (BOD) does in our state. In North Carolina, six of its eight NCBODE members must be licensed and practicing dentists (a majority). In Florida, seven of its eleven members must be “licensed dentists actively engaged in clinical practice” (again, a majority). After the NCBODE issued cease-and-desist letters to non-dentist teeth whitening services and product manufacturers, the Federal Trade Commission (FTC) sued. The FTC, the 4th U.S. Circuit Court of Appeals

www.floridadental.org

Legal Notes

and on Feb. 25, the U.S. Supreme Court, affirmed that the Board had unreasonably restrained trade in violation of antitrust law. Because a majority of the Board’s members are “active market participants in the occupation the Board regulates” who may “engage in private self-dealing” the North Carolina Board can invoke state-action antitrust immunity only if “the challenged restraint ... [is] clearly articulated and affirmatively expressed as state policy, and ... the policy ... [is] actively supervised by the state.” In North Carolina, the Court concluded there was a “structural risk of market participants’ confusing their own interests with the state’s policy goals.” So, now we know that “a state board in which a controlling number of decision makers are active market participants in the occupation the board regulates must satisfy [the] active supervision requirement in order to invoke state-action antitrust immunity.” The problem is easily remedied if the majority of the regulatory board doesn’t practice dentistry. But that is not a workable solution. Lay people can’t tell dentists how to practice because they don’t know how. While Florida’s BOD could see some changes in composition, it is more likely that state review mechanisms will be implemented to provide “realistic assurance” that the BOD “promotes state policy, rather than merely the party’s individual interests.” Most troubling is that the Court sets forth a vague and subjective standard: “In general, however, the adequacy of supervision ... will depend on all the circumstances of a case.” No one yet knows definitively what

will pass muster under the Court’s realistic assurance of active state supervision test. The Court’s guidance is limited to a state supervisor who must review the substance of the board’s decision; “the supervisor must have the power to veto or modify particular decisions to ensure they accord with state policy;” and the “mere potential for state supervision is not an adequate substitute for a decision by the state.” OK, thanks for clearing that up! Arguably, Florida’s BOD is actively supervised by the Joint Administrative Procedures Commission (a legislative agency) regarding rulemaking; by the Division of Administrative Hearings regarding licensure discipline (but only if appealed); and by the judiciary regarding unlicensed practice (again, only if appealed). Will this be enough? Time will tell.

Working Interview or Job Training? A “working interview” is when the dentist/ employer wants to observe the clinical skills of job applicants (e.g., dentists, hygienists, assistants) or their clerical skills (e.g., front office and billing staff) by actually seeing the applicant perform essential job duties before they are hired as employees. Does the dentist/employer have to pay wages for “working interviews?” Probably yes. Under FLSA, unpaid working interviews are lawful only if no work that is of benefit to the practice is performed and the interview is limited to only the necessary amount of time to test the applicant’s ability to perform essential job functions. So, if you have the applicant “interview” by working an eight-hour day and watching them actually

schedule appointments, submit claims or care for patients; then you really need to pay them. The FLSA recognizes that pre-employment job testing and working interviews are different than post-employment training and orientation sessions. Wages must be paid during post-employment job training and orientation (think about how much time you spend with new employees going over HIPAA, blood-borne pathogens and infection control alone!). Unless the worker is exempt or an independent contractor (topics outside the scope of this article), as the employer, you must pay wages for time spent on post-employment orientation and training (“work hours” in legalese).

Board of Pharmacy Fines A dentist was fined $5,000 by the Florida Board of Pharmacy for improperly dispensing topical fluoride and Peridex™. But under section 466.017(8), Fla. Stats., a dispensing practitioner permit is NOT required if all the dentist dispenses is “fluorides and chlorohexidine rinse solutions.” The Board of Pharmacy has been fully staffed since the pill mills and the compounding pharmacy/ meningitis scandals over the last few years. They are conducting in-office dental practice inspections even though they may not know the Dental Practice Act. Dispensing practitioner regulations, health care clinic establishment permits, pedigree papers and drug handling protocols are complicated. If you’re unsure, please log on to http:// www.floridadental.org/convention-ce for a complimentary FDA members-only continuing education (CE) course that walks

Please see LEGAL, 9

www.floridadental.org

March/April 2015

Today's FDA

Legal Notes

LEGAL from 7

you through all the basics before the Board of Pharmacy comes to visit! Do you know how to properly store opened vials of Botox Cosmetic™?

Patient Abandonment Practice long enough and you will need to terminate a doctor/patient relationship. If done correctly, you’ll sleep well. Florida has specific laws on how to avoid the tort of patient abandonment. For the few of you who don’t have a lawyer in the family, torts are different than tortes. One is something you can get sued for (bad); the other is a tasty pastry (excellent). If you need a refresher course on patient abandonment, please log on to http://www.

floridadental.org/convention-ce and get two complimentary CE hours upon successful completion of the course. It’s not as much fun as eating French pastry, but trust me it is more interesting than you think! Check out one of my favorite cases: Maltempo vs. Cuthbert, where a doctor was held liable for $45,000 dollars (in 1974 money!) when he never even saw the patient, examined him, formed a diagnosis or undertook treating him. Health law and health care risk management, especially in Florida: a promise of never-ending entertainment. Next issue, we’ll look at managed-care organizations and participating provider agreements and how organized dentistry can help members succeed. Or, maybe we’ll talk about subpoenas and whether a doctor’s PA should own a Mercedes™ — by the

way, the FDA Crown Savings Program can help you do that, too! Contact FDA Services at 800.877.7597 for more information. 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. He will be speaking at FDC2015 and presenting the course,“You Want Me to Sign What?” on Thursday, June 11 at 3:45 p.m.

NEW COURSE! Patient Abandonment At some time in their practice, all dentists will need to terminate a doctor/patient relationship. This Legal CE explains how to do so without violating Florida’s patient abandonment law. It covers the following topics: potential civil and disciplinary liability resulting

from improper termination

required content of patient termination letters required notice provisions

proper and improper reasons for termination

emergency treatment and continuing-care

warning signs indicating that the doctor is at risk

obligations other legal and ethical requirements

of abandoning a patient

Take this course online to earn a free CE credit. For link, go to floridadental.org/members. FDA Members Only! Expires 4/1/2016

www.floridadental.org TFDA_0415_Legal CE banner.indd 1

March/April 2015

Today's FDA

3/14/2015 2:32:21 P

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Information Bytes

Spam, Phishing and Spoofing, Part 1: I Don’t Like Green Eggs and Spam! By Larry Darnell DIRECTOR OF INFORMATION SYSTEMS

Email is still a primary form of communication, and at least 85 percent of the world uses it. Something this popular is bound to be used and abused. We’ve all received the emails that promise a fortune from the Nigerian uncle we didn’t know we had. We can spot that from a mile away. However, it’s a little more difficult to discern an email from UPS/FedEx/USPS talking about an undelivered package or an email from a co-worker who needs help with a file. Both require you to click on something. Any time you click on a link or an attachment in an email, there is risk involved. I even get a lot of messages that appear in my inbox from me. I’m a fairly clever guy, but I don’t send myself a lot of emails. We will look at each of these situations over the next few issues of Today’s FDA. How does this stuff happen? Let’s start with spam. Spam is unwanted or unsolicited email that just shows up in your inbox. Despite there being some laws and fines for spam, they keep on appearing. Remember the Do Not Call Registry … pretty ineffective, right? Every retail store asks for an email. Every website you sign in to may

www.floridadental.org

Take control of your email account. Pay attention to whom you give your email address and why, and be careful of how it’s used. require you to enter your email. When is the last time you read privacy notices and how they intend to use the data you provide them? I thought so. You’re giving people a direct pipeline to send spam to your inbox. You could block or unsubscribe from these emails until your fingers fall off, or you can simply outsmart the spammers. I have several email accounts (they’re all free, by the way) for different purposes. I have one that is a complete throwaway email account; I never check it, but I regularly give it out to stores and websites where it’s required. Then there’s my work email, which is used for work-related communication and nothing else. And, of course, I have my personal email account that I use for just close friends and family. I never give that out to work folks, nor does it show up anywhere else. I even have a few email accounts in between (for Facebook, Twitter, etc.). I don’t check them all every hour of every day; I check three on my phone or tablet, and that’s it.

I realize some complain about having more than one email account to keep up with, but think of it this way: How many phone numbers do you have? You don’t give everyone your home number (if you still have a home phone), do you? You probably even think twice about giving some people your cell number. Email makes it easy to have as many accounts as you want and they’re all free. What’s not free is the time that I use to sift through all the clutter, junk and spam that show up in my inbox. Time is valuable. Email accounts are free. I set them up to screen my emails. You’re in control of spam at some level. Take control of your email account. Pay attention to whom you give your email address and why, and be careful of how it’s used. Next month, we are going phishing. I’d better make my way over to Bass Pro Shop to get some gear. Mr. Darnell can be reached at ldarnell@ floridadental.org or 850.350.7102.

March/April 2015

Today's FDA

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

The Foundation Announces Date and Location for the 2016 Mission of Mercy Event Join us in Jacksonville! The Florida Mission of Mercy is a two-day, free dental clinic designed to treat the most pressing needs of patients who are either uninsured, underinsured or would normally not have access to dental care. At the event, patients will undergo medical and dental triage to identify their needs and then be routed to the appropriate treatment areas: oral surgery, extractions, restorations, pediatrics and hygiene. We anticipate treating 2,000 patients over the course of the event. The two-day clinic will be held on April 22-23, 2016 in Jacksonville, Fla. If you have an interest in volunteering for leadership and/ or making a donation, please contact Director of Foundation Affairs Heather Gioia at 850.350.7117 or hgioia@floridadental.org.

Agency Profile: From School to Retirement — Florida Agency Commits for the Long Haul Educate students. Write their first policy at graduation. Support every phase of their careers. This lifelong commitment to the client has become the defining philosophy of FDA Services and its chief operating officer, Scott Ruthstrom. “We pride ourselves on being able to take care of the dentist while they’re in school, throughout their career, until retirement,” says Ruthstrom. “While they’re in school, we’re teaching them the need for disability insurance and professional liability insur-

Today's FDA

March/April 2015

ance. They need health and life insurance while they’re dental students. When they graduate, we provide that first professional liability policy. A couple years later they might join a practice. Then they expand and buy their own practice, and we’re there to provide their property and liability and workers’ comp insurance. Our dentists trust us to handle their entire insurance portfolio.” For more than 25 years, FDA Services has operated as a for-profit subsidiary and independent agency of the Florida Dental Association (FDA). The program started with its first policy in 1989 and now insures more than 4,000 dentists across the state. Ruthstrom has been there since the early years, joining FDA Services in 1994 when he was just a few years out of college. He held nearly every position in the company and worked under the mentorship of former COO Frank Lauria, who taught him the business from the ground up and prepared Ruthstrom to replace him four years ago. Ruthstrom heads an internal staff of 19, plus five outside agents.

University of Florida dental student earns 2015 Dr. Ray Bowen Student Research Award The ADA Foundation (ADAF), in cooperation with the Academy of Operative Dentistry, has announced the winner of the 2015 Dr. Ray Bowen Student Research Award. Andres Jorge Alvarez, a first-year dental student at the University of Florida College of Dentistry (UFCD), received the award for his proposed research project, “A New Arginine-based Bonding Agent with Long-lasting Anti‐caries Activity.”

“I am thrilled to have received this prestigious award. It is a true honor,” said Mr. Alvarez. “I look forward to the opportunity to further my research interests and to represent the University of Florida College of Dentistry on this national landscape.” The biennial Dr. Ray Bowen Student Research Award is open to dental students at all levels, including residents and Masters of Science degree candidates, who wish to undertake research relevant to contemporary operative dentistry. The award provides $6,000 to the awardee to perform the proposed research and an additional $1,000 to help meet their obligation to present a table clinic based on the research proposal at the Academy of Operative Dentistry’s scientific session. The student must have a research mentor who is a member of the Academy of Operative Dentistry at his/her institution to provide guidance and act as a co-investigator. Mr. Alvarez’ mentor is Dr. Marcelle Nascimento, an assistant professor in the Restorative Dental Sciences department at the UFCD. The award honors the nearly 60-year career of Dr. Ray Bowen, the inventor of resin composites and dentin adhesives and an internationally recognized authority on composite materials. Dr. Bowen is a former director of the ADA Foundation Dr. Anthony Volpe Research Center (VRC), formerly the Paffenbarger Research Center, and is presently active as Distinguished Scientist at the VRC. The award is administered by the ADA Foundation through and in collaboration with the Academy of Operative Dentistry. The award was known as the George C. Paffenbarger Student Research Award between 2007 and 2013.

www.floridadental.org

Dentist Named No. 1 Job in 2015 The U.S. News & World Report published “The 25 Best Jobs in 2015.” Results were ranked on salary, work-life balance and expected employment growth. Dentists were ranked No. 1! The Florida Dental Association would like its members to share what they think is the best part about being a dentist. Email your thoughts to communications@floridadental.org, and include your headshot if you’d like. Responses may be shared on social media to get the conversation going on the benefits of being a dentist.

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 Craig Meskin, Dania Beach Daniel Pichler, Hobe Sound Yelena Prato-Guia, Weston Christopher Ramsey, Jupiter Craig Schroeder, Delray Beach

Central Florida District Dental Association Claudio Buonfiglio, Altamonte Springs Juliana Correal, Kissimmee Sujin Ju, Gainesville Justin Lieneck, Palm Bay Ericka Lowe- Bennett, Apopka Sanaz Nasseri, Winter Park Kathleen Neiva, Gainesville

Nguyen Nguyen, Orlando Tuquyen Nguyen, Ocala

West Coast District Dental Association

Janisha Patel, Kissimmee

Patrick Carrigan, Naples

Makom Powell, Melbourne Myrna Rodriguez-Cardona, Orlando Pamela Sandow, Gainesville Alex Snyder, Port Orange Catalin Teodoru, Groveland

Northeast District Dental Association Diego Andrade, Fernandina Beach Benjamin Diller, Fernandina Beach Valerie Ligeon, Jacksonville

Northwest District Dental Association Nancy Fitzgerald, Shalimar Melissa Kyriakakis, Pensacola David Lister, Wewahitchka Brion Long, Tallahassee Sasha Minor, Chipley Stephen Speck, Pensacola Martin Woolsey, Niceville

South Florida District Dental Association Seng Kyu Choi, Miami

David Goldschein, Tampa Lisa Lapointe, Sarasota Pablo Silva, Cape Coral Mohammad Spouh, Zephyrhills Gretel Viera, Clearwater

In Memoriam The FDA honors the memory and passing of the following members: Kenneth Scales Jacksonville Died: 2/10/15 Age: 86 Susilendra Vijay Plant City Died: 9/23/14 Age: 70 Philip Levine Pensacola Died: 1/27/15 Age: 80

Ramiro Esparragoza, Coral Gables Jorge Fornaris, Miami Manuel Lopez, Coral Gables Heidi Ortega, Miami Ernesto Perez, Miami Yoaris Ramos Collazo, Miami Ramon Saldana, Miami Luis Sanchez, Miami Mariana Velazquez, Miami Kari Vinuela, Pembroke Pines Larry Vinuela, Pembroke Pines Susana Wilhelm, Miami

A contribution has been made to The Florida Dental Association Foundation In Memory of Dr. Kenneth I. Scales By Dr. and Mrs. Barry Stevens Jacksonville, FL

Kathleen Nguyen, Winter Garden

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March/April 2015

Today's FDA

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HOD Announcements

House of Delegates to Consider Bylaws Changes At its June 2015 meeting, the Florida Dental Association (FDA) House of Delegates (HOD) will be asked to consider rewriting the bylaws and shifting content to an FDA Agencies Manual that will be maintained by the Board of Trustees. In January, the HOD voted to proceed with discussion of the bylaws changes and the agencies’ manual. Since then, a town hall meeting has been held and the Council on Ethics, Bylaws and Judicial Affairs has reviewed the proposed changes. According to the FDA’s Articles of Incorporation, the FDA bylaws may be changed as follows: q by a two-thirds affirmative vote of the members of the HOD, provided the changes are sent in writing to the association’s membership postmarked at least 30 days in advance of that session of the HOD. q or, at any session of the HOD, by a three-fourths affirmative vote of the members present and voting, providing the proposed changes have been presented in writing at a previous meeting of the session and unanimous consent has been given to consider the changes.

www.floridadental.org

March/April 2015

Today's FDA

FD A

em be

rsh ip

HOD

e s u o HDelegates of

January 23-24, 2015 18

Today's FDA

March/April 2015

www.floridadental.org

HOD

By FDA Staff

On Jan. 23-24, the Florida Dental Association (FDA) House of Delegates (HOD) met at the Tampa Airport Marriott. The HOD discussed many issues, including the following business. Dr. Rick Stevenson, 2014-2015 FDA presi-

Next House of Delegates Meeting The next HOD meeting will be June 12-13, 2014, at the Gaylord Palms Resort and Convention Center.

dent, reported that the FDA is the first state dental association to implement a consis-

17th District Trustee Report

tent single brand for the association and all

Dr. Buckenheimer stated that Florida is

Bylaws Task Group Proposal to Streamline Bylaws

its affiliated entities. He also reported that

the only state to ever have five American

The HOD adopted a resolution that invites

the Foundation has hired a new director,

Dental Association (ADA) council chairs or

FDA members to attend an electronic town

Ms. Heather Gioia, and plans to have an an-

vice chairs. He said Florida’s Action for Den-

hall meeting in March and to submit writ-

nual Florida Mission of Mercy event, starting

tal Health is a welcome response to activism

ten comments through April 1, 2015.

in 2016.

to create new, less trained providers.

Special Report on Membership

Report of the Board of Dentistry Chair

Dr. Terry Buckenheimer and Mr. Drew

Dr. Bill Kochenour thanked the FDA for

Eason announced that Florida was one of

its peer review process and mentioned

only a few states to increase market share,

that it is the best benefit a dentist can have.

and the only state to increase by one full

He asked for Florida-licensed dentists to

percentage point. The HOD recognized the

volunteer as dental licensure examiners and

significance of this accomplishment, con-

indicated that a licensure assessment may

sidering the number of members retiring.

be necessary in the future.

With an influx of newly licensed dentists,

Dental Therapy Prior to Prescription of Medications with Risk of Oral Ulcerations The HOD referred a resolution to the Council on Dental Health (CDH) that the dental profession develop a communication in cooperation with the Florida Medical Association that will help inform Florida physicians of the benefit of a dental consultation prior to initiating medications prone to

Confirmation of ADA Officers

the increase the risk of Medication-related

The HOD confirmed Dr. Buckenheimer’s

Osteonecrosis of the Jaw (MRONJ) — pre-

Special Report on South Carolina Dental Therapist Bill

nomination by the delegation to run for

viously known as Bisphosphonate Associated Osteonecrosis of the Jaw (BONJ). The

Dr. Mike Eggnatz briefed the HOD on a

ADA president-elect and Dr. Cesar Sabates’ nomination to serve as ADA trustee-

CDH should return with a resolution for

elect for the FDA.

the HOD at its June 2015 session.

the FDA added 402 new members in 2014.

bill pending in South Carolina that would greatly expand the scope of practice for “dental therapists.”

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March/April 2015

Today's FDA

Board of Dentistry

By Casey Stoutamire FDA LOBBYIST

The Florida Board of Dentistry (BOD) met in Jacksonville on Friday, Feb. 20. The Florida Dental Association (FDA) was represented by BOD-Liaison Dr. Don Ilkka and FDA lobbyist Casey Stoutamire. Drs. Andy Brown, Bill D’Aiuto, Mark Romer, Linda Trotter, and many others also were in attendance. All eleven board members were present: Dr. Bill Kochenour, chair; Dr. Leonard Britten, vice chair; Drs. Dan Gesek, Robert Perdomo, T.J. Tejera, Joe Thomas, Wade Winker; hygienists, Ms. Catherine Cabazon and Ms. Angie Sissine; and consumer members, Mr. Tim Pyle and Mr. Anthony Martini. This was Dr. Kochenour’s first meeting as BOD chair. At the meeting, Dr. Gesek gave a report on the Anesthesia Committee conference call that took place on Dec. 16, 2014. The Anesthesia Committee is reviewing the requirements for conscious sedation per-

Today's FDA

March/April 2015

mits and may make modifications, but the discussion was tabled until the American Dental Association (ADA) House of Delegates makes its recommendations on the issue. The BOD approved a change to Rule 64B5-14.003, General Anesthesia Permit, which now requires a two-year residency instead of a one-year residency. Dr. Tejera is the Anesthesia Committee’s new chair and the FDA looks forward to working with him. The FDA would like to thank Dr. Gesek for all his hard work as the Anesthesia Committee chair. Dr. Gesek also gave an update from the Dental Budget Task Force. The BOD currently is in a deficit of about $1 million and will be $8-9 million in the red by 2020. All professional boards are housed under the Medical Quality Assurance Division (MQA) at the Department of Health (DOH), which pools all professional boards’ funds into one main trust fund. However, all boards are encouraged to operate as budget neutral. The BOD has been running a deficit for many years, so BOD staff brought it to the BOD members’ attention during the November 2014 BOD meeting. Dr. Thomas, chair at the time, created the Budget Task Force to explore the issue further. Members of the task force include Dr. Gesek (chair), Dr. Ilkka, Ms. Tami Miller (Florida Dental Hygiene Association) and Dr. Saul Brotman. The Task Force analyzed all the BOD’s accounts and researched the issue thoroughly. The FDA also had its Chief Financial Officer, Mr. Greg Gruber, review the BOD’s accounts. All parties agree there is no malfeasance. Instead, the Task Force found that while the cost of doing BOD business (office inspections, researching and prosecuting discipline cases, licensure review) has risen, the licensure fee amount has remained stagnant. Due to this anticipated budget shortfall, the task force recommended the following: q Review the cost of anesthesia permits. This issue was referred to the Anesthesia Committee to discuss ways to reasonably charge for what the BOD needs to do to comply with the inspections and permitting requirements for those applying for an anesthesia permit (e.g., a per site visit charge for an inspection). For example, an anesthesia permit is $100; however, to inspect the site for anesthesia permit, it may cost the BOD close to $300. Thus, it costs the BOD more to inspect and approve an applicant for an anesthesia permit than it takes in with the permit fee. q Modify the current hygiene fee structure to make the licensure fees less expensive. Currently, the hygiene fund runs a surplus and is swept by the legislature every year. The hygiene and dentistry budgets are separate.

www.floridadental.org

Board of Dentistry

q Increase dental licensing fees. Dr. Gesek stated that for the BOD to get to a neutral budget there would need to be a $265 assessment this biennium and next biennium. In addition, the licensing fees would need to be raised to around $475. However, no assessment or licensure fee increase will be done for the 2016 biennium. These two issues need legislative approval and the deadline has passed to be able to do anything this legislative session. The BOD approved a motion to raise the statutory cap for licensure fees to $600 dollars. This is in line with current FDA policy. Please note, this will not automatically raise the licensure fee to $600; it will give the BOD flexibility to raise licensure fees to adequately cover the cost of doing BOD work. The FDA will be monitoring this issue closely and updating its members accordingly. Ms. Cabazon gave a report on the Hygiene Council conference call to the BOD on Jan. 21, 2015. The FDA submitted language to the BOD to clarify that a dental hygienist with an anesthesia certificate may only administer anesthesia to one patient at a time. The Hygiene Council rejected this language, but the FDA has not changed its position on this issue. Mr. David Flynn, the BOD attorney, gave an update on the status of several rules moving through the administrative process. Rule 64B5-17.002, Written Dental Records: Minimum Content, Retention, is not yet effective. Mr. Flynn is working with the Joint Administrative Procedures Committee (JAPC) on their approval of the rule, but does not foresee any substantive changes. The FDA will update its members once this rule becomes effective. The FDA thanks the JAPC for all their hard work on this issue!

Next BOD Meeting The next BOD meeting is scheduled for Friday, May 29, at 7:30 a.m. EDT in Gainesville, at the Hilton University of Florida Conference Center. The BOD proposed meeting dates for remainder of 2015 are Aug. 21 and Nov. 20.

The BOD also dealt with eight disciplinary cases and one voluntary relinquishment by a dental hygienist at this meeting. There were several below standard-of-care cases and some that dealt with substance abuse. If you have not yet attended a BOD meeting, it is suggested that you take the opportunity to attend and see the work of the BOD. It is much better to be a spectator than a participant in BOD disciplinary cases. Ms. Stoutamire can be reached at 850.350.7202 or cstoutamire@floridadental.org.

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March/April 2015

Today's FDA

T H U R S D AY

F R I D AY

S AT U R D AY

Dr. Uche Odiatu

Dave Weber

Morris Morrison

LIVING YOUR DREAMS  NC01

OVERCOMING LIFE’S GOLIATHS  NC12

LEAD-UR-SHIP STARTS WITH YOU!  NC20

Do you wake up on the wrong side of the bed every day? Do you need coffee to kick-start your brain? Do you suffer from “afternoon blah?” Legendary football coach, Vince Lombardi said, “Fatigue makes cowards of us all.” Enjoy this morning session and fortify your body’s natural VITALITY, end fatigue and take action on your life’s works.

As the title suggests, every person, company and industry has Goliaths: barriers, obstacles or challenges. The key to success is not avoiding them (that’s unrealistic) but rather dealing with and overcoming them. While everyone remembers that David overcame Goliath in the epic battle more than 3,000 years ago, very few people realize the leadership concepts he used and how we can apply those same principles to help us in our lives today.

Why are some dental professionals far more successful than others? How can you “position yourself for success” as a professional in today’s dental industry? Morris Morrison will take things to a whole new level during his high-energy keynote address. Fueled by a personal story that sounds like it was written in Hollywood, Morris Morrison has a unique speaking style that will inspire you to persevere when facing challenges in life and business. Get ready to be energized and motivated!

Grab your coffee and join your colleagues for an hour of learning and credit earning from 8-9 a.m. each day. All attendees are eligible to register. Pre-registration for keynotes is free to FDA/ADA members, their teams, guests and laboratory technicians. All others are $25.

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

March/April 2015

Today's FDA

Dr. Yvette Godet Creates a Balanced Program at the 2015 Florida Dental Convention

COMPREHENSIVE CONTINUING EDUCATION FOR THE ENTIRE DENTAL TEAM IN A BEAUTIFUL FAMILY-FRIENDLY SETTING

Today's FDA

March/April 2015

FDC2015: Career & Life in Balance яБо www.floridadentalconvention.com

By Jessica Lauria, Publications Coordinator, after interviewing Dr. Yvette Godet, 2015 Scientific Program Chair

and Continuing Education continues to diligently identify and meet the needs of the target audience and exhibitors, as well as remain practical and relevant, she believes FDC will continue to grow in an increasingly competitive market.

This year, the Florida Dental Convention’s (FDC) theme is Dentistry Beyond the Tooth – Career & Life in Balance, and features a broad spectrum of topics ranging from “Balancing the Occlusion” to “Creating a Balance in Dr. Godet Life.” FDC2015 Scientific Program Chair Dr. Yvette Godet has put together an excellent program to touch on the many elements that work together to create a cohesive and healthy mind, mouth, body and practice.

So why should you take time out of your busy schedule to travel to Orlando? The committee and FDA staff have put together a remarkable three-day convention that has something to offer everyone on the dental team. It’s a great opportunity for team building, learning, comaradarie and discounted buying in the Exhibit Hall. This year, a two-day laser certification workshop is available and will provide participants with standard proficiency as recognized by the Academy of Laser Dentistry. Attendees also will have an opportunity to participate in a head and neck dissection workshop, as well as many other wonderful courses and workshops.

Due to the numerous benefits FDC has to offer, including advocacy and education that protect and enhance your professional, personal and economic objectives, the convention continues to ensure that innovation, quality of dental care, standards and peer relationships are perpetually enhanced and protected. The Florida Dental Association’s (FDA) goal is to provide comprehensive continuing education (CE) for the entire dental team, and reduced course fees help make that possible. Dentists, hygienists, assistants, the administrative team, and lab technicians should all attend FDC. Current technologies and standards impacting each of these disciplines are featured at the Gaylord Palms Resort and Convention Center, a location that is beautiful and family friendly.

Featured speakers include: Lois Banta, Drs. Gary Dewood, Charles Blair, Lee Ann Brady, David Little and Harold Crossley. FDC2015 is offering approximately 110 lectures to choose from, FREE pre-registration for members, 24 hours of FREE CE, reduced workshop fees for team co-learning, 33 hands-on workshops, two mini-residencies and state mandated courses. Each day begins with energizing and motivational keynote sessions for the entire team, featuring: Dr. Uche Odiatu, Dave Weber and Morris Morrison. FDC2015 has a lineup of exceptional and dynamic speakers and exhibitors who will propose solutions to better equip dental professionals for the challenges they encounter daily in practice. This program promises to be exciting, rewarding and fun.

Families also are encouraged to attend and enjoy the local attractions and participate in the festivities each night! One event you don’t want to miss is Friday night’s “Junkanoo!” This year’s party is a close encounter with island culture. This event is fun for all ages, featuring Caribbean-themed food, steel drum band entertainment; rush out parades, hair braiding, face painting and more.

The better question is: why wouldn’t you want to take advantage of all that FDC2015 has to offer? We hope to see you there!

Dr. Godet is excited and encouraged by the growth FDC has enjoyed over the past few years. FDC truly is a quality resource for all dental professionals. As long as the Committee on Conventions

Ms. Lauria is the FDA Publications Coordinator and she can be reached at jlauria@floridadental.org or 850.350.7115.

Dr. Godet is the 2015 Florida Dental Convention Scientific Program Chair. She has a cosmetic and restorative dental practice in Gainesville and can be reached at drgodet1@gmail.com or 352.333.9898.

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

March/April 2015

Today's FDA

THE AFTER PARTY! The party doesn’t have to end! Join the “New Dentists” at “The After Party” in Wreckers on Friday, 10 PM-1 AM. Enjoy drinks, dancing and DJ King playing all your party favorites.

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FDC2015: Career & Life in Balance  www.floridadentalconvention.com

March/April 2015

Today's FDA

In addition to our name change, now the Florida Dental Convention (FDC), you can expect to see some significant changes based your feedback.



Better Dates

Shorter Lines at the CE Stations

This year’s convention dates, June 11-13, do NOT conflict with Father’s Day weekend. Make plans now to bring the whole family! Contact the hotel at 407.586.2000 and mention you’re with the FDC to reserve your room at the $185 rate that includes FREE parking, or go to www.floridadentalconvention.com.

CE verification is now automatically provided for all attendees. No need to worry about CEU codes anymore. To receive CE credit for course attendance, attendees must scan their badge at the entry door of the course and upon exiting. The system will then calculate the amount of time an attendee was present and award the credit appropriately. Attendees will be emailed their CE certificate automatically on June  15, 2015. Attendees can also obtain a printed CE Reduced Room Rates verification certificate at any time after the end of the For those seeking lower room rates, we’ve set aside a course from the traditional CE stations located in the block of rooms at the Springhill Suites Marriott just Exhibit Hall. As an added bonus, the FDA will report three miles from the Gaylord. The rate is $114 per night your earned the CE directly to CE Broker within two plus taxes and includes complimentary breakfast buffett weeks. and wireless Internet. Parking is an additional five dollars per night. Call 888.789.3090 to reserve your room. 

Education Tailored to Your Needs



You’ll find sessions specifically designed for dentists, Recognition new dentists, assistants, hygienists, administrative This year you will not want to miss the Awards Luncheon team members, laboratory technicians, students and even guests. on June 13th. Come recognize and honor our FDA President, Dr. Rick Stevenson, as well as the 2015 award recipients, including FDA Dentist of the Year! Tickets for the event are $35 per person or purchase a table of ten for $300. Tickets must be purchased by May 29.

Today's FDA

March/April 2015

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

 More Learning Options We’re keeping the standard three-hour lectures and workshops, but we’ve also added shorter one-hour, two-hour and 2.5 hour sessions to the mix. There are five one-hour courses on Thursday to choose from that are FREE for FDA/ADA Member Dentists. In addition, we’ve added table clinics in the Exhibit Hall where you can earn one-hour of CE credit each day. We also are offering three classrooms on the Exhibit Hall floor with FREE CE to FDA/ADA Member Dentists. Looking to dive deeper? Then our Laser Certification workshop is for you. This two-day workshop provides a Standard Proficiency Course according to the curriculum guidelines and Standards for Dental Laser Education as recognized by the Academy of Laser Dentistry (ALD). This program consists of both lecture and hands-on portions, includes a comprehensive overview of dental laser devices, laser tissue interactions and dental laser operation and safety. With more education options, you’re sure to find a learning style to fit your needs.

 More Time on the Exhibit Floor You’ll have more time to meet with the important vendors you need to see with earlier openings as well as open exhibit time that doesn’t conflict with learning. The Exhibit Hall will open daily at 9 a.m. immediately after the General Session. From 12-2 p.m. each day, enjoy a leisurely lunch in the back of the Exhibit Hall and meet with exhibitors. On Friday, June 12th the Exhibit Hall will stay open until 6 p.m. In addition, we’ve brought back appointments with exhibitors. We know your time is valuable. This year, you have the ability to schedule one-on-one sessions prior to the meeting with the exhibitors that you want to see. Avoid long waits and get more business done in half the time! Appointments range from 10-15 minutes. As an added plus, attendees that complete six or more appointments over the three days will be entered to win one of five $200 American Express gift cards.

 Some Things to Stay the Same Not all things require change. You told us you valued free member registration, free course offerings for members, lower course fees for team members, badge printing in the hotel lobby on Wednesday and Thursday from 4-9 p.m., free wi-fi on the classroom level and in your hotel room, lunch coupons for purchasing an AM and PM course on Thursday and the fun, family-friendly evening events. All these things will remain the same. Plus, this year enjoy some informal networking with the New Dentists on Friday night after Junkanoo! Join us for “The After Party” in Wreckers from 10 p.m.-1 a.m. Enjoy drinks, dancing and DJ King playing all your favorite party music. On Saturday from 4-11 p.m., add some magic to your FDC trip and join us at the Magic Kingdom® Park with your colleagues, friends and family at “Night Out at Disney.” Drive yourself or take advantage of the Gaylord Palms shuttle. Tickets are $59 and must be purchased online by June 10.

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

March/April 2015

Today's FDA

FDC2015 Speaker Preview

Overview of Dental Photography By Dr. Frank Lozano

Imaging in dentistry has a long history of improving patient care. For many decades, cameras used in dentistry had technology similar to film-based radiography. Digital camera sensors function in much the same way as digital radiography sensors in practice. Differences in sensor design, lenses, flashes and handling properties all affect how easy photography is to use in dentistry. Digital photography gives immediate feedback about exposure, and can be used to instantly communicate any oral conditions. Photography aids treatment planning, presentation, pathology monitoring, specialist communication and practice marketing. As treatment becomes more complex, it requires the dental team to use various approaches to communicate the treatment plan. Patients also are part of this team and many expect to be involved in understanding their diagnosis and treatment. Implant treatment often is interdisciplinary and complex. Using the correct camera system in your practice can significantly simplify all phases of communication. Ultimately, this improvement in communication is aimed at saving clinicians’, technicians’ and patients’ time and expense. The most basic modern digital camera used in dentistry is a compact “point and shoot”

Today's FDA

March/April 2015

Fig. 1

camera (Fig. 1). Modern compact cameras are beneficial for a number of reasons, chiefly their small size and comfort level for staff. Most compact cameras’ sensors are much smaller than a 35 mm frame of film and therefore, have an inherent advantage with keeping things in focus from the front to back of the mouth. Focusing is difficult in some situations where manual focus cannot be achieved easily.

Fig. 2

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

FDC2015 Speaker Preview

A digital single lens reflex (SLR) camera (Fig. 2) is the most flexible camera to use. SLR cameras use a movable mirror, which allows you to preview the image through the lens before capture. Full-time manual focus achieves critical focus and maximum sharpness where desired. Interchangeable lenses use dedicated close-up, or macro, lenses in the optimal focal length for dentistry, approximately 100 mm. Shorter focal lengths tend to over-emphasize the anterior teeth (Fig. 3). The 100 mm focal

“

Fig. 4

Fig. 5

Fig. 3

length range allows minimal distortion and adequate working distance for intra-oral photos. This lens is optimized for close-up work with small subjects. The flash is the most critical part of any camera system used in dentistry, and many types exist. Almost all flashes designed for close-up photography place the flash tubes at or near the end of the lens to minimize distracting shadows. Ring flashes have a circular flash tube around the lens that provides uniform, flat lighting that tends to provide more accurate representations of color, while point or twin point macro flashes provide more contrast and better reproduction of fine details with more apparent depth. The differences between these flash types for dentistry can be subtle (Fig. 4, ring flash; Fig. 5, twin point flash).

The most recent advance in digital imaging, which I only will touch on briefly, is the so-called “interchangeable lens compact” segment. This type features a hybridization of the compact camera without a reflex mirror, but still using SLR-like interchangeable lenses. With its macros lenses and ability to use close-up flashes, this new camera has the potential to be valuable in a dental setting. Without using the mirror and prism to view the image, these cameras use the LCD screen on the rear of the camera instead to show the image being captured. Omitting these parts makes the entire system much more compact and less intimidating for auxiliaries and patients alike.

Using imaging in daily practice benefits dentistry in numerous ways, and almost all involve enhancing and accelerating communication in some way.

”

The most important question facing clinicians when contemplating adding any new technique or technology is: Why use it? Using imaging in daily practice benefits dentistry in numerous ways, and almost all Please see PHOTOGRAPHY, 37

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

March/April 2015

Today's FDA

THURSDAY, JUNE 11

ATRAUMATIC EXTRACTION AND SOCKET GRAFTING FOR IMPLANT OR PONTIC SITE DEVELOPMENT — A LIVE PATIENT SURGICAL PRESENTATION EX12  2-4 PM  CE CREDITS: 2

DIGITAL DENTISTRY FOR THE SURGICAL AND RESTORATIVE PRACTICE EX13  10 AM-12 PM  CE CREDITS: 2 This lecture is fully sponsored by Implant Educators.

This lecture is fully sponsored by BioHorizons.

BEAUTIFUL, ECONOMICAL ALTERNATIVES TO PORCELAIN VENEERS EX11  10 AM-12 PM  CE CREDITS: 2 This lecture is fully sponsored by Coltene.

CHECKING THE PULSE OF YOUR PRACTICE WITH EAGLESOFT EX22  2-5 PM  CE CREDITS: 3 Fee: see pgs. 26, 27 (Registration Brochure). This lecture is fully sponsored by Patterson Dental.

PREVENTIVE MAINTENANCE EX21  9 AM-12 PM  CE CREDITS: 3 Fee: see pg. 31 (Registration Brochure). This lecture is fully sponsored by Patterson Dental.

RESTORING FUNCTION AND ESTHETICS WITH DENTAL IMPLANTS EX31  9 AM-12 PM  CE CREDITS: 3 This lecture is fully sponsored by DENTSPLY Implants.

RESTORING FUNCTION AND ESTHETICS WITH DENTAL IMPLANTS EX32  2-5 PM  CE CREDITS: 3 This lecture is fully sponsored by DENTSPLY Implants.

FRIDAY, JUNE 12

PRINCIPLES FOR A PRODUCTIVE DENTAL OFFICE EX34  2-5 PM  CE CREDITS: 3 This lecture is fully sponsored by Henry Schein Dental.

“REAL WORLD” DENTISTRY FOR THE AESTHETIC/RESTORATIVE PRACTICE EX33  9 AM-12 PM  CE CREDITS: 3 This lecture is fully sponsored by SDI (North America) Inc.

REALIZING THE IMPACT OF QUALITY ONE-VISIT RESTORATIVE DENTISTRY EX14  2-4 PM  CE CREDITS: 2

SATURDAY, JUNE 13 EXTRINSIC STAIN REMOVAL EX25  9 AM-12 PM  CE CREDITS: 3 This lecture is fully sponsored by Colgate.

RESTORATIVE OPTIONS FOR IMPLANTS EX35  9 AM-12 PM  CE CREDITS: 3 This lecture is fully sponsored by Preat Corp.

TREATING POST ORTHODONTIC BLACK TRIANGLES AND UNDERSIZED TEETH EX15  10 AM-12 PM  CE CREDITS: 2 This lecture is fully sponsored by Bioclear Matrix Systems.

FOR DETAILED INFORMATION, SEE PAGES 8-9 OF THE FDC REGISTRATION BROCHURE.

This lecture is fully sponsored by Patterson Dental.

VIRTUAL PATIENT FLOW: EAGLESOFT NUTS AND BOLTS EX23  9 AM-12 PM  CE CREDITS: 3

We added another classroom to offer more opportunities for great CE!

Fee: see pg. 41 (Registration Brochure). This lecture is fully sponsored by Patterson Dental.

“YES WE CAN”— TREATMENT OPTIONS TO EFFECTIVELY COVER EXPOSED ROOT SURFACES EX24  2-5 PM  CE CREDITS: 3 Fee: see pg. 47 (Registration Brochure). This lecture is partially sponsored by BioHorizons.

THANKS TO OUR SPONSORS! Operatory sponsored by Patterson Dental.

Today's FDA

March/April 2015

Camera sponsored by Magnified Video Devices.

Corporate Classroom sponsored by Henry Schein Dental.

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First published in Forum Implantologicum Volume 7, Issue 1, 2011.

PHOTOGRAPHY from 35

involve enhancing and accelerating communication in some way. Miscommunication frequently causes patients, laboratories and treatment teams to be confused. The time it takes to capture and print an image of teeth for shade matching is fractional compared to how long it would take to give the same information written on a lab script for a technician. With a click of a shutter and less than a minute of printing, patients can be informed about any serious conditions and aesthetic risks (Fig. 6). They may never reach that point with hours of discussion in a treatment consult. Once you’ve decided to use digital photography in your dental practice, there are a few things to consider for it to be effective

Dr. Lozano is a prosthodontist with a practice in Gainesville, Fla. as well as an adjunct faculty member at the University of Florida Department of Oral and Maxillofacial Surgery. He teaches in the Center for Implant Dentistry. He can be reached at drlozano@ lozanodentalcare.com.

Fig. 6

for the dental team. Examples include: who will take the pictures, and how will they be sorted and stored in a way that can easily be accessed later? How will the images be used? Will they be printed out, or only be viewed on a computer screen? When you’ve taken these into consideration, the only thing left to do is go out and buy your new dental digital camera!

He will be speaking at FDC2015 and presenting his course, “Digital Dental Photography for the Whole Team” on Friday, June 12 at 9:30 a.m., with a repeat course at 2 p.m.

The most important reason I retain my membership is supporting and belonging to an organization that remains committed to our profession … — Dr. Marcus Higgins

Helping Members Succeed NEW MEMBERS IN 2014! FDC2015: Career & Life in Balance  www.floridadentalconvention.com TFDA_0415_MEMBER INCREASE-half.indd 1

March/April 2015

Today's FDA

3/18/2015 4:14:25 PM

FDC2015 Speaker Preview

HPV — Changing the Face of Head and Neck Cancer and Dental Societies’ Responsibilities By Dr. Cherylle Hayes

In fact, oropharyngeal cancers are thought to be rising in epidemic proportions. A

The human papillomavirus (HPV) is the

reported 62 percent of oropharyngeal

name for a group of viruses that affect the

cancers are attributable to the HPV viruses

skin and mucous membranes of many sites

(high-risk strains). Additionally, if any of

of the body, including the oropharynx. It’s

your patients smoke (reported incidence of

the most common sexually transmitted

smoking in the U.S. by the CDC is roughly

infection (STI) in both men and women

18 percent, or 42.1 million adults), it has

in the United States; most sexually active

been found that as few as three cigarettes

people will acquire at least a few strains of

daily is enough to increase the HPV infec-

HPV in their lifetime. Recent data indicates

tion risk by one-third!

that nearly 80 million people are infected with HPV, and 14 million people are newly

The oral cavity (OC) and oropharynx (OP)

infected each year in the U.S.

always should be thoroughly examined; the tonsils and the base of the tongue are

Today's FDA

March/April 2015

So, why is it important that all members

the most common sites of HPV-associated

within the dental society know about such a

cancers. Cancers in these and other OC

virus? Recent U.S. population-based studies

and OP sites can be difficult to see, and

conducted by the Centers for Disease Con-

continue to rely on patient presentation and

trol and Prevention (CDC) show that while

physical examination with biopsy confir-

smoking-related head and neck cancers are

mation. Many people continue to blame the

on the decline, HPV-related cancers of the

dental and medical communities for “miss-

oral cavity and oropharynx are on the rise.

ing these cancers” on routine examinations

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

FDC2015 Speaker Preview

as most are diagnosed at a late stage. Keep

in others or community immunity). In my

in mind that 25 percent of oral, head and

practice, we have seen a significant increase

neck cancers are detected in patients who

in OC/OP cancers in young people. Ad-

do not smoke or drink alcohol, especially

dressing HPV with our patients will have a

in those older than 50. However, current

large impact not only with head and neck

research has shown us these ratios and age

cancers but with other HPV-related cancers

groups are rapidly changing.

that involve female and male genitalia.

Younger, non-smoking patients under the

The dental and medical communities have

age of 50 are the fastest growing segment

a responsibility to help with diagnostic and

of the oral cancer population. Unfortu-

preventive measures, such as a thorough

nately, this increase in cancers diagnosed

physical examination at routine visits

in men and women in their 20s and 30s

and using screening tools. Additionally, a

is more than making up for the decline in

discussion/documentation of preventive

tobacco-related head and neck cancers.

measures with our patients should be a part

Tobacco products use has declined in the

of every contemporary dental examination.

U.S. every year for more than a decade. As the frequency of OP cancers continues to

Dr. Hayes is an oncologist at the North

rise in more men than women, evidenced-

Florida Cancer Center in Gainesville. She

based research and HPV prevention with

can be reached at Cherylle.Hayes@HCA-

the Food and Drug Administration (FDA)-

healthcare.com.

approved vaccinations become challenging. For example, we are in the midst of a

She will be speaking at FDC2015 and

measles outbreak in the U.S. in which the

presenting two courses on Thursday, June

majority of the people were unvaccinated.

11. At 9:30 a.m., she will present, “HPV and

To call the news surrounding such an

Oral Cancer,” and at 2 p.m., “Micronutrient

outbreak a national debate is undeniable.

Impact on the Oral Cavity.” On Friday, June

When educated about the disease and how

12, both courses are repeated. “Micronutrient

to prevent it, many young men and women

Impact on the Oral Cavity” will be at 9:30

have the propensity to receive the vaccina-

a.m., while “HPV and Oral Cancer” will be

tion. One young lady in her teens came to

at 2 p.m.

“

Younger, non-smoking patients under the age of 50 are the fastest growing segment of the oral cancer population.

”

my office recently with a skin cancer and after learning about HPV, walked out with a prescription for the vaccine. This action may not only protect her but also lead to herd immunity (i.e., preventing future cases

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

March/April 2015

Today's FDA

add

some

magic to

FDC2015 FLORIDA DENTAL CONVENTION 2015 "Night Out at Disney" Magic Kingdom® Park Saturday, June 13, 2015 FDC2015 attendees are invited to bring family and friends to enjoy an evening of enchanting entertainment, classic attractions, beloved Disney Characters and spectacular parades and fireworks in a place where fairytale dreams can come true. Purchase your "After 4pm" tickets to Magic Kingdom® Park today and get ready to experience the magic of Disney with family, friends and colleagues during FDC2015! Transportation on your own. Park Hours: 9:00 AM - 11:00 PM (subject to change)

PURCHASE YOUR TICKETS TODAY! Call 407-566-5600 or visit www.mydisneymeetings.com/fdc15

40 Today's ©Disney

FDA

March/April 2015

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Tickets are $35 per person or purchase a table of 10 for $300 — available on your FDC2015 registration form. Tickets must be purchased by May 29.

Florida Dental Association 2015 Award Recipients PRESIDENT’S AWARD Richard A. Stevenson, DDS DENTIST OF THE YEAR David Russell, DMD J. LEON SCHWARTZ LIFETIME SERVICE AWARD Donald Clay Erbes, DDS

SPECIAL RECOGNITION AWARDS Gregory Archambault, DMD ■ Robert Hayling, DDS Don Ilkka, DDS ■ Charles Llano, DDS Crissy Tallman, CMP, CAE SERVICE AWARDS Suzanne Ebert, DMD ■ Robert Ettleman, DDS John Krueger, DDS ■ James Strawn, DDS

LEADERSHIP AWARDS Andrew Brown, DDS, MS ■ Beatriz Terry, DDS ■ Stephen J. Zuknick, DMD

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March/April 2015

Today's FDA

FRIDAY, JUNE 12 7-10 PM • ATRIUM

A close encounter with island culture is a family-friendly event featuring entertainment and performances for all ages! There will be Caribbean themed food, steel drum band entertainment, rush out parades, hair braiding, face painting and more. Tropical attire is encouraged. We hope you’ll join us! Everyone is invited and tickets are FREE – request your ticket when you register. Name badges will be required for entry for all attendees. Children under 12 years of age do not need a badge.

Today's FDA

March/April 2015

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

Anal

Local thetic

NEW! FDC CE VERIFICATION MADE EASY NO NEED TO WORRY ABOUT CEU CODES ANYMORE! CE verification is now automatically provided for all FDC attendees. To receive CE credit for course attendance: ■■ Attendees must scan their badge at the entry door of the course and upon exiting. ■■ The system then will calculate the amount of time an attendee was present and award the credit appropriately. ■■ Attendees must be present in a course a minimum of 50 of the 60 minutes to receive one hour of CE credit. NO MORE STANDING IN LINE! Attendees will be emailed their CE certificate automatically on June 15, 2015. OBTAIN A PRINTED CE CERTIFICATE Print a certificate at any time after the end of the course from CE stations. The CE stations are located: ■■ In the Exhibit Hall through Saturday at 2 p.m.; ■■ On the classroom level on Saturday after 2 p.m.; ■■ Or, can be printed for free at home or the office. CE certificates can be accessed for free online until Sept. 1, 2015 at www.floridadentalconvention.com. After that date, there is a fee to obtain a CE certificate. VIPhost_quarter.indd 1

lgesics

l anescs

ACCESS FOR FREE ONLINE. CE certificates also can be accessed for free online at www.floridadentalconvention.com until Sept. 1, 2015.

SUBMITTED AUTOMATICALLY TO CE BROKER. All verified course attendance will be submitted to CE Broker on your behalf no later than June 30, 2015. Your CE certificate will list all purchased courses, however credit will not be reported to CE Broker for NC and EX(NC) course codes. Each state varies on what is accepted for CE and those courses can be self-reported to CE Broker after the event, should your organizing BOD accept those courses.

Spend time with an EXPERT in your field and receive lunch and free CE credits! FDA members and their teams have the opportunity to host the speaker of their choice at the 2015 Florida Dental Convention. Get to know an expert in your field and learn from them in a personal setting not available anywhere else. Be an FDC host and you will receive FREE tuition to the speaker’s lecture course and a lunch voucher for Exhibit Hall concessions. Call now (800.877.9922, Ext. 7106) and sign up to host your favorite speaker today. You also can sign up online under “Education ” at: www.floridadentalconvention.com.

WE RECOGNIZE YOUR SACRIFICE AND SERVICE!

3/8/2015 10:13:30 A

ATTENTION ALL ADA FEDERAL DENTAL SERVICE MEMBERS — FDC2015 OFFERS YOU:  Reduced registration of $30 (a $395 value)  Access to more than 30 hours of FREE CE  Member pricing on all continuing education

www.floridadentalconvention.com FDC2015: Career & Life in Balance  www.floridadentalconvention.com vertical.indd 1

Vetprices_quarter.indd 1 3/9/2015 11:09:21 AM

March/April 2015

Today's FDA

3/9/2015 10:13:29

FDC2015 Speaker Preview

Airway Management of Sedated Patients Tips 1. Place a bolster under the neck. 2. Stop treating the patient. 3. Remove all dentistry and debris from the mouth. 4. Chin lift/head tilt. 5. Pull the tongue forward. 6. Pulse oximeter above 94 percent.

By Dr. Marc Gottlieb

In many states, anxiolysis using a pill or nitrous oxide doesn’t require any special training or permit. Using medications to sedate patients, either orally or intravenously, is safe as long as the patient is conscious and responds to your commands. The objective is to put the patient in a minimally depressed level of consciousness that

Left image of a sedated child after a tooth extraction with an obstructed airway. Right image showing an open airway using a simple head tilt and open palm to feel the flow of air and regular breathing.

retains the patient’s ability to independently and continuously maintain an airway, and respond appropriately to physical stimulation or verbal command. Many states and countries regulate additional training to protect the public from anesthesia complications, specifically death. In the United States, it’s estimated there is

A red flag and obvious difficult airway.

one death every two weeks in the dental office. Many dental boards have responded

Today's FDA

March/April 2015

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

FDC2015 Speaker Preview

to this problem by legislating additional

sedated patient. Record the initial oxygen

training, including Advanced Cardiac Life

saturation and then follow the trends. You

Support (ACLS). This sounds great on

would expect a slight reduction in the

paper; however, the flaw with this type of

oxygen saturation while treating a sedated

legislation is obvious. The patient is already

patient. Also, listen for a change in sound,

dead and now we have to bring them back

pitch and rate. Most pulse oximeters sound

using skills with a poor chance of success.

deeper, lower and slower when the values begin to drop due to respiratory obstruc-

Florida recently passed a continuing educa-

tion or a decreased rate of breathing.

tion (CE) requirement into law for dentists who sedate patients or treat patients under

Another simple yet essential piece of equip-

sedation, to be trained in the early recogni-

ment is a precordial stethoscope. Place this

tion of airway problems and airway man-

device in the sternal notch and you can

agement. Early recognition and interven-

hear the constant flow of air in and out

tion will save lives and provide safe sedation

of the lungs. The newer versions now are

services to our patients.

Bluetooth compatible to eliminate the clutter of the cord or hose.

Look and listen to your sedated patients. Pulse oximetry is essential to monitor the

Please see AIRWAY, 47

Chin Lift, Head Tilt

“

Encourage and train your staff to be active observers and part of your rapid response team.

”

If the patient becomes unresponsive to verbal commands, stop treating the patient and remove all dental materials from the mouth. I prefer to treat patients with a mouth prop so I always have access to the mouth and airway. Establish vital signs: blood pressure, heart rate and oxygen saturation. It’s rare that a patient actually stops breathing during conscious sedation. They often become partially obstructed or completely obstructed, and that’s when early intervention is required to prevent hypoxia. Consider advanced airway device placement only if the patient is unconscious and the chin lift/ head tilt in combination with pulling the tongue forward doesn’t open the airway. The lack of spontaneous respirations is another reason to consider advanced airway devices.

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

March/April 2015

Today's FDA

TWO HOTEL OPTIONS!

Seeking convenience? Reserve your room at the Gaylord Palms Resort & Convention Center, and be in the middle of the action! GAYLORD PALMS RESORT & CONVENTION CENTER (HOST HOTEL)  DISCOUNTED RATE: $185 PER NIGHT (INCLUDES FREE SELF-PARKING)  CALL 407.586.2000

Crown Gem Half-Page Ad.pdf

2/18/15

On a budget? Stay at the Springhill Suites Marriott for the discounted price of $114 per night. SPRINGHILL SUITES MARRIOTT  DISCOUNTED RATE: $114 PER NIGHT  PARKING $5 PER NIGHT  CALL 888.789.3090

1:58 PM

www.floridadentalconvention.com

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MEET RELIABLE MERCHANTS AND

3/9/2015 11:07:45 AM

WIN AMAZING PRIZES! Find out more when you play

COLLECT THE GEMS

BO VISIT O TO TH 41 PLA 5 Y

Friday, June 12th, 11 a.m. - 2 p.m. at the Florida Dental Convention Visit the Crown Savings merchants in the Member Benefits Center to play for a chance to win a variety of great prizes.

Prize drawing every half hour! The first drawing will be held at 11:30 a.m. and the final drawing will be held at 2 p.m. . *You must be present to play and win.

Today's FDA

March/April 2015

*Only registered FDA attendees are eligible to play “Collect the Gems”

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Untitled-2 1

FDC2015 Speaker Preview

Prevention and Early Recognition Know your limitations. Treat healthy patients with easy airways. Slim patients with no medical problems are ideal candidates for sedation. Obese patients with a bull neck are a red flag and should be referred to a skilled practitioner with advanced training in anesthesia and airway management. If the patient is unresponsive, stop treating the patient and access the airway. Start with a chin lift/head tilt followed by pulling the tongue forward out of the mouth.

See the Chin Lift, Head Tilt sidebar for the necessary initial steps to open the airway in the partially obstructed or completely obstructed patient given conscious sedation. There is no substitute for advanced training using real patients with a pulse. Embrace automated patient monitors that allow early recognition of hypoxia. Encourage and train your staff to be active observers and part of your rapid response team. Dr. Gottlieb is a general dentist in Levittown, N.Y. He has advanced residency training in the management of the apprehensive, unmanageable and medically compromised patient. He can be reached at .

AIRWAY from 45

Look for a Reversible Cause and Call for Help Early If your intention is anxiolysis or conscious sedation, the patient will always respond to verbal commands. Tap the patient on

He is a speaker at FDC2015 and will be presenting two courses. On Thursday, June 11, his course, “Jewels You Can Use on Monday” is at 9 a.m., and on Friday, June 12, he’s presenting, “Hypnosis for Dentists and Health Professionals” at 2 p.m.

Measurement of a patients vital signs is essential to the early recognition of an airway problem. Keep the oxygen saturantion above 94 and look, listen and feel for a change in pulse rate. Always treat the patient, not the monitor.

the arm or shoulder and ask them to take a deep breath. Watch them take that deep breath. If the patient is unresponsive, stop to look, listen and feel. The most likely cause is your sedative/hypnotic medications. Are they breathing? Have a pulse?

Did you know … You can schedule one-on-one appointments with exhibitors? Get twice the amount of business done in half the time!

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

March/April 2015

Today's FDA

Exhibitors as of 3/4/15

EXHIBIT HALL HOURS Thursday, June 11 Friday, June 12 Saturday, June 13

3M ESPE

9 AM - 5:30 PM 9 AM - 6 PM 9 AM - 2 PM

DEDICATED EXHIBIT HALL HOURS: How many times have you felt torn between going to the Exhibit Hall and attending our invaluable CE sessions? To ease that dilemma, we’ve added dedicated Exhibit Hall hours each day from 12-2 p.m. During this time no educational sessions will take place.

B Bank of America Practice Solutions Belmont Equipment Benco Dental Berryhill, Hoffman, Getsee & DeMeola LLC Best Instruments USA Bien Air Dental Bio-Flex / BFI Products Inc. Bioclear Matrix Systems BioHorizons BIOLASE Biotec Inc. Bisco Dental Products BQ Ergonomics LLC Brasseler USA Bright House Networks Business Solutions

Start making a list now of what you need in your office and be sure to buy from the exhibitors at FDC who support your association! CHILDREN UNDER 12: Unless attending an educational session, children under 12 do not need to be registered and will not receive a badge. Children are only allowed in the Exhibit Hall if accompanied by a registered 1.parent or guardian. Infant strollers and carriages are not allowed in the Exhibit Hall. For the safety and convenience of others, the use of baby carriers is strongly encouraged.

EXHIBITORS IN BLUE ARE FDAS CROWN SAVINGS MERCHANTS.

Today's FDA

March/April 2015

A A-dec A. Titan Instruments Accutron Inc. ADA Members Retirement Program ADS Florida | Henry Schein Transitions Advantage Technologies Inc. AFTCO Air Techniques Inc. AMD Lasers Ascentium Capital LLC Aseptico Inc. Aspen Dental Atlanta Dental Supply Atlantic Dental Solutions / Brewer Company

CareCredit Careington International Carestream Dental Centrix Inc. Cigna Dental Citi Healthcare Practice Finance Classic Craft Dental Laboratory ClearCorrect CliniPix Inc. Clorox / HealthLink Coast Dental Colgate Coltene Convergent Dental Inc. Cool Jaw by Medico International Crest Oral-B CUTCO Cutlery

D Darby Dental Supply daVinci Dental Studios Delta Dental Insurance Company

Demandforce Inc. DenMat LLC Dental Access Mobile Clinics LLC Dental Care Alliance Dental Dealer Solutions Dental Medical Sales Dental PC Dental Sleep Solutions Dental Staffing Solutions Dental USA Inc. DentalEZ Group DentalMarketing.net DentalVibe DentaQuest Dentegra Insurance Company DENTSPLY Caulk DENTSPLY Implants DENTSPLY International DENTSPLY Maillefer DENTSPLY Professional DENTSPLY Raintree Essix DENTSPLY Rinn DENTSPLY Tulsa Dental Specialties Designs For Vision Inc. DEXIS Digital X-Ray Digital Doc LLC Doctor’s Choice Companies Inc. Doctors’ Disability Specialists DoctorsInternet.com Doral Refining Corporation Doxa Dental Inc. Dynamic Dental Partners Group

E-F Enovative Technologies Find My Weakness First Citizens Bank Florida Combined Life Florida Dental Anesthesia Services Florida Dental Association Florida Dental Association Services Forest Dental Products Inc. Fortress Insurance Company Fortune Management of Florida Fotona LLC

G Garfield Refining Company Garrison Dental Solutions GC America Inc. Gendex/NOMAD/SOREDEX/Instrumentarium Gentle Dental GlaxoSmithKline GLO Science Professional Good On Ya Greater New York Dental Meeting

FDC2015: Career & Life in Balance  www.floridadentalconvention.com

H Hager Worldwide Halyard Health (formerly Kimberly-Clark) Hawaiian Moon Hayes Handpiece Repair Heartland Dental Henry Schein Dental Heraeus Kulzer Hiossen Inc. Hu-Friedy

I ICW International IDS / Genoray Implant Educators Inada Massage Chairs Infinite Therapeutics Insurance Credentialing Specialist Ivoclar Vivadent Inc.

K Karl Schumacher Dental KaVo Kenwood / CGX Radios Kerr Corporation Kettenbach LP Keystone Dental Inc. Knight Dental Group, CDL, DAMAS KOMET USA Kuraray America Inc.

L Lares Research Laxmi Dental Lab USA LIBERTY Dental Plan Lighthouse 360 LumaDent, Inc.

M MacPractice Magnified Video Devices Inc. MCNA Dental Medidenta Meisinger USA LLC Meta Biomed Inc. Microcopy Midmark Corporation Milestone Scientific Millennium Dental Technologies Inc. Modular & Custom Cabinets Ltd. Myofunctional Research Co.

N-O NSK Dental LLC Office Depot Business Solutions Officite OraBrite OraPharma Inc. Orascoptic Osada Inc.

P-Q Pacific Dental Services Palisades Dental LLC Paragon Management Associates Inc.

Patterson Dental Pelton & Crane PeriOptix, a DenMat Company Philips Sonicare & Zoom Whitening Piper Education & Research Center Planmeca USA Inc. Porter Instrument Co. Inc. Preat Corporation Precision Dx / Global Dental Solutions Prexion Inc. ProAct Health Solutions Inc. Professional Sales & Consulting Group Inc. Professional Sales Associates Inc. Proma Inc. Propel Orthodontics Prophy Magic Prophy Perfect ProSites Protected Trust Pulpdent Corporation Inc. Quintessence Publishing Co. Inc.

R RealTime CPAs Regions Bank RGP Inc. Rose Micro Solutions Royal Dental Manufacturing Inc.

S Santech Solution Inc. SciCan Inc. SDI (North America) Inc. SecureTip Shamrock Dental Co. Inc. Shofu Dental Corporation Sierra Dental Products LLC Sirona Dental Smile Brands Inc. Snap on Optics Solutionreach Square Inc. SS White Dental Sun Dental Labs Sunrise Dental Equipment Inc. Sunset Dental Lab Superior Dental Design Svcs & Upholstery SurgiTel | General Scientific Corp.

MAKE AN APPOINTMENT! Get twice the amount of business done in half the time by scheduling one-on-one sessions with the exhibitors that you want to see at FDC2015. Appointments will range from 10-15 minutes so you can maximize your time and have specialized attention for your business needs! Attendees will be able to search for products, find the company they would like to meet with at the tradeshow and request an appointment with that company. Once appointments are confirmed, you can print your schedule of appointments or access them on the FDC mobile app. Appointments will fill up quickly, so request your appointment time before you leave for FDC. As an added bonus, attendees who complete six or more appointments over the three days will be entered to win one of five $200 American Express gift cards.

T-U TD Bank TeleVox The Doctors Company Ultradent Products Inc. Ultralight Optics Inc.

V-W Vatech America Video Dental Concepts Vitamix VOCO America Inc. WEAVE Webco Dental and Medical Supplies Wells Fargo Practice Finance Wolters Kluwer / Lexicomp

FDC2015: Career & Life in Balance ď Ž www.floridadentalconvention.com

X-Y-Z XPdent Corp Yodle Zimmer Dental

FDA SERVICES INC. IS A MAJOR SPONSOR OF THE FLORIDA DENTAL CONVENTION. March/April 2015

Today's FDA

pdc@fdc Thank you for bringing smiles to children! Your gift of time and expertise during the FDC bring this program to life, and provide muchneeded care to area foster children.

VOLUNTEER FOR PROJECT: DENTISTS CARE DURING FDC. Dentists, hygienists and assistants are invited to volunteer to provide pro bono treatment for a group of area foster children. ■ Receive CE credit – hour for hour ■ No fees or fundraising requirements ■ Treatment center is on the Exhibit Hall floor during Exhibit Hall hours ■ Sign up early, as space is limited! To register as a volunteer, please check the box next to “Yes, I want to volunteer for PDC@FDC,” on your FDC registration form and choose a date/time. You also can register online by searching for keyword “PDC” during course selection. For

more information: foundation@floridadental.org.

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March/April 2015

Today's FDA

Diagnostic

Diagnostic Discussion By Drs. Indraneel Bhattacharyya and Nadim Islam

A 48-year-old Hispanic female was referred to Dr. Ruben Mesia, a periodontist in Tampa, from her dentist, with the chief complaint of loose front teeth in the lower jaw (Figs. 1 and 2). Dr. Ruben also was immediately aware of the unusual radiographic presentation in the area in spite of prior endodontic therapy on teeth Nos. 24 and 25. Radiographs taken two years ago also were available for comparison (Figs. 3 and 4). Her medical history was mostly unremarkable, with a prior history of anemia diagnosed and treated by her primary care physician. She was not on any medications other than birth control pills. Dental examination revealed Class II mobility on tooth No. 25 and Class I mobility on teeth Nos. 23, 24 and 26. Her plaque control appeared to be good, with bleeding on probing <10 percent and moderate 3-4 mm pockets on lingual aspect of teeth Nos. 24 and 25. Localized periodontal attachment loss was noted on tooth No. 24. Other than teeth Nos. 24 and 25, the teeth tested vital.

Fig. 1

Question: What is the most likely diagnosis? A. Periapical cyst/Granuloma B. Ameloblastoma C. Cementoblastoma D. Florid Cemento-osseous Dysplasia E. Periapical Cemento-osseous Dysplasia Fig. 2

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Fig. 3

Fig. 4

Please see DIAGNOSTIC, 54

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Diagnostic

DIAGNOSTIC from 53

Diagnostic Discussion A. Periapical cyst/Granuloma Incorrect. This is an important consideration in the radiographic differential diagnosis for this case, especially given the periapical location of the radiolucencies involving multiple mandibular anterior teeth. Periapical inflammatory disease (granuloma or cyst) radiographically demonstrates a radiolucent area of bone destruction that is typically located at the apex of the root and is associated with lamina dura loss. The radiolucency may be poorly or well-defined, and resorption of a portion of the root apex is not uncommon. Importantly, unless treated, periapical inflammatory lesions will continue to enlarge gradually and become extensive with significant destruction of adjacent bone/teeth. Here the radiolucencies were intermixed with small opacities that remained unchanged over two years. Moreover, radiographs taken two years apart show minimal change, except for a slight increase in the opacity. A periapical granuloma/cyst is an inflammatory lesion that develops in association with a nonvital tooth. When the tooth pulp undergoes necrosis due to caries or trauma, a granulation tissue response may develop around the root apex as a defensive reaction to bacteria or toxic products from a root canal. If this inflammation persists, epithelium at the apex of a nonvital tooth may be stimulated to proliferate and form a cyst. These lesions can occur at any age, but are most frequent in young adults. A patient may present with current or previous symptoms of pain, ten-

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March/April 2015

derness, swelling or drainage in the affected area. However, many periapical cysts are asymptomatic and are discovered only during routine radiographic examination, as in this case. These cysts are usually 2 cm or less in size. Treatment usually involves either root canal therapy or extraction of the associated tooth. If root canal therapy is the treatment chosen, follow the lesion radiographically for subsequent bone fill-in. Many other lesions may mimic periapical inflammation; hence, biopsy is mandatory for non-healing or large or destructive periapical lesions. B. Ameloblastoma Incorrect. Though rare, these are the most common and clinically destructive neoplasms of odontogenic epithelial origin. Radiographically, ameloblastomas typically tend to be multilocular and â&#x20AC;&#x153;soap bubbleâ&#x20AC;? like. No product formation is noted as was seen in this case. Approximately 50 percent are unilocular and 15-40 percent of tumors may be associated with an impacted tooth. In addition, they manifest local infiltrative intraosseous growth with significant expansion, destruction of surrounding bone and resorption of adjacent teeth; whereas in this case, minimal changes were seen over time. These lesions are most common over 30 years old, though may be seen at any age. There is no strong racial predilection. Eighty-five percent of lesions arise in the mandible with the majority occurring in the molar/ramus area. Maxillary lesions also are seen in the molar area. These neoplasms may be discovered accidentally or secondary to facial swelling. Most are asymptomatic. Due to its infiltrative nature, marginal or en bloc resection is the most widely used form of therapy. Lifelong follow up

is strongly recommended. Rare malignant transformations have been reported. In the present case, lesions are seen in the anterior mandible and radiographically, showed a mixed lucent/opaque appearance, though a hint of locularity is seen. A unicystic ameloblastoma should not be considered since they consist of a single cystic structure and typically surround an impacted tooth. C. Cementoblastoma Incorrect. Good selection! Cementoblastomas are a benign odontogenic neoplasm of cementoblasts. It is important to distinguish this entity from other reactive cementoosseous lesions, such as periapical cementoosseous dysplasia or focal cemento-osseous dysplasia, since a cementoblastoma is considered a true neoplasm and exhibits behavior similar to most intra-osseous neoplasms, including expansion, root resorption and surrounding bone destruction. Radiographically, a cementoblastoma presents as a radiopaque mass surrounded by a radiolucent rim, fused to one or more roots of the tooth, often obscuring the root. This is in contrast to cemento-osseous dysplasia where the root and the periodontal ligament space are clearly discernable in most cases. The majority of lesions (>75 percent) arise in the mandible and 90 percent of those show a predilection for the molar and premolar region. These most often are seen in young adults in their 20s and 30s. Pain and swelling is common and noted in approximately two-thirds of patients. Most cases are innocuous. Aggressive behavior is manifested by cortical erosion and adjacent teeth displacement. Treatment includes surgically extracting the tooth along with the attached calcified mass. In the present

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case, lack of any symptoms for two years or more, or absence of cortical expansion and root resorption, make this diagnosis untenable. Moreover, the lesion seen here was mostly radiolucent, a feature not seen in cementoblastomas. D. Florid cemento-osseous dysplasia Incorrect. This is an excellent choice! Florid cemento-osseous dysplasia (Florid COD) often is seen in middle-aged to elderly African American females. Florid COD is defined as lobulated masses of dense, highly mineralized, mostly acellular cementoosseous tissue, usually observed in multiple areas of the jaws. The lesions are routinely bilateral and symmetrical, and involve all posterior regions of the jaws. It’s a poorly understood condition, considered to be reactive where mature bone is replaced with woven bone in a fibrous connective tissue matrix. It’s almost always localized to the tooth-bearing areas and the affected area undergoes changes from normal vascular bone into an avascular cementum-like osseous area. The lesion is usually benign and requires no treatment unless warranted due to cosmetic reasons. Radiographically, these lesions appear as radio-opaque, irregular or lobulated masses without radiolucent borders, interspersed with ill-defined radiolucent/radio-opaque areas and tend to become increasingly radiopaque. The clinical presentation is similar to the current case, except other areas of the jaws were not involved. Florid COD may get secondarily infected and management can be difficult and complicated. Rare cases are expansile, and patients may report experiencing some symptoms, such as pain. Few authors have suggested a hormonal imbalance as a likely

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causative or contributory factor. Moreover, an inherited autosomal pattern has been proposed. Florid COD is considered to be in the same spectrum as focal and periapical cemento-osseous dysplasia of the jaws. E. Periapical cemento-osseous dysplasia Correct! The typical radiographic presentation and the localization in the anterior mandible involving the apices of the incisor teeth highly support this diagnosis. The absence of expansion, growth and symptoms also point to this diagnosis. The concurrent presence of chronic periodontal disease in the area along with the two central incisors’ mobility makes the presentation unusual. Additionally, since this condition overwhelmingly is seen in middle-aged African American females, the current case is highly unusual because the patient is Hispanic. Periapical cemento-osseous dysplasia (PCOD) is a non-neoplastic process wherein normal bone is replaced by fibrous tissue and varying amounts of cementumlike calcified material. PCOD, like florid COD, usually is confined to the toothbearing areas of the jaws. PCOD classically affects the periapical tissues in one or more anterior mandibular teeth and is a relatively common condition. In approximately 64 percent of cases there are no clinical signs or symptoms, and the lesion is discovered incidentally on routine radiographs. Clinically, apparent lesions present as jaw swelling, dull pain or with increased sensitivity. The involved teeth in such cases often end up undergoing endodontic therapy, which may be unnecessary. Also, direct exposure of the internal calcified mass to the oral cavity may result in secondary infection

and associated complications. This exposure may be due to extracting adjacent teeth or progressive atrophy of the alveolar process beneath a denture. The mandible’s involved area may exhibit reduced vascularity, which could further predispose the inflamed area. Hence, biopsy and/or extraction are best avoided. Early PCOD lesions may be entirely radiolucent with minimal calcifications. Gradual increase in radiopacity as lesions “mature” is commonly reported. At a later stage, the radiopacity coalesces and appears as substantial, somewhat lobulated but distinctly radiopaque conglomerates. The lamina dura of the involved teeth is typically intact and the roots do not exhibit resorption. The associated teeth are always vital. Treatment generally is not recommended. The current case underscores several considerations: 1) The fact that early PCOD lesions may be entirely radiolucent and therefore resemble periapical pathology and endodontic therapy may be unnecessary. Endodontic therapy also runs the risk of complications. Therefore, careful pulp testing and clinical correlation are of utmost importance and required in the absence of symptoms. 2) In this case, the two central incisors were periodontally involved as well with Class I to Class II mobility and may need to be extracted. 3) Furthermore, PCOD definitely should be considered in the differential diagnosis when a mixed radiolucent/radiopaque presentation in the relation to anterior mandibular teeth is noted. 4) Additionally, recognizing this

Please see DIAGNOSTIC, 57

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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.

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DIAGNOSTIC from 55

condition based on its clinical and radiographic presentation in other races also is important, though this is a rare occurrence. But several cases in non-Black races have also been reported.

Useful references: Eversole R, Su L, ElMofty S. Benign fibroosseous lesions of the craniofacial complex – a review. Head and Neck Pathol. 2008; 2:177-202. Senia ES, Sarao MS. Periapical cementoosseous dysplasia: a case report with twelveyear follow-up and review of literature. Int Endod J. 2014. Smith S, Patel K, Hoskinson AE. Periapical cemental dysplasia: a case of misdiagnosis. Br Dent J. 1998 Aug 8; 185(3):122-3. Wilcox LR, Walton RE. Case of mistaken identity: periapical cemental dysplasia in an endodontically treated tooth. Endod Dent Traumatol. 1989; 5(6):298-301.

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ONLINE CE: THE EASY WAY

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

Islam MN, Cohen DM, Kanter KG, Stewart CM, Katz J, Bhattacharyya I. Florid cemento-osseous dysplasia mimicking multiple periapical pathology--an endodontic dilemma.Gen Dent. 2008 Sep-Oct;56(6):559-62. Diagnostic Discussion is contributed by UFCD professors, Drs. Indraneel Bhattacharyya, Nadim Islam and Don Cohen, and provides insight and feedback Dr. Bhattacharyya on common, important, new and challenging oral diseases. The dental professors operate a large, multistate biopsy service. The column’s case studies originate from the more than 10,000 specimens the service receives every year from all over the United States.

Dr. Islam

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

Earn CE credit for reading “Diagnostic Discussion.” Visit the FDA website and click the “Online CE” button for this free, members-only benefit. Be sure you are logged in to the members-only side of www.floridadental.org. You will be given the opportunity to review this column and its accompanying photos, and will be asked to answer five additional questions. Questions? Contact FDC Meeting Coordinator, Brooke Mills at bmills@floridadental.org or 800.877.9922. * These courses expire on 2/29/2016.

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Employment Relationship

Setting the Stage for a Successful Employment Relationship By Jodi Schafer, SPHR

Question: I feel like we’ve had a revolving door lately. I’ve had several employees not work out. Some left voluntarily, and others I’ve had to terminate. I’m not sure what I’m doing wrong, but I think it is safe to say that our current process is not working. Do you have any tips when it comes to hiring? How can I increase the likelihood that a new hire will be a great fit and become a tenured employee? Answer: There is no magic formula involved in selecting and retaining top talent within an organization. Your chances of success hinge primarily on your abilities to plan, clearly communicate expectations and empower your team to hold each other accountable. Sprinkle in a little luck, and there you have it! Sure, I’m oversimplifying things a bit. But you would be amazed at what a little effort on the front end can save you on the back end. It starts with your ability to clearly define “who” your organization is, “what” you’re all about, “why” you exist and “how” you are different from your competition. If you don’t know why people should choose to work for you, then how can you ever hope to attract those who share your same vision and buy in to the practice’s mission? The goal should be to hire people who believe what you (the practice) believe, not simply people who have the skill set to the do the job you need them to do. Remember,

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you can train a skill set. You can’t change a person’s personality, work ethic and general outlook on life. All too often I get phone calls from clients who need to terminate an employee because they aren’t a good “fit” for the organization. It’s not because they can’t actually do the job. Sound familiar? Hiring people who believe what you believe increases the likelihood that they will work for you long term. They are after more than a paycheck, and will add to your corporate culture instead of detracting from it. Finding these individuals starts with you and the amount of clarity you have about who you are as a practice and what you expect from the people who join your team. Once you know that, you then need to make sure that you communicate it effectively (over and over again) in what you say and in what you do. For example, your job descriptions should accurately reflect your expectations of the work being performed in each position. These should be created in tandem with the employees who actually do the work. They should be updated regularly, shared liberally and used as a guide in the hiring, training and performance review process. A simple document such as this can bring consistency to your processes and keep everyone focused on what’s truly important in a position.

Another key area that often is underutilized by employers is the orientation and onboarding process. Don’t just let them fend for themselves after the basic new hire paperwork has been completed. The first few weeks on the job cement an image of your company in the mind of your new employee. What do you want that image to be, and who do you want to be crafting it? Be intentional about who you place that new hire with to learn the ropes. Don’t place them with Negative Nancy, the office gossip who hates her life and undermines you every chance she gets! Be sure that your training program is comprehensive, that new employee performance is closely monitored, and that feedback is given early and often. A poorly developed orientation program can increase the odds of a qualified hire seeking employment elsewhere in short order, further perpetuating your lack of time and resources. So, it’s worth the investment to take a step back and make sure that your current hiring practices are aligned with who you are as a practice and that your expectations are clearly communicated to staff. Only then will you start to reap the benefits of successful employment relationships that will endure over the long run. Reprinted with permission from the Journal of the Michigan Dental Association, December 2014 issue.

March/April 2015

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PROFESSIONAL STAFF I HELP MEMBERS SUCCEED by providing them with online CE and CE Broker information as they prepare to renew their licenses and by assisting members as they register for FDC2015. — Brooke Mills FDA Meeting Coodinator QUESTIONS ABOUT YOUR CE OR CE BROKER? 800.877.9922 or 850.350.7103 bmills@floridadental.org

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Cyberliability

Cyberliability: Are You Prepared to Handle a Data Breach? Every year, cybercrime in the United States costs the economy billions of dollars, with 51 percent of all cyberbreaches occurring in the health care industry. Why is health care so vulnerable to cyber attacks? There are a number of reasons, including: (1) criminals find patients’ personal information especially lucrative and (2) health entities, such as dental practices, often fall behind in updating their cybersecurity due to small staffs. With the risk of a cyberbreach lurking around the corner, it is crucial to stay informed and protected for your practice and financial security.

Scenario 1: An employee of your dental practice experiences a burglary and has his laptop and cell phone stolen from his car. Both devices, not password protected, were packed with patient information including names, phone numbers, addresses and types of care required. The total costs of this HIPPA violation are expected to exceed $150,000.

Scenario 2: An oral surgeon posts before and after photos of several patients on her website. Unbeknownst to her, the code for the practice’s website was written incorrectly, and the photos that were posted acciden-

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tally expose patients’ personal information. Legal settlements per patient will exceed $150,000. Five claims have been filed and five additional claims are expected, with a total cost of more than $1 million.

How to minimize your risks: q Have a data recovery and/or disaster plan. q Create, record and use enforceable cyber and data breach protocols. q Be sure that your staff is extensively trained in these protocols and implements them. q Secure all computers and devices with passwords that contain numbers, letters and symbols. q Keep your facilities protected by securing building access, shredding documents and implementing firewalls. q Create separate office and guest Wi-Fi networks in your office and/or practice. q Use endpoint security software, including anti-virus, anti-spyware and antimalware. q Buy cyberliability insurance coverage to mitigate your risk.

“

With the risk of a cyberbreach lurking around the corner, it is crucial to stay informed and protected for your practice and financial security.

”

Article source: http://bit.ly/1800LBH

March/April 2015

Today's FDA

Card Data Security

Shift Happens — Will You be Ready? By Elavon Staff

This year, one of the most talked about changes in payment acceptance is the liability shift that goes into effect on Oct. 1, 2015. To provide enhanced payment card data security, the major card brands have been pushing for widespread EMV (Europay, MasterCard®, Visa®) adoption in this country for years. EMV adoption entails moving away from the traditional swipe payment cards to new smart/chip cards, or EMV cards. Shifting the liability for acceptance of counterfeit card transactions is one of the big milestones on the path to EMV adoption. Smart/chip cards work by using chip technology. Instead of swiping a credit card as they do today, consumers will use a chipenabled card, which stores all of the credit card’s data in a tiny computer chip within the card. Payment terminals read the chip to ensure the card is valid. These cards provide more security than current swipe cards since the data is dynamically encrypted and unique for each purchase.

During an EMV transaction, the card never leaves the cardholder’s hand. The card stays in the terminal until the transaction is completed by the consumer either by entering a four-digit pin, signing or in some cases, the card issuer will verify by the chip alone. Why the change? Let’s look at a few statistics from Business Insider. In 2013, the U.S.: q totaled $7 billion in credit/debit card fraud-related losses. q accounted for 51 percent of the amount of global credit card fraud.

What do you need to know? The liability shift will be effective for present fraudulent card losses that can be detected through the EMV cards and terminals. This means that after Oct. 1, 2015, if your practice accepts and processes a counterfeit card transaction on a non-EMV terminal, which would have been detected with an EMV terminal, the liability for that transaction is yours, not the card issuers’. In order to protect your practice from potential card fraud liability, you will need an upgraded EMV-enabled terminal solution.

While card issuers across the U.S. continue to replace the traditional magnetic strip cards, the EMV terminals will still support the legacy cards through the transition. In addition, many EMV terminals also are near field communication (NFC) enabled, which enables mobile wallet payments such as Apple Pay™, Visa PayWave®, MasterCard Pay Pass™ and American Express® ExpressPay. Smart/chip card terminals are a new, secure way for your patients to pay for services and another way for you to securely accept payments. If you are ready to begin accepting new smart/chip cards, or want to learn about Elavon’s many other secure payment solutions including: encryption and tokenization; mobile, online and tablet based payments; or our exclusive solutions for health care, please contact Danielle Gibson at 800.546.1831, Ext. 5434 or Danielle.Gibson@elavon.com. We are an FDAS Crown Savings Merchant and offer exclusive pricing for the Florida Dental Association’s members. We have solutions to fit your needs.

We are an FDAS Crown Savings Merchant and offer exclusive pricing for the Florida Dental Association’s members. We have solutions to fit your needs. 66

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Comprehensive Dentistry

The Future of Dental Consulting By Dr. Edward Hopwood

I recently attended a lecture by a consultant who was speaking about dentistry’s future. He spoke about the headwinds facing our profession: the corporate entities, mid-level providers, student loans, PPOs, etc. The news was grim and he felt that unless you are 60 years old and have $5 million in the bank, then you are going to have to join up with a large corporate entity or sign up for some PPOs and make a small group practice. The news sounded dire, and as a 41-year-old dentist with less than $5 million in the bank, I was somewhat depressed. Then I started thinking about how familiar this message sounded; I’ve heard the same theme many times over the years. In fact, this consultant was speaking to an organization that was founded by a group of dentists who recognized that there were headwinds facing fee-for-service dentistry — and that was 50 years ago. Back then, fluoride was coming into widespread use and there would be no need for dentists as there would be no more cavities. After that, there were the insurance plans in the 70s — they would ruin the profession. Then there was the first round of clinics in the 90s. But — wait for it — this time it is DIFFERENT; we are hearing about the Dental Management Organizations (DMOs) and the corporate entities that will take over the profession.

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Truth be told, I am worried about dental consulting’s future. Many consultants are advising their clients to go into group practice, or to join PPOs and try to become more efficient. I’m not sure about the value of a consultant who is telling you to join plans you can just sign up for. I wouldn’t pay someone to tell me to sell my practice to a large group — it’s easy enough to just sell it to a large group. The huge concern is that so many consultants are being paid by the insurance companies and large groups. Before I would hire a consultant or a speaker, I would verify that they are not on an insurance company’s or a DMO’s payroll. I also would ask if they have ever been employed by an insurance company or a DMO. We need full disclosure from our consultants and lecturers. The argument for the end of solo practice is basically a variation of the “Internet changes everything” argument that we heard in the late 1990s. At the time, we were being told that with the Internet’s magic, the economy of scale, and the lack of the bricks and mortar, we would be moving into a new world where companies like Pets.com would replace regular stores. I agree that there will be changes in the future (and there always will be), but I think that the truly forward thinkers are preparing for the post-corporate world, where the corporate entities have taken their bite out of the patient pool and things have balanced out. That’s what is happening in the business world and that’s what will happen in dentistry. Some things, such as art, simply cannot scale to the large corporate model, whereas some things are commodities, like gasoline, and they lend themselves well to large corporate models.

So, this particular consultant continued on about mid-level providers and how PPOs are taking over the insurance marketplace. The disturbing thing is that many consultants are responding by clinging to the early 1990’s model of improving efficiency and trying to work within the PPO framework. They claim it’s over for the profession. We will go the same way as hardware stores, pharmacists and gas stations, which all sell commodities. The price is too high for entry into private practice; no one will want to pay that price. We will all have to work for someone else. Unless we choose not to go down that path. You see, some dentists may elect not to go down the path to work for someone else. They may choose to pursue a different path where they aren’t working for a corporate master. Who are these dentists? They are the ones willing to step up and pay the price (to paraphrase L.D. Pankey). How can we challenge the headwinds our profession faces? The same way those successful dentists did before us. This article is the first in a series of columns designed to help those dentists who are willing to step up, pay the price and pursue the comprehensive dentistry model espoused by L.D. Pankey, Peter Dawson and the other great dentists who successfully faced some headwinds in their day. We need to do these things to preserve a bright future for dentistry and also to improve the future for dental consulting. Dr. Edward Hopwood is a restorative dentist in Clearwater and can be reached at edwardhopwood@gmail.com.

March/April 2015

Today's FDA

Credit Cards

Payers Using Credit/Debit Cards for Payment It’s not uncommon today for dental benefit carriers and third-party administrators (TPAs) to pay dental offices with a credit/debit card instead of the traditional paper check. In fact, this trend seems to be more popular with TPAs than it is with traditional dental plan carriers, and it has created concerns for dental offices. VPay is a company that provides this service and offers a virtual stored-value debit card program designed specifically for claims payments. VPay is delivered to the dental office by either fax or secure email. The dental office can process the payment the same as with any other credit card transaction — by entering the card number, security code, expiration date and amount. VPay touts quicker reimbursement as an advantage to using the stored-value card; however, dentists have reported that the card may carry a higher processing fee than a traditional debit or credit card transaction.

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You do not have to accept the stored-value card as payment if you do not wish to do so. You can request to opt out of using the storedvalue card and instead receive a check as payment for services rendered. If that is your choice, you should call the toll-free number provided on the explanation of benefits (EOB) statement that accompanies the stored-value card and inform VPay (or the issuing company) that a check is preferred and that you are not interested in using the stored-value card for claim payments. The American Dental Association (ADA) has received reports from some dentists indicating that some of these companies’ customer service representatives are reluctant to waive the stored-value card as payment; thus, you may have to escalate your request to a supervisor or manager with the company. The ADA’s Council on Dental Benefit Programs (CDBP) recommends dentists carefully read the fine print accompanying EOB statements and suggests that members call CDBP staff at 800.621.8099 for additional assistance.

March/April 2015

Today's FDA

YOU CAN WIN AND SUPPORT THE FDA FOUNDATION! LOOK FOR THE FDAF DRAWING OF CHANCE AT FDC2015. Your donations support these FDA Foundation programs: Florida Mission of Mercy Project: Dentists Care Oral health education programs Scholarships Disaster aid For more information, or to volunteer: 800.877.9922 foundation@floridadental.org www.floridadental.org/foundation

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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/.

Today's FDA

March/April 2015

ANNOUNCING: Dental Implant Training. Learn implant training on one to one mentorship in your office or mine. Take your implant training to the next level. Immediate implant placement after extraction. L-PRF grafting. Crestal sinus lift when close to sinus. T-Mesh grafting for deficient ridges. Full Arch cases with immediate loading. Overdenture cases. Complex case planning inc. CT analysis. drbroggi@comcast.net. http://www. dentalimplantsbb.com. ANNOUNCING: Hands On Extraction, Immediate Denture, Mini-Implant Classes. Hands On CE May 22-23, 2015 Orlando. Learn extraction techniques, elevating flaps, using instruments properly, immediate dentures, miniimplants and more. Live Patient Course June 28-July 3. Alaskan Cruise August 7-14.drtommymurph@yahoo.com. www.weteachextractions.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. POSITION DESIRED: ORTHODONTIST- Seeking FT/ PT locum tenens position (temporary professional). Member of ADA, AAO, Certified, licensed specialist. Experienced, personable, good sense of humor, managerial, and organizational skills, can consult, treat your patients in your office. Successful in drawing patients; experienced in young patients starting at 7 yrs. Willing to travel. Per diem open. Please contact: johnmaria7@yahoo.com, or call 305.932.3584. 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. General Dentist. Full-Time Permanent. http://www. Click2Apply.net/kz9hw4s. Periodontist: Available one day a week to provide services in a quality oriented dental practice in Miami-Dade or Broward County. Experienced and bilingual. Call 305.373.5807. General Dentist Opening – Southeast Florida. Great Expressions Dental Centers has a current opening for a full-time General Dentist in Miami-Dade/Broward County in South 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 (such as medical, dental, 401k, continuing education), 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/ ppc7td8.

www.floridadental.org

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. Endodontic Position Available. Florida, Tampa Bay Area – Full time endodontist wanted to join established multispecialty 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. General Dentist needed for Cocoa Beach practice. Christie Dental is currently seeking a General Dentist that appreciates the professional, financial and administrative benefits of group practice to join our team. Our doctors are offered a generous compensation and benefit package including: medical, professional liability, life and disability insurance; a 401(k) plan with employer match; and a continuing education allowance. Future ownership is available and encouraged. Doctors in our group enjoy traditional doctor-patient relationships while practicing in a team environment that offers the opportunity to discuss clinical cases with peers and support for professional/group development and growth. We are actively seeking a fulltime Dentist for our amazing beachside practice in Cocoa Beach, FL! Apply today email C.V. to sbolduc@amdpi.com or call 781.213.3318. Associate Dentist Wanted. Associate Dentist FT/PT wanted for busy Dental Office in West Palm Beach. We are seeking a caring Pediatric or General Dentist who is comfortable treating children. We are a family-oriented private practice with experienced staff and friendly office environment. We offer competitive compensation. Please send your resume to drleminh@firstcaredental.net.

FFs office/3 days a week. South Florida, Fee-for-Service office. Great patients and staff. Dentist must be able to perform: all oral surgery (except some 3rds). Molar Root canals, Crown and bridge, All Denture cases. kurthausy@ hotmail.com.

GENERAL DENTIST – TAMPA/ CLEARWATER. Looking to hire enthusiastic dentist FT/PT. Flexible hours w/welltrained staff. State-of-the-art facility, fully computerized. High income potential doing what you enjoy. Fax resume 813.886.5559.

General Dentist Associate with option to buyin, needed for nice practice F/T or P/T. Offices available in Naples, Port St. Lucie or Coral Springs. Please email: pbfloridadentist01@ aol.com.

Endodontic Position available. Established Endodontic office in need of FT/PT Associate with Buy-in opportunity. Tampa area. Please send CV to chris@cpendo.com or fax to 813.374.9048.

Dental Team seeks a motivated associate. Happy New Year! Our multidisciplinary team in South Florida is seeking a motivated associate. The center is well established, warm, and growing. We are 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. Please email CV to Mr. Howard Corbeau at howard.corbeau@gmail.com or fax to 888.800.4955.

CAREER OPPORTUNITIES AT THE LECOM SCHOOL OF DENTAL MEDICINE. The LECOM School of Dental Medicine is currently seeking a full-time Endodontist, Oral Maxillofacial Surgeon, Periodontist, and Pediatric Dentist; as well as Simulation Clinic Faculty for positions located at our campuses in Bradenton, Florida, DeFuniak Springs, Florida and Erie, Pennsylvania. LECOM offers challenging, enjoyable and rewarding positions. Each employee contributes directly to LECOM’s growth and success and takes pride in being a member of the LECOM community. Employees embrace the osteopathic principles of compassionate and caring primary health/dental care and serve as professional role models for LECOM students. LECOM offers competitive work conditions, wages and benefits. Interested applicants should apply online at: http:// lecom.edu/job-openings.php. EOE/AA. M/F/D/V.

General practice in Lake City, Florida seeking full time associate, possible partnership opportunity. Collectionbased pay. Fee for service and PPO practice. Health insurance, flexible schedule. Please contact Melanie Holden, DMD: 772.214.8029 or myeagerdmd@gmail.com. Associate Dentist Wanted/Come Work With Apollo! Apollo Beach Dental Excellence, owned and operated by Dr. Sean Gassett is a private, family practice that offer’s the finest in technology, all digital x-rays and paperless charts, progressive and expanded dentistry, continuing education, and an environment that emphasizes quality and an outstanding patient experience! We utilize intra-oral cameras for patient treatment plans and co-diagnosing with our great patients. We are a Private Pay/PPO, non-HMO and non-Medicaid office. We are seeking a patient focused, versatile, team oriented Associate Dentist who finds satisfaction in practicing excellent dentistry and continual learning. This is a terrific opportunity for an Associate willing to commit to an outstanding practice. We will commit to you! If this sounds like you apply directly at the link listed below! https://www.appone.com/MainInfoReq. asp?R_ID=956161. Dynamic Dental Health Associates of FL and Dynamic Dental Partners Group (DDPG), a new private fee-for service group, is growing and expanding rapidly. Top Compensation, daily guarantee, health insurance, modern facilities with latest technology, great patient flow, no administrative headaches and professional mgmt. We also buy dental practices and create exit/transition strategies for solo and group practices. If interested in selling your practice, please email Dr. Alex Giannini at agiannini@ ddpgroups.com or call 941.893.3999. If interested in an Associate Dentist position, please email your CV to Jeff Hokamp at jhokamp@ddpgroups.com or call 941.312.7838. Current openings in Sarasota (F/T and P/T) and Gainesville (F/T).We are offering a $5,000 signing bonus ($2,500 at start and $2,500 after 6 months) for the F/T positions. Please don’t hesitate to send your CV if interested in other areas in FL. Immediate opening for general dentist associate, full or part-time, with group practice in St. Petersburg. We’ve been here 40 years with excellent reputation in the community. Possible equity ownership in the future for the right person. Please send your resume via fax 727.525.3686.

General Dentist and Specialist Openings for Multiple Offices. General Dentists and Specialists. Grow with us: Large intimate group practice seeks experienced, highlyproductive General Dentists and Specialists for busy growing general and multi-specialty practices. Gentle Dental Group operates 29 large, well-established practices in Broward, Palm Beach, Dade, and the Treasure Coast with new practices on the horizon in the Orlando Market. Our beautiful and modern facilities are in premium locations and state-of-the-art equipment and digital X-rays with a supportive staff and professional management team. Cash, private, and insurance. Highest compensation in industry. Full schedules, excellent benefits, malpractice insurance reimbursement, and CE. www.GentleDentalGroup.com. Call Bradford Cabibi, Doctor Recruiter: 561.999.9650, ext. 6146. Fax or email CV to: 561.526.2576 or bcabibi@ gentledentalgroup.com. The University of Florida College of Dentistry (UFCD) is recruiting a full-time, non-tenure, Clinical Assistant/Associate Professor in the Naples Children’s Education Foundation (NCEF) Pediatric Dental Center. Responsibilities include clinical and didactic teaching to pediatric dental residents, participation in research/ scholarly activity and intramural clinical service. To apply and review ad, please go to https://jobs.ufl.edu and search for requisition number 0907675. Christie Dental is a multi-specialty dental group with approximately 55 dentists and specialty doctors in nearly 20 practice locations in the Brevard and Ocala Florida area. We currently have a wonderful opportunity for a Periodontist to join our team in the Ocala area, on a full or part-time basis. This is an opportunity which provides a high number of referrals from inside and outside the Christie Dental group, and offers excellent paraprofessional support. We offer a comprehensive compensation and benefits package which includes medical, life, disability and professional liability insurances, flexible spending and 401(K) with employer match! Be a part of our outstanding team and be well-positioned to receive referrals from our general dentists. To learn more about American Dental Partners and Christie Dental please visit us at www.amdpi. com and www.christiedental.com.

Please see CLASSIFIEDS, 74 www.floridadental.org

March/April 2015

Today's FDA

Your Classified Ad Reaches 7,000 Readers! CLASSIFIEDS from 73 PT/FT General Dentist Brevard County, FL. Part time or Full time opportunity available for a General Dentist to practice 2-5 days per week at our offices in Brevard County on the beautiful Space Coast of Florida. Qualified and supportive team members and modern updated offices. We offer competitive compensation and full and part time benefits packages. Submit resume to areimiller@dentalpartners.com for consideration. General Dentist. Seeking an energetic and positive dentist to provide exquisite dentistry in a beautiful and quickly growing fee-for service practice, located in Bonita Springs, FL. Associate will be mentored clinically and trained extensively in practice management with opportunity to partner with owners in second location. If you’re looking to do exceptional dentistry, learn to be a leader and are ready work — reply today! Competitive salary Requirements:Must have a valid dental license for the state of Florida; A year or more of clinical practice experience. lacygilbertdmd@gmail.com. Tampa associate dentist for full time position in wellestablished private dental practice. Seeking long term associate to partnership. mickjw22@gmail.com. Pediatric Dentist Opening – Miami. Great Expressions Dental Centers has a current opening for a part-time Pediatric Dentist to join our Miami, FL practice. 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. Specialists can expect unlimited production based earnings vs. a base, full benefits, continuing education reimbursement, paid time off, malpractice coverage assistance, a stable patient base, strong referral network of 15+ General practices, trained dental staff, 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/d984gmt. Dental Hygienist. GREAT opportunity! Immediate opening for full-time hygienist for quality-focused General Dentistry practice. Positive attitude and desire to excel is what we are seeking to provide ultimate care to our patients. Dentrix experience a plus. Must hold current Florida license. Forward resume or call the office and speak with JoAnn. jtoppin@myparkdental.com, 239 263-1151. Pediatric Dentist. Excellent opportunity for a compassionate, ethical, pediatric dentist looking for an associate position leading to partnership. This well respected private Pediatric dental and Orthodontic practice has been established for 23 years. Office is located in a beautiful state-of-the-art building with experienced, caring staff devoted to providing high quality preventive care. The practice is high energy with a great reputation for providing excellent care and patient service. Associate must have excellent interpersonal and social skills and be highly motivated. We have an onsite pediatric anesthesiologist for I.V. sedations. The practice has a desired suburban location in a very close proximity to the Orlando and Tampa. You may visit our website at www.dentistry-pediatric.com to learn about our practice. If you are interested in being part of our outstanding team providing quality care you may email your resume to dry@dryasrebi.com or call 813.600.8032.

Today's FDA

March/April 2015

Endodontist – Brevard County, FL. Established group looking for part time Endodontist to work 1 day a week in the Brevard County area. In addition to working with a wonderful support team, this is a great opportunity to supplement an existing schedule. We have a proven patient base and referral record. If interested please send CV and cover letter to kathleenawalsh@hotmail.com. Venice, FL state of the art private practice. Great community, exceptional opportunity. Top tier comp. 941.488.1075. General Dentist – South Miami, FL. Great Expressions Dental Centers has a current opening for a part-time (3 days) General Dentist in our busy, multi-specialty practice Culter Bay in South, Miami, FL. Dentists can expect unlimited production based earnings, 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! We do it all for you. The highest standards. Our National Doctors Panel has set standards for clinical excellence, including clinical protocols, sterilization, materials, standards of care, quality assurance, charts and charting. “Look for the Smile Above Our Name!” Apply Here: http://www.Click2Apply.net/fmw762b. DENTIST. We are seeking a long term associateship with future partnership in our new office. Lady Lake/ The Villages is occupied predominantly of senior citizens, therefore, experience in crowns/bridges, extractions/ dentures is needed, and knowledge of placing and restoring implants is a plus. Digital, paperless. Well trained staff. 2-3 days to start. Competitive salary/commission. Dentalcare2015@yahoo.com. Part-time Orthodontist (Central Tampa). Part-time Orthodontic associateship in high-end general dental/ prosthodontic office in central Tampa. 2 days per month with potential for growth. Robust in-house referral system. Modern office with cone beam CT, intraoral scanner, and in-house lab. Generous compensation based in percent of collections. Orthodontist would have the opportunity to work with a multidisciplinary team. Please email CV, cover letter, and three professional references. dentalFLA@ gmail.com. Part-time General Dentist. Non-profit clinic in Stuart for low income and Medicaid patients needs licensed part-time general dentist with strength in extractions and restorative dentistry. Salaried position 2-3 days per week. Please send your resume to ccccenter@bellsouth.net or fax to 844.269.6899. Pediatric Dentist Opening: Ft. Myers. Great Expressions Dental Centers has a current opening for a full time Pediatric Dentist (or a General Dentist focusing on Pediatrics) to join our recently renovated Fort Myers, FL practice. 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. Specialists can expect unlimited production based earnings vs. a six figure base; strong 8 office referral network; full benefits (including dental, medical, 401k), 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 http://www. screencast.com/t/M3xWM5CYN and apply via this ad! Apply Here: http://www.Click2Apply.net/2psgv2k.

Pediatric Dentist Opening – South Florida. Great Expressions Dental Centers has a current opening for a part-time Pediatric Dentist to join our South Florida practice. 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. Specialists can expect unlimited production based earnings, benefits (such as medical, dental, 401k, continuing education), paid time off, malpractice coverage, a stable patient base with a strong network of 15+ General practices, 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/5pvnnq4. I am a fourth year dental student graduating on June 2015, and will be practicing general dentistry. I am looking for an associate position in South Florida. I have passed my boards and I am applying for my FL license. Please contact me at andreamazate@hotmail.com or 719.930.3776 for more information.

For Sale/Lease Beautiful Lakefront Property. Brandon, FL. FOR LEASE Beautiful 2000 sf lakefront office space available for custom build out. Adjacent to Endodontist. Ideal for Oral Surgeon or Periodontist. Contact Julie 813.654.3636 or julieh@ aeoftb.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 & 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. West Palm Beach, Fl. 1/2 mile west of I-95. This existing specialist only suite has 4 operatories in a 1001 ft 2 space and is surrounded by 10 dentists. Two generalists and an endodontist have offices in this professional only building. As dental “start ups” are challenging a one year lease is available. The rent is $1251.25. Contact 561.964.9105.

www.floridadental.org

Turnkey Free Standing Dental Building. Clearwater turnkey dental building, free standing 1400sq. Ft., 4 ops, 1 new, quality dental equipment, instruments, furniture, etc. included. Large internally lit sign on major road to beach with easily changeable lexan panels, and timer. Attached shed w/plumbing and electrical for storage & holding 4 head air techniques compressor, and dual suction. Call 813.215.1871! Prefer no e-mail, not typically checked! 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. 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. DENTAL PRACTICE-SEBASTIAN. Treasure Coast/Sebastian General Practice – Well established, high visibility location. Easy access, abundant parking. 2200 sq ft scenic, renovated space. Large, open waiting/reception w/ children’s play area. Six fully equipt ops, all digital. Lab, consulting room, breakroom, private office. Digital X-Ray, Panorex, Cerec, Wave One Endo system, Astra Implant system, Picasso Laser. All fully functional. Low transferable lease. $500,000 gross/3.5 days. MUST SEE. IndianRiverDDS@cfl.rr.com. Profitable Central FL Practice. Sales of $350,000+/-. Asking $195,000 with owner financing available, half down. Busy office, owner motivated. Call Chris Andrews, Lic RE Broker at 407.772.3672, or email ChrisAndrews@WatsonCommercial.com.

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

OFFICE IN KEY WEST. The only full time periodontal-implant practice in Key West. The practice is strictly fee for service with a highly skilled referral base. Looking for someone to transition into 100% sale. Doctor is willing to work in practice for a period of time to ease transition. Spectacular Gulf of Mexico views from this brand new office with 3 operatories equipped with ADEC chairs & delivery systems. Key West boasts its own professional theaters, symphony & opera companies & fine restaurants. Surrounded by beautiful waters you can experience fishing, diving, sailing, incredible sunsets & enjoy outdoor sports all year round. msgordondmd@gmail.com. Bradenton/Anna Maria Island Beaches; General and Cosmetic Practice. 1600 Sqft bldg in park like setting with great traffic view. Five digital ops; paperless; Dentrix, DexIs & Panorex. Strictly fee for service; 500,000.00 plus in production with 96% collection. 32 hr work week. Building FOR SALE with new roof and 2 new AC units. For detailed practice info VISIT & REGISTER dentaldirectsales.com. Owner is retiring and moving. Tampa Westshore area private practice. Average 1.2M gross. 10 ops, all digital including pan. Established great than 25 with solid patient base. 6000 active patients. Owner would like to stay on mid to long term on reduced schedule. mikula28@aol.com. FOR SALE – LAKE COUNTY, TAVARES. Lake County, one of the fastest growing counties in Florida. 4 op, 1100 sq ft, fully equipped, fully functional. Practice has been established in 2000. Gross over $1 million 5 years ago. Doctor has moved. Lots of potential. Asking $125,000.00. Please email me at dentalcare2015@yahoo.com for more info. Tampa – #FL161. Tampa – General 4 Op, 1,200 Sq Ft Office, GR $488,000, great location, high visibility-Motivated Seller!!Tampa is a vibrant city. Residents can experience a large range of great amenities, year round! Please contact: Henry Schein Professional Practice Transitions’ Consultant: Heather Brown – Licensed Sales Associate, Cell: 727.844.8588, Email: Heather.Brown2@henryschein.com. Largo – #FL108. 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. Please Contact: Henry Schein Professional Practice Transitions, Heather Brown – Licensed Sales Associate, Cell: 727.844.8588, Email: Heather. Brown2@henryschein.com. #FL108. Orlando – #FL112. 5 Ops-Well-Established Practice — Dr. willing to stay on as associate! Orlando has unlimited recreation, a variety of restaurants, golf courses, professional sporting events, festivals, and spas. We are also less than 2 hours from either coast offering swimming, fishing, boating, and more. Please contact: Henry Schein Professional Practice Transitions: Heather Brown – Licensed Sales Associate, Cell: 727.844.8588, Email: Heather. Brown2@henryschein.com. #FL112. Clearwater – #FL110. Clearwater, FL – 7 Op General Practice – Updated Equipment and All New Computers – GR $820,000, 3,800 Sq. Ft. Office Space-Real Estate Included! Clearwater is known for its award-winning amenities. The city offers world-class entertainment. Please contact: Henry Schein Professional Practice Transitions: Heather Brown – Licensed Sales Associate, Cell: 727.844.8588, Email: Heather.Brown2@henryschein.com. #FL110. 7 Ops 2,000 sq ft Office – VERY MOTIVATED SELLER!! #FL111. Ocala, FL. Our city is an equestrian lover’s dream! The area boasts 70,000 acres of thoroughbred breeding and training farms! Our city also offers unique attractions, outdoor adventure, championship golf, and rich arts & culture. Please contact: Henry Schein Professional Practice Transitions, Heather Brown – Licensed Sales Associate, 727.844.8588 or Heather.Brown2@henryschein. com. Jacksonville – Established Oral Surgery practice – FL #162. 6 Op + 2 Recovery areas, 3,700+ Sq Ft – Great Visibility!! GR $650,000. Jacksonville has plenty to do for all ages and interests!! Please contact: Henry Schein Professional Practice Transitions, Heather Brown – Licensed Sales Associate, Cell: 727.844.8588. #FL162. Tampa, FL – #FL163. Tampa, FL – the city offers unique and exciting recreation for all ages and interests and an exciting nightlife. A diverse selection of great restaurants and some of the state’s best attractions. We are also within 30 minutes of the Gulf! Please contact: Henry Schein Professional Practice Transitions, Heather Brown – Licensed Sales Associate, Cell: 727.844.8588, Email: Heather.Brown2@henryschein.com. #FL163.

www.floridadental.org

415_Concierge.indd 1

March/April 2015 2/17/2015 1:00:41 PM

Today's FDA

Dental Staff

Do You Want That Mouthwash Straight Up or on the Rocks? Intoxication Isn’t All it Used to Be By Cathleen Terhune Alty, RDH

A wise choice in our purchasing, use and storage of products is important and requires some consideration in light of its possibility for abuse.

The Journal of Emergency Medicine reported that a 55-year-old woman arrived in an emergency room with acute ethanol intoxication. Medical personnel were puzzled because her serum ethanol levels were persistently elevated. They later discovered she was secretly swigging mouthwash from her personal hygiene product stash in her purse while under their care. Two teenagers in Troy, Mich. reportedly drank mouthwash after seeing videos of people doing it on YouTube. Some of the teens’ friends alerted authorities after they saw the pair become extremely ill, and they took them to an ER. When the local poison control center was contacted, someone at the center was quoted as reporting, “Drinking mouthwash is a common teen problem.” In 2003, the Journal of Intensive Care Medicine reported that a 45-year-old male entered a Los Angeles Veterans Administration hospital and soon died of acute ethanol consumption due to “massive mouthwash ingestion.” A British ethanol “connoisseur” offered this mouthwash endorsement on the web: “Been drinking [popular consumer mouthwash] on the streets for ages now, gets you mashed good and proper. Best bit, it’s cheap and makes you smell great. With four different colors and flavors, you just can’t get bored with it. Nothing beats going down to the park on a Friday night with a bottle of [mouthwash] and getting mashed with your mates. It even comes with that cap that doubles as a shot glass. My favorite though is [mouthwash] on the rocks. You can’t beat that, and add an umbrella and you’re south of the border.” While most cases of acute ethanol intoxication follow a binge with conventional alcoholic beverages, ethanol also can be obtained easily from a variety of commercial products. These products often contain high levels of ethyl alcohol but are not manufactured for drinking or ingestion. Called nonbeverage ethanol (NBE), these products are unorthodox definitions of a drinkable beverage — mouthwash, hair spray, hand sanitizer, cough and cold remedies, aftershave and perfume, to name a few. The alcohol content in many of these products may exceed conventional alcoholic beverages by large margins.

Today's FDA

March/April 2015

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Dental Staff

For example, original formula Listerine® is about 54 proof with 26.9 percent alcohol, and many of the mint flavored mouthwashes are almost 22 percent alcohol. The alcohol content in Scope® weighs in at 18.9 percent and Cepacol® at 14 percent. When compared to beer (3-7 percent alcohol), wine (12 percent), and even some liquors and distilled spirits, these products are concentrated sources of ethanol. Experts claim it is possible, if not probable, that swishing with alcohol-containing mouthwash can trigger a positive breathalyzer test result for seven to 20 minutes after use. If alcohol in mouthwash were the standard, it would be subject to the federal excise tax that is levied by the government on all alcoholic beverages. Instead, the manufacturer modifies the ethanol in mouthwash into a “specially denatured alcohol,” or SDA. Basically, this means the company adds other chemical ingredients designed to make the product “undrinkable,” but this doesn’t deactivate the ethanol’s effects if ingested. For example, the SDA form is proprietary in Listerine®, but the label says it contains eucalyptol, menthol, thymol and methyl salicylate (wintergreen oil), all deliberately added to discourage ingestion. Apparently this does little to deter an alcoholic’s search for an ethanol source when conventional alcoholic beverages are unavailable. Even the strong, medicinal taste doesn’t stop an alcoholic. It may seem unbelievable that anyone would drink mouthwash, hand sanitizer or hair spray. Unfortunately, it’s not unusual to read reports about alcoholics who go to any lengths to “feed the need.” Purchasing personal care products containing alcohol is socially acceptable and allows an alcoholic to secretly consume and have access to alcohol 24/7. It’s cheap and easy to sneak products into shelters, it can be purchased easily by underage youths, and it’s easy to conceal use from family and friends. Many of these products are reportedly shoplifted from stores due to the relatively small package size. Stores in Alaska moved the mouthwash and vanilla extract behind the counters in 2008 to thwart theft of the products from nonpaying ethanol seekers. The Internet is rampant with accounts of alcoholics triumphantly leaving rehab who relapse by swallowing mouthwash. “A highly functioning alcoholic wouldn’t buy alcohol outright because it means the person relapsed,” writes one recovering alcoholic on a blog. “But it’s normal to buy mouthwash, and it’s easy to hide. Besides, who would admit to being so desperate they’d drink mouthwash to get a buzz?” But isn’t drinking mouthwash poisonous? The warnings on the labels state, “Warning: Keep out of reach of children. If more than used for rinsing is accidently swallowed, get medical help or contact a poison control center right away.” It may sound like a stern warning, but only to a nonalcoholic. Drinking mouthwash is openly discussed and even joked about on substance abuse forums, YouTube, Alcoholics Anonymous (AA) meetings and rehab clinics.

Ethanol vs. Methanol vs. Isopropyl Alcohol There are many forms of alcohol. These alcohol substances look and sound similar but have some important differences, and mistaking one for another can be fatal. All of these alcohols are colorless, flammable, and used in solvents and fuels. Ethanol (C2H6O) or ethyl alcohol is produced by yeast and is found in alcoholic beverages. It burns with a blue flame and is safe to consume in moderate amounts. Ethanol (E85) for automobile fuel is ethanol that has been further distilled. Denatured alcohol sold at drugstores also is ethanol, but has additives to make it poisonous. Methanol (CH4O), also known as wood alcohol, is toxic and should never be ingested, inhaled or come in contact with skin. Methyl alcohol burns with a bright yellow flame. Methanol often is found in windshield wiper fluid and is made from natural gas. Isopropyl alcohol (C3H8O), or rubbing alcohol, is not as poisonous as methanol but also is toxic if ingested, inhaled or topically absorbed. It metabolizes into acetone in the body, and 15 g can be toxic for a person of average weight.

There are many examples in medical literature of extreme mouthwash intoxication that lead to multiple system failures and even death. Determining what other ingredients in mouthPlease see STAFF, 79

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wash may be toxic in greater concentrations when someone drinks copious amounts has been studied recently. In January 2013, the Food and Chemical Toxicology Journal tested 30 mouthwash brands containing ethanol to learn if any other ingredients were toxic and in what quantities. They discovered that even though some of the other ingredients exceeded “acceptable daily intakes,” these were “inconsequential in their effects in comparison with the direct toxic effect of ethanol.” Even ingesting 100 g of ethanol in the form of mouthwash, the ethanol is the most toxic ingredient. They concluded, “The occasional or even chronic ingestion of mouthwash may not cause health effects except the effects of ethanol alone. Only in extreme exposures, ingredients such as thymol or methyl salicylate could exacerbate the effects of ethanol, especially by contributing to metabolic acidosis.” Some denatured alcohol products contain added poisons such as methyl (wood) alcohol. In October 2013, one hand sanitizer sold in Canada used unlabeled methyl alcohol in its formula, and at least two people died from drinking it. There seems to be little awareness by the public that these alcohol-containing products are abused and can be toxic or fatal. Medical studies of alcohol abusers indicate 10-15 percent ingested non-beverage ethanol products, and half the members of this group were regular consumers of NBE products. Ease of accessibility was the No. 1 reason for regular use. A study in New Mexico found blue laws, which restrict the sale of alcohol during early morning hours and on Sundays, were directly related to consumption of non-beverage ethanol products during times when alcoholic beverage sales were restricted. So why put alcohol in mouthwash at all? It’s often the carrier for the flavor or other ingredients, provides a refreshing “bite” and contributes an antibacterial effect. It’s also drying, causes tissue sloughing and burns, alters taste, and leads to stains and mouth ulcers. Most mouthwash manufacturers do make an alcohol-free version, but many consumers feel it isn’t as effective without the burn and tingle that proves the product “is working.” It’s hard to say if alcohol mouthwash manufacturers are aware of the abuse problem associated with their products. Will removing the ethanol from mouthwashes make any real difference in stopping an alcoholic or teen drinker? That is difficult to speculate. An alcoholic is sick and alcoholism is a disease. But making it easy to imbibe by purchasing personal care products and being able to successfully hide the behavior behind a minty fresh mask also is a problem.

liver pills, and there are even more ways to alter one’s state of consciousness, so it really does come down to personal accountability. I know it’s a bitter pill, but seriously, it is not [a dental manufacturer’s] fault or problem.” Awareness and education can help patients select the products that are right for their circumstances. A wise choice in our purchasing, use and storage of products is important and requires some consideration in light of its possibility for abuse.

References 1. http://www.ncbi.nlm.nih.gov/ pubmed/23041419 2. http://www.ncbi.nlm.nih.gov/ pubmed/14984634 3. http://webcache.googleusercontent. com/search?q=cache:s02BLKSNLRwJ:ask. metafilter.com/45110/Is-there-a-deliciouspremixed-cocktail-in-my-bathroom-closet+&cd=4&hl=en&ct=clnk&gl=us 4. http://alcoholrehab.com/alcohol-rehab/ recovering-alcoholics-and-mouthwash/ 5. http://ethicsalarms.com/2010/04/14/theamazing-mouthwash-deception-helpingalcoholics-relapse-for-profit/ 6. http://www.cbc.ca/news/canada/toronto/ hand-sanitizer-ingestion-linked-to-2-ontario-deaths-1.2252046 7. http://www.straightdope.com/columns/ read/2582/can-you-get-drunk-on-listerinehow-about-vanilla-extract Reprinted with permission by DentalIQ.com.

“The thing is, if an alcoholic wants to drink, there is absolutely nothing on God’s green Earth that’s going to prevent the behavior short of chaining them up and chucking them in the basement,” said a man identified as Weaver on an Internet blog. “The alcoholic must accept life on life’s terms! The next thing you’re going to ban is fruit and bread and sugar because that can make jail juice. There are more ways for a drunk to get drunk than Carter has www.floridadental.org

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OFF THE CUSP

JOHN PAUL, DMD, EDITOR

A Short Rant The other day, I was telling a buddy of mine about this nifty little part-time job I have. It gives me a private clubhouse where I can keep some of my toys and the excuse to write off some of my meals as a business expense. It keeps my kids in animal crackers and my wife in cute shoes. It’s just that nobody told me back in pre-Hurricane Hugo (in Charleston, 1989) that I might work harder to get through school than I would in private practice but all across America our patients are staying away in droves. That’s not just my anecdotal experience; Dr. Marko Vujicic, our resident economist at the home office in Chicago, has done the research to back it up. Check out our Facebook page for his latest 90 seconds: “Lawyers, Lattes and Dentists.” While the rest of the economy seems to be recovering, spending is stagnant at law offices; coffee and tea sales are down; and, people don’t see the value of visiting their dentist (that’s assuming they have a dentist in the first place). In my office, fewer patients actually means more money spent on coffee. You can complain that you don’t like the lemons life is serving up, or you can slice a thin spiral to garnish your Horse’s Neck*, have a nice big drink and move on. The not-so-busy times are great for beefing up the systems in your office and learning new skills. Staying away from my chair has a

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You can complain that you don’t like the lemons life is serving up, or you can slice a thin spiral to garnish your Horse’s Neck, have a nice big drink and move on.

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poor long-term prognosis. As Mr. Goodwrench used to say, “You can pay me now or you can pay me later.” It could be that our patients are seeking discount care beyond our borders. It’s possible that time will prove fixing poorly done dentistry will be as rewarding as caring for disease of a more natural origin. I had a patient tell me the other day, “I didn’t need to come in for the last 10 years because nothing hurt.” I had obviously skipped class the day in dental school where they taught that you are in perfectly good health as long as nothing hurts. Now all of a sudden, something broke and it hurts. There was nothing to be gained by lecturing about the evils of dental neglect; I just hope he had banked all the money he saved by not coming in for 10 years because it would be a good down payment on his treatment. Besides, I was bored doing crosswords. Next issue I’ll write about how often I have to explain that not seeing patients is not the same thing as not being at work. *Not that I promote drinking, but for those that question, a Horse’s Neck is an old school cocktail made with strong flavored rye or bourbon, ginger ale, bitters and a twist of lemon.

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

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