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Hospitality from the past. Education for the future. The One Hundred Twenty Eigl1tll Annual }'leeting

of tlw Virginia DentalAssociation

will convene at the Hotel Roanoke & Conference Center

from September 24 through September 28, 1997.

Nestled in the lzeart of the spectacular Blue Ridge Mountains, tIle com足 pletely

restored and remodeled Hotel Roanoke ami adjoining ultra-modern

Conference Center will welcome you witll tIle warm Soutl1ern hospitality

and all tlIe amenities

and services you'd expect of a four diamond hotel.

An excellent scientific session has been scheduled, including presenta足 tions by

Drs. "William 11cm Dyk, Christine Dumas, andIIarald Heymann. Dr.

Dm'e wJ1iston, ADA President-Elect, and 11is wife Julie will be lwnored

guests.

71Ie

Virginia Dental Assistants Association will be holding tlu,ir Annual

Meeting concurrently witl1 tIle VDA. In addition, virtually all Virginia

specialty societies

will conduct business or educational sessions in Roanoke.

Plan now to attend tlIe

1997

VDA Annual J.1eetinq

Roanoke!

Representing and serving member dentists by fostering quality oral health care and education.

~ ~

OFFICERS

President: William H. Allison, Warrenton President Elect: Wallace L. Huff, Blacksburg Immediate Past President: Ronald L. Tankersley, Newport News Secretary- Iressurer: Charles L. Cuttino, III, Richmond Executive Director: William E. Zepp, CAE P.O. Box 6906, Richmond, 23230

EXECUTIVE COUNCIL

Councilors at Luge:

Ex Officio Members: Parliamentarian: Emory R. Thomas, Richmond Editor: Leslie S. Webb, Jr. Richmond Speaker of the House: D. Christopher Hamlin, Norfolk Desn, MCV School of Dentistry: Lindsay M. Hunt, Ir., Richmond

I II III IV V VI

Edward ]. Weisberg, Norfolk Bruce R. DeGinder, Williamsburg Harold]. Neal, Jr., Emporia James R. Lance, Richmond Daniel E. Grabeel, Lynchburg, Chairman Ronnie L. Brown, Abingdon VII William J. Viglione, Charlottesville VIII Rodney]. Klima, Burke

PRESIDENT

SECRETARY

PATIENT RELATIONS

Tidewater

T. Wayne Mostiler 303 DePaul Medical Bldg Norfolk VA 23505

Ralph Howell, r-. J 02 Western Avenue Suffolk, VA 23434-4434

Wayne E. Stroud 5301 Providence Road Virginia Beach, VA 23464

Peninsula

Jeffrey N. Kenney 716 Denbigh Blvd. #C Newport News, VA 23602

Corydon B. Butler, Jr. 1319 Jamestown Road Wi 1Iiams burg, VA 23185

Lawrence A. Warren 106 Yorktown Road Tabb, VA 23693

Southside

Roger A. Palmer 307 Dogwood Lane Emporia,VA 23847

Richard Roadcap 350 I Boulevard Colonial Heights, Va 23834

John R. Ragsdale, ill 9 Holly Hill Drive Petersburg, VA 23805

Richmond

Benita A. Miller 5700 Old Richmond Avenue Richmond, VA 23226

Charles E. Gaskins, III 703 N. Courthouse Rd Ste 20 I Richmond, VA 23236

Thomas S. Cooke, ill 39 W, Williamsburg Road Sandston, VA 23150

Piedmont

James R. Evans 936 Main Street Danville, Va 24541

Gregory T. Gendron 7 Cleveland Avenue Martinsville, VA 24112

Edward M. 0 Keefe 4102 Electric Road Roanoke, VA 24014

Southwest

David L. Stepp 330-B Cumrnings Street Abingdon, VA 24210

Dana Chamberlain 645 Park Blvd. Marion, VA 24354

Jack D. Cole 303 Court Street Abingdon, VA 24210

VII Shenanoah Valley

J. Ted Sherwin 111 Spicers Mill Road Orange, VA 22960

Edward L. Amos 1002 Amherst Street Winchester, VA 22601

William J. Viglione 3025 Berkmar Drive Charlottesville, VA 22901

VIlI Northern Virginia

Bruce R. Hutchison 14260 A-B Centreville Sq Centreville, VA 22020

J ames A. Pell 6319 Castle Place, Ste IE. Falls Church, VA 22044

Neil J. Small 9940 Main Street Fairfax, VA 22031

SOCIETY

III

Councilors:

David C. Anderson, Alexandria - Vice Chairman Thomas S. Cooke, II, Sandston Gus C. Vlahos, Dublin Andrew J. Zimmer, Norfolk

ae LLeslie S

William E. Zepp, CAE, Business Manager

Webb, Jr., Editor

1. Bernard I. Einhorn 2. Jeffrey N. Kenney 3. H. Reed Boyd. III

Volun1e 74

ASSOCIATE EDITORS 4 Charles E. Gaskins. III 5. Edward P Snyder 6. R. Graham Hoskins

7. William C. Bigelow 8. Bruce W Jay MCV Thomas Burke

January · March 1997

Number 1

TABLE OF CONTENTS 5 6 7 8

13 15 16 19 20 23 29 38 42 46

Editorial • Letters to the Editor Message from the President Large Mucous Retention Phenomenon (Mucocele) of the Upper Lip - Case Report and Review of the Literature - Drs. Dent, Svirsky, & Kenny Membership Benefit Highlight - Dr. Kim Swanson From the Executive Director... Leadership-A Virginia Tradition Executive Council Actions in Brief Report on the ADA House of Delegates-Dr. Wally Huff 1997 General Assembly Overview - Mr.Chuck Duvall Is There a Need for More Hygienists in Virginia?- An Update Dr. William J. Viglione Dental Hygiene Program at Virginia Western & Danville Component News MCVNotes

COVER: Virginia Capitol grounds' Provided by Patricia A. Zepp PUBLICATION TEMPLATE & TYPESETTING: C:\Change

THE VIRGINIA DENTAL JOURNAL (ISSN 0049 6472) is published quarterly (January-March, April-June, July-September, October-December)

by the Virginia Dental Association, 5006 Monument Avenue, PO Box 6906, Richmond, Virginia 23230-0906, Telephone (804) 3 58-4927

SUBSCRIPTION RATES: Annual: Members, $6.00. Others $12.00 in U.S., $24.00 Outside U.S. Singlecopy: $6.00.

Second class postage paid at Richmond, Virginia. Copyright Virginia Dental Association 1996

POSTMASTER: Send address changes to: Virginia Dental Journal, PO Box 6906, Richmond, VA 23230-0906.

MANUSCRIPT AND COMMUNICATION for publications: Editor, PO Box 6906, Richmond, VA 23230-0906.

ADVERTISING COPY, insertion orders, contracts and related information: Business Manager, PO Box 6906, Richmond, VA 23230-0906.

VIRGINIA JOURNAL EDITORIAL

BOARD

Louis M. Abbey Ralph L. Anderson James R. Batten Cramer L. Boswell James H. Butler Gilbert L. Button Charles L. Cuttino, III Frank H. Farrington Barry I. Griffin Jeffrey L. Hudgins Wallace L. Huff Lindsay M. Hunt, Jr. Lisa Samaha Hunter Ford T. Iohnson

Thomas E. Koertge

James R. Lance

Daniel M. Laskin

Travis T. Patterson, III

W. Baxter Perkinson, Jr. David Sarrett Harvey A. Schenkein James R. Schroeder Harlan A. Schufeldt Kenneth J. Stavisky John A. Svirsky Ronald L. Tankersley Douglas C. Wendt Roger E. Wood

VDA COMMITTEE CHAIRMEN Direct Reimbursement Benita A. Miller

Annual Meeting Andrew J. Zimmer Auxiliary Education A. Carole Pratt

Relations

Environmental Health and Safety Paul Supan

Budget and Financial Investments Jeffrey Levin

History and Necrology Edmund E. Mullins, Jr.

Cancer and Hospital Dental Service James A. Pell

Institutional Affairs Elizabeth Bernhard

Caring Dentists Harry D. Simpson, Jr.

Journal Staff Leslie S. Webb, Jr.

Constitution and Bylaws Ronald L. Tankersley

Legislative T. Wayne Mostiler

Dental Benefits Programs Fred A. Coots, Jr.

Membership

H. Reed Boyd, "'

Dental Delivery for the Special Needs Patient New Dentist Barry Shipman Russell A. Mosher, Jr. Dental Continuing Education Ralph L. Howell, Jr.

Nominating Ronald L. Tankersley

Dental Health and Public Information

Adel J. Rizkalla

Peer Review and Patient Relations Edward M. O'Keefe

Dental Practice Regulation Douglas C. Wendt

Planning

Ronald L. Tankersley

Dental Trade and Laboratory Relations

George L. Nance, Jr.

Search Committee for VA Board Ronald L. Tankersley, Jr.

Education Foundation Ralph L. Howell, Jr.

Relief Foundation Scott H. Francis VDSC Insurance Committee

William H. Higinbotham, Jr.

1997 ADA DELEGATION:

Delegates: 138t!J ADASession/ October 18-22/ 1990 Washington DC William H. Allison (1999);' Gary R. Arbuckle (1998) M. Joan Gillespie (1997) Wallace L. Huff (1998) Emanuel W. Michaels (1999) Leslie S. Webb, Jr. (J 997) Ronald L. Tankersley (1999) Raleigh H. Watson, Jr. (1998) Richard D. Wilson (1999) Alternate Delegates: Anne C. Adams (1998) Charles L. Cuttino, III (1997) Bruce R. Hutchison (1997)

4 Virginia Dental Journal

David C. Anderson (1998) D. Christopher Hamlin (1997) Gus C. Vlahos (1998)

Richard D. Barnes ( 1997) Lindsay M. Hunt, Jr. (1997) Andrew J. Zimmer ( 1997)

1[l~ITORIALJ]

If Not, Why Not?

It's that time again. The Virginia General Assembly is in session. How will it impact me? How will its actions impact dentistry? Do I know the issues? Do I care what happens? I cannot do much to make a difference. The Virginia Dental Association and its lobbyist will look out for me. These are statements I have heard from member dentists when dealing with the Virginia legislative process. In fact, the Virginia General Assembly passes laws each year that impact dentistry, small business and every resident of this commonwealth. The Virginia Dental Association and its lobbyist, Chuck Duvall, introduce and support pro足 active legislation, but also monitor every bill introduced during the session and attempt to impact those that will affect dentistry and dentists. We are effective, but to be truly effec足 tive each dentist in Virginia must get involved in the legislative process. We must under足 stand the legislation and issues before the General Assembly. We must offer to be a grassroots volunteer. We must contact our delegate and senator and ask for their support for dentistry's legislative goals. We must get involved in the legislative process by working in carnpaigns and supporting candidates financially. We must join our political action com足 mittees, VADPAC and ADPAC, so that collectively, we can support those candidates who understand dentistry and its message. By working together we can gain political strength and legislative results. Are you involved? If not, why not?

Leslie 5. vVe{jh, Jr. Editor

Please join me in welcoming Les Webb as Editor ofthe Journal. An ADA Delegate and VDA Past President. Les brings fresh insights and new pcrspectives to your publication. I want to give special thanks to Connie Jungmann. Pat Zepp and Bill Zcpp for their ideas and their improvements to the Journal during my tenure. They make a great team.

Thank you for allowing me to serve as your Editor. FranCIS F. Carr. .lr.

, ------'

Virginia Dental Journal 5

I[ L~~~RS"l"() THE EDITOR JI

Dear Editor:

It is not who is right, but what is right, that is llnpol1ant. Thomas

Huxley

Dear Editor: USAir flight 427 in Pennsylvania; American Eagle turbo prop in Indiana; ValuJetAirliner in Florida; TWA/flight 800 in the Atlantic Ocean off Long Island, New York: the Federal Building. in Oklahoma City: All were mass disasters requiring rigorous, challenging, and painstakingly difficlut identification of victims, Dentists played key roles in the victim identification process in all of these recent tragedies, Dentists with skills, training and interest in the area of Foren sic Odontology responded when call and accomplished the tasks at hand, ln these various recent incidents ofairplane crashes and bombing attack, dental forensic identification teams came together to meet the challenges. Sometimes the team response was smooth and efficient, and sometimes more an exercise in scrambling with less than ideal organization. At the present time there is no organized Virginia Emergency Response Dental Identification Team (VERD!T). An effort is being made to organize such a team which would be prepared to respond to a call from the Chief Medical Examiner for tile Commonwealth, Dr. Marcella Fierro, at a moment's notice in case of a major disaster. The Chief Medical Examiner, Dr. Fierro, and her primary dental contacts, Dr. James Burns and Dr. Dennis Page, at VCU/MCV School of Dentistry, are all in favor of such an organized team. Some ten to twelve dentists in Virginia, with some training and experience in Forensic Odontology, have been involved in discussing this unfulfilled need ofour state. Interested dentists should be aware that the nature of this work is service. Members ofVERDIT need to: I. Be dependable. 2. Be committed to respond immediately when called. 3. Be good team workers. 4. Be willing to give without expecting anything in return. 5. Be motivated to participate in difficult and stressful work. 6. Be committed to continuing education and training on an annual basis. Dentists licensed to practice in Virginia who might be interested in being a part ofVERDIT arc asked to contact: Dr. Madison R. Price 50 Settlers Road Newport News, VA 23606 Telephone: 757/599-4736 Sincerely,

This letter is an alert to Virgmia dentists who are thinking about filing

insurance claims electronically.

Be careful about hooking up with any software, insurance company or

electronic clearing house before next fall. That is when our state

association hopes to endorse and select a vendor from a field of many

after more than two years of study.

Filing your insurance claims electronically is a very good idea. It is

quicker to process in your back office. It yields faster reimbursements

from insurance carriers.

But do not jump the gun. Jfyou sign up with the wrong clearing house

the security of your data may be compromised. Insurance companies

can purchase data from clearing houses.

"So what') You ask.

Just this: one day the insurance companies will dictate your fees,

prescriptions, dosages, and treatment plans.

The way the world of electronic claims filing is today, every claim you

file goes to one of several electronic clearing houses. Every insurance

company in the health care field has written contracts with those

clearing houses to access/purchase claims data going through it.

The vast cost-and-care information amassed at such houses, and shared

freely with insurers, has given the insurance industry the nuts and bolts

means to build the reputation it has today among our colleagues in the

other healing arts. Dentistry is next on the list of fields to be analyzed,

summarized and cost managed by these financial giants.

The temptations to go forward with electronic billing are compelling:

lower cost, faster cash recovery. You might ask what harm one dentist

could do to the whole profession by going ahead now') If enough people

in an insurance company demanding you change your fee to fill a cavity

"based on industry fee standards."

Be patient until next fall. The Virginia Dental Association has been

working quietly for over two years to establish a "clean clearing house."

That is, one that would not sell you out to the insurance companies, one

that would keep the confidentiality of dentist and patient at the core of

its business conduct. The VDA has been close to a solution, but held up

by management system software.

At the national level of our profession, not everyone shares or was

unaware of Virginia's and other states deep cone em about the confiden足

tiality of practitioner information. The American Dental Association

Board of Trustees recently signed two contracts that have been

negotiated by a Board fanned ED! committee: one a software vendor

and the other a major clearing house. Virginia has concern about the

clearing house contract with regard to confidentiality.

Madison R. Price, DDS The Virginia Dental Association hopes to be able to provide its state

members with a way to file claims electronically that is safe for your

practice of dentistry and safe for your future.

-+足

6 Virginia Dental Journal

Sincerely, Fred A. Coots, DDS Chairman, Dental Benefits Committee Virginia Dental Association

[~~SSAGE FRO~~SI~~I

The Winter months have become an important time for many VDA activities. The recent Leadership Conference held at the Boar's Head Inn in Charlottesville set a new standard in presenting up to date information for the membership. Entitled VDA's Brave New World - featuring Direct Reimbursement, Managed Care, For Profit and the Net, the program headlined Dr. AI Guay and Mr. Tom Killam from the ADA; Mr. Jon Swan, Mr. C.P. Coyner from Benefits Administration, Inc. and Mr. Phil Pfeifer fromADRP. The weekend also included a top notch scientific program, Contemporary Cosmetic Restoration Dentistry presented by Drs. W. Baxter Perkinson, Jr., John C. Cranhan and Christopher A. Hooperto benefit VADPAC. On Sunday morning, the conference finished with Committee meetings. The ever-increasing workloads of the committees have made these gettogethers a necessity. Upcoming events include the VDA Winter Committee Meetings at the Omni Hotel in Richmond from January 3 to February 2. The ADPAC Seminar Series will present with VADPAC Dr. Hugh Doherty an all day program, Control The Numbers That Control Your Ufe on Friday, January 31. The national political activities of the VDA will be centered on the Second National Grassroots Conference in Washington, DC, February 9-11. The gettogether with dentists from across the country features briefings by lobbyists and federal regulators. After this, liaison dentists will go to Capitol Hill and meet with their legisla足 tors and discuss those items that affect the practice of dentists.

If you, as a member of the VDA, have read this far and you are not involved with any of these important activities, please accept this as an invitation to join and work with us to help protect our profession and the patients we serve. William H. Allison President

Virginia Dental Journal 7

LARGE MUCOUS RETENTION PHENOMENON

(MUCOCELE) OF THE UPPER LIP

CASE REPORT AND REVIEW OF THE LITERATURE

C. Daniel Dent, D.D.S., Clinical Professor, Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University-Medical College of Virginia, School of Den tistry; Chairman, Division of Dental Medicine, Medical College of Virginia Hospitals & Staff Dentist VA Medical Center, Richmond, VA. John A. Svirsky, D.D.S., M.Ed. Professor of Oral Pathol ogy, Virginia Commonwealth University-Medical College of Virginia, School of Dentistry, Richmond, VA. Karen F. Kenny, DD.S., Former Geriatric Fellow & Chief Dental Resident, VA Medical Center, Richmond, VA.; Presently in private practice in Lynchburg, Virginia.

***

INTRODUCTION

Figure 1

* Fluctuant lesion of left upper lip

Intraorally, the lesion appeared circumscribed, fluctuant, and purple in color (Fig. 1). After administration of local anesthesia, an excisional biopsy was performed. The post-operative course was uneventful.

• HISTOPATHOLOGY

The mucous retention phenomenon (MRP), referred to as mucocele or mucous retention cyst, is a common lesion of salivary glands and their ducts. It is thought to be of traumatic origin, I.e and accounts for 2.8% of oral biopsies submitted.' This article describes a rare presentation in the upper lip.

Microscopic examination revealed sectioned soft tissue consisting of mucosa covering a submucosal lesion composed of basophilic mucinous material lined by a compressed layer of fibrous connective tissue (Fig. 2). Regional mucous gland lobules showing chronic siaload enitis are evident within the specimen (Fig. 3).

CASE PRESENTATIOI\J A 70 year old white male was referred from a nursing home for evaluation of a lesion of the upper lip which had developed four months previously. A dermatologist diagnosed the mass as an infected epithelial cyst and warm compresses and antibiotics were recommended. The lesion drained spontaneously within a week, but returned to its previous size within three months. Antibiot ics and warm compresses were again prescribed and the patient was referred to the Dental Service.

Diagnosis: Mucous Retention Phenomenon/Mucocele with Chronic Sialoadenitis. DISCUSSION The clinical appearance of a mucous retention phenom enon/mucocele is variable, but usually is solitary, soft, nodular and fluctuant. MRP cannot be emptied on palpa-

Medical history was significant for alcohol abuse, chronic anemia, chronic obstructive pulmonary disease, os teoporosis, non-insulin dependent diabetes mellitus, and peptic ulcer disease. His medication included Fe 2 S04 ' Beconase® inhaler, Tolinase®, and Ranitidine®. The patient reported having been in a motor vehicle accident ten years earlier resulting in trauma to the left upper lip. Extraoral examination revealed a 2cm x 2cm mass near the midline of the left upper lip. A faint 2cm irregular scar was present on the skin overlying the mass.

Figure 2 Mucosa covering a lesion with a fibro us connec t'Ive . . tissue wall surrounding a mucinous rnaterial . Th e arrow In indiIcat es . . fibrous connective tissue wall.

8 Virginia Dental Journal

glands and surrounding connective tissue show infiltration by a mixed inflammatory infiltrate, predominantly Iympho cytes.1235 Induration at the base of a MRP may be fibrous tissue, but should alert the clinician to the possibil ity of a malignant tumor.' It is important to remove the suspected MRP (especially of upper lip) lesion for histo logical examination, as mucin producing tumors particu larly the mucoepidermoid carcinoma, may mimic the mucous retention phenomenon clinically. DIFFERENTIAL DIAGNOSIS

Figure 3 Regional mucous gland lobules showing chronic inflammation.

tion or moved independently of the mucosal layer.' A superficial MRP appears blue due to thin overlying mucosa permitting the pool of mucous to absorb most of the visible wavelengths except blue, which is relected.' A deeper lesion may have a normal pink appearance because of the thicker mucosal covering. i.' If the MRP is subjected to chronic irritation, the lesion may appear red to purple.' MRP may persist for days to months, may regress, but inevitably recurs.>" The lesion is found most commonly on the lower lip, although it can be found anywhere on oral mucosa.' MRP are rarely seen on the anterior hard palate" in major salivary glands' , or on the upper lip.' In a review of 63 lesions, Cohen observed 52 (82%) in the lower lip, 8% in the cheek, 2% in the retro molar area, and 1% in the palate.' In another study, Standish and Shafer found 45% of 97 MRP on the lower lip and no cases in the upper lip.' MRP show no sex or age predilection." Robinson and Hjorting-Hansen found 65% of the IVIRP in patients from birth to thirty years, but found there to be no sex predilec tion." Ramanthan and coworkers report a series of 250 cases, in which 85% occurred in the first three decades." Numerous authors have suggested that MRP is caused by severance of a salivary duct which results in continuous pooling of saliva in the fibrous connective tissue and development of a well demarcated cavity." Traumatic severance can occur by lip or cheek biting or by pinching of the lip with an extraction forceps." Chronic partial obstruction of the salivary duct due to scar tissue, and rarely intraductal calculus, has also been reported." Microscopically, the majority of MRP are of the extravasa tion type which has a cyst-like cavity filled with lightly basophilic homogenous mucous material.P-" The cavity lining is usually formed by compressed fibrous connective tissue and rarely by epithelium and is not a true cySt.124 5 When an intact flattened epithelial lining is found, it is usually a duct bordering the severed area. In rare cases, an epithelial lined IVIRP is a true cySt.125 In both the epithelial lined and unlined types, the associated salivary

The clinical differential diagnosis for the upper lip lesion included such entities as Benign mixed tumor, monomor phic adenoma, sialolith, lipoma, benign neural tumor, lymphangioma, cavernous hemangioma, and mucoepider moid carcinoma or acinic cell carcinoma." TREATMENT The lesion should be completely excised and associated accessory salivary glands in the immediate area should be removed to decrease the risk of recurrerice.!" 34 SUMMARY An unusual presentation of a mucocele of the upper lip has been described. Differential diagnosis, clinical presentation, histology, and treatment were discussed. 1. Neville BW, Damm DO, Allen CM, Bouquot ,IE. Oral and

Maxillofacial Pathology. Philadelphia: WB Saunders Co.

1995:322.

2. Regezi JA, Sciubba JJ. Oral Pathology Clinical-Pathologic Correlations. 2 nd ed. Philadelphia: W.B. Saunders Co. 1993:239. 3. Bhaskar SN, Synopsis of Oral Pathology. 4 th ed. Chicago: CV Mosby Co. 1973:52,399,503. 4. Wood NK, Goaz PW Differential diagnosis of oral lesions. 3,d ed. Chicago: CV Mosby, 1985: 158,216,1189. 5. Shafer WG, Hine MR, Levy BM. A textbook of oral pathology. 4 th ed. Philadelphia: WB. Saunders Co. 1983:557-558, 231. 6. Cohen L. Mucoceles of the oral cavity, Oral Surg. 19:365 372,1965. 7. Standis SM, and Shafer WG. The mucous retention

phenomenon. J. Oral Surg. 17:15,1959.

8. Robinson L, and Hjorting-Hansen E. Pathologic changes

associated with mucous retention cysts of minor salivary

glands. Oral Surg. 18:191,1964.

9. Kenny KF, Dent CD, DeBoom GW Slowly enlarging,

asymptomatic mass in the upper lip. JADA 1989: 118-96.

Virginia Dental Journal 9

ABSTRACTs:J1

The following five abstracts were provided by the Endodontic Program at MCVIVCU School of Den tistry. The graduate students are listed following their abstracts. We appreciate their contribution to this journal.

Rohde TR, Bramwell JD, Hutter Jw. Roahen JO. An In Vitro Evaluation of a New Root Canal Sealer Journal of Endodontics 1996; 22:365-8.

The final stage of endodontic therapy is the three-dimen sional obturation of the root canal system, most commonly using gutta-percha with a sealer. The gutta-percha serves as a core material, whereas the sealer acts as a binder, fills discrepancies between the gutta-percha and the canal walls, and serves as a lubricant. Sealers can be divided into three categories based on their ingredients; eugenol containing, non-eugenol con taining, and calcium hydroxide-based. A glass-ionomer based sealer, Ketac-Endo, has recently been introduced. The purpose of this investigation was to compare the in vitro apical microleakage of Ketac-Endo to Roth's 801 elite and AH26, and to compare the microleakage of Ketac Endo used with a single master gutta-percha cone to a lateral condensation technique. Sixty-four single-rooted human teeth were instrumented and randomly divided into four groups. Three groups were obturated with laterally condensed gutta-percha and either Roth's 801 E, AH26, or Ketac-Endo. A fourth group was obturated using a single master cone and Ketac-Endo sealer. The teeth were suspended in methylene blue dye for 6 days, sectioned longitudinally, and evaluated for apical dye penetration. In general, Ketac-Endo root canal sealer showed greater dye penetration than Roth's 801 E and AH26. There was no statistically significant difference between the laterally condensed Ketac-Endo group and the single-cone obturated Ketac-Endo group. The manufacturer states that Ketac-Endo may be used with either a single or multiple gutta-percha cone tech nique. The insolubility of glass-ionomers d~ctates that at least a single gutta-percha cone be used WIth Ketac-Endo to serve as a pilot pathway for retreatment. Ultrasonics can then be used to remove the glass-ionomer sealer. 10 Virginia Dental Journal

Two properties of an ideal root canal sealer are that it provides a hermetic seal and is impermeable In tissue fluid. The results of this study showed complete dye penetration in both Ketac-Endo groups, with the dye . absorbed by the sealer. It is not known whether bacteria or exudative substances are absorbed by Ketac-Endo, nor is it known how this absorption may affect the success rate of root canal treatment.

Dr. Kris D. Johnson is a second year-postgraduate student in endodontics at MCVNCU School of Den tistry. He is a graduate of the University of Minnes~ta Duluth and received his D.D.S. degree from the Uni versity of Minnesota in 1990. Dr. Johnson served in the U.S. Navy Dental Corps from 1990 to 1994, and practiced general dentistry in Minneapolis from 1994 to 1995.

Penninston S, Hargreaves K

Evaluation of Periapical Injection of Ketorolac for Manage

ment of Endodontic Pain. Journal of Endodontics 1996;

22:55-59.

Successful management of acute pain is the primary goal

of all dentists. Endodontic pain is often linked to the

inflammatory process and results from the stimulation of

nociceptors, as well as central mechanisms. It has been

suggested that elevated levels of prostaglandins can result

in inflamed pulps and periapical tissues of humans and

animals. Ketorolac is the first NSAID available for intra

muscular injection. The study determined whether

ketorolac tromethamine is also effective when injected

intra orally, at the site of inflammation. They compared

the analgesic efficacy following intraoral periapical

infiltration injection with intramuscular injection of the drug

in a prospective, randomized, double blind clinical trial.

Fifty-two health patients with pain originating from either a

vital or non-vital tooth were included. Patients were

randomly allocated into 1 of 4 groups: (1) 1M placebo &

periapical placebo; (2) 1M Ketorolac & periapical placebo;

(3) 1M placebo & periapical Ketorolac; and (4) 1M placebo & Periapical local anesthesia. Following the drug injec tions, pain scores were recorded at 15, 30,45 and 60 minutes. After the 60 minute evaluation all patients were treated with a pulpotomy. A dry cotton pellet was placed in the chamber & closed with Cavil. Patients were given a pain diary and a reserve packet containing 8, 200mg ibuprofen tablets. They were instructed to record their pain scores at 3,4,5 and 6 hours postdrug injection. The pain diaries were then returned by mail.

During the first 60 minutes of the study a significant analgesic effect was present for all groups. Both the intraoral Ketorolac and the local anesthetic groups demon strated a significant reduction in pain 30 minutes following injection. The infiltration Ketorolac group produced nearly twice the reduction in pain compared to the placebo group. After the pulpotomy treatment, all groups reported a general decline in pain levels. An Interesting finding was that infiltration of Ketorolac in the mandible produced significantly greater analgesic effect, both in mag~itude and duration as compared to the response noted In the maxillary arch. In conclusion, the results indicate that intraoral infiltration of Ketorolac may prove to be a useful adjunct in the management of endodontic pain.

Dr. Steven G. Forte is a second year postgraduate student in Endodontics. He attended Virginia Com monwealth University and received his D.D.S. degree from MCVNCU School of Dentistry in 1995.

Weller NR, Kimbrough WF, Anderson RW. Root Surface Temperatures Produced During Post Space Preparation. Journal of Endodontics 1996; 6:304-307. The placement of a post into the prepared root canal is often part of the final restoration of an endodontically treated tooth. To create a post-space, gutta-percha is removed by thermal, mechanical or chemical means. Recently, a new rotary instrument, GPX, by Brasseler USA Inc., was introduced to remove gutta-percha. GPX removes gutta-percha by frictional heat, without removing dentin. The gutta-percha becomes thermoplasticized and the flutes of the bur pull the material from the root canal. The rotational speed of the bur might produce higher temperatures in the root canal leading to higher tempera tures on the root surface of the tooth. The purpose of this in vitro study was to measure the temperature increase on the root surface of a tooth when a post space was crated with the GPX bur at various rotational speeds. The crown was removed from a maxillary central incisor and the incisor was imbedded into a block of clear orthodontic acrylic resin. The tooth was accessed and prepared with standardized techniques. A channel (2mm x 15mm) was cut longitudinally into the acrylic block exposing the root surface. Five thermocouples were placed in contact with the root surface. The first thermo couple was placed 1mm from the coronal root end and the rest were spaced 3mm apart in a line leading toward the apex. The root canal was obturated with Obtura thermoplasticized gutta-percha.

ABSTRACTS,cont.

A size 50 GPX burwas used in a Titan slow-speed hand piece to remove the gutta-percha. 9mm of apical root canal filling material was left in the canal. Twenty separate post space preparations were performed in the model for each of the speeds evaluated; 6500, 8000, 9500,11000 and 15000rpm, respectively. The temperatures on the surface of the root were simultaneously measured by the five thermocouples as the post space was created. The temperature measurements were started 5 seconds before the GPX bur was introduced into the root canal and continued in 1 second increments for a total of 180 seconds for each procedure. All rotational speeds evaluated produced a temperature increase on the surface of the root. The mean increase ranged from .66 degrees to 4.81 degrees Celcius. Gener ally, an increase of ten degrees Celcius is the critical temperature when permanent damage to the supporting structures of the tooth may occur. The results from this study indicate that using a GPX bur to create a post space should not cause thermal damage to the supporting tooth structures.

Dr. Katherine R. Garrett is a first-year postgraduate student in Endodontics. She received her D.D.S. degree from Indiana University School of Dentistry in 1989. Dr. Garrett served in the U.S. Navy Dental Corps from 1989 to 1996.

Fouad AF, Rivera EM, Walton RE. Penicillin as a supple ment in resolving the localized acute apical abscess. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 81 :590-5. Antibiotics are often prescribed indiscriminately to treat endodontic emergencies. This is especially true for the localized acute apical abscess (LAAA), which is frequently seen in general and endodontic practices. It is important that the effectiveness of these medications be clarified and should not be administered without demonstrable benefit relative to risk. The purpose of this study was to examine the effect of penicillin supplementation on the reduction of symptoms and the course of recovery of the LAM after emergency endodontic treatment.

Virginia Dental Journal 11

ABSTRACTS,cont.

Thirty patients with pulp necrosis, periapical pain and/or swelling were treated as follows: after local anesthesia, the offending tooth was accessed, the working length determined, and cleaning and shaping of the canals was either partially or completely done with copious irrigation with 2.6% sodium hypochlorite. Canals were dried, medicated with calcium hydroxide paste and then temporized with Cavit or IRM. When indicated a localized intraoral swelling was incised for drainage with a drain inserted for 24 to 48 hours. The patients were then randomly assigned to one of three groups: (1) penicillin group: Pen VD 500mg 1 qid for 7 days: (2) placebo group; placebo tablets according to the same regimen; (3) neither medication group. All patients were given 600mg ibuprofen immediately before treatment and were maintained on this medication four times daily for 24 hours, and then as needed. Each patient was given a post-treatment card and instructed to mark their pain and swelling experience before treatment, as well as at 6, 12,24,48 and 72 hours after treatment. Based on a visual analog scale (VAS) on the post-treatment card, pain and swelling experiences were ranked and given numerical scores. A symptoms index was calculated by combining scores for pain and swelling and the differences between patients' symptoms at each time period were compared using statistical analysis. The overall finding was no clinically significant differ ence in the three groups as to reduction of symptoms or course of recovery of patients with LAM in the 3-day postoperative period. Most patients given appropriate local treatment, showed marked reduction in symptoms within 3 days and did not benefit from penicillin supple mentation.

Dr. Steven R. Sluyk is a second-year postgraduate student in endodontics. He received his D.D.S. degree from the MCVNCU School of Dentistry in 1990 and practiced general dentistry in Phoenix, Arizona for 5 years.

I. Rotstein. CD. E. Dankner, Drv1D, Msc, A Goldman, DMD. I. Heling, DMD, Mse.A. Stabholz. Drv1D and IVI. Zalkind. Drv1D Historical Analysis of Dental Hard Tissues Following Bleaching. Journal of Endodontics 1996; 22:23 26.

There are many new bleaching preparations on the market today that are used in mouth guards at home. Materials such as hydrogen peroxide at different concentrations, sodium perborate, and carbamide peroxide are generally used for bleaching purposes. The ability of these prod ucts to lighten the tooth color is clear, but the safety of some of these oxidizing agents is a subject for concern. Pulpal irritation, changes in the tooth structure, micro leakage of restorations, reduced bond strength of com posite resins, external root resorption, and other alter ations were associated with these agents. Recently, it was found that bleaching agents caused alterations in the chemical structure of pulverized human dentin and cementum. These agents changed the original ratio between the organic and inorganic components of the tissues and increased their solubility. The purpose of this study was to assess the effect of commonly used bleach ing agents on intact non pulverized teeth, using scanning electron microscopy and energy-dispersive spectrometric analysis. Twenty-one fresh intact human premolars extracted for rthodontic reasons were used, the apical two thirds of the tooth was removed and the remaining tooth stump was cut longitudinally and prepared for bleaching in one of the following materials: 30% Hydrogen Peroxide (HP), 10% Carbamide Peroxide (CP), Sodium Perborate (SP), Nu smile Gel (NS), Opalescence (OP), Dental Bright (DB). The levels of calcium, phosphorus, sulfur, and potassium in the enamel, dentin and cementum of each specimen were measured. The results of this study indicate that most of the bleaching agents examined caused changes in the levels of calcium, phosphorus, sulfur and potassium in the tissues. In general, decreases in the Ca/P ratio were found to be more significant in the cementum and dentin than in the enamel, HP was the only material that significantly re duced the Ca/P ratio in all these tissues. CP and OP significantly reduced the Ca/P ratio only in dentin and cementum. Dr. Justin D. Thornton is a first year postgraduate student in Endodontics at MCVNCU School of Den tistry. He is a 1996 graduate of MCVNCU School of Dentistry.

12 Virginia Dental Journal

Membership Benefit Highlight:

Managed Care Resources and Information

Kimberly S. Swanson, D.D.S.

Dr Kim Swanson practices Oral and Maxillofacial Surgery in Richmond and serves on the state-wide Membership Task Force.

In a recent survey of both member and non-member dentists of the Virginia Dental Association, the majority of re spondents identified managed care as one of tile most critical issues facing the dental profession. The Virginia Dental Association and the American Dental Association provide members with compre hensive resources regarding managed care includ ing publications, seminars, computer models, and other services. These resources can help the individual dentist make informed choices about whether to participate in managed care plans. Publications available through the ADA include: "Alternative Dental Benefit Models: Their Design and Impact on Your Practice"; "Individual Practice Associations and Dentistry"; "Direct Reimbursement-The Dental Benefits Plan for Smart Companies"; "The Antitrust Laws in Dentistry"; "Managed Care Resource Packet"; "A Dentist's Guide to Managed Care Marketplace Information"; and "What Every Dentist Should Know Before Signing a Dental Provider Contract." Most of these publications are available at no charge to members from either the ADA or VDA, or for a nominal fee through the ADA's Department of Salable Materials/Catalog Services. Contact either the ADA or the VDA Central Office for ordering assistance.

charge (1-800-552-3886 or 804-358-4927). The ADA Division of Legal Affairs will analyze third party contracts, including those from managed care com panies, and inform member dentists in clear language about the contract provisions so that he/she can make informed decisions about the implications of participation. "The Changing Face of the Marketplace: Is Managed Care Right for You?" is a seminar on the legal as pects of managed care, contract analysis, managed care economics, marketplace issues, and the implica tions for dentists. This seminar is available through the ADA for a nominal fee to constituent and compo nent societies. Those interested may call ADA Seminar Services (1-800-621-8099 ext. 2908). A new service is now available through the ADA Catalog Services (1-800-947-4746). The "Managed Care Financial Impact Analysis" is a computer spreadsheet model for dentists to complete which will help them determine the potential financial impact on their practice of participating in a specific managed care plan. Finally, individual telephone assistance by experts is available through the VDA Central Office, the ADA's Council on Dental Benefits (1-800-621-8099 ext. 2746), Council on Dental Practice (ext. 2895), Divi sion of Legal Affairs (ext. 7479), and the Office of Quality Assessment and Improvement (ext. 2746). The dental profession will face significant challenges in the future. One goal of the Virginia Dental Asso ciation and the American Dental Association is to help its members meet the challenge of managed care. Please help yourself, your practice, and your profession by taking advantage of this important benefit of membership in organized dentistry.

Additionally, the ADA's Contract Analysis Service is also available through the VDA Central Office at no

Virginia Dental Journal 13

Upcoming Continuing Education 1997

n aJeLTi me

Component

Meeting

Location

February 20 6:00 pm

Richmond (4)

CE Program Dinner Meeting

Embassy Suites Hotel

Dr. Singh Salmi "New Trends for Managemcnt of Facial Pain Syndrome"

March 5 6:00pm

NOVA (8)

Membership CE Dinner Meeting

Fairview Marriott

Ms. Sherry Keramidas "Dentistry & the Computer Age"

March 7

Southwestt6)

CE Program

Emory & Henry College

Dr. Ben Bissell "Dealing with Difficult People"

March 20 6:00pm

Richmond (4)

CE Program Dinner Meeting

Embassy Suites Hotel

Dr. Tom Phillips "Esthetic Dentistry"

April 17 6:00pm

Richmond (4)

CE Program Dinner Meeting

Embassy Suites Hotel

Dr. James F. Nelson "Problems and Complications in Implant Surgery"

Apri118&19

Shenandoah(7)

CE Program Omni Hotel Leadership Conference

April 24 &25 8:30 am - 4:30pm

Tidewater (I)

CE Program

April 24 &25

Peninsula * in conjunction with Tidewater

May 2

NOVA

May 16

Dr. Paul Belvedere (April 18)

Dr. Franklin Weine & Dr. Stanley Malamed

Omni r lotcl 1-64 s. Rte 17

Membership CE 8:00 a111

Fairview Mall Iott

Working Dinner -Dr. Frank Spear "Restoration for Health Function & Esthetics"

Southwest (6)

CE Program

Pipestem, WV

Dr. Jasper Lewis & Anne Page Griffith "Secrets to Managing the Accelerated Dental Practice"

June II 3:30

Southside (3)

CE at Emporia

Pork Festival at Emporia

Dr. W. Baxter Perkinson "Contemporary Cosmetic Restorative Dentistry"

June 11-14

VDA Committee Meetings Virginia Beach, V-4

·\ugust 15

Southwest (6)

(8)

CL Program

Dr. Harold Crossley "Therapuucs & Pharmacology"

Abingdon

Please Note: VDA sponsored Continuing Education appears in blue.

AIDA.

C-:E:-~-.I=»

CO NT IN U IN G ED U CAT 10 N R EC OG N IT 10 N PRO GRAM

The Virginia Dental Association is recognized as a certified sponsor of continuing dental education by both the ADA CERP and the Academy of General Den tistry. All courses presented at the 1996 VDA Annual Meeting are approved for credit by these agencies. as well as by the VirginiaState Board of Dentistry

14 Virginia Dental Journal

[[ FROM THE EXECUTIVE DIRECTOR~I

My first indication that I would miss former VDi~\ Journal Editor Fred Carr came when l\Jew Editor Webb told me (you heard correctly - told me)

that I would do an Executive Director's Column and that the Deadline for the column was January 1. Pat

Watkins had advised me that if I would smile and nod, Dr. Webb would eventually forget his request and go

on to something (or in this case somebody) else. Not so.

Actually, I am pleased to have this forum to communicate with the VDA membership - even if the communi足

cation is one-way. However, since my intention is to pay a few compliments to the Virginia Dental commu足

nity, rebuttal and/or equal time is probably unnecessary. One would think that entering my tenth year

working with 'dentists, I should know better.

The Virginia Dental Association is changing and growing in its interests and activities. This change and

growth is and will continue to be painful at times - change and growth do not occur without a little discom足

fort. The strength of the membership and leadership of the VDA will see us through the changes of the

upcoming months and years. Associations are classified somewhere on the spectrum of staff-driven to

volunteer-driven. It is easy to become staff-driven and allow staff to make the decisions for the association.

In today's association world, staff are professionals with expertise in various areas. Organizational growth,

rate of growth, and diversification call for specific expertise not often addressed in dental school.

However, totally staff-driven associations are in a declining stage of association life. Eventually, the totally

staff-driven association will collapse. The ideal relationship for an association is a balance of staff-driven

and volunteer-driven.

The VDA is primarily volunteer-driven, as evidenced by the well developed committee structure. More

importantly, the activity and involvement of the individual committee members is a sign of good health. Over

250 of your colleagues were in attendance for the 1996 June Committee Meetings in Virginia Beach.

Component officers and leaders are active in the committee meetings, the annual Leadership Conference,

as well as their component level activities. Any successes experienced by the VDA are to the credit of the

individual, active members.

I have served as your Executive Director since January 1995. This has been an incredibly fast paced

twenty-four months for the VDA. The time has been somewhat intensified by the Whiston '96 Campaign,

not to mention the ideas and energy level of your officers. If I have not had the pleasure of meeting you

personally, perhaps that will happen in 1997. The 129th Annual Meeting in Roanoke in September presents

an excellent opportunity - I know 1'1/ be there.

William E. Zepp, CAE Executive Director

Virginia Dental Journal 15

~UR Dental Team:

Where Everyone a

Star

__ :

.< -... (

satisfaction andtreatment. Your office performs best through

laboratory technician and busmess staff. Patients appreciate the effort you andyour staff make to conduct a premier performance dedicated to their oral health and well being So. go ahead. doctor, and give

A\O)A. This message of TEAM recognition IS part of a ser.es produced by the

American Dental Ass5ciation, Council on Dental Practice

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On Friday, November 1, VADPAC presented a seminar by Drs. John Cranham, Christopher Hooper, and W. Baxter Perkinson on "Contemporary Cosmetic Restor ative Dentistry." This seminar helped raise funds for VADPAC and was well received by those attending.

C..?:v;:-li'~~r,

RG.2nokc:

Saturday, November 2, featured a program entitled VDA's Brave New World: DR, Managed Care, For Profit, and The Net. Dr. Will Allison welcomed a large audience in attendance and introduced those participat ing in the program on Direct Reimbursement. Dr. AI Guay, ADA Associate Executive Director, and Mr. Tom Killam, ADA employee who heads PINSERV (Purchaser Information Service), gave an overview of ADA Direct Reimbursement activities. These include a S25 dues increase directed to marketing DR nationally. increased

[)C \.-';'),.!.-. /,

nnua'

'~< c \,~. rn b er E'.:z<"!~ '3'

These goals include: I. To improve and expand membership services. 2. To promote the policy of the Association through proactive legislative and regulatory advocacy. a. Increase legislative activity b. Increase activity with regulatory agencies c. Increase involvement in the election process. 3. To increase membership recruitment and retention a. Develop innovative recruitment activities b. Improve membership retention c. Increase and maintain active participation 4. To enhance membership communications a. Improve perceived value of membership and association communication b. Improve public awareness of VDA mission 5. To increase access to quality oral health care a. Promote public education b. Promote dental benefits c. Reaching the underserved.

your staff the recognition they deserve.

•

.... ...,

a cooperative HAM effort involving the dentist, hygienist, assistant,

o Ii ctob 8 r 3 -I with a review of the Goals for the VDA which were established a year ago at the VDA Goals and Roles Workshop. Our Executive Director, Bill Zepp, led the participants in a re-evaluation of VDA goals and the necessary planning to achieve them.

The entire staff plays a vital role In the patient's comfort,

_: .' '-.

'~'.~

(jC2JS P.e~'~el\:·

1 4,

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lnr., Charlottesville

:>.t., ~. _::~,.jr;.~~'£hrr;, Conference'

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16 Virginia Dental Journal

-_-~-,_--

staffing of PINSERV to handle DR contacts, and enhanced coordination of constituent DR activities. Mr. Phil Pfeifer of the Alliance for Dental Reimburse ment Programs, an independent group promoting DR, gave a report of alliance activities. The alliance is concentrating on developing certified brokers networks to sell DR and handle DR contacts. It is also helping constituent members set up DR marketing programs. Printed materials and data bases are also being devel oped.

Goals and Roles Workshop participants.

Dr. John Willhide, a VDA member who serves on the ADRP Board of Directors, made a strong plea for dentists to become involved in DR marketing in their offices and component societies. Dr. Benita Miller, VDA DR Committee Chairman, Connie Jungmann, VDA Assistant Executive Director, and Jon Swan and Cork Coyner of Benefits Administration Inc., our VDA endorsed broker, reported on VDA DR activi ties including current firms utilizing DR. Our members must become active in DR marketing in order to achieve optimal success. The afternoon session began with Dr. Cory Butler, VDA Communication Committee Chairman, presenting plans for a VDA on-line web site. This site will be operational early in 1997. Virginia Dental Service Corporation, the VDA's new for profit arm, presented plans for the future for-profit activities. Dr. Ken Copeland, VDSC Chairman, and Dr. Jeff Levin, VDSC Director, stressed that the VDA will have attractive for-profit programs to mutually benefit our members and our association. Virginia has been selected by the ADA to participate in the ADA Field Service Program to increase member ship. Dr. Russ Mosher, Chairman of the VDA New Dentist Committee, outlined activities for membership recruitment in 1997. Each VDA component society will be involved.

John Swan of Benefits Administration discusses

Virginia DR efforts with program participants.

lobbyist, and Lisa Finnerty, VDA Public Affairs Coordina tor. The Hygiene Task Force is recommending a $225,000 budget supplement to support accredited hygiene programs in the Community College System. In cooperation with the Virginians for Patient Choice Alli ance, the VDA is supporting patients' rights to a point of service (freedom of choice) insurance option. The VDA will oppose any effort by the Virginia Dental Hygienists Association to have hygienists administer local anesthesia. On Sunday, November 3, the conference concluded with VDA Committee Meetings and an Executive Council Meeting. Dr. Les Webb Editor

Legislative efforts by the VDA in the 1997 General Assembly were discussed by Chuck Duvall, VDA

Virginia Dental Journal 17

EXECUTIVE COUNCIL ACTIONS IN BRIEF November 3, 1996

9. Approved a recommendation that the Virginia Dental Association arrange for the design and production of a pin to be presented to individuals involved in VDA leadership at the Committee Chairman level and above.

Approved a recommendation that the VDA terminate conditional approval of DENTRIX, due to failure to approve contract.

Approved a recommendation that the VDA establish Beta sites with DOlCO, Inc.

Approved a recommendation that $500 be allocated for an annual budget for the VDA Fellows.

11.

Approved a recommendation that the Membership Committee examine the Minnesota Dental Association Student Member Plan for possible implementation in Virginia.

Approved a recommendation to establish a position in 1997 in the VDA Central Office that is an assistant's position to a number of operations with funding from the VDSC and Direct Reimbursement.

12.

Approved a recommendation that Dr. William A. Burston (Component 8) be nominated for honorary membership in the Virginia Dental Association, in recognition for his service to the Northern Virginia Dental Clinic.

Approved a recommendation that Dr Leslie S. Webb, Jr. be elected as Editor of the VDA Journal.

Approved a recommendation that the VDA create an expanded directory of volunteer services throughout the state for special needs patients with information to be collected at the local component level.

13.

Dejeated a recommendation that the Executive Council members should serve on only Standing Committees mandating their services and that this Policy be followed.

Withdrew a recommendation that the Executive Committee have our lobbyist meet with the Legislative Committee to investigate problems with lack of reim足 bursement to the dentist for Medicaid patients.

14.

DeJeated a recommendation that the 1989 Policy dealing with the appointment of Executive Council members to committees be rescinded.

15. 7.

A-pprQ'Le_d the VOA Peer Review Manual.

Iableo a recommendation that since the original intent of

ApprQ'Led a recommendation that all Executive Council members on Standing Committees remain on the Committee and the new members that were appointed remain on the committee until the issue is brought before the House of Delegates.

an original dues increase was for continuing education only that the funding for continuing education be restored.

Dr. Wayne Mostiler, Dr. Mike Miller, Lisa Finnerty, Dr. H.J. Barrett and VDA lobbyist, Chuck Duvall.

Virginia Dental Journal 19

REPORT ON THE 1996 ADA HOUSE OF DELEGATES

More than 50, 000 attendees consisting of

Wallace L. Huff, Chairman, Virginia Delegation

dentists, team members and guests from around the world were present at the 1996 ADA/FDI World Dental Congress in Orlando, Florida. This was the first joint meeting of the ADA/FDI World Dental Congress in eight years.

Resolution 127H - urges the Board of Directors of the ADREC (American Dental Real Estate Corporation and the ADA Board of Trustees to continue holding the ADA Washington office building and to retire the debt from reserves or any operation surpluses within five years.

The highlight of this, the 137 th Annual Session, was the election of our own Dave Whiston as ADA President Elect. Dave has just completed his 4 year term as our 16 th District trustee; I am sure that the same strong leadership, knowledge of the issues, and tough decision making that he brought to the ADA Board as Trustee will continue in his new elected position.

Resolution 74H - urges the Association to pursue legisla tion/regulations assuring the patients right to know the basis on which benefits are calculated in both insured and self-funded plans.

Elected unanimously were Dr. Anthony L. Dimango of Brooklyn, NY as first Vice-President and Dr. Zack D. Studstill of Montgomery, Alabama as second Vice President. Reelected unanimously to a second term as speaker of the AD~ House of Delegates was Dr. James 1. Fanno from Canton, Ohio. Dr. Gregory Chadwick from Charlotte, NC is the new trustee of the 16th Dis trict. Dr. Gary Rainwater was installed as the 133 President of the ADA for 1996-97. The House considered more than 160 resolutions, and an unprecedented 25 reports from the Board of Trust ees, 15 supplemental agency reports, three special committee reports and four resolutions carried over from 1995. Listed below are some of the key resolu tions passed by the House.

Resolution 12H - approves guidelines on coordination of benefits for patients with coverage under two or more group dental plans. Resolution 36H - directs the Association to seek federal and encourage state legislation opposing contract lan guage restricting providers from discussing treatment options and other plan requirements. Resolution 37H - directs the ADA to seek federal and encourage state legislation declaring that plans cannot refuse to contract with or compensate providers who discuss plan terms and requirements with patients. Resolution 38H - directs the ADA to seek federal and encourage state legislation requiring full disclosure of financial incentives and other health plan information.

Resolution 47H - approves a three-year national marketing campaign to promote direct reimbursement, funded at 2.5 million annually.

I thank all the members of the Virginia Delegation for their conscientious and tireless efforts from the pre-convention caucus in Asheville, NC to the convention caucus, refer ence committee hearings, and House of Delegate session in Orlando, Florida. Everyone did a superb job and they are to be commended for their superb effort.

Resolution 128H - authorizes the Association to seek proposals for a media campaign to increase demand for dental services.

A special thank you goes to:

Resolution 67H - (unanimously adopted) - extends the reduced dues program for recent dental school gradu ates from two to three years. Right now, new dentists begin paying full dues in their third year out of dental school. This new resolution delays full dues payment until the fourth year after graduation and becomes effective January 1, 1998. Resolution 45H - approved a revised policy statement on dental auxiliary personnel. In these provisions, it opposes unsupervised dental auxiliary practice.

20 Virginia Dental Journal

Joan Gillespie, who chaired the Reference Committee of Communications, and did a superb job in delivering her report to the ADA House of Delegates. Dick Wilson, who has chaired the Council of Dental Education for the past two years. Dick's integrity matches his dedication- giving of himself both in the amount and quality of work for the association. Les Webb, who served as chairman of the Sixteenth District Caucus. What an outstanding job! With more than 160 resolutions to consider, l.es's leadership was invaluable.

Drs. Cuttino, Wilson, Hutchison, Allison and Mr. Bill Zepp for their leadership in carrying out the activities connected with Dave Whiston's campaign for ADA President-Elect. Fred Carr, who is retiring as the editor of the VDA Journal, for his editorials of the Whiston campaign and election and for his tireless effort in taking pictures of the delegation during the house sessions. Thanks for a job well done. Bill Zepp, our Executive Director, for his untiring effort in keeping Dave Whiston on schedule. Last, but not least, to all the Delegates/Alternate-Delegates, members of the 16th District delegation, spouses and others who put in a tremendous amount of time and worked very hard to see the hospitality suite and all areas of the campaign ran well. Thanks for a job well done.

We were sorry that Chris Hamlin was not able to be with the Delegation in Orlando due to an illness in her family. Four members of the Virginia Delegation serve on ADA Councils and Committees. They are:

Dick Wilson - Council on Dental Education Les Webb - Council on Dental Benefits Programs Joan Gillespie - Council on Ethics, Bylaws and Judicial Affairs. Anne Adams - Council on Membership.

- ---

-._

L..

Dr. Wally Huff is Chairman of the Virginia Delegation to the ADA House and the VDA President Elect.

PPC Brokers is proud to announce the availability of practices in the following areas:

• • • • •

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PPC Brokers Specializing in Appraisals, Sales, Mergers, Associateships, and Equity Plans. For Irifor-rnat.ion., call Dr. Douglas S. Johnson Office (800) 222-0455 • Fax (813) 791-8628

Virginia Dental Journal 21

WE'RE ON YlHiR

VD,L\S

SCIENCE TALEf\IT AWARDS

PROGRAM GOES REGIONAL

You re working hard today to Improve your total health and w"ll· being. Oral Health America IS working hard. too Were work:rl(] 10 build coalitions to support caUSe,s Important to you and your oral health as a major portal to tala' health

by Dr. Timothy E. Russell, III A graduate of MCV, Dr Timothy E. Russell, III IS a general dentist practicing in Alexandna. He IS a Fellow of/he Academy of General Dentistry and IS a member of both the /smericon Academy of Oral Medicine and the American Academy of Implant Dentistry Dr Russell has served 017 the Peer Review Committee for his component society, and has been extremely active with the youth science fair program both on the local and state lever

Some of these causes Include initiatives to reduce the inCidence of baby bottle tooth decay. programs aimed at mcreasmo the use 01 dental sealants III children. educational campaigns oesrqneo 10 teach children and youth II,al SPit tobacco IS not a safe alternative to smoking, and planning health promotion and education proq-a-ns aimed al high risk population" anc the older adult

The VDA"s Science Talent Awards Programs (VSTAP) is expanding its participation in high school science competitions to include fifteen regional science and engineering fairs to be held this spring across the state. Regional representation by the VDA will complement its participation in the annual Virginia State Science & Engineering Fair held in April. Each year thousands of our state's talented high school students compete in local, regional, state and national competitions. The best of these students vie with their counterparts from allover the world in the International Science & Engineering Fair (ISEF). Hundreds of professional science and engineering organizations gain the attention of these young, science-oriented students through their participation in multi-level competition judging and awards program. Organizational awards include cash, equip ment, jobs, trips and scholarships. Consequently, these organi zations assume a high profile to potential professional candidates at a time when college, academic major and career decisions are being made. Until now organized dentistry has not seized upon this golden opportunity to attract highly qualified students. For the second year VDA"s program will seek to recognize the I research accomplishments of our state's science talented youth and promote their interest in dentistry I I and dental research as careers.

We can't do it alone. We need your help. Please send a tax deductible contribution today to Ilelp us continue to work for you

Oral Heallh America-America's Fund for Dental Health-is a national, independent, 501(c)(3), non prottt tounceuon mcorporateo ill 1955, and is recognized (most recently in August 1995) tor meeting all nine standards of the National Charities Information Bureau, a national watchdog group headquartered in New York City.

AMERICAS FUND FOR

DENTAL~HEALTH

.. _ - - - - - .. _ - - - - - -

1997 VDA Science Talent Awards Competitions

REGION Arlington Alexandria Falls Church Charlottesville

NorthernVirginia

LOCATION

DATE

Wakefield H.S.

Sat. Mar. 8

PiedmontRegional Piedmont C.C.

Fairfax (4) Fairfax County

Fairfax H.S.

Tues. Mar 11

Sat Mar. 15

Farmville

Southside Virginia

Harrisonburg

ShenandoahValley James Madison U. Tues. Mar 4

Manassas

Prince William

C.D. Hylton H.S.

Sat. Mar. 15

Norfolk

Tidewater

Ocean Lakes H.S

Sat. Mar 15

Roanoke

Western Virginia

VA Western CC.

Sat. April 12

Sterling

Loudoun County

Broad Run H.S

Thurs Mar.20

Sweet Briar

Central Virginia

SweetbriarCollege Sat. Mar. 22

Wise

Southwestern

Clinch Valley CollegeSat April 5

WythevilleBlue Ridge

22 Virginia Dental Journal

For more Information about Oral Health America, call us at (800) 523-3438.

Ii!!

.-------------_.~----~--_

The program (VSTAP) needs dentist-judges to repre sent the VDA at the regional competitions listed below. Volunteers need not have research backgrounds or previous judging experience. All dentists are invited who are Willing to represent their profession, provide a valuable community service and share their expertise with some extraordinary young people.

sun:

LongwoodCollege

New RiverC.C Highlands

Wed. Mar. 12

Sat April 5

97 GENERAL ASSEMBLY OVERVIEW by Charles R. Duvall,Jr. VDA Lobbyist d this article, the 1~97 Session of ~I Assembly will be In full swmq. eduled to convene Wednesday, and will run through Saturday,

s the State Senate remains dead足 u'blicans and 20 Democrats with the tes member Roscoe Reynolds being er 17th to fill the vacancy created by of state Senator Virgil Goode, who has () Congress. There were two special rthern Virginia, one replaced Republi足 ;er, with a Democrat, George Lovelace. ther, a district vacated by the death of gate Bob Harris, will be filled by a lican, Delegate Jack Rust. "']de issue which will receive major focus :r'hdments to the $34 billion dollar biennial anticipated that a surplus of approxi足 5 million will be available for lawmakers to 'rexisting programs such as education and form as well as to find some funds to take

from both the dental and hygiene communities, as well as private citizens. The study concluded that there is shortage of dental hygienists, particularly in medically under served areas of the Commonwealth, specifically in the upper valley, Piedmont and Southside. The study recommended several courses of action to try to alleviate this short足 age, including: -Improve job search networks. -Provide educational opportunities where the need is greatest. -Explore options to attract non-working hygienists back to the field. -Provide incentives to hygienists to work in under served areas. -Improve access to the program. -Expand existing programs to non-traditional students.

e. n reform will also receive much attention at

elevel as it has at the federal level.

e and referendum, which died in the State e on a tie vote in 1996, will once again receive 'on during the 1997 Session. ific issues of direct importance to the members e Virginia Dental Association are highlighted

e 1996 Session of the Virginia General Assembly Pproved House Joint Resolution 81 to study the :availability of dental hygienists in the Commonwealth . .;That subcornnuttee, Chaired by Delegate John J. )?(Butch) Davies, III, of Culpeper, was composed of ~ members of the House and Senate, representatives

The proposals outlined will all be implemented by either the private sector (i.e., cooperative efforts between dentists and dental hygienists) or the public sector through increased educational opportunities. The Community College System is in a position to address shortages in the under served areas very quickly. With the use of their distance education program, which includes compressed video, courses by computer, multimedia self-contained courses, they can provide increased dental hygiene training to under served areas and to non-traditional students, who may at present, have full time working jobs and thus cannot afford to move out of their existing locations. Continued on Page 25

Virginia Dental Journal 23

Aftco® Associates

PRACTICE TRANSITION /MANAGEMENT CONSULTANTS

Established 1968

Five or Three, But Not Four

practice is a business. This is becoming more apparent to dentists every day. A practice is made up of an office, a doctor, a staff and patients. A practice brings in income, pays expenses and (hopefully) makes a profit. Income must exceed expenses in order to make a profit. Overhead expenses for the average den tal practice will run about sixty percent of gross income. That leaves forty per cent to be paid to the doctor for provid ing dental services. This is the 60/40 overhead rule, and it applies to most practices. For most practices, this. forty percent of gross in When come represents doc tor compensation, not they are "profit."

money gets set aside for the children's education, the home mortgage gets paid off, etc This is when most doctors de cide to cut their workdays back to four days a week instead of five. Working four days a week sounds great. However, that causes problems, not so lutions. Think about it. The rent, utili ties, telephone, staff salaries, payroll taxes, etc. are all five-day expenses. These expenses don't drop or become less if the doctor works four days a week. If the first three days of income pays the overhead expenses, then the

doctors cut back to cutting out a doctor

There is something you can do about it, however, and you need to do it before you lose too many patients (because of iess accessibility) and too much money from paying five days of overhead out of the income from a four-day work week. It will require some changes in your lifestyle, but we have found that dentists can get used to anything Are you ready for the answer?

\Ve want you tocommit to 111iJking more money than you are currently makmg and we want you to do it by working three days J week instead OffOUL That's right, we want you towork three days a week if four days a week,

your practice can support this pro compensation day ...

gram.

or fifty percent of the doctor's net compensation.

During their early years in practice, most dentists will work five days a week in order to build a practice. There is over head five days a week, and the doctor works five days a week. Thus, a balance is maintained between overhead and workdays. Now, let's go back to the 60/40 over head rule. If office overhead averages 60% using a five-day work week, then the income from the first three days pays the overhead expenses of the prac tice, and the income from the last two days represents doctor compensation. That's how it works for most practices where the doctor works five days a week. As the years go by, the doctor's income needs tend to lessen, and quality of life considerations come into play. Educa tion and equipment loans are paid,

last two days provides the doctor com pensation. When doctors cut back to four days a week, they are not cutting out an overhead day ... they are cutting out a doctor compensation day. Thus, one of two net income days is cut out, or fifty percent of the doctor's net compen sation. It does not make sense to cut personal income by fifty percent, but doctors do this all the time. Every doctor has five days a week of overhead expenses. Working five days a week is fine, but unnecessary. If you are working four days a week, then you are losing a lot of money, but perhaps your income needs are less than they once were and you haven't noticed it. Regardless, it is cost ing you a lot of money.

AFTCO will need to evaluate your facility, staff and patient base. If your practice has what it takes for this pro gram, then all we will need is a commit ment from you to be willing to work less time in the practice... and make more money than you are making now' Oh yes, one other thing, you will have twenty six weeks of vacation time every year for the remaining years you wish to practice and stili make more money than you are now making. AFTCO d eveloped this three-day pro gram for dentists who have decided that they are ready to work less time in the office and still make more money. This is for dentists who feel that there should be a pa yoff for all those years uf hard work and sacrifice. If vou are a dentist who thinks it is time to improve your "Quality of Life," call us today!

\For more information, call AFTCO Associates todayll

1 (800) 232-382&

i I I

____I

OVERVIEW, cont.

1997 Actions: The Community College System will be asking for a small appropriation to initiate this program during the 1997 Session of the Virginia General Assembly. It should be underscored that all programs that they will be initiating are accredited programs. All must receive appropriate accreditation and recognition from national accreditation sources. Members of the Virginia Dental Association have been contacting members of the Legislature to encourage their support for these amendments. If you have not made legislative contacts to this point in time, we would encourage you to contact your local member of the House of Delegates or State Senate. If you desire information with regard to how to contact them, please feel free to call VDA.

Virginians__tor Patient Choice: VDA is an active member of Virginians for Patient Choice. This coalition, as its name indicates, is working very actively in the General Assembly to

make certain that patients do continue to have choice of providers as managed care proliferates. During the 1997 Session of the General Assembly, the coalition is focusing on the point-of-service option within managed care programs. An effort is under足 way to try to set up a structure outside of the General Assembly framework where all of the players (provid足 ers, insurers, business representatives and most importantly, patients) can come together to review point of service options and try to make proposals that can be adopted by either regulatory bodies or the 1998 Session of the Virginia General Assembly. VDA, again, is an active participant in that process. Undoubtedly, other issues than those mentioned here, will receive much attention during the 1997 Session. Regrettably, as we go to press, many of those issues have not surfaced. VDA will continue to make every effort to see that all of its members are provided with up-to-date, accurate information with regard to General Assembly activity. Again, if you have any questions at all with regard to anyon-going General Assembly actions that may impact VDA members across the state, you are encouraged to call the VDA office.

This should bf muzzlfd. Not your practicf. Communication iscritical. Not onlywith patients, but also between organized dentistry and thefederal government Which iswhy ADPAC is soessential. ADPAC andyourstate PAC helpelect candidates who will work to protect the integrity of your practice Candidates who will defend your right and responsibility to tell your patients the whole story about treatment options and their long-term oral health. And who understand thatdentistry is health care thatworks - as iong as patients trust and have confidence in their dentists. Help keep the muzzle off. To learn more about ADPAC contact your state PAC director or call (202) 898-2424.

American Denlol Political Action CommiNee

Prevpntivr care for your practicp. Palo br by the .A.men~aiC Demal Polmca' !",cliar. Commlhee (ADPAC. ConmburI::;ns to ADPf.C areStrlctiy VOiJmary end are rio' deductible for federal Incometaxpu'poses

Virginia Dental Journal 25

This article is being reprinted by request and with the permission of the author. Dr. Munn is a general dentist practicing in Sandston, Virginia. His article first appeared in the Fall-Winter 1996 issue ofthe VAGDEchoes. Dr. Munn currently serves as the membership chairman for the Virginia Chapter of the Academy of General Dentistry.

Flames vs. Darkness "Every quivering tongue of flame Seems to murmur some great name, Seems to say to me, 'Aspire!' But the night wind answers, 'Hallow Are the visions that you follow, Into darkness sinks your fire!" Henry Wadsworth Longfellow "The Wind Over the Chimney" This past legislative session was truly monumental. Battles raged between special interest groups fighting for position on regulating managed care. Some points were won. some points were lost and some points were tabled for study. Many salient points of the Patient Protection Act were passed by overwhelm足 ing margins. This coming legislative session is, in my opinion, the "do or die" defining moment in how managed care will influence the health care profession in Virginia. The Joint Commission on Health Care has been studying the impact of requiring a point of service option on managed care plans. Many states have, in the past few years, passed legislation requiring that patients enrolled In managed care plans have the freedom of choice in choosing health care professionals. In other words, patients can obtain care outside the plan's "network" without encounter足 ing prohibitive cost barriers. The insurance industry knows the trend other states have started and have both barrels aimed at Virginia ready to stop this trend now. Freedom of choice costs them too much. They would have trouble maintaining the fact that they have the highest paid CEO's of any current industry in America. Theywould have trouble maintaining the managed care industry as the fastest growing and most profitable industry in America. Removing freedoms from our patients is essential to their pockets.

Lobbying efforts, as well as special interest dollars, will be fierce

from both sides and we need to make sure our voices are heard

on this issue. Listed below are the members of the Joint

Commission on Health Care.

Senate:

Stanley Walker (D) - Chairman, 100 W Plume St., Suite 750,

Norfolk, VA 2351 0

Kenneth R. Melvin (D) - Vice Chairman, 601 Dinwiddie St.,

Portsmouth, VA 23704

William T Bolling (R) - P.O. Box 112, Mechanicsville,VA 23111

Joseph V Gartland, Jr. (D) - 5813 River Dr., Mason Neck, Va

22079

Benjamin J. Lambert, III (D) - 904 North 1st St., Richmond, VA

23219

Stephen H. Martin (R) - P.O. Box 36147, Richmond, VA 23235

Edward L. Schrock (R) - P.O. Box 62996, Virginia Beach, VA

23466

Jane H. Woods (R) - P.O. Box 1387, Fairfax, VA 22030

House:

Thomas G. Baker, Jr. (R) - P.O. Box 1847, Dublin, VA 24084

David G. Brickley (D) - 4310 Ridgewood Circle Dr., Woodbridge,

VA22192

Julia A. Connally (D) - 3563 N. Abingdon St., Arlington, VA 22207

Jay W DeBoer (D) - 16 E. Tabb St., Petersburg, VA 23803

Alan A. Diamonstein (D) - 11817 Canon Blvd., Suite 400,

Newport News, VA 23606

Franklin P Hail (D) - 2800 Buford Road, Suite 303, Richmond,

VA 23235

George H. Heilig, Jr. (D) - 1501 Bayville St., Norfolk, VA 23503

Harvey B. Morgan (R) - P.O. Box 949, Gloucester, VA 23061

Our only hope is to remain focused and unified in our message.

Contact the above legislators as well as your own representa足

tive. Encourage your patients to voice their opinions. Become

pro-active in this battle. If we continue to fight for patients'

rights, then Dentistry as a whole wins.

by Dr. William B. Munn

GET READY!! Roll-up your sleeves and dig in. Every aspect of our profession must get the word out to every representative, especially to the Joint Commission on Health Care, that patients deserve freedom of choice when choosing health care provid足 ers. The facts back our course. Current research by Millman and Robertson showed that, depending on the structure of the health care plan, patients choice may increase or decrease the cost but only marginally either way. Recent surveys have shown that 94% of the people surveyed say patients should have the option of changing dentists at any time. 86% call the ability to choose any dentist important, or very important when selecting a dental benefit plan. 74% agree that there should be a law requirinq health plans to allow participants to see any dentist they choose. Unfortunately, money can cloud even this overwhelming information.

26 Virginia Dental Journal

Note: Pages 27 and 28 are intended to be copied for distribution to interested patients. Please feel free to run as many copies as you wish.

___ I' ~~ "j\ ,'

~~:~;f:~ ~,

;

~'I,~~' i are they? Make the choice yours! J

,,\\~/

~,__ ~ \ '~"\r ",-"

Virginians for Patient Choice...a coalition for patient care. PO Box 675, RICHMOND, VIRGINIA

our

has a chemically-based depression that was diag - ---- - ---- ---- nosed a vear ago. She ____ ~Cl~g~~~! received so-me therapy then md is on medication that seems to be helping. TO U are seeing the beginning symptoms of a elapse, but your employer changed health care .lans since her diagnosis. The only network ther pists are at least 25 minutes from your home and our daughter's school. In addition to needing to e-buikl trust with a new therapist, travel to ppointrnents will take an additional 40 minutes, iking away valuable time from your other chil ren, your work and your daughter's school.

-pre-teen-

our

23218.

804-648-4442

is diagnosed with a rare cancer --~i~t~~- that is fatal unless it is com ----------- pletel~ rem.aved by surgery. __. . _ - ... __ Your SIster IS referred to her health care plan's general surgeon who tells her that it is unlikely that all of the tumor can be totally removed because of its location. After doing research, you discover that a new surgical technique has been developed that greatly increases the chance of removing all of the tumor. Unfortunately, your sister's health care plan will not cover the specialist surgeon who can perform that operation.

our

needs home health ser vices because he has a -----.---------- chronic health condition. -~M~ There is a home health care agency in your community that specializes in pediatric patients, with specially-trained staff and equipment and supplies designed for pedi atric patients. Unfortunately, your health care plan will not cover that home health care agency.

- preschoof _.

.__

These are real life examples of the impact that changes in health care delivery and payment sys tems have on patients. You, someone in your fam ily, or one of your friends or neighbors probably have had similar experiences. What can you do?

""'-

-" ~~.~-------,,-~~-~-~~'" ---=-::.:.:"- -

I:J_ ::ft~1~~: oin the

of supporters of Virginians for Patient Choice, a coalition of orga nizations, businesses and individ uals who believe health care plans should allow patients to choose their own health care providers. Vuginians for Patient Choice is working with members of the Virginia General Assembly to let them know how important patient choice of provider is to ensuring effective, quality health care.

--------------ftEASONS.io.suPPORT------------- -------'iIRGINIA- P·ATIENT ·CHOICE rE-G-ISLATIO-ti ------ Patient choice of provider brings health care delivery and payment systems into balance. In the past, health care delivery systems paid insuffi cient attention to costs. With the increase in managed care, cost is the overriding consideration. Patient choice of provider brings the system into a balance of cost and quality through a free market solution. The ultimate free market protection for health care consumers is to ensure they have a choice of health care providers.

- " ~~-=~-

money isn't everything. In fact, without your health, money is virtually meaningless. Point-of-service laws and other laws that allow patients to choose their health care provider do not impact costs significantly. Depending on the benefits structure, a point-of-service requirement may increase costs slightly or decrease costs slightly, according to a Millman and Robertson actuarially-based study. The number of patients who choose out of network coverage is very predictable. Some studies suggest that out of network usage is low est in plans with high levels of consumer satisfaction; those patients rarely feel a need to use a non-network provider. In plans with a low consumer satisfaction, the point-of-service option gives patients the ability to use a provider with whom they will be satisfied. Many HMOs now offer a point-of-service feature, still control costs and maintain competitive premiums.

These Health Care Providers

Are There for You...

Contact your state senator and delegate now to let them know you want to be able to choose your own health care providers. When you write or talk to your legislators, use personal examples. Virtually everyone knows someone who has had a problem getting access to the health care provider who can best meet their needs. Examples let legislators know just how critical this protection is to patients.

T------------------- , n : : _ ::fj;!t~li~~f!~: Giving patients a reasonable choice of provider does not gut managed care-it improves it. Patients realize that

Add my name to the list of people who support patient choice of health care providers:

I I I I

Vrrginians for Patient Choice PO Box 675, Richmond, Virginia 23218.

For more information call: 804-648-4442.

N,."

•

Street

City

Occupation

Yes, I contacted Delegate/Senator

State

Zip

Patient choice of provider laws are pro-patient, pro-business, and pro-competition. They are supported by the majority of patients and small businesses in Virginia.

I I

~----_-------- -I

••

IS THERE A NEED FOR MORE

HYGIENISTS IN VIRGINIA?

For the majority ofdentists in Virginia this question is answered immcdiatelv and tirmlv with a rcsoundinv "Absol utcly." If you w~re a hygieni:t you might hedge a lit~~ and say, "I don't think there is clear answer." Legislators would form a committee to study it. They did. Through the efforts ofthe Legislative Committee of the Virginia Dental Association (VDA) a proposal was made and passed through legislative process to study the shortage of hygienists throughout the Conl1~on wealth. The proposal read as follows: The 1996 Session of the General Assembly approved House .loint Resolution 81 to study the availabilty of dental hygienists in the Commonwealth. The study committee IS charged with: 1. Determining the availability ofdental hygienists throughout the Commonwealth; 2. Reviewing the Commission on Dental Accreditation standards applicable to alternative accredited educational programs in dental hygiene which parallel existing dental hygiene programs in the Common wealth' 3. Det~lmining the possibility ofexisting funding and approved programs to make available additional accredited educational opportuni ties for those who desire to become dental hygienists; and 4. Considering ways, incentives, and programs which will encourage and make available additional dental hygienists in rural and under served areas. Assignments to a .loint Committee of both House and Senate were made by the Speaker of the House of Delegates. Those who served were: The Honorable .lohn.l. Davies, Ill, Patron The Honorable Warren E. Barry The Honorable William S. Moore, .lr. The Honorable W. Henry Maxwell The Honorable Whittington W. Clement The Honorable Edward L. Schrock The Honorable .lulia C. Connally Dr. .loy S. Graham Margaret Lappan Green Dr. William.!. Vigilone Anne B. Hutcherson Dr. Mark Crabtree I Iistorically this issue has been defeated lJ1 the legislature due to the lobbying efforts of the Virginia Dental Hygienists' Association (VDHA). There were whispers nearly ten years ago about "prcceprorship" program, that might help Virginia gain numbers ofhygienlsls in a short period oftime. Thc whispers went nowhere. Dentists and hygienists alike didn: appro\'e of the concept. The VDA did a survey of the numbers In 19S8 and it was deemed unacceptable because it \vas considered to be sclf-scrvmu therefore not a \ alid survey for the legislators. The \'DA then spent S2~.819 in 19S9 for the veu Program Administrators to conduct an independent survey

(an update)

by William J. Viglione, D.D.S., F.A.C.D,

of dentists and hygienists on the subject of dental hygienist shortage. The report presented in 1990 stated: The results of the survey revealed that currently (1990) there are 1,713 hygienists residing and licensed in the Commonwealth. Of this number 20.4'~;) (350) are not working and most were not eager to return to ' clinical practice. According to the survey, the reported current unrnct need for hygienists is 490. Even if all non-practicing hygienists could be persuaded to return to clinical practice. a highly unlikely occurrence. there would still be considerable urunet need. The need for hygienists was amplified for the future as the dentists' responses projected a need for an additional 930 hygienists one year in the future. The results of this survey Jed to approval offunding for a Dental Hygiene Program at Lord Fairfax Community College in the Winchester area. The program was denied funding through Governor Wilder's cut back programs. It still has not been funded. With the history behind us, the VDA pursued the route described earlier. We would encourage the legislators to evaluate the shortage. During the first meeting, the committee members were presented with multiple written reports and listened to testimony from the VDA, VDHA, MCV (VCU), ODU and the community college systems that currently have two-year programs for hygienists. It was decided the second meetings of the committee were to be held in four different sites around the state. The chairman wanted to gct a feel for this problem from the dentists and hygienists. These meetings were to be the deciding influence on the members of the committee. On a week night after work hours in their areas of the state: (Tidewa ter. Danville, Harrisonburg, and Northern Virginia), the dentists of this state poured into meeting rooms, In two areas there was standing room only and many dentists had their say. Hygienists were present as well, though not quite in the same quantity. They also spoke their views, Assistants spoke stating they would love to become hygienists, but the education was not accessible to working people without nearby facilities. DiSCUSSIOn continued for hours. The conclusion: There is an uneven distribution of dental hygienists in Virginia. The rural areas are in more critical need than metropolitan areas, and there are a few spots of saturation of hygienists in areas where there are schools. The demand for denta I hygiene education is strong. At the final meeting of the committee. we heard hom Dr. Richard Wilson representing the ADA. lie spoke of accreditation standards for hygiene education as established by the ADA. It was unanimously decided to provide accredited eiluc.n iona: opportunity where the need IS grcatest and improve access to those programs. The program would

Virginia Dental Journal 29

use telecommunication systems along with available facilities ncar community college systems in the under-served areas like Danville, Shenandoah Valley and Charlottesville. The community college system felt this was a viable opportunity for them and for the students in their

those who sacrificed their time (some traveling two hours one way) to be present for dentistry that night. It is now your job to talk to your local state rcprescntati ve to encourage him or her to approve the committee's report and to make it a funding priority. "Carryon!"

areas.

The Joint Committee encouraged cooperation between the VDA and VDHA to improve job search networks and try to alleviate some of the frustration felt by both dentists and hygienists as they seek to fill or find positions.

Dr. Viglione is a member ofthe VDA Executive Council from Component VII and served as the VDA representative to the Joint Committee to study the availability ofdental hygienists in Virginia.

The findings of this committee will be presented at the next Session of the Legislature and will vic for some funding through the Budget and Finance Committee of the Commonwealth. Some funding may also be available through grant funding sources such as the Virginia Healthcare Foundation. The presence of the VDA at the various state-wide meetings was the push that his Joint Committee needed to believe that we dentists do need more available hygienists. When we, as VDA members, come together as one we are able to achieve objectives. My personal thanks to all

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VIRGINIA

CONGRESSIONAL DELEGATION

"OUSE OF REPRESENTATIVES i:IIERBERT H. BATEMAN (R)

'ffiee: 2350 Rayburn House Office Building

~shington, DC 205] 5

hone: (202) 225-426]

:AX: (202) 225-4382

'OWEN B. PICKETT (D)

fffiee: 2430 Rayburn House Office Building

. ashington, DC 205] 5

bone: (202) 225-4215

:AX: (202) 225-42] 8

_mail:opickett@hr.house.gov

. ROBERT C. SCOTT (D)

raffiee: 2464 Rayburn House Office Building

iWashington, DC 205] 5

. hone: (202) 225-835]

i\X: (202) 225-8354

iit. NORMAN SISISKY (D)

;Office: 2371 Rayburn House Office Building

Washington, DC 205]5

',Phone: (202) 225-6365

, FAX: (202) 226-1170

'.5. VIRGIL H. GOODE, JR. (D)

Office: ] 520 Longworth House Office Building

Washington, DC 20515

Phone: (202) 225-4711

FAX: (202) 225-5681

6. ROBERT W. GOODLATTE (R)

Office: 123 Cannon House Office Building

Washington, DC 205]5

Phone (202) 225-5431

FAX: (202) 225-968]

E-mail: talk2bob@hr.house.gov

7. THOMAS J. BULEY, JR. (R)

Office: 2409 Rayburn House Office Building

Washington, DC 205]5

Phone: (202) 225-28]5

8. JAMES P. MORAN, JR. (D)

Office: ] 2] 4 Longworth House Office Building

Washington, DC 20515

Phone: (202) 225-4376

FAX: (202) 225-0017

E-mail: repmoran@hr.house.gov

9. RICK BOUCHER (D)

Office: 2329 Rayburn House Office Building

Washington, DC 205] 5

Phone: (202) 225-386]

FAX: (202) 225-0442

E-mail:ninthnet@hr.house.gov

]0. FRANK R. WOLF (R)

Office: 24] Cannon House Office Building

Washington, DC 205] 5

Phone: (202) 225-5136

FAX: (202) 225-0437

I]. THOMAS M. DAVIS, III (R)

Office: 224 Cannon House Office Building

Washington, DC 205] 5

Phone: (202) 225-] 492

FAX: (202) 225-3701

E-mail:tomdavis@hr.house.gov

SENATE JOHN W. WARNER (R)

Address: 225 Russell Senate Office Building

Washington, DC 205] 0-4601

Phone: (202) 224-2023

FAX: (202) 224-6295

E-mail: senator@warner.senate.gov

CHARLES S. ROBB (D)

Address: ] 54 Russell Senate Office Building

Washington, DC 20510-4603

Phone: (202)224-4024

FAX: (202) 224-8689

E-Mail: senator@robb.senate.gov

* Not all have e-mail addresses. PLEASE NOTE: Page ] 33 of the 1996-1997 Membership Directory and Resource Guide has the listing of the Virginia Delega足 tion. The representative from the 5th District was left blank due to the pending election of November 5. 1996. The individual elected to the 5th district is Virgil H. Goode. Jr. (D). Congressman Goode was formerly a Virginia State Senator. In addition. office addresses have changed for Congress足 men Scott. Bliley, Moran (not Morgan). Boucher and Davis.

Virginia Dental Journal 31

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VDA NEWS

AMY FULTON - NEW VDA

MEMBERSHIP COORDINATOR

"y Fulton joined the VDA

staff on December 9th as

~rnbership Coordinator. Amy is a 1993 graduate of the

~ilege of Charleston, with a degree in Sociology.

the past three years, Amy worked for Ski Industries erica based in Maclean, Virginia. She began as an rninistrative Assistant and later assumed the duties of embership Coordinator and Trade Show Assistant. In "ddition to membership responsibilities with VDA, Amy will "ssist in meeting planning and will be responsible for the . nual Meeting trade show. Amy Fulton at work in the VDA office. my's family resides in Northern Virginia and she is ~ngaged to be married to John Snearer this summer.

1996 AMERICAN COLLEGE

OF DENTISTS INDUCTEES

VIRGINIA CHAPTER

-+足 1996 INTERNATIONAL COLLEGE OF DENTISTS INDUCTEES VIRGINIA CHAPTER The following Virginia dentists were inducted into the International College of Dentists on Friday, September 27, during the 1996 ADA Annual Session in Orlando, Florida: Or. Gary R. Arbuckle, Arlington Dr. William J. Bennett, Williamsburg Or. Michael A. Fabio, Springfield Dr. Rodney J. Klima, Burke Or. Jeffrey Levin, Richmond Or. Patricia L. Speer, Chesapeake Dr. John W. Willhide, Fredericksburg Or. Andrew J. Zimmer, Norfolk

Back row (I-r): Drs. M. Alan Bagden, Springfield; Kirk M. Norbo, Falls Church; John C. Doswell, II, Richmond; A. Wright Pond. Colonial Heights; David J. Cantor, Fairfax; Bruce R. DeGinder, Williamsburg. Front row (I-r): Drs. James C. Gordon, Jr., Winchester; Nora M. French, Sterling; Bruce R. Hutchison, Centreville; John A. Svirsky, Richmond: Thomas W. Peterson, Norfolk.

Virginia Dental Journal 33

ALLIANCE OF THE VDA NEWS JOCELYN LANCE TO SERVE AS

LEGISLATIVE COMMITTEE CHAIR OF

NATIONAL DENTAL ALLIANCE

Jocelyn Lance of Richmond was installed to serve a third term as Legislative Committee Chair of the Alliance of the American Dental Association during the organization's recent convention in Orlando, Florida. A past president of the Alliance of the Virginia Dental Association, Mrs. Lance has held numerous elective and appointed leadership positions in local, state and national dental alliances. She currently works as Committee Clerk for the Senate of Virginia when in Session. She is a member of the Woman's Club of Richmond and Chapter XXIII of the Colonial Dames of America. Jocelyn is married to Dr. James Lance, an endodontist in Richmond. They are-the parents of three children, Brian, Stephanie and Christopher, as well as grandparents of Christian and Max.

Jocelyn Lance, Jennifer Hudgins, Allene Rice, President of the VDAA and Lisa Finnerty. VDA Public Affairs Coordinator, plan visit to General Assembly.

LOCAL COMMUI\IITY VOLUNTEER INSTALLED AS DISTRICT 2 TRUSTEE OF NATIONAL DENTAL ALLIANCE Sandy Parks of Newport News was installed as District 2 Trustee of the Alliance of the American Dental Association during the organization's recent convention in Orlando, Florida. District 2 includes Delaware, Maryland, Pennsyl足 vania, Virginia, West Virginia and the District of Columbia. Mrs. Parks is a past president of the Alliance of the Virginia Dental Association. She has held numerous elective and appointed leadership positions in local, state and national dental alliances. She currently participates in the Junior League of Hampton Roads, Hampton Roads Academy Parents' Association and the Christopher Newport University Sailing Foundation.

1 8 7 \)

Sandy is married to Dr. William Parks, an orthodontist with offices in Newport News, Williamsburg and Smithfield. They are the parents of Allison, Meredith and Will. The Alliance of the American Dental Association (AADA), a national organization for spouses of dentists, promotes dental health through community involvement and legisla足 tive activities.

34 Virginia Dental Journal

Dental Careers Foundation "Educating Virginia's Finest Dental Assistants" 1905 Huguenot Road, Suite 200, Richmond, Virginia 23235

Dental Radiation Safety

Comprehensive Dental Assisting Training

(V A Dental X-ray Certification) DCF offers "Denial Radiation Safety" as an individual course, several times per semester. Upon successful completion of this g hour course, a participant is certified to expose and develop radiographs in the State of Virginia. Our course offers training in technique as well as radiation safety and includes: -All Aspects of Radiation Safety -FMX Placement and Film Mounting -Panoramic & Cephalometric Technique -Endo Films and Quick Developing -Use of RINN XCP Holders -Developing Films & Caring for Processor -Quality Control & Trouble Shooting -And Much More! The fee is $99.00. Space is Limited, so call (804) 794-1754 to reserve a seat for your assistant. Our next courses will be taught Fri. Feb 07, Sat. Mar 01, Sat. Mar 29 & Fri. Apr 04.

DCF offers a course in Dental Ass/sung 3 times per year. It will be taught on Saturdays for 12 consecutive weeks in a practicing dental office using state-of-the-art equipment for a true "hands-on" experience. The course includes: -Four Handed Chair-side Assisting -Impressions and Lab Procedures -V A X-ray Certification -Adult & Child CPR Certification -Sterilization and Infection Control -All Textbooks, Notes, Materials & Supplies -Resume' and Employment Interviewing -Use & Care of All Equipment -And Much More! The all inclusive fee is $1,495.00.Space is limited, so call (804) 794-1754 to reserve a seat for your assistant today. Our next classes begin January 4th & April 5th.

(Summer dates avaitable after March) (Ask about "on-site" training and certification.)

DCI' is licensed by the Virginia State Board of Education and by theVirginia Board of Dentistry Department of Radiology.

"Those students enrolled in the Dental Assisting course need not register for this course as it is included.

DCF Registration Form - Spring 1997 Name

Soc. #

Home Phone

,__ .

City ,, White

Sex Male Native American

Work Phone

Address Birth Date Race: Black

State

Female _ _ County or City of Residence Alaskan Native Asian or Pacific Islander

Zip

Hispanic _ _ Other _ _

""DCF maintains and promotes equal educational opportunity without regard to race, color, sex, age, religion, handicap, national origin, sexual preference, or other non merit factor. Information identifying age, sex and race is voluntary and is used for research, reporting and student services. Such information is not used for admission decisions. Please enroll me in the course listed below: Check one please. This form may be duplicated for other assistants or students. Registration is accepted until five days prior to the beginning class date provided that a class is not full. Visa or Mastert.ard #

_ _ _ _ Expiration Date

Print Name of Card Holder Check Here

Course # 100 100 101 101 101

,, Section # 001 002 002 003 004

,_ _ Signature of Card Holder

Course Title Dental Assisting Dental Assisting Radiation Safety Radiation Safety Radiation Safety

Starting Date & Time Sat., January 04, 1997, 8 am Sat., April 05, 1997,8 am Fri" February 07, 1997, 8 am Sat., March 01. 1997,8 am Sal., March 29, 1997,8 am

Cost $1,495.00 $1,495.00 $99.00 $99.00 $99.00

Mail your Registration form and credit card information or check (payable to DCF) to: Dental Careers Foundation, 1905 Huguenot Rd, Suite 200, Richmond, VA 23235. Or FAX our re istration (credit card only) to 804-794-7974, This is a paid advertisement

WHY A DIRECT REIMBURSEMENT PLAN?J

Direct Reimbursement is a simple. cost-effective method for employers to provide dental health care benefits to their employees. Whether the company is large or small, these self-funded dental benefit plans can be designed to employer's specifications. DR plans have been proven to save employers money when compared with traditional dental insurance plans. How Can You Participate In Promoting DR? First, educate yourself about the advantages of Direct Reim bursement. Secondly, talk with your patients about their dental benefits plan. Each clay you are in contact with patients. busi ness organizations, ancl neighbors; among this group of people you probably know at least one business owner or human re source manager for a business. These are the individuals who are making the insurance purchasing decisions for their busi ness or company. '{our role is to help us to identify those deci sion makers whom yOli feel will be open to discussing the ben efits of DR. If you are able to provide a referral or have a contact who would like more information about Direct Reimbursement, please con tact anyone of the individuals listed below:

CDC ORAL HEALTH

DIVISION FORMED

Effective December 1, 1996, the Centers for Disease Control and Prevention's (CDC) Oral Health Program became the Division of Oral Health in the National Center for Chronic Disease Prevention and Health Promotion. The Division will provides leadership in support of dental infection control, community water fluoridation programs, state and local oral health programs, oral health surveil lance, and reduction in the occurrence of oral/pharyngeal cancer. In addition, Division staff works with partners to enhance collaboration and synergy with chronic disease prevention and health promotion programs. Dr. Donald Marianos serves as Division Director. In this capacity he is responsible for developing and implement ing an oral health agenda, and developing linkages with other programs throughout CDC and externally.

VIRGINIA BOARD OF

DENTISTRY

July 1,1996 - June 30,1997

Connie L. Jungmann

Assistant Executive Director

Virginia Dental Association

804-358-492 7

800-552-3886 (toll free in-state)

804-353-7342 FAX

c.P. Coyner, Benefits Consultant Benefits Administration, Inc.

804-320-4500 804-379-3509 FAX Jon L.W. Swan, Benefits Consultant Benefits Administration. Inc.

804-378-6206 804-379-3509 FAX

Benefits Administration, Inc. rEAl; administers Direct Rcnnbursrment Dcnta] Plans and Section 1]5 Cafeteria Plans ill [our states and the District of Columbio IJA! has received the endorsement of the American

Association of Orthodontists 10 market

and administer their Concept DR

dental reimbursement plan.

The I 'irginiu Dental Association endorses B·!! as the sole administrator to market DR plans in Virginia.

36 Virginia Dental Journal

The Virginia Board of Dentistry is appointed by the Governor and is composed of seven dentists, two hygienists and one citizen representative. Contact the Board office or 3 member of the Board on questions on rules and regulations.

French H. Moore, lr., DDS--President

Mark A. Crabtree, DDS--Vice-President

John S, Lyon, DDS--Secretary-Tf'easurer

Nora M. French, DMD

MonroeE.Ha~~Jr.,DDS

Robert J. Isaacson, DDS, MS, PhD

Gary Taylor, DDS

Carolyn B. Hawkins, RDH

Stephanie P. Olenic, RDH

Pat K. Watkins

STAFF

Marcia J. Miller, Executive Director

Pam Horner, Administrative Assistant

Kathy Lackey, Administrative Assistant

Lychla Morris, Office Services Specialist

6606 W. Broad Street, #401

Richmond, VA 23230-1717

(804)662-9906 FAX(804)662-9943

DENTISTS

Step up to a rewarding future in today's Air Force. Discover a challenging future with opportunities for professional growth. Serve your country while you serve your career. The Air Force offers an exciting change of pace for advancing your career with great pay and ben efits, comprehensive medical and dental care and 30 days vacation with pay per year. You'll also discover a challenging environment with continuing opportunities for professional advancement. Find out how to qualify for a career in today's Air Force. Call USAF Health Professions Toll Free

1-800-423-USAF DENTAL HEALTH DIRECTOR DENTIST needed to provide management direction for the Virginia Department of Health 's statewide Dental Pro gram which includes the promotion and initiation of pre ventive programs for all Virginians and primary treatment programs for special populations. Also, provides consul tative and technical support to Local Health Departments regarding operation of dental clinics; develops dental edu cational materials for distribution; develops and manages the Dental Program's budget and supervises three staff. Based in the central office III Richmond. Must be a Vir ginia licensed dentist (or eligible). with DDS orDMD and preferably an MPH in Dental Public Health or Health Administration. Board certification is desirable as well as progressive responsibility for governmental program man agement Salary range: $62.355-97,354. Apply to posi tion #2-+3. Completed Virginia State Application with ref crcnccd position and number must be received bv 5:00pm on 1\1arch 3. 1997 at the Virginia Department of Health, 0111ccof Quality Improvement & Human Resources, P.O. Box 244K, R00I11220, Main Street Station. Richmond. VA 2321 K. Fax copies are accepted for meeting deadline pur poses: f/\X f;04-371-6345. Direct questions to David Armstrong f;04-7S6-49l!3. Minorities. females. and Dis abled arc encouraged to apply. Equal Opportunity-Affir mative Action Employer.

Virginia Dental Journal 37

Dental Hygiene Program announced at

Virginia Western CC and Danville CC

Virginia Western Community College and Danville Com munity College are pleased to announce the initiation of a joint venture dental hygiene program, with enrollment beginning in the Fall 1997 semester. This program is made possible through grant funding from the Virginia Health Care Foundation, and the cooperative interaction of the two colleges, George Washington High School, and contributions from Danville/southside dentists. The objectives of the program are to provide accredited dental hygiene education for Danville/southside residents, and to increase access to preventive oral health care services for medically underserved residents of the region.

video technology. The clinical aspect of the program will be conducted at the GWHS Dental Assisting facility; this site will serve as an extended campus facility of the existing program. This unique type of program delivery permits admitted students to remain in the Danville area while pursuing their chosen career.

The dental hygiene program is a two year, restricted admissions program leading to an Associate of Applied Science Degree in Dental Hygiene. Twelve students will be admitted to the Fall 1997 class. Graduates will be eligible to take the Dental Hygiene National Board Exami nation, regional, and state examinations leading to licen sure as a Reqistered-Dental Hygienist. The program will be an expansion of VWCC's existing accredited program, with lecture courses broadcast to DCC using compressed

Questions regarding the program should be directed to Anne Hutcherson, RDH, MS, Dental Hygiene Program Head, Virginia Western Community College, 540/857 7206.

Individuals interested in applying for Fall 1997 admission should contact Pamela Woody, VWCC Health Technology Information Specialist, 540/857-7307, to obtain application guidelines and materials. Deadline for application is March 15, 1997.

Dentists or dental hygienists interested in contributing equipment, library resources, clinical supplies, or funds for scholarships/program costs are requested to contact Dr. Edward Polhamus, Division Chair, Arts and Sciences, Danville Community College, 804/797-8402.

ADA announces Survey Availability The American Dental Association's Survey Center is pleased to announce the availability of several reports of interest to anyone concerned with the dental profession. The first of these, the 1995 Survey of Dental Fees, continues a long-standing series of House of Delegates mandated reports on fees dentists charge for selected procedures. Since 1976 the Survey Center has produced reports on dental fees charged by general practitioners and specialists. The latest report, which was published at the end of July, includes more information than previous fee reports. In addition to including fees charged by GPs and specialists on a national basis, this publication reports fees for GPs for nine regions as well. The fee tables contain mean and median charges for various procedures as well as the CDT-2 codes for each listed procedure. Also, the complete set of 1995 Survey of Dental Practice reports is now available from the Survey Center. This set of reports offers the most comprehensive overview of the private practice of dentistry available from the ADA. The complete set of four reports includes the following individual titles: Income from the.Private.Practice oLOentjstry, ~ntists_in_Solo~l]dNJ)DSolo ~r.a.ktic~,EmpJQyment of.Dental.Eractice Per.sQnnJtl, and C..b_aracter.istics of D~ntis.ts_i!J Private Practice_and.jheicP_atients. The latest reports in this annual series continue a survey which has been conducted since the 1950s. All of the above reports, and much more, are available by contacting the Survey Center using the ADA's toll free number (extension 2568) or by calling 312-440-2568.

38 Virginia Dental Journal

Exclusively Endorsed By

Virginia Dental Association A dividend is contributed to your dental association for every case of powdered gloves purchased by the members to support dental programs in your association

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Your Orders Can Now Be Placed By: IMG, Inc. 8231 Alpine Avenue Suite 8 Sacramento, CA 95826

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o Payment Enclosed * o VISA 0 MasterCard

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Expiration Date

(Contact Name)

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Signature Today, Date

(Phone #)

* Make checks payable to International Manufacturing Group, Inc.

(Fax #)

The Glove Program A dividend is contributed to your dental association for every case of powdered gloves purchased by your members to support dental programs in your association.

$39.50/per case

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Extra Small Small Medium Large Small $60.00/per case Powder-Free Non-Chlorinated Latex Examination Gloves plus shipping White glove. No chlorine or silicone residue. Reduces skin irritation. Medium Large $60.00/per case Powder-Free Chlorinated Textured Latex Examination Gloves Small plus shipping Yellow glove. With chlorine. Provides better grip. Reduces skin irritation. Medium Large plus shipping

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(Component New~ Component I Tidewater

Dr. Jack Atkins, our peripatetic volunteer, made a cross country bike trip to honor his wife and to benefit ( . local charity Lee's Friends. ,.,

Component I News Happy new year from your col leagues in Hampton Roads. We are beginning the new year with enthusi asm and high ambitions. This year our Children's Dental Health Month program is being directed by Dr. Pam Morgan. Pam has some exciting plans including a kickoff dental health fair at the Portsmouth Children's Museum. There will be special guest appearances by the Tooth Fairy and Mr. Sparkle. Booths featuring information on mouth guards, bicycle safety, baby bottle decay, sealants, nutrition, orthodon tics, and the dangers of smokeless tobacco will be manned by compo nent members. A very busy schedule of continuing education programs will begin on Friday, February 7 at the Norfolk Airport Hilton with Dr. Richard Wilson as guest speaker. Dr. Wilson's topic will be: "Practice Building With Quality Restorative Care, The New and The Traditional." In conjunction with area laboratories we will hold a two day program at the Norfolk Airport Hilton featuring Dr. Frank Speer. On April 24 and 25 a joint program with the Peninsula Dental Society will be held. On Thursday, April 24: Dr. Franklin Weine, "Avoiding Problems in Clinical Endodontics". On Friday, April 25: Dr. Stanley F. Malamed, "Emergency Medicine in Dentistry". For Further information you may contact Mrs. Virginia Donne at (757) 491-4626.

42 Virginia Dental Journal

Dr. George McGuire was recently appointed to the Board of Visitors of the Medical College of Hampton Roads.

We mourn the loss of four of our colleagues: Dr. Milton Clark, Dr. Oscar E. Cordle, II, Dr. Wesley B. Jones and Dr. James Woodson Phillips. Dr. Barry Einhorn Associate Editor

Component II Peninsula

Component II News The members of Component 2 and their families hope that everyone has enjoyed a wonderful 1997 to this point. The year started off quickly in our area with a CE presentation by Malcolm P. McConnell, Ilion risk management on January 13th. This meeting was followed closely by the VDA committee meetings at the Omni Hotel in Richmond. Decisions were made to enhance and cultivate existing efforts such as Direct Reim bursement and membership recruit ment and retention. Prior to the committee meetings a "Legislative Day on the Hill" was offered to all interested members with special guidance and expertise by our lobbyist, Chuck Duvall; we are all thankful for his efforts. There's more to politics than you may expect. Locally, "retired dentist", Madison Price is heading up an ad hoc committee to develop a possible free clinic on the Peninsula in 10\97. While this is a large undertaking, the workload for each volunteer dentist will be less with more participation. The facility, equipment, and materials will be donated by an outside source.

On the membership scene there was an ADA Field Service program on Membership recruitment and retention on the 8th of February; according to Mike Link this program was viewed as a large success and will help our society immensely in the future. Along the same venue we would like to extend a warm welcome to Dr. David Mattney, a general dentist and Dr. Tom Hake, an endodontist to our society; we look forward to working with them both. On March 10th we had another general membership meeting with the topic being "Oral Complications of Cancer Therapy" given by Ron Kersh, M.D., Director of the Williamsburg Cancer Center. Of course don't forget our upcoming joint CE program with the Tidewater Dental Association on April 24 & 25th. On Thursday the 24th we have world recognized speaker Dr. Stanley Malamed on "Emergency Medicine in Dentistry". If you have any interest, suggestions or comments concerning any course or information given in this column, please contact Kim Blore at (757) 259-0594. Additionally, as you may have already seen in the Journal the state is attempting to develop a Virginia Dental Identification Team in case of disaster response; this is a volunteer position; however, you do not have to have any previous background in forensics to become a part of the team; they will provide the training necessary. On behalf of the members of Compo nent 2 have a wonderful Spring. Dr.Cory Butler Associate Editor

••• Winter is upon us, but as you receive the VirgLojaDental Journal and read all the articles inside, Spring is beginning to show herself, at least in some parts of our great Common wealth. Many of us have had snow since before the holidays, others of us have had little if any snow and icy weather, with temperatures barely approaching freezing. Here in Component III, the Southside Dental Society continues on its mission. Our Winter calendar is probably one of our busiest. January 29, we held our annual Fellowship Dinner. This meeting includes our spouses, and we are always looking for a speaker and a topic that is of interest to "our better halves". This year, at the suggestion of some of our spouses, we invited Mrs. Lisa Barzel to speak to us. Lisa is a Licensed Clinical Social Worker practicing in Richmond. She came to us very highly recommended from several sources. Her remarks were entitled "Enhancing Your Marriage Through Communication". She gave us some very simple tips for listening to your spouse ... I mean really listening and understanding what your spouse is asking you and saying to you. I learned that to really listen and be effective at listening to what my wife is saying I cannot be reading the paper, the ADAJ~urnal or thinking about the office. The decks have got to be cleared and the mind opened to just one task, listening. This may mean actually scheduling a set time into the day to talk with and listen to your spouse. I know you think you listen to your spouse, because I thought I did. But try this. Sit down and without your wife knowing, engage in a conversation. When you are asked a question try and repeat it back to your spouse. Then ask if that is what he/she said. Then answer it. You might be surprised at how well

you thought you listen but at how poorly you actually do listen. I realized that no matter how good you think your marriage is, it can be even better. There is still a lot of life left (even being fat and forty something) and we each need to make the most of it. Lisa is a very personable young lady and could be of real assistance if you are not getting everything you want out of your life and marriage. Our annual OSHA Update and CPR Recertification Day was February 7. Dr. John Svirsky came down to be with us to review OSHA's rules and guidelines with us as is required by the OSHA guys. After a cold cut lunch buffet, Mrs. Vivian Biggers, R.N. brought her staff with her to renew our CPR certifications. This is a fun day with casual clothes. It was born out of an idea to speed up dues payments. If the member's dues were paid by January 10, this course was free of charge. Our membership has responded very well to it and the component society is providing a benefit to membership. In addition, the attendees pick up about six hours of CE credit toward the fifteen needed to renew their State License. Sam Galstan is heading up our Dental Health Fair scheduled for February 11. Sam does a great job of lining this up. We usually have the Dental Van from MCV with us, along with displays from our alliance and the Dental Division of the Public Health Department. I am continually amazed at that van. It is a self contained dental office on wheels and is a tremendous goodwill tool that we have available to us. Those of you that have seen it know what I am talking about. If you haven't seen it, do so at your first opportunity. It can be used as a great public relations tool. Dr. Frank Farrington at MCV is the man to call to schedule an appearance by the van in your area and he is always most helpful and happy to assist you in scheduling the Van into your area. By the way, I would like to thank Dr. Farrington for all his help and assis tance to our component. lV1any thanks to Dr. Farrington! Our regular component business meeting is scheduled for March 12. This summer, specifically June 12,

we will hold what is becoming an annual CE meeting. The meeting is scheduled in conjunction with the Pork Festival in Emporia, Virginia . Dr. Baxter Perkinson will speak to us about "Contemporary Cosmetic Restorative Dentistry". We will adjourn the meeting about 3:30 and retire to the Pork Festival for all kinds of pork delicacies and libations. This doubles, better triples, as a great fellowship meeting, a CE meeting and a staff "perk" ...all and all, a very fun and relaxing day out of the office. Dr. John Bass, our resident health and fitness guru, has had another setback. John as you might recall carried the Olympic Torch in its trek to Atlanta. He has run several marathons and rides a bike for miles in races all across the country. Several years ago, John fell and broke his wrist requiring extensive treatment to repair it. He fell again and damaged a hip. Well, recently he fell and broke the other hip, prompting him to comment that he wasn't sure if trying to stay healthy, fit and in shape wasn't in fact bad for his health. John is on the mend and recovering nicely now. However, I am not sure what John's advice to you might be if your inquired about the best way to stay in shape. With the holidays behind us and but a memory, each of us needs to con sider our futures. I urge you to look at your life and make the most of it. The new year in front of us is a blank shape. We get to mold it and make it what we want. The VDA and the ADA are working hard to protect our interests. Get involved with them, take a role. Strive to improve your per sonal relationships. Challenge yourself to be a better dentist and employer. It's a win win situation. However, you are the biggest winner. You achieve the satisfaction of your efforts and we all know how self fulfilling and rewarding a successful case makes us feel. Strive to make today a better day than yesterday and tomorrow better still! Challenging one day at a time will make 1997 your

Virginia Dental Journal 43

best year yet! We, in Southside Virginia, hope that each of you are enjoying a bright, healthy, happy and prosperous 1997. Carpe diem! Dr. H. Reed Boyd, III Associate Editor

Component IV Richmond

Component IV News As Winter continues to make its presence felt here in Central Virginia, Component IV has begun 1997 with lots of excitement and pro,gram activities. Dr. Gordon Christensen presented another great C.E. program, entitled "Dentistry for The 21 st Century," on January 9. Next, Dr. Jane A. Soxman will present a C.E. program on "Practical Pediatrics" on February 14. The Component's January monthly membership meeting featured "our own" Dr. Roger Wood, who spoke on "Pediatric Dental Trauma." Singh Sahni, M.D., a Richmond-area neurosurgeon, will speak at the February monthly membership meeting on "New Trends for Manage ment of Facial Pain Syndrome." Then, March's meeting will address "Esthetic Dentistry," as presented by Dr. Tom Phillips. This year's February Children's Dental Health Month activities, led by The Dental Health, Public Information and Community Involvement Commit tee, so far have included: a dental health fair at the Science Museum of Virginia on February 1; participation in a "Family Health Exposition" at the

44 Virginia Dental Journal

Virginia Center Commons Mall in Henrico County on February 8; presentations at various schools by individual member dentists, their dental hygienists, and other staff members; and ticket sponsorship at a game of the newly-founded, local women's basketball team franchise, The Richmond Rage. Also with regards to The Richmond Rage team, congratulations to Dr. Erika Mason who was selected to be the team's dentist. When recently asked whether she had mouth guards made for the team members, she replied "Of course ... !" Great Job, Way To-Go Erika! During the weekend of October 25 and 26, an ADA Goals & Roles Workshop was facilitated in Rich mond for Component IV by Mr. Ron Polaniecki, CAE., Manager, Dental Society Services of the American Dental Association. In August, a Richmond Dental Society and ADA survey was mailed to the component's membership and the results tabulated. During the October workshop, the component's leadership considered and summarized the "strengths of," "weaknesses of," "opportunities for," and the "threats to" the component. The member-described survey issues regarding topics such as legislation, education, membership and public dental awareness, non-dues rev enues, community service, and membership retention and recruitment were discussed and strategies for implementations were formulated. Ongoing and future actions and/or outcomes will now require individual membership comments, support and positive actions. The Component wishes to extend many thanks to those members who helped with this study, the planning session, and the ongoing enactments. With best wishes for a safe remaining winter season, free of traffic acci dents and skiing injuries, as many members in the Component hope that Spring is right around the corner' Dr. Charles E. Gaskins III Associate Editor

Component V Piedmont

As was noted in the last '1irglDla DentalJQJJLrwl, Dr. Fred Carr of Richmond was stepping down as the editor of our Journal. Dr. Carr provided wonderful leadership, portrayed excellent editorial skills while producing a new more reader friendly and informative journal format. His hard work and dedication was appreciated and will be missed. Thanks Dr. Carr! Dr. Jim Evans, of Danville, took over the office of President from Dr. Rick Huffman, of Roanoke, at our fall meeting in Roanoke. The meeting was a success with 236 individuals in attendance. Please mark your calendars for our spring meeting which will be held in Danville at the QANVILLE GOLF CLUB. The date will be FRIDAY, APRIL 25TH. Staff is encouraged to attend and 7 hours of continuing education is available. Dr. G.T. Phillips from Fredericksburg will be our speaker and his topics will be "Beyond the Basics: Esthetic, Clinical and Politically Correct Dentistry". The morning session will be geared towards the entire dental team with the afternoon session aimed towards the dental staff. There will be a golf tournament in the afternoon for those of us who enjoy chasing the little white pellets. Come prepared for both mental and physical stimulation! Our officers for 1996-1997 year are as follows: President: Dr. Jim Evans, Danville President Elect: Dr. Frank Crist, Lynchburg Secretary/Treasurer: Dr. Greg Gendron, Martinsville Councilor: Dr. Dan Grabeel, Lynchburg Immediate past President: Dr. Rich Huffman, Roanoke Please provide these individuals with your support and ideas so that they can keep our Piedmont Dental Society strong.

If you have any information that you would like in my report, please contact me. My address is: Dr. Ed "Chopper" Snyder 15 Cleveland Avenue, Suite #6 Martinsville, VA 24112 FAX 540/632-9083 email e.snyder(@)kimbanet.com

i Component VI Southwest

Component VI News

We would like to wish everyone a Happy New Year. Our component as well as the VDA had a very success足 ful 1996. We should all strive to make 1997 even better.

We mourn the passing of a fellow Southwest Virginia dentist. Dr. Milton A. Owens of Abingdon, Virginia, passed away Sunday January 5, 1997. Dr, Owens was a graduate of the Medical College of Virginia School of Dentistry. He had lived in Abingdon for the past 40 years.

Looking forward further, the Abingdon Component VII meeting is scheduled for August 15, Shenandoah Valley 1997 with Dr. Harold Crossley speaking on "Therapeutic Drugs in the Dental Office.: This meeting is timed to coincide with the local Highland Crafts Festival which offers unusual shopping and browsing opportunities. The Barter Theatre is Component VII-Shenandoah right across the street from the Martha Washington Inn and makes Welcome from the Valley and Happy for an enjoyable stay. New Year! The last component meeting of the year will be held in Blacksburg, Virginia on the campus of Virginia Tech. The speaker will be Dr. Jeffrey Hutter, speaking on "Fascial Space Infections of Dental Origin and Traumatic Injury Update." All out-of-component members are invited and welcome to attend these meetings Have a great Year! Dr. R. Graham Hoskins Associate Editor

Mark your calendars for April 18 & 19, 1997 for our component leader足 ship conference "SVDA: A Vision For The Future" - Tentative speaker Paul Belvedere (4/18) and half-day leadership conference on April 19, to be had in Charlottesville at the Omni Hotel. For those members who budget their contributions early in the year, please consider Governor's Club, Commonwealth Club or at least VADPAC/ADPAC. Everyone's support is crucial to protect our vital interests. Will close with a short report; all is quiet in the Valley at this time.

Dr.Gerald Brown Associate Editor

Our component has four excellent meetings scheduled for 1997. Our spring meeting will be held at Emory and Henry College in Emory, Virginia, on March 7,1997. The speaker will be Dr. Ben Bissell and the topic will be: Dealing with Difficult People and the Art of Listening." The May meeting is slated for May 16-18, 1997 at Pipestem State Resort Park in Pipestem, Wv. The compo足 nent is pleased to announce the speakers, Dr. Jasper Lewis and Anne Page Griffith, founders of Practicon. They will be speaking on "Secrets to Managing the Accelerated Dental Practice." Plan ahead now for an enjoyable weekend with the annual golf tournament and outdoor barbe足 cue.

Virginia Dental Journal 45

['----_~J

Mev NOTES

Component VIII Northern Virginia

Renovation Of Patient Reception Area Complete Component VIII News As we approach the New Year component eight celebrates the election of Dr. David Whiston as President-Elect of the ADA. Con gratulations Dave! Congratulations to Drs. M. Alan Bagden, David J. Cantor, Nora M. French, Bruce R. Hutchison and Kirk M. Norbo on their induction to the American College of Dentists at the 137th Annual Session of the American Dental Association on September 27, 1991). Drs. Gary Arbuckle, Michael A. Fabio, Rodney J. Klima and John W. Willhide were inducted as Fellows of the International College of Dentists at the 66th Annual Convocation held in Orlando, Florida on September 27, 1996. Congratu lations Fellows! Mark your C.E. calendar for Dr. Tom Orent, "1000 Gems" seminar at the Fairview Marriott in Falls Church on Friday, February 7, 1997. Dr.Bruce W. Jay Associate Editor

46 Virginia Dental Journal

The patient reception and waiting area, located on the second floor between the Woods and Lyons Buildings, reopened on January 6. The space has been redesigned and furnished with new carpeting, chairs, paint, lighting and office equipment. The reception desk has also been redesigned to serve as a reception space as well as an information center. The receptionist will provide patients with information and direc tions to the Schools' eight clinical areas located on the second floor. Within this space is the electronic bulletin board, which provides faculty, staff and students with information on School and University activities. The reception desk has a unique concave circular design, with bullnose molding and a curving counter surface, and is adjacent to the escalators. Several new design features of the reception area include: eight semi-private alcoves for patient counseling and paper work, four private administrative offices, and a patient orientation video room. Patients will be greeted by a receptionist and directed to a staff person, who will then assist them with scheduling appointments and/or handling financial matters. New patients will then be asked to view the School of Dentistry Patient Orientations Video, while patients of record will be asked to take a seat and wait for their student. The waiting area itself has been designed with lavender patterned carpeting with purple borders and off-white diamond shape inlays. It is a very stylish floor covering design, and it extends from the waiting area to the elevators located in the Lyons building. Another improvement is an updated lighting and ceiling design. The lighting has been improved by adding recessed fixtures and the

ceiling has been remodeled with several drop molding shapes match ing the diamond design in the carpet. Thus, the 1960s institutional appearance of the Lyons building has been replaced with an updated modern look and feel. The recep tion/waiting area has also been outfitted with new tables and chairs made of light colored oak and maple. Although it may have "slightly" longer than we had anticipated, the results are marvelous.

Deans Serve Staff A Hearty Breakfast In 1988, Dean Lindsay Hunt began a January Dental School tradition of celebrating the many achievements and efforts put forth by our dedi cated Dental School staff. The event is entitled "Staff Appreciation Day," and culminates with the selection of a staff person(s) as the Staff Mem ber of the Year. This individual(s) is awarded a $100 cash prize, a certificate of appreciation, and his/ her name is inscribed on a plaque with the previous winners. The most interesting aspect of the selection process is that the winner is selected by a non-dental school university administrator based upon nomination forms submitted by faculty, staff and students. This individual, along with the entire dental school staff, is honored at a breakfast at which each dean dons a Chef's Hat and serves the staff a "hot" buffet break fast. The previous winners of the Staff Member of the Year Award are: 1988 Ms. Opel Chandler 1989 Mr. Jim Ostrander Ms. Mary Hawley Mr. Dick Pearson 1990 Ms. Pat Fleming 1991 Ms. Debra Doyle Mr. Steve Gross 1992 Mr. Calvin Howerton 1993 Ms. Joyce Gunter 1994 Ms. Darlene McElderry 1995 Mr. Greg Council 1996 Mrs. Carolyn Snyder I know you will recognize many of

se names, as individuals who have aed positive impact on the School, nd many of you during your dental chool years

Renovated Oral Surgery

Clinic Opens

he Oral Surgery Clinic located on esecond floor of the Lyons Building 'opened on January 11. The clinic as been undergoing renovation ince the early fall and has been 'mpletely remodeled and equipped heclinical facilities have been pdated with Adec chairs, units and hts. It features nine operatories,

o equipped for IV-sedation, and

another equipped for general anaesÂ thesia. An important component of the new design was improving the volume of cubical space in each operatory to Improve teaching and patient comfort. The clinic has also been designed with a one bed recovery room that will also be used for follow-up care and evaluations. Faculty, students and patients will also benefit by having a conference room located within the clinical area to facilitate teaching and/or patient counseling.

Carolyn Snyder was selectedasthe 1996Staff Member of the Year

Workmen complete the installation of thenew patient reception desk.

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