Virginia Dental Journal by Virginia Dental Association

HIGH QUALITY HEALTH BENEFITS ARE HARD •••UNLESS

You

FIND •••

FIND A COMBINATION SUCH

AS THE VDSC INSURANCE SERVICE CENTER

AND TRIGON BLUE CROSS BLUE SHIELD.

The Virginia Dental Association (VDA) and the Virginia Dental Services Corporation (VDSC) are proud to announce a new association sponsored healthcare program through Trigon Blue Cross Blue Shield. This new program is available for all dentists interested in setting up a benefit program for themselves or their practice.

all our toll-free number between 8:30 am VDA's HEALTH INSURANCE PROGRAM INCLUDES: • Choice of Products - Indemnity, PPO, POS, and 5:30 prn, Monday through Friday. HMO, and MSAs. Simply dial 1-800-832-7001 for quick • Trigon's extensive networks of participating and efficient service. It's that easy. The hospitals and doctors. VDSC Insurance Service Center also has • Special Trigon "Value Added" and "Membership" a toll free fax line, 1-800-886-4913. benefits available to you because of your association membership.

CALL TODAY for

information on the wide variety of exciting health products

our association is offering for the upcoming year. Our service and marketing departments will be delighted to answer your questions. Call the VDSC Insurance Service Center at

1-800-832-7001 to find out how our

association is working to assist members in this important area.

VJ ..

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Leslie S. Webb, Jr. Editor 1. Barry I. Einhorn 2. A. J. Booker 3. H. Reed Boyd III

Tanya D. Moore Publications ASSOCIATE EDITORS 4. Harry A. "Jack" Dunlevy 5. Barry K. Cutright 6. Robert G. Schuster

William E. Z Business M 7. Carolyn 8. Melanie ! J ! School of D~~j

January - March 1999

Volume 76

Thomas Burke

Number 1

TABLE OF CONTENTS 4 5 6 10 12 14 17 18 19

23 25 28 31 32 33

35 36

37 38 40 41 41 42 48

Editorial Message From the President Abstracts Great Question- Glad You Asked That... Executive Council Actions in Brief Candidate Information Insurance Update 1998 VDA Leadership Conference Strategic Planning Goals From the Executive Director Report on the ADA House of Delegates Whiston Address Health Practitioners Intervention Program Five Ways You Can Help Lobby the Legislature Medical Malpractice Cap Upcoming Continuing Education Membership Benefit Highlight BUdget Committee Report DR News VDANews Alliance News Assistant News Component News & Specialty News Classified Advertising COVER: James River Rapids; PHOTO CREDIT: Linda Gilliam

PUBLICATION TEMPLATE: C:\Change

THE VIRGINIA DENTAL JOURNAL (ISSN 00496472) is published quarterly (January-March, April-June, July-Se by the Virginia Dental Association, 5006 Monument Avenue, PO Box 6906, Richmond, Virginia 23230-0906, Tele SUBSCRIPTION RATES: Annual: Members, $6.00. Others $12.00 in U.S., $24.00 Outside U.S. Single copy: $

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 COPV, insertion orders, contracts and related information Business Manager, PO Box 6906, Ric

, October-December)

04)358-4927

VA 23230-0906.

VIRGINIA JOURNAL EDITORIAL

BOARD

VDA COMMIITEE CHAIRMEN

Ralph L. Anderson james R. Batten Cramer L. Boswell James H. Butler Gilbert L. Button Charles L. Cuttino 11/ Frank H. Farrington Barry I. Griffin Jeffrey L. Hudgins Wallace L. Huff Lindsay M. Hunt, Jr. Thomas E. Koertge James R. Lance Daniel M. Laskin Travis T. Patterson llJ W. Baxter Perkinson, Jr. Lisa Samaha David Sarrett Harvey A. Schenkein James R. Schroeder Harlan A. Schufeldt john A. Svirsky Ronald L. Tankersley Douglas C. Wendt Roger E. Wood

Annual Meeting

Bruce R. Hutchison

M. Joan Gillespie

Auxiliary Education & Relations T. AndrewThompson

Fellows Selection

Donald L. Martin

Budget & Financial Investments

Raymond L. Meade

History & Necrology

French H. Moore JII

Cancer & Hospital Dental Service

Michael E. Miller

Infection Control & Environmental Safety Paul F. Supan

Caring Dentists

Harry D. Simpson,

Institutional Affairs

Elizabeth A. Bernhard

Jr.

Ethics & Judicial Affairs

Communication & Information Technology Corydon B. Butler, Jr.

Journal Staff

Leslie S. Webb,

Constitution & Bylaws

Wallace L. Huff

Legislative T. Wayne Mostiler

Dental Benefits Programs

Fred A. Coots, Jr.

H. Reed Boyd JII

Dental Continuing Education B. Ellen Bryne

New Dentist

Carolyn C. Herring

Dental Delivery for the Special Needs Patient AI J. Stenger

Nominating

Wallace L. Huff

Dental Health & Public Information

AI J. Rizkalla

Peer Review & Patient Relations Neil J. Small

Dental Practice Regulation

Albert L. Payne

Planning

William H. Allison

Dental Trade & Laboratory Relations

Jeffrey L. Hudgins

Search Committee for VA Board of Dentistry Wallace L. Huff

Direct Reimbursement

David Swett

VADPAC

Rodney J. Klima

Jr.

Membership

FOUNDATIONS Relief Foundation

Scott H. Francis

1999ADADE Delegates:

William H. Allison (199 M. Joan Gillespie (2000 Ronald L. Tankersley ( 1

VDA Foundation

William H. Allison

ON Session, October 9-/3, /999, Honolulu, HI David C. Anderson (2001) Wallace L. Huff (200 1) Leslie S. Webb, Jr. (2000)

Charles L. Cuttino JII (2001) Emanuel W. Michaels (1999) Richard D. Wilson (1999)

Richard D. Barnes (2000) Lindsay M. Hunt,Jr. (1999) Edward K. Weisberg (2000)

Thomas S. Cooke 1JI (1999) Bruce R.Hutchison (1999) AndrewJ.Zimmer (1999)

Alternate Delegates: Anne C. Adams (2000) Bruce R.DeGinder (200 Rodney J. Klima (2000)

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

OFRCERS

President: Charles L. Cuttino 11/, Richmond President Elect: Andrew J. Zimmer, Norfolk Immediate Past President: Wallace L. Huff, Sr., Blacksburg Secretary- Treasurer: Thomas S. Cooke III, Sandston Executive Director: William E. Zepp, CAE P.O. Box 6906, Richmond, 23230-0906 EXECUTIVE COUNCIL

COUNCILORS

Includes officers and councilors listed and: David C. Anderson, Alexandria - Chairman Gus C. Vlahos, Dublin - Vice Chairman Richard H. Wood, Richmond William J. Viglione, Charlottesville

I 1/ III IV V VI VII VIII

Ex Officio Members: Parliamentarian: Emory R. Thomas, Richmond Editor: Leslie S. Webb, Jr., Richmond Speaker of the House: D. Christopher Hamlin, Norfolk Dean, School of Dentistry: Ronald J. Hunt, Richmond

Edward J. Weisberg, Norfolk Bruce R. DeGinder, Williamsburg Harold J. Neal,Jr., Emporia James R. Lance, Richmond Edward M. O'Keefe, Roanoke Ronnie L. Brown, Abingdon James C. Gordon, Jr., Winchester Rodney J. Klima, Burke

SOCIETY

PRESIDENT

SECRETARY

PATIENT RELATIONS

Tidewater, I

Stanley P. Tompkins 5830 Trucker Street Portsmouth, VA 23708

Harvey H. Shiflet II/ 3145 Virginia Beach Blvd., 104 Virginia Beach, VA 23452

W. Walter Cox 5717 Churchland Blvd. Portsmouth, VA 23703

Peninsula, II

Corydon B. Butler, Jr. 1319 Jamestown Rd., #103 Williamsburg, VA 23185

Wayne E. "A.J." Booker 6632 Geo Wa Mem Hwy Grafton, VA 23692

Lawrence A. Warren 106 Yorktown Road Tabb, VA 23693

Southside, III

Richard F. Roadcap 3501 Boulevard Colonial Heights, VA 23834

Richard W. Bates 3505 Boulevard Colonial Heights, VA 23834

Richard F. Roadcap 3501 Boulevard Colonial Heights, VA 23834

Richmond, IV

John S. Kittrell 2600 Grove Avenue Richmond, VA 23220

H.A. "Jack" Dunlevy 11601 Robious Rd, Ste 130 Midlothian, VA 23113

William J. Redwine 6808 Stoneman Road Richmond, VA 23236

Piedmont, V

Mark A. Crabtree 407 Starling Avenue Martinsville, VA 24112

Gregory T. Gendron 7 Cleveland Avenue Martinsville, VA 24112

Craig B. Dietrich 604 E. Church Street Martinsville, VA 24112

Southwest, VI

Robert G. Schuster P.O. Box 68 Laurel Fork, VA 24352

Susan F. O'Connor PO Box 1086 Galax, VA 24333

Paul T. Umstott 300 W Valley Street Abingdon, VA 24210

Shenandoah Valley, VII

Robert B. Hall, Jr. 130 W. Piccadilly Street Winchester, VA 22601

J. Darwin King 1220 N Augusta Street Staunton. VA 244010

Alan Robbins P.O. Box 602 Timberville. VA 22853

Northern Virginia, VIII

James L. Gyuricza 5212-B Lyngate Court Burke, VA 22015

Neil J. Small 9940 Main Street Fairfax, VA 22031

Paul N. Zimmet 5206 Dawes Avenue Alexandria, VA 22311

[II

EDITORIAL

As I sat watching the ice storms of 1998 unfold before my eyes and contemplating an editorial for the Journal, my mind turned to the thought of how unpredictable life is in its twists and turns and how change is a major factor in life. Planning ahead helps us cope with life and change; however, even great plans have to be adjusted or changed due to unexpected circumstances. As we begin a new year we make plans, set goals, and make resolutions to change. It is hard to change. Most of us resist its push, but change we must because change is constantly occurring around us.

Rather than resist change, flow with it and give it positive direction where you can. In your profes足 sionallife as a dentist, put your patients' care and concerns first no matter what occurs. Strive to stay abreast of all the new technology, materials and techniques. Keep your staff current in all aspects of patient care; maintain up-to-date office facilities capable of providing efficient quality. Be a positive force for change in your profession and in your community. In order to anticipate and cope with a changing world and a changing profession be involved and flexible, continually be a student and maintain a sense of humor to laugh at what appears at times to be the insanity of it all.

of.dA. S. w.tt,J,.., D.D.S. Editor

4 Virginia Dental Journal

[II

MESSAGE FROM THE PRESIDENT

I hope each of you had a very happy and safe Holiday Season. The ADA Annual meeting in October produced some resolutions which will impact our Association over the coming years. One of the biggest discus足 sions at the meeting concerned the Public Awareness Campaign. The House of Delegates did not pass the Awareness Campaign and therefore did not increase the dues by three hundred dollars. The House did make available to the various states what had been produced for the national campaign. This material may be used as the state desires and includes consultation with the advertising agency that developed it. The cost of utilizing the Campaign will be borne by the states. This will necessitate an assessment of our members if Virginia decides to present our own Awareness Campaign. This will by necessity need to be considered by the VDA House of Delegates in September. I would ask each of you to look to your perception of the need for such a campaign and the potential cost to put such a campaign on. This is a membership issue and you the members must let your delegates know your wishes. The Leadership Conference in November included a panel of our members who openly discussed the issues that affect their own diversity. This was well received by the leaders who witnessed and participated in the discussion. As someone told me, "We came up the mountain not thinking about this and we are going down the mountain with a lot of thought". This is an issue that we need to continue to discuss and find ways to open the doors to all in Virginia to be a part of our Association. My personal thanks to Jim Watkins, Rebecca Swett, Carole Pratt, Manny Michaels and Reed Boyd who led and provided their personal insights into Membership: Unity through Diversity. Spring is right around the corner and by then we will know whether the acorns, berries and wooly worms were an omen of a harsh winter.

CIw.,.1e6 of. Cullino

III, D.D.S.

VDA President

Virginia Dental Journal 5

ABSTRACTS

Schwartz RS, Murchison DF, Walker WA. Effects of Eugenol and Noneugenol Endodontic Sealer Cements on Post Retention. Journal of Endodontics 1998; 24:564-567. Resin cements are sometimes recommended to enhance the retention of posts in endodontically treated teeth. Many sealers used in endodontics contain eugenol, which has been shown to inhibit the polymerization of resins.

The following abstracts were provided by the Department of Endodontics at VCU/MCV School of Dentistry. We appreciate the contribution that these individuals have made to the Journal.

The purpose of this study was to evaluate the effects of a eu genol and a noneugenol sealer on the retention of posts. Sixty extracted canines were divided equally into four groups. Each tooth received conventional endodontic therapy and was pre pared to receive a post. Two sealers were used in obturation: one contained eugenol (Roth's 801 Elite Grade) and one was eugenol-free (AH26). The posts were cemented with either Fleck's zinc phosphate cement or Panavia 21 resin cement. Each combination of sealer and post cement was tested for retention by using an Instron testing machine.

Sousa SMG & Bramante CM. Dens Invaginatus: Treatment Choices. Endodontics & Dental Traumatology 1998; 14:152-158. The purpose of the article was to discuss treatment options for dens invaginatus. Dens invaginatus results from the invagina tion of the enamel during the soft tissue stage of development before the hard tissue mineralizes. Salter wrote the first report on this condition in 1855, but it wasn't until 1859 that Tomes accurately described the condition. Dens invaginatus affects between 0.04% and 10% of the popu lation. The maxillary permanent lateral incisor is the most com monly affected tooth; however, malformations may occur in teeth anywhere throughout the oral cavity. A bilateral occurrence is frequently seen and this anomaly has been associated with other abnormalities such as taurodontism, microdontia, gemi nation and dentinogenesis imperfecta. According to Oehlers, there are 3 forms of dens invaginatus. Type 1-an enamel-lined invagination confined within the crown, Type 2-the invagination extends to the amelocemental junc tion and may communicate with the pulp, and Type 3-the enamel-lined invagination penetrates the entire root without com munication with the pulp. Clinically, the labiolingual diameter of the crown can be greater than normal and the enamel may seem hypoplastic with a deep groove in the coronal lingual portion. It is advisable to take radio graphs from various angles to provide a better understanding of the extension of the anomaly. Dental treatment is indicated be cause the invagination may allow irritants to enter into the pulp either directly when there is communication with the pulp or indirectly when caries develops in the invagination and eventu ally leads to pulp exposure. Various treatment modalities have been proposed for these teeth depending on which type of in vagination is present. They include conservative restorative pro cedures, nonsurgical root canal therapy, endodontic surgery, intentional replantation or extraction. Extraction would normally be the last resort treatment option. In summary, it is important that an early diagnosis of dens invaginatus be made so that pulpal and eventual periapical in volvement can be prevented. Dr John T. Marley is a first year-postgraduate student in endo dontics at MCVNCU School of Dentistry. He received his D.D.S. degree from the State University of New York at Buffalo School of Dental Medicine in 1994. He is presently on active duty with the US Army and will continue to serve on active duty upon completion of the program.

The type of sealer used had no effect on post retention with either cement. Post retention was significantly greater with the zinc phosphate cement than the resin cement. Dr Sean O'Sullivan is a second year-postgraduate student in endodontics at MCVNCU School of Dentistry. He received his D.D.S. degree from the University of Maryland in 1991. Upon graduation he completed an AEGD-1 year with the US Army, and he continues to serve on active duty.

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6 Virginia Dental Journal

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Pagavino G, Pace P, Baccetti T

A SEM Study of In Vivo Accuracy of the Root ZX Electronic Apex

Locator.

Journal of Endodontics

1998; 24:438-41.

The Root ZX electronic apex locator is a device capable of making an accurate measurement of the root canal length, even if a strong electrolyte is in the canal. The purpose of this scanning electron microscopy study was to assess the accuracy of the Root ZX in measuring the root canal length when vital tissue was present in the root canal system. Specifically evaluated were the effects of variations in the postion of the foramen (apical versus lateral) on the accuracy of measurement. Thirty-five single rooted teeth from 19 patients were selected for use in this study. The teeth were scheduled for dental extrac tions for orthodontic reasons. Following administration of local anesthetic, the major part of the clinical crown was removed and entrance into the root canal was enlarged by means of a Gates Glidden bur. The Root ZX was used according to manufacturers instructions. The file insertion stopped when the inscription "AP~X': on the display flashed and the audible continuous sig nal Indicated that the anatomical foramen had been reached. The file was locked in place using the undercuts in the pulp chamber and light-curing composite material. The handle of the file was removed with a high-speed handpiece and the teeth were extracted, cleaned and rinsed. The position of the foramen and the relation between the file tip and foramen were observed and photographed at X40 magnification using a SEM. In 18 specimens the position of the foramen appeared to be centered in the root and coincident with the root apex (apical position). In 17 specimens the foramen deviated from the long axis (lateral POSition) and exited on the lateral aspect of the root.

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The Root ZX instrument located the apical foramen in an abso lute precise manner in only one tooth. In all the other examined teeth the file tip protruded beyond the most coronal border of the foramen. The protrusion beyond the apex varied between 0.12mm and 0.85mm. No tooth exhibited the file tip being short of the foramen. When the +/- 0.5mm protocol tolerance level was applied, the results demonstrated an 82.75% accuracy for determining the location of apically located foramina but the accuracy noted with laterally located foramina was significantly lower. Overall the error in apex location by means of the Root ZX was always an overextension of the file tip in relation to the border of the foramen. It seems reasonable to recommend a withdrawal of the instrument of about 0.5 to 1.0 mm (in apical and lateral foramen) to avoid overextension of instruments during canal preparation. Dr. Christian Achleithner is a second year postgraduate stu dent in Endodontics at MCVNCU School of Dentistry. He re ceived his D.M.D. degree from Oregon Health Sciences Uni versity in 1986. Dr. Achleithner is currently serving in the United States Army Dental Corps.

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Nusstein J, Reader A, Nist R, Beck M, and Meyers WJ,

Anesthetic Efficacy of the Supplemental Intraosseous Injection

of 2% Lidocaine with 1:100,000 Epinephrine in Irreversible

Pulpitis.

Journal of Endodontics 1998; 24:487-491.

The intraosseous (10) injection allows placement of local anes

thetic solution directly into the cancellous bone adjacent to the

tooth to be anesthetized. Currently, there is an 10 system mar

keted under the trade name Stabident. The purpose of this

study was to determine the anesthetic efficacy of a supplemen

tal 10 injection of 2% lidocaine with 1:100,000 epinephrine in

teeth diagnosed with irreversible pulpitis.

Fifty-one symptomatic patients from age 19 to 68 yr, participated

in this study. All teeth were vital maxillary and mandibular poste

rior teeth diagnosed with irreversible pulpitis. The teeth received

conventional infiltrations or inferior alveolar nerve blocks of 2%

lidocaine with 1:100,000 epinephrine. Pulp testing was used

(EPT and Green Endo-Ice) to determine pulpal anesthesia after

"clinically successful" injections. Patients who were positive to

the pulp tests, or were negative to the pulp tests but felt pain

during endodontic access, received an intraosseous injection

using 1.8ml of 2% lidocaine with 1:100,000 epinephrine. The 10

injection was given with the Stabident system. The success of

the 10 injection was defined as the ability to complete endodon

tic treatment without pain.

The discomfort ratings for the 10 technique were: infiltration in

jection - 86 to 100% had no pain or mild pain; Stabident perfora

tion - 92% had no pain or mild pain and 8% had moderate or

severe pain; and solution deposition - 96% had no pain or mild

pain. Forty-six percent of the patients subjectively reported an

increased heart rate with the 10 injections. Overall, 42% of the

teeth required supplemental injections. Eighty-one percent of

the mandibular teeth and 12% of the maxillary teeth required 10

injections.

Overall, the success rate of the 10 injection was 88%. The supple

mental 10 injection of 2% lidocaine with 1:100,000 epinephrine

should be a valuable adjunctive technique when mandibular blocks and maxillary infiltrations fail to achieve adequate anes thesia to allow pulp extirpation in posterior teeth diagnosed with irreversible pulpitis. Dr. Ellen Ramos Kelly is a second year postgraduate resident in Endodontics at MCVNCU School of Dentistry. She com pleted a residency program in Periodontics and received her certificate in 1997 from MCVNCU. Dr. Kelly is a graduate of the University of Pennsylvania School of Dental Medicine and received her D.M.D. in 1994.

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An Evaluation of Root Canal Treatment in Patients Who Have

Received Irradiation to the Mandible and Maxilla.

Oral Surgery, Oral Medicine, Oral Pathology 1998; 86:224-226.

Patients receiving head and neck radiation therapy are SUbject to many tissue changes including changes in the mucosal, muscular, vascular, osseous and glandular tissues. In nonirradiated patients, treatment alternatives for irreversible pulpitis or pulpal necrosis include extraction or root canal therapy. However, tooth extraction in the irradiated patient is associated with a high incidence of osteoradionecrosis. The preferred al ternative for the restorable tooth is root canal treatment. This study presented a retrospective analysis of 11 irradiated patients receiving 22 root canal treatments. The most common pulpal diagnosis before treatment was necrosis (16/22) with irreversible pulpitis being second most common (4/22). The following radiograph and clinical criteria were used to deter mine success rates: (1) radiographic evidence of the absence of a peri radicular inflammatory lesion, (2) absence of clinical symptoms, and (3) absence of a sinus tract. Of the evaluated teeth, 11 were anterior and 11 were posterior. The mean time from last fraction of irradiation to root canal therapy was 50 months, with a range of 24-80 months. The mean time of endodontic follow-up was 19 months. Of the 22 cases, 20 (91%) were considered successful. Moreover, when considering patients with a preoperative periapical diagnosis of chronic apical periodontitis (CAP; apical radiolucency), the suc cess rate was 89% (8/9). No cases of osteoradionecrosis were observed tollowinq root canal treatment. The pathophysiologic sequence of osteoradionecrosis is de scribed as: (1) radiation therapy, (2) hypoxic-hypocellular hypovascular tissue changes, (3) tissue breakdown, (4) chronic nonhealing wound. It is also reported that increased postradiation time (more than 6 months) leads to further reduc tion in vascularity, less tissue perfusion and more fibrosis re sulting in a greater susceptibility to osteoradionecrosis. When considering the criteria for endodontic success and the absence of osteoradionecrosis, this study demonstrates a relatively fa vorable outcome (91%). Therefore, root canal therapy should be the treatment of choice and should be completed as quickly as possible after diagnosis of pulpal and/or periapical pathosis. Dr. Linda Baughan is a first year postgraduate resident in En dodontics at VCUlMCV School of Dentistry. She received a MEd from VCU in 1978, a D.D.S. from MCV in 1983 and a Gradu ate Certificate in Aging Studies from VCUlMCV in 1994,

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Virginia Dental Journal 7

Garlock JA, Pringle GA, Hicks ML.

The Odontogenic Keratocyst: A Potential Endodontic

Misdiagnosis.

Oral Surgery, Oral Medicine, Oral Pathology 1998; 85:452-56.

The odontogenic keratocyst (OKC) is classified as a developmental odontogenic cyst and is believed to arise from cell rests of the dental lamina. These lesions are more common in males than females, occur over a wide age range, are typically diagnosed during the second, third or fourth decades and manifest themselves as radiolucencies that can appear anywhere in the maxilla or mandible. There are reports of this cyst occurring in peri radicular areas that may masquerade as lesions of endodontic origin. The purpose of this retrospective study was to determine the incidence of OKC's occurring in the peri radicular area of teeth with necrotic pulps or previous endodontic treatment. Pathology reports of 5,439 biopsy specimens during a 37-month period were retrieved, reviewed and classified according to the location of the lesion. Information regarding case history, treat ment and follow-up was obtained for each of these cases. Of a total of 239 OKC's diagnosed during the study period, 21 (9%) were located in the peri radicular area and of these, 12 (57%) were associated with teeth with necrotic pulps or with teeth that had previously undergone root canal therapy. The average age of the patients was 56 years, there was a male predilection in 83% of the cases and 50% occurred in the man dible. Eighty-three percent of the lesions were unilocular and most were 1-2 em in diameter. Over 90% of the cysts were located anterior to the molars with the anterior mandible being the most common site. The differential diagnosis of a periradicular radiolucency asso ciated with a tooth may include odontogenic cysts and tumors, nonodontogenic tumors and mesenchymal reactive lesions. The growth of the OKC is not dependent on inflammatory stimuli therefore root canal therapy will not resolve this lesions. Surgi cal treatment of any persistent or enlarging peri radicular radi olucency associated with a nonvital or previously root canal treated tooth should include thorough curettage to minimize the potential risk of recurrence. Dr. Harold J. Martinez is a first year postgraduate resident in Endodontics at the VCU School of Dentistry. He received his D.D.S. degree from the Baltimore College of Dental Surgery University of Maryland in 1995. Dr. Martinez completed a one year AEGD while on active duty with the U.S. Air Force from 1995 to 1998.

Berry KA, Loushine RJ, Primack PO, Runyan DA.

Nickel-Titanium Versus Stainless-Steel Finger Spreaders in

Curved Canals.

Journal of Endodontics 1998; 24:752-754.

The placement of endodontic spreaders to within 1 to 2 mm of

the root canal working length has been advocated as a

requirement for obtaining the most favorable apical seal during

the lateral condensation of gutta percha. Lateral condensation

with gutta percha and sealer has been shown to provide an

excellent apical seal; however, the lateral condensation

technique has demonstrated less favorable apical leakage

8 Virginia Dental Journal

results in curved canals when compared with straight canals. Conventional stainless-steel spreaders usually fail to achieve the depth of 1 mm from the working length in curved root canal systems due to the resistance encountered when binding occurs against the canal walls.This inflexibility can lead to an inadequate apical seal or to a root fracture if the operator attempts to force the spreader to the proper length. Newly marketed nickel-titanium spreaders may offer an advantage in this regard due to the increased flexibility of these instruments. The purpose of this study was to compare the differences in the penetration depths of nickel-titanium and stainless-steel finger spreaders in prepared straight and curved canals. Seventy mesial and distal mandibular molar canals were instrumented to a #35 master apical file size. Measurements of the canal curvature were made from preoperative radiographs. Canal curvature angles ranged from 0 to 51 degrees. The teeth were placed in a radiographic mount to ensure a constant focal length and postoperative radiographs were exposed with comparably sized stainless-steel and nickel-titanium spreaders inserted into each prepared canal. Measurements were made with a mi crometer to the nearest 0.02 mm on the radiographs. The analysis revealed a statistically significant advantage in the ability of the nickel-titanium spreader to approach the working length in canals when compared with a similarly sized stain less-steel spreader. The mean values for distance from the apex was 1.15 (+/-0.28) mm for the nickel-titanium spreader and 2.4 (+/-1.43) mm for the stainless-steel spreader. Overall, the study concluded that the nickel-titanium spreader demonstrated a greater ability than a comparably sized stain less-steel spreader to achieve a depth of 1 to 2 mm from the working length in prepared curved root canal systems. The clinical use of nickel-titanium spreaders may enhance our abil ity to create better apical seals in curved canals. Dr. Peter Mayer is a first year postgraduate student in Endo dontics at theVCU School of Dentistry. He received his D.D.S. degree from Case Western Reserve University School of Den tistry in 1988. Upon graduation he completed a GPR at Southside Hospital in Youngstown, Ohio. Dr. Mayer served in the U.S. Navy Dental Corps from 1989 to 1998.

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for giving OUR seal of approval YOUR seal of approval!

1 8 7 \\

You want only professionals on your team ... That's why the Virginia Dental Association has recognized members of the Virginia State Dental Laboratories Association. We are a group of dental laboratory owners dedicated to the highest standards of our industry. Our members have made a commitment to our organization AND to the dental profession. As members of the National Association of Dental Laboratories, our state com ponent is dedicated to continuing education for technicians and establishing voluntary standards in an unregulated industry.

So, look for our seal... when you want a professional laboratory partner

who will help you enhance the lives and health of your patients!

The Virginia State Dental Laboratories Association invites you to join us in Williamsburg for our Fall Educational Event

October 14路16, 1999

Virginia Dental Journal 9

[

GREAT QUESTION- GLAD YOU ASKED THAT. .. B. Ellen Byrne, R.Ph., D.D.S., Ph.D.

For several years now I have been fortunate enough to offer continuing education classes in pharmacol ogy. After and during every program I receive very interesting questions. Sometimes I know the answers and sometimes I have to research the question before I can give an answer. I would like to share these questions and answers with the dental community. I would also like to encourage more questions. I believe in a better life through pharmacology. Call me at (804) 828-0784 or FAX me at (804) 828-4916. 1. My patient has "Dilantin hyperplasia" but doesn't take Dilantin (phenytoin). Are there any other drugs which cause this hyperplasia? Yes, there are numerous drugs which can have this adverse effect on periodontal tissue. The most common drugs implicated in this condition include: 1. 2. 3.

Dilantin® - phenytoin Sandimmune® - cyclosporin Calcium channel blockers Bepadin®; Vascor® - bepridil Cardizem® - diltiazem Plendil® - felodipine DynaCirc® - isradipine Cardene® nicardipine Adalat®; Procardia® - nifedipine Ninotop® - nimodipine Calan®; Isoptin® - verapamil

USP-DI, (ed. 17) Rockville, MD, 1998, United States Parmacopeial Convention. 2. A patient called the office to tell us that he had tested positive for cocaine on a random drug screen. He wanted us to call his work place and tell them that he had received an injection of lidocaine and that it had caused his drug screen to test positive for cocaine. Is that possible? No, that is a very old excuse for a positive drug test. While it is true that the first local anesthetic was cocaine isolated from the leaves of the coca bush, Erythroxylon coca, it is not true that lidocaine and cocaine produce the same metabolites or interfere with each other on a drug screen. Cocaine itself is not what they look for on a drug screen. The half-life of cocaine itself is very short, only approximately 20 minutes. Because of this the drug test is for the metabolite, benzoyl-ecogonine, which has a longer half-life at about 36-48 hours. The benzoyl-ecogonine molecule looks nothing like lidocaine or any of its metabolites. According to Dr. Alphonse Poklis, Professor of Pathology at MCVNCU the tests for cocaine are specific and there are no other drugs which would interfere with these tests. If it looks like a duck, quacks like a duck and walks like a duck... it's a duck. A positive cocaine test is a positive cocaine test. Time to call the parole officer. 3. My patient takes Antabuse (disulfiram) for alcohol abuse. Do local anesthetic contain any type of alcohol as a preservation? No, local anesthetics used in dentistry are supplied in 1.8 ml single-dose cartridges. The cartridges contain pyrogen-free water with sodium chloride added for osmotic balance. Citric acid and sodium bisulfite are added as an antioxidant to help prevent the vasoconstrictor break down. Multidose Vials contain methylparaben as an antimicrobial. Methylparaben serves no purpose in dental cartridges and its incorporation has been discontinued in the United States. Antabuse (disulfiram) is used in alcoholics to help maintain sobriety. It blocks the enzyme responsible for the metabolism of the ethanol metabolite acetaldehyde. The resultant accumulation of acetaldehyde produces flushing, nausea and vomiting, blurred vision and dizziness. Dental concerns for patients on Antabuse including warning the patient about use of alcohol containing products, including mouth rinses. Also patients can experience metallic or garlic like taste in their mouth.

Yagiela JA, Neidle EA, Dowd,FJ. Pharmacology and Therapeutics for Dentistry, (ed. 4) St. Louis, MO, Mosby, 1998, pg. 217-234. Malamed, Stanley. Handbook of Local Anesthesia, (ed. 4) St. Louis, MO, Mosby, pg. 24-37. USP-DI, (ed. 17) Rockville, MD, 1998, United States Parmacopeial Convention.

10 Virginia Dental Journal

EXECUTIVE COUNCIL ACTIONS IN BRIEF NOVEMBER 8, 1998

II]

Approved a motion that an expense allowance of $800.00 be established to cover the expenses of the Parliamentarian.

The Following Recommendations Were Considered: The Following Items Were Referred To Committee: 1.

Approved a recommendation that the 2003 VDA Annual Meeting be held at the Richmond Marriott.

Approved a recommendation to designate the scholar ship money annually given to MCV as the David A. Whiston Scholarship.

Approved a recommendation to adopt the following resolution: WHEREAS the House of Delegates at the 1998 Annual Meeting of the American Dental Association has ap proved support of alternative Dental Hygiene Educa tion programs similar to the Alabama program.

Referred to the Budget & Financial Investments Com mittee a recommendation that the Committee investi gate the establishment of a sequestered building fund and a three-year dues increase to capitalize the fund.

Referred to the Planning Committee a recommenda tion that the Committee explore the possibility of having VDA Annual Meetings outside the confines of the Com monwealth and report back to the Executive Council at the 1999 June Committee Meetings.

Referred to the Planning Committee a motion that the Committee evaluate ways to involve non-VDA members, such as members of the Old Dominion Dental Society, members of other dental groups within Virginia and other non-members, in the VDA Annual Meeting. Con sider inviting them to attend the Annual Meeting at VDA member fees.

Referred to the Executive Committee for further study and a decision on support, a resolution that the Legis lative Committee supports the Board of Dentistry draft legislation #DEN-1. (Relating to license, application, qualifications and examinations.)

Referred to the Constitution & Bylaws Committee for review the following changes to the membership of the Planning Committee:

BE IT RESOLVED that the Virginia Dental Association restate its position to continue to investigate and pro mote accredited Dental Hygiene Education programs to expand these educational opportunities for citizens of the Commonwealth. The Executive Council recommends adoption of the above recommendations by the House of Delegates. The Following Items Were Approved: 5.

Approved a recommendation that the VDA adopt the PANDA Program resolution as follows: Be it resolved that the Virginia Dental Association supports, in principle, a dental coalition aimed at educating dentists about the problems of child abuse and neglect, teaching them to recognize the signs of abuse and neglect, and informing them of their ethical and legal responsibilities in reporting suspected cases.

Approved a recommendation to eliminate the 1999 November Leadership Conference and schedule the 2000 Committee Meetings in mid-January, mid-April and mid-June. The Leadership Conference will be held in conjunction with the Mid-April Committee Meetings.

Approved a recommendation that the Legislative Committee support the Department of Health draft legislation 32.1-122.9 (conditional grants for certain dental students).

Approved a recommendation that the Legislative Com mittee prepare for the introduction of legislation in the 2000 General Assembly Session to change the defini tion of dentistry in the VA Code to conform to the 1997 ADA statement.

12 Virginia Dental Journal

Article VIII, Section 4

12. Planning Committee a. Membership: This Committee shall consist of the President-Elect, fettf two most recent Past Presidents aRe four memBers at lar~e, two of WRom sRall Be appoiAtee for two year terms By tRe PresieeAt Eleet. OM of tRese at lar~e memBers sRall Rave ~raeuatee from eeAtal seRool witRiA tRe past teA years. and the chairmen of the tollowinq Regular Standing Committees; Annual Meeting, BUdget and Financial Investments, New Dentist, Dental Benefit Programs, Dental Delivery for the Special Needs Patient, Dental Practice Regulations, Auxiliary Education and Relations, Legislative, Membership, Ethics and Judicial Affairs, Direct Reimbursement and any other committee that the President may specify. The Committee shall elect its own chairman annually. b. 7.

Duties: ....... (no changes)

Referred to the Legislative Committee a recommenda tion that the Committee encourage VDA members to

get petitions signed by patients reiterating the patient's right to have assignment of benefits honored.

15.

Form sound relationship with present Dean and

suggest mandatory student and faculty member

ship in ASDA and VDA respectively. Action target

date - November 1998.

Appoint dental students as ad-hoc members of

state committees. Action target date - January 1999.

Items 8 - 27 are referrals from the action plans developed at the Strategic Planning Workshop November 6, 1998. 8.

Referred to the Legislative Committee: Promote a training session for liaison dentists. Promote increased one-on-one contact with each individuals own legislator Determine and prioritize issues which affect the practice of dentistry and membership issues as a whole Increase the number of VDA members in attendance at legislative and regulatory committee meetings Utilize the assets of other states in identifying is sues and strategies common to our constituent society Increase the exposure of legislators to dentistry

10.

17.

18.

Referred to the Budget & Financial Investments Committee:

Referred to the Component Executive Committee: Have a combination CE course and New Member Reception. Action target date - ongoing.

Referred to the Executive council: 20. Consider increasing funding for lobbying efforts of the Association Referred to all:

Referred to the New Dentist Committee: Invite senior and graduate dental students to January Committee meetings and reception. Action tar get date - January 1999.

Continue presentations to senior dental students,

which outline the benefits of membership. Action

target date - ongoing.

VDA sponsored breakfast for freshmen dental

students with a panel of dentists discussing the

benefits of membership. Action target date

September 1999.

Referred to Component Staff: Communicate with members and nonmembers

through monthly e-mail messages (For example:

"what the VDA has done for you this month ... ")

Action target date - ongoing.

Continue working on e-mail directory to improve

communication with dentists. Action target date

ongoing.

Utilize the Alliance in legislative initiatives 14.

Referred to Components: Treat new or non-members, on a one time basis, to free CE at component level. Action target date immediate.

19.

13.

Referred to the Component Membership Committee: Component Chairman - have a mentor-mentee

program in place in all components. Action target

date - ongoing.

Introduction of new members at annual compo

nent meeting. A mentor should be the person to

take this new member to that meeting. Action tar

get date - spring 1999.

Consider increasing funding for lobbying efforts of the Association 12.

Referred to the Membership Committee: Approach dental supply companies to develop VDA

discounts on certain products. Action plan date

January 1999.

Communicate through various types of technology

(fax, e-mail, phone) to elicit feedback on satisfac

tion of members with their membership in VDA.

Action plan date - spring 1999.

Through phone calls or personal meetings, articu

late benefits of membership that would be of inter

est to long standing non-members (insurance

plans, credit cards, legislative issues, etc.) Action

plan date - ongoing.

Referred to the Dental Practice Regulations Committee: Increase the number of VDA members in attendance at legislative and regulatory committee meetings Continue to monitor the actions of the state regula tory boards

11.

16.

Referred to VADPAC: Increase PAC contributions and awareness Identify those legislators chairing committees which impact dentistry Increase the exposure of legislators to dentistry

Referred to the President and President-Elect:

21.

Referred to VDA staff: Continue working on e-mail directory to improve

communication with dentists. Action target date

ongoing.

Communicate on a component level with mem

bers and nonmembers through monthly e-mail

messages. Action target date - ongoing.

Virginia Dental Journal 13

22.

23.

Develop the VDA as an information resource to keep members informed of developments to man aged care and DMSO contract arrangements. Action target date - ongoing.

27.

Referred to the Ad Hoc Committee on Communication and Information Technology, a motion that the Commit tee consider their dissolution and re-establishment as a Regular Standing Committee in Article VIII, Section 1.A with their input in the development of the duties of this Committee and to report their recommendations back to the Executive Council for action at the January Committee Meetings.

28.

24.

Referred to the Annual Meeting Committee: Pursue corporate partnerships for the different

endeavors of the VDA.

Review the role of the VDA Annual Meeting as a

non-dues revenue source.

26.

Referred to the Executive Council: Encourage VDA membership participation in VDSC endorsed programs.

The Following Items Were Received As Information Only:

Received as information only that the Executive Com mittee has directed the Central Office staff to delay pub lication of the Membership Directory until January 1999.

Received as information only from the Annual Meeting Committee: Dr. Michael Miller was re-elected vice-chairman. A Casino Night will be held at the 1999 Annual Meeting.

Referred to the Budget & Financial Investments Committee: Review the role of investments as a non-dues rev enue source.

Pursue corporate partnerships for different en

deavors of the VDA.

25.

Pursue corporate partnerships for the different endeavors of the VDA.

Referred to the VDA Foundation: VDA Foundation should increase revenue sources not only to fund CE but also VDA charitable endeavors.

Referred to the VDA President:

Received as information only from the Legislative Com mittee, the following list of Legislative priorities for 1999: 1. Assignment of Benefits 2. Medicaid Issues 3. Reimbursement for General An esthesia for Dental Procedures/ Special Needs 4. New Definition of Dentistry

Referred to the Building Committee: Pursue corporate partnerships for the different endeavors of the VDA.

PUBLICATION OF CANDIDATE INFORMATION IN THE

VIRGINIA DENTAL JOURNAL

Nominations for the elective offices of the Virginia Dental Association may be made either by a Component President on behalf of the Component he/she represents, or by obtaining signatures from a minimum of twenty-five members of the Association. These nominations should be directed to Dr. Thomas S. Cooke III, VDA Secretary-Treasurer. The following positions are up for election at the 1999 Annual Meeting in Reston: President-Elect; SecretaryfTreasurer (2 year term); four ADA Delegate positions (3 year term); four ADA Alternate Delegate positions (2 year term). All candidates must have submitted their CV's, pictures (black & white head-shots preferred), and biographical information to the attention of Dr. Leslie S. Webb, Jr., Editor at the VDA Central Office no later than March 1, 1999, for publication in the April-May-June issue of the Virginia Dental Journal. Forms for submission of Candidate Information have been mailed to all VDA Component Society Presidents. Candidates for the offices of President-Elect and Secretary-Treasurer of the Association will be allowed a maximum of 500 words. Candidates for all other offices will be allowed a maximum of 250 words. Candidates are asked to limit their biographical information to major accomplishments, but to include such pertinent data as education, memberships, honors, positions of leadership held in the ADA, VDA and Component Society, and community leadership activities. Due to space limitations, the VDA Journal Editor will reserve the right to condense biographical information, as necessary. Should you have any questions regarding the Journal criteria, please contact Dr. Les Webb either by phone 804-282-9781 or by fax 804-282-3647. If additional Journal submission forms are needed, please contact Tanya Moore at the VDA Central Office either by phone 800-552-3886 or by fax 804-353-7342.

14 Virginia Dental Journal

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INSURANCE UPDATE MEDICAL INSURANCE

Over the past several years the VDA has worked hard to ensure that the major medical plan through CNA remained financially competitive while offering excellent benefits and unparalleled service. However, the CNA policy underwent higher than anticipated rate increases that were unacceptable to all involved. Therefore, effective December 31 , 1998, the VDA endorsement of the CNA plan ceased. In response to the needs of the members and in order to ensure a more financially competitive product for the future, the Virginia Dental Services Corporation (VDSC) negotiated a new program with Trigon Blue Cross Blue Shield. This new program is available for all dentists interested in setting up a benefit program for themselves or their practice. Some of the exciting new benefits now available are: • • •

Choice of Products - Indemnity, PPO, pas, HMO, and MSAs Extensive Networks of Participating Hospitals and Doctors Special "Value Added" and "Membership" benefits

Please call the VDSC Insurance Service Center at 800-832-7001 Monday through Friday from 8:30am to 5:30pm for more details. You will speak with experienced benefit consultants who are solely dedicated to the servicing and marketing of the VDA major medical program.

PROFESSIONAL LIABILITY INSURANCE After reviewing numerous insurance carriers, in August 1998 the Board of the Virginia Dental Services Corporation (VDSC) endorsed The Medical Protective Company because of their flexible product design, fee structure, customer service(s), and their commitment to the dental professional. The Medical Protective Company invented professional liability insurance in 1899. Through their partnership with The Hartford, they are able to provide all your practice coverage in The Package. You can purchase professional liability, property, workers' compensation, employment practices liability and pension plan coverage in convenient, one-stop shopping. In order to speak with an agent please call 800-344-1899.

The VDA and the VDSC are proud of the insurance

programs we offer to the members of the VDA

and hope that you take advantage

of these benefits.

Virginia Dental Journal 17

DIVERSITY, MEMBERSHIP AND STRATEGIC GOALS

HIGHLIGHT 1998 VDA LEADERSHIP CONFERENCE

Andrew J. Zimmer, D.D.S., VDA President-Elect

The 1998 Leadership Conference was held at the Wintergreen Resort November 4-8, 1998. Partici足 pants were treated to some spectacular fall color on the mountainsides and chilling temperatures on the mountaintop. More than thirty members participated in a Stragetic Planning Workshop facilitated by Mary Byers, CAE of Word Works. Mary quickly established fairly intense audience participation by utilizing consensus identification of our Association's Strengths, Weaknesses, Opportunities and Threats. These categories were then considered in establishing five priorities: Membership, Com足 munication, Legislative, Non-dues Revenue and the (Virginia Dental) Association Building. The proposed implementation action plans and appropriate committee referrals for our Strategic Goals are listed on pp.19 -21 of this journal issue. The theme for the 1998 Leadership Conference was "Membership: Unity through Diversity". Mary Byers gave a stimulating presentation titled Intentional Leadership: Leadership by Design offering many tips on more effective stewardship and focused participation in the Association. Dr. John Zapp (ADA Executive Director) and Paul Jarr (Director of ADA Membership Services) provided extensive membership information and insight. A Membership Diversity and Sensitivity Panel that coura足 geously addressed diversity issues such as age, gender and ethnic heritage highlighted the day. The entire program was informative and thought provoking and will undoubtedly catalyze some changes in our approach to membership in the future.

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STRATEGIC PLANNING GOALS

[II

Action Plan for Dental Students

November 6, 1998 NON-DUES REVENUE

Recognizing the need for increased expenditures in carrying out the mission of the VDA, and the desire for limiting in creases in dues, the VDA is working towards increasing rev enues from non-dues revenue sources. No time line.

•

To invite senior and graduate dental students to Janu ary Committee meetings and reception Budget: $500.00 Group responsible: New Dentist Committee Action target date: January 1999

•

Appoint dental students as ad-hoc members of state committees Group responsible: Presidential appointment Action target date: January 1999

•

Form sound relationship with present Dean and sug gest mandatory student and faculty membership in ASDA and VDA respectively Group responsible: President and President-elect Action target date: November 1998

•

Continue presentations to senior dental students which outline the benefits of membership Budget:? already established Group responsible: New Dentist Committee Action target date: Ongoing

•

VDA sponsored breakfast for freshmen dental students with a panel of dentists discussing the benefits of membership Budget: $100 Group responsible: New Dentist Committee Action target date: September 1999

Action Plan

•

VDA Foundation should increase revenue sources not only to fund CE but also VDA charitable endeavors. (VDA Foundation)

•

Review the role of investments as a non-dues revenue source. (Budget & Financial Investments Committee)

•

Pursue corporate partnerships for the different endeav ors of the VDA. (President, Building Committee, Annual Meeting Committee, BUdget & Financial Investments Committee)

•

Review the role of the VDA Annual Meeting as a nondues revenue source. (Annual Meeting Committee)

•

Encourage VDA Membership participation in VDSC en dorsed programs. (Executive Council)

Action Plans for New Dentists

Due to the mission of the VDA, CE should not be used as a non-dues revenue source.

•

Have a mentor program in place in all components Group responsible: Component membership chair Action target date: Ongoing

•

Treat new or non-members on a one time basis to free CE at component level Group responsible: Component members Action target date: Immediate

•

Introduction of new members at annual component meeting. A mentor should be the person to take this new member to that meeting Group responsible: Component Membership Committee Action target date: Spring 1999

•

Components having a combination CE course and New Member Reception Budget: $200 for reception

MEMBERSHIP GOALS AND STRATEGIES

Background: •

Membership is an increasingly important issue due to a 1/2 to 1 % decrease in market share over the past 10 years.

•

Traditionally membership in our organization was seen as an obligation. Now, new dentists are more concerned with "perceived value" of membership in the organization.

•

There appears to be a lack of response to changing practice conditions.

Group responsible: Component Executive Committee Action target date: Ongoing

Virginia Dental Journal 19

•

Communicate on a component level with members and nonmembers through monthly E-mail messages (for example: "what the VDA has done for you this month ...") Group responsible: VDA / component staff Action target date: Ongoing Continue working on email directory to improve com munication with dentists Group responsible: VDA / Component staff Action target date: Ongoing

• •

•

Action Plans for Retention of Members

• •

•

Develop the VDA as an information resource to keep members informed of developments in managed care and DMSO contract arrangements Group responsible: VDA staff

Action plan date: Ongoing

Approach dental supply companies to develop VDA dis counts on certain products Group responsible: Membership Committee Action plan date: January 1999 Communicate through various types of technology (fax, email, phone) to elicit feedback on satisfaction of mem bers with their membership in VDA Group responsible: Membership Committee Action plan date: Spring 1999

Action plans for long standing non-members •

Through phone calls or personal meetings, articulate benefits of membership that would be of interest to this group (including insurance plans, credit cards, legisla tive issues, etc.) Group responsible: Membership committee Action plan date: Ongoing

LEGISLATIVE Due to the continuing and increasing threat from numerous sources, the Virginia Dental Association shall promote the policies of the Association through proactive legislative and regulatory advocacy. Time Line: Ongoing Actions and Committee referral:

• • •

Promote a training session for liaison dentists Legislative Promote increased one-on-one contact with each indi viduals own legislator -Legislative Determine and prioritize issues which effect the prac tice of dentistry and membership issues as a whole Legislative

20 Virginia Dental Journal

• •

Increase PAC contributions and awareness - VADPAC Increase the number of VDA members in attendance at legislative and regulatory committee meetings - Legis lative and Dental Practice Regulations Identify those legislators chairing committees which impact Dentistry - Legislative and VADPAC Utilize the assets of other states in identifying issues and strategies common to our constituent society Legislative Consider increasing funding for lobbying efforts of the Association - Budget and Financial Investments and Executive Council Utilize the Alliance in legislative initiatives - All Continue to monitor the actions of the state regulatory boards - Dental Practice Regulations Increase the exposure of legislators to Dentistry Legislative and VADPAC

COMMUNICATION Communications are the lifeblood of any organization. They must be timely, effective and easily accessed. Modern infor mation technology must be integrated into the communica tion system to increase speed and availability. Currently our membership communication efforts are cen tered on a web page, mass mailings, faxes, and the VDA journal and directory. New technologies should be incorpo rated as they evolve. Additionally, an action plan should be developed for public awareness and education.

Action Plan Membership Communication • increase effectiveness of current communication mediums • develop and implement improved e-mail/fax communications • explore mentorship opportunities for educating new mem bers on current issues and available benefits • improve the chain of personal communication between officers, executive council, & committee members to the general membership • one on one "personal contacts" with members and non-members • establish a statewide phone tree • continue to monitor new technologies that become avail able in this field and implement as indicated Public Awareness • develop mechanisms to effectively disseminate information to the public • establish a spokesperson training program

We recommend the Ad Hoc Committee on Communication and Information Technology be dissolved and re-established as a Regular Standing Committee in the VDA By-Laws. We further recommend that these action plans then be de veloped and implemented by the new Regular Standing Com mittee on Communication and Information Technology.

Site selection

Existing building vs custom built

Preliminary report should be presented to the

Executive Council in June, 1999.

If possible include a dentist who is also an architect and a dentist who is also a contractor or dentists who are knowledgeable in these fields.

BUILDING At the 1998 Strategic Planning Workshop at Wintergreen, it has become evident that the Central Office Building is now inadequate in size to accomodate our needs. In order to maintain our current functions and in order to grow as an organization a new facility is necessary.

Send the information presented by the Ad Hoc Com mittee to the Budget & Financial Investments Com mittee to research specific or alternative ways to finance the recommendation of the Ad Hoc Commit tee. A preliminary report from the Budget Commit tee should be presented to the House of Delegates in September 1999.

Action Plan Overall time line is three years. A.

Request that the following be researched by a new ad hoc committee or current Ad Hoc Building Committee: 1.

Size and composition of new central office

building (meeting space, work space, com

puter space, etc.)

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22 Virginia Dental Journal

FROM THE EXECUTIVE DIRECTOR. ..

I am struggling with this column for several reasons, not all of them connected with avoidance and denial. It is hon estly difficult both to determine what will be of interest to you, the members, and to determine if it will be of interest to you in mid-February when you will read it versus mid January as I write it. In addition, I share a common past-life with Tanya Moore, the VDA Publication and Meetings Coordinator: we were both high school English instructors. She gave me this assignment well in advance, has reminded me in positive terms of the impending deadline, and has smiled know ingly every time I say, "I'm working on it." The last two days I have avoided her on the stairs and I've been cutting third period. Actually, between the current Journal deadlines and the 1999 Membership Directory, Tanya has no time to bad ger me. Now that Christmas 1998 has become another Christmas Past, things are back in high gear for the VDA staff and leadership. Activities associated with the General Assem bly will be reported in other columns and articles. However, I would like to mention our appearance before the House Subcommittee on Health & Human Resources on January 12. Lisa Finnerty, VDA Public Affairs Coordinator, arranged, coordinated and introduced a presentation to the Subcom mittee on Medicaid access and funding by Dr. Burton Edelstein, Director of the Children's Dental Health Project. Dr. Edelstein is the foremost national authority on Medic aid and dentistry. We know that the Subcommittee was favorably impressed with dentistry's position and feel that the Medicaid situation will continue to improve. Again, we encourage your renewed participation in Medicaid in the effort to provide access to Virginia's underserved children. A mini-Spokesperson Training Seminar was held on Janu ary 11 to prepare selected members from throughout the Commonwealth to respond to media questions regarding a planned segment on children's deaths from dental anes thesia on the new CBS program "60 Minutes II," which pre miered January 13. Drs. Charlie Cuttino, Pat Dolan, Christy Hamlin, and Roger Wood were trained by Dick Green, Di rector of Communications at the ADA Washington office. This training was scheduled on short notice, due to the impending telecast, and provided a preview of the full ADA Spokesperson Training program, scheduled for April 23 in Richmond. Component representatives will be selected in late January.

Ronya Edwards developed and distributed a marketing survey for the VDSC in January to attempt to de termine members' inter ests and needs regarding potential product endorse ments. Hopefully, you took the time to respond to the survey to assist the VDSC Board in their planning ses sion in late February. Dues collection has been a major priority for both Connie Jungmann and Linda Gilliam since early December. Linda's life is further complicated by the end of the year closing and reporting requirements for all VDA and VDA-related accounts. Connie is also cur rently investigating the IMIS Association Management soft ware system as a potential backup to the ADA TAMS pro gram, which seems to have suffered some recent setbacks. She will visit the Pennsylvania Dental Association offices to observe IMIS in action. PDA has used the program for approximately five years. We are awaiting word on a grant proposal submitted to the CFX Corporation Community Resources Award program by Liz Keith. She is seeking additional funding to supplement the current grants to operate the Donated Dental Services program. DDS continues to grow; Barbara Rollins, our new est staff member, assists Liz on a part-time basis. The January Committee Meetings will also be January Com mittee Meetings Past by the time this is published. These annual meetings in Richmond involve all staff, but none more so than Bonnie Anderson. Bonnie prepares the materials for the Executive Committee, Executive Council, and the vast majority of the VDA Committees and has been occu pied accordingly since we returned from Wintergreen and the Leadership Conference. So if all goes right in late Janu ary, it's to my credit - any problems ... talk to Bonnie. We're all looking forward to 1999 and serving the VDA membership.

William Go Z.pp, CAE Executive Director

Virginia Dental Journal 23

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Various Provisional Materials Used Shaping & Contouring* Direct Vs. Indirect Techniques Custom Shading Single & Multiple Unit Written Materials to Take Home ( 'Must Provide Your Own Slow Speed Handpiece)

VSDA Registration Form Winter-Spring 1999 Name

SS# ----:P:O-r:-in-,-t;-;-Na-m-e-as---'y'-;-o-u---;W-:-;-ou~ld~Li:;-ke~Fo-r~it:-:t-o--;-A-pp-e-a-r -o-n-,-y,--o-ur-,C;:;-e--:rtificate-----------足 Home Phone Work Phone -.,-_ Address City Zip _ Dental Practice Name _ Dental Practice Address - - - - - - - - - - - , - - - - c : : - - - - c - - - . , - - - - , - - - - - - - - - 足 Birth Date Sex M _ F _ County or City of Residence _ VISA or MC # Expires _ Signature-:-:--:---:---:-_---:-足 -.,--_ Print Name of Card Holder Please enroll me inthe course listed below: Check one please. This form may beduplicated for other assistants or students.

Registration isaccepted until class begins, provided that a class is not full. Refunds will begiven for short courses if

cance IIanon IS receive d 48 hours be~ore schedid u e cIass minus a $10 00I processm gee. f VA X-RA Y CERTIFICATION COURSES Check Here Course # Time Cost 101 Saturday, February 13, 1999 (Fairfax) Sam-Scm $109 101 Saturday, March 13, 1999 (Richmond) 8am-5prn $109 Saturday, May 22, 1999 (Roanoke) 101 8am-5pm $109 101 Saturday, June 12, 1999 (Richmond) 8am-5prn $109 COMPREHENSIVE DENTAL ASSISTING Jan 9-Mar 27, 1999 (Saturdays Only) (Richmond) 100 8am-5pm $1595 Apr 1O-Jun 26, 1999 (Saturdays Only) (Roanoke) 100 8am-5pm $1595 FABRICA TlNG TEMPORARY CROWNS 104 Friday, March 26, 1999* (Richmond) (4 CE Hrs) 9am-lpm $165 Class Size Limited * Experienced Assistants Only (*Must Bring Slow Speed Handpiece) Mali this registrauon form and credit card information or check (payable to VSDA) to: Virginia School of Dental ASSISting, 1905 Huguenot Road. Suite 200, Richmond, Virginia 23235. OrFAX it (credit card only) to 804-794-7974.

24 Virginia Dental Journal

REPORT ON THE ADA HOUSE OF DELEGATES

Wallace L. Huff, D.D.S., Chairman of the Virginia Delegation to the ADA House The 139th Annual Session of the American Dental Associa tion held in San Francisco was a great success as more than 47,000 dentists, dental team members and guests from around the world were in attendance.

and local societies who want to adopt the campaign. Those states that want to participate in the campaign will be re sponsible for their own media buys. Other resolves in Res. 100 are:

One of the reasons for these outstanding numbers was due to the popularity of San Francisco. But I believe that the primary reason was due to the popularity of the ADA Presi dent, our own Dave Whiston! Dave's leadership style has set a new standard for the office of the ADA President. He and Julie have worked tirelessly throughout the year on our behalf. They have made all of us proud to be a member of the ADA and on behalf of the Virginia delegation, I want to thank them again for their contributions to our profession

•

• •

• Dr. Timothy Rose, a periodontist from Appleton, Wisconsin was installed as the 135 th President of the Association. Dr. Richard F. Mascola, a prosthodontist from Jericho, New York and currently serving as 2nd District Trustee on the ADA board of trustees, was elected by the house as President-Elect of the ADA in a four-way race. Dr. Richard Smith a general dentist from Atlanta, Georgia was elected by the house as 2 nd Vice-President of the ADA in a two-way race. Candidates for the offices of the First-Vice-President and speaker of the House of Delegates ran uncontested as did trustee candidates for four districts. Elected unanimously were Dr. Bettie R. McKaig of Raleigh, North Carolina as first Vice-President and Dr. James T. Fanno from Canton, Ohio who was reelected to a fourth term as speaker of the House of Delegates. The four new trustees are Dr. Howard B. Fine, 2nd District; Dr. Leo R. Finley, Jr., 8th District; Dr. Steven Bruce, 11 th District and Dr. Eugene Sekiguchi, 13th District. Dr. Rene M. Rosas is beginning his third year as treasurer of the ADA. As anticipated, Resolution 99 as presented in board report 13 (Public Awareness Campaign) created the most activity on the house floor. With the approval of the HOD House Speaker James T. Fanno limited discussion of the measure to 30 minutes-- 15 minutes for those in favor of the Res. And 15 minutes for those opposed. At the end of the allotted time, twenty-eight (28) delegates had spoken to Res. 99.14 were in favor and 14 were opposed. But after all was said and done, Res.99 (the proposed three year, $30 million a year campaign) failed by a three-to-one margin 174 for and 309 against. With Res.99 defeated, the HOD adopted Res. 100 which authorizes an additional funding of $982,000 to assist state

•

that Jordan Associates (the Oklahoma-based advertis ing agency) and the ADA staff in consultation with the Council on Communications be available to help those states that wish to participate in the campaign. that new and existing campaign messages be tested through necessary research. that new products (broadcast and print) be developed based on research findings. that the appropriate ADA agencies meet with state den tal associations to explain the program and to seek their input and participation. that the council on communications be in charge of accessing current and future public relations activities which may supplement public awareness advertising activities, particularly those activities related to consumer education. that a progress report on the above program be presented in resolution form to the 1999, ADA HOD.

This years House of Delegates was particularly interested in the entire board of trustees budget presentation. The pro posed budget was returned to the board of trustees during the second business session because the board requested a two dollar ($2.00) dues increase to balance an operating budget of $65,285,700.00. The House of Delegates wanted a balanced budget! Other significant resolutions adopted by the 1998 House of Delegates concerning budget and business matters were: • The House of Delegates approved a 1999 budget of $66.8 million and a $17.00 dues increase. As of January 1, 1999, the ADA's membership dues went from $365 to $382. • The $17 dues increase is projected to boost the 1999 revenues to $66,781,250 with anticipated on budgeted expenses of $66,777,500 which will leave a projected net surplus of $3,750. • Res. 114S-1 urges the Board of Trustees to set the ADA's reserve at 30% of the association's annual operating budget. • The proposed ADA headquarters Phase H asbestos abatement/renovation was amended and referred back to the board for review. This project (Res. 27RC) would have necessitated an additional dues increase of $62, for three years and will be considered by the 2000 House of Delegates.

Virginia Dental Journal 25

Other key resolutions that were passed by the House:

tice of dentistry as described in the 1996 house ap proved definition of professional dental care and the 1997 definition of dentistry.

•

Res. 22 allows installment options for active and active life members to pay their dues.

•

Res. 3 IBS-1 states that the ADA supports the alternate pathway model of dental hygiene education as used in Alabama; that a committee be formed to develop a work book for creating alternate pathway models for dental hygiene as used in Alabama; and that this workbook (after being approved) be made available to all constitu ent and component dental societies, educational insti tutions and others.

•

Res. 325-IB urges the commission on dental accredita tion to consider outcome-based evaluation of hygiene education programs and that the commission submit a report to the 1999 ADA-HOD's which identifies the ex act outcomes assessments used to evaluate hygiene programs.

I want to thank all members of the Virginia Delegation for the hard work and conscientious effort each demonstrated at the district caucus in Durham, NC to the convention caucus, reference committee hearings and house of delegate ses sions in San Francisco, California. Every member of the delegation demonstrated real responsibility to those who elected them- you, the members of the VDA. Everyone is to be commended fortheir preparation.

•

Res.38 amends ADA policy on the use of conscious sedation, deep sedation and general anesthesia in den tistry under the section on state regulation

On behalf of the Virginia delegation, I want to thank:

•

Res. 56 urges all ADA constituents to submit formal proposals to their state dental licensing agencies to ac cept, for the purpose of licensure in their state, the completion of a licensure exam administered by any rec ognized individual state or regional testing agency.

•

Res. 59 calls for the ADA to urge its constituents to promote and support high-school level dental assisting programs approved through state vocational education recognition programs.

•

Res. 61 calls for the association agencies to study the feasibility of seeking legislation or regulations that would require licensed dentists to publicly disclose their pro prietary connection with a DMSO or a dental practice not owned by a dentist.

The ADA House of Delegates considered more than 117 resolutions this year. I would encourage all VDA members to consult their ADA news (Nov. 16 and Dec. 14) issues for a more complete summary. In addition, please feel free to contact any member of our delegation if you have any questions concerning the actions of the 1998 ADA House of Delegates.

Jack Sowter (NC) for his leadership as the 16 Caucus Chairman.

District

Faye Marley and Charlotte Johnson of the North Carolina Dental Society who made all the necessary arrangements for a productive and enjoyable meeting. Our Trustee, Greg Chadwick who has been an involved and effective leader and has represented us with distinction at the ADA in Chicago. A special thank you goes to:

•

Res. 94 urges the ADA health foundation to solicit pro posals for the second phase of a research project on ascertaining acceptable levels of nitrous oxide in the dental office. Funding for the project will be sought from government, industry and other sources. The ADA will contribute up to $67,300 to help finance the research.

•

Res. 15 adopts a policy statement by the ADA on the health hazards of intraoral/perioral piercing. It also di rects ADA agencies to continue both to monitor scien tific literature on the subject and educate the public about those risks.

•

Res. 98 calls for the Board of Trustee's to direct the strategic planning committee to review the ADA strate gic plan; 1998-2000 for the purpose of developing lan guage that would reflectthe broadened scope of the prac-

26 Virginia Dental Journal

The outgoing delegation members Gary Arbuckle and Ra leigh Watson. Both Gary and Raleigh have played key roles in the success of the VDA delegation. Both have been an asset to our profession and the ADA. Both of them will be sorely missed, not only by the members of the VA delega tion, but by all who have been fortunate enough to have served with them. Thanks for a job well done! Dick Wilson, who chaired the reference committee on Dental Education and Related Matters. As always, Dick did a superb job in delivering his report to the ADA House of Delegates. Ron Tankersley who served on the ADA reference commit tee of Dental Benefits, Practice and Health and also as Vice chairman of the ie" District Caucus. As always Ron was well prepared and did an outstanding job. Joan Gillespie who served on the reference committee on Presidents' Address and Administrative Matters and is an outgoing member of the council on Ethics, Bylaws and Judicial Affairs.

Les Webb who is the outgoing Council on Dental Benefits Chairman. Anne Adams who is the retiring Council on membership Chair (Anne remains on the Council one more year). Ellen Byrne-outgoing Council on Scientific Affairs member. (Ellen is not a member of the ADA delegation but I would like to recognize her because she has done such a tremendous job for our profession at the local, state and national level.)

For the VDA members information the 16th District passed unanimously a motion that the district acknowledge the memory of Pat Watkins' husband by each delegation donat足 ing to the Virginia Dental Foundation. (Executive Committee to determine amount of memoriam.) The 1999 16th District Caucus will be September 24-26 at the Boar's Head Inn, Charlottesville, VA. Our Executive Direc足 tor, Bill Zepp will be in charge of the arrangements.

Will Allison who served as 16th District Teller in San Fran足 cisco and as Parliamentarian at the 16th District Caucus. Bill Zepp our Executive Director who got us the best seats in the house at the ADA Presidential Dinner Dance. Congratulations to: Christy Hamlin who has been appointed to ADA Council on Ethics, Bylaws and Judicial Affairs. Charlie Cuttino who has been appointed to ADA Council on Dental Benefits. Bettie McKaig (NC) who was elected as First Vice President of the ADA.

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Virginia Dental Journal 27

ADA PRESIDENT'S ADDRESS David A. Whiston, D.D.S., ADA Immediate Past President

For the American Dental Association to be successful, I believe we all understand that we have to be relevant, we have to be responsible and we have to be representative of this changing profession. We've tried very hard to push for a sense of urgency within the Association this year to accomplish these goals - to be more relevant, responsible, and representative. That includes a sense of urgency--eertainly on the member ship side-in the scientific and legislative arenas and also, for a specific example, with our for-profit subsidiaries. We listened to you and, I believe, made some great progress by changing the structure of each SUbsidiary. l\Iow a volun teer-a non-trustee, non-staff volunteer dedicated only to that job-is the president of each of our for-profit subsidiaries. I'd like to add that this was all done with the assistance and support of the executive director and senior management staff, with all of us understanding that we do a better job with increased volunteer input. In some ways there's a similar sense of urgency at this year's House. And regardless of how we feel about the issues that we talk about, the important thing is that we're talking. The important thing is that we are asking members what they think. They're in the debate. For that reason alone, when we leave here we've got a big job to do; and we'd better do it with a sense of urgency. For example: with the Public Awareness Campaign, obvi ously there are those for the campaign and there are those against it. Most disappointing of all, though, are those (and it cuts across all areas of the membership, including private practice, academics, federal services) who are using this proposal as a litmus test for deciding whether or not to stay in the Association. So either way-and it's not just the Council membership all have the difficult, complex job of explaining, really, a very simple fact: The profession of dentistry, as we know it, can not exist in this country without the leadership of the Ameri can Dental Association. And the American Dental Associa tion, as we know it, cannot exist without strong member support. It's really very simple: the profession needs the American Dental Association and the ADA needs its members. As we leave here, let's focus on that membership issue, and let's do it with a sense of urgency. Now-as we look to the future, it's our job to make sure that we're a relevant, representative association that acts in a 28 Virginia Dental Journal

responsible manner in all of our areas of influence. And to accomplish these goals, we need to ask the right questions on every issue; we need to make decisions more quickly; and we need to make good decisions, always, always re membering that often saying no is the best decision we can make. Let's look at a couple of examples here, first on the scientific side. This year we were invited nationally and internationally to pursue initiatives that would compromise the integrity of the ADA Seal of Acceptance. Not that these things can't be rationalized at times. But it's a very comforting feeling to talk to Consumer Reports or Time or Newsweek and say, "No, we don't get a dime. Not only do we not get royalties on seal products, we don't grant the Seal exclusively to any one. We reject thirty to forty percent of applicants. And our members foot about seventy percent of the bill." When Barron's refers to ADA standards as higher than the FDA's, and when the AMA News refers to the American Den tal Association as "long being held up as the model for health care products testing and endorsement," I think we all real ize that our scientific integrity really stands for something, and we all realize we can't do anything that would compro mise that integrity. Let's look at another example of a time to say no, this time on the legislative front. As you well know, after the evaporation of PARCA we were invited to go down several roads on the so-called patient protection front. At that time, the Republicans offered pa tient protection with essentially meaningless choice; and the Democrats promised some choice, with essentially no chance of achieving it. We met or talked with all the players; on the Senate side Senators Nickels, Kennedy, Daschle; on the House side representatives Armey, Ganske, Linder, Norwood and Speaker Gingrich. We heard what they said. We heard what they didn't say. And as the landscape got hazier and hazier, one thing be came very clear. It was time to take a good hard look at our principles and what we stand for. First and foremost is real patient choice. And let's just fo cus on choice for now, although we certainly have other prin ciples such as plan accountability and anti-discrimination language.

But our job is not to get credit for passing a specific bill-it's to help push the debate so we get the best protection for our patients. When Senator Nickles was voicing his considerable displea sure over our original support of PARCA, we reminded him that without dentistry's grassroots, we wouldn't even be dis cussing these issues. In fact, let's recognize the ADA grassroots effort for the progress we've made on these issues-especially the Geor gia Dental Association and Charlie Norwood. Then after leaving Senator Nickles' office, we heard from the other side of the aisle, as Senators Kennedy and Daschle and Representative Ganske explained their latest promise of choice, leading with the fact that the American Medical As sociation had already signed on.

our principles bring clarity to that hazy landscape, wher ever it may be. Thanks to you, I've had the privilege of delivering our mes sage to the toughest media in this country, to the Senate and House, and to the Cabinet members and the President and the Vice President of the United States. And again, it's a great feeling of security to know that your statements are backed by the integrity and the strength of our Association and our profession. And that also is thanks to you. So as we move forward in a relevant, responsible, represen tative way, let's aggressively pursue these goals. Let's main tain that integrity. Let's stand for our principles. Let's make the greatest profession in this country even better. Thank you very much for the honor of representing you as president of the American Dental Association.

The AMA, by the way, predicated their endorsement on "the five key factors that should be part of any truly effective patient's bill of rights." And they are all laudable goals: 1. full disclosure; 2. an end to physician gag clauses; 3. an external appeals process for patients over health plan decisions; 4. access to emergency services based on a prudent lay person standard; and 5. health plans accountability for their decisions. If anyone heard the word choice in there, please raise your hand. And this is not an AMAJADA face off. I'm just calling atten tion to the fact that our number one is not one of their five. And most times-if it's a head to head issue-we lose. We lose for one reason, and that is a number and that number is seventeen. That's the seventeen million dollars that they've thrown at this issue over the past couple of years-just a little more than we've spent. And I don't want to minimize our role, because we have become a very important player in the health care arena; and we'll be more important as we return to the debate year after year after year. And there's no choice on that issue. Somerset Maugham said, "It's a funny thing about life, if you refuse to accept anything but the best, you often get it." That's certainly true on the scientific side, and it's often true on the legislative side. Compromise is such a way of life inside the Capital Beltway; but in these situations we an swer to a higher power: our patients.

1999

VIRGINIA BOARD OF

DENTISTRY

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 a member of the Board on questions on rules and regulations. Nora M. French, D.MD. Monroe E. Harris, Jr., DD.S. Michael J. Link, DD.S. French H. Moore, Jr., D.D.S. Edmund E. Mullins, DD.S. Gary Taylor, D.D.S. Richard D. Wilson, D.D.S. Carolyn B. Hawkins, R.D.H. Stephanie P. Olenic, R.D.H. Pat K. Watkins STAFF Marcia J. Miller, Executive Director Pam Horner, Administrative Assistant Kathy Lackey, Administrative Assistant Lychia Morris, Office Services Specialist 6606 W. Broad Street, #401 Richmond, VA 23230-1717 (804 )662-9906 FAX(804 )662-9943

We've got a great story to tell. We have great principles and

Virginia Dental Journal 29

NEW LAW HELPS HEALTH PROFESSIONALS

WHILE PROTECTING PUBLIC

Mark Christie The Health Practitioners Intervention Program (HPIP), en acted by the 1997 General Assembly with the support of the Virginia Dental Association has now been in effect for one year.' Based on my own experience representing healthcare professionals before regulatory boards, the new law appears to be working. The legislative intent of the new law was to provide an alter native to disciplinary action for healthcare professionals such as dentists, dental hygienists, physicians, nurses and phar macists who suffer from impairments whether physical or mental. The law defines "impairment" broadly, to include not only substance abuse, whether of alcohol or drugs, but also mental impairments such as severe depression. Let's use a hypothetical example to illustrate the way the new law is supposed to work: Dr. John Doe has been a heavy drinker for several years and the effects of his drinking have become noticeable to his own staff and patients. A complaint is made to the Virginia Board of Dentistry, which initiates an investigation and disciplinary proceeding pursuant to its mandate to protect the public. Before the HPIP law was enacted, Dr. Doe would have had no altemative but to attempt to fight the Board's disciplinary proceeding or negotiate a consent order, which could have included a temporary or permanent suspension of Dr. Doe's license to practice dentistry. With the HPIP law now in effect, however, Dr, Doe has an alternative to disciplinary action. Dr. Doe could voluntarily enter the program (sometimes called the "diversion" pro gram). Dr. Doe would sign a participation agreement, which would require him to undergo an alcoholic treatment regi men monitored by a case manager. He may also be re quired to accept limitations on his practice or stop practic ing dentistry altogether while undergoing treatment depend ing on whether he is considered a threat to the health and safety of his patients.

disciplinary proceedings will take place as long as Dr. Doe meets the conditions of the stay, which would likely include a requirement that he continue to seek treatment for his alcoholism. Most important for Dr. Doe, there would be no action taken against his license to practice dentistry, thereby keeping his record clean and the proceedings and records of the HPIP Committee are considered confidential and not to be disclosed under the Virginia Freedom of Information Act. The new law is intended to encourage healthcare profes sionals such as dentists and dental hygienists to seek help for their impairments. It provides a non-punitive alterna tive to disciplinary action. Often the key to whether the new law works is whether the healthcare professional is willing to cooperate fully and voluntarily with the HPIP pro gram. If the healthcare professional violates the terms of his participation agreement, the HPIP Committee has the authority to dissolve the stay it previously granted, in which case the regulatory board with jurisdiction over the practi tioner will resume disciplinary proceedings. A key factor that the regulatory boards and HPIP Committee seem to be considering in applying the new law is whether the practitioner represents a present threat to the health and safety of the public. This is an appropriate factor to consider. After all, the reason we have health regulatory boards is to protect the public from incompetent or dangerous healthcare professionals. When the new law works as intended, it represents a "win/ win" that gives impaired healthcare professionals a non punitive incentive to seek help for their problems, while at the same time protecting the public. The HPIP law is a positive step that will serve the interests of both healthcare practitioners and their patients. 1

While Dr. Doe is participating in the program, the Board of Dentistry's disciplinary proceedings against him would likely be suspended. Ultimately, if his cooperation level remains high and his treatment shows indications of success, the Department of Health Professions HPIP Committee has the authority to grant an indefinite stay of disciplinary proceedings against him. If a stay is granted, no further

Va. Code 54.1-2515 et seq., effective January 1, 1998.

(Mark Christie is an attorney with the Richmond-based firm of Williams, Mullen, Christian & Dobbins whose practice includes representing healthcare professionals before health regulatory boards. He was formerly chief counsel to Gov. George Allen.)

Virginia Dental Journal 31

FIVE WAYS YOU CAN HELP VDA LOBBY THE LEGISLATURE

Lisa M. Finnerty, VDA Public Affairs Coordinator 1. Join VA's Key Contact Legislative Network

3. Contribute to the Governor's Club

Do you personally know a state legislator, either in the Vir ginia House or Virginia Senate? If so, why not consider serving as a VDA Contact Dentist?

Contribute to the Governor's Club, a higher level of giving to VADPAC. A contribution of $500 includes regular active VADPAC/ADPAC membership, active Commonwealth Club membership, ADPAC Capital Club membership, two tick ets to the Annual VADPAC Leadership Dinner, and a pri vate meeting & briefing with a key political figure.

VDA Contact Dentists form an essential part of the VDA's legislative program, by providing one-on-one contact be tween the profession and members of the Virginia House & Senate, as well as members of Virginia's U.S. congres sional delegation. VDA will provide information on issues via phone, fax, e mail and mail for quick response as legislation moves through the Session. You provide the contact.

2. Contribute to VADPAC and the Commonwealth Club Contribute to VADPAC and the Commonwealth Club. Your dollars fund the VADPAC contributions to legislative candi dates who support dentistry's issues. A minimum $50 contribution automatically enrolls you as a member of VADPAC as well as the ADA's political action committee, ADPAC, which funds equally important contributions to congressional candidates. Your support of the Common wealth Club provides VDA with the money needed for lob bying and VDA's key contact network. A $100 contribution is suggested in addition to the active VADPAC/ADPAC dues of $50.

4. Attend the Annual VADPAC Leadership Dinner Dinner with legislators each year during the January Com mittee Meetings. A key political player is invited to be our keynote speaker to provide an update on the General As sembly and the state of the Commonwealth. In the past we have hosted the Governor, Lt. Governor, Attorney Gen eral and a Sr. VA Senator.

5. Attend the Annual Alliance Day on the Hill The Alliance of the Virginia Dental Association annually goes to the State Capital to promote children's dental health month and dentistry in general. Legislators and staffers are presented with a Virginia apple and a dental health packet compliments of both the Alliance and the VDA. This is a perfect opportunity to educate legislators on VDA positions while at the same time promoting oral health.

---------------------------------------VDA Legislative Key Contact Network

Phone:

FAX:

E-mail:

Name of Legislator: Please list the name of any state legislator with whom you are acquainted and/or are willing to contact regarding dental issues:

How do you know this legislator?

Would you be interested in becoming a grassroots contact for an U.S. Senator or Congressman? If so, please list the name(s):

Return to: VDA, P.O. Box 6906, Richmond, VA 23230 or by FAX 804/353-7342 32 Virginia Dental Journal

Dr. Guy Levy, PDS Immediate Past President, and wife Robin share a laugh with Delegate Phil Hamilton. Jocelyn Lance presents Senator Walter Stosch from Richmond a contribution at the fund raiser held on his behalf.

Members of the Tidewater Dental Association gather at their legislative social with honored guests: Senators Randy Forbes, Louise Lucas, Yvonne Miller, Frederick Quayle, Edward Shrock, Ken Stolle, and Stanley Walker; Delegates Harry Blevins, Jerrauld Jones, Chris Jones, Bob Purkey, and Robert Tata.

ir~

Dr. Dave'Anderson and Dr. Bruc~J'Hutchison attend the....NVDS legislative brunch held at the Boyhood Home of Robert E. Lee which was attended by fifteen legislators.

MEDICAL MALPRACTICE CAP

Charles R. Duvall, VDA Lobbyist

On Friday, January 8, 1999, the Supreme Court of Virginia issued an opinion with regard to Virginia's Medical Malprac tice Cap. It upheld a prior ruling that the cap on medical malpractice damages of $1 million is legal and valid. The 1999 Session of the Virginia General Assembly, in spite of that decision, will see the introduction of legislation deal ing with the cap. The Virginia Trial Lawyers Association will undoubtedly introduce legislation that will attempt to increase the existing $1 million cap significantly. The Medical Society of Virginia and the Virginia Hospital and Health Care Association jointly plan to seek legislation designed to address those rare cases where a patient's medi cal fee may exceed the current $1 million limit. Their proposal would allow an injured patient to have the choice of pursuing one of two options. First, an injured pa tient could choose to pursue a remedy for an injury seek

ing damages subject to a cap that would be increased by 25% ($1,250,000). The second option for an injured patient would be to recover future medical costs under a catastrophic plan. This is a plan similar to one that was introduced sev eral years ago in the Virginia General Assembly. Though receiving unanimous support in the Senate, it was not voted out of the House Courts Committee. The catastrophic plan would allow injured parties to choose to seek a $1 million cap on a malpractice award but receive lifelong payments for their medical fees (not to exceed $2.7 million) once their out-of-pocket actual medical expenditures had exceeded $300,000. Obviously, the Trial Lawyers proposal to raise the cap and the proposal being advanced by MSV and the Virginia Hospi tal Association will be very aggressively debated and lobbied during the 1999 Session of the Virginia General Assembly.

Virginia Dental Journal 33

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UPCOMING CONTINUING EDUCATION

Month

Component

Meeting

Location

SpeakerfTopic

Feb. 18, 1999

NVDS (8)

CE Program/ Dinner

Fairview Marriot

Dr. George Blakey, "Dental Emergencies/ Pharmacology"

March 5, 1999

NVDS (8)

CE Program

Fairview Marriott

Dr. John Svirsky, "Oral Pathology/ Radiography"

Omni Hotel, Newport News

Dr. John Svirsky, "Oral Pathology for the Fun of It"

VDA co-sponsored

March 12, 1999

Peninsula (2)

CE Program VDA co-sponsored

March 12, 1999

Southwest (6)

CE Program

Van Dyke Center, Emory

Dr. Jeffrey Hutter, "Facial Space Infections of Dental Origin & Traumatic Injury Update"

March 18, 1999

Richmond (4)

CE Program/ Dinner

Embassy Suites Hotel, Richmond

Dr. James Soderquist, "Orthodontics to Enhance Your Restorative Dentistry"

March 19, 1999

Shenandoah(7) CE Program

Holiday Inn, Winchester

Dr. David Sarrett, "Sticking to the Principles of Esthetic Adhesive Dentistry"

March 26, 1999

Richmond (4)

CE Program/ Dinner

Embassy Suites Hotel, Richmond

Dr. Dan Fisher, "Everyday Adhesive Dentistry"

April 9, 1999

Tidewater (1)

CE Program VDA co-sponsored

Holiday Inn, Chesapeake

Dr. Dick Barnes, "Creating the Successful Practice"

April 15, 1999

Richmond (4)

CE Program/ Dinner

Embassy Suites Hotel, Richmond

Drs. James Schroeder and AI Stenger, "Successful Associateships"

April 21, 1999

NVDS (8)

CE Program/ Dinner

McLean Hilton, McLean

Dr. Art Mourino, "Pediatric Dentistry"

Apr. 3D-May 2, 1999

Piedmont (5)

CE Program/ Annual Meeting

The Homestead, Hot Springs, VA

Dr. Daniel Becker, "Update in Pharmacology for the Dentist"

May 14-16,1999

Southwest (6)

CE Program/ Annual Meeting

Pipestem State Park, Pipestem, WV

Dr. David Chance

Aug. 13, 1999

Southwest (6)

CE Program VDA co-sponsored

Higher Educational Center, Dr. Samuel B. Low, "Successful Abingdon Management of the Perio Patient"

Sept. 17, 1999

VDA

CE Program/ Annual Meeting

Hyatt Regency Reston, Reston

Dr. Dan Sullivan, Restoration of Implants

Sept. 18, 1999

VDA

CE Program/ Annual Meeting

Hyatt Regency Reston, Reston

G.L. Johnson, Practice Management

Nov. 5, 1999

Southside (3)

CE Program

TBA

113A

Donaldson Brown ConferenceCenter, Blacksburg

Dr. Michael V. Dishman, "Bleaching & Cosmetic Dentistry"

VDA co-sponsored

Nov. 12, 1999

Southwest (6)

CE Program

AIDA C路E.R..P

CONTINUING EDUCATION RECOGNITION PROGRAM The VDA is recognized as a certified sponsor of continuing dental education by both the ADA CERP and the Academy of General Dentistry.

Virginia Dental Journal 35

[II

MEMBERSHIP BENEFIT HIGHLIGHT

Kimberly S. Swanson, D.D.S., VDA Membership Task Force The Annual Session of the American Dental Association offers over 160 continuing education courses on topics including the science, art, and practice of dentistry, dental technology, and quality of life issues. It is the premier dental meeting in the world. The next meeting will be October 9-13 in Honolulu, Hawaii and the 2000 meeting will be in Chicago on October 14-18. In conjunction with the Annual Session, the ADA offers two unique pre-session programs. Technology Day presents over 25 programs on dental technology and methods for incorporating the technology into the dental office. The format includes lectures, question and answer sessions, and technology exhibits. The Team Building Conference is an opportunity for the dentist and staff to develop and enhance their most valuable resource- the dental team. This interac tive program teaches dental teams to maximize the strengths of individual members and to maximize the strengths of individual members and to develop a common vision and cohesiveness. For details, call the Annual Session 24-hour information line at 1-800-232-1432. For Annual Session course atten dance verification, contact the Council on ADA Sessions and International Programs, extension 2745. The 13th National Conference on the New Dentist will be July 29-31,1999, in Nashville, Tennessee. The theme for the conference is "Networking in Nashville ... Dentistry for a New Century". Course topics include practice management, clinical topics, professional issues, and leadership. Virginia Dental Association members who attended last summers' conference in Seattle indicated that they found it to be educational, fun, and very worthwhile. I encourage any inter ested VDA member to attend next years' conference. The Committee on the New Dentist also hosts the "New Dentist Committee Network Idea Exchange and Open Forum", a discussion format for new dentist issues and idea sharing. The nationwide New Dentist Network also helps new dentists get involved in organized dentistry. For more informa tion about the conference, the forum, or the nationwide network, contact the ADA Committee on the New Dentist, extension 2779. The "Calendar of Dental Meetings" is a complete and comprehensive listing of state dental society meetings and other dental meetings held throughout the United States and Canada. It is free to members through the Council on ADA Sessions and International Programs, extension 2745. The ADA Commission on Dental Education assures the maintenance of rigorous and consistent educational stan dards. Many members have become directly involved in the accreditation process- a professional growth opportunity reserved for ADA members who are dental educators. Contact the Commission on Dental Education at extension 4660 for details on the nominating process. A listing of advanced dental, postgraduate, and allied educational programs in the United States and Canada is also available through the Commission. This publication is free to members. For more information on the many benefits of membership in organized dentistry, call the ADA at (312) 440-2500, or use the member-only 800 number listed on the back of your membership card. You may also call the Virginia Dental Association at (804) 358-4127 or 1-800-552-3886. Membership matters!

36 Virginia Dental Journal

BUDGET AND FINANCIAL INVESTMENTS COMMITTEE

LETTER OF INFORMATION TO VDA MEMBERS

Raymond L. Meade, D.D.S., Budget and Financial Investments Committee Chairman These are exciting times in the VDA. Our committee wants you informed and knowledgeable about how your dues are

used and how other non dues income help support the VDA budget and programs. For your information the budget for

the Virginia Dental Association for 1999 is over $764,000.00. The Budget and Financial Committee takes preparing a

budget of this magnitude very seriously.

First the good news-since 1994 there has only been a $15.00 increase in general operating fund dues for the VDA.

Non dues income from different sources as the MBNA credit card, VDA annual meeting, insurance sponsorships,

specialist organization management, and investments have increased from about 15% in 1994 to just over 33% in the

1999 budget. The Budget and Financial Investments Committee has made some hard choices and worked with other

committees to keep dues increases at the present level over the past few years.

What does the future hold? The VDA building has become crowded due to increased services and programs. The

VDA Executive Committee has appointed a new building planning committee. Their charge is to determine what

facilities the VDA will need in the future. The Budget and Financial Investments Committee has been charged with how

to pay for it. We are looking for ideas. The plan is to have building plans and funding options to present to the 2000

House of Delegates. A new building is a big project that will require additional resources.

Other programs and activities are occurring in the VDA. In the Virginia legislative area our lobbying has been very

effective and has required considerable funding. Additional funds for lobbying may be needed if we are to continue to

keep our gains and deal with future issues. The DDS "Donated Dental Services" Program has been a success for

dentistry in Virginia. The program was started by grants that are decreasing over a period of years. Where will the

funds come from to continue this program? The VDA is presently searching for additional grants and/or corporate

sponsorship so this program remains self-supporting. Also our committee is studying the amount needed in a capital

reserve fund for an organization the size of the VDA and how to subscribe such a fund.

As you can see many different programs are in the future for the VDA and its members. You are probably thinking it

sounds like there is a dues increase in the making. That may be true but our committee remembers what happened

to the ADA awareness campaign and will justify any increases necessary.

The Budget and Financial Investments Committee is open you. If you desire to attend our meetings please feel free to

come and share your insights. If you have comments or questions contact me or your component representative listed

below. Also speak with your component Executive Council member or House of Delegates delegate because they are

the ones who vote on our committee suggestions.

Budget and Financial Investments Committee Component Representatives:

James Baker (1)

Gary Riggs, Jr. (2)

Raymond L. Meade (3)

Charles E. Gaskins, III (4)

William W. Martin (5)

David L. Stepp (6)

Gerald J. Brown (7)

Charlie French II (8)

Virginia Dental Journal 37

DR NEWS Connie Jungmann, VDA Assistant Executive Director

1998: A Year of Progress

Internal research conducted by the ADA in November 1998 has helped to assess the year's DR promotional efforts thus far, according to Ms. Maria Ellis, assistant manager of the ADA's Purchaser Information Service (PINSERV). "This year has seen a dramatic rise in the number of inquiries generated and in the number of DR plans imple足 mented." For example, between January 1 and October 30, 1998: Total number Total number Total number Total number

of of of of

inquiries generated: 5,282

new plans implemented: 223

new employees covered: 50,616

new lives covered in 1998: 118,756

Topping the number of new plans implemented in 1998 are California and Pennsylvania; Virginia, Louisiana and Nebraska top the list of most number of employees covered by new plans. These statistics were reported in the December-January 1999 issue of the ADA's Direct Reimbursement News. The numbers reported were taken from the DR Lead Tracking Reports, as submitted by the states.

Virginia Advertising Enhances ADA's Campaign

As the ADA continues it's national advertising campaign for DR, the VDA has taken two of the ads currently being used and has modified them for the Virginia market place. The first of these full-page, full-color ads was placed last year in the Virginia Business Magazine, as well as the Virginia Health Care Buyer resource guide. The second ad, "'Save time, Save money, Save teeth" will be used during our 1999 print advertising campaign. A black-and-white version of this ad is provided on the facing page.

Four More Virginia Businesses Choose DR

The New Year is off to a good start for Direct Reimbursement with the announcement of four new DR plans put into place as of January 1. Chesapeake Masonry Corp. - Newport News

Referred by: Dr. Paul Orphanidys

Labat-Anderson, Incorporated - McLean

Referred by: ADA direct mail campaign

Moseley, Harris & McClintock - Richmond

Referred by: Dr. Edward Griggs

Rutherfoord Benefit Services - Richmond

Referred by: Jon Swan, Benefits Administration

Our thanks to Dr. Griggs and Dr. Orphanidys for their time and efforts. If your office is interested in getting involved in promoting Direct Reimbursement, please contact Ronya Edwards or Connie Jungmann at the VDA Office. Brochures and other DR educational materials are available to VDA member dentist at no cost upon request.

38 Virginia Dental Journal

Virginia Dental Association

The H.R. manager who can breathe a little easier.

The boss who's pleased with the bottom line.

The family that can choose any dentist it wants.

Save time. Save money, Save teeth.

Direct Reimbursement helps you three ways.

It helps you save time because it's easy for everyone to understand, and there are no complicated claims procedures. It can save money because, instead of paying monthly insurance premiums, even for employees who don't use dental benefits, you pay for actual treatment received. It allows employees to get the treatment they need from dentists they choose. So you can offer a quality dental benefit at less cost and with fewer hassles than ever before. For information about a Direct Reimbursement plan deSigned to meet the company needs you speCify. just call 1-800-552-3886

Or visit our web site at http://www. vadental.org

The

D enta1 DIRECT

REIMBURSEMENT

Benefits Plan for

Smart Companies

Virginia Dental Journal 39

VDA NEWS

[II

INTERNATIONAL COLLEGE OF DENTISTS

CLASS OF 1998

The new Fellows of the International College of Dentists, Class of 1998 were inducted into the College at its annual meeting at the Hilton Towers Hotel, San Francisco, Califor足 nia on October 23, 1998.

SCHOLARSHIPS AVAILABLE Dental auxiliary and student loan funds are available through the Virginia Dental Association. Scholarships up to $500 are available to Dental Assisting Students and loans up to $1000 are available to Dental Hygiene Students. If you are interested in an appliation or wish to learn more about the availabilty of these funds, please call the Virginia Dental Association Central Office (804) 358-4927 orfax (804) 353-7342.

IMPORTANT INFORMATION ABOUT YOUR 1999 MEMBERSHIP DUES STATEMENT

Pictured: (front row) Ralph L. Howell, Jr., R. Leroy Howell, Sr., Guy G. Levy, Robert L. O'Neill. (back row) French H. Moore, Jr., Neil J. Small, Jay S. Lipman, Harold ~1. Neal, Jr. (not pictured) T. Wayne Mostiler, Augustus A. Petticolas, Jr., Frank R. Portell.

THE ALTON D. BRASHEAR POSTGRADUATE

COURSE IN HEAD &NECK ANATOMY

A four-day course entitled "The Alton D. Brashear Post足 graduate Course in Head and Neck Anatomy" will be held at Virginia Commonwealth University, School of Medicine, Department of Anatomy, March 8-11, 1999. The course is approved for 44 credit hours by the Academy of General Dentistry. The course is open to any individual who holds one of the following degrees: MD., DD.S., PhD., or equivalent. The class size will be limited to 36. All applications will be processed in the order in which they were received. Contact Dr. Hugo R. Seibel, VCU, Department of Anatomy, for an application (804) 828-9791.

The ADA has advised that, based on guidance given from the IRS, a revised estimate of the non-deduct足 ible portion of ADA dues for 1999 is 8.9%, which is a change from the 9.2% figure shown on your VDA dues statement. Only that portion of an association member's dues not attributable to lobbying activities is deductible as an ordinary and necessary business expense. 7% of VDA dues and 0% of component society dues is allocable to lobbying activities and therefore, nondeductible as a business expense.

\t'

~ Looking for info on upcoming CE courses?

What's happening at the VDA? Want to learn more about Direct Reimbursement? Visit the VDA's website for answers to these questions... and much, much more.

www. vadental.org 40 Virginia Dental Journal

[II

ALLIANCE NEWS

Jocelyn Lance of Richmond was installed as Treasurer of the Alliance of the American Dental Association during the organization's recent convention in San Francisco, California. Mrs. Lance is a former Associate Membership Chair, Public Relations Chair and Legislative Chair and has held various elected and appointed leadership positions in local and state dental alliances. She is a Thelma J. Neff Award recipient, a distinguished service award for alliance members making outstanding contributions to their components. She currently participates in "The Woman's Club", "The Tuckahoe Woman's Club", and "Colonial Dames of America, Virginia Chapter". Jocelyn is married to Dr. James Lance, an Endodontist in Richmond. They are the parents of three children, Brian, Stephanie and Christopher. The Alliance of the American Dental Association (AADA), a national organization for spouses of dentists, promotes dental health through community involvement and legislative activities.

ASSISTANT NEWS

GLORIA CRIST RECEIVES NATIONAL AWARD

DR. JAMES WATKINS NAMED AS DANS DIRECTOR

One of the highlights of each year's American Dental Assis tants Association Annual Conference is the presentation of awards in various categories of achievement including the recently inaugurated American Dental Assistants Associa tion/Sullivan-Schein Awards of Excellence. The award may be presented to as many as 12 ADAA members- one from each district- and from this pool of recipients a national win ner is selected. This year, seven district awards were in addition to the national award.

The Dental Assisting National Board's Board accepted the American Dental Association (ADA) nomination of James D. Watkins, D.D.S., from Hampton, Virginia, to serve as a DANB director. Dr. Watkins is a general practitioner in Virginia and is a past-president of the Virginia Board of Dentistry. He also served on the ADA Commission on Dental Accredita tion and the Council on Dental Education and Licensure. Dr. Watkins will serve a three-year term, ending at the conclu sion of the 2001 annual meeting.

National recipient for the ADAA/Sullivan-Schein Award of Excellence was Gloria Crist of Concord, VA. Ms. Crist was recognized in part for her leadership in the area of identifying continuing education professionals in the Lynchburg, Virginia area. She is the second national award winner. She was concurrently named winner of the District award for the ADAA's 3rd District which includes Delaware, District of Columbia, Maryland, Ohio, Virginia, and West Virginia. The national winner is chosen from among the winners of each ADAA:s twelve districts comprising over 15,000 members.

DANB's board of directors consists of nine members repre senting the American Dental Assistants Association (3), the American Dental Association (2), the American Association of Dental Schools (1), the American Association of Dental Examiners (1), At-Large Population of DANB Certificants (1), and the Public (1).

Virginia Dental Journal 41

(

COMPONENT NEWS

)

Component I Tidewater

wanted to be heard from. I sent an e mail to my congressman the day be fore the vote and his line was so busy that the message could not be delivered. Have a great winter, we look forward to greeting you all in the spring.

Dr. Barry Einhorn, Editor Happy New Year from Tidewater. Our component is looking forward to 1999 with great anticipation. Our program committee has prepared a very interest ing series of continuing education pro grams, beginning on February 5th with Dr. Dean Elledge. His topic will be "Re storative Magic". On April 9 th we will present Dr. Dick Barnes whose topic will be "Practice Management". These are two outstanding clinicians and we in vite attendance from all VDA members. For further information please call Ginnie Donne at 757-491-4626. Dr. Pam Morgan, chairperson for Children's Dental Health Month has scheduled an exciting series of events for the month. The highlight of the month's celebration will be a Fair to be held at the Virginia Marine Science Museum on Saturday, February 6th from 11 :OOam - 1pm. VDA President-Elect Bud Zimmer has mounted a campaign to influence the state legislature to pass the assignment of benefits bill that will be coming up in this year's session. This is a patients' rights issue which we feel strongly about. I hope by the time this article is read we will be able to say our efforts bore fruit. As I am writing this article the sun is shining and the temperature is 60°. It is hard to get the feel of winter under these conditions, but I know that the cold wind will blow soon, if not today. Unfortunately there is likely to be some frigid goings on in our nation's capital in the next few months. Let us pray that whatever the outcome, it will cause little disruption in all our lives. Perhaps that is part of the genius of our country, that we can weather political storms and move on to better days. Regarding the impeachment issue, I guess a lot of folks 42 Virginia Dental Journal

Component II Peninsula

the next time we meet as to dates and location. Component II would like to welcome three new members to it's midst. Dr. Ed Owens, Dr.Brian Frandsen, and from the "Land of Lincoln", Dr. Raymond Flanders. It's time to close for now with the wish for smooth sledding to all you skiers and snowboarders out there. For me, I'll just sit here with brandy in hand trying to figure out how to get around the course without hitting the buoys this year. I sure hope the power stays on - it's a long walk in the dark for a second brandy!

Dr. A.J. Booker, Editor I don't know about you folks out there but I'd like to start something different. You see the holidays come at the same time of year that I'm suddenly too busy tying up loose business ends or cement ing that forty unit bridge at the stroke of midnight. I say let's move all these fes tivities to the middle of January. At least it will liven up an otherwise dark and dis mal month for us sailors! However, there is a light at the end of the tunnel. And that light will be carried down interstate 64 by none other than Dr. John Svirsky on Friday, March 12 at the Newport News Omni Hotel. Dr. Svirsky's programs on oral pathologyare always both informative and great fun. Anyone who misses the fliers on this course can obtain all the information necessary by calling the PDS office at (757)259-0594 or on the web at www.blackhairytongue.com. Our Caribbean/Legislators night seems to have been another success this year. Especially for Dr. Jim Watkins who was the winner of a color TV donated by Benco Dental. It has been quite interesting to watch the communication grow between membership and our legislators. Take one good idea - a picnic. Stir in lots of good food. Then top it off with a theme park and you have all the neces sary ingredients for a spring outing the PDS is planning for its members and guests. Will keep everyone informed

Component III Southside

Dr. Reed Boyd, Editor I am writing these notes shortly after Christmas and before New Year's. We are recovering from an ice storm, supposedly the worst in five years. It started the Wednesday before Christmas. Power, phones, cable TV and heat were lost at midnight the Wednesday before Christmas and were restored to my home the Monday after Christmas. Some parts of Petersburg, including my office, do not have power yet, and do not expect power back until New Year's. Talk about the "Southside Shuffle", the temperature in my house got to 37 degrees, so we become homeless and started moving from motel to motel, all the while praying for power to be restored. The first day or so camping out in the house was fun, cooking on the fire, sleeping in front of it, but after three days it did get old. Memories of times and days gone by... Anyway, the Southside Dental Society continues to move on and stay active with many interesting and exciting programs and activities scheduled for

the next year. January will bring our annual Spouses' Night. This year we will have as our speaker Alexander Wise, the current Director of the Virginia Department of Historic Resources to talk to us about "Why Virginia's Historic Resources Matter to You". Should be interesting. February 6 brings our National Children's Dental Health Month Celebra tion. Dr. Samuel Galstan is heading that up again this year and it will be a most successful event involving our Alliance members, the Component members, the Dental Division of the Public Health Department and of course, the MCV Dental School's van and students. Later in February on the 26th, we will have our annual OSHA and CPR Update and Recertification day. This has been a successful project from the beginning and a great membership recruitmentand retention tool. If the Component member's dues are paid in full by Janu ary 15, the OSHA Update course is free to them and their office staff. Then on March 24th, we will hold our Compo nent Business Meeting. Nominations will be presented for next year's Com ponent officers, as well as other busi ness will be taken care of, I am sure that officers for statewide offices will join us as well. We have scheduled several continuing education courses. On April 30,1999, we will present Suzanne Boswell who will talk on "Unmasking Your Mystery Patients". She will give her presenta tion at the Holiday Inn Koger Center in Richmond. Then in June, Dr. Joe Tregaskes will be our speaker at our annual continuing education course held in conjunction with the Emporia Pork Festival. That is scheduled for June 9, 1999. Our final continuing education course scheduled for this year is to be held on November 5, 1999 at the Country Club of Petersburg. "Contemporary Concepts in Aesthetic Dentistry" will be presented by Dr. Doug Lambert. Please mark your calendars now and watch for information in the mail about these opportunities to join us to learn, have some fun and fellowship.

We in Southside Virginia hope that all of you had a happy, safe and joyous holiday season. In the throes of winter, be careful on the slopes and the high ways. Here's hoping that everyone is enjoying a prosperous and great 1999. Get yourself ready for the new millen nium. Be Y2K compliant, whatever that means and involves! Get more active in organized dentistry; take a role in the development of legislationaffecting den tistry. Make dentistry better for us as dentists and our patients, those we serve, the citizens of Virginia. Contact your legislators on the issues that af fect dentistry and let them know how you and organized dentistry feel! Call Lisa Finnerty at the VDA office in Rich mond for any information that you might need. Hope to see you soon!

Component IV Richmond

Dr. Jack Dunlevy, Editor

nated to the Red Cross. The Compo nent is appreciative of the combined ef forts of Drs. Shari Ball, Charlie Thomas, co-chairs of the Committee, and Ms. Caroline Sweeney, President of the lo cal Dental Alliance. The March monthly meeting will feature Dr.James Soderquist, discussing "Orth odontics to Enhance Your Esthetic Den tistry." Another day long course is scheduled for March 20, when Dr. Dan Fisher, President of Ultradent Products, will be speaking on "Everyday Adhesive Dentistry." The April monthly member ship meeting will feature two Compo nent IV dentists, Drs. Jim Schroeder and AI Stenger who will discuss "Suc cessful Associateships." The Component expresses appreciation to the Alliance of the RDS, as well as to Drs. Anne Adams and Charlie Cuttino. The Alliance sponsored a des sert for Senate Majority Leader Walter Stosch at Anne and Charlie's home. We congratulate Dr. Monroe Harris, an Oral and Maxillofacial Surgeon, selected by Inside Business magazine as one of Richmond's "Top40 Under Forty,"for his various community activities. We also congratulate Russ and Rebecca Mosher on the birth of their daughter, Riley, on November 6.

New Year's greeting from your col leagues in Central Virginia. Component IV has begun 1999 with numerous pro gram activities. Our January monthly membership meet ing featured Mr. John Fitzpatrick, attor ney, who spoke about "Pitfalls of Docu mentation and Malpractice - Is Each Patient a Potential Lawsuit?" On Feb ruary 5, Dr. Charles Blair presented a day long courseentitled"ImprovingPrac tice Profitability."

Component V Piedmont

Dr. Barry Cutright, Editor February is Children's Dental Health Month and the Dental Alliance of the RDS is again assisting the Dental Health, Public Information and Commu nity Involvement Committee in several programs. Component dentists as sisted in a puppet show at the Science Museum of Virginia on February 20, a "Toothbrush Swap" at the Children's Museum and toothbrushes were do

Begin your New Year by marking April 30 - May 1. 1999 aside for the Pied mont Dental Society Spring Meeting. Dr. Daniel E. Becker will be our guest speaker at The Homestead in Hot Springs, Virginia. His topic an "Update in Pharmacology for the Dentist," like computer technology, is a must know for us to evolve as practicing dentists. Virginia Dental Journal 43

Our society met on October 30, in Lynchburg,and Dr. David Felton was the guest speaker. Dr. Felton was an un usually effective prosthodontic lecturer. He didn't ramble. He could address succinctly yet thoroughly any prosthetic procedure from a scientific, materials, or clinical point of view. If you were un able to attend, make it a point to attend one of his lectures in the future.

from MCV this past spring. Welcome back to work Dr. Denby Lewis. Your dedication to dentistry and excellence continues to be an example for your colleagues.

Dr. Carolyn Herring, Editor Component VI Southwest

A welcome to the following new mem bers of the Piedmont Component: Dr. John Carter Dr. Christine Mayhew Enright Dr. David Foley Dr. Richard Golden Dr. Paul Kiser Dr. Christine Roberts Also, we welcome two new practicing dentists in Lynchburg, Dr. Jason Crist and Dr. Brad Sorenson. During our fall business meeting Dr. Bill Martin was nominated for president elect in 1998-1999. Dr. Doug Price was nominated to serve on the executive council to represent Danville. Likewise, Committee Assignments include Dr. Dan Grabeel who was appointed to the Ethics and Judicial Affairs Committee. Dr. Grabeel will also serve on the VDA Foundation. Dr. Frank Crist will repre sent the Piedmont Dental Society on the Annual Meeting Committee. Finally let's remember the contributions of three fellow dentists who passed away in the previous year, Dr. Doug Handy, Dr. Andy Lipford, and Dr. George Vaughn.

Correction to Component V news in the October-November-December issue: The names of Dr. Arthur Sil vers, Dr. Norm Prillaman, and Dr. Denby Lewis were misspelled. This error was of no fault to the Piedmont Editor. The news should have read as follows: Practice transrtions-- Dr. Norm Prillaman has joined Dr. Richard Zechini in Lynchburg in the practice of Orthodon tics. Dr. Pamela Baker has joind Dr. Arthur "Skip" Silvers in the practice of General Dentistry. Dr. Baker graduated

44 Virginia Dental Journal

Component VII Shenandoah Valley

Dr. Robert G. Schuster, Editor Winter has finally arrived in Southwest Virginia. A beautiful, mild fall season transformed itself with a smattering of ice and snow on Christmas Eve. The mesmerizing appearance of a crystal line landscape would cause the onlooker to appreciate the beauty and peace of the season.

All are encouraged to attend the con tinuing education course "Sticking to the Principles of Esthetic Adhesive Dentistry" presented by Dr. David Sarrett, which will be on March 19, 1999, at the Holiday Inn in Winchester. Look forward to seeing you there!

Component VIII Northern Virginia

Dr. Melanie Love, Editor As the New Year of 1999 unfolds, we are reminded of achievements of the past year, and goals for a New Year. Our component is currently preparing for the winter committee meetings in Richmond, VA. The first component meeting of 1999 will be held at the Van Dyke Center, in Emory, VA, on March 12. The featured speaker will be Dr. Jeffrey Hutter. His topic will be "Facial Space infections of Dental Origin and Traumatic Injury Update." Our spring meeting will be held at Pipestem State Park and Resort in West Virginia on May 14-16. The featured speaker is Dr. David Chance. His topic will be "Crown and Bridge."This is a fam ily weekend event which features a golf tournament, an old-fashioned barbecue, and the many amenities and activities offered by Pipestem Resort State Park. Best wishes to all for a Happy New Year that will hopefully bring new challenges and aspirations.

Happy New Year from Component 8! I hope the Holidays were healthy and happy for everyone. Northern Virginia has had a few bouts with some slick weather, but no blizzard yet! We would like to welcome the following new members into the Dental Society: Dr. Deidre J. Maull, Dr. Shavaprasanna Rai, and Dr. Edward J. Strittmatter. On a very sad note, we suffered the loss of two of our members. Dr. Zachary T. Gray, III, passed away on October 4 af ter a battle with leukemia. Also suffer ing from leukemia, we lost Dr. Sameh K. Hanna on December 22. We know they will both be missed. Component 8 has a busy winter sched ule with New Member orientation on January 20; an ali-day meeting with Dr. Gerard Chiche on January 29, speak ing on "Recipes for Predictable Anterior Esthetics"; and Dr. George Blakey pre senting an evening meeting on "Dental Emergencies/Pharmacology." The NVDS VDA Fellows will host a dinner for new members on February 8. Kathleen Todd, Esq., Director of the ADA Council on Ethics, Bylaws and Judicial Affairs is the featured speaker.

The Committee on the New Dentist will host an evening with Dr. Dave Whiston for current members and non-members on February 24. An appreciation party for Dr. Whiston is being planned.

VAO NOTES (~--'"')

Dr. Robert Miller, Past President

As winter falls fast upon us, final ar rangements are being made for the an nual winter seminar this January in Big Sky Montana. The featured speakers have planned a variety of topics that will interest both the dentist and orthodon tist alike. I would encourage everyone to consider this CE opportunity next year which will likely return to Colorado! Plans are also well underway for the upcoming annual meeting for the VAO annual meeting this summer at Kingsmill Resort in Williamsburg. The dates to mark on your calendars are June 26-30 th . This years meeting will be "family friendly" with lots to do for everyone. Many thanks to Alan Bagden, VAO President, who has planned both the location and the events. Also thanks to Rod Klima for arranging our speaker, Dr. Wick Alexander, an orthodontist known world wide. His discussion topic for 2 days is "Practice Pearls and Secrets to Ulti mately Finishing Cases". Rod reports Dr. Alexander cancelled a speaking engagement in Japan over the favored Kingsmill, Williamsburg location! Complementing Dr. Alexander will be Mr. Lou Walensky, a financial expert and friend of Dr. Bagden. His topic in cludes how to achieve and maintain wealth. Along with these great speak ers, our traditional golf tournament will occur at Kingsmill's famous River Course. Also, an evening of "dine around" in Williamsburg followed by a ghost tour of Colonial Williamsburg will highlight the social portion of this meet ing. Free shuttles will be provided to Colonial Williamsburg and Bush Gar dens in conjunction with the opening reception and great fellowship with other member's promises to make this more

than just another VAO meeting! If you are a "regular" at the VAO meetings or a newcomer, plan now to attend. These meetings have been the highlight of be ing a VAO member for me personally over the last 10 years. Special congratulations go to Orin Clifton, who very deservedly was awarded the Southern Association of Orthodontists Citizenship Award this past fall in Asheville, NC. This is awarded to the orthodontist in the south ern region who has contributed greatly to their community in the good name of orthodontics. At the same meeting, Bill Wallert was awarded the SAO's high est honor as he was bestowed with the Orin Oliver Distinguished Service Award (the first ever from Virginia), recognizing his many years of contributions to the society. Knowing both of these men professionally and socially, I can think of no two other Orthodontists in the Commonwealth more deserving for these high honors. I want to personally congratulate them and their families for representing Virginia! I would also like to thank Dr. Alan Helwig for Leading the SAO last year as presi dent. Also many thanks to Steve Garrett, who continues to serve us so well as Director to the SAO. Also, Eddie Ross who is always present at both Board of Director meetings and UVA football games, but more importantly serving as our Delegate to the AAO.

Dr. Michael E. Miller, President As I write this note I feel quite fortunate to have the electrical power to do so, knowing many of my colleagues in Vir ginia may not be so lucky due to the blanketing of ice that has recently plagued our commonwealth. For those who spent some of the holidays under candlelight and kerosene heaters, I'm sure the coming of Spring will be a wel come sight indeed.

The VSOMS Executive Committee con vened on November 11, 1998, where a number of pertinent issues were ad dressed. Communication with the VDA Legislative Committee led to the pru dent deferral of the definition of dentistry issue to the 2000 Legislative Agenda. A seminar on implant dentistry spon sored by the VSOMS and presented to the MCV third and fourth year dental students will be held at an MCV cam pus site, featuring Drs. James Nelson and Harlan Schufeldt. The final date is pending at the time of this publication, but this will likely occur in March 1999. The combined VDNVSOMS Meeting being held in Reston, Virginia, Septem ber 15 -19, 1999, is expected to show case Dr. Dan Sullivan discussing a va riety of aspects of implant dentistry, as well as G.L. Johnson, a well-received lecturer on practice management with regards to implant dentistry. The high light of the Executive Committee Meet ing was undoubtedly a speakerphone conversation with Dr. Jim Priest, who continues to exemplify courage and stamina in his steady recovery from paralysis as the result of Guillain-Barre Syndrome. In the "Thanks for your knowledge, dili gence, and watchful eye" department, the VSOMS recognizes Dr. Charles Cuttino for his attendance as ADA liai son dentist at last years (1998) Ameri can Medical Association meeting. Dr. Cuttino's experience and educated in put on issues such as anesthesia and bottled water (a fluoride issue) became instrumental in AMA decision-making on these topics of concern to the den tal community as well. On a somber note, the VSOMS has recently lost two of its members. Dr. Harry J. Dennis of Virginia Beach died December 12, 1998; he was a retired Life Member of the VDA and had prac ticed both in the U.S. Navy and in l\lew port News. Dr. Sameh Hanna, who practiced in Sterling and Leesburg, Vir ginia, died on December 22, 1998 from complications of leukemia. Our con dolences to their families and friends.

Virginia Dental Journal 45

VSOP NOTES

supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of the eight dental specialties recognized by the American Dental Association.

('----')

RICHMOND PERIODONTIST RECEIVES HIGHEST HONOR FROM PERIODONTOLOGY

The Gold Medal is given annually in rec ognition of outstanding contributions to the field of periodontics. Maynard re ceived the award, funded by the John O. Butler Company at the AAP's 84th Annual Meeting in Boston. A past president of the AAP, Maynard is a member of the Board of Directors of The American Academy of Periodon tology Foundation and, for 1997-1998, was the chairman of The American Board of Periodontology. He also has served as president of the Virginia So ciety of Periodontics, the Southern Academy of Periodontology, and the Richmond Dental Society. He was the recipient of the AAP Presidential Award in 1996 and the AAP Special Citation Award in 1990. In addition to his private practice, Maynard is a clinical professor of peri odontics at Virginia Commonwealth Uni versity. He has published numerous articles in professional journals and lec tures extensively in the United States and abroad. Maynard received his AB degree from Davidson College in 1958, his dental degree from the Medical College of Vir ginia School of Dentistry in 1962 and his certificate in periodontics from the University of Kentucky College of Den tistry in 1967. He has been in the pri vate practice of periodontics in Rich mond, Virginia since 1967. The American Academy of Periodontology is a 7,000-member association of dentists specializing in the prevention, diagnosis and treatment of diseases affecting the gums and

46 Virginia Dental Journal

Tom Burke, Assistant Dean WHITE COAT CEREMONY HELD

THEAMER~ANACADEMYOF

J. Gary Maynard, Jr., D.D.S., a peri odontist from Richmond, VA, is the 1998 recipient of the American Academy of Periodontology (AAP) Gold Medal Award, the highest honor bestowed by the Academy.

SCHOOL OF DENTISTRY

NOTES

( PUBLIC HEALTH NOTES) Dr. Karen C. Day, Director Division of Dental Health The staff of the Divisionof Dental Health, Virginia Department of Health, has been busy during 1998. The main focus of our activities continues to be the pre vention of oral disease in Virginia. The water fluoridation program monitors 136 communities in Virginia that fluoridate drinking water. During 1998, the com munities of Hillsville, Fries, Clarkesville, Keysville, and South Boston were as sisted with upgrading fluoridation equip ment to maintain optimal fluoride levels. More than 43,000 children in areas with out the potential to fluoridate partici pated in the topical School Fluoride Mouthrinse Program. New programs were established in schools in Warren, Clarke, Nelson, Powhatan, Alleghany, Russell,Buchanan, Dickenson, Bedford, Wythe and Bland Counties. Guidelines and new educational materials for this program, including a display and bro chures, were developed and distributed. Thirteen dental sealant projects funded by the Division provided nearly 13,000 sealants for 3,000 children in Virginia's schools. Finally, workshops regarding oral hygiene, nursing bottle caries, fluo ride, smokeless tobacco prevention and dental sealants were provided for public and private associations. I look forward to a productive year working with mem bers of the Virginia Dental Association in 1999.

The School of Dentistry recently estab lished a new and significant event for first year dental students and third year dental hygiene students. This event entitled the "White Coat Ceremony" was held on January 8 th at the Medical Col lege of Virginia Alumni House. The White Coat Ceremony is an event at which entry level dental and dental hy giene students are officially presented their white clinic jackets. This presen tation signifies their entrance into clini cal dentistry and the treatment of pa tients. The event, hosted by Dean Ronald Hunt, featured a keynote pre sentation by Dr. W. Baxter Perkinson, Jr. Dr. Perkinson delivered a thoughtful address on the role and responsibility of the practitioner in delivering quality patient care. He welcomed the students to the profession of dentistry and sug gested that they conduct themselves professionally while treating their pa tients with dignity and respect. The presentation of the white clinic jack ets followed Dr. Perkinson's address, Dr. Marshall Brownstein called students forward, where they were presented with their clinic jackets by Drs. Ronald Hunt, Betsy Hagan, James Revere, and James Hardigan. Ms. Janet Scharer presented the Dental Hygiene students who also were coated. For some stu dents, a dentist parent presented the coat. An important component of the event was the administration of the dental and dental hygiene oaths. Dr. Robert Strauss, administered the dental oath and Ms. Janet Scharer administered the dental hygiene oath. The oath for den tistry, was developed by faculty and stu dents from the School of Dentistry, and has been approved by the American Dental Association as the official oath for dentistry. A reception followed the ceremony for students, faculty, and guests in the alumni house parlors.

NEW RESEARCH STUDIES

UNDERWAY AT SCHOOL

UPCOMING SCHOOL EVENTS

Class of 1969

Dr. S. Weldon Brown III

Donor Recognition Dinner

Department of General Practice

Begins Class II Composite Trial

As new product technology evolves the School of Dentistry stays on the cut ting-edge by participating in the research and evaluation of these innovative prod ucts. The Department of General Prac tice has received a grant from the Kerr Corporation to complete a clinical trial on their new Prodigy Condensable com posite material. The trial will involve placement and follow-up recall of 50 class II restorations in premolars and molars. The primary investigator on the project is Dr. David Sarrett, who will be assisted by co-investigators Dr. Carol Brooks and Dr. Jennifer Rose. This study is a result of an AD Williams re search project conducted over the sum mer by Dr. Peter Moon, which focused on evaluating and comparing several new composite materials. The results of Dr. Moon's research will be presented at the International Association of Den tal Research meeting in March.

Department of Oral Pathology

Studies Effectiveness of

New Oral Rinse

The Department of Oral Pathology is also conducting a research project for 1-DENT INTERNATIONAL to evaluate a 0.07 Triclosan-based Mouth Rinse in the treatment of common oral ulcers. Al though there are many topical agents on the market today for the treatment of lesions like recurrent aphthous ul cers, this project will investigate a mouth rinse which will be evaluated in a multicenter, double-blind, placebo-con trolled group study. Dr. James Burns, the principal investigator, says that this study is potentially the final step in the FDA approval of a new over-the-counter drug for the treatment of common oral ulcers.

On March 26, the School of Dentistry will host its first Donor Recognition Din ner at the Country Club of Virginia. This recognition dinner is being planned to acknowledge and thank donors who have supported the School of Dentistry with gifts and pledges to the "Excellence Through Research-An Investment In Our Future" Campaign. It will also pro vide us an opportunity to thank other major benefactors of the School. A very special guest will provide the keynote address at the inaugural event. Dr. Harold C. Slavkin, Director of the Na tional Institute of Dental and Craniofa cial Research in Bethesda will be our honored guest and speaker. Dr. Slavkin is internationally known for his entertain ing and knowledgeable presentations. We are indeed fortunate to have him join us on this special evening.

Class of 1974

Dr. James Wallace

Class of 1979

Dr. Arden Sterling

Class of 1984

Dr. Kanyon Kenney

Class of 1989

Dr. Richard Vacca

Class of 1994

Dr. David Montgomery &

Dr. Tamara Langebeck

Homecoming 1999 The 1999 Homecoming for School of Dentistry Alumni in classes ending with a 4 or 9 will be April 23-25. The reunion activities are scheduled for the Omni Hotel in Richmond. The festivities will begin with a reception on Friday evening and continue through the week-end cul minating with the reception, banquet, and dance on Saturday evening. The School of Dentistry continues to have the largest returninggroup and we would like to see this continue in1999! If you have questions concerning this year's reunion activities you may call your class captain listed below or the MCV Alumni Association offices at (804) 828 3900. We look forward to seeing you in April.

Drs. Hunt and Revere assist freshmen students on with their clinic jackets during the White Coat Ceremony.

Class of 1949

TBA

Class of 1954

Dr. Charles Fralin

Class of 1959

Dr. Madison Price

Class of 1964

Dr. Kenneth Copeland

Freshmen Dental Students recite the Oath of Dentistry as part of the White Coat Ceremony under the watchful eye of parents and guests. The Dental Oath was developed at VCU. and is now recognized as the official oath of den tistry nationwide.

Virginia Dental Journal 47

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ASSOCIATE AND PT POSITIONS AVAILABLE

Classified advertising rates are $30 for up to 30 words. Additional words .25 each. All advertisements must be prepaid and cannot be accepted by phone or fax. Checks should be payable to the Virginia Dental Association. The closing dates for all copy will be the 15th of December, March, June, and September. Example: March 15, at 5pm is the closing date for the April-May-June Journal issue. After the deadline closes, the Journal can accept no ads nor can it alter or cancel previ ously ordered ads. This deadline is firm.

Several FT or PT opportunities available immediately for GP's and Specialists at modern, high-traffic, well-estab lished practices. Competitive salary and flexible hours. Several buyer-friendly partnership opportunities for a dedi cated dentist. If you're ambitious, motivated and wish to work in a quality environment along with highly trained support staff, call now! Recent grads considered and still enthusiastic semi-retired encouraged to work and earn PT only the days you choose. No strings, no fees, never an obligation. Unlike others, no hidden agenda to later sell you a practice. Just seeking great dentists for FT and PT positions. Strictly confidential enrollment. Since 1996. Doctors per Diem Inc 800-600-0963.

As a membership service, ads are restricted to VDA and ADA members and are restricted to non-commercial copy. Advertising copy must be typewritten and sent to: Journal Classified Department, Virginia Dental Association, P.O. Box 6906, Richmond, VA 23230-0906. The Virginia Dental Association reserves the right to edit copy and does not assume liability for the contents of classified advertising.

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