Virginia Dental Journal by Virginia Dental Association

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Phone 703-345-7319 800-47fi路,7319

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VIRGINIA DENTAL ASSOCIATION OFFICERS President: Ronald L. Tankersley 716 Denbigh Ave., Suite C-1, Newport News 23602 President Elect: William H. Allison Fauquier Professional Bldg., Warrenton 22186-3239 Immediate Past President: Leslie S. Webb, Jr. 6800 Patterson Ave., Richmond 23226 Secretary-Treasurer: Charles L. Cuttino, III 3217 Grove Avenue, Richmond 23221

Councilors 1) Edward J. Weisberg, Norfolk 2) Richard D. Barnes, Hampton 3) Harold J. Neal, Jr., Emporia 4) James R. Lance, Richmond 5) Daniel E. Grabeel, Lynchburg, Chairman 6) Gus C. Vlahos, Dublin 7) William J. Viglione, Charlottesville 8) Rodney J. Klima, Burke

Executive Director: Mr. William E. Zepp, CAE P.O. Box 6906, Richmond, VA 23230

Ex Officio Members:

Parliamentarian: Emory R. Thomas, Richmond Editor: Francis F. Carr, Jr., Richmond EXECUTIVE COUNCIL Speaker of the House: D. Christopher Hamlin, Norfolk Officers Listed Above and Councilors: Dean, MCV School ofDentistry: Lindsay M. Hunt, Jr., Councilors at Large

Richmond David C. Anderson, Alexandria (1997), Vice Chairman

Thomas S. Cooke, II, Sandston (1996)

Wallace L. Huff, Blacksburg (1996)

Andrew J. Zimmer, Norfolk (1997)

ADA DELEGAnON to the 137th Annual ADA Session, Sept 28-Oct. 2, 1996, Orlando David A. Whiston, Trustee 16th District Delegates: Emanuel W. Michaels (1996) Raleigh H. Watson, Jr. (1995) William H. Allison (1996) Gary R. Arbuckle (1998) Wallace L. Huff (1995) Stephen L. Bissell (1996) Richard D. Wilson (1996) Leslie S. Webb, Jr. (1996) M. Joan Gillespie (1997) Alternate Delegates: Anne C. Adams (1996) Richard D. Barnes (1997) Thomas S. Cooke, II (1996)

Bruce R. DeGinder (1995) D. Christopher Hamlin (1996) David Anderson (1996)

Dr. Lindsay M. Hunt, Jr. (1995) Andrew J. Zimmer (1997) Bruce R. Hutchinson (1996)

COMPONENT SOCIETY DIRECTORY

SOCIETY

PRESIDENT

SECRETARY-TREASURER OR SECRETARY

PATIENT RELAnONS COMMITTEE

Tidewater

David P. Paul, ill 4616 Thoroughgood Drive Virginia Beach, VA 23455

James E. Krochmal 801 W. little Creek Rd., SU 107 Norrfolk, VA 23505

W. Walterwx 5717 Churchland Blvd. Portsmouth, VA 23703

Peninsula

Gisela K. Fashing Corydon B. Butler, Jr. 150 Stra wberry Plains Rd., SU C 1319 Jamestown Rd. Williamsburg, VA 23188 Williamsburg, VA 23185

Lawrence A. Warren 106 Yorktown Road Tabb, VA 23602

Southside

Michael R. Hanley 2001 W, Broadway Hopewell, VA 23860

John M, Bass

212 N. Mecklenburg Ave. South Hill, VA 23970

John R. Ragsdale, ill 9 Holly Hill Drive Petersburg, VA 238847

Richmond

Edmund E. Mi11ins.Jr. 6808 Stoneman Rd. Richmond, VA 23228

Gary R. Hartwell 4107 W. Franklin S1. Richmond, VA 23226

Thomas S. Cooke, ill 39 W. Eilliamsburg Rd. Sandston VA 23150

Piedmont

Richard D. Huffman, Jr. 4346 Starkey Rd., SU 3 Roanoke, VA 240 14

Gregory T. Gendron 7 Cleveland Ave. Martinsville, VA 24112

Edward M. O'Keefe 4102 Electric Road Roanoke, VA 24014

Southwest

Gus C. Vlahos P.O. BOll 1379 Dublin, VA 24084

Dana Chamberlain 645 Park Blvd. Marion, VA 24354

Jack D. Cole 303 Court Street Abingdon, VA 24210

Shenandoah Valley

Edward L Amos 1002 Amherst St Winchester, VA 22601

Gerald J. Brown 324 Boscawen St Winchester, VA 22601

William J. Viglione 3025 Berkrnar Drive Charlonesvi11e, V A 22901

Northern Virginia

M. Alan Bagden 6120 Brandon Ave., SU 104 Springfield, VA 22150

James A. Pell Seven Corners Proessional. Bldg. Falls Church, VA 22044

John A. McIntire 10721 Main Street Fairfax, VA 22030

MEMBER PUBLICATION, AMERICAN ASSOCIATION OF DENTAL EDITORS

Mr. William E. Zepp, CAE, Business Manager

Francis F. Carr, Jr., Editor

ASSOCIATE EDITORS 1) Bernard I. Einhorn 5) Edward P. Snyder 2) Jeffrey N. Kenney 6) R. Graham Hoskins 7) William C. Bigelow 3) H. Reed Boyd, ill 4) Benita A. Miller 8) Bruce W. Jay MCV - Thomas Burke October-December 1995

Volume 72

Number 4

T ABLE OF CONTENTS 5

Editorial

Special Correspondence

Guest Editorial

President's Message

Survey ofAnesthesia Practices by Oral and Maxillofacial Surgeons

15-24

Annual Meeting Summary, Addresses by Leadership

MCVNews

Component News

31-35

Up Close: 1995 Annual Meeting in Photos

COVER: David A. Whiston, DD.S., Falls Church, Sixteenth District Trustee and candidate for 1996 American Dental Association President Elect.

THE VIRGINIA DENTAL JOURNAL (lSSN 0049 6472) is published quarterly (Jan.-March, April-June, July-SepL, Ocr-Dec) by the Virginia Dental

Association at the Corporate Centre, 5006 Monument Avenue, P.O. Box 6906, Richmond Virginia 23230-0906, Telephone 804/358-4927.

SUBSCRIPTION RATES: Annual: Members, $6.00. Others $12.00 in U.S., $24.00 in other countries. Single copy $6.00. Second class postage paid at

Richmond, Virginia. Copyright Virginia Dental Association 1995.

POSTMASTER: Send address changea to: Virginia Dental Journal, P.O. Box 6906. Richmond, VA 23230-0906.

MANUSCRIPT AND COMMUNICATION for publications should be addressed to the Editor, Francis F. Carr, Jr., P.O. Box 6906, Richmond,

Virginia 23230.

ADVERTISING COPY, insertion orders, contracts and requests for infonnation relating to advertising should be addressed to the Business Manager,

Mr. William E. Zepp, CAE, P.O. Box 6906, Richmond, Virginia 23230-0906.

VIRGINIA DENTAL JOURNAL EDITORIAL BOARD

Constitution and Bylaws Dr. Leslie S. Webb, Jr., Chairman

Peer Review and Patient Relations Dr. Edward M. O'Keefe, Chairman

Dr. Louis M. Abbey Dr. Ralph L. Anderson Dr. James R. Batten Dr. Cramer L. Boswell Dr. James H. Butler Dr. Gilbert L. Button Dr. Frank: H. Farrington Dr. Barry I. Griffin Dr. Jeffrey L. Hudgins Dr. Wallace L. Huff Dr. Lindsay M. Hunt, Jr. Dr. Lisa Samaha Hunter Dr. Ford T. Johnson Dr. Thomas E. Koertge Dr. James R. Lance Dr. Daniel M. Laskin Dr. Travis T. Patterson, III Dr. W. Baxter Perkinson, Jr. Dr. David Sarrett Dr. Harvey A. Schenkein Dr. James R. Schroeder Dr. Harlan A. Schufeldt Dr. Kenneth J. Stavisky Dr. John A. Svirsky Dr. Ronald L. Tankersley Dr. Douglas C. Wendt Dr. Roger E. Wood

Dental Care Programs Dr. Kirk M. Norbo, Chairman

Planning Dr. Leslie S. Webb, Jr., Chairman

Dental Delivery for the Special Needs Patient Dr. PatrickJ. Dolan, Chairman

Relief Scott H. Francis, Chairman

COMMITTEES 1996 Annual Meeting Dr. Andrew J. Zimmer, Chairman Auxiliary Education & Relations Dr. A. Carole Pratt, Chairman Budget and Financial Investments Dr. Jeffrey Levin, Chairman Cancer and Hospital Dental Service Dr. Robert L. O'Neill, Chairman Caring Dentists Dr. Harry D. Simpson, Jr., Chairman

Dental Education and Continuing Education Dr. James K. Johnson, Chairman Dental Health and Public Information Dr. Gisela K. Fashing, Chairman Dental Practice Regulations Dr. Douglas C. Wendt, Chairman Dental Trade and Laboratory Relations Dr. George L. Nance, Jr., Chairman Environmental Health and Safety Dr. Dennis E. Cleckner, Chairman Executive Dr. Ronald L. Tankersley, Chairman History and Necrology Dr. Edmund E. Mullins, Jr., Chairman Institutional Affairs Dr. Elizabeth Bernhard, Chairman Insurance Dr.Wm. H. Higinbothan, Jr., Chair足 man Journal Staff Dr. Francis F. Carr, Jr., Chairman Legislative Dr. Harold J. Barrett, Jr., Chairman Membership Bruce R. DeGinder, Chairman New Dentist Dr. Russell A. Mosher, Jr., Chairman Nominating Dr. Leslie S. Webb, Jr., Chairman

Search Committee for VA Board of Dentistry Candidates Dr. Leslie S. Webb, Jr., Chairman Virginia Dental Political Action Dr. John C. Doswell, II, Chairman

NOTE THESE DATES: (Mark your calendar now for these future meetings) VDA 127th Annual Meeting September 18-22, 1996 Colonial Williamsburg Lodge 16th Trustee District Caucus September 6-8, 1996, Winston-Salem, NC ADA 137th Annual Meeting Sept. 28-0ct. 2, 1996 Peabody Hotel, Orlando VDA Leadership Conference October 18-20, 1996 Boars Head Inn, Charlottesville VDA Committee Meetings January 25-28, 1996 Hyatt Richmond VSOMS Annual Meeting June 28-30, 1996 Boar's Head Inn, Charlottesville VAO Annual Meeting June 28-July 2, 1996 Cavalier, Virginia Beach

Editorial

David A. Whiston, D.D.S.: ADA President Elect-1996 The Virginia Dental Association proudly endorses Dave Whiston for ADA President Elect in 1996. He is the one candidate who brings the commitment to responsible leadership that both the profession and the position demand. Dentistry daily faces opportunities and challenges requiring strong, alert and knowledgeable volunteer officers at the national level. Dave Whiston will furnish vision and responsible leadership as President Elect that will move all of dentistry confidently forward. Virginians know Dave as our Sixteenth District Trustee, our ADA Delegate and our VDA Past Presi足 dent. We have seen the positive attitude that he consistently brings to the profession through his service to our state, our district and the ADA. The responsibilities he has undertaken in more than a dozen Trustee assignments during his service on the Board, have brought him deserved national recognition. Dave is a major contributor on two special committees, one to study The Future ofDental Education and the other to study the Continuing Education Recognition Program (CERP). One of this year's one important commitments is serving as Board liaison to the Council on Dental Benefit Programs. With Dave Whiston leading the 16th District in the Direct Reimbursement issue, this assignment will benefit all of dentistry as we confront managed care in all its forms. Dave Whiston can get the message across that dentistry truly is Health Care That Works. He is the ADA spokesperson on water quality, waste management and related regulatory issues. He continues to testify convincingly before Congressional committees and regulatory agencies. From working with Dave, we all know the clarity and intensity of his commitment to the issues that affect our profession and our patients. These valuable insights and duties have provided Dave with definite direction on what must be ac足 complished for dentistry. He will work to maintain patient freedom of choice in selecting oral health care. He will insist upon the best scientific information available as a basis for any proposed regulation, rather than speculation or worst case scenarios. He will ensure that dentistry's point of view is always heard in the legislatures; correct, credibly and in a timely fashion. He believes that the ADA must be the one voice of our profession and that we must broaden our representation, at all levels of dentistry, to increase that voice. Dave is our candidate. He has the skills, the experience and the strong desire to serve. We can help through our components and our individual contributions. When you are contacted, participate with the enthusiasm that Dave has shown in his efforts on behalf of the dental profession. One final word: When Dave is installed as ADA President on October 22, 1977, in Washington, D.C., it will have been 40 years since the last ADA President from Virginia - Harry Lyons.

:rrands :r. Carr, Jr.

Editor

SPECIAL CORRESPONDENCE

The Presidents of the three states in the Sixteenth Trustee District (Virginia, North Carolina and South Carolina) all sent special correspondence to the Journal endorsing Dr. David Whiston for ADA President Elect.

Dear Dr. Carr: The profile of an American Dental Association president is synonymous with that of Dave Whiston. His diversity of experience--OSHA, Waste Water Management, Budget, Membership, New Dentist positions him at the heartbeat of dentistry. He has developed a foundation of leadership which the office of ADA President demands. Dave will respond to the concerns of all dentists across the nation with the same integrity and intensity that has been used to guide the three states of the Sixteenth District.

Dear Dr. Carr:

Dear Editor:

The South Carolina Dental Association is proud to endorse and support Dr. David Whiston for President Elect of the American Dental Association. He has been an outstanding leader here in the Sixteenth District as well as across the nation.

Members of the Virginia Dental Association have an opportunity to help shape the future of dentistry in this country. Our own Dave Whiston is running for Presi dent Elect of the American Dental Association! The ADA president helps set both the moral tone and the agenda for our association. I have known Dave since my first involve ment in organized dentistry and would like to review a few of his numerous activities.

I am constantly amazed at Dave's vast knowledge and understanding of the issues that face dentistry today. In addi tion, he has an excellent ability to articulate that knowledge in a way that can be understood by any type of audience. His ability is well recognized by the other members of the Board of Trustees, as evi denced by the number of times that he has been chosen to be the spokesperson for dentistry on important issues.

The officers of the North Carolina Dental Society enthu siastically endorse Dave Whiston as the next President Elect of the American Dental Association.

We extend to Dave both our best wishes and our total support in his upcoming campaign to become President Elect of the American Dental Association.

Sincerely,

Sincerely yours,

Bettie R. McKaig, D.D.S., M.P.H. President, North Carolina Dental Society

Richard F. Hewitt, D.D.S., M.S.D. President, South Carolina Dental Association

Dave chaired the ADA Special Committee on Oral Health Care Guidelines and the Council on Access, Prevention, and Interprofessional Rela tions. He participated in ADA studies on the Continuing Education Recognition Pro gram and the Future of Dental Education. Dave served as the ADA representative for the American Hospital Association and the Joint Commission on Hospital Accreditation. As our 16th District Trustee, he was Board Liaison to the Commit tee on the New Dentist, the Joint Commission on National Dental Examiners, and the Council on Governmental Affairs. This year, he is the liaison to the Council on Dental Benefit Programs. He has been a member of the ADA Publishing Company Board

and the ADA Strategic Plan ning Committee. In addition, Dave has found the time to be an ADA spokesperson for the Waste Water Task Force and board member of the National Foundation of Dentistry for the Handicapped. The thousands of volunteer hours required to fulfill these duties reflect Dave Whiston's commitment to our profession. While fulfilling these responsi bilities, he takes the time to acquire the background neces sary to effectively deliberate, facilitate, and lead. This expe rience has given him expertise in the essential arenas of ADA activity: education, licensure, legislation, market place issues, interprofessional rela tions, membership, and com munication. Through all of this activity, Dave maintained an active clinical practice in Northern Virginia and conducted himself as a role model for other dentists to emulate. He is a good listener and does not discount the opinions of others. It is hard to imagine a more qualified leader for our profes sion. Virginia dentists have never had the opportunity to provide such leadership to our parent organization. As Dave presents his vision of the future to the dentists across the country, he will need our encouragement and financial

support. I know he can depend upon you. If you would like to help Dave's campaign, call the VDA central office, Charlie Cuttino, or Dick Wilson. With hopes of victory for Dave, Ronald L. Tankersley, D.D.S.

President Virginia Dental Association ~

Erma Freeman, DDS 1st term ends 6{30197 21207 Chesterfield Ave. Ettrick. VA 23803 804/526-2424, FAX 526-4660 Robert I. Isaacson. DDS. MS, PhD 1st term ends 6{30/97 MCV School of Dentistry Departmentof~thodontics

Riclunond, VA 23298-0566 804/828-9326, FAX 828-5789 John S. Lyon, D.D.S. 1st term ends 6{30199 2774 Hydraulic Road, Suite 201 Charlottesville, VA 22901 804/973-2968, FAX 804/973-0257

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. President Patricia Lee Speer, DDS 1st term ends 6{30/96 6606 W. Broad St. Riclunond, VA 22314 804/662-9906 Vice President Alonzo M. Bell. DDS 1st term ends 6{30/96 1755-B Duke Street Alexandria, VA 703/836-3384

French H. Moore. Ir.. DDS Ist term ends 6{30/96 303 Court Street Abingdon. VA 24210 703/628-7862, FAX 676-5537 Saundra D. Nelson, RDH, MS Ist term ends 6{30/96 2000 27th Street Newport News, VA 23607 804/244-1010, FAX 929-0589 Mrs. Patricia K. Watkins 1st term ends 6{30/99 4623 Leonard Parkway Riclunond, VA 23226 804{358-6664 Marcia 1. Miller. Executive Director 6606 W. Broad Street, #401 Riclunond, VA 23230-1717 804/662-9906, FAX 662-9943 Ii.

Secretary-Treasurer Catherine COller Haywood. RDH, MEd 1st term ends 6{30/96 Spotsylvania Voc. Ctr. 6703 Smith Station Road Spotsylvania, VA 22553 703/898-2655, FAX 891-1784 Mark A. Crabtree, DDS 1st term ends 6{30/98 407 Starling Avenue Martinsville, VA 24112 703/632-7392, FAX 632-2341

Caring For Our Dental Patients

communicate sincerely and with compassion.

"No technology, no drugs, no power over the patient takes the place of caring." -Bill Moyers, Healin~ and the

It is in aging that we become more dependent on others for human support. Practitioners must regain the ability to communicate and reach patients in this most caring of ways, especially as the client base of the practice ages.

Mind As I look back in retrospect, I realize that compassion and caring should always playa vital part of our dental practice.

Touching can be communi足 cation form of caring. As my practice aged with me, I found that a message of truly caring became more important to my patients. For the patient to truly receive the message of care, they have to hear it, see it and sense it. Words or visual aids will not carry your message to the head and heart of the pa足 tient. There is an increasing divide between patients and practitio足 ners today. Office barriers may make the dental office appear sterile and cold, and may be perceived as impersonal and uncaring. By design we must overcome this obstacle. We may be so involved in our discipline that we forget our humanness that the patients so often crave. It is important to

Patients want to look in your eyes and facial expression and see that you earnestly feel what you say. A patient wants to be treated as a person, not as a tooth. The tooth is not more important than the person. It is important to reassure the patient with a touch to the arm or shoulder. Both of these areas have been found as neutral and non vulnerable areas of com足 munication. A touch in these areas may be reassuring to the patient that we really care. It is important to the fearful patient that they be assured that you will work with them to make your care as pleasant as is possible. Communication and caring are integral parts of being a doctor of the healing arts. It is a privilege to serve our fellow

human beings as a doctor, and with this privilege comes much responsibility. Try using touch to aid in communicating your real care for your patients. When patients know you feel compassion, it says you value them and want to communicate verbally and nonverbally. You will come even closer to bridging the divide and building greater trust in your patients and your friends. In closing, I would like to invite each of you to visit a retirement or nursing home and view the expressions on the faces of the residents as you speak to them with caring expressions.

W. H. Dickey, DD.S. Roanoke

Thanks to Dr. Einhorn Editor's note: This letter came as a tribute to Dr. Einhorn; rather than publish it as a Letter to the Editor, it is ad dressed to himDr. Bernard I. Einhorn Speaker, House of Delegates 1992-1995 Virginia Dental Association Dear Barry, The members of the Virginia Dental Association House of Delegates wish to congratulate you on the successful presiding over the deliberations of three consecutive House ~f Del egates. We are indebted to you for your service. Your sense of humor has promoted a certain warmth within the House, which created an atmosphere for cooperation amongst the components. By example, you have shown us how to conduct ourselves as professionals serving our components. Your leadership has always been a showcase of honesty, fairness and strength, which will be a challenge to continue for all of us who follow in your foot steps. We know that you have many pleasurable pursuits to occupy the hours that you once devoted to the work of the House of Delegates and the Executive Council, but we still need your wisdom. We will try not be too

bothersome. However, the precedent you have established and the spirit you have imbued within the House is an accom plishment of which you can be proud. We will try to do justice to your record. We thank: you again for a job well done as our Speaker of the House of Del egates. Sincerely,

The Richmond Dental Society and the MCVNCD School of Dentistry are hosting the Mid Winter Bahamas Getaway, February 1-5, 1996. The trip will include airfare, four nights at the Bahamas Princess Resort & Casino and more. Please call Linda Simon (804/379-2534) for further information. .1

D. Christopher Hamlin, D.D.S. Speaker, VDA House, 1995-96 !J.

Course in Head and Neck Anatomy to be Offered

A four-day course entitled The Alton D. Brashear Postgradu ate Course in Head and Neck Anatomy will be held at the Medical College of Virginia, Department of Anatomy, March 25-28, 1996. Lectures and demonstrations will augment the laboratory work. The course is approved for 44 credit hours in Cat~gory

1 of the Physician's Recogni tion Award of the American Medical Association and the Academy of General Dentistry.

Further information may be obtained from Dr. Hugo R. Seibel, Department of Anatomy, P.O. Box 980709, Medical College of Virginia, Richmond, VA 23298-0709. .1

A Message from the President Legislative initiatives, market place activity and the VDA House of Delegates have laid the groundwork for a very active year for those of us involved in Association affairs. We anticipate taking definitive steps to address Virginia's hygiene shortage in the legisla ture this year. Additionally, we plan to support legislative activity that gives patients the ability to choose their doctors and prevents doctors from being arbitrarily denied the . ability to provide care for their patients under "managed care" programs. Our lobbyist, Chuck Duvall, will be orchestrating these activities. We will be calling on many of you for assistance with these projects. Any of you that would like to help us should contact R.J. Barrett, Jr., or the VDA' s coordinator for legislative affairs, Lisa Finnerty. The VDA House of Delegates directed us to continue the development of a Direct Reim bursement program. A $35 dues increase was approved for this purpose. This gives us the . opportunity to offer an efficient alternative financing for dental care, but for the program to succeed, you will need to work with us in developing contacts and educating employers. If you would like to help with this program or have a good lead, 10

give John Willhide, Benita Miller or Gus Levy a call. The House of Delegates has also authorized that we proceed with the development of a for profit subsidiary. This permits us to offer additional member ship services and provides the potential for non-dues re~- . enues. If you have expertise In this type of activity and would be willing to help us, contact Bill Zepp or Ken Copeland. In an attempt to open issue oriented debate and increase participation in the electoral process for our officers and ADA delegation, the House of Delegates has directed the establishment of an Ad Hoc Committee on Electoral Re form. We would welcome your ideas. If you have suggestions, contact Les Webb. We are also developing a Committee on Communication and Information Technology to act as advisors to the VDA. We want members of this commit tee to help us disseminate information more efficiently and streamline our publications in the near future. If you have a special interest in computers or other information technology and would like to share your expertise with us, give me a call. The implementation of these programs would be impossible

without our capable central office staff and the leadership of Mr. Bill Zepp. As we con tinue to upgrade the staff, equipment and facilities of our central office, I trust that you are noticing a difference. Please stop by and meet the staff and see the facility when you are in Richmond. I know you will be proud. Your officers, committee chairmen and central office staff intend to make your association increasingly respon sive to your needs during these dynamic times. If you can suggest better ways of accom plishing this goal, feel free to give me a call. I look forward to this year's activities and welcome your ideas. Ronald L. Tankersley President 6

AGD Mastership Program The Medical College of Virginia and the Virginia Chapter of the Academyof GeneralDentistry are co-sponsoring their third master ship classes p!'OgraJ!l. Dr. Jeffrey Levin is chamng this class. There is still space for eight more doctors. If interested, call Dr. Jeffrey Levin (804/288~ 115) or Mr. Tom Burke, Jr., ASSIStaJ?t Dean for ContinumgEducation (804/828-4695). The mastership.program is designed to provide you WIth the participationrequirements neces sary to achieve your AGp master ship certificate. There WIll be eight sessions conducted over a four year period. For more information, please call Dr. Levin or Mr. Burke.

Survey of Anesthesia Practices by Oral and Maxillofacial Surgeons in Virginia by Robert Campbell, D.D.S., Professor, and Brad Nester, D.D.S. and William Langston, D.D.S., Anesthesiology Residents, Department of Oral and Maxillo facial Surgery, MCVIVCU

There are many pain and anxiety control options avail able to oral and maxillofacial surgeons, including ambulatory surgery centers and a wide variety of office techniques. In recent years, new drugs with markedly improved pharmaco logical properties including more rapid onset, distribution and elimination have become available to improve anesthesia care. Although still utilized mainly by pediatric dentists, one oral medication, chloral hydrate, has been threatened with extinction because of reports of carcinogenicity of its by-products and diminishing use in clinical practicel-I. Subsequent studies have not supported this carcinogenic effect on humans-. Morbidity and mortality data associated with dental office and sedation and general anesthesia has been documented in the literature. The incidence of mortality with sedation or general anesthesia ranges from 1:137,000 to 1:860,()()()4·5 and is consider able less frequent than the mortality associated with general anesthesia in a hospital setting (1: 10,000 to 1:19,000)6,7. However, hospital

anesthesia techniques (i.e., intubation, etc.) are consider ably different, therefore these statistics should not be viewed as direct comparisons and have been likened to "comparing apples and oranges. "8 In some respects there are similarities, especially when considering the American Society of Anesthesi ologists (ASA) classifications of the patients being treated", One study suggests that lack of proper monitoring and resusci tative efforts are the chief factors in morbidity and mortal ity in the dental office.? How ever, patient selection, anes thetic agents and administration routes employed, and the educational qualifications of the caregivers were relatively insignificant. 9 Children present unique problems in pain control and behavior management. While the majority of dentoalveolar surgery on adults can be per formed under various levels of consciousness, the same is not always true in pediatric cases. To evaluate the current tech niques of pain control and behavior management in the office, an attempt was made to survey all of the oral and maxillofacial surgeons in Virginia to test two hypotheses. The hypotheses were first that increased utilization of ambula tory centers for general anes thesia has contributed to the

decreased usage of chloral hydrate and other office tech niques and a second that there is a trend toward utilizing sedation techniques in children to avoid the risk of a serious adverse events attributable to general anesthesia.

Methods Request letters and question naires were sent to 104 sur geons. Six hypothetical cases were presented with three involving children and three involving adult case scenarios. The six cases presented were as follow: 1. A healthy, 40-pound, "typi cally apprehensive" three year old, that requires the "simple" extraction of a lower deciduous molar. 2. A healthy, 75-pound, eight year-old, good dental patient that requires the removal of an impacted mesiodens. 3. A healthy, 75-pound, eight year old (not mentally retarded) but crying, etc. at the time of consultation that requires the removal of two deciduous molars (i.e., management problem). 4. A healthy, 115 pound, 18 year-old female that requires the removal of four "routine (Continued on following page) 11

impacted third molars" (typically apprehensive of this type of procedure.) 5. A healthy, 155 pound, apprehensive 30 year-old male who requires an incision and drainage (intraorally) and extraction of a lower molar. 6. A healthy, 140 pound, slightly obese female that requires multiple extractions and insertion of an immediate denture. The patient says she "wants to be asleep." The surgeons' responses in each of the six case scenarios were evaluated and categorized according to the technique used, and the results tabulated. The pediatric responses were categorized as follows: local anesthesia only, local anesthe sia with nitrous oxide, oral sedation, intravenous/intramus cular sedation, general anesthe sia, and hospital setting. The adult responses were catego rized as follows: local anesthe sia with nitrous oxide, oral sedation, intramuscular seda tion, intravenous sedation, and general anesthesia. Results Fifty-six surgeons completed and returned the questionnaire (53.8%) with one surgeon declining to complete one question. In the first three questions which presented pediatric situations, 167 re

sponses out of a possible 168 were given with an omission on the first question. The pediatric cases were treated with a greater variety of techniques than the adult cases. (Table I). In the first situation, the three year-old patient, the most frequent modality used was general anesthesia (38.2%) with almost equal numbers of surgeons choosing an oral sedative (25.5%) and local anesthesia with nitrous oxide (23.6%) as second and third choices. A minority of surgeons performed the procedure with intravenous/intramuscular (7.3%), local anesthesia alone (1.8%), and two respondents (3.6%) preferred the hospital setting. In the second situation, the eight year-old with an impacted mesiodens, intravenous seda tion (30.4%), local anesthesia with nitrous oxide (25.0%) and general anesthesia (21.4%) were the most frequent tech nique responses. Of the 56 respondents only six (10.7%) chose oral sedation, four used local anesthesia alone (7.1 %), and three-did not treat the patient ill the office, preferring to utilize the hospital or an ambw.atory fllCi1ity. In the third situati()n,~eight year-old with two~uousmo1ars, intrave nous.sedation and general an~sth~a",~themost

com!,l,l"!.teCp~~uesutilized,

nettirig3~~7~~d30.4%, 'r_, -:__ .,

;_',_

respectively. Oral sedation accounted for 19.6% of the anesthetic methods while local anesthesia with nitrous oxide was chosen by three surgeons (5.4%). Five surgeons (8.9%) preferred the operating room when presented with this scenario. In pediatric cases, meperidine, chloral hydrate, and diazepam were the three most commonly used agents (Table 2). Almost all of the adult patients received intravenous sedation (86.9%). Only two surgeons gave oral sedation to an adult patient. However, 11 surgeons administered local anesthesia and nitrous oxide, all in re sponse to situation five. Nine surgeons distinguished general anesthesia as the treatment modality of choice (Table 3). The specific drugs were mentioned in the vast majority of adult cases (Table 4). Fentanyl was the most fre quently used narcotic (51.2%). Midazolam was used in 47.6% of the cases followed closely by diazepam (43.5%). Metho hexital was a part of the anes thetic regimen in two- thirds of the responses. Discussion Several clinical scenarios were presented and oral and maxillo facial surgeons were asked to propose an anesthetic treatment plan. The cases were represen

~tative of common dilemmas

faced frequently by surgeons. hloral hydrate is a popular choice of oral sedative for pediatric restorati~e .dentistry in young patients. Sumlarly, 25.5% of the oral and maxillo facial surgeons used oral sedation in the three year-old child, but 38.2% chose general anesthesia. 23.6% chose nitrous 'oxide with local anesthesia as an alternative. This would likely result in a struggle to complete the surgery and this . may reflect the uneasiness of the surgeon in treating the very young. Not so surprisingly, local and nitrous oxide was the least favorite technique for a crying eight year-old. Of the 56 surgeons who responded, few specifically discriminated between full general anesthesia and deep sedation. However, assuming that two categories, general anesthesia and intra muscular/intravenous anesthe .sia may be grouped together, it would appear that 25,29 and 37 . surgeons would use a technique other than oral or nitrous oxide in pediatric cases one, two and three, respectively (Table 1). Thus, between 45% and 66% would use a parenteral tech nique. It was notable that few surgeons would use the hospital or ambulatory surgical center to treat the children. Chloral hydrate was a popular choice second to meperidine, indicating that chloral hydrate remains a viable alternative if it

remains on the market. Four different benzodiazepines were mentioned as alternative agents for children. Although these drugs are less potent and sedation is less predictable than with a chloral hydrate and meperidine combination, they produce less respiratory depres sion than chloral hydrate or meperidine. Ketamine, which would have been useful for the first pediatric patient, was only mentioned by one surgeon. Adults are generally coopera tive for intravenous drug administration. Therefore, it was predictable that almost 87% of the respondents chose intravenous sedation and another 5% chose general anesthesia. Since there is a fine line separating deep sedation and general anesthesia, these two categories could have been interpreted as being essentially the same on a survey study such as this. Only 6.6% of the responses selected local and nitrous oxide for any of these cases. Realizing the limits of oral sedation in adults, only a few responses listed it as being useful. Fentanyl was the favorite narcotic, with the less expen sive meperidine a distant second choice. Apparently fentanyl, with its considerable pharmacologic advantages, has finally been recognized as a superior narcotic for office anesthesia. Both midazolam

and diazepam were equally as popular, This is not surprising in some respects. Diazepam was probably the choice of practitioners who were reluc tant to change drugs. Midazolam is considered superior to diazepam for many reasons. There is less phlebitis, shorter duration, better amne sia, and no active intermediary metabolites that could produce delayed effects. A few surgeons mentioned hypnotics other than methohexital (36.9%).

References 1. Daniel FB, DeAngelo AB, Stober JA, Olson GR, Page NP: Hepatocarcinogenicity of Chloral Hydrate, 2 Chloroacetaldehyde, Dichloroacetic Acid in the Male B6C3Fl Mouse. Fundam Appl Toxicol. 1992; 19:159 168.

2. Smith MT: Chloral Hydrate Waring. Science. 1990;250:359. 3. Steinberg AD. Should Chlo ral Hydrate Be Banned? Pediat rics. 1993;92(3):442-445. 4. LytleJJ, YoonC: 1978 Anes thesia Morbidity and Mortality Survey:Southern California Society of Oral and Maxillofa cial Surgeons. J Oral Surg. 1980;38:814. 5. Goldman V: Deaths Under Anaesthesia in the Dental Surgery. Br Dent J 1958; 105:160. 6. Coplans MP, Green RA: Mortality and Morbidity Stud ies, Anesthesia and Sedation in (Continued on/allowing page) 13

TABLE 1

Response to pediatric Scenarios

Dentistry. New York, NY, Elsevier, 1983, pp 131-147.

Case One

7. AlexanderDW, GraffID, Kelley E: Factors in Tonsillec足 tomy Mortality. Arch Otolaryngol. 1965; 82:409. 8. Jastak IT: Morbidity and Mortality from Pharmaco足 sedation and General Anesthe足 sia in the Dental Office (Dis足 cussion). J Oral Maxill Surg. 1992;50:698-699. 9. Krippaehne JA, Montgomery MT: Morbidity and Mortality from Pharmaco-sedation and General Anesthesia in the Dental Office. J Oral Maxill Surg. 1992;50:691-698.

N=55

Case Two

Case Three

N=56

Local Anesthesia

1 (1.8%)

4 (7.1%)

1 (1.8%)

Local Anesthesia with Nitrous Oxide

13 (23.6%)

14 (25.0%)

2 (3.6 %)

Oral Sedation

14 (25.5%)

6 (10.7%)

11 (19.6%)

17 (30.4%)

20 (35.7%)

Intravenous/Intramuscular 4 (7.3%) General Anesthesia

21 (38.2%)

12 (21.4%)

17 (30.4%)

Hospital

2 (3.6%)

3 (5.4%)

5 (8.9%)

TABLE 2 pediatric Oral Sedation Agents Meperidine 9 Pentobarbital 6 Chlorohydrate 8 Diazepam 7 Hydroxyzine 7 Lorazepam 2 Triazolam 2 Midazolam 4 Others: Ketamine (1), Thiamylal (1)

TABLE 3 Responses to Adult Scenarios N=168 Local Anesthesia w/ Nitrous Oxide 11 (6.6%) 2 (1.2%) Oral Sedation Intravenous Sedation 146 (86.9%) General Anesthesia 9 (5.4%)

TABLE 4

Adult Intravenous Agents

N=168

Fentanyl 86 (51.2%) Midazolam 80 (47.6%) Diazepam 73 (43.5%) Meperidine 36 (21.4%) Methohexital 113 (67.3%) Other 62 (36.9%)

Minutes of the Annual Membership Meeting

Virginia Dental Association September 17, 1996 The 126th Annual Member ship Meeting of the Virginia Dental Association was held at the Hyatt Regency Hotel, Reston, on Sunday, September 17, 1995, at 9:05 a.m. President Leslie S. Webb, Jr., called the meeting to order. Dr. Edmund E. Mullins, Jr., Chairman of the History and Necrology Committee, an nounced the following names of deceased members within the last year: Dr. Gerald W. Black, Luray Dr. Moffett H. Bowman, Roanoke Dr. Clarence R. Boyd, Richmond Dr. Carl Cline Byers, Harrisonburg Dr. William C. French, Virginia Beach Dr. James A. Flowers, Lynchburg Dr. Joe Warlick Guest, Arlington Dr. Ray A. Hamilton, Arlington Dr. Aubrey S. Harlow, Jr., Ashland Dr. William B. Harris, South Boston Dr. Ralph Maynard Hodges, Rich mond Dr. Robert L. Hopkins, Jr., Norfolk Dr. Porter A. Hughes, Altavista Dr. Kyle Thomas Lee, Knoxville Dr. Bennett A. Malbon, Richmond Dr. William E. Overcash, White Stone Dr. Jack C. Phass, Falls Church Dr. Rex A. Rusterholz, South Hill Dr. Joseph H. Turner, Palmer Springs Dr. James E. Walters, Ruskin, FL

A moment of silent remem brance was held after the announcemen t. President Webb called on the 1996 Annual Meeting Chair

man, Dr. Andrew J. Zimmer, for brief remarks concerning the 1996 Annual Meeting, scheduled for September 18-22, 1996, in Williamsburg. President Webb recognized Dr. Bruce R. Hutchison, 1995 Annual Meeting Chairman and thanked his committee for a job well done. President Webb introduced Dr. Richard A. Hewitt, Presi dent, South Carolina Dental Association. Dr. Hewitt ad dressed the House with a few brief remarks and presented a campaign contribution to the Whiston '96 Campaign from the South Carolina Dental Association. Dr. Webb also introduced Mr. Chuck Duvall, VDA Lobbyist. VADPAC Chairman Dr. John C. Doswell, II, made several presentations to component societies and recognized several individuals for their exemplary work in behalf of the political action committee. Dr. Daniel E. Grabeel, Chair man of the VD A Fellows Committee, presented certifi cates to the 1995 VDA Fellows. Dr. Charles L. Cuttino, III, VDA Secretary-Treasurer, presented certificates to the 50

year, 6O-year and Life Mem bers. President Webb recognized the 1994-95 Component Presi dents and thanked them for their support during his year as President. There was a call for Old Business. There was a call for New Business. President Webb called for the election of officers for 1995-96: 1) The nominee for President Elect - Dr. William H. Allison. There being no other nominees, the Secretary was instructed to record a unanimous vote. 2) The nominee for Secretary Treasurer - Dr. Charles L. Cuttino, III. There being no other nominees, the Secretary was instructed to record a unanimous vote. 3) At-Large Councilors for a two-year term - Dr. David C. Anderson, Dr. Andrew J. Zimmer. There being no other nominees, the Secretary was instructed to record a unani mous vote. 4) ADA Delegate for a three year term (three available positions) - Dr. Daniel E. Grabeel, Dr. Wallace L. Huff, (Continued on following page)

~ ~eigh H. Watson, Jr. An

-cmal nomination was

r -

Id:1 -c - from the floor of Dr. lad~ ~. Arbuckle. The vote ~ ~en and the President 'as ~ed the winners to be Drs. ~c1 ~kle,HuffandWatson.

.rb-....::

~ -esxpired

two-year term

~ - ~ee for ADA Delegate o~ ~slie S. Webb, Jr. There )

e1 ec::::

no other nominees, the e:::::- -.:ary was instructed to _~ a unanimous vote.

~C~ ..

Alternate Delegates ;) ~ available positions) - Dr. t~e ~d D. Barnes, Dr. Lindsay UC:::: ~ --...:J.nt, Jr., Dr. Andrew J. 011._ ~er. There being no other ~i~ , ~ees, the Secretary was lC>~ <::ted to record a unani ns vote. n~vG ~=-=,ired one-year

term c~d by Dr. Allison - There ,T a.~ ~ ~-wo nominees from the Ne:-$'~:= Dr. David C. Anderson ~~ ~r. Bruce R. DeGinder. :l..X"1 d- ~ <He was taken and the rh e :i,c3.-ent declared the winner PrC/ S ::=IJr. Anderson. r 1 e:

Dr. Hutchison, Annual Meet ing Chairman, reported on the attendance at this Annual Meeting:

)T__

from the floor: Dr. Bruce R. DeGinder, Dr. Daniel E. Grabeel, Dr. Bruce R. Hutchison. The vote was taken and the President declared the winner to be Dr. Hutchison.

~ ~ired one year tenn U ~e t:~d by Dr. Webb - There v a..c ~ --a:-wo nominees from the

ViooTC/:l'""~:=

Dr. Anne C. Adams and fl~17 .2.niel E. Grabeel. The vote r>r ' t:~en and the President ~ ~~~ed the winner to be Dr. de:-c ~s. .Ad~'-

-c ~ired one-year term

L.T..,e t:~d by Dr. Arbuckle c~

""'" ~ e::;;-~be:C

were three nominees

Dentists Staff Spouses Guests

Exhibitors

494 107 154 58 + 249 (representing 92 companies) 1,062

President Webb presented VDA Executive Director William E. Zepp with a Univer sity of Virginia sweatshirt and cap and thanked Mrs. Zepp for all her help during the Annual Meeting. President Webb also thanked the VDA Staff. President Webb installed the following VDA officers for 1995-96: President: Dr. Ronald L. Tankersley President Elect: Dr. William H. Allison Secretary-Treasurer: Dr. Charles L. Cuttino, ITI Councilors-at-Large: Dr. David Anderson Dr. Andrew J. Zimmer President Webb installed the following component presi dents for 1995-96: 1 - Dr. David P. Paul, ill 2 - Dr. Gisela K. Fashing

3 - Dr. Michael R. Hanley 4 - Dr. 5 - Dr. Jr. 6 - Dr. 7 - Dr. 8 - Dr.

Edmund E. Mullins, Jr. Richard D. Huffman, Gus C. Vlahos Edward L. Amos M. Alan Bagden

Immediate Past President Webb then passed the gavel to President Ronald L. Tankers ley. President Tankersley pre sented a presidential pin and plaque to Immediate Past Pres ident Webb and presented a gift to Mrs. Webb. Their business concluded, the Annual Membership Meeting adjourned at 12:15 p.m.

VDA Sixty Year Certificates, 1995 Component 8 Dr. Albert D. Alexander

Component 3 Dr. Thomas C. Bradshaw

Component 1 Dr. William B. Costenbader Component 7 Dr. Loren G. Johnson

Component 5 Dr. Nathan I. Somers

Fifty Year Certificates Component 1 Dr. Lawrence H. Cash Dr. Lloyd C. March, Jr. Component 2 Dr. Herbert R. Kolb Component 3 Dr. Martin Sheintoch

ComponentS

Dr. James Wilbur Shearer

Component 7

Dr. Robert Marvin Driscoll, Jr.

Component 8

Dr. Robert Allen Levine

Dr. James Albert Pell

Dr. Neil J. Small

VDA Life Members 1995 Component 4 Dr. Robert S. Burford, Jr. Dr. Edgar F. Jessee Dr. Watson O. Powell, Jr. Dr. Joseph H. Way, III Component S Dr. Curtis R. Woodford

! I

Component 6 Dr. Robert R. Jackson

,f fc

fto f;

Component 8 Dr. Theron L. Dikeman Dr. Dwight R. Newman, Jr. Dr. Albert G. Paulsen Dr. Gerald J. Rose

1995 Fellows Component 1 Dr. William Hopwood

Higinbotham, Jr.

Dr. Clarance Marshall Mahanes

Dr. Norman Patrick Moore

Component 2

Dr. McKinley Lenard Price

Component 4

Dr. Lindsay McLaurin Hunt, Jr.

Component 1 Dr. John I. Bowman, Jr. Dr. Cecil J. Carroll Dr. Lawrence N. Cross Dr. Avalon L. Fansler Dr. J. Crockett Henry, Jr. Retired Life Dr. Ralph Leroy Howell, Sr. Dr. Leonard H. Jarvis, Jr. Dr. Eugene L. Kanter Dr. Bobby Mark Martin Dr. Emanuel W. Michaels Dr. Roger L. Visser

Dr. Howard B. Stanton, Jr. Dr. Gene Reasor Dr. Charles D. King Retired Life Component 7 Dr. Herbert D. Deane, Jr. Dr. John H. Knight Component 8 Dr. J. William Goering Dr. Richard F. Hymack Dr. Peter P. Kunec Dr. Charles H. Miller, Jr. Dr. Alvan M. Morris Dr. Samuel E. Saunders, Jr. ~

Component 2 Dr. I. Jules Goldsand Component 4 Dr. Gilbert F. DeBiasi Dr. John H. Harding, Jr. Retired Life Dr. Albert I. Huband, Jr. Dr. Robert V. Perkins, Jr. Dr. Hugh R. Rankin

â&#x20AC;˘

Component S Dr. Harry B. Fleming Retired Life Component 6 Dr. Thomas B. Haller Dr. Walter H. Hankins, Jr.

liest Wisoes for a ~appp &: ~ealtop I

1996!

VDAHouse of Delegates Actions in Brief... September 17,1995 1) Commended Dr. Leslie S. Webb, Jr., for his efforts during a very challenging year in the transitional times in the VDA Central Office, for his leadership in the legislative arena, his knowledge and foresight making VDA look and plan ahead for new challenges reshaping the practice of dentistry. 2) Adopted establishment of a VDA Charitable Foundation. 3) Resolved that the VDA would support legislation eliminating the post-test requirement for continuing educa足 tion credit for license renewal for hygienists. 4) Adopted Bylaws amendment and addition to Article VIII pertaining to the Committee on the New Dentist that members of the Committee shall have received their DDS or DMD degree less than ten years before the time of selection. 6) Adopted Bylaws amendment to Article VIII relating to the appoinnnent of subcommittees from the VDA membership.

7) Adopted Bylaws amendment to Article VIII relating to Liaison Subcommittee that there shall be a representa足 tive from each component society. from the Membership Committee and from the Committee on the New Dentist to encourage participation in organized dentistry.

8) Adopted Bylaws amendment to Article VIII pertaining to the Financial Aid and Auxiliary Education Commit足 tee that the name be changed to the Auxiliary Education and Relations Committee and that the Committee be charged with encouraging new or alternative education programs and to provide information concerning auxil足 iary certification. 9) Recommended to the Virginia Board of Dentistry procedures for obtaining a limited license to practice a specialty or specialties. 10) Adopted a resolution as amended to approve the Electronic Data Interchange subcommittee of the Dental Care Programs Committee's identifying 20 pilot dental offices to evaluate CAIR and MEDEX companies to set up electronic claims processing.

11) Adopted a resolution as amended that VDA mailing labels will be available to members for a fee of $90 and non-members for $195. Upon receipt and use of the labels there can be no representation of endorsement by the VDA or its members. 12) Adopted a resolution pertaining to the VDA proceeding with formulating a plan for an alternative training program for dental auxiliaries. 13) Adopted a recommendation that the VDA Science Talent Award Program be implemented. 14) Adopted a substitute resolution that the VDA supports legislation that funding appropriated for oral health programs be distributed to local health departments based on oral health needs and used in local health districts for oral health programs including dental health education. prevention and care programs. 15) Adopted an amendment to a resolution presented by the President Elect as follows: An Ad Hoc Committee is formed on Election Reform and will be composed of representatives from each component, the chairman from the Committee on the New Dentist, Membership Committee, Planning Committee and Executive Council. 16) Adopted a dues increase of $15 for 1996.

17) Adopted the 1996 VDA budget as amended. 18) Adopted a substitute resolution combining Resolutions 25 and 35 to appoint an Ad Hoc Committee to explore centralized dues collection and payment options for presentation to the 1996 House of Delegates. 19) Adopted a recommendation to establish a for-profit subsidiary. 20) Adopted a recommendation that capital improvements come from reserves and be replenished annually by the depreciation items in the budget. 21) Adopted a recommendation that pre-registration fees for the 1996 VDA Annual Meeting be set as follows:

$90 for VDA members; $190 for ADA non-VDA members; $290 for non-ADA member dentists; $45 for hygienists; $25 for assistants and other auxiliaries. On-site fees to be determined at a later date. 22) Adopted the following substitute resolution:

I) Recommends implementation of a Direct Reimbursement plan within the Commonwealth of Virginia. II) Recommends the VDA join the Alliance for Direct Reimbursement Plans, with the proviso that the Alliance

continue to promote Direct Reimbursement without manipulation of the Direct Reimbursement concept. The funding for membership in the Alliance will be derived from the funds generated by a dues increase designated for Direct Reimbursement. The Alliance for Direct Reimbursement plans will be required to present a biannual report to the VDA. III) Recommends-a dues increase of $30 to be utilized for the Direct Reimbursement program. IV) Recommends that all monies derived from any member dues for the promotion, marketing and operation of a Direct Reimbursement program be kept in a separate account. Disbursement will be made by the VDA Secre tary-Treasurer or Executive Director following direction from the Dental Care Programs Committee. 23) Elected Dr. D. Christopher Hamlin the Speaker of the House of Delegates for 1995-96. 13 _ _

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President'sAddress

I would characterize this past year as an investment in the future. Our objectives for the year have been to rebuild our association staff, carry out an aggressive legislative agenda, increase membership involve ment and participation, increase activity in our committee structure, expand membership services, improve our dialogue with all groups involved with dentistry and improve our central office physical plant. You, the involved dentists of Virginia, have helped the VDA make broad progress on all these fronts this year. The year began with the hiring of a new Executive Director, Bill Zepp. He has done a great job, and I want to express my appreciation to him for helping to make this year a success. Next, Chuck Duvall was hired as our lobbyist. Chuck has also done an outstanding job, as exemplified by our legislative success this year. Those of us who had the chance to work with him agree that his reputa tion as one of the best lobbyists in Virginia is well deserved. Carole Russell has rejoined our staff as Director of Meetings & Education. Lisa Finnerty has been hired as Public Affairs Coordinator, and Linda Gilliam is working as Director of Finance and Membership.

Jeanne O'Neill is Special Projects Manager and Jeanette Godfrey is Special Projects Assistant. I would also like to express our appreciation to Mrs. Pat Watkins, who retired as VDA Executive Director on January 1. Her dedication, leadership and friendship inspired all of us. It has been a joy to work with our other officers - Dr. Raleigh Watson, Past President; Dr. Ron Tankersley, President Elect; and Dr. Charlie Cuttino, Secretary-Treasurer - plus our executive councilors. They have given generously of their time and talents. I would also like to thank Dr. Fred Carr, Editor of our Journal; Dr. Emory Thomas, our Parliamen tarian; and Dr. Barry Einhorn, Speaker of the House. Three new committees Membership, Annual Meeting and Dental Practice Regula tions-are a meaningful addi tion to our committee structure. Our committees as a whole have been given more empow erment in their areas of interest and have been encouraged to form subcommittees of inter ested VDA dentists in order to expand their work and expand membership involvement. Many committees have found they had to add additional

meetings due to their increased work load. An Ad Hoc Com mittee on Forensic Dentistry has been formed under the chairmanship of Dr. Madison R. Price in order to evaluate the formation of an emergency forensic response team for Virginia. To make the VDA's physical plant more adaptive to our needs, the central office has combined two upper rooms into a large conference room for meetings, and we have improved furnishings and equipment. Our phone system has been updated, including the ability to receive multiple "800 calls" at one time and an answering machine to answer calls during non-staffing hours. While I am pleased with the progress we made this year, there is much left to do. The VDA legislative agenda in our state for the corning year is important to all of us. It includes:

1. Working with other health care associations and groups, labor and business to promote a consumer-oriented health care bill. 2. Asking that the inclusion of dentistry in the Department of

Health at least its current level of funding be mandated. 3. Initiating a bill to study how additional hygiene training can be implemented in Virginia. The approval by you-the House--of the bylaw change to form the Auxiliary Relations and Education Committee will help us as dentists to work effectively with those in our offices who help to determine the success of our practices. This committee will be actively involved with auxiliary educa tion programs and will meet regularly with our auxiliary associations. Currently the VDA Central Office is being asked to provide more services, such as an expanded yearly directory, and increasing number of inquiries from members and an expanded committee meeting schedule. In order to provide for these and other increasing services to our members, our staff and budget must grow. We now rank 47th among constituent societies in dues. This fact takes on greater meaning when we realize that 87% of our budget is generated by dues while the national average is 62%. Obviously, an additional means of VDA funding must be found. To enhance non-dues income, the Executive Council has ap proved the formation of a for profit subsidiary.

Our Central Office is now understaffed. We currently need an assistant to our execu tive director, and as we add more services, we will need more employees. Other states have found expanded staffs a necessity also. The average staff on constituents our size is 8, the median, 9, and the larg est, 14. We are handling the same type and volume of work with only six people, and two of these are part-time. We will be able to provide expanded and current services for our members only by adding appropriate staff. To help in our search for more funds, I recom mend a VDA foundation be established. A foundation would enable us to solicit grants, charitable gifts, in memoriams, gifts and estate bequests to fund dental projects in Virginia. We need to continue to ex pand our annual meeting. This year, we added a second day of continuing education. Next year, I urge the Annual Meeting Committee to run two days of CE with two concurrent pro grams. The concurrent pro grams should be aimed at staff participation in areas like risk management or OSHA require ments. A Direct Reimbursement (DR) program for Virginia will be debated by this House. Direct Reimbursement, the payment of the dentist's full fee by the

patient to the dentist and them his reimbursement by his employer, is a win-win-win insurance plan for the patient, the employer and the dentist. The employee gets to pick his dentist of choice and decide on his treatment. Documentation proves that the employer does save money with these plans and has more satisfied employ ees. The dentist wins by dealing directly with his patient without third party intervention. I fully support the VDA participation in DR because it is presently the best and only alternative to managed care. But the House must debate three major thoughts: 1) Should DR be funded by a $100 one-time dues charge or should it be funded as a yearly budgeted item? No matter which way you decide, DR will continue to need funding into the future. This funding should be in a separate account and the oversight of these funds should be under the Budget Committee and the Executive Council. 2) There will be a need for some VDA staff involvement in DR. The current thought na tionally, especially with the development of a DR alliance with its broker network and PR development, is that a portion, possible 50%, of one staffer's time will be needed. (Continued on following page)

3) DR budgetary needs must not overshadow VDA budget ary and staff needs which I have outlined previously. In 1996, Dr. David Whiston will be a candidate for Presi dent of the American Dental Association. I hope each of you will become involved in Dave's campaign. We want to make this a grassroots campaign in Virginia and urge our members to support Dave personally and financially. We need personal contacts with dentists in other states. We would also like to have a large contingent of Virginia dentists on hand in Orlando next September to cheer Dave on to victory. Dave is one of us. He is proven effective leader. The ADA will be enhanced by his committed, responsible leadership. Lastly, I want to address what I feel should be the ongoing goal of the VDA. It is to bring all the dentists of Virginia together to discuss the issues facing dentistry today in our Commonwealth and to come to consensus on the path to follow in representing dentistry and promoting its objectives. Our goal must be to be inclusive of • all geographic areas, all ages, all ethnic backgrounds, all sexes; • generalists and specialists, all practice types and settings, whether fee for service or managed care; • dentists in dental education, 22

dentists in government service, and dentists in private practice.

must help shape the future empowers us.

We must all be involved, have a relevant dialogue, and represent dentistry and its message to our fullest potential.

You will have the opportunity, during this meeting, to deter mine whether the VDA pro ceeds with two significant projects: The formation of a "for-profit" subsidiary and a commitment to the promotion of Direct Reimbursement. Both could positively effect the vitality of the VDA for years to come. I am personally enthusi astic about the potential of both projects, and I encourage you to review them with an open mind and positive attitude. As repre sentatives of our members, it is your responsibility to carefully evaluate the details of these proposals and decide whether they are properly structured, and that this is the appropriate time for their implementation.

You have honored me by electing me to serve as your president over this past year. I have thoroughly enjoyed my year-long journey. We have a great dental profession in Virginia, with many wonderful, involved, talented dentists committed to it. I thank all of you for your support this year, and I know Dr. Tankersley can count on you during his year as your president. Leslie S. Webb, Jr. President

President-Elect's Speech September 14,1995

VDA: Dentists Working Together for Better Oral Health Legislative and marketplace issues have resulted in a flurry of increased activity for the VDA. Staff and committee functions have been redefined and expanded; and new legisla tive initiatives have been developed. Threats to quality dental care for our patients have challenged us and made this an exciting and necessary time to be active in the VDA. The knowledge that we can and

During this legislative year, we anticipate intense efforts in addressing the shortage of hygienists and the preservation of our patients' right to "free dom of choice." We will also monitor the Board of Dentistry as they review the Rules and Regulations for dental practice. But this is just the beginning! During the next few years, American society will be making fundamental decisions about the way health care will be delivered in the future. These decisions will be made in both the political arena and the marketplace. We must be active

in both. But activity alone is not enough. VDA policies must truly represent the collective goals of our members and the best interests of our patients. Our goals and initiatives must result from issue-oriented debate. As your president, my goal is to make our Association in creasingly open to your ideas. Members must have the ability to openly discuss their sugges tions. After these suggestions have been evaluated by our committees, you, the represen tatives for our members, must carefully determine whether they are appropriate for the VDA. Obviously, everyone's ideas cannot be implemented, but the process will benefit us all, and the Association will move forward. If we minimize apathy and fragmentation, and increase participation, we will remain the voice for dentistry in the Commonwealth; if we fail, others will fill the void. The VDA's political and market place influence is directly proportional to the percentage of dentists that are members; its vitality is directly proportional to the percentage of dentists that actively participate. "Some make things happen; others watch things happen; others wonder what is happen ing." Dentists that are active in organized dentistry know what is happening and, together, can

often make things happen. They are able to cope with the frus trations of a changing practice environment. They can main tain an informed, realistic perspective. Fellow dentists are perceived as colleagues; and these colleagues are their personal and professional "support group." Dentists that are not active in organized dentistry wonder what is happening. They are often poorly informed, sense that they have no control over their destiny, and feel isolated. Without needed information and camaraderie, they often lose their confidence in the future and become disillu sioned. If the benefits of membership are so great, why don't we have a 100% market share? There are three explanations I feel we need to address: 1) Lack of understanding. Some dentists to not understand that membership is worth the price. "When value is not perceived, price becomes an issue." If dentists are not aware ofthe role of organized dentistry, its impact on current practice and its potential for influencing the future, they perceive our dues to be excessive. We need to clearly define our mission and policies, and develop effective methods for educating dentists about the value and goals of the VDA and ADA.

2) Lack of incentive to partici pate. Dentists receive many of our benefits without member ship. Unfortunately, this ability to abdicate personal responsi bility is an inherent deficiency in any volunteer organization. We must offer and promote indispensable benefits that only come with membership, e.g., essential information services, discounted supplies, and high quality continuing education, insurance programs and finan cial services. 3) Dissatisfaction with the political process. Some dentists are disenfranchised by their perception of our political priorities. The VDA represents a diverse group of dentists with many perspectives. Our mem bers include new and estab lished practitioners practicing in urban and rural settings that receive fee-for service and capitation as compensation for their services. We also repre sent both private practitioners and educators. There is nothing inherently bad about politics. The tremendous accomplish ments of organized dentistry are the result of political activ ity. Practically everything in our lives involves some type of politics. But we must assure that the political process in the VDA is one that permits par ticipation by all interested members. If dentists feel that Associa tion policy is determined by a (Continued on following page)

-small group of "insiders," and that individual and component political agendas take prece dence over substantive issues, they will be disenfranchised. If dentists sense that the VDA is not responsive to its rank-in-file members and does not value their input, they will lose interest. The opportunity for participation needs to be obvi ous and indisputable. In a volunteer professional organi zation, the outcome of an election or deliberation is often not as important as the process itself. "Issue-oriented" dialogue will empower our members and increase participation. You have permitted me to represent you at all levels of our tripartite system. I can attest to its effectiveness. You can take tremendous pride in what organized dentistry has done for dentists and their patients. As a result, dentistry's future looks bright, in spite of the volatile changes in other areas of health care. But, we cannot be satisfied with the status quo. We need to continu ally revitalize our organization and posture for the future. As an open and dynamic organiza tion, we can maximize our market share, increase active participation, and effectively represent our members. My recommendations for the next year are made with those goals in mind.

1. To better define and commu nicate our role in the future, I 24

recommend that the VDA develop a mission statement and establish the goals of the Association. To facilitate this goal, an ADA workshop on "Goals and Roles" will be conducted prior to this year's Leadership Conference. 2. To open the electoral process and increase issue-oriented dialogue, I recommend that the VDA establish an Ad Hoc Committee on Election Reform. The committee should evaluate the current electoral process, and explore more open and dynamic methods of electing our officers and the ADA delegation. I suggest that this committee be composed of chairmen from the Committee on the New Dentist, Member ship Committee, Planning Committee, and Executive Committee. They should report their findings and recommenda tions to the 1996 House of Delegates. 3. To better define VDA poli cies, I recommend that a VDA Policy Manual be developed and maintained. In addition to being a useful document for disseminating information, it will be an invaluable reference for policy review or revision.

members that have an interest in electronic communications should be selected to serve on the committee. "Information is power." In the future, quick dissemination of information will be both a valuable mem bership service and an essential tool for the Association. We must be vigilant in pre serving our ability to provide quality dental care. If you implement a Direct Reimburse ment program, it will be an important step in combating current trends in health care financing. Establishment of a for-profit subsidiary will give us the opportunity to offer additional membership benefits and increase our non-dues revenue. It is exciting to con template what can be accom plished by our working together to achieve goals that represent a true consensus of our members. I know we can do it, and I appreciate the honor of serving as your president during this time of transitions. Although we may not be able to change the direction of the wind, together, we can adjust the sails.

Ronald L. Tankersley, D.D.S VDA President Elect t1

4. To enhance communications with our members and posture for the future, I recommend that the VDA establish a Committee on Communications and Infor mation Technology. VDA

following: "Bennett was a statesman and leader who gave of himself more than he ever received. He give his wise counsel and unwavering loyalty and he had a wonderful sense of humor. While he was dedi cated to many causes, he did not take himself too seriously." Dr. Hunt then asked Bennett's long-time associate and friend Dr. Phil Peters to make re marks.

CVNews Tom Burke, MCV Editor

iBennett Malbon and Dr. Lindsay Hunt unveil the memorial in the Bennett A. Malbon Memorial Garden at MCV. on Memorial Garden 'eated riday, October 27, the ett A. Malbon Memorial was dedicated at the 1 of Dentistry. The Mal den is located in the d area between the Memorial Building and .. ns Building. The court a was completely reto include the installa o flower beds eny brick walking paths, e myrtles located along 'or wall of the Wood ,. a Bradford pear tree, els, azaleas, various f holly, and liriope grass) which will be :borderaround the s. The designer of

n Garden is Dr. Carl

a master gardener

ty member. "My goal

sign the garden with

lor as possible and .n color year round,

although it will be Spring before we see the fruits of our labor." Included in the design are some of Bennett's favorite flowers, such as his day lilies, which have been transplanted from his garden and will serve as an entrance to the garden. Dr. Lindsay M. Hunt wel comed the 150 guests who attended the dedication cer emony and recognized Susan Malbon and members of the immediate family. Dr. Hunt credited Jocelyn Lance for suggesting the concept of the garden and then rallying sup port for it. He also recognized the members of the Delegates and Alternate Delegates to the ADA 16th Trustee District from North Carolina, South Carolina and Virginia for their contributions which funded the purchase of four Charleston Battery style benches. Dr. Hunt concluded his remarks with the

The realization of the memo rial garden is the work of a few with the financial support of many. It was simply the most appropriate way to symbolize Bennett's personal commitment for the School. The redesign of the space and the costs of materials were funded by memorial gifts. 1996 General Assembly Initiatives for the School In 1995 the School of Den tistry received funds from the General Assembly to support two faculty and two staff positions. This $250,000 initiative was supported by the VDA, and their help was critical to its successful conclu sion. In 1996, the School will again be requesting support from the General Assembly for two faculty and two staff positions. Currently, the School ranks 22nd of the 35 public dental schools in student! faculty ratio. The School would like to express its appreciation (Continued on following page) 25

to the VDA for its continued support for its legislative initiatives in 1996. (FACf: In order for MCV to have the same state appropriation as the University of North Carolina, the General Assembly would have to increase the School's budget by 92% or $8.4 million.)

On October 20, we held a Risk Management Seminar. Atten

Component News

Congratulations to Christy Hamlin, who was elected Speaker of the House of Del egates of the VDA and to Bud Zimmer, who was re-elected Councillor-at-Large and elected alternate delegate to the ADA.

Component I Tidewater Dental Society

Dr. Barry Einhorn Associate Editor Tidewater held its annual meeting on Wednesday, August 23, 1995. We elected the following officers: President: Dr. David Paul, III President Elect: Dr. T. Wayne

Mostiller Vice President: Dr. James Baker Treasurer: Dr. Stanley Tomkins Recording Secretary: Dr. James

Krochmal Executive Committee: Dr. Christo

pherHooper Dr. Arnold Hoffman was selected to receive the Sim mons Award, which is the highest honor bestowed on a member of our Component. Dr. Manny Michaels presented the award to Dr. Hoffman in recognition of his many years of service to Component I and to organized dentistry.

dance resulted in a 7.5% reduc tion in malpractice premiums for three years from CNA, Suter, Haycroft and Simmons. VDA members from other components were invited, and attendance was good.

Thanks to the efforts of Drs. Bruce Barr, Bruce Longman, Chris Hamlin and Frank Beale, six hours of dental instruction has been instituted as part of the core curriculum of Eastern Virginia Medical School. Congratulations to Chris Hamlin and Mac Mahanes for their election to the American College of Dentists and to Bill Higginbotham, who became a Fellow of the Virginia Dental Association.

COMPONENT l/

Peninsula Dental Society Dr. Cory Butler Associate Editor As Fall "leafs" us behind, we should congratulate Dr. Ron Tankersley on his induction as VDA President at the state

meeting in Reston and not only wish him the best in his en deavors, but strive to help him execute the ideas and changes he and the VDA fmd important to the future of dentistry. One such action taken by the VDA House of Delegates was a $30 assessment per member to begin the marketing and subse quent implementation of a direct reimbursement plan. As we did in the Spring, our com ponent continues to recruit businesses interested in such a plan; if you know of any orga nizations that could benefit from this plan, please have them contact Kim Blore at 804/ 259-0594. Another initiative aimed at the future of dentistry is an ad hoc committee being formed on communications and technology; this committee will take a look at today's methods and attempt to predict the direction of tomorrow's dental office communications. Anyone interested should contact the VDA office in Richmond. Additionally, in Reston there were 12 hours of CE available at the VDA meeting and nu merous hours available at the ADA meeting in Las Vegas, October 7-11. Remember, there is a mandatory CE requirement no in effect. Plans are currently underway for a joint continuing education program with the Tidewater Dental Association in April, 1996. All dentists and staff are encouraged to attend these upcoming events.

A motion was passed to support Dr. David Whiston in his campaign for ADA presi dent for 1996-97 and money was set aside to be presented to his campaign. On the membership front, we would like to welcome the following new members to our component: Drs. Joanne Clark, Harold McGrane, Andy Maeso and Shannon Martin. During the November elec tions, please contact your candidate and let him/her know the issues facing dentistry today and how you feel. This "grass roots" approach has been successful in the past and legislators do take notice. We can make a difference together. On behalf of the members of the Peninsula Dental Society, have a safe and happy holiday season!

COMPONENT J11 Southside Dental Society Dr. H. Reed Boyd, III Associate Editor We have survived another harsh season here in Southside Virginia. This summer was not only very dry, but extremely hot. We set a new record of 32 straight days with temperatures above 90·F. Many of those days the temperature index soared to 100'+ due to the humidity. Pity the poor farmer

who depends on the weather to make a living. Many of our patients are farmers in this part of the state and they are strug gling, but I admire their grit and determination to beat Mother Nature and make their living, risking hundreds of thousands of dollars in equipment and supplies. Our component lost another member recently when Dr. Rex Rusterholtz died tragically back in the summer. Rex was only 30 years old and practiced in South Hill at the time of his death. Earlier in the summer, the component lost Dr. Joe Turner in a tragic car accident. Our sympathies go out to the families of our colleagues. We have gained a new mem ber, Dr. Douglas Peoples, a general dentist who practices in Petersburg. He shares a practice with Dr. Ronald Terry, another general dentist. We welcome Doug to our component and challenge him to get involved in organized dentistry. Two of our members have retired after long and dedicated careers. Dr. Robert Comstock graduated from MCV in 1948. Born in Chesterfield County, he had practiced general dentistry in Petersburg for 45 years, joining the U.S. Air Force from 1950-52. He retired in the late summer and sold his practice to Dr. George Lake. Dr. Lake came to Petersburg after a

military career to practice general dentistry. Dr. W.H. "Winks" Alexander graduated from MCV in 1942 and is retiring after 54 years of private practice. "Winks" began his career in the U.S. Air Force and then settled in Hopewell. Originally from Petersburg, Dr. Alexander was active in the fluoridation of municipal water supplies in this area. His wife Martha has worked with him for most of 36 years. With his retirement, Dr. Alexander will donate all of his dental equip ment to a field missionary in Africa for use there. He told me he has practiced standing up his whole career and that he en joyed every minute of his professional life. We congratu late these men on their out standing careers and wish them the best in their retirement. Mr. Bill Zepp made his first VDA annual meeting a memo rable one. The meeting was active and busy. The scientific programs were good. The annual meeting was attended by 494 dentists, 107 staff mem bers, 154 spouses, 58 honored guests and 242 exhibitors, representing 92 companies. In all, 1,062 people attended the annual session. There was even a fire alarm during one of the scientific sessions to heighten the excitement. Two members of our compo nent were recognized for their (Continued on following page)

service and dedication to dentistry. Dr. Martin Sheintoch was awarded the 50 year certificate and Dr. T.C. Bradshaw was awarded the 60 year certificate. We congratu late these gentlemen on out standing careers dedicated to the care of their patients' oral health and for their service to organized dentistry. Next year's VDA annual meeting will be held in Williamsburg, September 18 22, 1996. Dr. Andrew "Bud" Zimmer is the chairman. If you attended last year's meeting you had first-hand experience of what a great meeting he and his committee planned. I am sure that the 1996 meeting will be as good, if not better. I urge you to mark your calendar and make plans now to attend.

COMPONENT IV Richmond Dental Society

Dr. Benita A. Miller Associate Editor The fall and winter anticipate many activities for the Rich mond Dental Society. To help meet our members' needs for continuing education, we have already held well attended all day courses, and we have extended to one hour the time allotted for speakers at our monthly membership meetings (to allow for one hour of CE credit). Two exciting and 28

talented speakers are still to come: Dr. Bud Mopper, Achieving True Dental Esthet ics with Today's Composite Resins on February 16, 1996; and Dr. John Svirsky, Sex and the Single Nevus: Everything You Wanted to Know About Oral Pathology But Were Afraid to Ask on March 29, 1996. Please call Linda Simon (804/379-2534) if you are interested in attending. (FYI, for those with sensitive ears, Dr. Mopper's topic has re ceived a "G" rating, and as usual, Dr. Svirsky's presenta tion has not yet been rated!) The ADA Field Service Task Force has wrapped up its first year of activities. Under the direction of Dr. Ed Mullins, our committee has focused on better identifying and meeting the needs of our newest mem bers and potential members, and on increasing our member ship and decreasing our non renewing membership. We are within reach of our year-end goal of 40 new members with fewer than lOnon-renewing members! Our increased inter action with the dental students has also been well received, and more activities are planned. The efforts again this spring of Drs. Russ Mosher and Kitt Finley-Parker produced another extremely successful Board Assistance Program for MCV seniors. (This program is sponsored by the VDA Com mittee for the New Dentist.)

Our most popular RDS event from the students' perspective has been our annual golf/tennis outing and cookout in May. Senior students playing golf and tennis are sponsored by RDS members and are joined by spouses and children for the evening cookout and festivities. Many students have expressed an interest in seeing how our offices actually operate, and so we are planning some type of open house, with a number of offices participating. The Alliance continues to keep an extremely busy sched ule, including a variety of monthly meetings and special projects, as well as ongoing philanthropic commitments and legislative activities. A major undertaking this year is a revamping and rejuvenation of the ever-popular puppet show, with new costumes and an updated script. This year's Alliance president is Mrs. Tina Nyczepir. As many of you already know, a fund has been established at MCV for the Bennett A. Malbon Memorial Garden. It is planned for the courtyard area between the Lyons and Wood Buildings, and among the myriad plants will be cuttings from Dr. Malbon's own garden. Please call the MCV School of Dentistry if you would like to make a contribution; they are greatly appreciated.

Best wishes for a holiday season filled with joy!

November 15, 1996, at Blacks burg and the speaker will be Valerie Beecham on Pharma cology.

COMPONENT VI

Southwest Virginia Dental

Society

Dr. R. Graham Hoskins Associate Editor The next meeting of the Southwest Component will be March 8, 1996, in Marion at the Holston Hills Country Club. The speaker will be attorney John Bagwell, and his topic will be on collecting fees in the dental office. In the Spring, the Southwest Component will again sponsor its annual weekend at Pipestem State Resort Park. The dates will be May 17-19, 1996, and the speakers will be Drs. John Cranham and Chris Hooper, who will speak on Functional Esthetics. The weekend will also feature entertainment on Saturday night and a traditional golf tournament, so plan to spend a relaxing and informa tive weekend with us. August 16, 1996, will be the date of the annual Abingdon meeting at the Martha Wash ington Inn. The speakers will be John Kennedy and Lynn Maulding on Preventing Child Abuse and Neglect. Looking deep into our crystal ball, the Fall meeting will be on

Election of officers took place at the August meeting and the new slate is: President, Gus Vlahos; Vice President, Bill Thompson; President-Elect, David Stepp; and Secretary Treasurer, Dana Chamberlain. The Component regrets the loss of Kim Swanson, who has moved to the Richmond area. We will miss her help in the New River Valley, but hope that she finds her new practice situation professionally fulfill ing. The following members have been inducted into Life Mem bership status: Tom Haller, Walter Hankins, Jr., Howard Stanton and Gene Reasor. Charles D. King has been inducted into Retired Life Membership. New members in the South west Component include: Bradley Nester, Galax; Anne Johnston, Abingdon; and Tina McGeorge, S1. Charles. The Component Editor would like to remind Association members that their contribu tions of original research clinical tips, etc., are welcome, no matter how unassuming you might think them to be. Addi tionally, all members are

reminded to inform me of retirements, life memberships, honors, awards, papers pub lished, appointments and elections, whether personal or professional, so that appropriate recognition can be granted. COMPONENT VII

Shenandoah Valley Dental

Society

William C. Bigelow Associate Editor Greetings from Component VII! As we enter the Fall season, we look forward to beautiful weather and colors. Our Component met on November 3 at the Boar's Head Inn in Charlottesville, where our speaker was Hugh Doherty on financial planning. The new officers for the upcoming year are: Ed Amos, President; Ted Sherwin, Presi dent Elect; and Jerry Brown, Secretary-Treasurer. We would like to thank Wayne Remington for his leadership over the last year. The Component welcome the following new dentists to the organization: Steven ZeBarth, Winchester; Jack T. Kayton, Charlottesville; Steve Anama and John Boyles, Staunton. We also recognize and congratulate Bob Driscoll, who became a Fellow in the VDA. Also, Ted (Continued on following page)

Sherwin and Wayne Remington were inducted in the Pierre Fauchard Academy. At the State meeting, we were proud of Raleigh Watson for being elected ADA Delegate. Raleigh has contributed count less hours to our organization and we are glad he is our representative from this Com ponent. Component VII re ceived recognition for having a 20% participation in VADPAC, the highest participation on any component in the State. I am glad to see our Component's recognizing the importance of this organization and its contri bution to its maintenance, I hope that the standard set by Component VII will set an example for others to follow. The dental community in Winchester has been working with local merchants to set up a direct reimbursement dental insurance system. That negotia tion is still undergoing and will probably be a model to other areas in the State if successful. We hope that you all have a good holiday and look forward to the coming New Year. COMPONENT VIII Northern Virginia Dental Society

Dr. Bruce W. Jay Associate Editor Needless to say, it has been a very busy year for our Compo 30

nent, and especially for Dr. Bruce Hutchison. As chairman of the Annual Meeting Com mittee, he delivered on his promise of making the annual VDA meeting in Reston excit ing and successful with the new four-day format. Record atten dance figures were set: 1,062 attendees, 494 dentists with 249 exhibits, representing 92 com panies. Congratulations to Drs. Steve Lanier, Stu Graves, Charlie Nardiello and Susan Nardiello in winning the golf tournament with an astonishing 14 under par! More news from the meeting: The following doctors from Component VIII received life membership certificates: J. William Goering, Richard F. Hymack, Peter P. Kunec, Charles H. Miller, Jr., Alvan M. Morris and Samuel E. Saunders, Jr. Dr. Albert D. Alexander received his 60 Year certificate and Drs. Theron L. Dikeman, Dwight R. Newman, Jr., Albert G. Paulsen and Gerald J. Rose received their 50 Year certificates. our sincere congratulations to these out standing clinicians! Drs. Robert A. Levine, James A. Pell and Neil J. Small received distinction in becom ing Fellows of the VDA. Best wishes for s successful year are in order to the follow ing Component VIII members who were elected to leadership positions at the general meeting

on Sunday morning: Dr. Will Allison, President Elect of the VDA; Dr. David C. Anderson, VDA Councillor-at-Large (also elected to serve as ADA Alter nate Delegate); Dr. Gary Arbuckle, Delegate to the ADA, and to Dr. Bruce Hutchison, ADA Alternate Delegate. In addition, Dr. Rod Klima was appointed to be the NVDS Councillor to the Execu tive Committee. In other news, Dr. Frank J. Samaha delivered a check in the amount of $500 on behalf ofVADPAC to Delegate Vincent Callahan on September 7, 1995. Dr. Samaha thanked Delegate Callahan for his continued support of VDA legislation and urged his abid ing interest and backing of dental issues in the future. Dr. John F. Bruno was elected to the Board of Trustees of the American Academy of Perio dontology from District II. We welcome the following new members inducted on August 30: Drs. Rodney A. Alejandro, Scott A. Allegretti, John Douglas Bramwell, Tony Chehade, Theodore Paul Corcoran, Bassem El-Hage, Timothy J. Goliam, Garrett Gouldin, Robert Hall, Gregg L. Kassan, James H. King, III, Denise Nguyen, Nikki T. Nguyen, Quan Nguyen, Anh H. Pham, Richard M. Pollock, Frank Portell, Steven Press, Mahtab Sadrameli, Annette Scott, Richard Sherwood, Olmedo I. Villavicenio, Suzanne S. Williams and Joyce Xia.