Virginia Dental Journal by Virginia Dental Association

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Virginia Dental Association

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Contents ForJuly-September 2004

VIr ..

a~ Number 3

News and Headlines

Departments

Denta Laborator

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Next Projects:

Wise County, VA

July 23-25, 2004

Grundy, VA

October 16-17, 2004

~\Missions

~ifMercy

'ir~inia

Dental lIealth Foundation

From The Editor

Leslie S. Webb, Jr. DDS

VA Dental Journal Editor

In the recent VD:\ membership survey. 21.8% of respondents rare third party dental insurance issues a major concern. Interestingly, while dental insurance issues rate this high, dentists are not using major tools available to them in dealing with these issues.

can also be sent to the 1\D/\ through its Dental Benefit Programs Committee. The VDA, ADA and their committees need to know about the problems dentists are encountering in dealing with third party carriers so they can help the individual dentist and the entire profession.

The American Dental Association offers a contract analysis service which will evalu ate contracts offered bv a dental insur ance carrier to the dentist. This service is offered by the ADA for a nominal fee. However. if the dentist submits the contract for review through the Virginia Dental Association, there is no charge. The VDA keeps copies of these reviews so that if another member submits this same contract, a response can be given quickly.

Are procedures being bundled (grouped together) to lessen payment? Are com panies modifying treatment plans? Are requested reviews being done by dentists? Are contracts being honored? Are pay ments being disallowed? Are payments made promptly?

The Dental Benefits Committee of the VDA has forms available so that dentists can report a third party problem and get aid from this committee. Complaints

Organized dentistry can help you under stand the third party contract before you sign it and help you deal with third party problems. Your obligation is to become informed about third party matters. Re port the problems you are experiencing and ask the questions yOU may have; you will help yourself and vour profession.

CAN YOU HELP?

The Board ofDirectors isforming a BioterrorismlMass Disaster Sub committee to formulate the VDA 5 emergency response to mass disasters and needs volunteers. Ifyou have an interest in bioterrorism orforen sic dentistry and would like to serve on this subcommittee, please contact Dr. Bruce DeGinder, VDA Presi dent, at brucedeginder@cs.com or by fax 757-229-8979.

NOTE: If you have a latex-free practice or are aware of one, please contact

Dr. Terry Dickinson at the VDA office at (804) 261-1610.

1\Im 1 (l, 2004 I hope all of you have made plans to attend this year's Virginia Meeting on September 9-12, 2004 at the Norfolk Marriott. The Annual I\Ieeting and Local Arrangements Committee have been working tirelessly to ensure a fun and educational experience for all par ticipants. Our keynote speaker, Dr. Art Dugoni, is one of the most respected dentists in the country-I think YOU will find his message both insightful and motivating. I'm personally \-ery excited to have someone of his caliber highlighting our meeting. Bring your entire family as we have many entertain ing activities planned. It has been an active and contentious year in the Virginia General Assembly. We are indeed very fortunate to have such a knowledgeable lobbyist in Chuck Duvall, great VDA Legislatiye staff sup port in Nicole Pugar, and such an active grassroots membership of legislati\'e contacts and liaisons. As a result of their hard work, we had a very successful year. We were able to help secure fund ing for virtual simulation equipment for the VCU School of Dentistry, and were able to get Dental Medicaid taken out of the managed care arena plus obtained funding for the administrative costs as sociated with this 'carve out'. \\ie also successful!v lobbied for two bills, one created preceptorships for dental and dental h\'giene students to expand their clinical practice opportunities in privnr« offices, and qualit , assurance and peer review protections for dentists. Please remember much of our success is direct II linked u) iur strong market shan: in membership. 1 once again ask vou t() acrivclx cnc. Jurage n: in-mcmlx-r to loin the a'c;oCLltion that i' \\'C lrktng c;o hard on behalf of the dental prr,fes sion. Pcr:« malk 1 c>11h refer m, patient' C

to specialist" who are member" of the i\DA/VDA became I know they are bound by the ADA Code of Ethics and through their involvement in organi%ed dcntistrv they are activclv participating in shaping our future destiny, If the specialists YOU refer to are not members, perhaps you should point out to them how much you would appreciate them contributing their fair share as we all strive to improve and better represent the profession. In just a few days, our next Mission of Mercy project will be held in Wise county. Log onto our new website at wwwvadental.org to register and come participate in an experience that will forever touch your heart. In the next few months, you will be receiving a CD-ROM on Direct Reimbursement Programs. This CD will be an excellent educational source of information for both you and your staff as we continue to promote the many benefit" of direct reimbursement plans for employers and your patients. It is hard for me to believe my year of service to the Virginia Dental As sociation is almost at an end. It has truly been an honor and lots of fun as well-l would encourage any of the 111a 11\' capable leader" in our association to take that next "tep and become more involved. 1\\'ould like to thank the 200,) delegates that appr<,yed our new streamlined f( '1'111 c)f g( l\TrnanCe, The dedicati( In and cooperation exhibited 1)\ \ our Board of Directors this vcar has bee-n phenomenal as \\T hav« made the leap inti) kn(J\dedge based g(l\ernance. j \\ould also like to l·specialh thank all of r iur participant-, in our flr'l leader ship dC\Tlopnll'nt conference held in Charlotte",ille this \pri!. I belin'e our prim.u. re,ponsibilit\ a, le:lder, is [()

1cmT the association better than when \\'e started and \\'ith strong leaders to continue that pursuit of excellence. J would like to reassure our member ship that if these participant' are anx indication of c.ur future l" .tcntial, we are indeed looking at an excitin,L': age in dcnri str v, Thank \(JU for allc)\\' inC! me the pri\'ilq!e tr) sene a' \( iur President'

Abstracts Of Interest

dental erosions, stage of dentition, and location of involved teeth. Standard EGD examination of the upper gas The following abstracts were pro vided by the Department of Pediatric trointestinal tract was performed and biopsy specimens were obtained from Dentistry at VCU School of Den tistry for the April edition but due the duodenum, stomach, and esopha to space restrictions, were held until gus. The severity of reflux esophagitis was graded as mild, moderate, or this month. We appreciate the con tribution that these individuals have severe according to established criteria. Patients with dental erosions were made to the Virginia DentalJournal. compared with patients without ero sions for the presence and severity of reflux esophagitis in each group as well Gastroesophageal reflux disease and

as age distribution, symptoms, acidic dental erosion in children

food intake, and dental hygiene. Dahsban A, Patel H, Delaney J,

Endoscopic and histologic evaluation Wuerth A, Thomas R, Tolia V. Gas

troesophageal reflux disease and dental revealed that 24 patients had GERD. Of these, dental erosions were present erosion in children. Journal of Pediat

in 20 patients (83.3%). Fifty percent rics 2002;140:474-478.

had mild erosion, 30% had moder ate and 20% had severe erosion. The This prospective study was done to

of erosion revealed that the pattern evaluate the presence of gastroesopha

geal reflux disease (GERD) and dental posterior teeth were primarily involved in 17 of 20 patients (85%). A large erosions in children with primary and

proportion of patients (84.5%) noted permanent teeth. Gastroesophageal

to have GERD and dental erosions reflux (GER) is a relatively common

had pain and indigestion from eating condition in infants and children.

fried and/or spicy foods. Dental erosion is the irreversible loss

Other factors besides GERD, in of dental hard tissue by a chemical

cluding dietary habits and the degree process in the absence of bacteria. It

of the individual salivary buffering is characterized as a hard "dished out"

capacity are also believed to influence area with a smooth, glistening base.

This problem is particularly harmful in the occurrence of dental erosion. Ero sions involving primary teeth could young children in whom the enamel

be prevented from progressing into and dentin layers of the primary teeth

permanent teeth if identified early and are much thinner than in adults. The

adequately treated. Current manage facial, occlusal, and lingual surfaces

ment of dental erosions include the are more commonly affected. Extrin

use of fluoride rinses, sodium bicar sic factors (mostly affecting the facial

bonate mouth rinse several times a surface of the anterior teeth) include

day, and periodic dental assessment. the consumption of acidic foods,

It is also important note that if dental beverages, and acidic contaminants in

the workplace. Intrinsic factors include erosions are detected in otherwise salivary flow, eating disorders, and acid asymptomatic children, especially involving posterior teeth, they should regurgitation.

be evaluated for GERD. The study focused on 37 children (18

males) 2 to 18 years old who were un

Dr. Ajit A. Patel received his D.D.S. dergoing elective esophagogastroduo

degree from VCU School of Dentistry. denoscopy (EGD) for possible GERD.

He is currently a 2nd year pediatric Dental examination was performed

dentistry resident at VCU. before the endoscopic procedure by

one of 2 pediatric dentists. The teeth

were evaluated for the presence or

Premature loss of the maxillary pri

mary incisors:

Effect on speech production

Theresa Ott Gable, MA,Ann

W Kummer, PhD,Linda Lee,

PhD,Nancy A. Ceaghead, PhD,LisaJ.

Moore, MA

Journal of Dentistry for Children,

May-June 1995

Background and Significance:

The maxillary incisors, maxillary and

mandibular canines, and the first mo

lars are the teeth most susceptible to

"baby-bottle caries". Studies by Dil

ley et al and Johnsen et al report that

the maxillary primary incisors are the

most severely affected teeth. These

teeth are at a greater risk for decay

because they are the first to etupt and

are maximally exposed to the liquids

during prolonged or excessive nursing

habits.

Baby-bottle caries is usually not

detected by the parents or profession

als until approximately eighteen to

twenty-two months of age. Extrac

tion of the maxillary primary incisors

is usually the treatment of choice.

Parents usually have several questions

to ask prior to maxillary primary

incisor extractions. Such questions

are: "How will my child's speech be

affected?" or "Will my child need

speech therapy before or after the per

manent teeth erupt?" These questions

are difficult to answer.

Purpose:

The purpose of this article is to edu

cate dental professionals about the

possible effects of early incisor extrac

tion on normal speech production.

Methods:

Twenty-six subjects, with a history

of early loss of the maxillary inci

sors by means of extraction before

the age of 5 years old were selected

for this study. All subjects had their

four maxillary permanent incisors at

the time of study. The subject's ages

ranged from 8 years and 1 month to

age was 9 years and 5 months. The mean age of extraction was 3 years old and 5 months, 3 years and 10 months, and 3 years and 2 months for the eight-, nine-, and ten-year-olds, respectively. The control group consisted of twenty six subjects with a history of normal exfoliation of their four maxillary primary incisors. Results: Subjects with premature extraction demonstrated more articulation errors, however t-test comparisons revealed that the differences were not statisti cally significant. In word and sentence contexts, distortion of the sibilants/s, z, 3, ,sp, st, sk, t , d31 were the most commonly occurring errors for subjects with premature loss group. The second most common error were in the form of substiturions and omissions of frica tives I , f, vi. The eight-year-old subjects in both

groups produced more total errors than the other age groups. Discussion: Children with normal exfoliation of their primary incisors manage to com pensate and produce correct sounds. Although, some children produce distortions in fricatives while their front teeth are missing. Parents are rarely concerned with speech develop ment, because they assume speech will be corrected once the permanent teeth erupt. Early loss of the primary central and lateral incisors during the time of speech acquisition is a more complex issue for parents, dentists, and speech language pathologists. This study showed no statistically significant dif ferences in the articulatory abilities of children with and without premature maxillary incisor extractions. Both subject groups revealed a maturation effect. The number of articulation

errors decreased as the subjects aged. Very few residual speech problems remained by the time the child was 10 years old. Conclusions: This study reports that children who lose their primary central and lateral incisors due to extraction before the age of 5 years will probably make no greater number of articulation errors, once the permanent teeth erupt, than children with normal exfoliation. The majority of children will acquire normal speech development without speech therapy intervention by the age of 10 years old. Dr. Jennifer Dixon is a first year ad vanced education student in Pediatric Dentistry at MCV/VCU, School of Dentistry. She received her D.D.S. from Virginia Commonwealth Uni versity, School of Dentistry in May of 2003.

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VDAAwards Dr. Bennett A. Malbon Prize Ms. Suravi Sircar of Mills E. God win High School in Richmond, VA is the VDA's 2004 recipient of the "Dr. Bennett A. Malbon Prize." Ms. Sircar's project entitled "Japanese Medake as an Alternate Vertebrate Model for Human Ag ing and Cancer," was a winner of the Nineteenth Annual Virginia State Science and Engineering Fair in the Medicine and Heath cat egory as well as the VDA's category winner. The Malbon Prize rec ognizes Ms. Sircar's excellence in scientific research and community spirit. Sircar is shown below with Dr. Jackson Payne who was both a presenter and judge at this year's fair which was held on April 17, 2004 at Randolph-Macon College.

Dental Students Participate In First Annual VDA Leadership Development Retreat On April 3-4, the VDA invited some of its members as well as students and faculty from the VCU School of Dentistry to attend the first annual VDA Leadership De velopment Conference in Charlot tesville, VA. The meeting provided a forum for the students to become more familiar with both the short and long term goals of the associa ...:,.... . . . Ih.o

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introduced strategies to cultivate the leadership skills of both current and future members. During dis cussion the ideas of strategic plan ning and membership involvement were viewed as critical for the con tinued success of the organization. In between the numerous breakout sessions and lectures, the group found time to get better acquainted and share their ideas about the

future role of the VDA within the profession. Thanks to the VDA for involving the students in this event. We truly appreciate your ef forts to involve us in the profession which you love. Submitted By: Clay Weisberg

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I HAVE HAD ENOUGHI By: Gordon]. Christensen, DDS, MSD, PhD Where has the professionalism of my "profession" gone) I have seen a major degeneration in the ethics of the dental profession over the past several years. Until recently, I have had the opinion that dental professionals and those companies involved with them were working for the good of the public; that service was a major purpose for a profession-not money; that advertising in professional publica tions was observed carefully by editors to weed out any hint of dishonesty; that the "peer reviewed" dental literature contained only scientifically acceptable, non-com mercially oriented information; that the public trusted the dental profession; and that dentists treat their patients like they would like to be treated themselves. WOW-have I been misinformed! On the positive side, as I start this written tirade, dentistry has made unbelievable progress during my career so far. As I look back at the profession when I became a dentist, the ability of dentists to serve patients was only partially developed when compared to today. The introduction of high-speed tooth cutting, implants, tooth colored restorative materials, porcelain fused- to-metal restorations, staff involve ment in clinical procedures, advanced surgical procedures, and great strides in preventive dentistry have made dentistry fulfill my three favorite words for patient care-dentistry is now faster, easier, and better than it was when I became a dentist. However, in my opinion, the ethics of the dental profession has taken a real "dive" during the same time. At the beginning of my career, dentists and dentistry used to be ranked by pollsters at the top of the list of professions the public trusted. Now, in numerous surveys of pub lic respect, we are reported to be far down on the trust scale. This editorial discusses the relatively recent and obvious degeneration of ethic, in the dental profession and calls for a change of direction by all parties involved. The following actual documented examples do not name specific individuals or companies to avoid confrontations. I present the following information as examples of the problems I see in the ethics of our profes sion. If the shoe fits-wear it! Let's exam-

contributing to this degeneration. OVERTREATMENT I was one of the original instigators of the recognition of esthetic dentistry, over 25 years ago. However, my pet subject has turned into a monster with unbelievable overtreatrnent of unsuspecting patients. This problem of overrreatment is not limited to esthetic dentistry. It is spread throughout the profession. I will list a few current examples. Convinc ing patients that removal of amalgam res torations is mandatory for systemic health reasons is not a legitimate or logical prac tice in most situations. Yet, many patients go through that elective procedure with the hope that some miraculous cure of a systemic condition will be accomplished. Of course, there are a few situations in which amalgam removal may actually be indicated for reasons other than esthetics.

Recently, a patient was examined by me and my staff for a second opinion on an "esthetic upgrade". She had traveled sev eral hundred miles to have the exam, and she did not inform me of her reasons for requiring a "second opinion" until later. We suggested a treatment plan that in cluded scaling, polishing, at home bleach ing, minor esthetic tooth recontouring, few anterior and posterior toothcolored resin-based composite restorations, and two elective veneers. When the plan was presented, she sighed in disgust. Just a few hundred miles from Utah, she had received a treatment plan for twenty-eight veneers and a total occlusal rehabilita tion, equal to the cost of a very good new automobile. If this were a singular occurrence from one less-than-reputable dentist, I could understand it, but this has happened to me several times in the recent past from various practitioners. Dentists are actually being taught by popular speakers on how to do the same overtrearrnent to their own patients. I have had the unfortunate challenge to redo several of these overtreated cases after the fracture failure of the ceramic restorations, debonding of veneers placed over grossly overprepared dentin surfaces, or degenera tion of the occlusion that appeared to have littl.. occlusal adjustment after seating the

restorations. If treatment plans containing all of the treatment alternatives are pre sented to patients, including the advantag es, disadvantages, risks, and COSts of each alternative, and if the consenting patient accepts and demands a radical plan, the treatment becomes more understandable. It is well known that patients elect to have radical esthetic plastic surgery on various parts of their bodies, knowing that the procedures are elective. But, oral over treatment in the name of esthetic dentistry without total informed consent of patients, primarily for dentist financial gain, is nothing less than overt dishonesty in its worst form. You cannot put tooth structure back after it has been removed. The solution-dentists should evaluate their diagnosis and treatment planning procedures to ensure that all of the various treatment options are presented to pa tients. If patients choose a radical, elective treatment plan, primarily for appearance purposes, they should be told all of the negatives before they choose to initiate the treatment plan, including potential premature failure, occlusal problems, and need for re-rreatment in just a few years. Informed consent should be thorough and complete. Treatment plans should be separated into mandatory treatment and elective treatment, and patients should have a complete understanding of the dif ference. Financial income to the practi tioner should be related to the needs and decisions of the informed patient, not the needs of the practice. ADVERTISEMENTS IN DENTAL JOURNALS/MAGAZINES As I thumbed through a current "cos metic" magazine, I noted the presence of ads for several light enhanced in-office bleaching devices, touting their superior ity to other bleaching techniques. It must not matter to some manufacturers that it has been proven and published that the tested bleaching lights do not effect a greater tooth color change than the bleach solution alone. I find it amusing that one manufacturer actually advertised that his product could be used with or without the light. Dentists are not without guilt in this situation. Recently, I talked to a practitio ner in a course who blatantly told me that he knew the lights did not improve the bleaching, but the thought that patients accepted bleaching fees better ifbleach l'

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DIRECT What Makes A GOOD DR Lead?

Elise \\!oodling, Director of Marketing & Programs

If you have ever wondered what the VDA is looking for when we request that you call in "leads" for DR, check out the list below that outlines what the best DR leads have in common. I. A lead is best when it is a personal contact of our members; friends, patients, business contacts, etc. will highly value your opinion on dental benefits as a dental professional. 2. The best leads are those for companies that have over 10 employees (over 50 employees is even better!). 3. Benefits decision-makers are among the best people to call in as leads to the VDA. Company owners, human resource professionals, benefits administrators, etc.

are the people most likely to be in a position to implement a DR plan.

4. Before calling the lead into the VDA, talk to them about the DR program and let them know that the VDA will be sending them additional information about the Direct Reimbursement program. Hopefully the list above will help you and your office staff identify potential DR leads in your area. Remember, the more companies who adopt DR as their dental benefit, the more fee-for-ser vice patients you will see in your office!

rv1 B U R 5 E M

E N

DR in the Office A Look at How DR has Impacted a VDA Member Seeing the result of eight years of Direct Reimbursement promotion in the state of Virginia is great for VDA mem bers. Sometimes it is difficult to recognize a DR patient from someone who simply pays at the time of service, but there are currently over 6,000 people in Virginia who have a Direct Reimbursement or Direct Assignment plan in place. Currently, for employees of Virginia companies with DR and DA plans in place there is $1,450,000 paid out annually in unrestricted, fee-for-service dentistry! One VDA member who has experienced Direct Reim bursement first-hand is Dr. Christian Tabor in Glen Al len. VA. In his new office, Dr. Tabor supports DR and is excited to have the plan used in his office. "DR patients are the best type to have" says Dr. Tabor, "they are no hassle because they pay for services immediately; there is no need to track them down after treatment for out standing payments." As more companies adopt DR as their dental benefits plan, more dentists in Virginia will experience a return to fee-for-service dentistry. In addi tion to the quick and easy payments from DR patients. there are typically no procedure exclusions (other then cosmetic) allowing dentists and patients to develop the best treatment plan for each situation. Since he has seen the results of Direct Reimbursement in his office. Dr. Tabor now works to educate businesses about the alternative dental benefits plan. "1 wish all

of my patients had DR, that would be great!" says Tabor about the possibility of getting more patients in his prac tice with a DR plan. In order to expand his DR patient base, Dr. Tabor has been talking to businesses in his area about the DR plan and the many advantages it can have over traditional dental insurance. He hopes that with persistence and a good understand ing about the DR program, he will Dr. Christian Tabor in his Glen be able to Allen, VA office.

influence more Virginia businesses in their dental benefit selection. If you would like more information about Direct Reim bursement for local businesses or to educate your office staff, please contact Elise Woodling at the VDA at 800 552-3886.

Catch a Glimpse Of Some Of The Exciting CE Speakers Planned For This Y

The VDA is proud to present to you with highlights of the 135th Annual Meeting of the Virginia Dental As sociation in Norfolk, VA September 8-12,2004. It is our great pleasure to be offering over 100 hours of contin uous education seminars along with a wide range of family friendly social events! Take a moment to see why you should follow us to Norfolk!

Keynote speaker announced for the opening session of the VDA House of Delegates

of Washington, University of San Francisco, and the University of the Pacific. He has received the Hinman Medallion for Leadership, the Albert H. Ketcham Orthodontic Award from the American Board of Orthodon tics, the Medallion and Merit Award from the Orthodontic Education and Research Foundation, the Chairman's award from the American Dental Trade Association, the Presidential Citation and the Distinguished Service Award from the ADA and the Pierre Fauchard Academy Gold medal.

getting involved and taking risks, and about unity and teamwork. His questions (and challenge) to the audi ence will be "What role will you take? What will be the measure of your commitment?" Seldom do we have the honor to hear someone of Dr. Dugoni's stature and from someone who loves and cares about this profession we call den tistry. Please join us in celebrating what's right about our great profes sion.

,A.1J,a~el1dees and guests are invited to Dr. DLlgg~i isafounding member of the National Academies of Practice, he(iU-'~l't Dugoni. He is ~~·hon?ra.ty member and recipi~ ent of an honorary fellow~hip from the Academy of General[)entist~ytpq. an honorary member of the American Academy of Oral Medicine. Heg3f presented more than 500 lectures, papers, clinics and assays thr9J:!;g~out For The First Time his career and is the author ofl00 Ever! CE Comes To published articles. Dr. D~9?~i and his wife have seven children ~ndfifteen Thursday! grandchildren.

Dr Arthur A. Dugoni, Dean fessor of Orthodontics at the School of Dentistry at the University of the Pacific, will give the keynote address the opening session of the VDA House of Delegates. Dr Dugoni has been at the University of the Pacific since 1978. He is a past president of the ADA and the American Association of Denal Schools. He currently serves as treasurer of the Federation Dentaire Internationale World Dental Federa tions (FDI). Dr. Dugoni graduated from the Col lege of Physicians and Surgeons (now University of the Pacific) and main tained a private practice for some 40 years. He has been awarded the honor of Alumnus of the Year by universi ties: GonzaQ"a Universirv. Universirv

In Dr. Dugoni's words "We are com mitted (at the University of the Pacific) to excellence in education, research and service, al1cl{oiesponding to our students' neeclSii~ their pursuit of knowledge and professional skills. Ac centuating-the positive, respecting the :ihdividualandempowering our dedi cated faculty to provide the best pos

sibl~l~a,r~~l1~envlronme~t fo~ e~ery dental student are among our primary goals. I'm confident thatPacificwill continue to graduate dentists who, by virtue of their diverse training, caring attitude and clinical experience, will be leaders in the dental profession. The title of Dr. Dugoni's presenta tion is "Did you come to play? Did you come to make a difference?" His address will center on his thoughts about the profession of dentistry and our country, in the present and in the future. He will talk about challenge, chanze and commitment and about

Dr. Jack Shirley presents Occlusal Based Restorative Dentistry and Robert Marbach presents Mastering the Art of Cosmetitc and Restorative Dentistry: A Technician's Perspective These sessions are brought to you by the Virginia Dental Association and the Virginia Academy of General Dentistry. Pay one fee of $95 for both lectures!

DUal

Meeting In Norfolk!

Contracting and Legislative Matters For Dentists Patrick C. Devine, Jr., Esquire

The program will discuss contracting and legislative issues which are important to Vir ginia dental practices. The first portion of the program will attempt to address a variety of contract related issues faced by dental practices. The initial discussion will involve managed care contracts. We will review important contract provisions and negotiating strategies which may be helpful to you in your

The Keys To Maximum Dental Performance By:Joe Dillion

"Staying on Balance" (www.Znaturallws.corn) You are what YOU eat. You can look better, feel better, and even live longer by changing whar you pur into you mouth. The besr way to eat healthy and sray in shape rakes a little bit of discinline. FoocJ xrnarrx. and rhe will

practice. We will also discuss various reimbursement alternatives. We will then present an overview of important internal practice contract documents including employment agreements, shareholder or operating agreements and other governance doc uments. With respect to employment agreements, we will review a variety of relevant concepts, including covenants not to compete, compensation ar rangements, deferred compensation on retirement and indemnity. We will also consider differences between employment agreements with dentists who have an ownership interest in the practice and those who do not. We will follow with a short overview of shareholder or operating agreement issues. Among the provisions we will consider are buy-in arrangements foe new owners, restrictions on transfer, voting and governance rights and buy-out provisions on retirement or termination of employment.

is found in nutrient rich foods. Your body needs amino acids (protein) to rebuild you cells, essential fats, glucose (carbohydrates) for energy, vitamins and minerals and plenty of water. Start the year by paying atten tion to what you put in your mouth. All too often we choose what tastes good or is easy and convenient. It's not enough to feel good. It's time to feel good about your food choices! Protein: Choose lean sources of pro tein. lhe quality of a protein source is determined by the amount of pro tein it contains, the number of amino acids and the ease of assimilation. Whey protein isolate powder is the best source of protein! Egg whites are second followed by cage-free whole eggs; salmon; ahi tuna; white meat, skinless chicken; skinless turkey; water-packed tuna; and non-far milk products.

The second segment of the program will involve a discussion of Virginia legislation affecting dentists. We will discuss existing Virginia managed care legislation, including the Managed Care Health Insurance Plan law, the Virginia Fair Business Practices Act, the Virginia Patient Protection Act, the Virginia Any Willing Provider Act and the Virginia Assignment of Pay ment law. We will also consider other important legislation, including the recent changes to the laws affecting the Board of Dentistry. We will then discuss possible legislative opportuni ties.

As time permits, we will conclude the program with a question and answer period on business issues facing Vir ginia dentists, and we will try to offer practical solutions to your concerns.

Come See Me. Devine's lecture on this topic on Friday, September 10,2004 from 1:30pm - 4:30pm.

Essential Fat: While you want to avoid the fat that comes in most meat or is added to foods when you fry, you don't want to avoid fat. Your body needs it. Up to 1/3 of your calories can be from fat it you choose the right fats. Raw fats are best (high heat turns good fat into badl). Eat some raw fat with each meal for brain and eye health, to aid in digestion, boost your immune system, balance your blood sugar and even help your body to burn fat! Good sources are avocado, extra virgin olive oil, raw seeds & nuts and Udo's Choice Oil Blend. Carbohydrates: Just as not all fats are bad, not all carbs are to be avoided. Locarb diets have replaced la-fat diets as the eating plan for success. Bur you don't have to give up all carbohy drates-in facr, you shouldn't give up all carbs. Your body will feel better with a balance (up to 1/3 of your

choice) of unprocessed carbs (whole vegetables and fruits). 'these foods are your best source of fiber, antioxidants, phyro-nutrients (health-producing substances found only in plants) and glucose (the only fuel your brain can use). 'The key work is unprocessed. Choose foods as grown carbohydrates that come directly from nature to your plate with minimal processing. Water: Drink as much as you can! You wouldn't go without showering! Keep your insides clean with pure fresh liquid (distilled water is best, followed by filtered, spring, sparkling, herbal tea and decaffeinated coffee).

protein meal for lunch or dinner. Grilling is a great alternative to steam ing for vegetables as well. Cook your whole meal in minutes with the flavor and moisture sealed in, It's as quick and easy as the microwave and better for you! Sometimes you want more than ef ficiency when you cook. Preparing meals is part of nuturing yourself and your family. Healthy eating can feel like giving up the comfort and the car ing. Let the George Forman Grill be part of your new vocabulary to say "I love you/me!" with food. Heavy Hands are Herd!

The Thrill of the Grill! While food is usually best eaten as close to natural as possible, meat is preferred cooked. The challenge with meat is to minimize the fat content of the meat. You can do this by choosing lean selections and by cooking it with a minimum of added fat. Meats that yield the most protein and the least bad fat are white meat chicken, turkey, and fish and lean cuts of red meat. Grilling as opposed to frying reduces the amount of added fat. Using a George Froeman Grill reduces the fat even further by draining it away, Like Shakes for breakfast, grilled meat is a quick and easy way to create a high

A Financial Prescription For Uncertain Times By: Steve Blaising

Conditioning is one of the 7 Natural Laws. While what you put in your mouth is the biggest part of the health equation, how active you are signifi cantlyaffects the quality of your life and contributes to your longevity. The best exercise for over-all health is cross-country skiing. It is an aerobic activity using the whole body (this means using the upper and lower body simultaneously). The more work you do at or above the level of your heart, the more improvement you get in you cardioyasc,ll1ar fitness. CC Skiing also puts min'imum of stress on the joints, In addition, it is weight-bear ing (as opposed to swimming) and therefore stimulates your bones as well

Recent economic and political events have made many people anxious and fearful about their futures. At the Blaising Group, our business is help ing successful dentists increase their sense of direction, confidence and capability in all areas of their financial lives. The following is a discussion of our approach to transforming the un certainty of the current economic and market environment into an opportu nity for growth and progress toward an ideal future.

as your muscles, reducing the risk of osteoporosis. What do you do when you don't live where it snows, or during the summer months? There are several pieces of equipment that have been developed to simulate the movement. One of these is Heavy Hands Walking. Leonard Schwartz originally designed Heavy Hands when he was in his late 50s. He was sedentary and out of shape. He was a smoker and had been a non-ath lete all his life. Within a year he was 8% body fat. He looked and felt great. Today he is 76 years old, 2% body fat, with a resting heart rate of 32 beats per minute. Heavy Hands were designed to be so easy to use, that anyone-even overweight, out of shape, middle-aged guy- could use them. Heavy Hands walking combines the ease and aftey (injury protection) of walking with the cardiovascular conditioning of cross-country ski ing. It is convenient to carry with you (although you won't get these through airport securiryl) to the office or gym. Even better, it makes trips to the gym unnecessary, turning your walk around the neighborhood into and effective workout.

Come hear Mr. Dillion on Friday, September 10, 2004 from 8am-llam and Saturday,September 11,2004 from 9am-Noon. focus on creating value. Periodically, you may be concerned about not sell ing as much dentistry. People may not be responding to the best advice for treatment. When times are uncertain, they turn off, hang up and slam shut. But, what patients want at all times is value creation- that is, solutions that help them eliminate their fears, cap ture their potential and reinforce their strengths. Focus on deepening the power and possibility of the patient re lationship. Every time you strengthen this relationship, the viability of your _________ .__ . L.' __ . __,11 ,_ ...

Second, forget about your regrets, focus on your opportunities. Things you had, things you took for granted may have disappeared. Some people never get over this. Financially speak ing, many regret the portfolio losses from 200 to 2002. But you can recov er and eliminate the risk of this kind of setback. How? By realizing that the most important governing variable in investment returns in real life isn't cost, or active vs. passive investing. It is wildly inappropriate investment behavior (choosing the hot dot, panic, market timing, excessive switching). The proof of this conclusion was presented in The Economist's July 5th 2003 issue. The magazine presented results from a recent study conducted by DALBAR and the Bogle Financial Center. Here is the most powerful statistical argument for professional advice over self-managed investments. Between ] 984 and 2002, the Standard and Poor's 500 stock index returned 12.9% a year. During this same period the average equity fund owned by a professionally guided investor is a better way to go. But, there is one final statistic that obliterates the index. John Bogle, the founder of Vanguard funds, found that the average investor in the same time period (1984-2002) only received a 2.7% average an nual return. This is due to multiple changes made inside a portfolio over

Take This Job and Love It! By: Mark Hyman, DDS

an eighteen year time span. In other words, the index averaged 12.9% annually, but the people who owned the index fund only got 2.7% a year. This is what people do in reaction to chaotic events in their lives and in the world. The professionally ad vised investor would have been more that 350% better that the self-guided investor. Once and for all investors don't get investment returns, they get investor returns, which are orders of magnitude worse, unless they hire a professional behavioral advisor. Third, forget about your difficulties and focus on your progress. Yes, port folio values may be half of what they were four years ago. On top of this, family demands on cash flow grow every year from rising healthcare costs, college tuition and long-term care for aging parents. These challenges will either defeat you or force you to improve your financial condition. The best way to improve financially with out working more and overloading your schedule is smart tax planning. For example, there are two different business structures that allow you to withdraw more money tax-free out of your dental practice. More money can be invested with pre-tax dollars and more benefits such as education, healthcare, disability and severance can be paid tax-free. Our LifePlan Imagine a day in your practice when everything is going right. Now, imag ine that a key teammate sheepishly approaches you and says, "Doc, can I have five minutes of your time after work?" Oh no! Our dental colleagues would rather hear from the IRS or the State Board of Dental Examiners than imag ine where this conversation may lead. At best, we may anticipate a request for time off. At worst, it may turn out to be a staffing crisis or the opening line of a resignation! 11

analysis combs through the financial details of your practice to determine the best business structure for mini mizing all taxes. Remember, markets face increasing uncertainty. Soc, the best way to make progress toward a secure financial future is (0 eliminate as much tax as possible on current income as well as future retirement cash flow. Don't be anxious about the future by focusing on today. The future doesn't exist as an idea. It is an abstraction. The future is what you create through each day's contributions, achieve ments and results. 'This is a great time to ignore all those experts who never prepared you for the unexpected. Focus on what you can do in you relationships, your money decision and your own talent over the course of each day and you will be prosperous even when times are uncertain. The Blaising Group is the creator of LifePlan, a comprehensive program for transforming a professional's sense of direction and capability into a secure financial future.

Come hear Mr. Blaising on Friday, September 10, 2004 from 9am Noon and again from 2pm-5pm.

seen this coming? Isn't it hard enough to be CEO/CFO/personnel director and head cheerleader? Fortunately, there is a simple questionnaire that can give you and your team a thumbnail sketch of the practice at any moment. It allows you to focus on areas of concern, study the cause, brainstorm all possible solutions, and institute real change.

discover 12 key questions that can predict success and happiness in the workplace. For you next staff meet ing, consider handing out the survey! In a safe and professional fashion, ask the entire tern from 1 to 5 strongly disagree to strongly agree: • Do I know what is expected of me at work? Are job descriptions written, understood and owned by the entire team? What type of follow-up occurs when we "drop the ball"? • Do I have what I need to do the job right? Does the doctor want a cut ting-edge periodontal program, but fails to provide modern ultrasonics? Do you want higher case acceptance, but lack intraoral cameras or educa tional DVD programs? • At work, do I have the opportu nity to do what I do best every day? Does the doctor delegate duties along with the appropriate training? Is the clinical team doing all the allowable delegated duties? • In the past seven days, have I re ceived recognition or praise for good work? Does the doctor constantly "catch the team doing things right," instead of criticizing? Do you cel ebrate small victories daily? Do you feel there is enough appreciation?

Bone Grafting For The General Dentist By: Dennis Thompson, DDS

• Does my supervisor, or someone at work, seem to care about me as a person? Do we ask and listen with the intention of understanding? Do we encourage time off for special family events such as All Star games, award ceremonies, or the first day of school? Do we celebrate happy occasions together, such as birthdays, weddings, and anniversaries? • Is there someone at work who encourages my development? Do we encourage and pay for quality continu ing education - even outside dentistry - such;::s Dale Carnegie or Toastrr:;as ters? R8we~h~~f:B?ndental self-im provcmcnt books and tapes? • At work, do my opinions seem to count? Does the doctor ask for and re ceive advice? Or is it, as I heard once, "We keep talking about all these things and nothing ever changes!" • Does the mission/puf1:'8se of the office make me feel like my work is important? Are all~eammates a value piece of the puzzle? • Are my co-workers committed to doing quality work? Is excellence the standard in our office? What may

·~-··Bonegraftingwas

once performed

only by specialists.

Now conscientious clinicians are ob taining predictable results in sockets, on ridges and with perio defects utiliz ing a new generation of bone graft materials and inexpensive guided tissue (bone) barriers. The result is improved esthetics, simplified prosthetics, and salvaged dentitions for everyday, happy pa tients. Join your colleagues in utilizing this exciting technology by reading the following synopsis and attending the Virginia Dental Association hands on course, Saturday, September 11, 2004. Begin your grafting with the highly predictable extraction socket preser vation. The rewards are enormous:

be going on that we are not privy to? These may include OSHA rules, quality of provisional restorations, and other duties. • In the past six months, have I talked with someone about my progress? Do we have consistent, scheduled, written performance reviews, or is this critical growth opportunity relegated to an impromptu five minutes after work one day? • At work, have I had opportunities to learn and grow? Does the team share ideas with each other after continu ingdenral education courses? Do out teammates support our dreams?

How to Score Toral the answers to these 12 ques tions, . r~~~ ~5~l'l1at~ will have a 60. If we are serious abq~!improving our practices and the OPpo!t~l1ity to quickly iden tifY and solve pr~ctice management issues, we'll share the results with the team!

scorer~~ng'trom 12 to

Come hear Dr. Hyman on Friday, September 10, 2004 from 8am l1am and Saturday, September 11, 2004 from 9am-Noon.

·..-restoraeien-of-the vertical bone height and protection of the papilla; all while gaining remarkable pontic contours The socket graft is initiated with an atraumatic , Periotome assisted extraction. For all extraction sites, the aggressive debridement is a key to re generation. The surgical spoon curette and large round burs assure proper removal of all granulation tissue and decortication of the socket wall. Vig orous bleeding is a frequent complica tion of the decortication procedure that can be controlled with lint-free gauze prior to placement of the graft material. Load the syringe with 1 inch of graft material, hydrate and gently fill to the crest of bone. Cover with

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contain the particulate graft. Several suture techniques will be described in cluding a four corner crisscross suture approach that holds the GBR mem brane and simultaneously protects the papilla. Examination of a wide range of graft material will give the clinician an insight into product selection for every specific application. Emphasis will be place on using a resorbable graft material which will stabilize the socket, while allowing a wide variety of prosthetic and implant options not available with dense, non-resorbable materials. Restoration of the lost ridge can be accomplished with gingival grafts or bone grafting. The benefit of bone grafting is the ability to add dimen sion in both a horizontal and vertical dimension. Admittedly, some pa tients will requirea-two stage proce dure utilizing bot~techniques. The keys to ridge graft;in,gsuccess are the preservati0.l1;()f~;~*~g§*~lvn, creation of "space" and"p~~i~eRa.p manage ment. All fac~~~.~~ll be addressed in the hands on s~rrii:riar. Every practice has examples of the vertical bone loss

associated with the surgical extraction of the third molar. These defects can be effectively treated with the new generation of bone graft materials that provide scaffolding, mineraliza tion potential and utilization of host supplied growth factors and BMP's. These tissue engineered products have added an unprecedented predictability to these simplified graft therapies. Following the principles of good surgical technique, the root surface preparation becomes the#

iJ'IlP~I~:nt variable for~g! success;:,Jn addition, ade't{1.1 .. "litates prope~t:ie~~r~ic .ng and ab4~c.t,; The violation of can emit a sense of te . unsuspecting clinia~~;' Now advent of biocom~~~ib1e graft carriers, the doctor can,peE()oly be confident of a quality cJ~~~r.e, he/she might use the opport~~.~osecure additional implant s ',.. \ by hydraulically elevatin ihus membrane. An hnique is commonly are the apical osteotome

area for placement of the flowable graft material. The resulting dome like bone formation at the apex of the implant affords additional implant stability. A masrerful approach (0 solving the problem of voids around the immedi ate implant placement is the use of hone grafting. The clinician atrau matically removes the tooth, prepares the osteotomy sire and inserts the appropriate grafr material just prior co placing the implant. The gel like con sistence assures all voids are properly filled for more complete osseoinregra tion. These and other bone grafting tech niques will be thoroughly discussed wit incus clinical examples ar course. Join us, please, d seminar that will kick fting success.

Come hear Dr. Thompson on Saturday, September 11, 2004 from 8am-5pm.

CE On Thursday!

Brought To You Through e Virginia Academy()f Ye.Q.~al Dentistry and The

Mastering the Art of Cosmetic and Restorative Dentistry: A Technician's Perspective

always pleasantly surprised:b : edback. we get after our I e , . .. ' i~gj;h~:Ai:tofC:;osmetic.an· ." Restotative Dentis9Y:ATechnician's Perspective. It'seems the perspective of a technician is unique and valuable on a practical level that dentists and their staffs can appreciate.

By:Robert Marbach In my estimation, the appreciation comes from the realization that the information they are being given can actually change the specific things that cause them stress on a daily basis. What causes those stresses? Let's examine: The following is the course outline of Mastering the Art of Cosmetic and

Perspective along with a description ofthe problems that can actually be solved: A. Lab Communication - Achieving Optimal Results on Every Case • Rx Communication - Tips on how (0 let the lab know what you are try ing to accomplish. Better Rx commu nication can eliminate misunderstand ings, missed instructions, incorrect assumptions, and can also help ensure that you have given enough informa tion. Prevents remakes.

• Sofe Tissue Model - How to fabri care soft tissue replication to ensure gingival embrasure correctness. Elirni

• Shade Communication - Conven tional and digital shade-taking tech niques. What Kelvin Temperature should you request to take the best shades? What is CRT (Color Rendering Index) and how does it affect shades? What bonding materials affect shades? Discussion on every aspect of shade taking communication in dentistry. Reduces shade remakes and adjust ments. • Incisal Edge Matrix - Will show the laboratory where to place the incisal edge, thickness, width of teeth, midline and pitch. Very helpful, patients will enjoy the natural feeling of their new restorations. Increases patient satisfac tion and reduces remakes and adjust ments. • Custom Temps - How to fabricate custom temps that will hold the posi tion of your interproximal and occlusal contacts. This step can drastically reduce contact and occlusion adjust ments. • Impression Troubleshooting - Dis cussion on different types of impres sion materials and techniques. How to be sure your impression will lead to a restoration that fits. What commonly used materials and processes cause dis tortion of impression materials? Which trays work best? How to eliminate the guesswork in impressions. Reduce remakes and frustration. • Fabricating a Crown Under a Partial - What is the best method? Whether your patient tells you that they must keep their partial or they allow you to send their partial to the lab. Tips to avoid problems. • Model Discrepancies - How you and your laboratory can eliminate this com monly missed cause of high occlusion and adjustments. • Porcelain Crown/Veneer Checklist - List of criteria that is recommended f('"\r C'11rrpc:c-h,1

nnrrp]'"1;n rrn"'l;);rn/"lfPnpp.r

cases for the best possible esthetics, predictability and communication. B. Advanced Restorative Systems - What's Available, How to Choose One of the most frequent comments we hear from dentists is that they have a difficult time keeping up with all the new porcelain systems available. We will break down all restorative systems as to their indications, conrraindica tions, strengths, weaknesses, etc. By the end of the seminar we will sim plify the process of materials selection, preparation and cementation.

Come hear Mr. Marbach on Thurs day, September 9,2004 from Ipm 5pm. This session is co-sponsored by the Virginia Dental Association and the Virginia Academy of General Dentistry.

• Aluminum Oxide Ceramics - Proc era, In-Ceram, Wol-Ceram • Zirconia Ceramics - Procera Zirkon, In-Ceram Zirconia, Cercon, Lava • Pressable Ceramics - Empress, Eris, Finesse, Authentic • Polychromatic Feldsparhic Ceramics - Chromatech • Polyglass/Indirect Composites - Cristobal +, Sculpture, Tescera • Advanced Crown and Bridge Materi als - Captek

C. Building a Successful Cosmetic Practice What do successful cosmetic practices have in common? We will recom mend tips and techniques in the areas of:

i " ,,:',::,,:,' I

like sure to send

• Marketing/Patient Education • Marketing/Image • Clinical Skills • Laboratory/Dental Office Relation ships We are looking forward to our presen tation at the 135th Annual Meeting of the Virginia Dental Association. Yours For Better Dentistry,

IV7I" ."'.,',''.". ','-,.. " on ,the wel1,gj' .'

Robert P. Marbach, BA, CDT Authentic Dental Laboratory, Inc. 1-800-683-1025 bob@authenticlab.com

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. ~~j[J ,&.7':£'.'. ~t1'....'~'

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uadental:

"My practice merger purchase could not have been a more successful venture. I experienced immediate results and, in fact, would not hesitate to look into another merger transaction in the future. AFTCO is a professional organization with things to say that are truly worth listening to. "

"1 really appreciate the fact that AFTCO was there to keep everything on a fair and equitable basis. They were truly interested in and attentive to my needs and goals. I recommend AFTCO's dual representation approach without qualification. " James H. Pauley, DDS Portsmouth, Virginia

Jeffrey B. Wetter, DDS Bridgewater, Virginia

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Dental Practice Owners Allowed To Protect Assets Using Retirement Plan David S. Lionberger, Esquire - Christian & Barton LLC A recent decision of the United States Supreme Court confirms that a work ing owner of a business may participate in an employee benefit plan covered under ERISA (Employee Retirement Income and Security Act), such as a retirement plan, so long as the plan covers at least one employee besides the owner and his or her spouse. As a participant under such a plan, the owner (as with any other employee) is entitled to the rights and protections afforded under ERISA. ERISA contains numerous require ments, including how and when certain information regarding the operation and benefits under employee benefit plans be communicated to employees. In addition, an important protection for employees is required by and provided under ERISA retire ment plans. Under ERISA the funds

in the account of a participant are not subject to garnishment, alienation or attachment by creditors, either of the employer business or of the employee, while such funds are part of the retirement plan. Even in the event of a bankruptcy by the participant, the funds in the account of an ERISA plan participant are generally not sub ject to the claims of the participant's creditors. Because of the protection afforded to assets held in an ERISA retirement plan, this decision provides another incentive for dental practice owners and other small businesses to consider adopting retirement plans for the ben efit of their employees as well as them selves. In addition to the protection of plan assets, many retirement plans are structured to be tax qualified under the Internal Revenue Code, meaning

that amounts contributed to the plan by the employer may be immediately deducted by the employer, but are not included in the taxable income of the participant until the participant later begins receiving distributions of their plan account balance or benefit payment amount (depending on the type of retirement plan). Annual costs of administration should also be considered, but these tax qualified retirement plans can provide valuable incentives of tax deduction and tax deferral for employers and employees, while also keeping employers com petitive in the labor market to both attract and retain needed employees.

Wednesday, September 8, 2004 11 :OO-S:OOpm Board Of 0 irectors Noon-6:30pm Golf Lunch, Tournament, and Reception Thursday, September 9, 2004 7:00-S:00pm 7:1S-7:4Sam

Registration Credentials Committee House of Del足 Registra足

7:45-8:1 Sam egares rion 8:1S-10:1Sam Opening Sessionl House of Del足 egates 8:00-Noon "Occlusal Based

10:30-Spm Noon-Spm I :OO-S:OOpm

10:00am-7pm

10:00am-7:pm 10:00-7:00pm 6:00-11 :OOpm All Day

Restorative Dentistry" Dr. Jack Shirley Reference Committees VDHF/VADPAC Silent Auction "Mastering the Art of Cosmetic and Restorative Dentistry: A Technician's Perspective "* Robert Marbach Reference Com. 1000 Reports Reference Com. 2000 Reports Reference Com. 3000 Reports ACD Dinner and Dance Board of Dentistry Meeting

Friday, September 10, 2004 7:00-S:00om

Rezistration

8:00-S:00pm

VOHF/VADPAC Silent Auction 8:00-11 :OOam "Maximizing the World ofEsthetic Dentistry?" Dr. Gerald Kugel 8:00-11 :OOam "Pre-Term Birth and Periodontal Disease?" Dr. Majorie Jeffcoat 8:00-11 :OOam "Bone Grafting" * (Hands On) Part 1 Dr. James Grisdale 8:30-11 :30am "Producing Peak Performance" Joe Dillion 8:30-1 1:30am "Treating the Female Patient: Medical and Dental Considerations ,,* Part 1 Dr. Barbara Steinberg 9:00-12:00pm "Dam-It, It's Easy!"* (Basic) Mary Costello 9:00-12:00pm "The Next Financial Shock, Are lOu Ready?" Steve Blaising 9:00-12:00pm "HelpfUl Hints For Building and Starting A New Dental Office" Sky Financial! Dave Lionberger 9:00-4:00pm VADPAC Shoeshine 9:00-4:00pm VDA Logo Shop 10:00-Noon Adult Heartsauer CPR"' Vivian Biggers 9:00-S:00pm Exhibit Hall open 11:00-2:30pm Alliance Board Meeting II :30-1 :30pm ACD Luncheon for Learning 11:30-1 :OOpm Fellows Lunch I:30-4:30pm VAO Board

1:30-3:30pm

Adult Heartsaver

CPR*

Vivian Biggers 1:00-4:00pm "Maximizing the World ofEsthetic

Dentistry'? Dr. Gerald Kugel

1:00-4:00pm "Great Question 足

1:00-4:00pm

I:30-4:30pm

1:30-4:30pm

2:00-S:00pm

2:00-4:00pm 3:00-4:30pm 4:00-6:00pm 4:00-6:00pm

4:30-6:30pm

Glad lOu Asked That!"* Dr. Ellen Byrne "Perio Surgery For The General Dentist" * (Hands On) Dr. James Grisdale "Treating the Female Patient: Medical and Dental Considerations ,,* Dr. Barbara Steinberg "Dam-It, It's Easy!" (Advanced) * Mary Costello "Dentists Contracting and Legislative Matters" Pat Devine "infection and Trauma For The General Dentist'? Col. John Leist "The Next Financial Shock, Are lOu Ready?" Steve Blaising

Constitution &

Bylaws Comm.

Speaker of the

House Hours

ADA 16th

District Delegation VDSC Board Meeting

VAGD Board

5:00-6:30pm MCV/VCU Reception 6:30-10:30pm VDA Friday Party Saturday, September 11, 2004

for Diseases That we Catch"* John Svirsky 1:00-4:00pm "The Team Approach to Periodontal

Tberapy'" 7:00am-5:00pm Registration & Ticket Sales 7:30-8:30am lCD Breakfast

(Continuation) Dr. Alan Fetner

1:00-4:00pm 'Alveolar Ridge Preservation ,,*

8:00-3:00pm

Exhibit Hall Open 8:00-9:00am VAE Board Meeting 8:00-11 :OOam "Memoirs OfAn Oral Pathologist?" Dr. John Svirsky 8:00-11 :OOam "The Team Approach to Periodontal Therapy"* Alan Fetner

1:30-4:30pm

2:00-5:00pm

8:00-11 :OOam "Alveolar Ridge Preservation ,,* (Hands On) Dr. Dennis Thompson 8:30-1l:30am "Take ThisJob And Love It!" Mark Hyman 8:30-11:30am "Endodontic Uh and No-No's"* Dr. Stephen Schwartz 9:00-12:00pm "Cutting Edge Products For Clinical Excellence" Derek Hein 9:OO-12:00pm "Producing Peak

os.

Perjormance "

Joe Dillon 9:00-4:00pm VADPAC Shoeshine 9:OO-4:00pm VDA Logo Shop 1l:30-1:30pm Pierre Fauchard Luncheon Noon-2:00pm CDHS Lunch and Meeting 1:OO-4:00pm "Druvs I haue

2:00-5:00pm

4:30-6:00pm 6:00-9:00pm

(Hands On) Dr. Dennis Thompson "Take ThisJob And Love It!" Mark Hyman "Endodontic Uh Oh's and No-Nos?" (Continuation) Dr. Stephen Schwartz "Cutting Edge Products For Clinical Excellence" (Continuation) Derek Hein "Great Question Glad }OU Asked That!"* Dr. Ellen Byrne Relief Fund President's Party Nauticus

Sunday, September 12, 2004 7:30am

Past President's Breakfast 7:30-9:00am Voting 8:00-9:00am Mtg and HOD Registration 9:00-11 :OOam Old Dominion Dental Society 9:00-1O:00am VDA Business Meeting 10:00-1 :OOpm House of Delegates

1:00-3:00pm Board Of Directors

The meeting schedule is current as of May 2, 2004. Please double check event times when you get to the meeting for any changes.

Due to limited seating in all continuing education lectures, seating will be available on a "£1 rst come, £1 rst serve "b asrs .

AIDA C·:E.~.: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. The Virginia Academy of General Dentistry is proud to be the co sponsor with the VDA of both of the Thursday, September 9. 2004 CE sessions.

Cost

Workshop Title stration materials will be sent to the Primary strant. Make the Primary Registrant the first entry on ·egistration form.

Class Limit Code

(VDNnon·VDA)

Code 01

Occlusal Based Resorative Dentistry Thursday, 8:00 a.m. - Noon

$95/$95

200

Ridge Restoration and Perio-Defects

$325/$395

TakeThis Job and love It

Saturday; 8:30 a.m. - 11:30 a.m .

Saturday; 1:30 p.m. - 4:30 p.m.

Badge

200

Endodontic Uh-Oh's and No-No's

Saturday; 8:30 a.m. - 11:30 a.m.

Saturday, 1:30 p.m. - 4:30 p.m.

Badge

300

Cu~ Edge ProductsFor Oinicd

ExceUence [all-day)

Saturday, 9:00 am. - 12:00 p.m. and

Saturday, 2:00 p.m. - 5:00 p.m.

Badge

300

Adult HeartsaverCPR Friday; 10:00a.rn. - Noon Friday; 1:30 p.m. - 3:30 p.m.

$35/$50

(Hands-On)

Saturday; 8:00 a.m, - 11 :00 a.m. and

Saturday, 1:00 p.m. - 4:00 p.m.

and

Code efund requests must be submitted in writing;

erence badges must accompany request. Workshops Special Events are not refundable. All refunds are

ect to a $10 per registrant fee. Refunds will be

Code

Mastering the Art of Cosmetic and Restorative Dentistry Thursday; 1:00 p.m. - 5:00 p.m.

srrations dealines: •ugust 25 Pre-Registration deadline •ugust 25 Requests for Refunds/Cancellation deadline -prernber 8 Onsite Registration Begins At Marriott

03 04

Maximizing the World ofEsthetic

Dentistry Friday; 8:00 a.rn. - 11:00 a.m.

Friday; 1:00 p.m. - 4:00 p.m.

20 21

Code

Badge

200

Code

essed after the conference.

Pre-Tenn Birthand Periodontal DIsease Badge Friday; 8:00 am. - 11:00am.

t names clearly, include preferred first name for each on.

Code

Perio~ ForThe GeneralPractioner

Code

06 :t registration category and enter corresponding letter ach person registering. Include appropriate fee rding to registration date. tists may only register as dentists. Dentists may not ter as guests. ses must be worn and visible at all times.

eted events are on a first-come, first-served basis. stration will not be processed until payment is ved. nit registration by fax, mail or online at v.vadental.org.

Code

1i'eat:in2 the FemalePatient: Medical and Badge

29 200

200

VDA EVENT TICKETS:

Code 09 10

Dam-It, It's Easy! (Basic and Advanced) $25/$25 30

Friday; 9:00 a.m. - 12:00 p.m.

Friday, 1:30 p.m. - 4:30 p.m. *

Code

Fellows Lunch*

$30

Friday; 11 :30 am. - 1:00p.m.

Code

TheNextFmancial Shock,AreYou Ready? Badge Friday, 9:00 a.m.- 12:00 p.m.

Friday, 2:00 p.m. - 5:00 p.m.

Code

VDAFridayNtght Party Friday, 6:30 p.m. - 10:30 p.m.

Badge

Code

Presidents Party at Nauticus Saturday; 6:00 p.m. - 9:00 p.m.

(a) Adults- $20/ (b) Children - $5

Code

Past Pr-t5ident's Breakfust* Sunday, 7:30 am. - 8:30 a.m.

Badge

Code

200

Hel ful Hints For Building and Starting Badge f.!'ew Dental Practice Friday, 9:00 a.m. - 12:00 p.m.

120

Great Ouestion•••Glad You Asked That! Badge

120

Dentists Contracting and LegisIame Matters Friday; 1:30p.m. - 4:30 p.m.

120

Code 14

Frida)! T:O~ p.m. - 4:0~ p.m. Saturday, 2.00 p.m. - 5.00 p.m.

Code 15

Code 16

1reatment ofMmlofucial Infectionsand Badge Thuuna for the GeneralDentist Friday; 2:00 p.m. - 5:00 p.m.

200

Badge

200

Code

Memoirs OfAn Oral Pathologist

Saturday, 8:00 a.m. - 11:00am.

10:00 am 11:15pm 12:30pm

Code

Badge

TheT(::r-Lr~ to Periodontal n~

}herapy ~ ~n

••

•

Badge

34 35

110

mrs of the Wisconsin are available of Friday 9/10 and 1 9/11, please pick the correct date and time code from xlow, Space is limited.

Drugs I HaveKnownAnd UnOO For Badge Diseases We Catch Saturday 1:00p.m.. - 4:00 p.m.

$80/$100

Tours of the USS Wisconsin

Code

VDA GolfTournarnent Wednesday; Noon - 6:30 p.m. Elizabeth Manor golf CoUISe

11 12

ge.

27 28

ABC

200

Code

Dental"tonsiderations (all-day)

Friday; 8:30 a.m, - 11:30 p.m. and

Friday; 1:30 p.m. - 4:30 p.m.

. confirmation letter and registration materials will railed three weeks after you submit your registration payment.

~""rrl",v 1 0·00"... 11·1'n... "-.'lOn...

Badge

Code

Friday

$325/$395 30

Producing Peak Performance Frida)! 8:30 a.m. - 11:30 a.m.

Saturday; 9:00 a.m. - 12:00 p.m.

Code

'egistrations will be accepted by phone or email.

.pelled name badges will be reprinted on-site at

(Hands-On) Friday; 8:00 am. - 11:00am. and Firday, 1:00 p.m. - 4:00 p.rn,

22 23

200

AFFILIATE EVENT TICKETS:

Badge

Code 41

VAGD Breakfast'"

Code 42

ACD LunchFor Leamiog** Friday; 11:30am. - 1:30 p.m.

$40

Code 43

MCVNCU Reception Friday; 5:00 p.m. - 6:30 p.m.

Badge

Code 44

ICD Breakfast*

Badge

Saturday, 7:30 a.m. - 8:30 a.m.

Friday; 7:00 a.m. - 8:30 a.rn,

Code

Pierre Fauchard Luncheon*

Sanudav. 11:30 a.m. - 1:30 nrn,

$40

VII')' 1.U

er 8-12,2004 - Norfolk, Virginia

0 0 0 0

Ilt Clearly! Registration Materials to: Ime

8/23/04) .'/;70· (A) First Time Attendees (B) VDA Member Dentist $140 (C) ADA Denrist (non-VDA) $250 (D) Non-Member Dentist $450 (E) Dental Hygienist $'55 (F) VDAA Member Assistant $25 (G) Non-VDAA Member $35

Endodontics

Oral Pathology

Oral!Maxillofacial!

\ddress State

Zip

rrnber (__) __ - _ _ Fax Number (_ _) _ _ - _ _

mes For Badges: or type - please be neat, errors can lead to delays in processing. y Registrant On First Line- List dencisr's name first if attending)

0 0 0

Pediatrics

Prosthodontics

0 0

Public Health

Oral Surgery

Fee

Category

Individual Tickets:

Code/Fee

$300 $500 $65 $35 $45

(H) Other Office Staff $35 (I) Lab Technician $100 (J) Dental, Hygiene & $0 Assisting Student (K) Spouse/Guest $0 (L) Exhibitor $0 (paid booth fee) (M) VAGD Dentist (non-VDA) $200

Military

S170 $190

Assistant

Orthodontics

Registration:

(after 8/23/04)

(on or before

General Practice

Radiology

~cgistrant

mber

vu, •

l<-l ....... ,' ...... ~ "

lUU,"'"

Attending the Luncheon (Code 42)

Code/Fee

7 Code/Fee

$45 $150 $0

(A) Local Anesthetics (B) Bleaching (C) CrackedTeeth (0) Pre-Med Contriverices

(E) Sedationand Special NeedsFor Children (F)Temporomandibular Joint (G) Serial Extractions Dernysrified (H) Preparations For Irnpants

Choices: 1st - nd - - ,~rd -

$0 $0 (paid booth fee) CJ Refund If ChoicesAre Not vailable. $250

VDA and Affiliate Event Tickets:

Code/Fee

8 Totals:

Code/Fee Code/Fee Code/Fee

$ $ $ $ $ $

------

----_.--_.

__. _ .

$ $ $ $

---'

Use Only

---~

Processed By:

-~-

Sfaff

-----~-

Date'

On 1lle Web: jwww.vadental.org Ivisit our Web site to register or for updated information.

Payment Method:

o Check (Payable to VDA) o Visa o MasterCard

Check #

---"~---

Exp.

Credit Card #

-_.

Signature ---~

k IlH hv - - -

Dec:

(Signature Indicates approval for charges to your account)

Date

Mail To: Before August 23, 2004! Virginia Dental Association 7525 Staples Mill Road Richmond, VA 23228 Fax To:

(804) 261-1660 Credit Card registration Only! If you fax

Print Name r

~'our registration, DO NOT MAIL THE

10 Grand Total:

$--

Please-take-o: ~"to-v ~ ~yect¥'~~o-Y\¥n'"~~~~of

't:h013 5th-A ~ /v1eetf¥l~r()f't:h0 VLY~Vet'\t""c«"A~UW\I. Plecue. n.ot"0' that- ~ l.Mt: ~ up "to- date: Ct1' ofJ lM'te' 8, 2004. For cv 1'J'1OY0' C«¥vet'\t"" of

us:

meet"'~~01I\4rOV~~~ov¥,p~~'t:h0VLY~Vet'\t""c«" A~Uh1/w~0'Cltwww.vcuiettt"~ovfr

Sponsors Include:

Exhibitors Include:

President's Party Virginia Academy of Endodontists Drs. Niamtu, Alexander, Keeney, Harris, Metzger & Dymon

3i, Impant Innovations, Inc. 3M ESPE ADC Group Financial Services A-DEC AFTCO Anthem Blue Cross/Blue Shield Asset Protection Group, Inc. Authentic Labs B&B Insurance Associates, Inc. Belmont Equipment Benco Dental Biolase Technology, Inc. Brasseler USA C and F Investment Services, Inc. Colgate CollaGenex Pharmaceuticals Delta Dental Plan ofVirginia Den-Mat/Rembrandt DENTSPLY Caulk Dentsply Gendex DENTSPLY/Tulsa Dental Products Designs For Vision, Inc. Direct Reimbursement Discus Dental, Inc. Dodd Dental Laboratories Doral Refining Drake Precision Dental Laboratory Garfield Refining Company GE Medical GE Medical Protective Hannover Dental Refiners Healthy Communities Loan Fund HPSC Financial Services International Dental Products John Hancock Financial Services KaVo America Corp. Kerr Corporation Lifeservers March of Dimes MCVIVCU New Image Dental Laboratory Nobel Biocare OMNII Oral Pharmaceuticals

Bronze Virginia Academy of Orthodontists Lab One Pierre Fauchard Academy The Virginia Academy of General Dentistry Drs. Karesh, Shivar and Peluso Silver Sky Financial Solutions, An MBNA Company Gold American College Of Dentists BrassIer USA Commonwealth Oral and Facial Surgery International College of Dentists, Virginia Chapter Commonwealth Oral and Facial Surgery Platinum Bayview Dental Laboratory Delta Dental Plan of Virginia Titanium Virginia Dental Services Corporation Totebag Sponsors Anthem Blue Cross/Blue Shield Baran Dental Laboratory B & B Insurance Lanyard Sponsor Benco

Oral B ORASCOPTIC Patterson Dental Supply Paul Banditt Inc. Pauline Grabowski and Associates Pelton and Crane Pittman Dental Laboratory Planrneca, Inc. Porter Instrument and Royal Dental Group PracticeWorks/SoftDent/Trophy Premier Dental Products Company Procter and Gamble Professional Practice Consultants, Ltd. Professional Sales Associates, Inc. R.K. Tongue Co., Inc. RGP Dental Rx Honing Machine Satterfield Computer Services, LLC Sheer Vision Inc. Sherer Dental Laboratory, Inc. Silent Auction/Photo Contest Sky Financial Solutions, An MBNA Company SMARTMOVE Sonicare/Philips Oral Healthcare Southern Dental Industries Sullivan-Schein Dental Sunstar Buder Surgitel/General Scientific Corp. SybronEndo Televox Software, Inc. Thayer Dental Laboratory, Inc. The McNor Group Top Quality Manufacturing U.S. Air Force Dental Recruiter Virginia Health Practitioners' Intervention Program TO

•

Is there anything in the world happier than a kid's smile? At Delta Dental, it's always been our mission to work with Virginia's outstanding dentists to make children's smiles as bright and healthy as possible. One way we do it is through our Smart Smiles" program. Pannering with Boys & Girls Clubs, we make sure children get regular dental check-ups, learn how to take care of their teeth through educational programs, and receive transportation to dental appointments. This help is provided to those children who are under insured or who have no insurance.

Teeth on the Go!" is another innovative approach to children's dental care. Working with the Virginia Department of Education, Delta Dental is making an educational "tool kit" available to elementary schools across Virginia, free of charge. It helps kids make a commitment to taking care of their teeth now and for a lifetime. We'd like to thank all the Virginia dentists who help make these programs succeed.

c) DELTA DENTAl: Delta Dental Plan of Virginia (800) 237·6060

www.deltadentalva.com

Have You Seen The VDA website Lately?

Have you seen the new website? In April of this year, www.vadental.org came on line. We redesigned our website in order to make it more user friendly for the membership and public. Using the Navigation bar, you will find links to general calendar listing events, meetings, seminars, com ponent dental societies and topics such as amalgam waste and direct reimbursement. We particularly hope that you will participate in

our dental discussion area. While national sites are interesting, we believe Virginia dentists will use this area to explore our own local interest and issues. We developed this site with the goal of being easy to use for all our members. The internet has become a critically important com munication device. It's ability to rapidly disseminate information and communicate with the mem bers allows us to move in new directions such as online sur

Become A Mentor To A veu Dental

Student! Mission: To give back to the pro fession and to playa positive and educational role in the develop ment of a new dentist. VDA's mentorship program will include:

munications between you and your student mentor. 5. Assisting your student in the transition from dental student to the practice of dentistry with a continued interest in organized dentistry.

veys. We can also update you on General Assembly news in order to maximize our impact. I would like to recognize Drs. Tom Cooke, Terry Dickinson, and Bruce DeGinder and Robert Hall, the Information & Technol ogy Committee along with Leslie Pinkston. If there are any questions or ideas to improve our site, contact me at LannyRLevenson@comcast.net.

Please visit our website @ www. vadental.org to sign up! The mentoring program is listed un der the navigation side... double dick - go to the bottom of the page and dick on - Sign up to become a mentor! Easy! Ques tions? Email: Leslie Pinkston at pinkston@vadental.org or call (804) 261-1610.

1. Forming a personal relationship with one (or more) student/so 2. Inviting this student to your practice for practical experience in the professional and economic management of a dental practice. 3. Attending the professional con ferences with your student at the dental school, the Virginia Annual Meeting, and your local dental society functions. 4. Maintaining an open-door policy with frequent personal com

NET30~nc Toll-Free: 1 (877) 30NET30 • Tel: (804) 716-9070 e-mail: information@net30.net • www.net30.net

Abstracts Of Interest The following abstracts were pro vided by the Department of Peri odontics at VCU School of Dentistry. We appreciate the contribution that these individuals have made to the Virginia Dental Journal. Wound healing of degree III furca

tion involvements with GTR and/or

Emdogain. A histologic study.

Donos N, Sculean A, Glavind L,

Reich E, Karring T.

J Clin Periodontol2003; 30: 11061

1068.

Aim: To histologically evaluate the

healing of class III furcation defects in

mandibular molars following therapy

using GTR, emdogain, or a combina

tion of both modalities.

Methods: The study included first and second molars from 3 monkeys. Sec ond premolars and third molars were extracted 2 months prior to experi mental period. Surgical defects created in molar furcations, 4 X 3 mm in size and completely removing buccal and lingual plates as well as interradieular bone. Mesial and distal bone left at original height. Impression material in defects to prevent spontaneous healing, second stage of surgery 6 weeks later. At second stage, after dcgranulating defects and conditioning root surfaces with EDTA, roots were notched for reference. Then one molar in each monkey was treated by either GTR using resorbable membrane alone, em dogain alone, a combination of GTR and emdogain, or resutured at CE]. After 5 months of healing, animals were sacrificed and the teeth removed in block resection, sectioned for serial slides. Results: Furcations and/or membranes were exposed in two out of three teeth in the emdogain and CTR groups and in one out of three in the combination group. New bone formation ranged from 28 - 9] % in the GTR group, 51 92% in the emdogain group, 65 - 87%

the control group. New attachment,

defined in this study as new cemen

tum and connective tissue insertion

into that cementum, was seen in the

order of 31 - 89% gain in the GTR

group, 42 - 87% in the emdogain

group, 61 - 93% in the combo

group, and 25 - 62% in the controls.

Conclusions: GTR therapy, alone

and in combination with emdogain,

may result in inreased amounts of

true regeneration used in experimen

tal defects and compared to em

dogain alone and no treatment.

By: Dr. David Johnson, 3rd year

periodontal resident at Virginia

Commonwealth Unviersity. He

was born on November 4, 1970

in Provo, Utah. He received his

Bachelor of Science degree from

Brigham Young University in 1996

and he earned his D.D.S. from the

University of Colorado in 2001.

Effect of non-surgical periodontal

therapy on glycemic control in pa

tients with type 2 diabetes mellitus

Rodrigues D, Taba M, Novaes A,

Souza S, and Grisi M.

J Periodontol2003; 74: 1361

1367

Aim: To monitor the effect of

non-surgical periodontal therapy on

glycemic control in patients with

type 2 diabetes mellitus (DM).

Materials and methods: 30 patients

with type 2 OM were divided into

two groups for treatment of peri

odontal disease defined by the pres

ence of on site having at least 5mm

PD and 2 sites with at least 6mm

AL. Group 1 received full mouth

scaling and root planing as well as

amoxicillin/davulanic acid 825mg.

Croup 2 was treated with full mouth

scaling and root planing alone.

Blood samples and clinical measure

ments were taken at baseline and 3

months. Measurements were taken

with a computerized probe and us-

BOP, PO, CAL, supperation, and PI. Blood was analyzed for fasting glucose level and glycated hemoglobin (HbA 1c). Patients were placed on 2 week recall interval for three months following completion of initial therapy. Results: Both groups showed significant reduction in PO, with a reduction of 0.8mm and 0.9mm for Group 1 and 2, respectively. However, neither group demonstrated a significant gain in CAL. BOP, PI, and supperation were reduced significantly in both groups. HbAlc values were reduced by 0.3% in group 1 and by 1.2% for group 2, with a lot of variability. It was found to be signifi cant for group 2 only. Baseline fasting glucose levels were statistically differ ent between groups, but there was no significant change in fasting glucose level for either group. Conclusions: Effective periodontal treatment lowered blood glucose levels and reduced clinical parameters of periodontal infection. Therefore, peri odontal treatment should be included in diabetes preventative measures. By: Dr. R.Lee Fletcher, III, 3rd year periodontal resident at Virginia Commonwealth University. He was born in 1974 in Orlando, Florida. He received his Bachelor of Science degree in Microbiology in 1997 at the University of Florida and earned his D.M.D. at NOVA Southeastern University in 2001.

Eruption of Palatal Canines Follow ing Surgical Exposure: a Review of Outcomes in a Series of Consecutively Treated Cases Ferguson JW, Parvizi F Br J Orthod 2003; 24: 203-207 Aim: To review 72 patients records following surgical exposure of palatally impacted canines to determine outcome success. Methods: The clinical records of 72 con

secutive patients who had undergone excisional exposure of one or more palatal canines were reviewed. An approximately full-thickness incision was made and soft tissue and/or bone overlying the crown was removed as needed to expose the entire palatal surface from cusp tip to cingulum, but leaving the cementoenamel junction undisturbed. The wound was then packed with Barricaid light-cured periodontal dressing. Outcome was assessed and judged as successful (5) if the tooth erupted to the extent that bonding of an attachment to the buc cal surface was possible, without the need for any further orthodontically assisted eruption. 'The outcome was deemed partially successful (P) if suf ficient tooth enamel still remained ex posed to permit the bonding of an at tachment on the palatal aspect which could be used to assist eruption, and as a failure (F) if a degree of gingival regrowth had taken place that would necessitate surgical re-exposure. Also, prognosis according to tooth position on the panorex was determined-vthe closer the canine lies to the midline in the horizontal plane and to the apical third of the incisor root in the vertical plane, the poorer the prognosis. Results: Results were recorded for 78 teeth. The outcome was deemed (5) for 66 teeth (84.6%), (P) for 8 teeth (10.2%) requiring some orthodonti cally assisted eruption before a bond could be placed on the buccal surface, and (F) for 4 teeth (5.1 %) requir ing some re-exposure. There was no significant difference in groups related to age, however, the mean age for the (5) group was 15.1 years, compared to 17.1 for the (P) and (F) groups. For those who were in the (5) group, mean time between exposure and bonding an attachment to the buccal surface was 67.6 weeks. Results were statistically significant as related to the position of the canine on the panorex in the horizontal and vertical planes. Some post-op complications occurred including post-op bleeding and super ficial infection, but the outcome was

Conclusion: Excisional exposure of palatally impacted canines canines is successful in the great majority of cases. Total failure is rare. With a suit able exposure technique there seems to be little indication for bracket bonding at the time of surgery.

crowning distances from the edge of the decay or restoration to the bony crest at the tip of the furcation. Radiographs were taken 5 years after crown placement.

By Dr. Bindu Reddy, 3rd year peri odontal resident at Virginia Com monwealth University. She was born on April 27, 1974 in Saskatchewan, Canada. She received her Bachelor of Arts degree from the University ofVirginia in 1996 and earned her D.D.S. from Columbia University in 2001.

Results: In teeth that were treated with crown lengthening in 10 of the 26 teeth that underwent the surgery and were then crowned (38.5%). No crowned teeth that did not have crown lengthening showed radio graphic furcadon involvement. All teeth that showed furcation involve ment had less than or equal to 4 mm of distance from margin to bone prior to surgery.

Crown Lengthening in Mandibu

lar Molars: A 5-year Retrospective

Radiographic Analysis

Dibart S, Capri D, Kachouh I, Van

Dyke T, and Nunn M.

J Periodontol 2003; 74: 815-821.

Conclusion: If the distance to the furcation in lower molars is less than 4 mm from the margin of the restora tion, crown lengthening surgery is more likely to result in radiographic furcation involvement within 5 years.

Aim: To evaluate the outcomes of crown lengthening surgery in lower molars and determine a critical value for avoiding evidence of furcation involvement in these teeth. Methods: A retrospective analysis of bitewing radiographs was done to compare the furcation area of crowned lower moloars that underwent crown lengthening (26 teeth) or did not undergo crown lengthening (24 teeth). A grid was overlaid on the radiograph to determine pre-crowning and post

By Dr. Trang Salzberg, a 2nd year periodontal resident at Virginia Commonwealth University. She was born on November 28,1970 in Saigon, Vietnam. She received her Bachelor of Arts degree from University ofVirginia in 1993 and a Masters of Science degree from Vir ginia Commonwealth University in 1997. She earned her D.D.S. from Virginia Commonwealth University in 2001.

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Congratulations Erin Collins: 2004 Give Kids A Smile Essay Contest Winner! A recipe for a healthy smile by: Erin Collins, 5th grade Grange Hall Elementary School The health of teeth and gums can affect your overall health. Everyone has plaque bacteria in their mouths. When plaque bacteria meets up with sugars and starches that are found in snacks, like cookies, candies, dried fruits, soft drinks or even potato chips, the plaque reacts to create acid. The fact is, most snacks that you eat con tain either sugars or starches that give plaque the opportunity to make acid. During this period the plaque acid is attacking the tooth's enamel, making it weak. That's when cavities can start and the process of tooth decay begins. So, a recipe for a healthy smile truly depends on whether you are using the right ingredients, such as, healthy

ARE YOU DISCUSSING FOLIC ACID WITH YOUR PATIENTS? In 2003, the Virginia Department of Health Division of Dental Health, Vir ginia Folic Acid Council, and the March of Dimes developed a collaboration with the Virginia Dental Association to encourage all women of childbearing age to take a multivitamin with folic acid and eat foods that contain folate or folic acid daily. The Virginia Folic Acid Campaign was developed in response (0 the following recommendation, published in 1992 by the U.S. Public Health Service. • All women of childbearing age need (0 consume 0.4 mg (400 micrograms) of folic acid dailv to prevent two common and serious birrh defects, spina bifida

is not only a recipe for a healthy smile it's also a recipe for a healthy life.

DENTIST NEEDEDPCI

snacks, toothpaste containing fluoride, and maybe even mouth washes. Also tools we use in our recipe like soft bristle toothbrushes or electric toothbrushes and floss make a healthy smile. And finally, when combining all of our ingre dients and tools together to make a healthy smile it's important that we follow our directions very carefully and limit the number of snacks we take in between meals; drink lots of water; brush at a 45 degree angle for 2 minutes twice a day and floss. This

Vernon J. Harris East End Com munity Health Center, located in historic Church Hill, seeks full-time dentist for established practice. Provide comprehensive (children and adults) dental care in community-based practice. Competitive salary and benefits with no buy-in required. Join this well-equipped, progressive practice where you are needed and appreci ated!

For more details, please contact: Tracy Causey, Executive Director

Ph. (804) 253-1968 Fax: (804) 253-1979 e-mail: tcausey@vernonjharris.org

and anencephaly.

display and cards can be obtained from:

The Centers for Disease Control and Prevention estimates that 50 - 70% of these birth defects could be prevented if this recommendation is followed before and during pregnancy.

Sharon Logue, R.D.H., M.PH. Virginia Department of Health Division of Dental Health - 9th floor 109 Governor Street Richmond, VA 23219 (804) 864-7788 (804) 864-7783 fax Sharon.Logue@vdh.virginia.gov

Health care providers are recognized to be important motivators of health behavior change. The dentists, dental hygienists, and their support staffs' par ticipation in the Folic Acid Campaign is most welcome. Efforts to reach the target population not aware of the im portance of folic acid are patients whom receive dental services. Your influence can have a significant impact on making folic acid consumption an everyday lifestyle habit for your patients. "The colorful display and cards, available in English and Spanish, 'Babies Need Folic Acid', were designed as an edu cational (001 to initiate discussing and reinforcing the folic acid message. The

The Virginia Department of Health, Division ofWIC and Community Nutrition is dedicated to sustaining your efforts. Further information on folic acid is available by contacting: Kathy Orchen, PA., M.PH. Virginia Department of Health Division of WIC and Community Nu trition - 9th floor 109 Governor Street Richmond, VA 23219 (804) 864-7841 (804) 864-7854 fax Kathy. 0 rchen@vdh.virginia.gov

Virginia Dental Journal

The Spatial Distribution of Dental Facilities in Virginia

Co-authors: Stephen E. Wright Ph.D. Associate Professor of Integrated Science and Technology James Madison University David E. CockIey Dr.PH Associate Professor of Health Sciences James Madison University

Background: Adequate oral health requires accessible dental services. Little attention has been given to the spatial distribution of dentists, including the variables that predict why dentists locate where they do. The U.S. Surgeon General, the Centers for Disease Control, and Virginia's Joint Commission on Healthcare have all paid atten tion recently to the importance of dental health to the public's well being. Of significance in this study is the distribution of active dental practices in the Commonwealth of Virginia in 2001. Specifically the study assessed the spatial distribu tion of dentists, that is, what are the variables that predict or explain why dentists locate where they do, and whether that distribution impacts utilization of dental services or measures of oral health. Nationally there is a ratio of 1724 population per active dentist according to the American Dental Asso ciation . This ratio how ever overlooks the spatial variation of dentists within states that is more critical to local population access. Moreover state-based dentist to population ratios fail to extract consequential factors that enhance or inhibit

34 Virginia Dental Journal

population access to active dentists at the local level. Virginia has a population to dentist ratio of 1609 population per active dentist2. Methods: The study's dependent variable (DV) was Dental Radio logical Units, a proxy variable for dental facilities, dentist number and dentist location, and thus dental service potential. The DV was defined as the professional place where dental radiological units were located and therefore dental services were rendered. The Virginia Department of Health, Office of Radiological Health (VDHORH) is re quired to routinely inspect all dental radiology equip ment in use in the Com monwealth. Radiological inspection and certification occurs every three years and is documented in the Virginia Department of Health's database. The data base is updated regularly as information on equipment es tablishment and termination are reported. Radiological suppliers rather than dental practitioners are required to notify the Virginia Department of Health whenever a Virginia Denial Radiologkal Unill, 2001

;

~.~

... ..::. . . .

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new or refurbished radiology unit is installed or removed. There were 13,182 dental radiological units documented in the study's database in 2001 (Figure 1).

Virginia Dental Radiological

Units, 2001

Figure 1

Of the 135 Virginia counties and

independent cities, 11 did not have

licensed radiological equipment.

The counties with zero radiology

licenses were Charles City, Green

ville, Highland, King and Queen,

Rappahannock, Richmond,

Rockbridge, Surry, and Sussex.

The independent cities with zero

radiology licenses were Bristol and

Manassas Park (Figure 2).

Counties and Independent Cities

wllh Zero Dental Facllltles, 2001

Figure 2 This study used nine independent variables. They were: Population Change, Population Density, Urban Population, Rural Popula tion, Median Family Size, Median Age of Population, Residential Stability, Educational Attainment; High school graduate (includes equivalency), and Median Family Income. Choropleth maps, loca tion quotients (LQs), Z-scores, and regression analysis were the analyti cal tools used in analyzing the data. Dental radiological units' LQ's and dental radiological units' Z-scores were selected as the descriptive techniques because they both used standardized methods for visual izing the data. Regression analysis was selected as the inferential analysis technique.

The multiple regression Binary Z-scores of Virginia Dental Radiological Units. 2001 procedure was selected because the primary Binaryz.scores goals of multiple regres sion is to investigate the relationship between the DV and several IVs and the ability to assess "the importance of each of the variables, Urban Population and IVs to the relationship" . Population Density respectively. Results: The mapping of the Den Discussion: Dentists are more tal Radiological Units' location likely to be found and in greater quotients revealed that of the 135 nu~bers by the prevalence of large Virginia counties and independent populations. However, the lack cities 38 (28.1 %) had LQ's greater of indication of other population than 1. Of these 28 enumeration measures is relevant to issues of units, 6 (21.4%) were counties population access. Adding other and 22 (78.6%) were independent refining measures to gross popula cities, suggesting a geographical tion to dentist ratios, as is preva link between urban places and lent in other health professional higher magnitudes of dental units. shortage designations, appears to The LQ map did not illustrate or hold limited value. suggest a locational trend that was Measures of Education Status and regional in character. Economic Level, found in other The Z-score map of Virginia dental studies, did not add significant radiological units showed four amounts of predictability to the Independent Cities with unusual regression model. Since utilization deviational values (greater than 2 of general dental services is gener standard deviations from the mean ally discretionary, the researchers of dental units). Alexandria City, expected a greater relationship of Fairfax City, City of Richmond, dental facilities to the population and Virginia Beach City had indicators of education status and Z-scores of 6.65, 2.03, 5.77, and median family income. Neither of 4.10 respectively (Figure 3). All of these was found to be a predictor the enumeration units were ur of dental radiological unit distri ban places. Combined, these four bution. Independent Cities represented The study does call attention to 31. 9 percent (4,203) of all Virginia the importance of determinants of Dental Radiological Units. dental need in policies of den Binary Z-scores of Virginia Dental tist distribution. Recent Virginia Raadiological Units, 2001 Department of Health, Center for Primary Care and Rural Health assessmenr of health professional Figure 3 shortage areas. identified 36 The first stepwise model explained counties and 5 independent cites 70.6 percent of the variance with as dental shortage areas. Three ad one predictor, Urban Population, ditional counties and five indepen while the second stepwise model dent cities had portions designated explained 72.4 percent of the as areas of dental shortage. Only variance with two independent -046(01,99

•

20010666

four of the eleven counties or independent cities with zero dental facilities were designated as Den tal Shortage Areas by the Virginia Department of Health. The predominance of dental ra diological units location in a few urban areas in Virginia, as noted in the Z-score distribution, raises access questions across the rest of the Commonwealth. Eighty-nine percent of the population of Vir ginia resides outside of these four urban areas. They are served by only sixty-eight percent of the dental radiological units. Moreover, 99 percent of the Commonwealth's geographic area is outside these four locations. Access to dental care can not be guaranteed for the balance of the Commonwealth's population. Practice Implications: The spatial distribution of dental facilities has direct relationship to public access to dental services. Public health planners have responsibility for establishing incentives or limita tions to augment such distribution concerns.

Complete results of the study and further analysis are available on request from the Virginia Dental Association.

Virginia Dental Journal

Welcome New Members! Tidewater -

Check Us Out!

Dr. Jamie Ramsay graduated from the Medical University of South Carolina Dental School in 1999. He is cur rently practicing dentistry in Suffolk, VA. Dr. Peter Adams graduated from the VCU/MCV School of Dentistry in 1986. He then completed a one year Ad vanced Clinic Program with the US navy in Norfolk, VA in 1993. Dr. Adams is currently practicing in Virginia Beach, VA. Dr. Peter Kuenzli graduated from VCU/MCV School of Dentistry in 1988. Dr. Kuenzli is now practicing den tistry in Virginia Beach. Dr. Mark Sarin received his D.D.S. from Temple Univer sity in 1976. He then received his Certificate in Pediatric Dentistry from the Medical College of VA in 1990. Dr. Sorin is currently on active duty in the Navy and practic ing dentistry in Portsmouth, VA. Dr. Mary Dooley received her D.D.S. from VCU/MCV School of Dentistry in 1985. She then received her Certificate in Prosthodontics in 1988. Dr. Dooley is cur rently practicing dentistry in Virginia Beach, VA. Dr. Robyn K. Marshall graduated from VCU/MCV School of Dentistry in 1995. Dr. Marshall is a general dentist in private practice working as an associate in Virginia Beach, VA.

Peninsula Dr. Ben Steele - Dr. Steele graduated from the Univer sity of Kentucky in 2003, where he received his D.D.S. degree. Dr. Steele is currently practicing dentistry in Hampton, VA with Dr. James D. Watkins. Dr. Curtis W Dailey received his D.D.S. from the University of North Carolina in 1996. Working his way north, he attended the University of Virginia where he completed his CPR in 1998. Dr. Dailey then attended the University of Rochester where he received a Certifi cate in Pediatric Dentistry in 2000. He then received a Certificate in Orthodontics from the National Children's Medical Center in 2002. Dr. Dailey is currently practic ing orthodontics in Hampton, VA.

Southside Dr. John Ji graduated from the University of Pennsylva nia in 1999. He then attended Howard University where

36 Virginia Dental Journal

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he received his Certificate of Ortho dontics in 2001. Dr. Ji is currently practicing orthodontics in Colonial Heights, VA. Dr. Daniel Rhodes graduated from VCU/MCV School of Dentistry in 1995. Dr. Rhodes is currently practic ing dentistry in Colonial Heights, VA.

RichmondDr. Michael Webb - Dr. Webb gradu ated from Northwestern University in 1985. He then completed his Ad vanced Education at the Children's Hospital of Pittsburg Pediatric Den tistry in 1989, and Dental Anesthesia from the University of Pittsburg in 1991. Dr. Webb is currently on faculty at VCU/MCV School of Dentistry and is also practicing under the Faculty Practice Plan. Dr. Stephanie Sawyer - Dr. Sawyer graduated from the University of Missouri dental school in 2000. Dr. Sawyer is currently practicing at the Vernon J Harris Community Health Center in Richmond. Dr. Mark Diefenderfer received his D.D.S. from VCU/MCV School of Dentistry in May of 2003. Dr. Diefenderfer is currently practicing dentistry in Richmond, VA with W. Baxter Perkinson and Associates.

Piedmont Dr. W. Lee Phillips - Dr. Phillips graduated from MCV/VCU School of Dentistry in 1990. He is curren tly practicing dentistry in Lynchburg, VA.

Shenandoah Dr. Steve Breeden graduated from the University of Kentucky in 2000. Dr. Breeden is currently practicing dentistry in Stephens City with Dr. Richard Taliaferro. Dr. David Maybee graduated from the University of Maryland Dental School in 2002. He then received a certificate in 2003 from the University of Con necticut for completing the AEGD Program. Dr. Maybee is currently practicing dentistry in Scottsville, VA.

Northern Virginia Dental SocietyDr. Cudah Bogollagama graduated from M CVNCU School of Dentistry in 2002. She is currently practicing dentistry in Chantilly, VA. Dr. Jane Delaney graduated from the University of Detroit in 1981. She then received her Pediatric Dentistry Certificate and Master of Science in Dentistry in June, 1984. Dr. Delaney is currently practicing in Northern Virginia. Dr. True Duong graduated from the Medical College of Virginia in 1999. Dr. Duong is currently practicing dentistry in Sterling, VA. Dr. Joyle Fernandes graduated from GOA Dental College and Hospital in Goa, India in 1992. She then attended Louisiana State University School of Dentistry and received her Pediatric Dentistry Certificate in 1999. Dr. Fer nandes is currently practicing dentistry in Burke, VA.

Continuing Education

October 2004

October 22-23,2004 Hotel Roanoke, Roanoke VA Realworld Endo.com Dennis Brave, DDS (Saturday session will be hands on)

Meetings & Events Sept. 8-12,2004

VDA Annual Meeting Waterside MarrIott· Norfolk, VA Sept. 14-18,2005

VDA Annual Meeting

Marriott - Richmond, VA

September 13-17, 2006

VDA Annual Meeting

Hotel Roanoke & Conference Center

June 16 & 17, 2007

VDA Annual Meeting (Exhibits, CE &

Social)

Waterside Marriott - Norfolk, VA

~nent

CE Programs - For registra

tion information, contact the appropriate

person below:

Component I (Tidewater) (Executive Secrc-rarv)

Component 11 (Pl'nin~ula) (Executive Secretary) Component III {Southside) (President) Componcnr lV (Richmond) (Executive Secretary) Component V (Piedmont) (Executive Secretary) Component VI (Southwest] (l .xecutivc Secretarv) Cnmpcmenr V11 (Shenandoah) (Executivt- Secrerarv) Component Vlll (Northern \'j\) (J~x(,clJtin' DIrector;

VAC;!)

Pn)!'ra111~

Virginia Donne (707) 491A62() Kathy Harris (757) 565-6564 Dr. Samuel Galstan (HII4)7%-1915 LInda Simon (HII4):123-.1191 Ann Huffman (276) 732-37H9 Sonya Ferns (276) 62H-'19.14

Patricia Fuller (H04) 9HS-193') Susann \\~ t Iamiuor 0(3) 642-5297

pk-asc contacr L'rancvs Kimbrough

(Executive- Sccrnary) ar H04-320-HKO]

vel' SclViOI of

Dentl";lTY

rll'~I~L' contact

Martha Clements

at H04-H2H-IIHW.

W"\\'\\·.L1e11 nvtrv. vco. cdn.' ct- ,/ (f lur:-c .... shrm)

IT.L~ch(J()1

()( ,\luhul\L: /:\nal0m) D<.:pt

P1C;I':>l'

contact

Dr. I Ju,l';o \u1)(:'] af k()4_H2f'vr"t I

Southwest Dental Society Dr. Cameron Heydari received his D.D.S. from Meharry Medical College in 1997. He also completed an Intern ship from the Oral Surgical Institute in 2002. Dr. Heydari is currently practic ing denristrv at the Free Clinic of the New River Valley in Christiansburg, VA.

Dr. John Kim received his D.D.S. from New York University in 1999. He then attended the Medical Col lege of Virginia where he completed a two-year residency in 2001. Dr. Kim is currently practicing dentistry in Steding, VA. Dr. Hvue Kwon received her D.D.S. from the University of Maryland in ('omullIea Oil Page 3R

\'S( )\J". ,lm1 y",) - 1'iL':I'-l'

C()llt;ICI "JUl!c

Puca- ill KfI4-2(lj

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AIDA C·E·R·P CONTINUING EDUCATION RECOGNITION PROGRAM The VDA IS recognized as a certified sponsor of continuing dental edccctron by both the ADA

CERP and the Academy of General Dent,stry.

Virginia Dental Journal

1998. She then received her Ortho Certificate and Masters in Dental Sci ence from the University of Pittsburg in 2001. Dr. Kwon is currently practic ing in Vienna, VA. Dr. Robert McCall received his D.D.S. from UNC, Chapel Hill in 1973. He then did a General Dentist Residency at the National Naval Dental Center where he received his certificate in 1982. Dr. McCall is currently practic ing dentistry in Culpeper, VA. Dr. Evan Sapperstein received his D.D.S. from the University of Mary land in 1998. He then did a General Practice Residency at Baltimore Hospi tal, which he completed in 1999. Dr. Sapperstein is currently practicing in Reston, VA. Dr. Pariana Tung received her D.D.S. in 2003 from Howard University. Dr. Tung is currently practicing dentistry in Fairfax, VA. Dr. Cecilia Ykeda received her D.D.S. in 1992 from Peru. She then attended the University of Maryland where she received her Master of Science and

AEGD Certificate in 2001. Dr. Ykeda is currently practicing dentistry in Springfield, VA. Dr. Young Yoo received his D.D.S. from Howard University in 2002 and is currently practicing dentistry in Woodbridge, VA. Dr. Timothy Sumner received his D.D.S. in 1981 from VCU/MCV School of Dentistry. Dr. Sumner is currently practicing dentistry in Manassas, VA. Dr. Michael Grosso received his 0.0.5 in 2003 from VCU/MCV School Of Dentistry. Dr. Grosso is currently practicing dentistry in Falls Church, VA. Dr. Wesley Creamer received his D.D.S. in 203 from Tufts School of Dental Medicine. Dr. Creamer is cur rently dentistry practicing in Wood bridge, VA. Dr. Keith Kallas received his D.D.S. in 1989 and a Certificate of Pediatric Dentistry from Howard University in

Florida School of Dentistry Orth odontic fellowship, Gainsville, FL

Edward Kim - working some where in Northern Virginia Keith Van Tassell- Pediatric Den tistry at Sunrise Children's Hospi tal, Las Vegas, NV

_ _ _..........

Josh Rubinstein - Opening a .............. practice in Richmond, VA

2004 Graduating Dentists Jason S O l& traw - ra The VDA is happy to present a listing of newly graduating dentists, The VDA asked all graduat ing students to please email us their personal information for inclusion in this list. Many re

sponded - some did not.

Melanie Wexel- University of 38 Virginia Dental Journal

Maxl'11 0

1993. Dr. Kallas is currently practic ing dentistry in Vienna. Dr. Cesar Montalvan received his D.D.S. from the Universidad Pcrvana Cayerane Heredia in 1995. He then received a Certificate in Advanced Education and General Dentistry from the University of Maryland. Dr. Montalvan is currently practicing dentistry in Centreville, VA. Dr. Marjan Partovi received her 0.0.5 from the University of Mary land in 2000. She then received her certificate in Advance Education in General Dentistry in 200 1. Dr. Par tovi is currently practicing dentistry in Rockville, MD. Dr. Kamran Tavakkoli received her D.D.S. from Temple University in 2002. Dr. Tavakkoli is currently prac ticing dentistry in Woodbridge, VA. Dr. Arwa Zeineh received her D.D.S. from Lorna Linda University in 1998. Dr. Zeineh is currently practicing dentistry in Reston,VA.

his father, Dr. Tom Hudson.

Cameron Quayle - Pediatric Dentistry Residency at Primary Children's Medical Center in Salt Lake City, Utah. Mter the residency Cam and Mandie, plan to find a location to open/partner and start a family. Christabel Sweeney - AEGD Vir ginia Commonwealth University

facial Surgery Residency at Lorna Linda University in CA

Benjamin Webber - Army AEGD, Ft. Campbell, KY and Clarksville, TN

Brad Thweatt - AEGD University of Florida, St. Petersburg

Sheila R. Gillespie - Hampton, VA

Paul Hudson - Will be practicing dentistry in Short Pump, VA with

Flora Phipps - AEGD Residency atVCU

Lisa Danielle Hoffman - will be joining her father, Dr. Richard Hoffman in his dental practice in Hampton, VA. Eric Kerbs- will be doing an in ternship with Dr. Baxter Perkinson and Associates.

Gregory W Gatrell - will be mov ing to Portsmouth, VA, where he will be doing a GPR at Portsmouth Naval Medical Center. Shane Costa - AEGD - Dallas, Texas

Florida/Shands Hospital, Gainsville, Florida.

Julie Ferguson - Private practice in Southwest VA/Northeast TN Justin Ferguson - Private practice in Southwest VA/Northeast TN Jo-Marie Maniwang - Joining Konikoff Family Dentistry in Vir ginia Beach, VA.

Sarah Sharpley - private practice in Loudon Co, VA. Sharon Robinson - will be doing an internship in Oral and Maxil lofacial surgery at Shands Hospital, an affiliate of the University in Jacksonville, FL.

Zachary Casagrande - Orthodon tic Residency at Virginia Common wealth University

Darren Gardner - G PR - Univer sity of Utah

Christopher Loveland - Pediat ric Residency at the University of

LAB ONE Presents:

Dr. Bill McHorris The "Olde Master" Educator from Memphis, Tennessee Past. Pres.: American Acad. of Restorative Dentistry and International Acad. of Gnathology

Coming Fri. & Sat. March

t tv & 12 h, 2005 t

to the Beautiful Norfolk Airport Holiday Inn Select Dr. William McHorris, B.S., D.D.S, F.A.C.D. F.I.CD

"Occlusal flfJnllideratiBns It: Pia"., Techniques Plus "'h

_r'

In the tradition of Dr. Jack Turbyfill and Dr. John Kois, another one of the world's true MAster Dentist will show you how proper management

of the occlusion for compromised patients can significantly help to alleviate or even resolve some or all individual or collective problems such

as tooth loss, disease entities of the teeth or peridontium, sever attrition, mechanical over-loading, trauma, tmd, or iatrogenic dental

treatments. A real learning bonus to your practice will come as Dr. Bill McHorris shares on day two of his program his famous "STUFF THAT

WORKi2", a collections of valuable insights and tricks of the trade which he has gathered over almost 40 years as a "wet Fingered" restorative

dentist You will learn in the presence of an Olde Master Dentist how to practice SMARTER, instead of HARDER!

Call coordinator Tom Williford at LAB ONE Seminars

455-8686 or Toll Free 1 (888) 448-7889 e.mail: BIGTOM@LABONEDENTAL.COM Paid Advertisement Virginia Dental Journal

DDS Contributor Enjoys Successful Seminar

One of the DDS participating labora tories serving our profession recently extend-ed their scope of influence in the dental community. LAB ONE, the certified full service dental labora tory located in Norfolk, sponsored a two day continuing education seminar hosting Dr. John Kois from Seattle, Washington. It was attended by 175 dentists, dental hygienists, dental assis tants and dental technicians from many states throughout America and from Canada. Attendees came from South Carolina, North Carolina, every corner of Virginia, Maryland, Pennsylvania, New Jersey, all over New York state, New Hampshire, Ohio, Illinois, Cali fornia, and Toronto, Ontario. It was the largest seminar to date sponsored by LAB ONE. The event took place at Norfolk's new

Holiday Inn Select Hotel on Friday and Saturday, Febru-ary 6th and 7th. Dr. Kois, a world renowned prosth odontist, delivered an impressive advan-ced program entitled "Func tional Occlusion: Science Driven Managemenr''. The overwhelming and vocal response from those in at tendance has been very positive. Laboratory spokesperson, Tom Wil liford, stated, « Just like DDS, LAB ONE has long been involved in sponsoring programs which benefit the dental profession. Our participa tion in Donated Dental Services has not only given us the opportunity to serve the needs of certain Virginia patients who otherwise might not enjoy the benefits of good dental care, but has allowed us the ability to speak with many dentists from across the

Free Clinic Reaches

Volunteer Dentists *:

New Heights

Matt Ankrum, DDS Michael Ankrum, DDS Richard Anthony, DDS A. Carole Pratt, DDS William Armour, DDS Krieg Pursifull, DDS Richard Boyle, DDS Dennis Schnecker, DDS Graham Hoskins, DDS John Semones, DDS Chris Huff, DDS Wallace Huff, DDS Roger Kiser, DDS Damon Thompson, DDS Peter MacDonald, DDS Daniel Thompson, DDS Richard Newton, DDS Barry Wolfe, DDS Glenn Young, DDS

The Free Clinic of the New River Valley's Dental Program is reach ing new heights in bringing qual ity care to people who lack health insurance, and are low income. Last year, the Clinic provided $285,630 worth of care for over 1,000 patients. This care was pro vided by our part-time dentist, Dr. John Hurt, and a group of dedicat ed professional volunteers*. Most recently, the Clinic was awarded a sub-contract from a Radford Uni versity HRSA grant to establish a full-time practice. We welcome Dr. Cameron Heydari from Nash ville, Tennessee to help implement this bold initiative. The full time dental practice will now double it treatment capacity, as well as add ing renewed emphasis to preventa tive care.

40 Virginia Dental Journal

state." "We know that our exposure to den tists outside of our immediate area has furthered our reputation and added to our ability co reach a much broader market base", he added. "Our origi nal altruism in offering assistance to a need based dental community has been well rewarded by an excellent show of support from the profession. It's been a business blessing any dental laboratory would appreciate", Willi ford concluded. Lab One's president, Bill Willits added, "The DDS program is such a worthwhile effort, I would think every commercial dental labora tory in the State of Virginia would support their dentists and contribute to this profession's generous outreach."

Carla Taylor, Dental Assistant; and Dr. Cameron Heydari our new full time dentist

- The Virginia Dental Health Foundation, which works through (. HealthyS...,ileS) J the Virginia Dental ZOIO ~'\\'\\.;Idl C nest Association to help increase oral healthcare National Children's Dental Access Day access across the state, February 6, 2004 recently received more 'lhunk-; 10 111//" tricnds (/1/c/'IIPI'O!"lCJ'\" \\-}/O 11<'/Iwd 10 1)/(11,(' if hapPcl/' that $8,500 worth of free dental supplies from Henry Schein, Inc. (NASDAQ: HSIC), the largest provider of health care products and services to office based practitioners in the combined North American and European mar kets, to help the Foundation further its mission of improving dental health Working Together with the

Healthcare Community•.•

for the state's underserved. This ~Y''U1 Henry Schein Cares was the third shipment of donated supplies to the Foundation's MOM Project.

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The Virginia Dental Health Foundation Part ners With Henry Schein To Improve Oral Health care Access To The State's Underserved The Foundation will receive free dental and medical supplies from Henry Schein Cares, the global corporate citizenship program of Henry Schein, to help increase oral healthcare access and delivery across Virginia.

Crest Healthy Smiles 2010 The VDA has been pleased to team up with Crest Healthy Smiles 2010. Through this partnership, the VDA has been able to provide education, sup plies, and access to oral health care for even more of the undeserving children in Virginia. CREST HEALTHY SMILES 2010 (CHS2010) is designed to address the alarrninsb disparirv. in the oral health of America's low-income children and their families. CREST HEALTHY

The donations, which recognize the importance of the Foundation's work, come from Henry Schein Cares, the global corporate citizenship program of Henry Schein. Through Henry Sschein Cares, equipment and sup plies are donated to organizations working toward improving healthcare education, access and delivery in the United States and abroad. Last year the Foundation also received more that $20,000 worth of free supplies through Henry Schein Cares. "Henry Schein Cares continues to playa vital role in helping our Poun SMILES 2010 provides education, oral care tools and increased access to dental professionals to reach 50 mil lion children across the country within the next 10 years. Prompted by the Surgeon General's 200 report addressing the disparity of oral heal rh in America, CBS 2010 combines the passionate vision of Crest with national and local non profit partners and leading dental professionals to help provide healthy smiles to children nationwide.

dation further vital- but often over looked - oral healthcare delivery to Virginia's poor and underserved," said Terry Dickinson, D.D.S., Executive Director of the Virginia Dental Health Foundation. "These supplies will help the estimated 4,600 dentists better support the more that 7 million people that live in Virginia, and allow us to mobilize resources, from a financial and human perspective, to help make a difference in people's lives. Henry Schein Cares currently sup pOrts dozens of nonprofit organiza tions across the United States and abroad. Its mission is to help narrow the disparity of healthcare delivery, ser vices and information in underserved communities. Henry Schein Cares provides the programs of community based health professionals and their oranizations. "Henry Schein Cares is committed to helping narrow the gap in the delivery of healthcare services and improv ing access to care in underserved communities," said Stanly Berhman, Chairman, Chief Executive Officer and President of Henry Schein. "A partnership between the public and private sector is one of the best ways to achieve this mission. The Virginia Dental Health Foundation is an excel lent example of a community-based organization helping residents access critical dental care."

Crest 2010

v e: Healthy SK1iJeS) WL

2010

Crest

Virginia Dental Journal

Survey Results Reveal Oral Hygiene Habits of Men Lag Behind Women Text Via Press Release From American Dental Association

Men will have to brush up on caring for their teeth and gums to equal the oral hygiene efforts of women, according to survey find ings from the American Dental Association (ADA).

brushing and flossing, in addition to regular dental checkups, can be enough in most cases to help prevent tooth decay and gum disease."

In the ADA's 2003 Public Opinion Survey: Oral Health of the U.S. Population, women say they take better care of their teeth than men. According to the survey, women were more likely than men to brush their teeth after every meal (28.7 percent to 20.5 percent) or twice a day (56.8 percent to 49 percent). The survey also re vealed women were more likely to have a dentist than men (89.2 percent to 74.6 percent). Overall, American adults recorded a slight increase among those brushing twice a day or after each meal to 78 percent in 2003 com pared with 1997's 75.4 percent. But the most dramatic jump is brushing frequency occurred in the number of respondents say ing they brushed after every meal, reaching 24.8 percent in 2003 compared with 11.5 percent in the 1997 survey. The daily use of dental floss or an interdental cleaner rose slightly to 50.5 percent in 2003 compared with 1997's 48.2 percent. "Being thorough in your daily oral hygiene lays the groundwork for a healthy smile," explains Dr. Kimberly Harms, ADA con sumer advisor. "A daily routine of Virginia Dental Journal

• Eat a balanced diet and limit between-meal snacks. • Visit your dentist regularly for professional cleanings and oral exams. The survey, by Zogby Internation al in December 2003, consisted of telephone interviews with a nationally representative sample of 1,014 adults aged 18 years and older who identified themselves as the head of household. The not-for-profit ADA is the nation's largest dental association, representing more than 149,000 members. The premier source of oral health information, the ADA has advocated for the public's health and promoted the art and science of dentistry since 1859. The ADA's state-of-the-art re search facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient ex perience more positive. The ADA Seal of Acceptance long has been a valuable and respected auide to consumer and professional prod ucts. For more information about the ADA, visit the Association's Web site at www.ada.org.

The ADA recommends the fol lowing: • Brush your teeth twice a day with fluoride toothpaste. • Clean between teeth daily with floss or an interdental cleaner. Decay-causing bacteria still lin gers between teeth where tooth brush bristles can't reach. Floss ing removes plaque and food particles from between the teeth and under the gum line.

Will Your Retirement Dollars Weather The Coming Storm?

Submitted By: Richard Howard Alan Greenspan, testifying before Congress' Joint Economic Commit tee Wednesday, April 21 st, stated flatly, "Interest rates are going to rise and the increase will be sooner than later." That may be good news for CD investors who have been living on a fixed income and have watched the amount of money they live on go down as interest rates have dropped to a forty five year low in past years. When you consider that the inflation rate was recently reported at 5.1 % and CD income is tax able at ordinary income tax rates, this means that the majority of these

investors have no where to go.

Enough about CD investors, the an

nounced pending rise in interest rates

is not relevant to most astute inves

tors because they have chosen to buy

mutual funds and be fully invested in

the stock market, right? Let's look at

what Chairman Greenspan's com

ments mean for these investors.

If you imagine a huge see-saw

(remember the long board that two

elementary school children played

on at the play ground that went up

and down) where on one end is inter

est rates and on the other is stock and

bond prices. When interest rates are

low. as they are currently, the stock

and bond prices are historically high.

The Dow Jones Industrial Average

was at 10.317 as ofthis writing.

When interest rates go up. the other

end of the see-saw goes down - this includes mutual funds which are made up of stocks and bonds. When the rates are at a forty five year low, as they are currently, and the Chairman of the Federal Reserve announces that "Interest rates must rise at some point to prevent pressure on price inflation from eventually emerging" it is a market storm that is brewing that will affect all stock and bond investors. When he states that the rise in rates will "Be sooner than later" this should mean something to investors.

What does all this mean to some one who is considering retirement or someone who is already retired? Simply put: RISING INTEREST RATES MEAN FALLING STOCK AND BOND PRICES. If you are invested in the market, you will be affected! Will Rogers once said, "Even if you are on the right track, you will get run over if you don't move." With this fact in mind, what questions or considerations should the retiree or soon to be retired den tist take into account? Here are several: I) If there is a substantial drop in the stock market. will this affect my retirement monies and conse quently my plans and time table for retirement? Will I have to continue working past the date I have planned

to retire because of a drop in asset value? Note: Some investors lost 30% to 50% of their retirement ac count value in the 2000, 2001 and 2002 bad market. If I am invested in bonds, how far will the value of these bonds drop with rising rates?

3) If I sustain losses in the market, do I have enough time left to see the market recover and to recover my lost principal and any appreciation I may have gotten in past years? 4) As re demptions increase at mutual funds be cause of a falling mar ket and investors pulling money out, am I prepared to pay the long term capital gains tax bill I get at the end of the year from the mu tual fund, even though I didn't sell any shares myself? 5) Can I get these assets out of my

estate tax-free even if! don't lose money in a down market? 6) Do I have a large stock position

that I don't want to sell because I don't want to pay the long term capi tal gains taxes that would be due on the sale but can I afford the market risk to this stock position since it is a major part of my total assets? 7) Do I have a Charitable Remain der Trust that was designed to pay lifetime income and will a falling Cominued On Page 44

Virginia Dental Journal

WashEd

& StrEtchEs likE LatEX. "" Elasticity for a PErfEct Fit

market mean that the income I have been getting will be reduced or completely eliminated but the annual fees for the administration continue? 8) Will I be able to maintain my lifestyle in retirement as I liquidate assets from my retirement plans to take the required minimum distribu tion (RMD) when the value of the assets is falling with a declining market?

financial situation and plans to the benefits of using of the Virginia Dental Health Foundation's Tax Smart AnnuitylY in their financial and estate planning.

9) Am I paying a money manager or an advisor fees annually to give me less than average results (only 6% of all mutual funds beat the Dow on a consistent basis) and has my advisor or money manager cautioned me about the effect of rising rates-or have they insisted I remain invested in the market for the "long term"?

By using the Tax Smart Annuity'>' in your financial and estate plan ning, the dentist gets a current year tax deduction which saves immedi ate tax dollars and eliminates market and interest rate risk. In addition, the dentist gets lifetime income at a high rate for two people, the dentist and the spouse. In the process. the participant can move this money out of their estate to their heirs tax-free and save approximately one-half of the asset value in estate and inheri tance taxes that would otherwise have to be paid by liquidating assets.

These are just some of the questions that can be answered in a beneficial way for retiring or retired dentists when they compare their current

Mr. Howard is a Certified Senior Advisor, a member of the Financial Planning Association and the Soci ety of Senior Market Professionals.

44 Virginia Dental Journal

He is featured in the May issue of Senior Market Advisor magazine where he discusses several of these tax saving strategies. Before form ing his company in 1989, he was a Registered Representative, Vice President of Investments and Branch Manager for Shearson, Lehman Securities. He speaks nationally to industry groups, and conducts con tinuing education classes for CPAs, attorneys and financial planners.

Student News Gerald C. Canaan, II, Esquire spoke to the dental students March 22, 2004, for the last Dinner and Learn of the 2004 Academic year. Mr. Canaan had a wonderful presentation prepared on Dentistry and Law in Virginia. Mr. Canaan represents only medi cal professionals in Virginia. Dental malpractice, standard of care, informed consent, documentation, billing, risk management and several examples of

cases were presented. It was a very educational evening! In reviewing some of the trial cases, the audience was most surprised on the reasons and monetary amount the jury would award the plaintiff. Thank you Gerald Canaan!

Gerald Canaan, Esquire with students afrer rhe Dinner and Learn

A « warm" hello from Tidewater. We are in the throes of what is supposed to be spring, but it feels very much like summer. This has been an active year for our component. We had a large contingent of volunteers for our fall MOM project and as usual it was a rousing success. What is most amazing about this effort is the fact that those who participate seem to enjoy it so much and we have folks who repeat each time we make the trip across the bay. We held a very successful "Give Kids a Smile Day" in conjunction with the School of Dental Hygiene of Old Dominion University. According to chairman, Anthony Peluso, 40 chil dren were seen and besides exams and bitewings, 152 sealants were placed on indicated teeth. We have two significant functions planned for the summer. The first is The Alabama Implant Study group on August 5-8 at the Virginia Beach Re sort and Conference Center. Speakers will be; Dr. Charles English who will talk about Implant Prosthetics and Mr. Dan Root whose topic will be Implant Complications and Their Cosmetic Results.

Dr. McMunn ar rhe February Dinner and Learn

The second event is our annual meet ing which will be held on Wednesday, August 18, 2004 at the Holiday Inn Greenbrier at 6:00 PM. For Information about either of these events please call Ginnie Donne at

Dr. DeGinder Provides Keynore Address At Dental School Awards Ceremony

757-491-4626.

COMPONENT NEWS Component I

Tidewater

Dr. Barn Einhorn, Editor

•

We are proud of our retired colleague Jack Atkins who at age 80 undertook a cross country bike tour to raise money for Lee's Friends a local charity which provides services to cancer patients. We mourn the loss of two of our out standing colleagues. Van K. Heely and Jerry Weinstein. Do come and visit us. the water is get ting warm and the skies are remarkably blue.

Component II

Peninsula

Dr. Elizabeth A. Bernhard, Editor

No News To Report, Please Contact Your Component Secretary. Component III Southside

Dr. Mike Hanley, Editor

Greetings from Southside Not much good news from South of the James. Nothing really on the agenda until our annual golf and swim business meeting in late August. Lost a good friend in May when Dr. Eduardo Ortiz passed away after a prolonged illness. I met Eddie in 1986 while I was looking for a practice to purchase. We hit it off instantly and worked together for two very reward ing years. Eddie always had stories to tell; about his patients, about his family, and about his life. His patients loved him- talk about a tough act to follow! He always tried to give a painless injection ... and succeeded. He decided a long time earlier that he wouldn't extract any more teeth: his job was to save them. Up until his passing, his old patients would ask how he was doing. Many, many patients told me that Dr Ortiz took away their fear of dentistry. I'm still running explorers over the smooth margins crafted thirty year prior. Nice job, Eddie. I'll see everyone at the VDA in Norfolk. The last meeting there was great. Later in the month it's down to Orlando for the ADA. I hope to play one round of golf with Goofey .... .1 hope David Ellis is bringing his clubs.

Virginia Dental Journal

Talk to you later, Mike Component IV Richmond

Component V Piedmont

Dr. Lori Snidow, Editor

Dr. Kitt Finley-Parker, Editor We hope our fellow Virginia Com ponents are having a great summer! Component TV's end of the year Annual Golf Outing, Bike Ride and Family Cookout was a great success. Everyone had a wonderful time. We want to thank Mike Miller for orga nizing such a fabulous event. Our new slate of officers for the 2004 2005 year is: President- Dr. Frank Straus President-Elect- Dr. Kitt Finley-Parker Secretary- Dr. Roger Wood Treasurer- Dr.Ed Griggs We have some exceptional CE planned for the fall and into 200S! On November 19, 2004 we will have Connie Podesta for an all day course. On February 18,2005 the phenomenal Dr.Gordon Christianson will be in Richmond to give a course that is always filled with so much use ful information you can take it back to your office on Monday and start implementing it right away. Our last all day CE course will be Dr.Ray Bertolotti. Please mark these dates on your calendars and plan to attend. Enjoy your last few weeks of summer and we will see you in Norfolk for the Annual Meeting in September!

The Piedmont is pleased to announce that our very own Mark A. Crabtree, DDS from Martinsville is running for VDA President-elect. We wish him lots of luck! We had a great spring meeting at the Holiday Inn Select in April. Everyone learned a lot and seemed to enjoy the day. Our fall meeting is fast approaching and we are excited to have Dr. Den nis Brave with RealWorid Endo be our guest speaker. We will be having a hands on session Saturday with limited space so if you are interested in attend ing the hands on, please let Ann Huff man know as soon as possible. Get your golf clubs ready for our spring 2005 meeting. We will be going back to The Homestead, Hot Springs, VA. The dates are April 8-9, 2005. On Saturday we will be having a golf tour nament. Registration forms will go in the mail soon! Make sure to mark your calendar today. We are working to get some exciting speakers for our upcoming meetings. Linda Miles is one of everyone's favor ite. She will be with us corning soon. This will be a great opportunity for you to bring your staff. Details will follow as they become available. If additional information is needed please contact OUt executive secretary Ann Huffman at 276-732-3789.

Component VI Southwest

..'

Dr. Robert G. Schuster, Editor No News To Report. Please Contact Your Component Secretary Component VII Shenandoah Valley

Dr. Harry M. Sartelle, III, President No News To Report. Please Contact Your Component Secretary Component VIII Northern Virginia

Dr. Scott McQuiston, Editor Northern Virginia hosted its second M.O.M project in March under the direction of Dr. David Anderson. Overall the event was a success being held at the newly constructed dental hygiene facility at Northern Virginia Community College's Allied Health Center in Lorton, Virginia. Over 900 patients were served. Spe cial thanks goes to the Northern Vir ginia Hygiene Association for their help in keeping the hygiene chairs busy. The facility was superb and the staff was excellent. Thanks to Dr. Anderson for his hard work and dedication to this worthy event and to all the volunteers and sponsors for their unwavering commitment to the underserved of Northern Virginia. Most noteworthy was our annual fund-raising event for the Northern Virginia Dental Clinic. This years Field Day was held at the Virginia Oaks Golf Course in Gainesville , VA. The event generated nearly

46 Virginia Dental Journal

$9,000.00 for the clinic. There were many winners that day both dentist members and non-members alike. Rumor has it that all the awards in the female category were eked out by Dr's Brenda Young and Melanic Love. Hummm? Everyone was a winner that day because the weather was beautiful and all had fun. Thanks to Dr. Ron Hauptman and Tom Wil son (clinic director) for their efforts in planning this event. We were both informed and amused by the speakers Dr. Ellen Byrne and Dr. John Sivirsky in recent months. Sivirsky is synonymous with comedy and his show is a good one. Dr. By rne and Dr. Sivirsky are exceptional speakers as well as excellent educa tors. In related news our Committee for the New Dentist has put together a program titled, "Creating the Ideal Dental Practice", Thanks to Dr. Peter Cocolis' committee for bringing together those entities and businesses that can help the new dentist achieve their goals.

All<:6n;tr(j~e~tf'T~"'S Is.:~u~1nitte~

On A V91urite~BasisB~YourOo1n

ponent~ecretary.·l'oLe~~n'N1Q~e

About SpecificEvents, QrTo Find Out More Ab()utUpeom~ng.Events In Your 'Component,Plea~e Contact Your Component Secretary.

your lunch and garden admission with tram tour of the gardens. On Friday, September 10, the members of the Al liance Executive Board will meet at the Waterside Marriott Hotel from l Oarn until 2pm. All Alliance members and guests are invited to attend the Alli ance Annual Membership Meeting on Saturday, September 11, which will be held at The Painted Lady restaurant in the historic Ghent District. We will leave from the Waterside Marriott at 10:30am. After our meeting and lunch, we will have time to shop! The price is $20 per person. To attend any of these functions, please send a check made payable to AVDA to Shirley Meade, 13004 Chipstead Road, Chester, VA 23831. Please make your reservations by August 10. From Hampton Roads, it's off to Florida for a fantastic ADA meeting in Orlando in October. I'd like to high light a few of the Alliance activities that are scheduled to take place there. Thursday, September 30, we will take care of business, beginning with our ADPAC Breakfast and Awards, fol lowed by our first House of Delegates. Lunch will recognize the winners of the Thelma}. Neff Distinguished Ser vice Award. Later that evening all are invited to attend (for free) the AADA President & President-Elect Recep tion, underwritten by MBNA

Alliance News Shirlev S. Meade, President

Enjoy those lazy days of summer because fall is right behind and that means annual meetings! 'The Alli ance cordially invites you to join us and the VDA in Norfolk, September 9 - 12, and take part in the following activities designed for your entertain ment and enjoyment. On Thursday, September 9, enjoy having lunch and roaming through the Norfolk Botani cal Gardens. We will depart from the \XTaterside Marriott at ] 1am. The price is Si 1G per person which includes

Friday, October 1 is the date for the ADA/AADA/FDHE "Dish ing Up Smiles" Luncheon. This is a luncheon event planned to release the new AADA dental health cook book, "Dishing Up "Smiles". This fun and entertaining book combines humorous photos, quick, easy & healthy recipes, dental health tips and etiquette hints from the owners of Professional Courtesy. Speakers for the event are Karen Hickman and Nancv Sweet, nationally recognized etiquette consultants. Their focus is empower ing professionals, executives and indi viduals in Business Dining Etiquette and How to Dine like a Diplomat. Their presentation is for both men

and women. Proceeds from this event will benefit dental health programs in America sponsored by the AADA and the Foundation for Dental Health Education. For more information on this event, see page 10 of the ADA 04 Orlando preview book or your summer edition of KEY. Also on Friday, AADA will assist the ADA Foundation with their Health Screening Program from 2pm to 4pm. Saturday, October 2 will conclude our convention with the Member Project Awards Breakfast, 2nd House of Del egates, and the Incoming President's Reception. The Rosen Plaza Hotel will be the headquarters for the Alliance meet ings. It is located near the convention center. Our schedule will be posted in the Summer Issue of KEY. If you haven't been part of an annual Alliance meeting before..,you are just the dental spouse we are looking for! Everyone has something to offer to this profes sional organization and the Alliance has something to offer to each of you. You will discover the benefits of your membership by being with other members from across the United States and finding out what [he BIG picture is all about. You will find yourself sur rounded by some of the nicest people and possibly life long friends are await ing you! So much to look forward to! I look forward to seeing all of you - first in Norfolk and then down in Orlando!

VAENews Dr. TimothY J. C; olian,

President

No News To Report. Please Contact Your Organization Secretary

Virginia Dental Journal

Virginia Association of Orthodontists Penny L. Lampros, 0.0.5, M.S.D.

President, VAG

The Virginia Association of Ortho dontists had our annual meeting at the Cavalier Hotel in Virginia Beach from June 25-30. Our speakers were Dr. David Sarver who spoke on the esthet ics of orthodontics and Dr. Jerry Clark who discussed strategies to ensure retiring financially secure. Both speak ers were excellent. We also had a great time seeing old friends and meeting new colleagues.

The VAO has a long history of proven leadership in Virginia and across the United States. Many orthodontists have laid the groundwork for us to have successful practices by support ing the VAO The VAO continues to provide continuing education but more importantly allows us as orthodontists to gather to share experiences, net work, and understand current happen ings in local, national and international health care. Sincerely, Penny L. Lampros, D.D.S., M.S.D.

School Of Dentistry Dr. Betsy A. Hagan Senior Associate Dean for Dentistrv Meredith Brvk Contributing Editor Another Exciting Year -- Dean Ron Hunt

lt has been an exciting and busy year at the VCU School of Dentistry. In May, we sent classes of excellent dental and dental hygiene graduates into the dental workplace to help meet the oral health needs of the public. An exceptionally strong Class of 2008 has been accepted for the coming year and will begin classes in late July. At year's end, we had dental and dental hygiene students participating in off-campus rotations

48 Virginia Dental Journal

at Free Clinics in Lynchburg in Cen tral Virginia and Kilmarnnock in the Northern Neck. By fall, students also will be treating patients at the Bradley Free Clinic in Roanoke. Faculty retire ments have led to the recruitment of new faculty and administrators who are bringing stimulating change to the school's programs. We also began the series of renovations that ultimately will result in creation of the new preclinical simulation laboratories. From January through early May, we watched the 2004 Session of the Virginia General Assembly with great interest. The session was noteworthy for its unusual length and its contentious budget standoff. In the end, though, the VCU School of Dentistry emerged with major gains. Private Practice Preceptorships With the passage of House Bill 1049 unanimously in both houses of the Gen eral Assembly, the statutes governing dental practice in Virginia were changed to benefit dental and dental hygiene education. We now can begin placing dental and dental hygiene students in off-campus rotations in private practice preceptorships, which will expand the students' education while giving them important exposure to nonmetropolitan areas. We are very excited about the prospect of sending students into the smaller communities of Virginia to serve and to learn. Delegate Phil Hamilton of Newport News parroned this bill for us and was very helpful in steering the bill to passage. Private practice preceptorships will com plement the public clinic preceptorships we initiated this year, with a long-range goal of having all fourth-year students complete a one-month rotation in a public clinic and a one-month rotation in a private office. We will emphasize rotations in rural and underserved areas of Virginia. HB 1049 also leads to some statute and regulation changes that permit the creation of temporary licenses for dental graduate students. With the issuance of

these licenses, the school is able to avoid problems with Virginia laws regulating prescription writing. Rural Dental Scholarships In a related matter, Senator Benjamin Lambert of Richmond secured for us $25,000 for rural dental scholarships and loan repayments. This annual ap propriation doubles the funds available for students and graduates who agree to practice in rural underserved areas of Virginia. Senator Lambert serves on the School of Dentistry's Board of Advi sors and has been a long time supporter ofVCU and the School of Dentistry. Dental Simulation Funding In a very exciting budget victory for the VCU School of Dentistry, the Virginia General Assembly in May approved a $2. I million capital outlay for dental simulation equipment. The funds will be allocated to us over four years, and require the school to match 2: I with private funds. Our match is coming from the Clinical Simulation campaign that has just passed the half way mark toward raising its goal of $4 million. It took the work of many people to bring about this exciting funding victory. VCU leaders put the project in VCU's biennial budget request. It subsequently was supported by the Governor and by the Senate. However, the House removed it in forming its anti-tax budget. With the help of many people, especially from the Virginia Dental Association (VDA), our ap propriation was reinserted in the House budget, and remained a part of the budget that was hammered out by the Budget Conference Committee.

This simulation equipment will al low the VCU School of Dentistry to introduce state-of-the-art, virtual reality technology into its preclinical cur riculum. From their first day of dental school, students will be able to work with dental mannequins that closely simulate the direct patient care envi ronment that the students will enter later in the curriculum. Using infrared

sensors and computers, tooth prepara tions can be tracked and evaluated with Dental Simulators. With greater op portunity for self-study and self-assess ment, students will more quickly prepare for direct patient care, while being less reliant on full-time faculty. Dental simulation technology allows us to provide better and more timely instruc tion, while lessening our dependence on full-time faculty. Which, in turn, allows us to work within the smaller budget we now have. Thank You to the Virginia Dental As sociation and Other Friends We owe a great debt of gratitude to the leaders of the Virginia Dental Associa tion for their lobbying efforts -- especial ly with the nine members of the Budget Conference Committee -- in getting the funding reinstated in the House budget. Within the dental school, Ellen Byrne, Betsy Hagan, and Jim Revere were in strumental in contacting budget confer ees with whom they had close working relationships. Many other dentists in the VDA contacted other conferees on our behalf. In the end, the dentists were heard. When coupled with the General Assem bly's adoption of two statute changes for us - private practice preceptorships and temporary licenses for graduate students -- this was a great legislative session for the VCU School of Dentistry. The VDA also was instrumental in gaining those statute changes, sponsoring the legisla tion through Delegate Hamilton, and carrying the lobbying flag for us. Most notable in those efforts were Lobby ist Chuck Duvall, Executive Director Terry Dickinson, and Legislative Liaison Nicole Pugar of the VDA. The Virginia Board of Dentistry and the Virginia Dental Hygiene Association also helped draft HB 1049 and supported its passage. On behalf of the school, I'd like to thank all of these people For their guidance and support. Through the work of many, we were able to continue the remark able string of legislative successes for the dental profession and the public it serves in the Commonwealth of Virginia.

United Concordia Contributes to Mis sion of Mercy United Concordia Companies, Inc., has generously donated more than $48,000 to the School of Dentistry for expenses associated with the Mission Of Mercy (MOM). Through MOM, the school sends students, residents, faculty, and staff to contribute their skills and time to provide dental care to Virginians in underserved areas. The dental school anticipates participating in as many as six MOM projects per year. With a Glen Allen office in the greater Richmond area, United Concordia was looking for a unique service project in the Com monwealth. United Concordia is a dental insurance company with more than 6.5 mil lion members in the United States and abroad. Headquartered in Harrisburg, they carry the world's largest dental con tract on behalf of the U.S. Department of Defense. We thank United Concordia for their generous contribution and look forward to a fruitful relationship that will continue to advance the goals of the Mission of Mercy.

Alumni Return for Reunion Weekend 2004, Two Honored at Banquet On the weekend ofApril 23, 2004, more than 300 dental and dental hygiene alumni returned to the MCV Campus for the annual reunion week end. The festivities began on Friday evening with a reception hosted by the School of Dentistry and the MCV Alumni Association at the Richmond Omni Hotel.

'68 and Oral Surgery '71) was honored with the Harry Lyons Outstanding Alumni Award. A previous longstanding engagement prevented Tankersley from attending the banquet. However, his son, Dr. Ken Tankersley ('97), accepted the award on behalf of his father, who has been a tireless advocate for dentistry at all levels, including his dedication to the School of Dentistry, the Virginia Dental Association, the American Association of Oral and Maxillofacial Surgery, and the American Dental Association. This coming fall will mark his 30th year as a

member of the adjunct faculty. Dr. Lewis T. Rogers ('51) was awarded the School of Dentistry's first-ever Dr. James H. Revere, Jr. Outstanding Ser vice Award. Dr. Rogers was an adjunct faculty member of the school for almost his entire dental career. This year's award recognizes his tremendous dedication to service, and his 47 years of teaching at the dental school. This annual service award will recognize either an alumnus of the MCV/VCU School of Dentistry or an honorary alumnus who has shown outstanding leadership, loyalty, and service to the community, to the School or Univer sity, or to professional or community organizations. This award bears the name of Dr. James H. Revere, Jr. ('65) whose immeasurable contributions idealize the principles of this award. The award will be coordinated through the VCU School of Dentistry's Dean's Office and presented at the Annual MCV Campus Reunion Weekend dentistry dinner.

News Continued On Page 52

During the alumni banquet on Satur day evening, Dr. Ron Tankersley (DDS

Virginia Dental Journal

Continued From Page 12

future, bleach-lighr combinations may be found that will allow faster and better tooth lightening than the bleach alone. We are still waiting. I HAVE HAD ENOUGH! The solution-I suggest that editors of journals and magazines recruit thoroughly informed, honest consultants, who have had actual clinical experience with the concept being studied, to screen the advertisements, weeding out the mislead ing or overtly dishonest ads. Additionally, dentists need to be wary of advertising from companies known to exaggerate product characteristics or to misrepresent the advantages of their products in ads. Companies should realize [hat honest advertising is clearly evident to informed readers, and similarly dishonest ads soon are soon disproved by clinical results. When clinical research and experience do not confirm the claims in the ads, dentists soon lose confidence in believing any future ads from the company involved. ARTICLES IN JOURNALS A recent research paper published on the most commonly used esthetic dentistry procedure in a prestigious "peer reviewed" journal, and showing positive characteris tics for the product evaluated, was funded by the company selling the system. In some situations, this may be legitimate, but in this case, studies from other re searchers published in the same issue with the commercially supported paper would certainly have made the results more cred ible. Most companies are doing their best to be honest and sincere, but the few who flagrantly try to promote their products by "bought research" soon become identified by practitioners. A popular, well accepted technique was denounced in another research paper in a "peer reviewed" journal. Immediately, den tist participants in continuing education courses asked why the clinically success ful technique, which most of them were using, didn't do better in the research. After reviewing the paper, it was found that a third-party payment company, with obvious vested interests to reduce the use of the popular concept, had funded the research.

50 Virginia Dental Journal

You have read many scientific projects

that test a group of commercially avail

able products, and find one product to

be the best. It should not be a surprise to

find that the product from the company

funding the study had the most positive

results. Unfortunately, dental education

and dental educators have always been un

derfunded. Dental manufacturers provide

much of the funding for university-based

dental research. Although not impossible,

it is difficult for a dental faculty member

to remain totally unbiased, when accom

plishing a research project, if all or a major

portion of his/her salary comes from the

research grant. Additionally, when a com

pany-funded project does not come out

to favor a given product, it is well known

that publication of the ill fated project

can be delayed or stopped by the fund ing company. The recent tobacco research

fiasco is manifestation of this problem on a

larger scale. Such information is lost to the

public of practitioners until someone else

happens to study the same question.

Peer review of research in dentistry, with

a few exceptions, is not a guarantee that

a published paper has legitimate conclu

sions. In my opinion, peer review in den

tistry is in need of major revision, bringing

in many more practicing clinicians along

with their academic counterparts, and

using more than a few persons as reviewers

on controversial topics.

The solution-dentists-wake up! How

many companies can produce an unbiased

research project? I know a few, but there

are many that are questionable. Editors

publish more than one paper on the same

subject when a company- funded project

is published in your journals, recruit peer

reviewers who have expertise in the specific

subjects of the papers, and expand your

review teams to include more "real world"

practitioners who know clinical dentistry.

Companies - just be honest. We practitio

ners soon discover dishonest research by

simply observing our clinical results, and

you and the patients will be the losers.

EVALUATION OF PRODUCTS

Most dental journals/magazines have prod

uct endorsements in them from compa

nies or individuals that have been paid to

evaluate the products they are endorsing.

If independent companies want to evalu

ate dental products and report on them,

honesty in the results would be increased if these evaluations were accomplished without fees paid to the evaluating compa ny by the manufacturer that produced the product. The evaluating companies should obtain their income from publication of their data, or ocher means. The lay group, Consumer Reports, is a prototype for such evaluations. This company does not allow publication of their data for commercial purposes, but it is readily available from the company. Some dental companies use information from published papers in their product advertisements. With the permission of the author/researcher, and if the informa tion is used in fairness to other similar products in the study, such inclusions in ads appear to be appropriate. Reference to the published paper should be included. The solution-again, dentists beware! Analyze the source of endorsements carefully. When the endorsement in an advertisement looks questionable, money has probably changed hands. Companies, be honest! Your good products sell by word of mouth about clinical success. Honest, conservative ads are appreciated, and you are respected when practitioners read them. SPEAKERS ON THE LECTURE CIRCUIT After spending roughly 40,000 hours on the circuit, I can probably comment on this one with some experience. Can you smell a paidoff speaker? If you can't, you are pretty naive. Although for most of the larger meetings, speakers have to sign a statement that they are not being paid by companies producing products contained in their lectures, there are many devious ways to get around that challenge. How about paying spouses or other rela tives, funding children in college, donat ing to favorite charities in the speaker's name (this is okay if the money is donated in the company name and the speaker does not get a tax deduction), using company condos, cabins, or planes, paid vacations, and many other manufacturer perks? It is relatively easy to observe when a speaker favors one company or another in lectures. It is obvious when the speaker is selling his or her own dental product to the exclusion of other products in the course. Continued On Page52

Help Us Help You! At the 2004 Annual Meeting make sure you stop by the Exhibit Hall and visit the VDSC Endorsed Vendors. By visiting these seven booths, VDA Members are eligible to enter into the VDSC RAFFLE. RafRe winners will be announced following the conclusion of the exhibits. For more information about the VDA/VDSC Endorsed Vendor Program, please contact the VDA at 800-552-3886.

Booth 53 B&B Insurance

877-832-9113

Booth 61 Sky Financial Solutions

800-340-7460

Including endorsed Anthem health, endorsed GE Medical Protective malpractice, disability, life, home, auto, workers compo and long-term care insurance.

An MBNA Company, Sky offers practice and equip ment financing solutions to help you establish, grow and improve your practice.

Booth 54 LifeServers

Booth 62 GE Medical Protective

866-543-3500

800-344-1899

Automated External Defibrillators (AED) to help pro tect your patients, your staff and you.

Offering malpractice insurance that is highly rated and includes no arbitration clause.

Booth 55 C&F Investment Services 888-435-2033

Booth 56 Top Quality Manufacturing 800-483-8559

Investments, financial planning and management ser vices for both present and future financial planning.

Booth 60 SMARTMOVE®

Proving a full line of gloves for your office.

877-654-6560

Providing real estate rebates and personal move coun cilors who can assist you in the purchase and sale of real estate.

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Virginia Dental Journal

Continued From Page50

The solution-do not attend lectures of speakers who appear to be on the "take". These speakers soon expose their financial commitments by their overt favor of products, companies, or commercial tech niques. I have seen hundreds of speakers come on the circuit and burn our within a couple of years. Suggest reliable speak ers to your colleagues, especially younger dentisrs. SUMMARY I apologize for making some of you nervous, and perhaps even resentful, bur I HAVE HAD ENOUGHl I do not like rhe new unethical face of my profession, where incessant seeking of more money has replaced service to the public, honesty, and selfrespect, Numerous areas of major ethical concern in dentistry are identified in this article. The ongoing, if not accelerating, degenera tion of professional ethics in dentistry is clearly evident to even casual observers. Improvements in professional ethics are necessary to regain our self-respect and the respect of the people we serve. All of us need to improve, including practitioners, speakers, dental schools accomplish ing research, manufacrurers.editors, and evaluaring groups. It is time to rerum to honesty and to dealing with our fellow men and women in the way we would want to be treated ourselves. I do not rhink it is too late. BIO Dr. Gordon Christensen, a prosthodontist in Provo, UT, is Co-founder and Senior Research Consultant of Clinical Research Associares (CRA). Dr. Christensen is also the Director of Practical Clinical Courses, a continuing education career development program for the dental profession at Bring hamYoung University and the University of Utah. You can contact Dr. Christensen at: Practi cal Clinical Courses, 3707 North Canyon Rd., Suite 3D, Provo, UT, 84604-4587. FAX (801) 266-8637. Visit his website at gordonchristensen-pcc.com. Acknowledgment This article, appearing in the September 2003 issue has been reprinted with permis sion of Denral'Iown Magazine.

Your Personal Asset Allocation Submitted By: Douglas L Hartz, Branch Manager C&F Investment Services tend to have several needs and concerns Raymond James Financial in common (e.g., children, new home, Too many individual investors blur the distinction between "saving" and "invest ing". "Saving" is setting money aside in a secure location for a certain need or desire. "Investing" entails putting money to work toward achieving a financial foal with the possibility of generating return. As an investor, it is of utmost importance to be able to answer certain fundamental questions. Will your current investment portfolio be able to meet both short- and long-term investment objectives? Is your current portfolio correctly geared to your individual level of tolerance for risk? One sound way to answer these ques tions is by utilizing asset allocation - a disciplined, objecrive investment game plan that will help you meet your financial goals. Many financial professionals believe the asset allocation decision is the most impor tant step in the investment process. To be most effective, a personal asset allocation model should be tailored to your particular goals and needs. A simple asset allocarion model for an individual investor generally requires a portfolio of assets divided into three ca~ egories -stocks, bonds and cash. Each IS. assigned a fixed percentage. Based on this strategy, a conservative portfolio would generally contain more bonds and cash than stock. Since diversification of assets is generally recognized as a reliable way to reduce and manage risk in a portfolio, the mix of assets in your current spending requirements, tax implications and infla tion-adjusted return may also be addressed through the asset allocarion process. Asset allocation is flexible and revolves around personal needs. However, profes sional financial advisors have generally found that investors at various age levels tend to be best served by adopting alloca tion models that address the needs of their "life-cycle phase". In most cases, the longer your investment time horizon, the more aggressive your investment strategy might be. For example, investors in the 30s and 40s

52 Virginia Dental Journal

college education, retirement planning). To address these concerns, an asset alloca tion plan that emphasizes stocks is often recommended because they historically have provided superior returns over time. At the other end of the spectrum are in vestors who are close to or who maintain a lifestyle, or growth of their capital to ensure that they do not outlive their as sets. For these investors an above-average holding in bonds may be recommended. Obviously, these are guidelines. When implemenring as asset allocation strat egy, the various percentages allocated to stocks, bonds and cash should be assessed on a personal basis and reassessed annu ally. Be sure to check with your financial advisor regularly on your asset allocation strategy.

Virginia Department of Health News Continued From Page 49 Surveys by the Division of Dental Health (DOH) have shown that an average of 60% of Virginia children have decay in their primary teeth with increased risk of disease in permanent dentition and high treatment costs. This past year DOH used one year limited grant funds from the Maternal and Child Health Bureau to develop training materials for parental and provider an ticipatory guidance for the prevention of early childhood decay as well as informa tion on fluoride varnish application. Dr. Frank Farrington and JoAnn Wells worked on this project and have begun training for dental and non-dental professionals as well as pilot projects in some Head Start Centers. DOH will now be submitting a proposal for a State Oral Health Collabora tive Systems Grant to build on this year's accomplishments and expand educational information to high risk maternity patients. Data will also be collected on targeted groups of patients that will be participating in the program. As this grant cycle is for three years it is anticipated that if funded, there will be measurable results from the fluoride varnish intervention. Dr. Karen C. Day

Send Us Your Resume: Use your degree now to take the step from the ordinary to the extraordinary in the USAF. Enter a team where you can make a career out of defending freedom and honor in everything you do. For more details on becoming a dentist in the Air Force. Contact TSgt James Dull 9505 Hull St. 2 nd Floor Suite D Richmond Va. 23236-1421 804-276-0459 james.dull@rs.af.mi1

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Virginia Dental Journal

2004 Board of Directors Membership Survey Results

No:

7. If question 6 was answered yes, under what level of supervision should that duty be allowed:

The latest VDA survey says:

Direct: General:

l.Top three critical issues: 23% •Hygienist shortage •Insurance company issues 21.8% •Licensure by credentials 12.6% 2.Favor licensure by credentials for all dentists: Yes:

66%

No:

53%

37% 9%

Surveys returned: 819

Board responses to survey responses regarding hygiene shortage:

33%

VDAHouseof Delegates The Opening Session of the VDA An nual Meeting and the First Session of the House of Delegates will take place at 8: 15am, Thursday, September 9, 2004 at the Norfolk Waterside Mar riott Hotel. Issues will be discussed at the reference committee hearings following the House of Delegates. All VDA members are invited to attend to hear discussion of the issues that go before the House of Delegates Sunday, September 12th.

VDA Candidates

3.Model of licensure exa • Continue the clini rently is done bX • Eliminate live dentiforms or si • Completion of a ate general dentistr SRTA exam required 4. Model most favored giene practice: 1.Continue the c 64% model 2. Allow hygienists to prac tice also in alternative

create a volunteer license for retired dentist or dental hygienist during the to

Mark A. Crabtree ' avid C. Anderson, Charles L. CurGinder, Gus C. Weisberg A Alterna e e ega e - Mark A. Crabtree, Alonzo M. Bell, R~Ph L.

Virgrnia"')aEiitftl~iftssOiiiti;n

hygiene program at Thomas Nelson Community College, Williamsburg 5. Dental hygiene education model most Campus. (3) The Legislative Commit favored: tee will study, plan and recommend • Continue with current dental hygiene financing for development of a school education models 21 % of dental hygiene in the Shenandoah • Create an expanded function dental Valley and other areas of identified assistant (EFDA) to use as a scaling tech need for dental hygiene programs. nician 13% • Increase the number of 2-year dental hygiene programs 41 % We WANT To Hear What You • Create a model based on the Alabama plan 14% Direct:

General:

26%

6. Favor an appropriately trained dental hygienist being allowed to administer local anesthesia: Yes:

47%

56 Virginia Dental Journal

Think!

You have probably noticed that regular surveys appear in the Journal every quarter. These cards are an invaluable resource that the VDA staff uses to better serve your interests. Please take the time to fill out the surveys in your Journal and let us know what you think!

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