Advocate...Educate...Empower...Serve!
JUNE 2013 | Focus on: ‘The Jawbone’ (dental satire)
INSIDE THIS ISSUE
Springing into legislative action in Madison and local districts Carol Weber, APR WDA Director of Public Relations cweber@wda.org
p. 15
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POP award nominations needed....................... p. 5 Major changes to the Hazard Communication Standard..................... p. 6 WDA candidate line up........................ p. 7 Seal-A-Smile update... p. 16
Non-Covered Services legislation lead co-sponsors state Sen. Jerry Petrowski (R-Marathon) and state Rep. Joan Ballweg (R-Markesan) take turns addressing the Legislative Day audience. The energy in Madison’s Monona Terrace ballroom was palpable on March 27 when 255 dentists, dental hygienists, Marquette University School of Dentistry students, faculty and Wisconsin Dental Association staff gathered for Legislative Day 2013. Attendees were excited to hear from an impressive lineup of Democrat and Republican state legislative leaders and Gov. Scott Walker before canvassing the Capitol to convince 80 legislators to co-sponsor the non-covered services bill. (Subsequently, it was introduced as Assembly Bill 109 and Senate Bill 131 and passed by wide margins of 89-8 in the Assembly and 30-3 in the Senate.). WDA President-Elect Dr. Julio
Rodriguez (Brodhead) hosted this year’s “Democracy – and Dentists – in Action” event. Member dentists with strong constituent relationships provided a “personal touch” when welcoming these state lawmakers to the podium: • Assembly Speaker Robin Vos (R-Burlington) • Senate Majority Leader Scott Fitzgerald (R-Beaver Dam) • Assembly Minority Leader Peter Barca (D-Kenosha) • Joint Committee on Finance CoChair Rep. John Nygren (R-Marinette) • Senate insurance and health committee member Sen. Jon Erpenbach (D-Middleton)
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Six new members!
The Wisconsin Dental Association advances the interests of its members and the dental profession by promoting professional excellence and quality oral health care for the public.
Mission Statement:
The Wisconsin Dental Association is pleased to welcome six new members to organized dentistry. These new members, their cities of practice and/or residence or components (if applicable) are: Dr. Ryan Dulde, Hales Corners Greater Milwaukee Dental Association
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is a publication of
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Dr. David Kujak, Onalaska La Crosse District Dental Society
Justin Rhoe, RDH Dr. Brenda Garrison, Fort Atkinson Monroe Jefferson County Dental Society Crystal Rosenbrook, RDH Lauren Haun, RDH Eau Claire Sparta
WDA J ournal
• NCS lead co-authors Rep. Joan Ballweg (R-Markesan) and Sen. Jerry Petrowski (R-Marathon) Speaker Vos commended the WDA on its efforts to meet with opponents of the NCS legislation and come up with a bill that is more closely resembles the one passed in 30 other states, “You deserve a lot of credit for working to make this happen.” “Remember to get a ‘yes’ when asking your legislators to sign on as a co-sponsor,” he added. Building off Speaker Vos’s comments, Rep. Ballweg said, “Getting something done is more important than sticking to your guns while the whole ship sinks.” She told dentists to talk about
W isconsin D ental A ssociation , I nc .
From left, Dr. Tom Kraus (Fond du Lac) and two of his team members – Barb and Holly – look forward to hearing “Z” man Gary Zelesky’s message about bringing your passion for life to the dental office. Visit the Wisconsin Dental Association’s Flicker page to view and download more photos from WDA InSession 2013.
and visit us online @ WDA.org JUNE 2013 • Volume 89, No. 6
ATLs build relationships at the federal level John Moser, DDS ATL Statewide Coordinator jmoser@wda.org
Advocacy is one of the most important things our membership wants from the Wisconsin Dental Association. We advocate not only at the state level, but also at the federal level. The American Dental Association set up an Action Team Leader program at the federal level. An action team leader, or ATL, is the lead “go to” dentist responsible for building relationships between the local dental community and each U.S. House of Representatives member. Wisconsin has eight congressional districts, and we have one ATL in each district. An ATL statewide coordinator is responsible for communicating with our two U.S. senators, and ensures there is an ATL in each congressional district. I served as the ATL for the 4th Congressional District for five years, and then became the ATL statewide coordinator. Leading up to these positions, I attended the ADA’s National Grassroots Conference (now the Washington, D.C. Leadership Conference) in 1998. I went to this meeting on my own dime. I felt the political process was important enough to invest my
own money. Afterward, I submitted a report to the Greater Milwaukee Dental Association board which said, “I firmly believe we need to stay politically active if we want to keep the independent practice of dentistry alive and I personally found this conference to be a great experience. I would recommend that all directors and executive committee members take advantage of it. I will be there next year, too. While this conference dealt with national issues, many of the concepts carry over to local and state politics. It is how the system works. We DO need to look at political contributions as a cost of doing business.” Some of the leadership conferences have been great while others did not have the same caliber of speakers. Many times, ATLs were frustrated to take time out of their practices to attend only to meet with staffers rather than elected officials themselves. Therefore, the WDA decided to save our dues dollars and to also make our communications with our federal representatives more than just a thing that happens “out in D.C.”. WDA currently sends three people to the leadership conference and encourages
Action Team Leaders U.S. Representatives Paul Ryan (R) – Dr. Francesca DeRose (Racine) and Dr. Ned Murphy (Racine) Mark Pocan (D) – Dr. Russ Christian (Mount Horeb) Ron Kind (D) – Dr. Timothy Durtsche (La Crosse) Gwen Moore (D) – Dr. Michael Donohoo (Milwaukee)
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F. James Sensenbrenner (R) – Dr. Gene Shoemaker (Waukesha) Thomas Petri (R) – Dr. Steve Stoll (Neenah) Sean Duffy (R) – Dr. Gary Martin (Marshfield) Reid Ribble (R) – Dr. Craig Janssen (Green Bay) U.S. Senators Tammy Baldwin (D) and Ron Johnson (R) – Dr. John R. Moser (Milwaukee)
ADVOCATE
U.S. Sen. Ron Johnson (R) with ATL Statewide Coordinator Dr. John R. Moser (Milwaukee) during the ADA Leadership Conference in Washington, D.C. in May 2013.
all ATLs to invest their time in setting up meetings between a group of local dentists and their congressional representative back in the districts. As WDA treasurer, I am working hard to try to keep dues stable during these trying economic times. As ATL statewide coordinator, I would love to see us at full strength in our nation’s Capitol as it helps make a difference to meet in-person, in addition to setting up meetings in the district. Legislative staff does run the world! If you have an interest (and if the ATL is not already attending), the ADA is still willing to pay airfare to attend a future leadership conference for one person from each congressional district. All other expenses would be your responsibility (as my first meeting was), but are deductible as a business expense. Sometimes politics feels like running head first into a wall. However, not being at the table can hurt even more. A lot more.
Spring/Summer 2013
in this journal The Wisconsin Dental Association is pleased to make the print version of our patient newsletter available to our 3,100 members and their patients as a way of communicating oral health information and promoting quality care. We encourage you to place this public information tool in your waiting area for patients to enjoy and to use as a basis for chairside education. Tongue ‘n’ Cheek … and Teeth, too! also can be downloaded on WDA.org as a PDF or viewed in a digitial-flip format. A limited number of hard copies are available on a first-come, first-served basis. To request copies, contact WDA Communications Coordinator Emily Bultman at ebultman@wda.org or 414755-4110.
Patients can sign up for new, quarterly e-newsletter Tongue ‘n’ Cheek… and Teeth, too! now can come straight to your patients’ inbox four times a year as an electronic, quarterly newsletter. The next e-newsletter will launch at the end of May 2013. Patients can subscribe at www.wda. org/enewslettersign-up.
June 2013 WDA.org
ADVOCATE
Legislative continued from page 1
outreach efforts like Mission their small-business circumof Mercy. stances while clarifying that MUSOD Dean Dr. William NCS leads to greater transLobb (Milwaukee) provided parency in costs when seekthis year’s Legislative Day ing legislative co-sponsors. audience with an update on “Stories drawn from perdental school expansion. sonal experiences stick with He also highlighted a new legislators,” she emphasized. school brochure that stu Saying, “It’s not right that dents would share with leginsurance companies set fees islators during their Capitol for services they won’t pay visits. for,” Sen. Petrowski urged The morning’s program dentists to get their patients concluded with a panel of involved in dental-related WDA contract and staff loblegislative efforts. byists helping attendees nail A morning media advisodown NCS talking points ry from the governor’s office and last-minute details. about his WDA Legislative Greg Hubbard of the Day appearance brought Hubbard, Wilson and Zelenreporters from eight local The WDA is piloting grassroots meetings to strengthen member-legislator rekova government affairs firm and state media outlets lationships. Dr. Julie Lesher (Hudson), Dr. David Doroff (Amery), state Sen. sent the citizen lobbyists on to the meeting, including Sheila Harsdorf (R- River Falls) and Ms. Ashley Sempf, office assistant for their way with this rallying Wisconsin public radio and Dr. Tom Hauge (Osceola) met at the first coffee meeting in March 2013 to cry, “Focus on your story! television, the Milwaukee discuss various issues. We’re on the right side of Journal Sentinel and The following a standing ovation welcome. He this (NCS) issue!” Associated Press. then went on to thank all WDA members “I’m pleased to hear of your work to get for serving their local communities as oral In-district grassroots pilot update something constructively done about your health providers, business owners/employThe WDA is also working to strengthen top legislative issue,” said Gov. Walker ers and participants in charitable care
member-legislator relationships statewide at the local district level by piloting grassroots meetings. “The goal is to provide an intimate venue for small groups of member dentists to meet with their elected officials for about an hour over coffee to talk about issues affecting dentistry,” explains Executive Director Mark Paget. Contract lobbyist Forbes McIntosh of Government Policy Solutions is on hand to facilitate each discussion. Two meetings were held in March and April with state Rep. Erik Severson (R-Osceloa) and state Sen. Sheila Harsdorf (R-River Falls). Other meetings are being planned for later in the legislative session (e.g., July, August) when lawmakers are not as busy in Madison. These gatherings will most likely be scheduled for late afternoon around 5:30 p.m. to better accommodate dentists’ busy patient schedules. “Please take the time to participate in these ‘Tooth Party’ meetings when they are scheduled in your area. The personal contacts and time spent will greatly increase WDA’s chances of legislative success in the coming months and years,” Mr. Paget added.
WDA Government Buzz gives members a snapshot of the current status of dental-related policies and legislation. The Issue tells you who, what and why; Current Buzz gives you a status update on the issue; WDA Actions highlights your professional association’s activity and position; and Next Steps anticipates what’s around the corner and, in some cases, identifies what WDA members can do. “WDA Government Buzz” is updated for each issue of the journal. Current “buzz” available on WDA.org website and accessed monthly via WDA Executive Director’s Update e-newsletter. For more information, visit WDA.org or call the WDA Legislative Office at 608-250-3442. Updated information is highlighted.
The Issue Non-Covered Services or NCS legislation to stop dental plans from setting fees for services they don’t reimburse. Provides for transparency in the cost of care and also keeps treatment decisions between dentist and patient; improves small-business climate with marketplace determining reasonable fees.
Current Buzz
WDA Actions
Next Steps
Hours of meetings facilitated by Assembly Speaker Robin Vos (R-Burlington) and including the WDA, NCS bill lead sponsor Rep. Joan Ballweg (R-Markesan) , Assembly Insurance Chair Rep. Kevin Petersen (R-Waupaca) R-Burlington) and insurance representatives were held during March to determine middle-ground on the bill.
After significant discussion between dentist leaders, staff and lobbyists, the WDA agreed to compromise language similar to National Council of Insurance Legislators (NCOIL) model legislation plus a “de minimis” clause. This would prevent insurance companies from paying a nominal fee (e.g., $5 for an implant) and then calling the service “covered” and being able to dictate the fee. (Tennessee is the only other state with a de minimis clause).
WDA pleased to have almost twice the number of co-sponsors this session at 90 and strong bipartisan (45 Republications and 45 Democrats) support in both houses (69 of 99 Assembly members and 21 of 32 Senators).
Prior to Legislative Day there were a dozen Assembly and Senate co-sponsors. Within days of dentists and students visiting legislators a reMinimal fiscal impact on state budget. Existing New York law prevents NCS capping, markable 80 (out of 132) legislators signed on as which means 31 states prevent the practice; 30 co-sponsors of Assembly Bill 109/Senate Bill131. have passed stand-alone NCS legislation on The NCS bill passed a floor vote in the Assembly margins of 10-to-1 since 2009. April 17 with a final count of 89-8 (See roll call at http://1.usa.gov/11qaqgm). It passed the Senate on May 7 with a vote of 30-3.
WDA considers this a key step in the right direction to stopping the unfair tactics of insurance plans trying to dictate fees on dental services they don’t cover anything for.
WDA dentists asked to thank their legislator if they are in the group of 119 who voted for the bill. Find legislators and contact info here: http://1.usa.gov/VUSd1M. Contact Mara Brooks at 608-250-3442 or mbrooks@wda.org with questions.
President Dr. Tim Durtsche (La Crosse) testified before the Assembly Insurance Committee on April 4. Vice President Dr. Paul Levine (Milwaukee) testified before the Senate Energy, Consumer Protection and Government Reform Committee on April 16. The governor is being asked to sign the bill into law.
Dr. Jeff Chaffin is Wisconsin’s new state dental officer. He will join the Division of Public Health in the Department of Health Services on May 6 replacing Dr. Warren LeMay who retired last September.
Dr. Chaffin recently completed a 21-year Army career. His last assignment was as dental chief for TRICARE Management Activity with responsibility for oral health policy for the Department of Defense and managing three large multibillion dollar military dental insurance programs. A distinguished military graduate from the University of Tampa, he has a DDS from University of Nebraska and masters in public health, business administration and health care administration. Dr. Chaffin completed a one-year general dentistry residency at Fort Sill, Oklahoma.
WDA Madison and DHS staffers meet regularly to facilitate communications and cooperation on a range of oral health topics, such as public water fluoridation and statistical efforts to measure the impact of dental disease in Wisconsin.
WDA President Dr. Tim Durtsche (La Crosse) will invite Dr. Chaffin to meet with the Board of Trustees at an upcoming meeting.
The WDA was hopeful a licensed dentist would continue to serve as the state’s chief dental officer to help oral health care issues get the attention (staff time and state budget dollars) they deserve.
He is a diplomate of the American Board of Dental Public Health and a fellow of the American College of Healthcare Executives and International College of Dentists. A member of the Official Order of Military Medical Merit (O2M3), he holds the Surgeon General’s “A” designator for excellence in dental public health.
Legislative-related meetings 2013 • Dentistry Examining Board: July 10, Sept. 4, Nov. 6; all meetings are held at Department of Safety and Professional Services, 1400 E. Washington Ave. in Madison and start
promptly at 8:30 a.m.
WDA.org
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Messages
Timothy Durtsche, DDS, WDA President tdurtsche@wda.org
InSession merging with WDA House in 2014 – plan now to attend
W
e have just finished our WDA InSession – Wisconsin’s Largest Dental Study Club held in Wisconsin Dells. Hundreds of our member dentists, hygienists, assistants and office staff came together for a variety of lectures, interactive learning sessions, a terrific keynote speaker and an exhibit hall housing more than 100 booths with the latest and greatest equipment, new materials and an opportunity to visit with colleagues from around the state. By now, you have probably heard that this was the last time for a spring InSession. Beginning in 2014, InSession will be combined with the WDA House of Delegates. The event will be held Nov. 13-15 at the convention center in downtown Milwaukee. Some of you may remember when the annual session was held with the House, but it was eventually separated to allow the delegates to attend continuing education programs and visit the exhibit hall.
The WDA Annual Session Committee and staff are working hard to make this merger succeed. It requires some creative scheduling, but the advantage for our delegates to participate in the CE and for the rest of our attendees to be able to observe the House will be a win-win.
The WDA is our organization. We want to provide the continuing education, activities and events that are helpful to you. The Michigan Dental Association has been doing this for years with great success. Over the past few years, attendance at our annual session has dropped. The Chicago Midwinter, Minnesota and Iowa meetings have been tough to compete with.
We are confident that by moving InSession to the fall, there will be more interest by our members and staff attending to get their CE, enjoy class reunions and participate in social events. There will be several hands-on courses for your entire staff to take, so please make it a point to include your staff when you attend next year. If you are someone who usually doesn’t participate in WDA InSession, we are interested in what combination of courses and activities or other ideas you have to make the event a destination event for you and your staff. Please contact WDA Associate Executive Director Lani Becker at lbecker@wda.org or 414-755-4114 and share your suggestions or complete our short survey at http://svy.mk/12ZidxC. The WDA is our organization. We want to provide the continuing education, activities and events that are helpful to you.
Robert Brennan, DDS, WDA Editor rbrennan@wda.org
New ADA/AAOS guidelines for antibiotic prophylaxis
I
n 1997, the American Dental Association and the American Association of Orthopedic Surgeons issued guidelines for antibiotic prophylaxis for patients with prosthetic joints. Those guidelines recommended antibiotic prophylaxis for all patients the first two years post-op and after that only for patients with certain “high risk” medical conditions. This replaced the original recommendation of antibiotic prophylaxis for all patients for the rest of their lives. In 2009, the AAOS unilaterally issued a statement that recommended a return to the original guidelines of antibiotic prophylaxis for all patients for the rest of their lives. This was a step backward and created much confusion within the dental community, as it conflicted with the ADA’s recommendation. Finally after three years of uncertainty, the ADA and AAOS recently issued a report and guidelines titled “The Prevention of Orthopaedic Implant Infections in Patients Undergoing Dental Procedures”. This report was formulated by a diverse panel of physicians and dentists. They did a thorough literature search and reviewed all the relevant studies. Recommendations were sent to numerous interested parties for their comments before they were published. I reviewed the entire report, which is over 300 pages
Editorial Advisory Board WDA Editor Robert Brennan, DDS, Neenah 920-725-0551 • rbrennan@new.rr.com Robert Darling, DDS, Sheboygan 920-457-1717 • rdarling@midwest-dental.com Ellyn English, DDS, La Crosse 608-775-2696 • ellynmenglish@gmail.com Glenn Gequillana, DDS, Milwaukee 414-649-3510 • nicjenglen@msn.com Gene Shoemaker, DDS, Waukesha 262-542-0326 • gopackshoe@aol.com
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long, and it appears to be a well-done, evidence-based document. Full guidelines can be accessed at http://bit.ly/Vj6VSk.
The panel made three recommendations. Recommendation 1: The practitioner might consider discontinuing the practice of routinely prescribing prophylactic antibiotics for patients with hip and knee prosthetic joint implants undergoing dental procedures. There is only one study that tried to show a relationship between dental treatment, antibiotic prophylaxis and joint infection and it showed no relationship. Studies have shown that dental treatment causes bacteremias and that antibiotic prophylaxis likely prevents bacteremias, but there are no studies to show that dental bacteremias cause joint infections. In fact, staphylococcus bacteria cause most joint infections rather than the streptococcus bacteria that are associated with most dental bacteremias.
Submitting
Recommendation 2: We are unable to recommend for or against the use of topical oral antimicrobials in patients with prosthetic joint implants or other orthopaedic implants undergoing dental procedures. There is conflicting evidence regarding the effect of antimicrobial mouth rinses on the incidence of bacteremias and there is no evidence that antimicrobial mouth rinses prevent joint infections. Recommendation 3: In the absence of reliable evidence linking poor oral health to prosthetic joint infection, it is the opinion of the work group that patients with prosthetic joint implants or other orthopaedic implants maintain appropriate oral hygiene. Although there is no evidence that poor oral health causes prosthetic joint infections, good oral health is beneficial and will help reduce bacteremias. Oral hygiene measures are low cost, provide potential benefit, are consistent with current practice and are in accordance with good oral health. These guidelines are just another example of the benefits of organized dentistry. From the day the AAOS released their recommendation in 2009, the ADA has worked hard to bring all the interested parties together to reach an evidence-based consensus on the need for antibiotic prophylaxis of patients with prosthetic joints.
letters to the editor
The WDA Journal invites readers to express their views in letters to the editor. This provides a forum for discussing topics of interest to the dental profession. To be considered, letters must be 300 words or less and signed with an e-mail address or phone number. The Editorial Board reserves the right to edit for space, clarity, civility and accuracy. Any changes will be shared with the writer before publication. If your letter is selected, contact will be made to confirm receipt.
Submit letters to the editor via email to ebultman@wda.org or fax to 414-755-4111. You may also mail your letter to: WDA Journal | Attn: Dr. Robert Brennan | 6737 W. Washington St. | Suite 2360 | West Allis, WI 53214 WDA style note: We make every effort to bold members’ names in articles.
June 2013 WDA.org
Executive Director Corner
JUNE 2013 V OL UME 89, N UM BE R 6
Pyramid of Pride Award nominations needed Mark Paget WDA Executive Director mpaget@wda.org
Editor Robert Brennan, DDS, Neenah 920-725-0551 • rbrennan@wda.org Executive Editor Mark Paget 414-755-4100 • mpaget@wda.org Managing Editor Emily Bultman 414-755-4110 • ebultman@wda.org OFFICERS President Timothy Durtsche, DDS, La Crosse 608-784-7319 • tdurtsche@wda.org President-Elect Julio Rodriguez, DDS, Brodhead 608-897-8645 • jrodriguez@wda.org Vice President Paul Levine, DDS, Milwaukee 414-355-0213 • plevine@wda.org Past-President Steven Stoll, DDS, Neenah 920-725-4307 • sstoll@wda.org Treasurer John R. Moser, DDS, Milwaukee 414-273-9800 • jmoser@wda.org Editor Robert Brennan, DDS, Neenah 920-725-0551 • rbrennan@wda.org Executive Director/Secretary Mark Paget, West Allis 414-755-4100 • mpaget@wda.org Region 1 Northwest David Kenyon, DDS, Altoona 715-832-3385 • dkenyon@wda.org Jeff Nehring, DDS, Mercer 715-476-3432• jnehring@wda.org Jennifer Peglow, DDS, Stevens Point 715-344-2324 • jpeglow@wda.org Region 2 Northeast Paul Feit, DDS, Sturgeon Bay 920-743-6976 • pfeit@wda.org Peter Hehli, DDS, Appleton 920-997-1557 • phehli@wda.org Jeffrey Kraig, DDS, Fond du Lac 920-922-9000 • jkraig@wda.org Region 3 Greater Milwaukee Thomas Kielma, DDS, Milwaukee 262-649-3510 • tkielma@wda.org Lynn Lepak-McSorley, DDS, Milwaukee 414-383-8787 • llepak-mcsorley@wda.org Thomas Raimann, DDS, Hales Corners 414-425-1510 • traimann@wda.org Region 4 Southeast Ryan Braden, DDS, Lake Geneva 262-248-0120 • rbraden@wda.org Cliff Hartmann, DDS, Greenfield 414-543-4700 • chartmann@wda.org Ned Murphy, DDS, Racine 262-886-9440 • nmurphy@wda.org
The Wisconsin Dental Association is recognized as one of the most active dental constituent organizations in the United States. Our members are engaged and passionate about their profession. In addition, WDA’s outreach extends into communities, the media and legislators throughout the state. Since joining WDA in 2006, I have been impressed with the level of volunteer involvement among members. One of the ways that WDA recognizes and salutes the various things that individuals and organizations do to improve the oral health of Wisconsin residents is with our annual Pyramid of Pride Awards. Since its inception in 1999, dozens of awards have been presented to an
impressive list of WDA members, media representatives, community leaders and elected officials. With the July 15 nomination deadline rapidly approaching, we need your help in identifying deserving and qualified candidates for our 2013 awards in each of the following nine categories: • Lifetime Achievement • Community Outreach • Friends of Dentistry Award • Media Awareness • Media Relations • New Dentist Leadership • Outstanding Leadership in Mentoring • Political Action • WDA Award of Honor
Working harder to prioritize member needs
The POP award nomination form is on page 102 of the WDA 2013 Sourcebook (Practice Guide and Member Directory) that was recently mailed out. Visit WDA.org to review award criteria and learn more. I encourage all members to consider nominating a colleague or organization for one of these prestigious awards. POP awards will be presented during the WDA House of Delegates meeting on Nov. 15 in Middleton, Wis. I appreciate your assistance in helping to ensure this program continues to recognize those making a difference. As always, feel free to contact me if you have any questions or would like more information.
ADA Report
Dennis Engel, DDS, CDE ADA 9th District Trustee engeld@ada.org
There’s nothing better than four cold rainy days in Chicago when you have to attend an American Dental Association Board of Trustees meeting. I’m kidding, of course, but the following is a recap of the accepted reports and actions the Board recently took for the good of the association, practice of dentistry and quality oral health care. First, there’s some troubling news. The ADA ended 2012 with an active membership of 128,524 out of a total market of 194,160, for a membership market share of 66.2 percent. This represents a small decrease of 195 active members, and a market share decline of 1.1 percentage points. Overall dentist membership was up at 160,117. The number of active members was up in some key member segments, includ-
ing women, minorities and new dentists. The ADA saw a modest increase in the minority market share from 53.3 percent to 53.4 percent. Still, it is not good enough. The continuing decline in market share is causing concern. In Wisconsin, the market share is 80 percent, while in Michigan it is 76 percent. We must be doing something right here in the 9th District. But the situation’s worse in many other states, many of them larger states, where market share has been slipping fast, and thus pulling down the ADA’s overall numbers.
These concerns are being addressed in several ways. For example, a team of constituent and component executives are now working with the ADA to prioritize nearly 40 recommendations for all tripartite associations to align programs with member needs in high-impact, mutually supportive ways. Final recommendations will emerge from the 2013 Management Conference for either implementation by executive directors or further consideration by leaders as appropriate. The ADA is planning several other approaches, given the urgency of the continued on page 11...
Region 5 Southwest L. Stanley Brysh, DMD, Madison 608-417-6500 • lbrysh@meriter.com David Clemens, DDS, Wisconsin Dells 608-254-2345• dclemens@wda.org Patrick Tepe, DDS, Verona 608-848-4000 • ptepe@wda.org Region 6 Student Region Derek Schmidt Marquette University School of Dentistry dschmidt@wda.org Speaker of the House Richard Lofthouse, DDS, Fennimore 608-822-3770 • dlofthouse@wda.org ADA 9th District Trustee Dennis Engel, DDS, CDE, Mequon 262-242-8929 • engeld@ada.org Member Publication
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Key
BUSINESS
takeaways...
of Dentistry
• Review HCS changes with your staff to ensure compliance before June 2015. • Crowns and root canal therapy are two most frequent claims. • Sharing DPH’s brochure is the best way to help anyone asking about mobile dentistry services.
Major changes to the Hazard Communication Standard
Don’t become a claim statistic
Katherine Schrubbe, BSDH, MEd, PhD MUSOD Clinical Associate Professor kathy.schrubbe@marquette.edu
New changes to the Occupational Safety and Health Administration’s Hazard Communication Standard are bringing the United States into alignment with the Globally Harmonized System of Classification and Labeling of Chemicals, further improving safety and health protections for America’s workers. Building on the success of OSHA’s current Hazard Communication Standard, the GHS is expected to prevent injuries and illnesses, save lives and improve trade conditions for chemical manufacturers. Issued in March 2012, the new standard will prevent an estimated 43 deaths and result in an estimated $475.2 million in enhanced productivity for U.S. businesses each year. Dental health care providers and employers are required to comply with these new directives, because there is risk of exposure to chemicals used in dental care delivery as well as those involved in cleaning and disinfecting the dental workplace. OSHA outlines three major changes – hazard classification, labeling and safety data sheets.
Hazard classification The new, updated standard provides specific criteria to address health and physical hazards, as well as classification of chemical mixtures. This will ensure evaluations of hazardous effects are consistent across manufacturers, and labels and safety data sheets are more accurate. Labeling Chemical manufacturers and importers must provide a label that includes a signal word, pictogram, hazard statement and precautionary statement for each hazard class and category. Labels for a hazardous chemical must contain: • Name, address and phone number • Product identifier • Signal word • Hazard statement(s) • Precautionary statement(s) • Pictogram(s) As of June 1, 2015, the HCS will require pictograms on labels. Each pictogram consists of a symbol on a white background framed within a red border and represents a distinct hazard. How will this impact the dental health care team? Employers will be responsible for maintaining labels on containers, so they do not become faded, removed or illegible. All team members should be familiar with the new labels as they arrive on products/supplies.
According to OSHA, employers have the option to create their own workplace labels with the required information. Safety data sheets Starting in June 2015, the HCS also requires manufacturers, importers and distributors to provide safety data sheets, formerly known as Material Safety Data Sheets. These updated information sheets must be presented in a consistent, userfriendly, 16-section format. OSHA states employers must ensure that SDSs are kept in a binder or on computers, as long as there is a backup so that they are readily accessible to employees.
Claim data can be sorted and evaluated in many ways. The most useful risk management aspects of claim data are derived by studying injuries that patients allege, the likely cause of the alleged injury and the dental procedure that resulted in the injury. A “claim” is the receipt of a demand for money or services, naming the insured and alleging a dental incident. It also includes covered dental licensing board complaints. An “indemnity payment” is a payment made by an insurance company to a claimImplementing and training ant, on behalf of an insured dentist. All indemnity payments are required by The HCS is intended to benefit workfederal law to be reported to the National ers by reducing confusion about chemical Practitioner Data Bank. hazards in the workplace, facilitate safety Percent of total claims is the number of training and improve understanding. reported claims arising from a procedure. It is stated as a percent of the total number of It will not be fully implemented until reported claims. 2016. In the meantime, phase-in dates Percent of total dollars is the amount of have been delineated for compliance. money spent on claims arising from a particular procedure. This is stated as a percent of By Dec. 1, 2013, employers are required the total dollar volume spent on all reported to train dental team members on the new claims. labeling and SDS format. Claims can be separated by dental pro Ordinarily, dental offices do not store cedure, cause of loss and type of loss.
large amounts of hazardous chemicals. However, it is important for dental team members to be aware of any hazards they may encounter from the materials used in the practice of dentistry. References and additional information available at http://1.usa.gov/9OwDX3.
Antitrust, dentistry and YOU Addressing questions regarding mobile dentistry in Wisconsin Kate Bechen Attorney, Michael, Best and Friedrich LLP
The Wisconsin Dental Association is aware that for-profit, mobile dentistry businesses continue to approach school districts and nursing facilities across Wisconsin. These businesses offer limited preventive dental services to public and private school students and nursing home residents. Concerns about the scope, quality of care and accuracy of charges by some for-profit mobile dentistry businesses have been raised by the American Dental Association. At least 10 states have adopted regulations to address these mobile dentistry concerns. In Wisconsin, the Department of Health Services’ Division of Public Health, in collaboration with the Wisconsin Oral Health Coalition and the Children’s Health Alliance of Wisconsin, has published a list of frequently asked questions and answers to help guide schools and nursing homes approached by mobile dentistry marketers. WDA members contacted by school or nursing home officials seeking information on mobile dentistry should direct inquiries to DPH’s brochure (posted on WDA.org at http://bit.ly/10bWHcG). This is an appropriate and easy way to
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help local organizations get the information they need. WDA members should avoid discussing pricing, quality of services or other similar issues. DPH is also available by phone at (608266-1251) to help school and nursing home personnel review these for-profit mobile dentistry companies. With a mission statement that calls for “…promoting professional excellence and quality oral health care for the public,” the WDA will continue to work with the state, WOHC, CHAW and other partners to address any quality and continuity of care concerns surrounding mobile dentistry. But, member dentists and dental hygienists are reminded that any concerted action by the WDA, individual dental professionals or groups of members in regards to mobile dentistry may be seen as anti-competitive. Do not discuss the mobile dentistry issue – either in person or via email – with colleagues. Do not comment on these operations to patients, or to the public or media. Again, sharing
Mara T. Roberts, CLU, RHU, REBC WDAISC President mroberts@insuranceformembrs.net
DPH’s brochure is the best way to help anyone asking about mobile dentistry services. A formal Antitrust Statement was adopted by the WDA House of Delegates in 2008 to help association leaders, staff and individual members comply fully with all federal and state antitrust laws, rules and regulations. That Antitrust Statement has been updated and can be found in the 2013 WDA Sourcebook (Member Directory and Practice Guide) on page 49. The statement and other antitrust information and education resources also are available on WDA.org under the Practice and Legal FAQ section (member login required). DISCLAIMER: This WDA publication and article are only intended as an informational guide for individual dentists and Wisconsin components regarding the application of antitrust laws to certain areas of dentistry. The information is not intended as specific legal advice and cannot serve as a substitute for consultation with one’s own attorney.
Dental procedure • Based upon percent of total claims: Crowns at 14.2 percent • Based upon percent of total dollars: Root canal therapy at 19 percent Cause of loss • Based upon percent of total claims: Inadequate precautions to prevent injury at 23.2 percent • Based upon percent of total dollars: Treatment failure at 22.6 percent
Type of loss • Based upon percent of total claims: Corrective dental treatment required at 19.9 percent • Based upon percent of total dollars: Corrective dental treatment required at 25.8 percent Comparison of average indemnity payments by dental procedure While only 5 percent of total closed claim count, “fixed bridges, implant supported” accounted for the highest average indemnity payment at $120,000. The highest percentage of total closed claim count at 14.2 percent was “crowns” with an average indemnity payment amount at $16,065. Almost 20 percent of total claims were labeled “corrective surgical treatment required” and the average indemnity payment amount was $29,644. What are some of the non-procedural areas of claims we see starting to pick up? Employment practices liability is on the radar, as is failure to protect patient medical and personal information. Regardless of size, every dental practice should have an employee handbook and provide a professional office environment. With the increased dependence on electronic health records and the transmission of patient information electronically, it becomes critical that proper systems are in place to store and encrypt to avoid this sensitive information falling into the wrong hands. Wisconsin Dental Association Insurance and Services Corp. has a variety of resources to assist you with risk management. Don’t become a claim statistic. Source: CNA HealthPro Dental Professional Liability Risk Management
June 2013 WDA.org
WDA Trustee candidate line-up These are condensed CVs; for full CVs, visit the officer vacancies page on WDA.org (member login required).
Northwest Region 1 Jeffrey M. Nehring, DDS PO Box 146 5222 Hwy 51 Mercer, WI 54547-0146 715-476-3432 jeff@jnehring.com
Education University of Wisconsin-Milwaukee, Bachelor’s Degree, 1975 Marquette University School of Dentistry, Doctor of Dental Surgery, 1979 Practice Private practice in Mercer, Wis., 1979-present Professional American Dental Association • Member, 1979-present • Alternate delegate, 2010 Wisconsin Dental Association • WDA Trustee Northwest Region 1, 2008-present • Mid-Level Provider Task Force, chair, 2012-present Other Organizations • Pierre Fauchard Academy • National Oral Health Conference attendee, 2010-2013 Community Activities • Grandview Hospital Board, 2001-present; chair, 2006-present • Aspirus Wausau Inc. and Hospital Board, 2011-present • Indianhead Ski Patrol Volunteer 2007-Present
Practice General dentistry, with an emphasis on sedation dentistry two locations, Appleton and Sheboygan, Wis.
Community Activities • Crosspoint Community Church • Delafield Chamber of Commerce • Veritas Society
Professional American Dental Association • Alternate delegate, 2005-2006, 2013 • Tri-Partite Initiative Task Force, 20042006 • Annual Session attendee, 1999-2008
Family • Married for 37 years to Amy • Four children: Carolyn, Elizabeth, Emily and Molly • Five grandchildren: Dylan, Jason, Madeline, Mackenzie and Myles
Wisconsin Dental Association • WDA Trustee Northeast Region 2, 2011-present • Annual Session Committee, 2004-present • Legislative Advocacy Committee, 2004-present
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Outagamie County Dental Association • President, 2010 • President-elect 2009 • Executive Committee, 2004-2011
Family • Married to Lynlee • Five children: Marissa, Karley, Carson Peter, Faye and Logan David –––––––––––––––––––––
Greater Milwaukee Region 3 Thomas E. Kielma, DDS 2901 W. Kinnickinnic River Parkway #104 Milwaukee, WI 53215 414-649-3510 tkielma@gmail.com
Family • Married to Christine • Five children: Theresa, Matthew, Kristi, Elizabeth and Mary • Two grandchildren
Northeast Region 2 Peter D. Hehli, DDS 5760 Grande Market Drive Appleton, WI 54913 920-997-1557 phehli@newbc.rr.com
Education Marquette University, 1969-1972 Marquette University School of Dentistry, 1972-1976 Practice Private practice, 1976-present Professional American Dental Association • Member, 1976-present Wisconsin Dental Association • WDA Trustee Greater Milwaukee Region 3, 2010-pressent • Finance Committee • Delegate, 1999-2003, 2006-2010
Education University of Wisconsin-Eau Claire, 1981-1984 University of Minnesota School of Dentistry, 1984-1988 University of Minnesota Residency Program, 1989
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Greater Milwaukee Dental Association • GMDA past-president • Delegate, 1991-2009 • Budget and Finance Committee, 1992-1993; chair, 1994-1999 Other Organizations • Pierre Fauchard Academy • Seattle Study Club • Milwaukee Odontological Academy, past-president
David L. Clemens, DDS 245 W. Munroe Ave Wisconsin Dells, WI 53965 608-254-2345 drdave@dellsdental.net
Edward J. Chiera, DDS 2149 Pioneer Drive Beloit, WI 53511 608-362-5712 drbass34@aol.com Education Illinois Wesleyan University, 1972-1976, Summa Cum Laude University of Illinois College of Dentistry, 1976-1980, Honors
Education University of Illinois, Champaign-Urbana, 1981-1985 University of Illinois, Chicago College of Dentistry, 1985-1989 Practice Various associate positions in Chicago, 1990-1997 Private practice general dentistry in Beloit, Wis., 1998-present Professional American Dental Association • Member,1999-present Wisconsin Dental Association • Delegate, 2004-2010, 2012; alternate delegate, 2003, 2011 • Legislative Advocacy Committee, 2010-present; vice chair, 2011-present • Wisconsin Dental Political Action Committee board member, 2009-present Rock County Dental Society • Rock County Dental Society president, 2009 • Component vice president, 2008
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Southwest Region 5
Southeast Region 4
Professional Organization • American Academy of Implant Dentistry • American Dental Society of Anesthesiology • Fellow with Dental Organization of Conscious Sedation Community Activities • Tri-County Community Dental Clinic volunteer
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Other Organizations • Pierre Fauchard Academy Community Activities • Donated Dental Services volunteer, 2011-2012 • Mission of Mercy volunteer, 2009-2012 • Health Net of Janesville volunteer, 2008-present
Practice/Academic Appointments US Public Health Service, Fairbanks, Alaska, 1980-83 Public Health Service, Philadelphia, Miss., 1983 Private Practice, Bloomington, Ill., 1983-88 Public Health Service, Kodiak, Alaska, 1988-90 Public Health Service, Oxford, Wis., 1990-2005 Private Practice, Wisconsin Dells, Wis., 2005-present with daughter, Dr. Nicole Clemens, and son-in-law, Dr. Jeremy Gross Professional American Dental Association • Alternate Delegate, 2006-2012 • Member, Reference Committee on Legal and Legislative Matters, 2011 • Member, Reference Committee on Dental Benefits, Practice, Science and Health, 2007 Wisconsin Dental Association • WDA Trustee Southwest Region 5, 2010-present • Wisconsin Dental Political Action Committee chair 2010-present • Legislative Advocacy Committee, 2005-present Sauk County Dental Society • Sauk Juneau Adams County Dental Society, president, 1994-96, 2007-2009 • Delegate to WDA House of Delegates, 2006-2009 • Bylaws Committee Other Organizations • American College of Dentists, Pierre Fauchard Academy and International College of Dentists • Commissioned Officers’ Association • Federal Bureau of Prisons, deputy chief, 1998-2005 Community Activities • Donated Dental Services volunteer, 2006-2012 • Mission of Mercy Volunteer, 2009, 2010, 2012 • United Presbyterian member Family • Married to Inger • Six children: Nicole, Laura, Brad, Lisa, Eva and Karin
May 2013 WDA Journal correction Our apologies to WDA trustees whose photo on p. 8 of the May 2013 WDA Journal was flipped. In February 2013, the Board welcomed new trustees (clockwise from back row, far left) Dr. Cliff Hartmann (Greenfield; Southeast Region 4), Mr. Derek Schmidt (Wauwatosa; MUSOD Region 6), Dr. Lynn Lepak-McSorley (Milwaukee; Greater Milwaukee Region 3) and Dr. Jennifer Peglow (Stevens Point; Northwest Region 1).
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FOCUS ON: dental Satire
The Jawbone MUSOD unveils waterpark plans he Marquette University School of Dentistry expansion project is moving forward, and construction is underway. The approximately 45,000 square-foot addition is expected to open in fall 2013. However, it was recently announced that an anonymous donor gifted funds to include an outdoor waterpark for students and faculty to enjoy. Starting next summer, students can jump into the toothshaped wave pool or race going down a swirling oldfashioned “Cuspidor” slide . “Our students work very
T
Tooth fairy outsources jobs to Oz flying monkeys
The days of a kid placing their tooth under a pillow and having the tooth fairy pay a visit are over. Ms. Tooth Fairy announced she is subcontracting with flying monkeys from Oz to visit sleeping children and replace their lost teeth with a small payment. By outsourcing jobs to winged monkeys, she will have more time to focus on other endeavors, such as encouraging healthy eating and oral hygiene habits. According to Delta Dental’s The Original Tooth Fairy Poll®, the going rate for a lost baby tooth posted doubledigit gains in 2012. “My customers are now demanding an average gift of $2.42 per tooth, which is a 15 percent increase from the previous year. Outsourcing these jobs to Oz flying monkeys is saving money,” Ms. Fairy said. Motivated by the expertise and skill of the monkeys, Ms. Fairy said she is extremely happy with the job performance of her counterparts so far. “Santa Claus and the Easter Bunny operate once a year, but my job is throughout the year. I felt this was an important business decision to evolve with the demand,” she said.
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hard throughout the year. Thanks to this generous gift, the new outdoor waterpark will give them an opportunity to have fun and they don’t have to go far,” MUSOD spokesperson said. The new waterpark will accommodate the increase of students from 80 to 100 in each of the school’s four classes. Students and faculty can boogie board on the “Fluorider-r” surf simulator or relax on the 750-foot long “Root Canal” lazy river. For those wanting to stay on dry land, a rubber dam
trampoline will also be added. “The expanded clinical and research space will help MUSOD attract and retain world-class faculty, but I think the water-
park will be a big draw for students and faculty,” MUSOD spokesperson said. More details will be announced soon.
WDA sells popemobile back to Vatican n March 2013, the Wisconsin Dental Association announced it was selling its popemobile back to the Vatican. According to Vatican spokesman Cardinal Don Corleone, “We made the WDA an offer they couldn’t refuse. When we sold it last year, we never imagined it would be needed. It has been 600 years since we had two living popes.” The armored vehicle was purchased on eBay for $850,000, but the WDA was able to sell it back and make
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a profit. The WDA has since bought a dento-diesel vehicle that runs on recycled dental lubricants such as, handpiece, compressor and suction oils. According to WDA president Dr. Tim Durtsche, it was a great opportunity for the WDA to downsize and go green at the same time. “This will save the WDA and members money. It also provides dentists a way to dispose of their used oil while fueling the new presidential vehicle. We will even make it convenient by collecting the used oil during my presidential
component visits” Dr. Durtsche said.
June 2013 WDA.org
New periodontal delivery model launched Daytona – Looking to get an oil change while getting your teeth cleaned? If so, you are in luck because a new unique business model recently opened with this convenience. After completing a periodontal residency at Ford Hospital, Dr. Fred Carr was looking to open a practice in his hometown. His best friend, Todd Lubener, a certified auto mechanic, owns an auto service center and was looking for a way to increase steady business. “We were eating dinner one night, and both realized regular maintenance is at the heart of our business goals,” Dr. Carr said. The auto shop already had compressed air and vacuum systems, and with a little tweaking, Pit Stop Periodontal S.C. was born. Patients can now have their routine car maintenance, including an oil change or tire rotation, while getting
New dental apps
Do your patients need motivation to keep them brushing and flossing regularly? Well now there are apps for that. Here is a list of a few popular apps to remind them to take care of their teeth. Tooth Brushing Motivator – The app turns brushing into a fun, interactive painting game.
Flossed Today? – Set a daily reminder for flossing complete with an alarm that asks, “ Have you flossed today?” Patients can program with their dentist or dental hygienist voice or select one of the preprogrammed voices, such as a Marine drill sergeant, Swedish supermodel, Dr. McDreamy and Honey Boo-Boo’s dad. Tooth Fairy Beacon – After a tooth is lost, place it on the tooth fairy beacon which sends a message to the tooth fairy.
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Quotes to remember
Happiness is your dentist telling you it won’t hurt and then having him catch his hand in the drill. ~ Johnny Carson © 2001 - 2013 BrainyQuote®
C. . S L A T N O D O I R PITSTOP PE
NASA discovers fluoride in water on Mars NASA scientists said an analysis of drilled rock samples collected by the Curiosity rover shows that ancient Mars could have supported living microbes. After examining the rocks further, scientists discovered optimal-level fluoride was present. “Water fluoridation prevents tooth decay for people on Earth, so further evidence may provide insight to Martians teeth and oral health care,” NASA spokesperson said.
their periodontal maintenance completed at the same time, same location. “I am excited to open our doors and welcome customers and patients in. This could change the way auto and periodontal maintenance is delivered for years to come,” Dr. Carr said.
Strange, (but true) patient requests Patient requests have gotten stranger in recent years. Everything from prosthetic fangs, gold “grills” and tooth tattoos have been commonplace. But, it is the more unusual ones that give dentists cause for professional pause. Here are some bizarre (and true) patient requests: 1. Can you extract my tooth without anesthesia? 2. Please wire my mouth shut to aid in my diet. 3. Can you ID this set of dentures left in the bathroom of the bar I work at? 4. I will pay you or your dental hygienist to floss my teeth at my office every day.
5. Pull all my teeth, and just give me dentures. 6. I just broke off my engagement. Can you prepare my tooth so that I can keep the diamond in it? 7. Will you give me local anesthesia in my lips? I’m going in for permanent “lipstick” tattoos on my lips, and would like to avoid the pain. 8. May I have an emergency cleaning visit? It’s my high school reunion and I need a bright, white smile to face my old boyfriend. 9. Can I keep the teeth you pull out of my mouth? I’d like to make a necklace out of them. 10. Can you give my dog braces? June 2013
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MOM volunteers make it happen
What: WDA and WDA Foundation Mission of Mercy 2013 When: June 27-30 (setup, clinic and teardown) Where: Badger High School, 220 E. South Lake St. in Lake Geneva
Lani Becker, CAE WDA Associate Executive Director lbecker@wda.org
Last year in Madison, we hosted the first, and the only, double size clinic in the country. We were able to have more than 3,600 patient encounters in the standard two-day clinic and provided more than $1.75 million in free dentistry. Our cumulative totals will surpass 10,000 patient visits and total care will exceed $5 million. This has only been possible through the generosity of our volunteers with their time and our donors with their financial and inkind support. Without these groups, MOM would not happen. Thank you to each and every one of you who have been part of this incredible journey. In the past, we have shared what patients get out of it, but what about volunteers? Dr. Patricia Richardson (Fitchburg),
who has been with us every year and plans to be there this year, finds each MOM to be a rewarding experience. “The patients are so appreciative, and the other volunteer dentists, hygienists, dental students and staff are such caring and giving individuals. It takes a tremendous amount of organization, energy and spirit to put on one of these events, and it is very satisfying to be a part of it,” she said. Paul Batley, Director of Technology for Henry Schein Dental, was part of the initial meetings when “the pitch” was made to the WDA, and he continues to be there every step of the way. “I’m fortunate to work in the dental industry and at a company that supports the efforts of giving back to the local community. I cannot think of a better way to show that sense of pride than giving my time and resources to this event and the underserved
families of Wisconsin. It truly is a humbling and fulfilling experience.” Dr. Thomas Raimann (Hales Corners) volunteered for two years in the pediatric dental area before serving as vice chair of the MOM committee. “As chair of this year’s event, I am looking for many good women and men, not just a few, to join me in helping this community. The stories and thanks I received will last me a lifetime, so join us and get your own stories,” he said. You, your team and family members 18 years of age and older, are all welcome to be part of this year’s MOM event. If you haven’t already registered, we hope you will consider doing so. Mr. Batley sums it up best with his favorite inspirational quote, “From what we get, we can make a living; what we give, however, makes a life.”
Q&A CASE STUDY #144
Six years ago, Henry Schein Dental representatives approached the Wisconsin Dental Association about hosting a Mission of Mercy dental clinic here. The concept was reviewed by the WDA Public Relations Committee which, in turn, made a recommendation to the WDA Board of Trustees. The Board approved this event and appointed a task force to plan for the first MOM in 2009 in La Crosse. Fast forward to 2013, and we are now finalizing the plans for our fifth MOM event at Badger High School on June 28 and 29 in Walworth County. We’ve come a long way since that first event when 1,800 plus patients were treated and more than $800,000 in care was provided.
presented by Ezedin M. Sadeghi, DDS, MS, MUSOD Associate Professor and Oral Pathology Director ezedin.sadeghi@marquette.edu
A 52-year-old female was referred to an oral surgery clinic for the diagnosis and treatment of an irregularly shaped exophytic lesion of left lateral and ventral tongue (Figure #1). The lesion was asymptomatic and had presented as a leukoplakic lesion several years prior. The patient was otherwise healthy.
FIGURE #1
Questions: 1- What is the most probable diagnosis? A. Hemangioma B. Squamous cell carcinoma C. Erosive lichen planus D. Lymphangioma E. Epulis fissuratum 2- What would you do to make a definitive diagnosis? A. Excisional biopsy B. Incisional biopsy C. Brush biopsy D. Needle biopsy E. All of the above Answers on page 15
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June 2013 WDA.org
ADA continued from page 5
membership market share challenge with one being the formation of a committee under the Council on Membership to look at tripartite alignment. That committee will report back to the board in June 2013. There will be many more discussions and actions taken to address this membership problem affecting the tripartite. We don’t want to get into a situation where our national organization is not representing the majority of dentists nationwide. That’s what happened to the formerly all-powerful American Medical Association. Other items of interest: Group practices growing The growth of group practices has been noted as an increasing trend by several ADA agencies with unique perspectives and concerns. This is also a concern when it comes to membership. The Council on Dental Programs is
WDA.org
We don’t want to get into a situation where our national organization is not representing the majority of dentists nationwide. That’s what happened to the formerly all-powerful American Medical Association. learning more about group practice business models, and the CDP’s second ADA Annual Session forum on current dental topics will focus on the growth of group practice and its implications for the profession. AAOS-ADA clinical practice guidelines In December 2012, the American Academy of Orthopaedic Surgeons and
ADA approved a new clinical practice guideline on “The Prevention of Orthopaedic Implant Infections in Patients Undergoing Dental Procedures”. It is important every dentist read these and have a serious conversation with his or her patients as to the pros and cons of premedication for artificial joints. (See editorial on page four.) Radiation exposure Another report, “Dental Radiographic Examinations: Guide to Patient Selection and Limiting Radiation Exposure”, has been developed in collaboration with the Food and Drug Administration and appears on both ADA and FDA websites. PR firm hired Fleishman Hillard was recently selected as the national public relations agency to help meet the reputational, public affairs and communications needs of the association.
The ADA will work with them on proactive media relations, reputation management efforts and most importantly, making oral health a centerpiece for effectively advancing our access solutions. Excise tax On the legislative front, the medical device excise tax is being passed on to dentists and the ADA is continuing to lobby for its repeal. As a result of federal budget sequestration, dental programs could see cuts of $29.1 million this year. Antitrust legislation to remove the exemption for insurance companies is already under consideration on Capitol Hill. Contact me at engeld@ada.org with any questions or comments.
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Classifieds Practice for Sale/Lease
Edge Advisors has 15 and counting dental practices for sale! Want to sell your real estate with the practice? Contact Jessica at Jessica@ EdgeAdvise.com or call 715-379-1796 to find out about how to sell both at the lowest price in the industry. #11-2012-09 Western U.P. practice, near Wisconsin border, will gross buyer over $300,000 the first year, after debt service. Contact Mark Breit, Paragon Dental Transitions, 906-250-9666 or mbreit@ paragon.us.com. #04-2013-05
Properties/Office Space Available General dentist seeking a practioners, preferably with own patient base, to share office space. Ideally suited for general dentist, prosthodontist, periodontist or orthodontist. Four operatories and laboratory available. Respond to Wisconsin Dental Association, Blind Box 0403, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214. #04-2013-03
Dentist Available/ Position Wanted A dentist is available with advanced skills and ability to work in high-pace environment. Willing to come in another office once a week or once a month with instruments for extractions, perio, laser or mini-implant procedures. Contact gorodesky@sbcglobal.net or 414-364-3004. #062013-06 Dentist with five years of experience seeking Madison area associate position with potential for partnership or ownership. Please reply to madisondentistavailable@gmail.com. #052013-02 Dentist seeking association position (with buy-in potential) or practice to purchase on Madison’s west side or surrounding suburbs. Respond to Wisconsin Dental Association, Blind Box 0301, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214 #03-2013-01
Practice Wanted Two general dentists with 10 years clinical experience seeking the purchase of a metro Milwaukee area dental practice. 4-5 ops desirable but will consider other options, real estate purchase also desired. Please contact evonnenadelhoffer@hotmail.com, 414-2418175 or victorcullen2013@gmail.com, 503954-5488 or amanda.falkowski@marquette.edu. #06-2013-07 #WI500 – Madison Area Practice Wanted – Buyer interested in acquiring a satellite practice with owner willing to stay as associate. Are you looking to slow down and let someone else deal with the business management of your practice? You just want to treat patients and leave without a worry of the day-to-day management of the practice? This may be the perfect time to transition your practice! Call Deanna Wright at Henry Schein Professional Practice Transitions at 800-730-8883 or email Deanna.Wright@ henryschein.com for more information on how we can help. #02-2013-15 Southern Wisconsin Practice Wanted for Purchase: We are looking to purchase a modern general practice with at least 3 operatories. We currently have 4 locations and are open to retaining current owner as IC dentist. Please contact Mary Beth at 630-833-5110 or maybeth@chicagolanddentists.com. #01-2013-09
Practice Position Opportunity Beloit/Janesville Associate Dentist Wanted – Partners in Care, LLC, which currently has 4 office locations, is looking to expand and purchase 3 additional offices in 2013, in Southeastern Wisconsin. We currently have 3 offices in Illinois located in Elmhurst, Bloomingdale and St. Charles, and one office in Wisconsin located in Lake Geneva. If you visit our website, www.chicagolanddentists.com, you will be able to view our wonderful offices. We currently employ 12 General dentists, and offer the services of two oral surgeons, an endodontist, a periodontist and an orthodontist. We take great pride in our excellent reputation and longstanding commitment to our patients. Our first office, Elmhurst Dental, has been serving the Elmhurst Community for 40 years. We are currently looking to purchase practices in Janesville and Beloit, Wisconsin and are looking for Associate General Dentists with at least 3 years experience for these practices. We offer excellent benefits and a minimum pay guarantee to start. If interested, please forward resume/CV to marybeth@chicagolanddentists.com. #06-2013-03
Andy Lehmkuhl and your local team at Edge Advisors have transitioned 30 practices in the past two years. We charge less and get the best results in the industry. Need help hiring an associate? Currently we have more than 14 available. See what your colleagues are talking about at www.EdgeAdvise.com. Contact 414-255-5669 or Andy@EdgeAdvise.com. #112012-10 General dentist needed for 1-2 days per week at a growing general dentistry office in Brookfield. Individual should be proficient in all areas of dentistry and should be willing to learn. GPR or AEGD training preferred. Fax CV to 262-784-8424 or email to tracey@ brookfielddentistry.com. #06-2013-09 Associate Dentist – State of the Art Dental Facility located in Wauwatosa, WI has an opportunity for an experienced dentist to join our dedicated staff. Full-time with benefit package or part-time available. No evenings or weekends. Respond to Wisconsin Dental Association, Blind Box 0510, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214.#05-2013-10 General Dentist – State of Wis./Central Wis. Center for the Developmentally Disabled, Madison, WI. We are currently recruiting for a general dentist to provide dental care to outpatients and residents of the center and provide training to staff. We offer a competitive salary with excellent state benefits. To request more information, please contact Terri Jacobson at terri.jacobson@dhs.wisconsin.gov. An equal opportunity employer. #06-2013-02 Recently remodeled 2 doctor practice in southeastern Wisconsin. Fully digital, all the latest technology including CEREC and CBCT. Full service practice, refer out almost nothing. Full or part-time associate needed ASAP. Competitive compensation package with guaranteed minimum salary. Great opportunity for new dentist. Email resume to ben@ delavandentistry.com.#04-2013-02 Associate Dentist – State of the Art Dental Facility located in Wauwatosa, WI has an opportunity for an experienced dentist to join our dedicated staff. Full-time with benefit package or part-time available. No evenings or weekends. Respond to Wisconsin Dental Association, Blind Box 0510, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214.#05-2013-10
Greater Madison Area Midwest Dental is seeking candidates for a practice opportunity in the greater Madison area. Our philosophy of preserving and supporting the traditional private practice setting provides a great work-life balance, excellent compensation and benefits, and unlimited opportunity for professional growth. Our comprehensive support team provides you the freedom to focus on your patients, your skills and lead your team. If you possess a passion for providing fullservice quality dental care and are in search of a rewarding practice opportunity, we’d enjoy the opportunity to learn about your practice philosophy, career goals and expectations. For more information and practice specifics, please contact Laura Anderson Laehn by phone at 715-225-9126 or email atlanderson@midwest-dental. com. You may also visit us online at www. midwest-dental.com. #06-2013-01
Dental Dreams desires motivated, quality oriented associate dentists for its offices in IL (Chicago & suburbs), DC, LA, MI, MA, MD, NM, PA, SC, TX and VA. We provide quality general FAMILY dentistry in a technologically advanced setting. Our valued dentists earn on average $230,000/yr plus benefits. New graduates encouraged! Call 312-274-4524 or email dtharp@kosservices.com. #03-2013-05
Classified Advertisements The rate for classified advertisements for Wisconsin Dental Association members is $65 for 30 words or less; additional words 50 cents each. Nonmember rate is $90 for 30 words or less; additional are 50 cents each. Make your ad stand out by adding a company logo for $30 per month or add a blind box for confidentiality for $10 per month. Boxed classified ads also are available in three sizes: one inch = $100; two inch = $150; or three inch = $200. Make your ad stand out with a full color, mini-display. Save 10 percent when you run a display ad for three months or more. Mini-display classified ads now available in three sizes: two inches = $225; or three inches = $275; or four inches = $325. Artwork can be created for you at an additional charge: $75 for initial minidisplay creation $50 per hour for edits after initial run (one hour minimum will be charged). Visit WDA.org to view rate sheet and download classified contract.
Cancellation of ads must be received in writing. Please note all ads must be pre-paid. Please include payment (check or credit card number) with your classified ad when submitting. You can download the contract online at WDA.org or call 414755-4110. To place an ad, mail, fax or email ebultman@wda.org copy to the Wisconsin Dental Association, Attn: Emily Bultman, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214; fax to 414-755-4111. Classified ads submitted after the deadline can be posted on the last business day of the month as a web only ad at the standard rate. It is against WDA policy to do unauthorized mailings pertaining to individual classified advertisements. When responding to a Blind Box, please indicate the blind box number on the envelope. When they are received by the WDA office, they are forwarded unopened to the address of the person holding the blind box. Sample: Wisconsin Dental Association, Blind Box #10, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214.
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To
place a display or
classified ad , please contact
E mily B ultman at ebultman @WDA. org .
Outstanding Opportunity: Partners in Care is seeking a part-time general dentist, 3 and a half days per week, for our new Southeastern Wisconsin location. We offer excellent benefits and a minimum pay guarantee to start. We are looking for candidates with at least two full years of experience to be a part of our dedicated team of professionals. Visit our website at: www.chicagolanddentists.com to see our other four locations. Email Resume/CV to marybeth@ chicagolanddentists.com. #04-2012-11
ForwardDental is in search of exceptional Dentists to join our busy Wisconsin practices. Positions offer competitive compensation, enhanced benefits and the opportunity for ownership! Contact Kelly at kfredrick@amdpi. com. #10-2011-05
Temporary/Flexible/Dynamic Opportunities Do you have a passion for patient care? Do you enjoy new challenges and desire a flexible work environment? We want to talk with you! Our team is looking for doctors with open personalities who are interested in covering maternity leaves, military leaves, and extended vacations in our Fee for Service practices. If you’ve ever considered the benefits of temporary coverage, give us a call. With us, you can work as much or as little as desired. We have practices located in various communities throughout WI, MN, IL, and IA. To learn more, please contact Laura Anderson Laehn at 715-926-5050 or landerson@midwestdental.com. Visit online at www.midwestdental.com and www.mountaindental.com. #06-2010-01 Opportunities Available - Wisconsin. The Wisconsin Office of Rural Health has detailed information on general and specialty dentist positions in both smaller towns and larger cities located throughout Wisconsin. Most of these positions qualify for the $50,000 loan repayment program from the State of Wisconsin. The Wisconsin Office of Rural Health has recently added a Dentist Placement Program to our successful Physician Placement Program. Located at the University of Wisconsin School of Medicine and Public Health, we are a notfor-profit organization dedicated to helping improve the quality of health care for the people of Wisconsin. For information, call Marsha Siik at 800-385-0005, email siik@wisc.edu, or fax CV to 608-261-1893. #03-2013-06
MORE REASONS TO SMILE! We’ve always believed in putting patients first. In fact, Dental Associates was built on the notion that everyone deserves access to affordable dental care of the highest caliber. From a small solo practice that launched more than 35 years ago, Dental Associates has grown to 10 multispecialty dental centers. We’re proud to bring quality, progressive treatment to communities across with the day-to-day business tasks. Put all your focus back on your patients and you will enjoy more of those rewarding moments! We’d love to have you join us. Visit our website at dentalassociates. com, call or send resume/CV in confidence to: sbullen@dentalassociates.com or Dental Associates Attn: Susan Bullen, 11711 W. Burleigh St., Wauwatosa, WI 53222, 800315-71107, 414-456-9911(fax). #02-2013-02
Are you happy in your current office? Before you make a move or accept another offer, be sure to check us out! Our dental practice, located in Southern Wisconsin, is looking for a long term associate to join our steadily growing practice and community. We service all aspects of general dentistry, including implant placement and restoration. Come and be a part of our fun, talented and enthusiastic team! We are offering a top base salary, production bonus program, and a generous benefits package. Please submit CV/ resume to: dentaldr@gmail.com. #03-2013-04 Appleton, WI – Associate position available for 2 Dr. practice looking to add a 3rd Dr. 3,000 patient base. Sign-on bonus and no non-compete initially. Buy-in option available. Please call 920225-0123. #02-2013-14.
General Dentist – Kenosha, WI Excellent opportunity for a General Dentist to establish a new Affordable Dentures practice in Kenosha, WI. No personal financial investment required and outstanding income and equity potential. Affordable Dentures practices are niche practices oriented towards serving primarily a lower income, elderly population as well as value conscious patients. The practices focus on providing removable prosthetics, extraction services, and implants for denture stabilization. A number of affiliated practices provide sedation services and same day crowns using CADCAM technology. In addition to an exceptional income package, there is a full benefits package which includes a variety of insurance options plus an outstanding 401k plan with a generous match. The practice also provides paid vacation time / 9 holidays, license and DEA renewals, annual CE allowance, and professional liability insurance. The practice will be equipped with a fully staffed on-site laboratory operation enabling same day service for most patients. Hours of operation are Monday through Friday, 8am to 5pm with no evenings and no weekends. In addition to outstanding income, you will enjoy the benefits of a professionally gratifying and personally rewarding career. Affiliation with Affordable Care as your Dental Services Organization relieves the administrative burden of operating a busy dental practice, and allows the general dentist to spend more time providing quality patient care. Learn what current affiliated practice owners already know our unique business model allows you to do good for others while doing well for yourself. Contact: Alan Wallace 800313-3863 ext. 2234 or Email: alan.wallace@ affordablecare.com. #06-2013-08
Position available. Associate wanted in Eau Claire – Two Doctor general dental practice seeking associate to partnership candidate. Excellent salary guarantee/benefits. Reply in confidence to lgworknow@gmail.com. #05-2013-01
Opportunities in Rice Lake and Merrill Midwest Dental is seeking a full time dentist in our Rice Lake and Merrill practices. We offer the opportunity to lead your own clinical team without the administrative and financial burdens. Our philosophy of preserving and supporting the traditional private practice setting provides a great work-life balance, excellent compensation and benefits, and unlimited opportunity for professional development. If you possess a passion for providing quality care and are looking for a rewarding practice opportunity in the Rice Lake or Merrill areas, please contact us at 715-926-5050 or email development@midwest-dental.com. Visit us online at www.midwest-dental.com. #02-2013-06
Office Equipment for Sale Wauwatosa office closing used dental units, chairs, stools and sterilizers and X-rays. Modular cabinets, storage files, lab equipment and supplies. Reasonable cash and carry prices. Call 262-786-8365 or 414-453-0704. #062013-04 Evacuator for sale. Almost new Midmark 1.25 h.p. evacuator for sale. Used for only 680 hrs. Closing of office makes this evacuator available. $1,250 Call 262-646-8550. # 062013-05 Antique dental cabinet – Mahogany, dark green marble, beveled mirror and glass. Purchased used in 1947, probably fabricated in the 1920s. 22 drawers, 5 doors. 62”H x 30”Wx14”D. Beautifully restored. $2,450. Contact drmarcblum@gmail.com or 920-3797521. #05-2013-03
Miscellaneous
Mike Bark – The ONLY accredited “Institute of Dental CPA’s” certified Wisconsin CPA/ Accountant and best valued. Give us a call and let’s talk about how we can help you improve your situation. Contact 414-759-9629 or Mike@EdgeAdvise.com. #11-2012-11
Advertising Index
Thank you for supporting the WDA Journal! AFTCO.................................................. 5 www.aftco.net Baker Tilly............................................ 14 www.bakertilly.com Delta Dental......................................... 10 www.deltadentalwi.com Edge Advisors ............................. 11 & 15 www.edgeadvise.com Midwest Dental..................................... 12 www.midwest-dental.com Paragon. . ............................................. 13 www.paragon.us.com Scientific Metals ........................................... 2 www.ScientificMetals.com/org WDAIP ................................................. 16 www.insuranceformembers.com West Bend Mutual Insurance Co. . . ........... 11 www.thesilverlining.com
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Calendar
Summer Hours
WDA offices will be closed Monday May 27 for Memorial Day observance. Following Memorial Day, WDA Executive and Legislative offices will be open Monday through Thursday from 8 a.m. to 4:30 p.m. and on Fridays from 8 a.m. to noon through Aug. 31.
*Shaded events offer continuing education credits.
JUNE
13 “Implant Diseases and Complications” Wei-Ting, DDS and Paul Luepke, DDS 3 CE credits For more information, visit www.marquette.edu/dentistry 14 Wisconsin Dental Study Club meeting “Restoring the Worn Dentition and Complex Cases” Jose-Luis Ruiz, DDS 6.5 CE credits Contact Dr. Gene Sorensen at gsoren1974@aol.com or visit http://wisconsindentalstudyclub.com for more information 21-22 WDA Board of Trustees meeting Landmark Resort Egg Harbor For more information, visit WDA.org
28-29 WDA and WDA Foundation Mission of Mercy Badger High School Lake Geneva For more information, visit WDA.org
JULY
4-5 WDA offices closed for Independence Day and floating holiday 10 Dentistry Examining Board 8:30 a.m. 1400 E. Washington Ave., Rm 121A Department of Safety and Professional Services • Madison 18-20 ADA 27th New Dentist Conference Four Seasons Hotel, Denver For more information, visit www.ada.org/newdentistconf.aspx
SEPTEMBER
2 WDA offices closed for Labor Day 4 Dentistry Examining Board 8:30 a.m. 1400 E. Washington Ave., Rm 121A Department of Safety and Professional Services • Madison 9 WDA Foundation Golf Outing North Hills Country Club Menomonee Falls Visit WDA.org for more information
13 WDA Insurance Programs Risk Management Seminar Radisson Inn Paper Valley Appleton Visit www.insuranceformembers.com for more information 18 Wisconsin Oral Health Coalition statewide meeting Stevens Point 27-28 WDA Board of Trustees Crowne Plaza Wauwatosa 30 Renewal deadline for Wisconsin dental and dental hygienist licenses.Visit www.dsps.wi.gov for more information
NOVEMBER
1-3 ADA Annual Session New Orleans Visit ADA.org/session for more information 3 ADA Mission of Mercy New Orleans Visit ADA.org/session to sign up to volunteer 15-16 WDA House of Delegates Marriott Madison West Middleton Visit WDA.org for more information
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OCTOBER
31 ADA Annual Session New Orleans Visit ADA.org/session for more information
28-29 WDA offices closed for Thanksgiving ––––––––––––––––––––––––––––––– Do you have an event you’d like to include in the WDA Journal Calendar of Events? If so, please call WDA Managing Editor Emily Bultman at 414-755-4110 or 800-364-7646; fax to 414-7554111 or email to ebultman@wda.org.
Effortless networking Mara T. Roberts, CLU, RHU, REBC WDAISC President mroberts@insuranceformembrs.net
I recently had the privilege of spending time with the Dane County Dental Society at their 2013 New Dentist’s Dinner in Madison. Dane County Dental Society Immediate PastPresident Dr. William Bird (Madison) did an outstanding job organizing the event. I was also impressed with the mix of attendees at the event, which was meant to introduce dentists new to the area during the past two years and those new to dentistry. WDA President-Elect, Dr. Julio Rodriguez (Brodhead), WDA Southwest Region 5 Trustee Dr. Patrick Tepe (Middleton) as well as component officers, Dr. Terry Donnelly (Madison), president-elect; Dr. Thomas Reid (Madison), secretary/membership chair; and Dr. Michael Kokott (Verona), treasurer and so many others were also there that I could take up this entire column listing them. A special thanks to Dr. Tepe for bringing this event to my attention at the February 2013 Board of Trustees meet-
ing. The backgrounds of those attending this event were as diverse as the areas of practice specialty and each conversation was an opportunity for new business relationships to develop. Yes, we all have access to Facebook, LinkedIn and numerous other online resources to “connect” with our peers. Yet it isn’t the same as spending time at a simple social event getting to know someone. It makes it a lot easier to refer your patient to someone you actually spent time with rather than someone you merely have an online connection with. It’s not easy or convenient to attend after work functions, but as I looked around the room I saw a lot of dentists who looked as if it was the first time all day they were finally able to relax and enjoy some down time with their peers – it was effortless networking. Visit your local dental society page and the calendar of events on WDA.org for upcoming “effortless networking” opportunities in your area.
The WDA Journal is published monthly by the Wisconsin Dental Association (USPS 0285-460), 6737 W. Washington St., Ste. 2360, West Allis, WI 53214. Phone 414-276-4520. Yearly subscriptions are $20 for WDA members; $100 for nonmembers; $25 for associate members; $30 for dental school students; $45 for dental schools and agencies and $125 for foreign mailings. Periodicals postage paid at Milwaukee, Wis. POSTMASTER: Send address changes to WDA Journal, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214. The Wisconsin Dental Association reserves the right to illustrate and/or edit all reader contributions. Views expressed in the WDA Journal are not necessarily those of the WDA. All advertising in the WDA Journal must comply with the advertising standards of the WDA. The publication of an advertisement is not to be construed as an endorsement for approval by the WDA or any of its subsidiaries unless the advertisement specifically includes information that such approval or endorsement has been granted. The deadline for all display advertisements is the second Tuesday of the month, two months before advertisement insertion (For example, if you want your ad to appear in the September 2013 WDA Journal, which is mailed to members in mid-August 2013, all advertising materials must arrive in the WDA Executive Office by the second Tuesday of July 2013.) Advertising space is limited, so advertisers are encouraged to reserve space early. Back issues of the journal are available for six months following publication or while supplies last. Communications and copy for publication should be addressed to Dr. Robert Brennan, editor, and may be mailed to the WDA at 6737 W. Washington St., Ste. 2360, West Allis, WI 53214; faxed to 414-755-4111 or emailed to ebultman@wda.org. Portions of the WDA Journal can also be found on the WDA Web page, WDA.org.
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Step up to the tee! Statewide survey needs input The Early Childhood Advisory Council’s Preventive Oral Health Project and Wisconsin Oral Health Coalition (WDA works with both) want to learn more about efforts to improve the dental health of young children and pregnant women statewide. If your practice targets either of these groups, please complete the brief online survey at http://bit.ly/15KqQlu by June 24, 2013. If your community works to improve access for underserved young children and/ or pregnant women, please forward the survey link to the program staff and ask that they also complete the survey. Survey results will be used to improve existing and/or initiate new preventive oral health programs for young children and moms-to-be.
Vicki Bohman WDA Executive Director vbohman@wda.org
Whether you are a scratch golfer or new to the sport, the Wisconsin State Dental Golf Tournament is a great opportunity to enjoy a day with friends and colleagues while supporting the Wisconsin Dental Association Foundation. Registration is now open for this longtime dental tradition, which takes place on Monday, Sept. 9, 2013 at North Hills Country Club in Menomonee Falls. The day begins with lunch at 11 a.m. and a shotgun start at noon. Your $185 registration fee includes use of a golf cart, 18 holes of golf, a buffet lunch and dinner, a cash bar and an awards program following the round. Plus, $35 from each individual golf registration directly supports the chari-
table programs of the WDA Foundation, bringing oral care to disadvantaged residents in the Badger State. You’re sure to enjoy the experience at North Hills Country Club. With more than 80 years of golfing tradition behind it, North Hills is widely considered a favorite of southeastern Wisconsin golfers. The large wooded areas, rolling fields and the Menomonee River provide scenic beauty, as well as natural hazards to make your round challenging and entertaining. The registration deadline is Friday, Aug. 23, 2013, but be sure to sign up as soon as possible because 128 golfers is the maximum number of registrations available. Local dental societies, dental groups
and individuals are also encouraged to show their support of the WDA Foundation by becoming a sponsor. Sponsorship opportunities are available to fit every budget with higher levels, including golf registration at no additional cost. Sponsorship and registration forms are available at www.wda.org/wda-foundation. Contact Vicki Bohman at vbohman@wda.org, 800-364-7646 or 414-7554198 for more information. The WDA Foundation is a 501(c)(3) charitable organization. Gifts to the WDA Foundation support programs to provide dental care for the disadvantaged while meeting the current and future needs of the dental profession. Each gift is tax deductible to the full extent of the law.
Q&A
Case study continued from page 10
A:
1) b 2) b
Final Diagnosis: Invasive Squamous cell carcinoma
Discussion Squamous cell carcinoma is the most common primary malignancies of the mouth (90 percent of all oral cancers). Tobacco habits and drinking alcoholic beverages are implicated as the main causative factors in development of the oral squamous cell carcinoma. Actinic radiation, immunosupression and chronic irritation may also contribute in formation of this type of cancer in the oral cavity. Lower lip and lateral tongue and floor of the mouth are the most common locations for the development of oral squamous cell carcinoma. Clinically, the lesions may be presented as a leukoplakic, erythroplakic, ulcerated, fungating and expanding lesions. Any mucosal lesion in the mouth that does not disappear after initial treatment must be biopsied in order to rule out malignancy. Treatment of the oral squamous cell carcinoma may include surgery, radiation therapy and chemotherapy, depending on the size, location and the stage of the tumor. Acknowledgement: This case was contributed by Dr. Phillip Hawkins (Milwaukee), an oral and maxillofacial surgeon.
Ezedin M. Sadeghi, DDS, MS Oral & Maxillofacial Pathologist Associate Professor, Marquette University School of Dentistry Referral and Consultation: 414-288-6559. Biopsy Service: 414805-8440. WDA.org
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Seal-A-Smile continues to provide school-based preventive oral health care Matt Crespin, MPH, RDH Children’s Health Alliance of Wisconsin Associate Director mcrespin@chw.org
Children’s Health Alliance of Wisconsin, in collaboration with the Wisconsin Department of Health Services Oral Health Program, is wrapping up its 13th year of managing the Wisconsin Seal-A-Smile program. More than $600,000 is annually awarded to local health departments, federally qualified health centers, community clinics, dentists and dental hygienists to provide school-based preventive oral health care. Funding for the program is made available through state general purpose revenue and matching funds from Delta Dental of Wisconsin. It is anticipated that sealants will be placed on more than 20,000 children statewide in the 2012-13 school year due to program efforts. Wisconsin recently received an “A” in
the PEW report card on state sealant programs. Only four other states received this high mark. The Seal-A-Smile program targets high-risk schools where 35 percent or more of the children enrolled participate in the free and reduced meal program. About 50 percent of Wisconsin’s high-risk schools received care through the program during the 2012-13 school year. Children are provided with a dental screening, sealants and multiple applications of fluoride varnish. Some programs provide additional preventive services and a couple even provide school-based restorative care. Annually, more than 90 percent of the children served have Medicaid or are uninsured. All children who return consent forms are seen at no cost to families.
Every year, more than 35 percent of children seen statewide need additional restorative care. Program case managers assist patients with follow-up, but additional dental providers are almost always needed. In the past, nearly all school-based oral health programming in Wisconsin was being provided by the Seal-A-Smile program. Recently, mobile dental providers from both in and out of state (not Seal-ASmile funded) have begun providing care in Wisconsin schools. While we are supportive of programs seeing children in high-risk schools not currently being served, these programs are not subject to the same oversight and policies that our programs adhere to. The Alliance and DHS have extremely high standards for their funded programs, including program evaluation through retention checks, strict infection control standards and case management protocols. Collaboration with local health depart-
ments, area dental providers and clinics is a must for programs. We have received an increased number of calls from schools about choosing a mobile program, and in response developed a question and answer brochure, “Selecting a School-Based Oral Health Program”. It is available at www.chawisconsin.org/sas.htm. It is important that programs are using evidence-based practices to ensure appropriate care is provided. Our programs use the American Dental Association’s guidelines for school-based dental sealant programs in setting various protocols. The program is a nationally-recognized model due its success, and other states have replicated the practices put in place in Wisconsin. The Alliance is currently accepting SealA-Smile proposals for the 2013-14 school year. Contact CHAW Associate Director Matt Crespin at mcrespin@chw.org or 414-2924002 for more information or to get involved in a program in your area.
communiqu e´ ‘Fluoride Friday’ and social media explained Amanda Brezgel WDA Electronic Communications Coordinator abrezgel@wda.org
The “Fluoride Friday” posts on the Wisconsin Dental Association’s Facebook and Twitter channels are just one tool in a proactive, statewide fluoride public awareness plan. Staff developed this plan with public relations professionals at the national firm of Laughlin Constable. For three years, these PR consultants have been available to the WDA thanks to a State Public Affairs grant from the American Dental Association. All fluoride facts, information and language is taken from ADA resources and updated with recent peer-reviewed studies and websites. Member dentists of the WDA Public Relations Committee and/or leaders, trustees review all WDA print and electronic communications as much as possible. Unfortunately, the 24/7 format of social media doesn’t always allow for that review/approval process. Fluoride posts are intended to educate, inform and stimulate discussion. Unfortunately, this also means attracting anti-fluoride supporters. We have had anti-fluoride comments posted on our Facebook wall from a few individuals. WDA members and staff and the Fluoride Response Team members monitor these comments and reply with facts and data in support of fluoridation. Our social media policy discourages arguing with “disagreeable comments”. We don’t block or remove posts on the WDA social media channels, except in rare circumstances of foul language, lengthy spam-like posts or where a dentist or dental hygienist is named in a negative comment. It would discourage the very discussion that social media invites. WDA member dentists and dental hygienists are encouraged to join in the social media discussion by posting on the WDA Facebook wall in support of fluoride and other oral health topics Your professional insights and real-life observations bring a welcomed voice to your association’s public awareness efforts on all topics, including fluoride. 16
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