vda journal vol 87 number 2 april-june 2010
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Journal of the Virginia Dental AssociationTRANSCRIPT
Volume 87, Number 2 • April, May & June 2010
www.vadental.org
Volume 87, Number 2April, May & June 2010
Headlines & ArticlesPage5 LettertotheEditor-MoreMedications-MoreProblems! By: Dr. Marvin E. Pizer, DDS
7 MessagefromtheEditor
9 GuestEditorial-RogersHornsbyandtheGecko, By: Dr. Kerry Carney
11 MessagefromthePresident
13 Trustee’sCorner
14 Ethics-WhatAreWeSayingAboutOurselves? By: Melissa Wolfe, DDS
14 ADAStatementonZincinDentureCream
15-16 Achingtoothturnsintoa$44,000bill By: Frank Delano
17 VirginiaOralHealthPlan2010-ExcellentOralHealthForAll.... By: Sarah B. Holland
18-19 AnInterviewWith:SonjaLauren22 JackandTheMortgageMaster By: E. Wayne Bullis
24-25&27 PediatricAbstracts
29-30 UnderstandingDeltaDental’sNewPaymentPolicies By: Dan Schulte, JD
38 PewReportFindsMajorityofStatesFailtoEnsureProperDental... By: The Pew Center on the States
39 Extraoral By: Dr. Elizabeth Wilson
40-41 WhenShouldYouCallYourMed-MalCarrier’sRiskManagement... By: Kathleen M. Roman
44 Non-PatientBasedLicensureComingtoaStateNearYou? By: Richard Carlile, D-2011
45 ASmileRestored,NotesfromtheVCUSchoolofDentistry By: Joseph L Rodriguez, Class of 2011
58 YouGottaPutAFaceOnIt!DentistsRallytotheCause By: Chuck Duvall and Dennis Gallagher
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DepartmentsPage3 *New*ContinuingEducationCalendar
15-21 Outreach
23&27 PathologyPuzzler By: Dr. John Svirsky
31-37 VirginiaMeeting
43-45 UniversityConnections
46 Awards&Recognition
47-54 Governance&Membership
56-59 Legislative
60 ClassifiedAds
Member Publication
Volume87,Number2•April,May&June2010 3
REPRESENTING AND SERVING MEMBER DENTISTS BY FOSTERING QUALITY ORAL HEALTH CARE AND EDUCATION.
Virginia Dental Association7525 Staples Mill Road . Richmond, VA 23228804-261-1610 . Email: [email protected]
Editor-in-Chief RichardRoadcap,D.D.S.BusinessManager TerryD.Dickinson,D.D.S.ManagingEditor Mrs.ShannonJacobsGraphicDesign Mrs.ShannonJacobs
Virginia Journal Editorial BoardRalphL.Anderson,CarlM.Block,CramerL.Boswell,JamesH.Butler,GilbertL.Button,B.EllenByrne,CharlesL.CuttinoIII,CraigDietrich,FrankH.Farrington,BarryI.Griffin,JeffreyL.Hudgins,WallaceL.Huff,LindsayM.Hunt,Jr.,ThomasE.Koertge,JamesR.Lance,DanielM.Laskin,KarenS.McAndrew,TravisT.PattersonIII,W.BaxterPerkinson,Jr.,LisaSamaha,DavidSarrett,HarveyA.Schenkein,JamesR.Schroeder,HarlanA.Schufeldt,JamesL.Slagle,Jr.,NeilJ.Small,JohnA.Svirsky,RonaldL.Tankersley,DouglasC.Wendt,RogerE.WoodVDA Component - Associate EditorsBenT.Steele,MichaelR.Hanley,GregoryCole,GeneAyers,JaredKleine,ChrisSpagna,RichardCarlile-StudentLiason,VCUClassof2011.
VDA OfficersPresident: AlonzoM.Bell;AlexandriaPresidentElect: MichaelAbbott,SalemImmediatePastPresident: RalphL.Howell,Jr.;SuffolkSecretary-Treasurer: J.TedSherwin;OrangeExecutiveDirector: TerryD.Dickinson,D.D.S.Board of DirectorsAlonzoM.Bell,President-MichaelAbbott,President-Elect;J.TedSherwin–Sec.Treasurer;RalphHowell,ImmediatepastPresident;JamesE.Krochmal–Comp1;MichaelJ.Link–Comp2;SamuelW.Galstan–Comp3;BenitaA.Miller–Comp4;CraigB.Dietrich–Comp5;ScottieR.Miller–Comp6;RonDowney.–Comp7;NeilJ.Small–Comp8AdvisoryMembers:DavidSarrett;CharlieGaskins;RichardRoadcap,SarahKandrace,VCUD-2011
Volume 87, Number 2 • April, May & June 2010
THE VIRGINIA DENTAL JOURNAL(PeriodicalPermit#660-300,ISSN00496472)ispublishedquarterly(January-March,April-June,July-September,October-December)bytheVirginiaDentalAssociation,7525StaplesMillRoad,Richmond,VA23228,Telephone(804)261-1610.
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ADVERTISING COPY,insertionorders,contractsandrelatedinformation:BusinessManager,7525StaplesMillRoad,Richmond,VA23228
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Continuing Education CalendarCourse listings are deemed to be reliable but are not guaranteed. This calendar is for infor-mation purposes only and inclusion of a course does not imply endorsement by The VDA or the VDA Journal/Etch. Email your CE course submission to [email protected].
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ASD2010AnnualSymposiumDate/Time:June24-26,2010Location:Ritz-CarltonPentagonCityWashingtonDCSponsoring Organization: AcademyForSportsDentistryFee:unknownFor more information contact:ASDat217-227-3431orwww.sportsdentistry-asd.org
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Volume87,Number2•April,May&June2010 5
Letter to the EditorMORE MEDICATIONS – MORE PROBLEMS!
Fiftyplusyearsofpracticeinadentalspecialtywithmostpatientsreferredbyphysiciansanddentistshasal-lowedmetorecognizetheproblemsrelatingtonewandoldermedications.
Thedramaticincreaseinnewdrugshasnecessitatedthatdoctorshavemoreknowledgeregardingpharmacol-ogy,drugeffectiveness,side-effectsandinteractionswithothermedications.Knowingfrequentaswellasrareside-effectsareessential.Doctorsmustdifferentiatebetweendruginducedside-effectsfromthepatient’sal-teredphysiology.Occasionally,unsuspectedlifethreateningsymptomswillrequireemergencyinterventionandthisalsoistheprescribingdoctor’sresponsibility.
Somesuggestionsfordoctorsprescribingordispensingmedications,includingover-the-counterdrugs,arepre-sented:
(1)Everynewpatientshouldbringallbottleswithmedicationstheyarepresentlytakingtotheoffice.Thislistshouldbereviewedperiodically.
(2) Reducingunpleasantside-effectsmaybeaccomplishedby reverting toa recentPDR(PhysiciansDeskReference)oritsequivalent,beforeadvisingorprescribingnewand/oroldermedications.
(3)Adoctor’sjudgmentmustbeprudent.RiskversusBenefitsofmedicationsprescribedisanessentialfactorforalleviatingapatient’sillnessanddiscomfort.
(4)Somemedicationsrequiremonitoringwithperiodiclaboratorystudiesandclinicalobservation.Adoctorwhoignoresthisaspectofprofessionalhealthcareisnotcompetent.
(5)Manypharmacies,whendispensingmedications,includeapamphletforthepatient.Thisusuallyexplainsthepurposeofthisdrugaswellasproperdosage,precautions,andusualandrareside-effects.Thepatientwillrespondwithconfidenceiftheyknowoftheirdoctor’savailability.Therearealwayssomepatientswhocannotrememberorreadtheinstructionsofthenewmedications.Frequently,thepharmacistcanhelp–ifnotaphonecalltothepatient’sspouse,relativeorfriendwillalleviatethelanguagebarrier.Atelephoneserviceisavailableinmanyclinicsandhealthprofessional’sofficewhereEnglishistranslatedintowhateverlanguageisnecessaryforthepatient.
(6)Thepatientmaynothavethefinancialmeanstopurchasethedesiredmedication.Itisveryimportantthatthedoctorrealizetheapproximatecostoftheprescribeddrug.Thedoctorcanalleviatethiscrisisbyprescribinganothermedicationwithequaleffectiveness.Thisshouldbedoneinconjunctionwiththepharmacist.Usinggenericnamesonascriptwillalsolowercostofdrugs.
(7)Somepatientsstoptheirmedicationswhensymptomsdisappear–onlytofindthemrecurringtwoorthreeweekslater.Anon-compliantpatientwillfrequentlyrefertothisdoctorasincompetentandseekanotherdoctor.Thisinformationshouldberecordedinthepatient’schart–evenifnotverified.
(8) Pharmaceuticalsales representativescanbeavaluableassetwith theirnewmedication. Seeing theserepresentativesbetweenpatientsisnotadvisable.Ipreferafifteen(15)minuteappointmentbeforeorafterallpatientshavebeenseen.Mostsalesrepsarepersuasive,well-trainedandarmedwithpositivestudiesabouttheirproducts.Itisimperativethatthedoctorcollaborateswithpharmacists,PDR,internetandrespectedcol-leaguesbeforeprescribingnewdrugs.
Competentmedicineanddentistryistimeconsumingforthedoctor–butsoistimespentinacourtroomasthedefendant.Moreimportant,itistimethatthepatientiseffectivelytreatedandcomfortable.
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Volume87,Number2•April,May&June2010 7
DD_ProvideradShineStaff_8.5x11_2010.indd 1 2/25/10 1:56 PM
Message from the EditorDr. Richard F. Roadcap
Thisshouldonlytakeafewseconds,Ithought.TypeIIIalloy,micronsthick,perfora-
tionshereandthere…afewsecondslater,astheburslidthroughthecrown,myrighteyebegantosting.Pacingthefloor,Iwonderedhowthemetalcouldcircumventsafetyglasseswithsideshieldsandlandinmyeye.SoonIwasseatedintheophthalmologist’schair,rollingmyeyeinvariousdirectionswhileabrightlightlookedfordebris.Theoffending
particleswereflushed,eyedropsdispensed,andIwasbackchairsidethesameday,withonlyasoreeyetoaccountfortheincident.
We’renumbinglyfamiliarwithuniversalprecautions:mask,gloves,gowns,protectiveeyewear.Whataboutourpatient’seyes?TheCen-tersforDiseaseControlrecommendssafetyglassesbewornbypatientsduringtreatment1.Doyouofferglassestopatientsbeforethehandpieceturns,or,instead,askthemtoclosetheireyeswhentheproceduregetsmessy?Theliteratureisthinonthissubject,andthefewarticlesinthearchivecontainonlyanecdotalevidenceofeyeinjuriestopatients.Onlyone-halfofUSdentalschoolsrespondedtoa2006surveyoneyeprotection,withthree-fourthsofthoserespondingsayingeyeprotectionforpatientswasrequired;one-fourthdidnotrequirestudentstodoso.2IposedthequestiontoDr.B.EllenByrne,SeniorAssociateDeanatVCUSchoolofDentistry,andshesaidclinicpolicyrequireseyeprotectionforpatients.
Ireadyourthoughts.“I’vepracticedalltheseyearsandneverhadaproblem.”“Thiswouldn’thappenifproperfour-handedtechniquewereused.”Bothcommentsringtrue,butIsuspecteyeinjuriesarelikethepalatalburnswithwhichwearefamiliar:thepatientcan’trecalltheincident.Manygounrecognizedandunreported,assymptomsmaynotappearforseveraldaysafterdentaltreatment.Thinkaboutourpotions–phosphoricacid;hydrofluoricacid;bondingagents;primers;calciumcarbonate.Theycarrygreatpotentialforinjuries,asdohandinstruments,burs,andsharpsofalldescriptions.Ioncebounceda#301elevatoroffapatient’swraparoundsafetyglasses,gratefulIwasthattheywereinplace.
Considerthemtobeaproductivityenhancer–timesavedbynothavingtodivertourfocustoseeifthepatient’seyesareclosed,andnothavingtoremindthemtodoso.Haveyoutriedtokeepyoureyesclosedforanhour?It’sdifficult.Protectiveeyewearisavailableinmanyforms,frommirroreddarklensestoindustrial,I-work-in-a-laboratoryframes.Dentalsupplierssellthem,andmosthomeimprovementstoreshaveasafetydepartment.Lookontheinsideofthetemplesfortheinscription
1 http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1htm2 Hill,E.E.:EyeSafetyPracticesinUSDentalSchoolRestorativeClinics,JDentEduc2006;70(12)1294-1297
“Z87”,theANSIstandardforeyeprotection.3Ifyoudon’tbelievetheyserveapurpose,lookatthelensesafteracrownpreparation(orsimilarprocedure).There’llbeaconstellationofdebris,eachparticlecarryingmanyscionsofthegenusStreptococcus.
Neitherdoctorsnorstaffwouldconsideroperatingwithouteyeprotection–OSHAwon’tallowit.Whynotprovidethesameprotectiontoourpa-tients?Almostalleyeinjuriesarepreventable.Itonlytakesamomentforanaccidenttooccur:thefidgetingpediatricpatient,theunexpectedmovement,theinstrumentsquirtingfromourwetgloves.Doyourselfafavorandrequirepatientstouseeyeprotection.Theywillappreciateyourconcern.ManytimesIhavebeenaskedbypatientsiftheycouldkeeptheglasses,orwheretheycouldgetapairtomatch.Aslight,elderlyladyonceremarkedshecouldseemoreclearlywithoursafetyglassesthanher(prescription)lenses.Irecommendedaneyeexam.
3 www.osha.gov/pls/oshaweb/owadsip.show_document?p_table=STANDARDS&p_id…
Eight year-old patient wearing eye protection.
Volume87,Number2•April,May&June2010 9Call 1-800-232-3826 today for a free practice appraisal, a $2,500 value!
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WWW.AFTCO.NET Guest EditorialRogers Hornsby and the GeckoBy: Kerry K. Carney, DDSReprinted by permission of the California Dental Association.
c d a j o u r n a l , v o l 3 7 , n º 2
f e b r u a r y 2 0 0 9 69
Editor
Thinking Criticallykerry k. carney, dds
e don’t know what we don’t know.
Some decisions are dif-ficult to make even when we know all the facts. Some de-
cisions are difficult to make because we can-not know all the elements of the problem. Some decisions are a matter of conjecture based on assumption, but most decisions are better when based on good evidence. That is, of course, the rationale behind an evidence-based practice of dentistry.
This is not about evidence-based dentistry per se; this is about gathering good evidence and making good decisions about dentistry and oral health care in the future. It is easy to think we already know everything we need to know to make a good decision. In many ways, the less we know, the easier the decision. Dr. David Nash, of the University of Kentucky, Col-lege of Dentistry, recently told the Board of Trustees, “We don’t know what we don’t know.” We need more information to make good decisions about dentistry and the future of oral health care.
The first step in critical thinking is to understand the scope of a problem. The second is to gather the pertinent informa-tion. The third is to remain skeptical and critically evaluate information before incor-porating it into a well-justified conclusion. Finally, one needs to be able to tolerate a considerable level of chaos. By this, I mean that answers are frequently untidy. Life is messy and conclusions are equally so.
I had a classmate in a geography course in college who was always frustrated because she wanted each topic wrapped up with a proper answer and no loose ends. Instead, each system we studied began with some beautifully simplified representation
that, upon research and reflection, proved to be far more complex and unpredictable.
There are those who maintain that money is all we need to eliminate oral health disparities and access to care prob-lems. In a very simple sense that is true. Unlimited funds applied in unrealistic manners could possibly solve the prob-lem. But oral health disparities and access to care are not simple problems. It is re-ally misleading to use the word “problem,” because that implies, like a puzzle, there exists a “solution.” It is more like a “dilem-ma” because there is no simple answer. We must choose among alternatives, each of which may have associated unattractive ramifications. It is a multifaceted issue with no single silver bullet solution.
The Surgeon General’s 2000 Report documented advances in the oral health status of the U.S. population over the past five decades. We know how to deliver excellent oral health care. Dentistry is health care that works, but it is not work-ing for everyone.
Oral health disparities in the United States are not simply a supply side prob-lem. Improved reimbursement would clearly improve provider participation, but there are so many other aspects that need to be addressed.
There are patient-related access barri-ers. These include, but are not limited to, geographic, linguistic, mobility, cultural,
and transportation barriers, family in-come, lack of insurance, education level, child-care services, health care literacy, patient age, case complexity, fears and phobias, health fragility, and economic exigencies. The coordination of services may present a health care system too complex to successfully navigate.
Each practice owner is familiar with the provider-related barriers. We not only provide oral health care; we must operate our practices in a sustainable manner. Dental practices exhibit demand-based market distribution. Inadequate economic support means the traditional economic model cannot be sustained. This makes it impractical for new dentists, trying to re-pay student loans, to locate their practices in high-need/low-income communities. Low reimbursement rates, administrative burdens, patient compliance issues, and the dentist’s fear of loss of control over his/her exposure to low reimbursement all work against attracting more providers to participate in current programs.
The constellation of barriers may vary from place to place and over time. An effec-tive program in one area may not be effec-tive in another. What works in urban Cali-fornia may not work in remote, rural areas. What works in a culturally homogeneous community may be useless in a multicul-tural context. What works in a target group of individuals of high oral health literacy
w Oral health disparities and access to care
are not simple problems.
WhatcouldRogersHornsbyandtheGeicogeckohaveincommon?Theyarebothiconsofindustriesthatshareanunusualcom-monality:antitrustlawexemption.
In1922,RogersHornsbyplayedsecondbasefortheSt.LouisCardinalsandhadoneofthebestyearsever.Inthatyear,hebecametheonlyplayerinhistorytohitmorethan40homerunsandbatover.400inthesameseason.Thatwasthefirstyearthathewonbase-ball’striplecrown:battingaverage(.401),homeruns(42),andrunsbattedin(152).Whilehewasbusyonthefield,MajorLeagueBaseballwasbusyinthecourtroom.
In1922,theSupremeCourtruledintheFederalBaseballClubofBaltimore,Inc.v.NationalBaseballClubscase.Theissuewaswhetherbaseballwasaninterstateoranintrastateevent.ThesuithadbeenbroughtbythefederalleagueclaimingthatitwashinderedinitsabilitytosignplayersasaresultofantitrustviolationsbytheNationalandAmericanLeagues.JusticeOliverWendellHolmeswroteinthedecisionthatthoughtheteamstraveledfromstatetostatethattheessentialbusinessoccurredwithinthatstate.Atthetime,“therewasnorevenuesharing,noradioortelevisionandnonationalsponsorsorlicensingdeals.”1Interstatecommerceissubjecttofederalregula-tion’intrastatecommercefallsunderstateregulation.,MLBenjoysanexemptionfromantitrustlawsuniqueinitsbreadthandduration.
Nowhowaboutthatgecko?Before1944,insurancehadbeendefinedasasimplecontractofindemnityandwassubjecttostateregulation.In1944,thatchangedwhentheUnitedStatesSupremeCourtaffirmedalowercourt’sdecisionthat“thebusinessofinsurancedidindeedaffectinterstatecommerceandthiswassubjecttocongres-sionalauthoritypursuanttotheCommerceClauseoftheUnitedStatesConstitution.”2
Everyonelikestobethebeneficiaryofregulation,butnoonelikestotheregulated.TherulingontheUnitedStatesV.South-EasternUnderwritersAssociation,322U.S.533(1944)settheinsuranceindustryinmotion.ItlobbiedCongressandsucceededinconvincingPatMcCarran,asenatorfromNevada,andHomerFerguson,asena-torfromMichigan,tosponsorabillthatwouldexempttheinsuranceindustryfromsomefederalantitrustlaws.Unlikethebaseballexemptionthatcamefromthejudicialbranch,theinsuranceexemptionwastheresultoflegislation.
TheMcCarran-FergusonBillwasintroducedwithintwoweeksoftheSouth-EasternUnderwritersdecision.VersionsofthebillpassedintheSenateandtheHousewithoutanyhearingandlittledebate.Whentheconferencecommitteeconsideredtheversions,thefollowingphrasewasinserted,“insurersareexemptfromfederalanti-trustscrutinysolongastheyare‘regulatedbystatelaw.’”Judicialinter-pretationofthatphrasehastransformedatemporarymoratoriumonfederalscrutinyandprosecutionintoapermanentantitrustexemption.“Courtshaveinterpretedthisphrasetorequireonlythatstateregulatorshavejurisdictionoverparticularconduct,regardlessofwhetherthatauthorityiseverexercised…Asaresult,anticompetitiveconductmay
1 ESPN:Baseball’santitrustexemption:Q&ADec5,2001.Sports.espn.go.com/espn/print?id=1290707&type=story.AccessedOct.13,2009.
2 ADAAlertRe:HR1583McCarran-FergusonAct-KeyPointsforADAMembers,May2009.
escapebothregulatoryoversightandantitrustscrutiny.3TheMcCarran-FergusonActof1945wassupposedtobeastop-
gaptoallowtheinsuranceindustrytogetitshouseinorderbeforeitcameunderfederalantitrustlaws.ThiswassoclearlyarticulatedintheCongres-sionalRecordthatPresidentRooseveltprovidedthefollowingpressreleaseaftersigningthebill,“Afteramoratoriumperiod,theantitrustlaws…willbeapplicableinfullforceandeffecttothebusinessofinsurance.”3
Duringthepast64years,theinsuranceindustryhasforestalledattemptstorepealormodifyMcCarran-Ferguson.DuringtheaftermathofHurricaneKatrina,billS168wasintroducedinanattempttoallowtheFederalTradeCommissionregulatorycontrolandjurisdictionoverareasofthebusinessofinsurance.Thisbillfailedin2007.TheInsuranceIndustryCompetitionActof2009,HR1538,wasintroducedinMarch.Thetwobillsarevirtuallyidentical.TheADA’sstanceonthebillisclear,“Thefactisthatdentists,theirpatientsandthepublichealthareallvictimsofMcCarran-Fer-guson’snegativeimpactonrobustcompetitionamonginsurancecompanies,andallwouldbenefitfromitsrepeal.”2
Theargumentformaintainingtheinsuranceexemptionspringsfromthenotionthatthepoolingofhistoricalandprojectedlossexperiencehelpssetratesmoreaccuratelyandtherebybenefitsconsumers.Itisalsoproposedthatsmallercompaniesmaycompetemoreeffectivelybasedonpooledinformationthantheycouldbasedontheirownlimitedexperience.Finally,opponentsofliftingtheantitrustexemptionsforthebusinessofinsur-ancearguethestatusquo.Ifithasoperatedwellforthepast64years,whychangenow?
Theproponentsofeliminatingtheinsuranceexemp-tionpointoutthereareothermechanismsthatallowcompetitiveexchangesofinformationbyindustriesthatdonotenjoythesameexemptionastheinsuranceindustry.TheyalsoremindusthattheMcCarran-FergusonActwasproposedandpassedin1945forthebenefitofconsumers.Specifically,theADApointstothepotentialforunfairandbiasedindustrycalculationsforusual,customary,andreasonablefeesthatmayresultineconomicdisadvantagesforconsumers.4TheADAconcluded,“thelimitedantitrustexemptionenjoyedbytheinsuranceindustrydistortsmarketstotheseriousdetrimentofbothconsumersandbusinesses.”2
InCalifornia,wehaveanotherfactortoconsider.Inthespiritoftransparencyofpurposeandpotentialconflict,thereisourrelation-shipwithTDIC.Thefor-profitsubsidiaryofourassociationisintheinsur-ancebusiness.Theinsurancebusinesshasbeen,inlargepart,responsibleforthestabilitywehaveenjoyedinourdues.Wehaveadisincentivetoinviteamoreonerousregulatoryenvironmentforthatbusiness.
Thingsareseldomassimpleastheyinitiallyseem.Sothenexttimeyouseethatgeckoadvertisinginsurance,imaginehimbeingtaggedoutatsecondbasebyHornsby,Takeamomenttowonderabouttheiranomalousantitrustlawexemptionsandwhatthatmighthavetodowithdentistry..
3 Statement,UnitedStatesSenateCommitteeontheJudiciarytheMcCarran-FergusonActandantitrustimmunitygoodforconsumers?March7,2007.Hon.TrentLott,UnitedStatesSenator.4 ADA2009a.ADAAmericanDentalAssociation,America’sleadingadvocatefororalhealth,2009WashingtonLeadershipConference,HR1583InsuranceIndustryCompetitionActof2009.
Everyone likes to be the beneficiary of regulation, but
no one likes to be regulated.
Volume87,Number2•April,May&June2010 11
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Dr. Alonzo BellMessage from the President
Despiteawinterofhistoricsnowstorms,wehavebeenverybusyduringthethreemonthssincethelastprintingofourJournalinJanuary.Asmostofyouknow,themajorityofoureffortshavebeenfocusedonpromotingthepassageofourlegislativeinitiativeconcerningthefeesettingofnon-coveredservicesbydentalinsurers.IampleasedtoreportthatasIwritethismessage,ourbilllooksverypromisingandthatallwenowneedisthesigna-turebytheGovernorandthisbillwill
thenbecomelaw.Onceagain,Isaythankyoutoallwhoparticipatedinanywayinthismonumentaleffort.
AsIreflectontheseefforts,Ican’tthinkofabettertimetoremindyouoftheimportantrolethatADVOCACYplaysinthefutureofourprofession.ThetwomostcriticalfactorsintheadvocacyprocessareadequateresourcesinourPACandstrongmembershipnumbers.Ifyouhavenotalreadydoneso,IaskthatyougivegenerouslytoourVADPAC.Ifyouhavenotalreadydoneso,IaskthatyoumakecontactwithsomeonethatyouknowisnotaVDAmemberandaskhimorhertojoin.Wehavejustwitnessedthepowerandthevalueofmembershipinourdentalas-sociationandwemustcontinuetostaystrongtofacethenextchallengethatwillinevitablycometoourprofession.
Notsurprisingly,therehavebeenotheractivitiestakingplaceinadditiontoourlegislativeactions.Duringthisperiod,Ihavehadtheopportunitytotraveltoseveralofourcomponents,andinJanuary,wehadourcom-mitteemeetingsinRichmond.OnehighlightofourcommitteemeetingswasthecombinedworkshoponmembershipfacilitatedbyDr.BruceDeGinder.AcommonthemethatIseefrombothmyvisitstocompo-nentsandourcommitteemeetingsisthedifficultywefaceinidentifyingmemberswiththewillingnessanddesiretoserveinourcommittees.Sincethecommitteestructureisthebackboneofourassociation,Iimploreanyonereadingthismessagetomakeitknowntoyourcompo-nentleadersifyouhaveinterestinservingonanyofourcommittees.Evenifyouwanttoservebutareunsureofwhere,makethecontactandwewillfindaplaceforyou.Ifyoudon’tknowwhomtocontactinyourcomponent,pleasefeelfreetocallore-mailtheVDAofficesandwewilldirectyoutotheproperperson.Iamabigbelieverinthe“deepbenchtheory”andthereforewecanalwaysfindaplaceforyoutoserveourassociation.
Asthedaysarenowgettinglonger,weknowthatspringisfastap-proachingandsoIaskyoutorememberourupcomingVirginiaMeetinginJune.Pleasemakeplanstoattend;bringyourstaffandinviteyourfriends.Thisyear’smeetinginWilliamsburgpromisestobeanexcit-ingopportunityforfellowshipwithcolleaguesandexcellentcontinuingeducationatthesametime.
TakecareandIhopetoseeallofyouinWilliamsburg!
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Mid-level providers – are they effective?Youcannotopenanydentalpub-licationthesedayswithoutread-ingsomearticleabouttheuseofmidlevelproviderstoaddressaccesstocaredeficiencies.Ifyouarelikeme,youhavetobetiredofnon-dentistsproposingasolutionforthedentaldeliverysystemwhentheyknowverylittleaboutourprofession.Ofcourse,proponentspointtotheirappar-entsuccessfuluseworldwide
asavalidreasontosupporttheirusehereintheUS.Infact,thereisnoconsistencyoftraining,accreditation,scopeofpractice,oruseinthede-liverysystemamongstthecountriesusing“midlevels”.So,howcanyouevaluatetheirrolesinthedentaldeliverysystemortheireffectivenessinaddressingdentaldiseaseandaccessdisparities?ThereasontheUShasthebestdentalcareintheworldisbecausewedohavestandardsforeducation,accreditation,andlicensurethataresupportedwithsoundscienceandatrackrecordofsuccess.Standardizationandaccredita-
tionoftheeducationalprogramsrequiredforscopeofpracticeofbothdentistsandtheparafunctionalauxiliariesunderoursupervisionarethepillarsonwhichthequalityofourprofessionwasestablished.Let’sexaminewhatwereallydoanddonotknowabouttheuseofdentalextenders,theirroleindeliveryofdentalservices,andhowweevaluateworkforceproposalsinthefuture.First,whatisamidlevelprovider?Basedonthegoalofprovidingmorecaretomorepatientsattheleastcost,Icontendthatlikeourmedicalcounterparts,dentistryhaslongrecognizedthatthedelegationofsometasksofpatientcareisthemostefficientandcosteffectivewaytoex-tendthecapabilitiesofadentist.TheADAsupportstheexpansionofdu-tiestotraineddentalauxiliarieslikehygienistsandEFDAstosupportthedentalteamandfreethedentist’stimeformorecomplicatedprocedures.Today,withgraduatesofaccreditedtrainingprogramsthroughouttheUS,mostdentalofficesutilizestafftoprovideexcellenttreatmenttoafargreaternumberofpatientsthanwasthecaseintheearlytomidfifties.Asaconsequence,dentaldiseaseratesintheUShavefallendramati-callyinthelastfiftyyears.
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Aching tooth turns into a $44,000 bill By:FrankDelanoReprintedwithpermissionfromtheFreeLanceStarPublishingCompany
KennethC.VanDeusenisa32-year-oldWestmorelandCountylaborerwithbadteeth.Heliveswithhismother,sisterandnephewnearMontross.
VanDeusenisalsopoor.Hetakesworkwhenhecanfindit.Hereckonsheearned$2,000doingoddjobslastyear.Helacksmedicalanddentalinsurance.
InSeptember,atoothachesentVanDeusentotheNorthernNeckFreeHealthClinicinKilmarnock.
Itwasthefirst50milesofamedicalordealthatcostnearly$44,000.Hereceivedrapid,lifesavingcare,butmostofitscostwillbepaidbyeverybodyinonecomplexwayoranother.
Hisjourneyalsoillustratestheplightofthepoorinobtainingdentalcare.HealthcarereformsnowbeingdebatedinWashingtonappeartoofferlittlehopeforbetterdentalcareforthemillionsofpeoplelikeVanDeusen.
AttheKilmarnockclinic,VanDeusenpaid$25toseeadentist,whooutlinedaplanfor10ofhisteeth,includingextractionsandrootcanals.Hesaidthedentisttoldhimeachtoothwouldrequiretwoorthreevisitsatacostof$25pervisit.
“Itain’talot,butitisawholelotwhenyouain’tgotnothing,”VanDeusensaid.“ItjuststartedaddinguptothepointthatIcouldn’taffordit.”
Theclinicaskedhimtopay$25inadvanceforaseconddentalappointmentinOctober.“Ididn’thaveit,soIdidn’tmaketheappointment,”hesaid.
VanDeusen’stoothacheworsened.HewokeupSept.27withpainfulswellinginhisjawandneck.Theswellinginhisthroatmadeithardforhimtobreathe.HissisterdrovehimtotheemergencyroomatRiversideTappahannockHospital.
“Assoonasthedoctorsawme,hesaidthathe’dhavetosendmetoRichmond.Hecalledanambulance,butfoundoutitwouldtaketheambulanceanhourtogettothehospitalandanotherhourtogettoRichmond.HesaidIwassobadoffthathecalledthehelicopter,”VanDeusensaid.
Theambulancethattookhimaquarter-miletoRiverside’shelipadcost$457.The41-mileLifeEvacflighttoRichmondcost$16,298.52.TheambulanceinRichmondthattookhimonemiletoVCUMedicalCentercostanother$500.
Hewasadmittedtotheintensive-careunitatVCU.Insurgerythenextmorning,doctorsextractedthreeofhisteethandinstalledatubetodraintheabscessinhisthroat.Hewasdischargedthenextafternoon.
“WhenIleftthehospital,theytoldmetofollowupwithmyregulardentist,butIdon’thaveone,”hesaid.
Thebillssoonstartedtoarrive.ForhisthreedaysoftreatmentintheRichmondhospital,thebillwas$25,012,“plusbillsontopofthatforotherdoctors,”VanDeusensaid.
“Itjustaddedupsofast.Nowthetotalismorethan$43,000,andthebillsarestillcomingin.
“Nobodytoldmehowmuchallthiswasgoingtocost.Nobody.ButIreallyneededtreatmentatthatpointanddidn’thaveachoice.Icouldhavediedandbeenburiedfourtimesforthatamountofmoney,”hesaid.
ADESPERATENEED
DentalordealssuchasVanDeusen’s“aresituationsfacedbymanyadultsinVirginiaeveryday.Someofthemaresodesperateandinsomuchblindingpainthattheypulltheirownteeth,”saidDeborahD.Oswalt,executivedirectoroftheVirginiaHealthCareFoundation.
VanDeusenisoneofmorethan100millionpeopleintheUnitedStateswithoutdentalinsurance.HeisalsoavictimofwhattheU.S.surgeongeneralcalleda“silentepidemicofdentalandoraldiseases”causedby“profound”disparitiesindentalcare.
“Thosewhosuffertheworstoralhealtharefoundamongthepoorofallages,withpoorchildrenandpoorolderAmericansparticularlyvulnerable.Membersofracialandethnicminoritygroupsalsoexperienceadisproportionateleveloforalhealthproblems,”thesurgeongeneralwroteina2000report.
Locally,dental-careneedsareespeciallygreatamongthegrowingHispanicpopulation,saidDr.CathieH.Butterworth,aFredericksburgdentistwhoorga-nizesanannualfreedentalcliniccalledDentistrywithaHeart.
Dr. Stuart Martin of Richmond (left) and VCU dental student Matt Chapman (right) talk to Kenny Van Deusen about a treatment plan for his teeth. Van Deusen’s dental problems resulted in a $43,991 bill
Chapman shows Van Deusen the problems with his teeth. Van Deusen has no dental care insurance.
Ethics – What Are We Saying About Ourselves? By: Melissa L. Wolfe, D.D.S., Chair, Ethics & Judicial Affairs CommitteeIhaveovertimeobservedthevariouscommu-nicationsandadvertisementsplacedintothepublicview,andIamleftwithsomequestions.Whatdeterminesprofessionalethics?Bywhatimplementareweabletogaugetheappropri-
atenessofanaction?IwenttotheInternettolookforananswer.InanarticlewrittenfortheAcademyofGeneralDentistrybyDonaldPatthoff,D.D.S.,F.A.G.D.,andDavidOzar,Ph.D.onthetopicofethics,theywrotethat“...thecontentofaprofession’sethicsisnotdeterminedsolelybythemembersofthatprofession,butratherindialoguewiththelargercommunityinwhichitserves.”
Iinferfromthatstatementthatifwearelisteningtowhatourcommuni-tiesaresayingandrespondingtotheirneeds,wearetakingappropriateaction.Wealwaysmakesurethatourpatientsarereceivingthebestclinicalcare,butdoweallmakecertainthatwearecommunicatingasclearlyandpurelyasweshouldbe?Ifourpatientsfindamessageoradvertisementpresentedbyamemberofourprofessiontobemislead-ingorconfusingandnoattemptismadetoclarifytheissue,thenweareallowingthecreationofanunethicalsituation.Itfollowsthenthatallcommunicationneedstobeclear.TheproliferationoftheInternetwithin
thelasttenyearshasresultedinvirtualbombardmentofthepublicwithinformationandgreatlyexpandedthedialoguebetweendoctorsandpa-tients.Istheinformationandadvertisingweusetodistinguishourselvesfromotherdentistshealthyforthisdialogue?
Inordertopreservetheintegrityofthisdialoguethereexiststheneedtoimplementasetofguidelinestobefollowed.Thiswillensurethatwespeakwithacommonvoicewhichisconsistentwiththecurrentlan-guageusedbyourgoverningorganizations.Materialwrittenbymem-bersoftheseorganizationsthatisinconsistentwithorcontradictsthecurrentinformationgraysthedialoguewearestrivingtomaintainanddestabilizespublicperceptionofourprofessionandgoverningbodies.Ifwearen’tinagreementwithstandardsorinformationheldtobecurrentbestpractice,weneedtopresentfactualinformationthatbringschangeratherthanpublicizeinformationthatcontradictsit.Weneedtosupportourgoverningbodiesinordertosendacommonandthereforeclearermessage.Arewedoingeverythingwecantosendaclear,consistentmessagetomakesurethatourpatientsarestilllisteningtous?Hereinliesthevitalimportanceofethics.
American Dental Association Statement on Zinc in Denture CreamCHICAGO,Feb.19,2010—Millionsofpeopleusedenturecream(alsoknownasdentureadhesive).Some,butnotall,denturecreamscontainzinc.Afewrecentcasereportsinthescientificliteratureindicateapossibleassociationbetweenexcessiveuseofzinc-containingdenturecreamsandneurologicalandhematologicalproblems.
Ineachsituation,thepatientshadill-fittingdenturesandreportedusingexcessiveamountsofdenturecreamwithzincforyears.Severalpeoplereportedusingtwoormoretubesofdenturecreamperweekforyears,whenonetubewouldnormallylastfor3-10weeks,whenusedasdirected.Theauthorstheorizethatthepatientsprobablyswallowedexcessdenturecream,andthatoveryearsofuse,zincmayhavebuiltupintheseindividual’sbodies.Itiswelldocumentedthatswallowingexcessiveamountsofzinccanraisebloodlevelsofzincwhichcanleadtolowerbloodlevelsofcopper.Thelowerbloodlevelofcoppercanthenleadtoneurologicalandhematologicalproblems.
Moreinformationisneededtodetermineifthereisacauseandeffectrelationship.TheU.S.FoodandDrugAdministrationhasnotissuedanadvisoryorrecallofzinc-containingdenturecreamsatthistime.AsofFeb.19,2010,GlaxoSmithKline,amajormanufacturerofdenturecream,voluntarilydecided,asaprecautionarymeasure,tostopusingzincinthefollowingdenturecreambrands:SuperPoligripOriginal,
SuperPoligripUltraFreshandSuperPoligripExtraCare.TheADAadvisesdenturewearerstoseetheirdentistiftheirdenturesdonotfitwelloriftheyhavequestionsabouttheuseofdentalcream.Dentalexaminationsandappropriatecarecanreducetheneedfordentureadhesiveproducts.
Regulardentalcheckupsareimportantforeveryone,includingdenturewearers.TheADA’sCouncilonScientificAffairswillcontinuetomonitorthisissueonbehalfofourmemberdentistsandthepatientstheyserve.AbouttheAmericanDentalAssociationThenot-for-profitADAisthenation’slargestdentalassociation,representingmorethan157,000dentistmembers.Thepremiersourceoforalhealthinformation,theADAhasadvocatedforthepublic’shealthandpromotedtheartandscienceofdentistrysince1859.TheADA’sstate-of-the-artresearchfacilitiesdevelopandtestdentalproductsandmaterialsthathaveadvancedthepracticeofdentistryandmadethepatientexperiencemorepositive.TheADASealofAcceptancelonghasbeenavaluableandrespectedguidetoconsumerdentalcareproducts.ThemonthlyJournaloftheAmericanDentalAssociation(JADA)istheADA’sflagshippublicationandthebest-readscientificjournalindentistry.FormoreinformationabouttheADA,visittheAssociation’sWebsiteatwww.ada.org
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“Patientsstartliningupat3a.m.,”shesaid.
InJuly,2,715peoplefrom16statesshowedupatafreeweekendmedicalanddentalclinicstaffedby1,800volunteersinWiseCounty.Dentistsconducted1,850exams,pulled3,857teethandfilled1,628cavities.
TheVirginiaDentalAssociationwaspartoftheWiseCountyclinic.Inthepast10years,theVDAhasfielded41MissionsofMercyinmostlyruralsectionsofthestate.Themissionshaveprovided$16.5millionindentalservicesto32,000Virginiansseekingrelieffromthepainandembarrassmentoftheirteeth.
“Icallthisgroup‘thesilentvoicesofneed,’”saidDr.TerryD.Dickinson,execu-tivedirectoroftheVDA.“Youwon’tseethemdownattheGeneralAssemblyaskingforadultbenefits,astheywouldlosetheirjobsiftheymissedadaytoadvocateforthemselves.Thisistrulyapopulationthat,forthemostpart,isunseenandunheard.”
RegulardentalcaremighthavepreventedVanDeusen’stoothache.Buttheneedtofindadentist,highout-of-pocketfees,andtransportationandchild-careissuesoftenpreventlow-incomepeoplefromobtainingdentalcare,accordingtoa2008reportoftheKaiserCommissiononMedicaidandtheuninsured.
TheVirginiaDepartmentofHealthprovidesdentalcare,mostofitforchildren,in39ofthestate’s134countiesandcities.Asafety-netsystemof57commu-nity-baseddentalclinicsprovided43,976visitslastyear,“butthat’sjustadropinthebucketconsideringthehundredsofthousandsofpeoplewithnodentalinsuranceinVirginia,”saidtheVirginiaHealthCareFoundation’sdirector.
“There’sanunbelievableunmetneed,”saidOswalt.Somecommunityclinicsareopenonlyanightortwoaweek.Waitinglistscanbemonthslong.OswaltsaidoneclinicrecentlyreportedtotheVHCFthat“painisnotanemergency.”
HOLESINTHENET
ItwasintothisflimsysafetynetthatVanDeusenjumpedwhenhistoothacheforcedhimtoseekhelpattheNorthernNeckfreeclinicinSeptember.Itwashisfirsttriptothedentistsincehewasingradeschool,hesaid.
Theclinic’ssixdentalchairsarefullfourdaysaweek.Twopaiddentists,vol-unteerdentistsanddentalstudentsseelow-incomepatientslikeVanDeusen.“We’reprettyclosetomaximumcapacity,”saidJeannieNelson,theclinic’sdirector.
Shesaiditcoststheclinicabout$375,000ayeartoprovidenearly$2millionindentalservicestothepoor.Inall,theclinicprovides$6millioninmedical,dentalandpharmacyservicesona$1.2millionbudgetthatdependsondona-tionsandvolunteers.
Thebadeconomyhascutdonationsandincreaseddemandforservices.“Somedonorsarenowpatients.Thisyearwe’refacinga$250,000deficit.Itcouldbethefirsttimeinourhistorythatwe’vebeeninthered,”Nelsonsaid.
Shesaidthe$25feefordentalappointmentshelpsensurethatpatientswillshowupforappointments.Thefeecanbewaived,shesaid.
VanDeusensaidnobodyattheclinictoldhimaboutthewaiverwhenhewasthere.
ThemisunderstandingresultedinVanDeusen’semergencytreatmentthatcost$43,991.88.
Thebillwaspaidbyothers,throughtaxesandhighercostsformedicalcareandcoverage.
FrankDelano:804-761-4300 Email:[email protected]
Dr. Matthew Storm, a Spotsylvania dentist, was one of the volunteers at the 2007 free dental clinic in Southwest Virginia. The huge turnout at the annual event illustrates the need for better dental care for low-income people.
Richard Barnette, 50, was among the thousands of people treated at the free dental clinic in Wise County.
Upcoming M.O.M. Projects
Piedmont Regional M.O.M.May 1, 2010
Wise M.O.M.July 23-225, 2010
Grundy M.O.M.October 2-3, 2010
Register to Volunteer at www.vadental.org
TheThreeRiversHealthDistrict,oftheVirginiaDepartmentofHealthisa10countyHealthDistrict.FiveofitscountiesfallwithintheGreaterWilliamsburgservicearea(Gloucester,King&Queen,KingWilliam,Mathews,andMiddlesex).ThesearetheserviceareasforthedentalvanwhichwillbecomeanadditiontotheVDHsafetynetclinics.
Greater Williamsburg area added to the VDH Safety Net Clinics. By: R. Lynn Browder, DDS, MBA - Quality Assurance Manager, Division of Dental Health
Thevanisa40ftArmorMobilecoachwithtwofulloperatories,lab,x-rays,wheelchairaccessibleandshorepowerorgeneratoroperationcapability.ItisverysimilartotheoneinusebytheRichmondCityHealthDepartmentandstaffedwithafulltimedentist,assistant,dentalhygien-ist/programcoordinatorandaparttimedriver.ItwaspurchasedandmanagedthroughtheVDHwithconsultationandtechnicalsupportfromtheOfficeofCommunityHealthServicesandtheDivisionofDentalHealthandfundedbyagrantfromtheWilliamsburgCommunityHealthFoundationawardedasaresultofDr.Irungu’sef-forts.Theproject’sgoalistotakedentalservicestothecommunityusingamobiledentalclinic.Serviceswillincludepreventive,emergencyandcomprehensivecareforbothchildrenandadults.TheserviceareaandpopulationtobeservedwillbealltheresidentsofthefivecountiesintheWCHFservicearea;wewillspecificallytargetlow-incomeuninsuredandunderinsuredchildrenandadults,childrenwithMedicaid/FAMISandthosewithoutadentalhome.Thevanwillpartnerwithlocalnonprofits,schools,privateprovidersandtheVDAinsupportofthelocalMOMprojects.
Virginia Oral Health Plan 2010 - Excellent Oral Health for All VirginiansBy: Sarah B. Holland, Virginia Health Care Foundation
InOctober2009leadersinoralhealthfromthroughoutthestategatheredatanoralhealthsummittocreateafive-yearstateplandesignedtobearoadmaptobringallVirginiansexcellentoral
health.SummitparticipantscontributedtheirexpertiseandexperiencesinbreakoutsessionstoidentifygoalstowardachievingexcellentoralhealthforallVirginiansandtooutlinenecessarystepsandobjectivestomeetthosegoals.
TheVirginiaOralHealthCoalition(VOHC),agroupofindividualsandorganizationsfromthroughouttheCommonwealthwhoarecommittedtoimprovingtheoralhealthofeveryoneinVirginia,convenedasteeringcommitteeofrepresentativesofawidevarietyofgroupswhocareaboutoralhealthtosynthesizetheinformationfromthesummit.TheresultistheVirginiaOralHealthPlan,alivingdocumentdesignedtobeusedasaroadmaptomeettheultimategoalofexcellentoralhealthforallVirgin-ians.Theplanisdividedintosixstrategicareas:StrategicAreas:
I. PublicAwarenessII. AdvocacyIII. OralHealthDataIV. EducationV. NewOralHealthProgramsVI. VirginiaOralHealthCoalitionDevelopment
Theplan’soverarchinggoalsare:educateandengagethepublicabouttheimportanceoforalhealth;makecertainthelawsandregu-lationsinVirginiasupportoralhealthaccessandeducation;ensurethataccurate,comprehensiveoralhealthdataexists;andpreparedentalprovidersandfuturedentalproviderstomeettheneedsoftheunderservedinVirginia.TheplanwillbemanagedbyVOHC,whichhascreatedworkgroupsforeachstrategicarea.Membersoftheworkgroupswillactivelymanagetheactionstepstomakecertaintheobjectivesandgoalsoftheplanaremet.
IfyouareinterestedinimprovingoralhealthinVirginia,VOHCseeksyourparticipationinoneoftheworkgroups.FormoreinformationabouttheVirginiaOralHealthCoalitionortheVirginiaOralHealthPlan,pleasecontactSarahBedardHollandat:[email protected]
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Editor’s Note: “An incredible tale of abuse, neglect, parenting and triumph…” says Lynn Mouden, DDS, MPH, founder of P.A.N.D.A.. Dr. Terry Dickinson calls it “A story of hopelessness that turns into a story of hope.” Past ADA President Kathleen Roth says “…the facts behind her dental saga are…important for all of us in dentistry to hear and understand.” Since its publication in 2003 The Covered Smile has touched the lives of many dentists and their patients. The VDA Journal spoke with author Sonja Lauren as she prepared to launch her founda-tion dedicated to helping victims of dental neglect and abuse.
How has your life changed since The Covered Smile was pub-lished in 2003?I’veworkedharderthanIeverimagined.Networking,publicspeak-ing,volunteering,lecturingtostudents,andtryingtofindwaystohelpthoseinneed.Iwentfromworkingasanophthalmologist’sassistanttoworkinginthedentalfield,beingthepresidentofTheCoveredSmileInc.,andthePresidentoftheSonjaLaurenFoundationInc.Lifeisneverboring.Also,mydaughtergraduatedfromtheChesterfieldTechCenterandearnedherD.A.,andrecentlyhasbecomeanoralsurgeryassistant.Mydaughter’slifeandminewerechangedwhenwevolunteeredatourfirstMOMProjectin2006,inWiseCounty.Forthefirsttime–IfoundouttherewerepeoplewhotrulycaredandthatIwasnotalone.Mydaughter’sdesiretohelpotherswasbornatthisMOMproject.I’vechangedfrombeingabeggartobeingsomeonewhocannowhelpothers.Mydaughter’sdentalassistingteacherre-quiresherstudentstoreadthebookandattendaMOMProject.Everyfall,IaminvitedtospeaktotheChesterfieldTechCenterstudentsaftertheyhavereadThe Covered Smile-theyaretrulymyfavoriteaudience.Has writing this book led to any unexpected consequences? IttookmuchlongerthanIthought.Istruggledlongandhardtocom-pletethis.Itellpeoplewhowanttobepublished:walkintoBarnesandNobleandlookaround.That’syourcompetition.Also,published
An Interview With:Sonja Lauren
authorsareexpectedtobepublicspeakers.IjoinedToastmasters–itwasveryhardformeatfirst,speakinginpublic,infrontofpeople.IgavemyfirstlecturetothestudentsatMCV,onClinicDay,theclasswasaskediftheywantedtohearalecturefromafacultymember,orhearaboutapatientwhohadallherteethextractedatagethirteen.Theyvotedtohearmystory-“apatient’spointofview”.
What encouraged you to start your own foundation?JohnRandall,whowasontheboardofPreventChildAbuseVirginia,metmeatacharityeventandIsenthimacopyofmybook.He’sbe-comeamentortome,providinghelpandencouragementateveryturn.WhenItoldhimIwantedtohelpmorepeople,butIhaveadayjob,hesaid,“Youneedafoundationsoyoucancombineyourpassions!”LatertheShoeCarnivalcompanycontactedmeandwantedtomakeadona-tiontomyfoundation,butItoldthemIdidn’thaveone.FinallyIadmittedJohnwasrightallalong,andbegantheprocessofdevelopingtheSonjaLaurenFoundation,Inc.Sofar,myefforthasnotfreedmetodootherthings,butithasexpandedmycontacts,speakingengagementsandabilitytohelpothers.What makes the Sonja Lauren Foundation unique?I’vebeentoldbymanywehaveafreshnewwayofdoingthis.Iaskmyself:whatcouldhavehelpedtwelveyear-oldSonjaLauren?IdeeplyunderstandtheimportanceofthisissuebecauseIhaveworndenturessincetheageofthirteen.Wewillprovideeducation,exams,cleanings,prevention,andalso,wewillaskclientstobepartoftheeducationalprocessandbefollowedforoneyearaftertreatment.Dentistscancon-tactusandapplyonbehalfofapatient–wewillhelppayfortreatmentswhenthefundsareavailable.Wewantchildrenandeachsucceedinggenerationtohavegoodoralhygienepractices.Wewanttohelpthosepatientswhodon’thaveMedicaidordentalinsurance.Thosewhoarestuckinthemiddle,ifyouwill,thosewhoarewhereIoncewas.
Over the past ten years, has abuse and neglect of children gotten worse or better? Why?Icontactedtheexpertsonthisone.JohannaSchuchert,atPreventChildAbuseVirginia,sayssexualabuse,physicalabuse,andemo-tionalabusehavedeclinedsincethe‘90s,butemotionalneglecthasincreased.BothsheandDr.LynnMoudenofPANDAsayabuseandneglecthaveincreasedinthelasttwoyearsduetotheeconomy.Abuseandneglectalwaysgoupwhenunemploymentincreases.Ithoughtitwasgettingbetter,butitisstillaverybigproblem.I’venevergivenalecturewhenatleastonetothreepeopledidnotcomeuptomeafter-wardsandsay,“thatwasme”.
Do you have mentors? Who are they?Yes,IhavesoverymanywonderfulmentorswhoIamthankfulfor!I’vealreadymentionedMr.JohnRandall,andthere’sDr.BillieUnger,mypurple-pennedwritingprofessorwhotaughtmefarmorethanhowtowrite,shetaughtmetonevergiveup.DeborahHatchell,executiveassistantatChickenSoupfortheSoul,calledmebackafterIleftames-sage,andhassincetookmeunderherwing–andprotectedmewhenIwasnegotiatingwithpublishers.Iwasblessedtofindher.Dr.LynnMoudenfounderofPANDA(PreventAbuseAndNeglectThroughDentalAwareness)hasbeenamentor,alongwithLindaMiles(she’sfromWestVirginia,too),andofcourseDr.Dickinson,DavePelzer,whowroteAChildCalledIt,andDr.KathyRoth,whowaspresidentoftheADA.Therearemanymorewhohavehelpedalongtheway.My“adoptedmomanddad”asIcallthem,havelovedme,guidedmeandsupportedmesincetheageof18.
In what ways is the dental profession failing its patients? Idon’tfeeltheprofessionisfailingitspatients.Dentistsanddentalor-ganizationsareworkinghardtoincreaseaccesstocare,butthere’sstillsomuchtobedone.Nowwehavedentistsnotwantingtohavepooraccesstooralhealthcareanditsconsequences:there’sGiveKidsASmile,MOM,OralHealthAmerica.Theyareallreachingouttolegisla-torsandourcountrytobringawarenessofhowimportantoralhealthistotheoverallhealthofone’slife.
From your perspective as a patient, has the dental profession redeemed itself? Asforthegroupofdentiststhatwrote“situationhopeless”onmydentalchartandremovedallofmyteethforcingmetoweardenturesattheageof13yearsand3monthsofage–Idon’tassociatethemwithotherdentists.Somehow,Ineverhave.Duringmyadulthood,Ihavebeentreatedwithkindnessandrespectbymanydentists.EspeciallybyDr.JohnWardwhothroughkindnessandgenerositymademebeautifuldentureswhichnotonlygavemysmileback,butalsomyselfesteemandlifebackforthefirsttimesinceIwasthirteenyearsold…
Do you have any advice for new dentists? WhenIlecturetodentalstudents,Isuggestthattheyconsiderbuildingtheirpracticeontheconceptof“word-of-mouth”typemarketing.Whilemarketingagenciesandstrategiescanbehelpful,themostimportantfactorofallisthesatisfactionofthepatient.IsuggestnewdentistsvolunteerwiththeMOMProjects,GiveKidsASmile,orotherformsofcommunityservice,becausepatientsandtheircommunitywillknowthemasadentalpracticewhotrulycares.Ialsobelievedentalstudentsneedtoreadandunderstandthedentalcreedfully.
What changes should be made in the education of dentists? One,dentistsshouldberequiredtoattendaMOMorsimilarprojectbeforetheyareallowedtograduate.Two,dental(students)shouldberequiredtoreadThe Covered Smile.IspoketothestudentsatWestVirginiaUniversity(SchoolofDentistry)andthedeanmadeitrequiredreadingforthird-yearstudents.Onestudent(intheclassof2013)didhismaster’sthesisonthebookbeforeheenrolled.IhavebeentoldrepeatedlythatThe Covered Smileismakingadifference,notonlyinthelivesofthoseinneed,butalsointhelivesofthosewhoserveasprofessionalsinallmedicalanddentalfields…
Mrs. Linda Miles, Dr. Terry Dickinson and Sonja Lauren.
Visit the Sonja Lauren Foundation website at:www.sonjalaurenfoundation.org
DONATIONS NEEDEDDr.TaraZierandDr.GraceLeeofSmilesatFairfaxCorneraregoingonamissionstriptoRwanda,AfricaJune28ththroughJuly9th.Wewillbeprovidingdentalcaretoanindigentcom-munityinKigali,Rwanda.Currentlytherearenoinstrumentsorsuppliesavailable.Ourplanistosetupafacilitywithinstru-mentsandequipmentforfuturemissiontrips.Ourclinicalfocusfortheinitialtripissurgeryandoralhygiene.Weareinneedofextractionsetups,localanesthetic,needles,syringes,Tylenol®,Motrin®,penicillin,sutures,toothbrushes,toothpaste,floss,masks,gauze,smallandextrasmallgloves.Anydonations
aregreatlyappreciated.Ifyouhaveanyquestions,feelfreetocontactDr.TaraZierat(703)222-3245oremailherattzier@
fcsmiles.com.Pleasesendanysuppliesto:
SmilesatFairfaxCorner4210FairfaxCornerWestAvenue
Suite220Fairfax,Virginia22030
Thankyouforyoursupport!
Looking for your “Patient’s Page”?
Thumb Sucking and Pacifier UseSimply go to the ADA website
at this address:
http://www.ada.org/prof/resources/pubs/jada/patient/patient_77.pdf
20VirginiaDentalAssociation
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Middle Peninsula/Northern Neck M.O.M. ProjectBy: Phyllis Bryant Harris The25°tempera-turedidnotdeterpatientsfromliningupintheearlymorninghoursofSatur-day,February13,2010atGloucesterHighSchoolforthefirsteverMiddlePenin-sula/NorthernNeckM.O.M.Project.Theprojectwasheldfrom7a.m.to5p.m.withsetupandpre-regis-trationof125individualsonFridayafternoon.ItwasfundedbytheGloucester/MathewsFreeClinicandtheNorthernNeckFreeHealthClinic. AsthiswasourfirstMOMProjectintheGloucesterarea,theplan-ningstartedoverayearagointheofficeofDr.Charles(Chuck)R.Harris,Jr.ofHayeswithKellyCooperandSharonHargisleadingthe
charge.Wewereblessedwithanoverflowofvolunteers,havingtoturnawaymorethanwecaredto. AVolunteerDinnerwasheldFridaynightaftersetup.Thedeliciousfarewasdonated,preparedandservedbymembersoftheAbingdonRuritanClub.ManyoftheirmembersalsovolunteeredtimeinotheraspectsoftheM.O.M.Project.Atotalof367volunteerswerefedandleftfulloffood,fellowship,andfilledwithexcitement. I’membarrassedtoadmitthatI’veneverparticipatedinaMOMProjectpriortoMPNNotherthandroppingChuckoffatthedoor.I’velistenedinaweabouttheEasternShore,Emporia,andNagsHeadprojectsbut,asaretirededucator,neverfeltIhad
theskillstocontribute.Boy,wasImissingthespiritoftheproject. ItwasAWESOME!Dr.CarolBrooks’sVCUdentalstudentstransformedourauxiliarygymintoadentalextravaganzalikeawell-oiledmachineonFriday.AfterafewinitialbumpsSaturdaymorning,patientsmovedthroughregistrationandx-rayandwerebandedaccord-ingtotheirdentalneeds.ChildrenwerefortunatetobethefirsttousetwobrandnewNavymobiledentalunitsandtheThreeRiversmobileunit,whichhadonlybeeninusetwomonths.Alocalchildcareprovider
TheNumbers...
Totalpatientstreated:501
549Volunteers!Amazing!!
Totalvalueofcareprovided:$323,827
To date: 44 Completed projects
Patients treated: 34,398
Total value of donated care: $17.4 million
entertainedandcaredforchildrenwhiletheircaretakerswerebeingseenbyourwonderfulprofessionalvolunteers. Alongwiththe86studentsandfacultyfromVCU,wehad57doctors,24hygienists,65dentalassistantsandotheramazingindividualstotaling385cheerfulvolunteersgivingoftheirtimeandtalentstohelpserveourarea.Wewerehonoredtohaveasoneofourvolunteers,Dr.RonTankersley,presidentoftheAmericanDentalAssociation. Weservedatotalof501patientsonSaturday,442adultsand59childrenandturnedaway300people.OurpatientsnotonlycamefromtheMiddlePeninsulaandNorthernNeckbutfromChesa-peake,CharlesCity,Lynchburg,Hampton,NewportNews,YorkCounty,andManassas.Therewere129cleanings,630fillings,and709extractionswithanestimatedvalueofcareat$323,827.That’salotoffastmovingfingers! OursincerethankstoDr.TerryDickinson,executivedirectoroftheVirginiaDentalAssociation,forhisguidanceandvisionfortheMOMProject;toBarbaraRollinsforherexpertiseanddata;toDr.CarolBrooks,whohasmytotaladmirationasaneducator;toBillHall
formakingitallhappen;andtoGloucesterCountyPublicSchools&EdBerryformakingthemiracleofelectricityoccurwithoutahitch.SpecialthanksalsotoChuck’sofficefortheirdedicationandforincludingmeaspartthismomentousendeavor. DidImentionourphenomenalvolunteers?Wewereblessedwiththemostgiving,enthusiastic,pleasant,andwonderfulgroupofvolun-teers.TheentireMOMprojecthasbeenaneventthathasunitedourcommunity,workingtogethertohelpeachotherinatimewhentherearesomanyinneed.
Dr. Ron Tankersley, president of the American Dental Association and Dr. Ralph Howell, past president of the Virginia Dental Association at the MPNN MOM Project.
Dr. Nathan Vogt performs restorative work on a patient during the MPNN MOM Project at Gloucester High School, of which he is an alumni.
Sylvia Ransome, hygienist
Dr.MikeAbbottDr.AnaMayaAdkinsDr.HeathAllenDr.SethAndersonDr.BaughnDr.SidneyBeckerDr.BerryDr.BobDr.BrickhouseDr.DavidBurnsDr.DonnaBurnsDr.HenryCatheyDr.MichaelClarkDr.DennisClecknerDr.GregColeDr.CharlesCountsDr.BenjaminCrowleyDr.WilliamDavenportDr.BobbyDavisDr.CrisDedmondDr.TerryDickinsonDr.WilliamDodsonDr.RobertDreelinDr.RodneyDukartDr.EdwardsDr.StevenForteDr.BobbyGarofalisDr.IraGoldsteinDr.ChuckHarrisDr.RalphHowellDr.MarkHuieDr.AlfredHurtDr.HussonDr.ThomasIrunguDr.CharlesJohnsonDr.KordisDr.TrishaKrauseDr.AnnLagonegroDr.RandyLazearDr.RayLeeDr.TimothyLeighDr.CaseyLeserDr.LannyLevensonDr.JosephLombardDr.PrestonLovingDr.StuartMartinDr.KatieMartinDr.KristinMastrosDr.BenMcCartyDr.RodneyMcDanielDr.DanielMesserschmidtDr.EricMillerDr.ShanailMoormanDr.DavidMorrisDr.StephenMurphyDr.AubreyMyersDr.SusanO’ConnorDr.JohnOwenDr.DarrylPirokDr.DanielPouchotDr.ReedDr.ScottReidDr.PhilipRenderDr.MelvinResslerDr.RichardRoadcapDr.JuanRojasDr.NoelRootDr.MichaelShuckDr.JeremyShulmanDr.HarrySimpsonDr.Maria-PazSmithDr.JohnSpeelgeDr.PatrickSpragueDr.JamesStevensDr.DanielStockburgerDr.MatthewStormDr.KennethTankersleyDr.RonaldTankersley
Dr.MichaelTrudeauDr.CassidyTurnerDr.NathanVogtDr.WarrenWestDr.ThomasWittyDr.HollisWolcottDr.HarveyWoodruffDr.JamesWoodsonDr.GregZoghbySiobhanAbbottAshleyAbesamisMollyAdlerDarleneAebodiczAmenAlemayehuCheleAllenZaidAl-SamirKhalidAminKatherineAndersonLorettaAndersonRitaAndersonBrendaAsheMelodyAshleyTinaBaileyBethBarryEdBarryBrendaBazemoreAngelaBeachyDickBeasleyDorenaBeckJonBeckAdamBeckerAmyBelloliSanjayBhagchandaniTamaraBishopGrahamBlakeSueBlakeTaylorBlakeLeighBlakistonPamBlankenshipKatieBlanksDonBlazekJenniBobbiJohnBoonMollyBoonPamBowensJenniferBoylandLindaBradfrodKayBradleyRobertBradleySharonBrinkleyNicoleBrooksNilkaBrownTaylorBrownLisaBrownCarolBruceRonBruceAmandaBurakKristyBurakRandyBurakSusanBurakMarshallButlerRoseMarieButzJudyCahillReneeCallisAnnCarterBridgetCarverDanielCarverBrandonCastorJudyCatheyBettyCerroKathyChandlerRachelCharltonCindyCheelyEddieChoiMinChoiMatthewChroustJamieClarkJessicaClark
SteveClawsonCarolClecknerSylviaCliftonAndyCoalterMarkCockerhamSusanCockerhamFrankCollinsPatCollinsSelenaCollinsCrystalColwellRobinCombsCindyComerMikeComerAshleyComptonK.D.CooperKaitenCooperKamrynCooperKellyCooperDonnaCowherdanddaughterDarleneCoxChristinaCramerMariannaCrossBenCrowlyDavidDallingSharonDarnellJeffDavidsonLindyDaviesCherieDavisReneeDavisRoyDavisChuckDawsonJoanDawsonBrittneyDedmondAnnDeLusaJulieDeLusaStephenDePasqualeChantelDevalkRogerDickKimDisilvaYvonneDodsonBrittanyDossLindaDouglasChristineDragooVickiDreelinNeilDrumhellerSusannaDrumhellerAnnDugasSidDugasBettyJaneDuncanMichelleDunlevyMitchellDunstonDavidDurhamJohnDuttonRennieDuttonCourtneyDyeDoraDyeAnneDyleMalindaEdgecombAshleyEdlinAhmedEldibJodyEmersonRitaEngleLibbyEppsJoyceEstesCindyEubanksEdEwellJanetEzzellMaryFaryBrittanyFieldWandaFletcherRachelForemanLindsayForteStevenForteTammyFortuneJohnFosterPamFosterKurtFrancisElizabethFreeman
DonnaFunkhouserMaryGallowayJessicaGardnerLindaGaskinsDanaGeorgeCarolGiffordFrankGillerlainWilliamGoldenMichaelGoldsteinTomGoyneDoreenGrannissChristineGraybealKellyGreetKarenGreggSeanGreggFredGrossDottieGujuLoriHackettBarbaraHaleyLeighHaleyBillHallLydiaHallTiffanyHallAshleyHansinCherylHansinLeighHargisPamelaHarrellCherylHarrisChrisHarrisKathyHarrisNickHarrisPhyllisHarrisSaraHarrisChestonHarrisDianHartleJudyHartmanCindyHastingsJoanieHauryLisaHayesLizHayesCindyHaynesRudyHeinatzStephanieHeinatzTiffanyHellebranatBridgetHengleDavidHerceBrianHerodHeidiHessler-AllenAndreHintermanMaryHintermanAliceHockadayElliottHoggeWendyHoggePamHollisMichelleHoltBeckyHorsleyNedaHovaziJeanHowardDanielHowellTammyHowellConnieHudginsBettyHundleyJenniferHuntCathyIveyDonnieJacksonAveJappinenMichaelJeffersSusanJenkinsNatalieJohnsonPatJohnsonCharlesJohnson,Jr.KathleenJonesDavidJonesEdwardTJordanKarenJowersCindyKahleSarahKandracChelseaKanodeGailKerns
CarolineKerseyLisaKerseyHelenKietzCindyKillingerJanetKingStephenKingMaryJaneKipperErinKnouseJoKoontzKarenKrausThomasKrebsTommyKrebsJonathanKremserPatKurovicsNancyLaLandAllenLaRocheTheresaLatesMaryHelenLayneDennisLeFeverGailLeFeverAnnieLeffingwellBonnieLeffingwellJimmeLeifferSandraLeifferMegLemasterCaroleLewisDebraLillyScottieLovingPeytonLovingRaquelLovingJenLysenkoCathyMackerneyNickMadduxChavonneMarionSusanMasclatBrittanyMasiclatCorneliaMayesKimMazzolaBaileyMcBrideBillMcCoreyLaurenMcCoreyDianeMcGannonMaryCatherineMcGinnStephanieMcGowanRuthieMcNamaraJulietMeansGeneMedkiffAmyMelvin-WardKathyMenefeeWilliamMenefeeChrissyOguraMeyersSandyMikuleckyMarshaMillerPaulMillerRobertMillerSixiemeMillerBillMinnickPaigeMitchellCourtneyMooreMichelleMooreAnthonyMorandeGusMorandeIsabellaMorandeJacquelynMorandeSueMorecockPatsyMorganDanaMorrisMarilynMorrisPerryMorrisLissaMorrisonJeppyMossGlennahMoyKarrieMurphyJudyMyersElizabethNealSteveNeilJeanNelsonTaylorNelsonMelissaNewsome
PeggyNewsomeBrendaNicholsJuliaNiculescuJustinNorboDavidOnestyNickPappasLourdesParkerBruceParmiterDavidParmiterJanetParmiterArianaParodiSuzanneParodiJimPerryAmberPhelpsMaryAnnPhilyawTysonPickettBeckyPirokChrisPopeWilliamPotterMelissaPouchotKelliPrattBarbaraPreistWalterPreistValeriePrincePeatPruntyAnnQuinnKathleenRachelMargaretRandolphSylviaRansoneKevinRasmussenEmilyRatliffReneeRatliffSaraRatliffRobertaRayDawnReeseEllieReidMichelleResslerJohnReynoldsJosephRiceLeeRicePattyRichardsBerkleyRichardsonTraceyRichieBuddyRileeMaryRileeShannonRoaneGuenivereRobbinsEmilieRobertsKathyRochelle-BernhardtMichaelRoddyBarbaraRollinsJoeRollinsKimRonanLauraRoweJessiRowseyPatrickRuckAmanSabharwalCarolynSalmonGeraldSalmonLauraSamsEuNieceSamuelDonaldSandridgeTashaSaulsJackieSaundersAlexSchickLeoSchollGeoffSchreiberGlendaSchroederCharlieSchwabeCarolynScottJessieSeeleyEloiseShankleChristySharpePeteShepardSueSheppardAlexShickEmilyShuckHowardShye
RyanSimoneLaTonyaSladeDawnleighSlaughterAnthonySmithBeckySmithEthelSmithGordonSmithMichelleSmithRoseSmithMarySmitheRoySnowdenJohnSnyderSusanSolesBetseySoulsbyJanetSouthTiffanySpeasBettySpeegleJohnSpruillValindaStairsAmberStephensonBarbaraStevensJenStevensRobinStewartStephanieStewartHeatherStoddardDebraStodgehillAprilStricklandMichelleSwartzKristenSwartzAdamTaylorJoyceTaylorKentTaylorKerryTaylorLouTaylorMeghanTaylorShelbyTaylorRonTaylorKelleyTenhagenRupertThomasCoreyThompsonSylviaThompsonHarperAThompsonJessicaThompsonPamTokarzColeTomlinsonMatthewTTomodaCharlesTowmleyAmyTrnDorothyValentineLuzMarinaVaughnOscarVegaHuixinWangBillWarnerWilliamWarnerMaryWarrenTonyaWeaverWyattWeaverEllaWebsterDeenaWestAustinWestoverManaWestoverJulieWhiteToriWhiteCandaceWhiteheadArleneWillAngelaWilliamsBobbyWilliamsPriscillaWilliamsRachelWilsonDanielLukeWinterStephanieWisniewskiDeborahWoodMarthaWoodruffDianaWootenGrayWootenLaurenWunderMelissaYardLindaYoungRobinZophy
Thank you to the Gloucester M.O.M. Volunteers...
22VirginiaDentalAssociation
Onceuponatimeinalandnotsofarawaylivedayounglad(well,maybenotsoyoung)namedJack.Jackhelpspeopleplanfortheirfinancialfuturesandmanagetheirassets.Hisburningdesireistomakecertainthathisadviceisalwayssoundandcutting-edge.So,hesurroundshimselfwithotheradvisorswhohavethesamephilosophy.Asapartofhiswork,Jackalwayswantstomakesurethathiscli-entsarepreparedtomanagetheMortgageBeast,sohisfriend,Charles,theMortgageMaster,isonesuchadvisor.Thisbeastalwaysseemedtobesolarge,complex,andever-changing,andJackwantstobecertainthathisclientscanalwayskeepthebeastundercontrol.So,offJackgoesonajourneytofindoutwhattosaytohisclientswhentheyask,“WhatmortgagecanIafford?”Jackskipsmerrily(actually,hedrives)toCharles,TheMortgageMaster’smountain.HefindsCharlesathisdesk,calmlyreviewingrates,signingpapers,andtalkingwithhisclients.“Charles,myfriend,”Jacksays,“IhavesomequestionsthatIthinkonlythegreatMortgageMastercanhelpmewith.Willyou?”“Certainly,Jack.Whatwouldyouliketoknow?”repliedCharles,TMM.“Well,first,greatMortgageMaster,I’moftenaskedtheques-tion,HowmuchmortgageshouldIhave?WhatdoIsay?“Jack,youalreadyknowtheanswer.They’reaskingthewrongquestion!”“GreatMortgageMaster,whatdoyoumean?”“Jack,therightquestionsare:HowmuchmortgagecanIaf-ford?HowmuchmortgagecanIqualifyforcomfortably?”“Yes,you’reright.Theyaretherightquestions,butwhataretheanswers?”“Well,Jack,asofJanuary1,2010,therearenewrulesforqualifyingforaresidentialmortgage.Theyarebasedonratios;forexample,howmuchincomeyouhaveversushowmuchhomevalueyouwanttobuy.Or,saidanotherway,whatistheproposedhousepaymentplusyourtotaldebtinrelationtoyourgrossincomeorabilitytopaywithoutpotentialdefault?”“Ah,Isee,GreatMortgageMaster.Youhavetohavetheincometobeabletoultimatelypayoffalldebtthatyouincur.Therearenolongeran‘unbelievablefreeorhighlyleveraged’mortgagepackages.”“That’sright,Jack.Whiletherearesomegreatdealsavailable,theeconomicenvironmenthasfinallyrealizedthatdebtisanissueandyouhavetobeabletopayforwhatyouget.So,keepingyourcreditrecordcleanisimportant.Therearesomecompensatingfactorsthatweconsider,though.Forexample,goodcredit,incomestability,andliquidassetsareallareasweconsiderpositivelywhenwe’rereviewingarequest.”“O.K.,then.Nextquestion.Whatarethebiggestproblemsyouencounterwhenyoutrytohelppeoplegetresidentialmortgage.I’veaskedthequestion,butIbetIcantellyoutheanswers.”“Asafinancialadvisor,Jack,Ibetyoucan.Ofcoursethebig-gestproblemsweencounterare:1.Excessivedebt,and2.Unrealisticexpectationsaboutwhattheywanttobuyversuswhattheycanafford.”“GreatMortgageMaster,that’sexactlywhatIwouldhavesaid.Unfortunately,Ithinkthattheeconomicexuberanceandleveragingprogramsofthemid-1990scausedfolkstobeabitgreedyandthinkun-realistically.Someforgotthatdebthastoberepaid,regardlessoffutureeconomiccircumstances.Whenthemarketsbegantowhirloutofkilter,
debtwasstilltheretobepaid,eventhoughtherewassubstantialloss.So,what’syouradvicenowtofolksseekingresidentialmortgages?”“Jack,IthinkI’dtellfirsttimehomebuyerstoseekamortgagewithwhichtheyfeelcomfortablemakingthemonthlypayments.Havingabigfirst-timehomethatyoureallycan’taffordoraresqueezedinotherareasinordertopaywillprobablygetyouintrouble.Ifyou’rerenting,considerthecomfortoftherentlevelyou’repayingnow.Inwhateveryourcircumstance,buildyourmortgagepaymentaroundyourcomfortzone.Ifyou’rea‘mid-life’typeofpersonseekingalargerhome,againknowyourcomfortzonewithsomeupgrading.Remember,thereareadditionalcostssuchasinsurance,taxes,maintenance,upgrades,andcontinuingissues.Considerallpotentialcosts.Ifyou’refacingretirementyouhavevariousoptions.Youmightwanttopayoffyourmortgageasquicklyaspossibletohaveadditionalincomeinretirement.Butcheckwithyourfinancialadvisortomakecertainthat’sbestforyou.Oryoumightwanttoconsiderareversemortgageorsecondhome.Eachoptionhasotherfactorsthatneedstrongconsideration.Research,askquestions,gettoknowthefacts.Baseyourdecisiononyourcomfortzoneandthefacts.“Goodinformation,GreatMortgageMaster.Butwhatwouldbeyourfinaladvicetogivesomeoneseekingahomemortgage?”“Knowyourcredit-worthinessandprotectit.Makesurethatyouhaveanincomeandassetstopayyourdebts,includingyourmortgage,regardlessofeconomiccircumstances.Andaboveall,knowyourfinan-cialcomfortzone.”Ifyouworkwithallofthesefactors,you’llbeO.K.”“Thanks,GreatMortgageMaster.You’veconfirmedmythoughts.Icangonowinpeace,knowingthatmyclientswillreceivegoodadvice.”
Note:Ifyou’dliketogettoknowCharlestheMortgageMaster,pleasecontacthimat:CharlesA.Merrill,II,SeniorMortgageConsultant,DominionMortgageCorporation,2810N.ParhamRoad,Suite245,Richmond,Virginia23294,Office:934-9500,ext.113,tollfree;877-542-8500,ext113,[email protected]
Jack and The Mortgage MasterBy:E.WayneBullis,Ed.D.,CSA,CRFA
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A42-year-oldCaucasianmalewasreferredfromageneraldentisttoanoralsurgeonforevaluationofaradiolucentlesionoftheanteriormandiblebetweenteethnumbers26and27(figure1-3).Thelesionmeasured1.0cmby0.8cmandextendedfromthedistaloftoothnum-ber26andoverlappedtherootoftoothnumber27.Theteethwerevitalandthelesionwasasymptomatic.Therewasslightdivergenceoftheroots(figures1-2)ofteethnumbers26and27withslightexpansiontothelingualonthesagittalcrosssectionoftheCTscan(figure3).
Yourdifferentialdiagnosiswouldinclude:
A. LateralperiodontalcystB. OdontogenickeratocystC. Ameloblastoma.D. CentralgiantcellgranulomaE. CalcifyingepithelialodontogenictumorF. CalcifyingodontogeniccystG. CentralossifyingfibromaH. Adenomatoidodontogenictumor
Figure 1
Figure 2
Figure 3
Volume87,Number2•April,May&June2010 23
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Volume87,Number2•April,May&June2010 2524VirginiaDentalAssociation
Pediatric AbstractsDiversity of asthma, evolving concepts of pathophysiology and lessons from genetics. Lilly, C. J Allergy Clin Immunol 2005;115(4-S1):S526-531.
Inthedevelopedworldasthmaisnowanepidemicwithasmanyasoneinfoururbanchildrenaffected.Asthmaisassociatedwithsubstantialmorbidity,mortality,andaneconomicburdentothemedicalinfrastructure.Asthmaisacomplexdisorderofbronchialhyperresponsivenessandisadiseaseofgeneenvironmentinteractionwithcompleximmunobiology.Allergicasthmaisinitiatedearlyinlifebythedeliveryofanallergentotheairwayresultinginasubsequentimmunerecognition.Anothercomponentofasthmaisthegeneticmakeupofanindividual.RecentadvancesinhumanDNAsequencinghasmadeitpossibletoidentifyasthmagenesandtheirasthmamediators.Expressionarraytechnol-ogyallowscomparisonoftheexpressionofthehumangenomeincellsfromasthmaticsandhealthyindividuals.Theauthorshaveidentified141sequencesashavingincreasedexpressionand8thathavedecreasedexpression.Severalgenesareknowntobeassociatedwithallergenexposure,theseincludelipocortin,thep65subunitofNFKP,IL3,IL4andIL5receptorsubunits.Alargepercentageoftheidentifiedgenesareknowntobeafactoringrowth,differentia-tion,andproliferation.Theresultsimplyasthmaisnotonlyadiseaseofairwayinflammationbutinvolveschangesinthegrowthandtissueresponsivenesstoantigenexposurewhichevolveoveranextendedtimeperiod.
Dr.JamesDibelkaisaresidentinpediatricdentistryatVirginiaCommonwealthUniversity
Sporadic Burkitt’s Lymphoma of the Jaws: The Essentials of Prompt Life-saving referral and Management. Jan A, Vora K, Sán-dor GK. Journal Canadian Dental Association. 2005;71(3):165-8.
ThispurposeofthisarticlewastogiveabriefreviewofBurkitt’slymphoma(BL),presentacasereport,andtohelpcliniciansrecognizesuchcases.
Burkitt’slymphoma(BL)isamalignanttumorofB-celllympho-cyteoriginandisclassifiedasanon-Hodgkin’slymphoma(NHL).Threeclinicalvariantsarerecognized:African(endemic),American(sporadic)andHIV-associated.EachBLsubtypehasdifferentcharacteristics.EndemicBLisusuallydiagnosedbetweenagesof5and7yearsandinvolvesthejawsaswellasotherfacialbonesin60%to80%ofcases.Also,endemicBLisstronglyassociatedwiththeEpstein-BarrVirus(EBV).SporadicBLisassociatedwithslightlyolderchildren,averageage12years.Theabdomenisthemostcommonsiteofpresentation.About25%ofsporadicBLcasesinvolvetheheadandneck,mostcom-monlyintheformofcervicallymphadenopathy.AdultBLpatientsareal-mostalwaysafflictedwithAIDS.BLaccountsfor40%ofHIV-associatedNHLcases.UnlikeendemicBL,bothsporadicandHIV-associatedBLhavelowassociationwithEBV.
SignsandsymptomsoforalBL,whichincludemobileteeth,toothache,oralmasses,gingivalenlargement,pain,jawexpansion,swellingandsensorydisturbances,havebeenrecordedwithpainbeingthemostcommonpresentingsymptom.
Apatientmaybereferredtoyouforaconsultationfromanotherdentistorphysicianandmaypresentwithavarietyofworrisomesignsandsymptoms.Ahighlevelofsuspicionshouldcauseadentisttoactappropriatelyandpromptlytoavoidanydisastrousconsequences.Athoroughdentalandmedicalhistoryisimportantalongwiththeappropri-ateradiographs,includingacomputedtomographyscantolookforanyactivelesions.
JustinEdwards,DMD,isaresidentinpediatricdentistryatVirginiaCom-monwealthUniversity
An evidence-based assessment of the clinical guidelines for re-planted avulsed teeth. Part II: prescription of systemic antibiotics. Hinckfuss, S., Messer, L..; Dent Traumatol. 2009;25(2):158-64.
Approximately30%ofchildrenhaveexperiencedadentalinjury.Dentalavulsioninjuriesoccurmostfrequentlyinchildrenbetweentheagesof7and9,anagewhenthealveolarboneismorepliableandaccommodat-ingoftraumaticinjuries.Injuriesinvolvingthepermanentteetharealmosttwiceascommon inschool-agedboys,ascompared to femalesof thesameage.Sportsaccidentsandfightsare themostcommoncauseofdental trauma in teenagers.Themaxillarycentral incisorsare themostcommonlyinjuredteeth.Maxillaryteethprotrudingmorethan4mmaretwotothreetimesaslikelytosufferdentaltraumathannormallyalignedteeth.Currentclinicalguidelinesrecommendsystemicantibiotictherapyforpatientswhohaveanavulsedpermanenttoothreplanted.Theobjec-tive of thismeta-analysiswas to use the principles of evidence-baseddentistry toanswer thePICOquestion. (PICO=procedureorcondition,intervention,comparisontointervention,andoutcome)Theprimaryques-tionis:whenreplantingavulsedpermanentteeth,doesprescribingsys-temicantibioticsresultinanincreasedlikelihoodofsuccessfulperiodon-talhealingascomparedtoreplantinganavulsedtoothwithoutantibioticcoverage?The authors performed a literature search for relevant cita-tions. Inclusioncriteriawereappliedandthreepapersreportingon326total teethwere included in the analysis.Results:Meta-analysis foundnostatisticallysignificantdifferencebetweenprescribingornotprescrib-ingantibioticsforacceptableperiodontalhealingwithoutprogressiverootresorption(commonoddsratio=0.90,SE=0.29,95%confidenceinter-
Fused Teeth: A Review of the Treatment Options. Tuna E, Yildir-im M, Seymen F, Gencay K, and Ozgen M. Journal of Dentistry for Children 2009; 76(2): 109-116
Thepurposeofthisarticlewastoreviewtreatmentoptionsforfusedteethbydescribingtwoclinicalcasesshowingdifferenttreatmentmethodologies.Fusionisdefinedastheunionoftwoormoresepa-ratedevelopingtoothgermsatthedentinallevel,yieldingasinglelargetooth.Thetreatmentoffusedteethmaybeinterdisciplinaryandincludeendodontic,surgical,andperiodontalinvolvement.Inthefirstcaseatenyear-oldfemalepresentedinthemixeddentitionwithclassImolarrelationship,andfusionofthepermanentmaxil-laryrightcentralincisortoasupernumerarytooth.Thecasewastreatedintraorallybyseparatingthetwofusedteethandextractingthedistallypositionedsupernumerarytooth.Thecrownwasrestoredwithcompositeresinandorthodonticallysplinted.Systemicantibiot-icsweregivenandchlorhexidinerinsewasrecommended.At3,6,and12-monthfollowupappointmentsthetoothwasasymptomaticwithnopulpalnecrosisorrootresorption.Thesecondcaseconsistedofaneightyear-oldfemalepresentinginthemixeddentitionwithananterioropenbite,severemaxillarycrowdingandthepermanentmaxillaryleftlateralincisorfusedtoasupernumerarytoothalongthelengthoftheroot.Thecasewastreatedbyextractingthefusedteethandextraorallyseparatingthem.Thedistalportionwasreimplantedandorthodonticallysplinted.Systemicantibioticsweregivenandchlorhexidinemouthrinserecommended.At1,2,6and12-monthfollow-upappointmentsthetoothwasasymptomaticandbonehealingimproved.Atfour-yearfollowupthetoothwasvitalandtheperiapicalandperiodontalhealthwaspreserved.Bothpresentedtreatmentsyieldedfavorableesthetic,periodontal,andperiapicalresultsforpatientswithfusedteeth.
Dr.AndrewJ.Zima,Jr.,isaresidentinpediatricdentistryatVirginiaCommonwealthUniversity
Indirect Pulp Capping and Primary Teeth: Is the Primary Tooth Pulpotomy Out of Date?Coll, J. Pediatric Dentistry 2008;30(3):230-6
Theaimofthisarticleistoreviewthedentalliteratureandnewresearchinvitalpulptherapyto(1)determineifthepulpotomyisindicatedforatruecariouspulpexposure,(2)identifyadiagnosticmethodtoreliablyidentifyteeththatarecandidatesforvitalpulptherapyand(3)determineiftheindirectpulpcaptechnique(IPT)shouldreplacethepulpotomy.Primarytoothpulpotomiesshouldbeperformedonlyonteeththataredeterminedtohaveavitalpulp.Currentagentsusedinpulpotomiesincludeformocresolwhichworksby‘fixing’thevitalpulp,ferricsulfate,whichformsaclotbarriertopreservedeeperpulptissue,andmineraltrioxideaggregate(MTA)andcalciumhydroxidewhichactbyhealingtheradicularpulpandaidinginformationofadentinalbridge.Shoveltonfoundthatinpermanentteeth,ascariesapproximated0.25-0.3mmofthepulp,hyperemiaandpulpitiswereseen,thusimpairingthepulp’srepaircapacity.Inthisarticle,Collconcludesthatprimarytoothpulp-otomiesshouldnotbeperformedonteethwithcariouspulpexposuresbecausethoseteethhavealowlikelihoodofbeingtotallyvitalandthusarepoorcandidatesfortheprocedure.Likewise,ifapulpotomyisperformedonteethwithoutcariousexposures,thereisagreatchanceofdisplacingaffecteddentinchipsintothepulpwhichwillaffectthepulp’srepaircapacitybyincreasingtheriskofpulpalinflammation.Theuseoftheglassionomer-cariescontrolmethod(GICC)isindicatedinteethwithcavitatedcariouslesionstodiagnosevitality.Thismethodisusefulintreatingteethwithsignsandsymptomsofreversiblepulpitisorasymptomlesstooththoughttohavenopulpitisbeforeinstitutingpulptherapy.TheuseoftheGICCmethodhasbeenshowntodecreasetotalbacterialcountandcariesexcavationsignificantlyreducedthemutansstreptococcipresentinthelesion.Moreover,sealingthecavitatedlesionwithglassionomercontributestoremineralization.TheGICCtechniqueinvolvesminimallyremovingouter,superficial,decayusingaslow-speedwitha#4or#6roundbur,oraspoonexcavator.Then,aglassionomertemporaryfillingmaterialisused,suchasFujiIX®(GCAmericaInc,Alsip,IL),KetacMolar®(3MESPE,StPaul,MN),oraresin-modifiedglassionomer.Nomatrixbandisneededbuttherestorationmustnotbeinocclusion.After1-3monthsofGICC,ifthetoothisasymptomaticandshowsnoclinicalorradiographicsignsofirreversiblepulpitis,thenvitalpulptherapycanbeinstitutedusingIPTorpulpotomy.ThereareseveralfactorstoconsiderwhendeterminingwhethertotreatacariouslesionusingIPTversuspulpotomy.IPT’slong-termsuccess(3-4years)surpassesallotherpulpotomystudies,withtheexceptionofMTA.CollmentionedthatmostdentistsincludingpediatricdentistsfailtoutilizetheIPTsimplybecausethemethodwasneithertaughtnoremphasizedinthedentalschoolcurriculum.Studieshavealsoshownthatinthecaseofreversiblepulpitispain,IPThasbeenshowntohaveahighersuccessratethanthoseteethtreatedwithformocresolpulpotomy.Moreover,pri-maryteethtreatedwithformocresolpulpotomywereshowntoexfoliatesignificantlyearlier(>6months)thannonpulpotomizedteeth,whereasIPT-treatedteethexfoliatenormally.Lastly,IPTislessexpensivethanapulpotomy,requiresnopulpalentry,andthusdoesnotrequireprofoundanesthesia.
Dr.LatriceFosterisaresidentinpediatricdentistryatVirginiaCommon-wealthUniversity.
Local Anesthesia Affects Physiologic Parameters and Reduces An-esthesiologist Intervention in children Undergoing General Anes-thesia for Dental Rehabilitation. Watts, A., Thikkurissy, S., Smiley, M., McTigue, D., Smith, T. Pediatric Dentistry 2009;31(5):414-9.
Background-Painstemsfromavarietyofeventsandisaconscious,emotionalandindividualexperience.Nociceptionisphysiologicactivityresultingfromtissuedamage.Thebalancebetweennociceptionandantinociceptioniscommonlybasedonnonspecificautonomicreactionssuchashypertension,tachycardia,sweating,ortearing,aswellaspatientmovementinresponsetopain.PreviousliteraturereportsthatinconjunctionwithGeneralAnesthesia(GA),regionalanesthesiacanproduceamorehemodynamicallystablepatient,andcontrolspainintheimmediatepostoperativeperiod.Thereisapaucityofliteratureontheuseofintraoperativelocalanesthesia(LA)asanalgesia.TheAmeri-canSocietyofAnesthesiologistsandtheAmericanDentalAssociation(ADA)currentlyhavenorecommendationsastotheuseofLAduringGAanddentaltreatment.NodirectivestatementsexistintheAmericanAcademyofPediatricDentists(AAPD)guidelinesregardingtheuseofLAwithGA;theysuggestonlythatLA“maybeused”toreducepaininthepostoperativerecoveryperiod,andpractitionersmaychoosetouseLAduringGAcasesbasedonanecdotalexperiencesortraining.
Purpose-Thepurposeofthisstudywastoevaluatetheuseofintra-operativelocalanestheticsinpediatricoutpatientdentalsurgery.Theobjectivesincludedexaminingthephysiologiceffectsoftherepresen-tativepediatricdentalprocedure(rubberdam[RD]clampplacement,pulpotomy,cementationofastainlesssteelcrown[SSC],andextrac-tions)onchildrenundergoingGeneralAnesthesia,andtodetermineifthereisarelationshipbetweenLAusageandtherapeuticinterventionbyananesthesiologist.
Methods-Thestudyincluded48children12to84monthsofage,requiringatleastoneextractionofaprimarymaxillarytooth,useofaRDclamp,andonemaxillarytoothrequiringpulptherapyandaSSC.Operatorsused2%lidocainewith1/100,000epinephrine,andnopatientexceeded4.4mg/kgtotal.Thestudyusedthesamedentistanesthesi-ologistthroughouttoallowforstandardizationoftheanestheticregimen.Patientswereassignedtoacontrolgroup(noLA)oratreatmentgroup(LA),priortothestudy.Datawasbasedonobjectivereadingfromthephysiologicmonitors,andrecordedwhetherornotinterventionbytheanesthesiologistwasnecessary,duetovitalsignchangesduringtheprocedure.
Conclusions-PatientswhowerenotgivenintraoperativeLAweremorelikelytoexperiencevitalsignfluctuationsthatrequiredanesthesiaintervention.
Dr.MalindaHussonisaresidentinpediatricdentistryatVirginiaCom-monwealthUniversity.
Contemporary Perspectives on Vital Pulp Therapy: Views from Endodontists and Pediatric Dentists. Seale,N.; Glickmann, G. Pediatric Dentistry 2008; 30(3): 261-7.
ThepurposeofthisstudywastodeterminethelevelofagreementbetweenpediatricdentistsandendodontistsatthepulptherapysymposiumsponsoredbytheAAEandAAPDinNovember2007.Twosurveysweregiveninvolvingquestionsaboutpulptherapyforcariouslyinvolvedpermanentteeth,indirectpulptreatment(IPT)forcariouslyinvolvedyoungpermanentteeth,pulprevascularizationandregenera-tion.Onesurveywasapretest,theotherwasgivenafterpresenta-tionsviaelectronicrealtimeaudienceresponsesystem.Respondingtothesurveyswere231pediatricdentistsand79endo
Continued on page 27
vals=0.51–1.58).Conclusion:Theevidenceforanassociationbetweenprescribingsystemicantibioticsandanincreasedperiodontalhealing isinconclusive.Upon review of the available literature, there is inconclu-siveclinicalevidencetoeithercontradictorsupporttherecommendationofsystemicantibiotics.Pendingfutureresearchtothecontrary,dentistsarerecommendedtofollowcurrentantibioticguidelineswhenreplantingavulsedteeth.
Dr.AndyReed is a resident in pediatric dentistry atVirginiaCommon-wealthUniversity.
26VirginiaDentalAssociation
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PathologyPuzzler
Continued from page 25
dontists.Resultsonformocresolshowedthat37%oftheendodontistsand18%ofthepediatricdentistssaiditisacarcinogenandshouldnotbeusedonpatients.Fivepercentofthepediatricdentistsand15%oftheendodontiststhinkthatformocresolisadangertopatients.MineralTrioxideAggregatewasthefavoritepulpotomyagentof30%ofthepediatricdentistsand34%oftheendodontists.Ifcostwasnotanissue85%ofpediatricdentistsandendodontistssaiditwouldbeusedintheiroffices.Ninety-fourpercentofpediatricdentistsand69%ofendodontistssaidtheyperformIPTonyoungpermanentteeth.Amongallrespon-dents87%agreedthatrevascularization/regenerationwouldbeaviabletreatmentoptioninthenexttenyears.Conclusionsrevealedpediatricdentistsandendodontistsagreethatformocresolwillbereplacedasaprimarytoothpulpotomyagent,whileMTAisthefirstchoicetotakeitsplacewhenitbecomesaffordable.Also,IPTisanacceptablepulptech-niqueforcariouslyinvolvedyoungpermanentteethwithopenapices,andIPTincariouslyaffectedprimaryteethholdshopeforreplacementofthepulpotomy.Revascularization/regenerationwillbringexcitingnewtreatmentoptionsinthenearfuture.
Dr.HeathWhitfieldischiefresidentinpediatricdentistryatVirginiaCom-monwealthUniversity
Topical Anesthesia for Rubber Dam Clamp Placement in Sealant Placement: Comparison of Lidocaine/Prilocaine gel and Benzo-caine. Yoon, R., Chussid, S. Pediatric Dentistry 2009;31 (5): 377-381.
Abstract:Purpose:Topicalanestheticsareusedcommonlyindentistryformanypurposes,themostcommonbeingapplicationtonon-kera-tinizedoralmucosapriortolocalanestheticinjection.Theobjectiveofthisarticlewastocomparetopicalanestheticgeleffectivenessandpainperceptionwithrubberdamclampplacementforsealantsusing
Oraqix®(2.5%Lidocaine,2.5%Prilocaine,DentsplyPharmaceutical)non-injectablegeland20%Benzocainegel.Methods:Asingleoperatortreatedallparticipantsaged7-12yearsold(N=45)recruitedfromregu-larlyscheduledpatientsinapostgraduatepediatricdentalclinic.UseofasplitmouthdesignwithOraqix®gelplacedononesideand20%Benzocaineontheother.ThechildrenwereaskedtoratetheirpainaftertopicalanestheticandrubberdamclampplacementusingtheFacialPainScale(FPS).Results:Subjectpopulation;27female,and18malewith15lessthan9yearsand30greaterthan9yearsold.TheoveralldifferencesinmeanFPSratingsbetweenOraqix®andBenzocainewasnotstatisticallysignificant(P=.27)aswellasthechildrenlessthannineyearsold(P=.77).Nostatisticaldifferencewasnotedbetweengenders.TherewasastatisticaldifferenceinchildrengreaterthannineyearsoldwithOraqix®beingslightlymoreeffectivethanBenzocaine.Conclu-sions:Oraqix®applicationfor2minutesbeforeclampplacementdidnotsignificantlyreducepainwhencomparedto20%benzocaine.Oraqix®wasslightlymoreeffectiveinpainreductionforthe9-12year-oldgroup.Morestudieswithalargersamplesizeareneededtodeterminetheef-fectivenessofthisnewnon-injectabletopicalanestheticanditsapplica-tionindentistry.
LarryShults,DDS,isaresidentinpediatricdentistryatVirginiaCom-monwealthUniversity.
MostlikelypossibilitiesincludeA,B,C,andDsinceallareradiolucent.Sincethelesionisexpansilewithoutascleroticborder,anodontogenickeratocystisunlikely.Lateralperiodontalcystsnormallydonotoccurinthisarea(mostcommonlocationisbetweenmandibularbicuspids)andonlyonrareoccasionsareexpansile.Bothameloblastomaandcentralgiantcellgranulomacancauseexpansion.Thelocationfavorsacentralgiantcellgranulomasincetheameloblastomaisfoundmorefrequentlyintheposteriormandible.Theageistypicalforanamelo-blastoma.Calcifyingepithelialodontogenictumor,calcifyingodonto-geniccyst,centralossifyingfibromaandadenomatoidodontogenictumorwouldnormallybemixedradiolucentandradiopaquelesions.Earlylesionsthatinducecalcification,nevertheless,canappearradio-lucentuntiltheymature.Mydifferentialdiagnosisinorderofprobabilityis:1)ameloblastomabasedonageandexpansion;2)centralgiantcellgranulomabasedonlocationandexpansion;3)odontogenickerato-cyst;and4)lateralperiodontalcyst.CGCGtendstocrossthemidlineandfavorstheanteriormandible.Adenomatoidodontogenictumorhasapredilectionforyoungfemalesandtheanteriormaxilla.
Thebiopsyfindingsprovedthislesiontobeanameloblastoma(figure4).Therecommendedtreatmentwouldbelocalsegmentalresectionremovinginvolvedteeth.Withreconstructivesurgeryandimplantsthispatientshouldhavecompleteestheticandfunctionalrehabilitation.
ThiscasewassubmittedbyDr.AmirNaimi,anOralandMaxillofacialsurgeoninNorthernVirginia.
Figure4
Thehistologyshowsmultipleislandsofodontogenicepitheliumshowingreversepolarizationofthebasalcelllayerwithacentralzoneofstellatereticulumappearingtissue.
Continued from page 23
Volume87,Number2•April,May&June2010 2928VirginiaDentalAssociation
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BabyAd_VA_DentalAssoc.indd 1 12/3/09 11:06:30 AM
Understanding Delta Dental’s New Payment PoliciesBy:DanSchulte,J.D.MDALegalCouncilReprinted, with permission, from the Journal of the Michigan Dental Association, November 2008 issue. The author’s comments relate to the Delta policy as it exists in Michigan.
ThissummerDeltaDentalannouncedpaymentpolicychangesaffectingitsMichiganparticipatingdentists.Apparently,inconnectionwitha“systemupgrade”DeltaDentalhasestablishedamaximumfeeparticipatingdentistsmaychargeforcertainprocedures.Thismaximumfeeiscalledthe“MaximumPlanAllowance.”Forexample,feeschargedforcompositefillingsandporcelaincrownsarenowsubjecttoaMaximumPlanAllowance.
ThismeansMichigandentistswhoparticipatewithDeltaDentalmaynolongerchargeanypatientenrolledinaDeltaDentalunderwrittenoradministereddentalplanafeeexceedingtheMaximumPlanAllowanceifonehasbeenestablishedforaprocedure.Contrarytopastpractice,theMaximumPlanAllowanceapplieswhetherornotthepatientactuallyhascoverageprovidedbytheDeltaDentalunderwrittenoradministeredplan.DeltaDentalhastakencontrolofthefeesparticipatingdentistschargethesepatientsevenwhenonlythepatientisliableforpaymentofthefeeandwouldbewillingtopayahigheramountforanon-coveredservice.
Forexample,let’sassumeyourpatientisenrolledinaDeltaDentalunderwrittenoradministereddentalplan.TheplanprovidesthateitherDeltaDentalortheplan’ssponsor(usuallythepatient’semployer)willpay$50fortheprocedureyoujustcompletedonthispatient.TheMaximumPlanAllowanceforthisproce-dureDeltaDentalhasestablishedtobe$135.Thefeeyoucustomarilychargeforthisprocedureis$150.UnderDeltaDental’snewpaymentprocedures,themostyoucanbalancebillthepatientis$85(thedifferencebetweentheMaxi-mumPlanAllowanceandtheamountDeltaDentalpays)andisnolonger$100(thedifferencebetweenyourcustomaryfeeandtheamountDeltaDentalhaspaid).The$15youusedtocollectfromthepatient(andpresumablythepatientagreedtopayfortheprocedure)isnowlost.DeltaDentalisprohibitingyoufromcollectingit.
Questions raisedManyquestionshavebeenaskedregardingDeltaDental’snewpaymentpolicies.WhatmemberswanttoknowiswhetherDeltaDentalcanlegally:(1)establishamaximumfeeforservicesthatarenotcoveredbyaDeltaDentalunderwrittenoradministereddentalplan;(2)restrictparticipatingdentistsfrombalancebillingforservicesthatarenotcovered;and(3)unilaterallyamendtheparticipationagreementstoimposethesenewrestrictions?
TheanswerstoallofthesequestionsdependonthetermsofthecontractsinplacebetweenDeltaDentalanditsparticipatingdentists.WehavereviewedtheDeltaPremierFee-For-ServiceParticipationAgreementandtheUniformRequire-mentsbyDeltaDeltaPremierParticipation.Iwillrefertothesetwodocumentscollectivelyinthisarticleasthe“Contract.”
DeltaDentalisliterallyconstruingandbroadlyinterpretingtheContract.Whetherandtowhatextentdentistsunderstoodand/orintendedtheContracttohavesuchabroadapplicationcanonlybedetermineduponareviewofthefactsandcircumstancesofeachindividualcase.Thecircumstancessurroundingeachindividualdentist’sinteractionswithDeltaDentalbothatthetimetheContractwassignedandfollowingitssigningmaygiverisetodefensestoenforcementoftheContractonanindividualbasis.
TheContractrequiresparticipatingdentists“toprovidedentalcaretoEnrollees”inaccordancewiththetermsoftheContract.TheContractisnotlimitedtoonlythatdentalcarethatiscoveredinsomefashionbytheEnrollee’splan.Instead,itappliestoalldentalcareprovidedtoanyEnrollee.“Enrollee”isdefinedintheContracttoincludeanypatienteligiblefordentalbenefitspursuanttoanydental
programthatiseitheradministeredorunderwrittenbyDeltaDentaloranotherentitythatpursuanttoanagreementwithDeltaDentalhasmadetheContractapplicable.
Therefore,theContractapplieswhenDeltaDentalis:
• actuallyunderwritingthefundingofthebenefitsprovidedtotheenrollee;
• whenDeltaDentalismerelyprocessingclaimsandotherwiseadministeringthedentalplanforathirdparty(usuallythepatient’semployer)whoisfundingthebenefits;and
• whenDeltaDentalmerelysellstoathirdpartytherighttouseitsnetworkofdentists.DeltaDentalclaimsithasnotsoldtherighttousethenetworktoathirdparty.However,theContractgivesDeltaDentaltherighttodosoatanytime.
Whenreadliterally,theContractallowsDeltaDentaltosetmaximumfeesforservicesprovidedbyparticipatingdentistseventhoughthereisnocoverageoronlypartialcoveragebyadentalplanfortheservice.
Balance-billing limitedTheextenttowhichparticipatingdentistsmaybalancebillapatientisalsogov-ernedbytheContract.Specifically,theContractrestrictsaparticipatingdentist’sabilitytobalancebillapatientforanamountinexcessof“themaximumfeethatDeltaDentalapprovesfortheservice.”Again,theContractmakesnodistinctionbetweencoveredservicesandservicesthatarenotcovered.
Finally,theContractgivesDeltaDentalpowertoamendthetermsofparticipa-tion.Includedis“therighttomakechangesinitsProcessingPoliciesandtheUniformRequirementsofDeltaPremierParticipation.”Therefore,DeltaDentalhasthecontractualrighttochangeat-willanyofthetermsofparticipationincludingthesettingofthefeesyouchargeanypatientenrolledinaDeltaDentalunderwrittenoradministereddentalplan.
Obviously,manymemberdentistsareupsetaboutthesechanges.ManyhavesaidthattheyhaveneverbeensubjecttofeelimitationsbyDeltaDentaloranyotherpayorapplicabletonon-coveredservices.EvenmorehaveindicatedthattheyhadnoideatheContractcouldbeappliedinthiswayandthatthiswasneverexplainedtothematthetimetheysignedtheContract.
Participatingdentistshavefourchoices,asexplainedbelow:
1.ThefirstistoacceptthenewDeltaDentalpoliciesandlimittheamountofyourbalancebillingtotheMaximumPlanAllowance.
2.Thesecondistocontinuebalancebillinguptoyourcustomaryfeeasyouhaveinthepast.TheriskyourunobviouslyisthatDeltaDentalwillterminateyourContractandtakeactionagainstyouforbreachoftheContract.DeltaDen-talhastherighttoterminateyourContractatwillupon30dayswrittennotice.
3.Third,youmaylikewiseterminateyourContractbyproviding30dayswrittennoticetoDeltaDental.
30VirginiaDentalAssociation Volume87,Number2•April,May&June2010 31
4.Finally,youmaystopprovidingcertainservicestoDeltaDentalEnrolleesiftheMaximumPlanAllowanceisnotatalevelacceptabletoyou.
Selling a networkAnotherquestionthathasbeenfrequentlyaskediswhyDeltaDentalwouldlimitfeesforservicesthatpatientsknowarenotcoveredbythetermsoftheirdentalplanandforwhichpatientshavebeenwillingtopay?Theanswertothisques-tionhasmoretodowithhowDeltaDentalusesthenetworktogenerateincomethenitdoesthedeliveryofdentalcareand/orpatientchoice.
DeltaDentalgeneratesincomeprimarilyfromthesaleofdentalplanproductsanddentalplanadministrativeservices.Theabilitytocontroltheamountspaidfordentalcare(whetherbyDeltaDentaldirectlyorbythesponsorofadentalplanadministeredbyDeltaDental)makesitsinsuranceproductsandadministra-tiveservicesmoreattractivetoitscustomers.DeltaDental’sabilitytocontrolthecostofdentalcarevariesdirectlywiththesizeofthenetworkofdentistsandthescopeofthefeelimitationstheparticipatingdentistshavecontractuallyagreedto.
Therefore,havingalargenetworkofdentistswhohaveagreedtoabroadscopeofdentalservicesforwhichcontroloffeeshasbeengivenup,resultsinasignifi-cantcompetitiveadvantageforDeltaDentalinthesaleofitsunderwrittendentalinsuranceproductsanddentalplanadministrativeservices.
ThisadvantageisthecenterpieceofDeltaDental’srecentadvertisements,whichstate:
“Your Company Deserves a Deeper NetworkThe Delta Dental system includes three of every four dentists -- which makes our network the biggest in the nation. Offering your employees access to the deepest networks improves the chance that their pre-ferred dentist participates in one or more of our plans. That, in turn, helps us deliver greater plan savings to you. So if you are not with Delta Dental, shouldn’t you be? To learn more about Delta Dental, please contact your broker or visit DeltaDentalMI.com.”
DeltaDentalisacknowledgingthatgreaterplansavingsfortheircustomersresultdirectlyfrom“thedeepestnetworks.”
IndividualdentistsmustmaketheirowndecisionhowtoreacttoDeltaDental’spaymentpolicychanges.TheMichiganDentalAssociationcannotlegallyandwillnotfacilitateanyjointresponsetothesechangesonbehalfofMDAmembers.Todosoisillegal,violatingfederalandstateantitrustlaws.Thepurposeofthisar-ticle(andfuturecommunications)istoeducateMDAmembersaboutwhatthesechangesmeanandwhyitisinDeltaDental’sinteresttoimplementthechanges.
Mark YourCalendar
Financial Boot Camp
a VDA event
Sheraton - Richmond, VA
October 15-16, 2010
Details coming soon!
7:00A8:00A9:00A10:00A11:00A12:00P1:00P2:00P3:00P4:00P5:00P6:00P7:00P8:00P9:00P10:00P
Golf Tournament 9:00am-2:30PM Opening Reception 4:00-5:00PM
ACD Dinner & Dance 6:30-10:30PMGhost Tour
9:00-10:00PM
Frid
ay, J
une 1
8
AGD Breakfast7:00-8:00AM
MCV/VCU Reception5:00-6:00PM President’s Party 6:30-10:00PM
Pierre Fauchard Lunch
12:00-1:30PM
Exhibit Hall Hours 9:30AM-6:00PM
Satu
rday
, Jun
e 19
ICD Breakfast7:30-8:30AM
VDA Registration 7:00AM-5:00PM
VDA Registration 7:00AM-5:00PM
ACD Lunch &Learn
11:30AM-1:00PM
VDA Past President’s Breakfast7:30-9:00am
Exhibit Hall Hours 9:30AM-1:00PM
VDA Registration 7:00AM-3:00PM
VDAA Board Meeting5:00-7:00PM
CPR 2:00-4:00pm
Kay 8:00-11:00am Wilder 1:00-4:00pm
Swift 8:00am-4:00pmAfternoon Tea
1:00pm
Goldfaden 9:00am-Noon
Breiding 8:00am-3:00pm
Wahl 8:00am-3:00pm
Wilder 8:00am-11:00am
Blackwell 8:30am-4:30pm
Lambert 9:00am-Noon
Hooper 8:00am-4:00pm
Blackwell 9:00am-Noon
Breiding 8:00am-4:00pm
Byrne 8:30am-4:30pm
CPR 9:00-11:00am
Reynolds 8:30am-4:30pm
BOD Meeting 2:00-6:00pm
Hawkins 9:00am-Noon
Thur
sday
, Jun
e 17
Goldfaden 2:00-5:00pm
Wilder Noon-3:00pm
Hawkins 8:30am-11:30am Hawkins 1:30-4:30pm
Lambert 2:00-5:00pm
CPR 8:00am-NoonSolmeteX -
Exhibit Presentation12:15-1:15pm
SunriseYoga
6:30-7:30amVA Board of DentistryExhibit Presentation
12:15-1:15pm
Virginia Meeting At A Glance
JUNE 17-19, 2010Williamsburg Lodge
Williamsburg, VA
REGISTER ONLINE AT WWW.VIRGINIAMEETING.ORG
32VirginiaDentalAssociation Volume87,Number2•April,May&June2010 33
Hotel Information
HOTEL RESERVATION DEADLINE: MAY 17, 2010
Williamsburg Lodge:Southernhospitalitywithimpeccableserviceandachoiceofcomfortablelodgings.YouwillenjoyambienceofafamilyhomehereattheWil-liamsburgLodge.
Williamsburg Inn:ThecrownjeweloftheColonialWilliamsburgResortCollection.Revelinsimplyoneoftheworld’sgreatluxuryhotels.
Woodland Suites:Contemporaryroomsandsuiteswithseparatemasterbed-roomsandconveniencekitchencounters.Recreationaloptionsincludeminigolf,shuffleboard,andswimming.TheWoodlandSuitesoffersafunhavenforfamilies.WilliamsburgLodge
310SouthEnglandStreetWilliamsburg,VA23185 Reservations:
By Phone:1-800-HISTORY(1-800-447-8679)Meeting Code:VIRF10A
Online: https://resweb.passkey.com/go/virf10a
Virginia Meeting room rates:WilliamsburgLodge:Deluxe$229;Superior$199WoodlandsHotel&Suites:Superior$139WilliamsburgInn:MainBuilding$395;ProvidenceHallWing$289
Rates listed do not include 10% and $2.00 per room per night occupancy tax.
Photo courtesy of The Colonial Williams-burg Foundation, Williamsburg, VA
MakingitHappen...
2010 Council On SessionsChair: Dr.ClaireKaugars Dr.SharonColvin Dr.ElizabethReynolds Dr.AnthonyPeluso
2010 Local Arrangements CommitteeChair: Dr.MelanieLoveSocial: Dr.KittFinley-ParkerGolf: Dr.BruceHutchisonHosts: Dr.BrendaYoung
Dr.VinceDougherty Dr.MichaelAbbott PamMaciejewski,RDH Dr.SharonCovaney
The Virginia Dental Association is an ADA CERP Recognized Provider
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
Detailed course listings can be found on our web site at www.virginiameeting.org by clicking on Education.
01 Kay - OSHA 8:00-11:00am Free w/ Badge
02 Swift - Materials 8:00am-4:00pm $79
03 Wilder - Providing WOW Ser... 1:00-4:00pm Free w/ Badge
30 Opening Reception 4:00-5:00pm Free - ticket required
32 Annual VDA Golf Tournament $125.00 9:00am (Fill out additional information section on registration form)
33 Ghost Tour $15 9:00-10:00pm Recommended for ages 6 and up.
41 Afternoon Tea $35.00 1:00-2:30pm
34 AGD Breakfast* n/c 7:00-8:00am
35 Pierre Fauchard Luncheon* $40.00 Noon-1:30pm
36 VDA President’s Party (Adult) $30.00 6:30-10:00pm
36A VDA President’s Party (Child 2-12 yrs old) $10.00
37 MCV/VCU Reception* $0 5:00-6:00pm
38 ICD Breakfast* $25 7:30-8:30am
40A-G ACD Luncheon For Learning $40.00 11:30am-1:00pm
Table Topic 40A- Al-Anezi - Review of the Masticatory System and Its Function 40B- Archer - Problem Solving in Dental Anesthesia 40C- Brickhouse - Clinical Management of the Challenging... 40D- Carter - Digital Radiography Update 40E- Haselton - CAD-CAM and Your Practice 40F- Imbery - Advanced Topics In Restorative Dentistry 40G- Tufecki - Etiology, Prevention and Treatment... 42 Sunrise Yoga $17.00 6:30-7:30am
44 Colonial Williamsburg Historic Area Ticket $22.00 Tickets good for length of conference
* Only members from these groups can attend these functions
Continuing Education Tickets Event & Affiliate Group Tickets
Code Course Title/Speaker Cost Code Event CostThursday, June 17, 2010
Friday, June 18, 2010Code Course Title/Speaker Cost
Saturday, June 19, 2010
Code Course Title/Speaker Cost
Thursday, June 17, 2010
Friday, June 18, 2010Code Event Cost
Saturday, June 19, 2010Code Event Cost
Admission TicketsCode Event Cost
Category Fee RegistrantsList Primary Registrant on first line
Friday Lunch Option Saturday Lunch Option Course #1Code/Fee
Course #2Code/Fee
Course #3Code/Fee
Event #1Code/Fee
Event #2Code/Fee
Subtotal
1. + $16 Veg Opt Out Trky RB
+ $16 Veg Opt Out Trky RB
$
2. + $16 Veg Opt Out Trky RB
+ $16 Veg Opt Out Trky RB
$
3. + $16 Veg Opt Out Trky RB
+ $16 Veg Opt Out Trky RB
$
4. + $16 Veg Opt Out Trky RB
+ $16 Veg Opt Out Trky RB
$
5. + $16 Veg Opt Out Trky RB
+ $16 Veg Opt Out Trky RB
$
6. + $16 Veg Opt Out Trky RB
+ $16 Veg Opt Out Trky RB
$
04 Wilder - Periodontal Procedures 8:00-11:00am Dentist: $65 All others: $45
05 Wilder - Products & Promises Noon-3:00pm Dentist: $65 All others: $45
06 Wahl - Leading Change... 8:00am-3:00pm Free w/ Badge
07 Healthcare Provider CPR 8:00am-Noon $60 Hands On
08 Breiding - Sorry, Customer... 8:00am-3:00pm Free w/ Badge
09 Blackwell - Implant Dentistry 8:30am-4:30pm Free w/ Badge
10 Hawkins - Oral Sedation... 8:30-11:30am Dentist: $35 All others: $25
11 Lambert - Smile Design... 9:00am-Noon Free w/ Badge
12 Lambert - Conservative Prep... 2:00-5:00pm $195 Hands On
13 Goldfaden - Endodontics 9:00am-5:00pm Free w/ Ticket Hands On
14 Hawkins - Local Anesthesia 1:30-4:30pm Dentist: $35 All others: $25
15 SolmeteX - Amalgam Separators 12:15-1:15pm Free w/ Badge
46 Heartsaver Adult & Child CPR 2:00-4:00pm $50 Hands On
16 Hooper - Contemporary Funct... 8:00am-4:00pm Dentist: $65 All others: $45
17 Breiding - Turning Patience ... 8:00am-4:00pm Free w/ Badge 18 Byrne - Pharmacology Update 8:30am-4:30pm Free w/ Badge 19 Blackwell - Treatment Plan... 9:00am-Noon Free w/ Badge
20 Reynolds - Vitality & Youth... 8:30am-4:30pm Free w/ Badge
21 Hawkins - Medical Emergen... 9:00am-Noon $225 Hands On
22 VA Board of Dentistry Update 12:15-1:15pm Free w/ Badge
26 Heartsaver Adult & Child CPR 9:00-11:00am $50 Hands On
Volume87,Number2•April,May&June2010 3534VirginiaDentalAssociation
Virginia Meeting mailing list opt out (see page 18 for details): Yes, I would like to opt out of the Virginia Meeting mailing list. Leave this blank if you would like to be included in our meeting mailings.
30 Opening Reception 4:00-5:00pm Free - ticket required
32 Annual VDA Golf Tournament $125.00 9:00am (Fill out additional information section on registration form)
33 Ghost Tour $15 9:00-10:00pm Recommended for ages 6 and up.
41 Afternoon Tea $35.00 1:00-2:30pm
34 AGD Breakfast* n/c 7:00-8:00am
35 Pierre Fauchard Luncheon* $40.00 Noon-1:30pm
36 VDA President’s Party (Adult) $30.00 6:30-10:00pm
36A VDA President’s Party (Child 2-12 yrs old) $10.00
37 MCV/VCU Reception* $0 5:00-6:00pm
38 ICD Breakfast* $25 7:30-8:30am
40A-H ACD Luncheon For Learning $40.00 11:30am-1:00pm
Table Topic 40A- A;-Anezi - Review of the Masticatory System and Its Function 40B- Archer - Problem Solving in Dental Anesthesia 40C- Brickhouse - Clinical Management of the Challenging... 40D- Carter - Digital Radiography Update 40E- Haselton - CAD-CAM and Your Practice 40F- Imbery - Advanced Topics In Restorative Dentistry 40G- Tufecki - Etiology, Prevention and Treatment... 42 Sunrise Yoga $17.00 6:30-7:30am
44 Colonial Williamsburg Historic Area Ticket $22.00 Tickets good for length of conference
* Only members from these groups can attend these functions
Event & Affiliate Group Tickets
Code Event CostThursday, June 17, 2010
Friday, June 18, 2010Code Event Cost
Saturday, June 19, 2010Code Event Cost
Admission TicketsCode Event Cost
Virginia MeetingREGISTRATION FORM FOR ALL REGISTRANTS
Please use a ballpoint pen. Feel free to make additional copies as needed.
Contact Name: ________________________________________________________
Mailing Address: ______________________________________________________
City: ______________________________ State: __________ Zip: ____________
Phone: ____________________________ ADA#: ___________________________
E-Mail: __________________________________________ Component #: _______
Primary Contact for Conference Registration (If questions arise, VDA will contact this person) 1
2 Registration Categories: (Dentists many only register as a dentist)
First Time Attendee DentistVDA Member Dentist*ADA Dentist (non-VDA)*VDA Member Dentist (1st Yr Out of Dental School)*NON Member DentistActive Military Dentist (non-VDA)ODDS Member (non-VDA)*Retired Life VDA Member*Assistant - VDAA Member*Assistant - non-VDAA MemberSpouse/Guest of registrantGuest (ages 12 and under)Student (Dental, Hygiene & Assisting)Office StaffLab TechnicianHygienist *Membership verification will be required
$110 $160 $210$195 $245 $295$295 $345 $395$35 $47 $60$495 $530 $565$195 $245 $295 $195 $245 $295$0 $0 $0$50 $55 $60 $60 $65 $70$25 $30 $35$5 $7 $10$0 $0 $0$50 $55 $60$50 $55 $60$75 $80 $85
On or Before 4/30 5/1-6/4 Onsite Rates 6/17-6/19
40A- Al-Anexi 40B- Archer 40C- Brickhouse40D- Carter
ACD Luncheon For Learning: (Only for those attending luncheon)
Category Fee RegistrantsList Primary Registrant on first line
Friday Lunch Option Saturday Lunch Option Course #1Code/Fee
Course #2Code/Fee
Course #3Code/Fee
Event #1Code/Fee
Event #2Code/Fee
Subtotal
1. + $16 Veg Opt Out Trky RB
+ $16 Veg Opt Out Trky RB
$
2. + $16 Veg Opt Out Trky RB
+ $16 Veg Opt Out Trky RB
$
3. + $16 Veg Opt Out Trky RB
+ $16 Veg Opt Out Trky RB
$
4. + $16 Veg Opt Out Trky RB
+ $16 Veg Opt Out Trky RB
$
5. + $16 Veg Opt Out Trky RB
+ $16 Veg Opt Out Trky RB
$
6. + $16 Veg Opt Out Trky RB
+ $16 Veg Opt Out Trky RB
$
VDA Golf Tournament - In Honor of Dr. Donald MartinCode: 32 - Additional Information (only for those playing in tournament)
Handicap: _____________I would like to be grouped in a team with the following people:
_______________________________________________________
3 4 5 6
Grand TOTAL
Check (payable to VDA - Enclosed)Credit Card # __________________________________________________________________ Exp. Date: _________________
Security Code: _______________ Address on credit account: __________________________________________________
Signature _________________________________________________ Print Name: ___________________________________ (Signature indicateds approval for charges to your account and payment (As it appears on card) under the credit card issuer’s agreement)
8
A.B. C.D. E.F.G.H.i.J.K.K2.L.M.N.O.
7
9
Friday & Saturday Lunch Option
The Virginia Meeting will be offering a boxed lunch option for Friday, June 18, 2010, and
Saturday, June 19, 2010. For $16 per person you can enjoy a boxed lunch (Veggie, Turkey
or Roast Beef) with a drink. Lunch choices are on a first come, first served basis. Lunches will be available in the exhibit hall on Friday
from 11:30am-1:45pm and Saturday from 11:30am-1:00pm. If you opt not to have lunch on either Friday or Saturday, please indicate
that on the form below in section 4 or 5 . Your name badge will indicate if you purchased a
lunch and will be your ticket to pick it up.
Complete Details on page 25
40E- Haselton 40F- Imbery 40G- Tufecki
Choices: 1st ______ 2nd ______ 3rd ______
Refund if choices are not available
Payment Options:
2010 Exhibit Marketplaceas of March 18, 2010
ExhibitHours: Friday,June18,2010 9:30am-6:00pm Saturday,June19,2010 9:30am-1:00pm
3M ESPEA-dec, Inc.ADS SouthAFTCOAnthem Blue Cross Blue ShieldAsset Protection Group, Inc.B&B Insurance Assoc., Inc.Banc of America Practice SolutionsBenco DentalBioHorizonsBiomet 3i, LLCBrasseler USACareCreditDelta Dental of VirginiaDental DirectDentaQuest - Smiles For ChildrenDENTSPLYDentsply Tulsa Dental SpecialtiesDesigns for Vision, Inc.Discus Dental, LLCDMG AmericaDonated Dental ServicesDoral Refining CorporationDrake Precision Dental Laboratory
Elsevier/Mosby/SaundersFederal Bureau of PrisonsGazz ConsultingGendex Dental SystemsGive Kids A SmileHayes Handpiece Repair of Eastern Virginia LLCHenry Schein DentalHermitage Wealth Management, Inc.Ivoclar Vivadent, Inc.Kerr CorporationMacPractice, Inc.MDE - Mercury Data ExchangeMedical ProtectiveMedicus StaffingMidmark CorporationMissions of MercyNobel BiocareP&G Professional Oral HealthPatterson Dental Supply Co. Inc.PDT & TuttnauerPhilips SonicarePlanmecaPorter Royal SalesPracticeWorks / Kodak Dental Systems
Professional Sales Associates, Inc.Professional Solutions Insurance CompanyRBS WorldpayR. K. Tongue Co., Inc.RGP DentalRose Micro SolutionsSciCan Inc.SolmeteXSunstarSurgitel/General Scientific CorpTotal Medical ComplianceTransworld SystemsUltradent Products, Inc.Ultralight OpticsVADPACVDA ServicesVDA Services Glove ProgramVidentVirginia Board of DentistryVOCO America IncYodle Dental MarketingZimmer DentalZOLL Medical Corporation
Friday & Saturday Lunch OptionBack by popular demand...for your convenience.
For$16perpersonyoucanenjoyaboxedlunch(Veggie,TurkeyorRoastBeef)withadrink.Lunchchoicescanbeindicatedonyourregistrationformbutareonafirstcome,firstservedbasis.
LuncheswillbeavailableintheexhibithallonFriday from 11:30am-1:45pm and Saturday from 11:30am-1:00pm. Grab a boxed lunch and join us in the Exhibit Hall for a 1 hour timely dental update and 1 hour CE opportunity.
Ifyouoptnottohavelunchoneitherdaypleaseindicatethatonyourregistrationforminsection5orduringonlineregistration.Yournamebadgewillindicateifyoupurchasedalunchandwillbeyourtickettopickitup.
There will be NO on site lunch sales.
36VirginiaDentalAssociation Volume87,Number2•April,May&June2010 37
Tita
nium
Plat
inum
Diam
ond
Gold
Bron
ze
Pierre Fauchard AcademyLife Net
The Virginia Dental Association would like to thank the following individuals/companies for their generous
support of the Virginia Meeting!!! (Sponsorshipsasof3/18/10)
Virginia Association
of Endodontists
B&BFull Service Personal & Business Insurance Agency
B&B Insurance Associates, Inc. 1-877-832-9113 • www.bb-insurance.com
Drs. Shiver, Peluso & Andersen
Fairfax Oral & Maxillofacial Surgery
R.L. Tankersley, DDS, W. Les Davenport, DDS & Kenneth L. Tankersley, DDS, MD
3M ESPE
3M ESPE
Associated Printing Services, Inc.Keiter, Stephens, Hurst, Gam & ShreavesDr. Melanie Love
Even
t
Golf
Over
all
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sor
Golf
Lunc
heon
Golf
Hole
Spon
sor
Prod
uct
Dona
tion
Coltene WhaledentPin Crafters
Henry ScheinVirginia Dental Laboratories
Frid
ay C
offe
e B
reak Drs. Kaugars &
Miller, PC
Satu
rday
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ffee B
reak
Commonwealth EndodonticsPRACTICE LIMITED TO ENDODONTICS
American Associationof Endodontists
3107 Hungary Spring Road, Richmond, Va. 23228804.501.0501 Fax: 804.501.0509
www.commonwealthendo.com
Steven G. Forte, D.D.S.
Harold J. Martinez, D.D.S.
Ronald N. Vranas, D.D.S.
Madelyn G. Gambrel, D.D.S.
Steven J. Barbieri, D.D.S.
ComEndo Ad:Layout 6 2/2/09 6:05 PM Page 1
Volume87,Number2•April,May&June2010 3938VirginiaDentalAssociation
Pew Report Finds Majority of States Fail to Ensure Proper Dental Health & Access to Care for ChildrenAuthor:ThePewCenterontheStatesWASHINGTON,Feb.232010-AnestimatedoneinfivechildreninAmericagowithoutdentalcareeachyearandtwothirdsofstatesdonothaveeffectivepoliciesinplacetoensureproperdentalhealthandaccesstocare,accordingtoareportbythePewCenterontheStates.TheCostofDelay:StateDentalPoliciesFailOneinFiveChildren,releasedwithsupportfromtheW.K.KelloggFoundationandtheDentaQuestFoundation,gradeseachstate’spolicyresponsestotheurgentchallengesindentalhealthamongAmerica’slow-incomechildren.FebruaryisNationalChildren’sDentalHealthMonth.“Millionsofchildrengowithoutdentalcareeachyearbutthegoodnewsis,it’sfixable,”saidShellyGehshan,directorofthePewChildren’sDentalCampaign.“Byenactingahandfulofeffectivepolicies,statescanhelpeliminatethelong-termhealthandeconomicconsequencesofuntreateddentalproblemsamongkids.Severalstatesareleadingtheway--butallstatescanandmustdomoretoensureaccesstodentalcareforthe17millionchildrenleftoutofthesystem.”Pewscoredall50statesandtheDistrictofColumbia,usinganA-Fscale,onwhetherandhowwelltheyareemployingeightprovenpolicysolutionstoensuredentalhealthandaccesstocareforchildren.Thesepoliciesfallintofourcategories:cost-effectivewaystohelppreventproblemsfromoccurringinthefirstplace;Medicaidimprovementsthatenableandmotivatemoredentiststotreatdisadvantagedchildren;newworkforcemodelsthatexpandthenumberofqualifieddentalproviders;andgatheringdatatogaugeprogressandimproveperformance.Onlysixstatesmerited“A”grades:Connecticut,Iowa,Maryland,NewMexico,RhodeIslandandSouthCarolina.Thesestatesmetatleastsixoftheeightpolicybenchmarksandhadpoliciesinplacethatmetorexceededthenationalperformancestandards.Thesehighgradesdonotmeanthatallpeopleinthestatehaveaccesstoqualitydentalcareservices.Severeaccessproblemsstillexistinstatesthatreceived“A”grades,butthesestateshavepoliciesinplaceneededtoimprovedentalcare.Ninestatesreceivedagradeof“B”:Alaska,Colorado,Idaho,Illinois,Maine,NewHampshire,Ohio,TexasandWashington.Twentystatesreceivedagradeof“C”becausetheymetfourorfeweroftheeightpolicybenchmarks.SixstatesandtheDistrictofColumbiaearneda“D”grade:Alabama,Indiana,Mississippi,Montana,NevadaandUtah.Ninestatesearnedan“F,”meetingonlyoneortwopolicybenchmarks:Arkansas,Delaware,Florida,NewJersey,Hawaii,Louisiana,Pennsylvania,WestVirginiaandWyoming.Nostatemetalleighttargets.NewJerseyrankedlowestinthenation,meetingonlyonebenchmark.“Thechallengeofensuringdisadvantagedchildren’sdentalhealthandaccesstocareisonethatcanbeovercome,”saidRalphFuccillo,president,theDentaQuestFoundation.“Wehopestateswillusetheinformationinthisreporttomakeimprovementsindentalcareforchildren.Thereareavarietyofsolutionsthatcanbeachievedatrelativelylittlecost;thereturnoninvestmentforchildrenandtaxpayersispromising.”“Unfortunately,whilesomestatesareimprovingaccesstooralhealthcare,therearestillmillionsofchildrenandfamilies-especiallythosewhoarepoorandliveincommunitiesofcolor-whocan’tgainaccesstothecarethatexists,”saidSterlingK.Speirn,presidentandCEOoftheW.K.KelloggFoundation.“Statesneedtoexplorecreativeworkforcesolutions,suchasthedentaltherapistmodel,foraddressingthisglaringgapinourhealthcaresystem,andimprovingaccesstoqualityoralhealthcareforallchildren.”Therearemanysolutionsthatcanbeachievedatrelativelylittlecostandthereturnoninvestmentforchildrenandtaxpayerswillbesignificant.Americansareexpectedtospend$106billionondentalcarein2010.Thisincludesmanyexpensiverestorativetreatments-fromfillingstorootcanals-thatcouldhave
beenmitigatedoravoidedaltogetherwithearlier,easierandlessexpensivewaysofensuringadequatedentalcarewhentheywerechildren.ReportShowsNeedforLow-CostSolutionsThePewreporthighlightsfourprovensolutionsthatcanimproveboththedentalhealthofchildrenandtheiraccesstocare:--Sealants:Protectivecoatingsappliedtotheteethbyadentistorhygienistcostonethirdasmuchasfillingacavityandhavebeenshowntoprevent60percentofcavities.School-basedprogramsarethemostcost-effectivestrategyforprovidingsealantstodisadvantagedchildren,yetthisstrategyisvastlyunderutilized.--Communitywaterfluoridation:IdentifiedbytheCentersforDiseaseControlandPrevention(CDC)asoneof10greatpublichealthachievementsofthe20thCentury,fluoridatedwatercounteractstoothdecayandstrengthensteeth.Fluorideoccursnaturallyinwater,butthelevelvarieswithinstatesandacrossthecountry.Inadditiontobeingthemostfar-reachingpreventivemeasurestatescanenact,fluoridationalsooffersanunmatchedreturnoninvestment,saving$38indentaltreatmentcostsforeverydollarspent.About30percentofthepopulationoncommunitywatersystemsdoesnotyetreceivefluoridatedwater.--Medicaidimprovements:Makingminorchangestothisfederalprogramcanenableandmotivatemoredentiststotreatlow-incomechildren.Only38percentofMedicaid-eligiblechildrenreceiveddentalcarein2007,largelybecausetoofewdentistsarewillingtotreatthem.ThenumberofchildrenreceivingdentalservicesmorethandoubledoverjustfouryearsinseveralstatesthathaveincreasedMedicaidreimbursementrates.--Moredentalproviders:Newprofessionals,similartonursepractitionersinthemedicalfield,canexpandthenumberofqualifieddentalproviderswhocanfilltheunmetneedsofchildren.Agrowingnumberofstatesareexploringnewmodelsthatincreasetheinvolvementofphysicians,hygienists,andnewtypesofdentalprofessionals.Thereportcanbefoundat:www.pewcenteronthestates.org/costofdelay
ADAResponselink:www.ada.org/public/media/releases/1002_release04.asp
ExtraoralBy: Dr. Elizabeth M. Wilson
IS WASHINGTON BROKEN??GAMECHANGEObama and the Clintons,McCain and Palin, and the RaceofaLifetime*By:JohnHeilemannandMarkHalperin-NewYork,HarperCollinsPublisher,2010ISBN:978-0-06-173363-5,$27.99
GAMECHANGEObamaandtheClintons~McCainandPalin.andtheRaceofaLifetime*islikethekidinclass,armwavingandsquealing“ooh,ooh,Iknow,Iknow....“
Iadmitit,Iwantedtoreadthisbook.Yes,it’sgossipyandreallysortofunseemly,butifyouareapoliticaljunkie,itisalso“data”.Amidstthemanyshockers(andtherearemanyifyouhaven’theard),JohnHeilemannandMarkHalperingiveusthebroadback-groundofthelastPresidentialelection,beginningwiththeleadup.Asthetitlereferences,noonegetsabye.
Thetonetheauthorsusereflectsthepaceofunfoldingevents,keepingthereaderengagedandinvolved.Manydetails,quotes,andopinionsareincluded.Consequently,the“process”oftheelectionisrevealedforalltoexamine.AndlikeCongressandtheirsausagemakingbusiness,itisnotpretty.
Inthefirsthalfofthebook,theauthorsnarratethedemocrat-icraceforthenomination.Sometimesdepressing,othertimesoutrightfunny,butalwaysilluminating,thekeyplayersdukeitout.Wemightrememberthebasicsofthedemocraticnominationfight:thedebates,NewHampshire,Mrs.Clinton’stears,“You’relikeableenoughHillary”,thepost-racialspeech,andsoon.Thebookthoughisnosketch.And,again,notpretty.
Inthehighestheatofit,theauthorsdescribeBillClin-ton’sthoughtsasherealizestheClintonsideislosingtoObama:“ToBill,thepicturewasalltooclear.ByaccusinghimandHillaryofslappingtheracecardonthetable,theObamacampaignwasdoingexactlythatitself.Andthoughitinfuriatedhim,hecouldn’thelpbutrespecttheartfulnessoftheplay.”
Iwonderifanyonerealizeswhattheywroterightthere.Raceasa“play”,andrespectingit?Fromamoresoberperspective,trivial-izingraceisnolongeracceptable,eveninabookofthisnature.
Asthebookcontinues,momentumdashesabout,lurchingthiswayandthat,someegossoar,somecrashandburn.Oh,andyes,theEdwardsdebaclegetsplentyofattention.AlthoughEdwardsasaseriouscandidatedoesnot.
Also,weknowwhowon.
TheauthorsmoveontotheRepublicannominationsinthemiddlesectionofthebook.Abroaderbrushisusedinthisportion;
perhapswewouldallagreetheDemocraticracewasabitmoreeventful,certainlymorehistoric.
Thenationalpresidentialraceplaysoutnext.Here,theau-thorspresenttheMcCain/Palincampaignasatrainwreck.FollowingtheCouricinterview,andTinaFeyonSaturdayNightLive,theywriteofPalinspecifically:
“....intheeyesofthebroaderpublic-andevenmoresothoseofthenationalmediaandpoliticalEstablishment-anytracesofherimageasamaverickreformerhadbeenerased.Forthem,Palinhadbeenreducedtonothingmorethanahickonahighwire.”Shouldwewaitforhistory’sjudgmenthere?
Obamasurvivesreallyunscathed.Oneinterestinglineneartheconclusionfromtheauthors:
“ButwhatBidenquicklydiscoveredwasthatObama’spolicieswereawfullythin,notterriblyspecific,morerhetoricthansubstance.”
Imentionthatbecause,although,noonesayssointhebook,Bidenmustnothaveminded.
Afterfinishingthebook,mythoughtsdriftedtothequestiondominatingtheairwaves...isWashingtonbroken?
Basedonthe“data”,onemightconsidernotWashington,butthosewhopeopleit.
Anintriguingandfunbook,Iencourageyoutoreadit.Nodoubtitwillbefollowedbyothersfilledwith“allknowing”comments.
Currently,howdowerelatethisbooktothe“TeaPartyMovement”,totheprovocativeresponsestoitandtoourforth-comingelectionbattles?
Politicsisafascinatingarena-verydifficulttostayinthemiddleandviewitdispassionately.
*HarperCollinsPublishers
Editor’sNote:Dr.ElizabethWilsonhasbeenapracticingdentistinRich-mondsince2001.SheisadelegateoftheVDA,amemberoftheBoardofDirectorsfortheRichmondDentalSocietyandisadjunctfacultyatVCUSchoolofDentistry.Emailher:[email protected].
Virginia = C
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Articles of Interest Articles of Interest
Volume87,Number2•April,May&June2010 41
Dr.Michaelhasjusthadanunpleasanttelephoneconversationwithaformerpatient.Originally,thepatienthadexpressedsatisfactionwiththeresultsofhertreatment.Butheraccountisnowsixmonthsover-dueandshestillowesasubstantialamountofmoney.Dr.Michael’sbillingteamispressingthepatienttohonorthepaymentscheduleshesignedandsuddenlyshe’sbeguntoclaimthattheresultsare“hor-rible”andDr.Michaelshouldwriteofftheremainderofherbill.Theconversationendedwiththepatient’scommentthatshehopesthemattercanberesolved“withoutmyhavingtocontactanattorney.”
Dr.Michaelunderstandsthethreatbutisn’tatallcertainabouthowtorespond.Shouldhetellthepatienthe’lltalkwithhislawyer--withhismalpracticecarrier?Shouldhetellherhe’dliketoreviewherfileandgetbacktoher?Shouldhetellher,“Fine!Seeyouincourt!”?Shouldheignoreherdemandandhopeshe’lljustgoaway?
ThefactisthatDr.Michaeldoesn’treallyknowwhattodosincehe’sapleasantmanandagooddentist–andhereallydoesn’tliketogetinvolvedinconflict.Manyofhispatientshavebeenwithhimforyearsandspeakhighlyofhimandhisstaff.He’shadverylittleexperiencedealingwithunreasonablecomplaints.And,becausehehasacleanslatewhenitcomestolawsuitsordentalboardcomplaints,he’safraidthatifhecallshismalpracticeinsurer,hisrateswillberaisedorhisinsurancewillbecancelled.
Asisoftenthecasewhenwefeelrushedtomakeadecisionortakeaction,thiswouldbeagoodtimeforDr.Michaeltostepbackandgivehimselfsometimetothink.Hemightreplytothepatientthathe’dliketoreexamineherfileandthathe’llbegladtogetbacktoherwithinaspecificperiod.Thistimeframemayvaryfrommaybeacoupleofdays,toaboutaweek.Thespecificsituationwillusuallydictatehowaggressivethedoctorshouldbeaboutsettingafollow-update.Oncethisinformationhasbeencommunicatedtothepatient,heshouldpromptlycalltheriskmanagementdepartmentofhismalpracticeinsurancecompany.Hereareseveralreasonswhy:
1.Mostcarriersprovideriskmanagementconsultingtotheirinsureds;it’sgenerallyconsideredapartoftheinsuranceserviceandisusuallyavailabletothedoctoratnoadditionalcharge.There’sawin-winresultforboththedentistandtheinsurancecompanywhenapatient’scomplaintcanbepreventedfromturningintoalawsuit.Forthedoctor,it’smuchlessstressfultoworkwithanexpertriskmanager,someonewhodealswiththiskindofsituationonadailybasis,andwhoknowstheinsandoutsofthistypeofinteraction.Inaddition,theinsurercantypicallyreduceexpensesbypreventingalawsuit,ascomparedtodefendingone.
2. Dr.Michaelmightinadvertentlymakethesituationworseifhetriestohandleitonhisown.Hisverbalresponsestothepatient,orhisdocumentationofthediscussionwiththepatient,mightmuddythewaters.Whatif,forexample,hepromisedthepatientthathe’d
When Should You Call Your Med-Mal Carrier’s Risk Management Team? By: Kathleen M. Roman - ©MedicalProtectiveAllrightsreserved2010.
“takecare”ofthesituation?Fromhisperspective,he’dmeantthathe’dlookintothematterbutthepatientmightopportunisticallyinterpretthisstatementtomeanthathe’lldiscountherbill,writeoffthebalancedue,orpossiblyevenrefundherpartialpayment.
3. Evenwhenthequalityofthedentalworkisperfectlysound,manydentistsaresoafraidoflitigationthattheybendoverbackwardstoaccommodatedemandingpatients.Lackingexperienceinthesematters,thedoctormaynothavetheabilitytothoroughlyevaluatetheindividual’smotivation.Throughlisteningtothedoctor’sstoryandask-ingquestions,theriskmanagermaybeabletouncoverdetailsthedoc-tormaynothaveconsidered–andtohelpdeveloparesponsestrategy.Toooften,thedoctorisreadytoflingmoneyatthepatientinordertoclosethematter,withoutthinkingthroughalloftheramificationsofsuchaplan.Asavvyriskmanager,however,maylookatthedemandwithadispassionatefocus–andtheresultingresponseislikelytobemorefavorabletothedoctor.
4.Knowing“whentofold‘em”isanotherbenefittothedoctorwhohasariskmanagerhelpingtomanagethistypeofdemand.Theriskman-agermayaskthedoctorquestionsaboutthepatient’shistorywiththepractice,thenatureofthetreatmentplan,whetherornotthepatienthadbeencooperativeandcompliantatsomepointorwhethertherelation-shiphadbeendysfunctionalrightfromthestart.Theriskmanagermayaskaboutdocumentationinthepatient’srecordofinformationsuchasdiagnosticdiscussions,treatmentoptions,patienteducation,informedconsent,andpatientcompliance.Theriskmanagerisn’tthinkingonlyabouttheclinicalintegrityoftherecordbutalsoevaluatingitspotentialascourtroomevidence.InDr.Michael’scase,forexample,hisriskman-agerwillwanttoknowifthepatient’srecordincludesanystatementsaboutherearliersatisfactionwiththeresultsofthedentaltreatment.AnastutedefenseattorneywillbequicktopointouttoajurythatthepatienthadbeenpleasedwiththeresultsofDr.Michael’sworkatthetimeitwascompleted.“Isn’titodd,”theattorneywillinquire,“thatMs.Patientwasperfectlysatisfied–untilshewasaskedtopayherbill?”
Ifthedocumentationissound,thedoctormayhavegreaterleewayinforestallingthepatient’sdemands.If,ontheotherhand,keyelementsoftherecordaremissing,inadequate,orinaccurate,theriskmanagermaybeabletohelpthedoctornegotiateareasonableresolutionforthesmallestpossibleoutlay–andobtainasignedreleasefromthepatientacknowledgingthatthematterhasbeensatisfactorilyresolved.
Inonerecentexample,adentistattemptedtoplacateamoney-seekingpatientbyofferingheracashsettlement.Sheacceptedandpromptlycashedhischeck.Thenshesenthimaletterdemandingmoremoneybecausesheclaimedtohavelostadditionaldaysofworksubsequenttothesettlement.Atthispoint,hesawthelightandcalledhisriskmanager.
Bythistime,therewaslittletheriskmanagercoulddoexcepthelpthedoctorofferasmalladditionalsum–andrequireasignedrelease.
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Ratherthanagreetothis,however,thepatientpromptlyfiledacomplaintwiththestatedentalboard.
Thisbattlemighthavebeenpreventedhadthedoctorcalledhisriskmanagerafterthepatient’sfirstdemand.Awell-wordedreplyatthattimemighthaveweakenedthepatient’sresolve.Alternatively,acashsettlement,accompaniedbyasignedrelease-from-liabilitystatement,wouldhavepreventedanyfurtherfinaglingbythepatient.
5. Sometimesdoctorsreportthatthey’vebeenreluctanttocontacttheircarrier’sriskmanagementteamoutoffearthattheissueathandwouldleadtoanautomaticpremiumincreaseornon-renewal.Obviously,thisarticlecannotattempttoexplaineveryinsurer’sphiloso-phyonthismatterbutarigidstanceisgenerallynotineitherparty’sbestinterests.
Insurersunderstandthatdelayinrespondingtoacomplaintincreasesthelikelihoodthatitmaybecomealawsuit.Fromthisperspective,itisclearlytotheadvantageofbothdoctorandinsurertocollaborateinaresponsetothepatient’sdemands.
Further,riskmanagershaveaccesstothetechnicallanguagethatwilldocumentacloseddisputeinawaythatcanfoilapatient’sattempttoreopenthematter.Riskmanagersaremorelikelythanthepracticingdentisttobeawareofinsurancedepartmentmandates,stateboardrequirements,andpeerreviewprocesses.Theycansteerthedoctorthroughlegalisticlanguageandobscureregulations.Theycanhelpthe
doctorstrategizeresponsestopatients’demandsandtheycanhelpthedoctorswithdocumentationandwrittencommunications.Agoodriskmanagershouldknowwhentogetanattorneyinvolvedinadisputeandwillhelpthedoctoraccessgoodlegalrepresentationviatheinsurer’sclaimsinitiationprocesses.
6. PeaceofmindisperhapsthemostcompellingreasonwhyDr.Michaelshouldcallhisriskmanager.Often,doctorswillendaconversationwiththeirriskmanagerbysaying,“Oh,thankyouforyourhelp!IamsogladIcalledyou.IfeelsomuchbetternowthatI’vehadachancetotalkwithyou.”Iffornootherreasonthanithelpstoknowthatanexpertisonthedoctor’sside,itisasoundideatomakethecall.RuleofThumb:Ifthedoctorisworriedaboutsomethingthat’sgoingoninhisorherpracticethatisrelatedtopatientsafetyand/orsatisfaction,thenit’sprobablybettertocalltheinsurer’sriskmanagerthantolieinbedatnightworrying.
KathleenM.RomanisRiskManagementEducationLeaderforTheMedicalProtectiveCompany.Shecanbereachedatkathleen.roman@medpro.com
GPR General Dentist - Pediatric/Adolescent PracticeRoanoke, Va.
Carilion Clinic Dental Care is expanding its faculty of residency-trained hospital-baseddentists. This service was established in 1980, and expanded in 2001 to include pediatricdental care for children with little or no access to dental care. Located on the campus ofan 835-bed academic tertiary medical center, the service has experienced steady growthand seeks to add a Dentist with special training and interest in providing comprehensivedental care to pediatric and adolescent patients. Potential exists for academic affiliationthrough the new Virginia Tech Carilion School of Medicine (Fall 2010) and participationin research projects.
Carilion’s Dental Care program is a unique service provided by Carilion Clinic, the largest,nonprofit integrated health system in southwest Virginia, with eight hospitals, 110+practice sites and fifteen GME programs. A five-time All America City, the Roanoke Valleyis a metropolitan area of over 300k located at the southern tip of Virginia’s ShenandoahValley, surrounded by the Blue Ridge Mountains. The region offers recreational, culturaland professional opportunities, including mild weather and four seasons, award-winningschools and internationally acclaimed colleges and universities.
• DDS/DMD degree from accredited dental school• Completion of an accredited general practice residency • Interest in hospital-based pediatric dental practice, plus sedation skills desired• Current unencumbered dental license & DEA• Eligible for Virginia dental license
Submit cover letter outlining work history and CV to the attention of Rhonda Creger,Senior Consultant, Physician and Professional Staffing, Carilion Clinic, POB 40032,Roanoke, VA 24002-0022, or email documents to [email protected].
EEO/AA
Dental Recruit 8.5x5 K 2010_Layout 1 2/24/10 12:58 PM Page 1
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Get your CE at the beach in sunny South Carolina!
Keynote Speakers • Dr. Harald Heymann – Bread and Butter
Adhesive and Esthetic Dentistry • Dr. Charlie Hook – 2010 OSHA Guide-
lines• Dr. Patick Sammon – Prescription Drug
Abuse and Meth Mouth • Dr. Kelly Jones – Pharmacotherapy Re-
view for Dentists • Ms. Stacy McCauley – Practical Informa-
tion on Teen Health Issues & Customized Care for Healthy Patients and a Healthy Practice
• And many more…
Special Events • Welcome Reception and Beach Dance
featuring the Ninth Row Band on Thurs-day night
• Annual Golf Tournament • President’s Social Event – Lowcountry
Boil on Saturday night
Convenient Online Registration • Visit www.scdaannualsession.com to learn
more about this year’s event and to regis-ter yourself and your staff!
South Carolina Dental Association 120 Stonemark Lane Columbia SC 29210
803.750.2277
Dean Ron Hunt Moves OnBy:MarthaBushong,DirectorofCommunicationsandPublicRelations,VCUSchoolofDentistry
VirginiaCommonwealthUniversityandtheSchoolofDentistrybidDr.RonHuntfarewellat
areceptionheldinhishonoronFriday,February12.
Inhisremarksduringthegathering,Dr.MichaelRao,presidentofVCUsaid,“Weareheretocelebrate12yearsoftremendoussuccess.Thisbeautifulfacilityandotheraccomplishmentsleavealastinglegacy.ItisaprivilegeandapleasuretosaythankyoutoRon.”
Dr.HuntwillleaveVCUtotakeonnewchallengesatMidwesternUniversity’sSchoolofDentistryinGlendale,Arizona.Thenewlyestab-lishedschoolispartofahealthsciencesonlycampusinthesuburbsofPhoenix.
“My12yearsatVCUhavebeenthemostrewardingofmylife,”saidDeanHunt,“butIfoundthechallengeofbuildingsomethingbrandnewirresistible.MidwesternUniversityfocusesentirelyoneducatingprimarycarepractitioners–fordentistrythatmeansgeneraldentists.”
WhileVCUconductsanationalsearchforanewdean,Dr.DavidC.Sarrett,associatevice-presidentforhealthscienceswillserveastheschool’sinterimdean.Dr.Sarrettknowstheschoolwellasaformerdepartmentchair,academicdeanandcurrentpresidentofthefacultypracticeassociation.
“Iampleasedtobeabletohelptheschoolinthisrole,”saidDr.Sar-rett.“Ilookforwardtogettingreacquaintedandmakingthetransitionapositiveonefortheschool.”
The comprehensive web home for Dental
Direct plans in VA makes DR and DA
easier to research online.
The Direct Reimbursement Committee invites you to visit their website dedicated to Dental Direct
Reimbursement and Assignment dental plans at:
www.VADentalDirect.com On the site, information is available for
dental offices, employers, employees and
brokers.
Links to resources, articles and other sites
about DR plans are all available at
www.VADentalDirect.com.
Up to date news about Dental Direct in
Virginia is easy to access at the site!
The Dental Direct website has great resources available for your office. Check out the
Frequently Asked Questions section to get a better understanding about Dental Direct and
what it can mean for your office. If you or anyone at your office would like more information
about Dental Direct, please contact Elise at the VDA - [email protected]; 800-552-3886.
Standing, L-R: Drs. John Gunsolley, David Sarrett, Michael Rao, Sheldon Retchin. Seated: Dr. Ronald Hunt.
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Amalgam Separators Make School of Dentistry GreenerBy:MarthaBushong-DirectorofCommunicationsandPublicRelations,VCUSchoolofDentistry
Reduce,reuse,recycle.Thesefamiliarwordstakeonnewmean-ingwhenplacedinthecontextoftheVCUSchoolofDentistry.Evenbeforetheuniversity’spresident,Dr.MichaelRao,kickedofftheYearoftheEnvironmentinfall2009,thedentalschoolhadimplementedsomeimportantearth-friendlypractices.
Amongmanyactionstomaketheschoolgreener,onemajordecisionwastheinstallationofamalgamseparatorsfortheclinicsineachoftheschool’sthreebuildings.
“Noonerequiredtheirinstallation.”saidDeanRonHunt.“AswebuiltthePerkinsonBuilding,however,wethoughtifwecouldlessenanyenvironmentalimpactbyinstallingseparatorsinallthreeofourbuild-ings,itwastheresponsiblethingtodo.”
Now,threeseparators–oneineachbuilding--collectamalgamwastefromtheschool’sclinics.Theseparatorstheschoolneededaremuchlargerthatwhatadentalofficewouldrequire.Theircostwasover$39,000,butstudentsandfacultyremoveorplacemanytimesmoreamalgamrestorationseverydaythandentistsintheirprivateoffices.
AccordingtotheAmericanDentalAssociation,eightstatesandsomecitiesalreadyrequiredentiststoinstallamalgamseparators.Thismandateappearstobeanationaltrendaslocalwastewatertreatmentplantsseektoreducetheconcentrationofmercuryineffluentfromtheirplants.
CurrentlyVirginiadoesnotmandatetheuseoftheamalgamsepara-tors,butsomeofthecommonwealth’sdentistsareonboard,andliketheschool,haveinstalledthemintheiroffices.
“Alltheseparatorssoldnowareover99percentefficient.”saidDr.CraigDietrichofMartinsvilleandmemberoftheVirginiaDentalAs-
sociation(VDA)BoardofDirectors.“Thecostisreallyminimal;Ipaidaround$700formineandinstalleditmyself.Allthingsconsidered,itistherightthingtodo.TheVDAandtheADAhaveenvironmentalguidelinesintheir‘BestManagementPracticesforAmalgamWaste’,”Dietrichcontinued,“Sowearejustdoingwhatourassociationalreadyrecommends.”
LastyeartheVDABoardofDirectors,recognizingitspoliticalimportance,proposedaresolutioncallingforanamalgamseparatormandatethatwouldbecraftedbydentists,ratherthanstateregula-tors.ButtheVDAHouseofDelegatesdidnot
The largest of the three newly installed amalgam separators resides on the ground floor of the Perkinson Building. This unit collects amalgam waste from the Douglas and Graduate Periodontic Clinics.
supportit.
“Theseparatorsarerelativelyinexpensiveandfairlyeasytomaintain,”concurredDr.TerryDickinson,VDAexecutivedirector.“Eventually,ifwedon’tdoit,thestatewillrequireit.IampleasedDeanHuntandthedentalschooltooktheleadandimplementedthisbestpractice.”
Non-Patient Based Licensure Coming to a State Near You?By:RichardCarlile,VCUSchoolofDentistry,D-2011
WhenyouthinkofMinnesotayoumaythinkofsnow,peoplewithfunnyaccents,orevenAlFranken.OnJune26,2009MinnesotaalsobecameknownasthefirststateintheUniontoinstituteanon-patientbasedlicensureexam.
TheMinnesotaBoardofDentistryhasapprovedusingtheNationalDental
ExaminingBoardofCanada’stwo-partexamasameansfordentalstudentstoobtainalicenseinMinnesota.Thistwo-partexamconsistsofawrittenportionandanon-patientbasedObjectiveStructuredClini-calExamination(OSCE).Alongwithpassingtheexam,studentsmustgraduatefromaschoolaccreditedbytheCouncilonDentalAccredita-tion(CODA),passPartIandIIoftheNationalBoards,andtakeaMin-nesotajurisprudenceexamination.1
DentalstudentsaroundthecountrywhoareactivelyengagedintheAmericanStudentDentalAssociation(ASDA)areveryexcitedaboutthenewdevelopments.TheexamalignsitselffairlywellwithASDA’sL1policy,whichcallsforanon-patientbasedlicensureexam.2
LicensureboardshaveofficiallybegunattheVCUSchoolofDentistry,andatdentalschoolsacrossthenation.AsstudentsbegintogetfrustratedoverfindingtheidealClassIIorIIIlesiontheymaywanttoaskthemselves-“ShouldImovetoMinnesota?”
1 http://www.dentistry.umn.edu/news/CanadianLicensureExam/home.html2 http://www.asdanet.org/_AboutPage.aspx?id=1568#L-1
Midwaythroughthefirstsemester of my thirdyear of dental school
Iwasassigned“Susan”,aprospec-tive patient referred by Dr. ReedBoyd,whopractices inPetersburg.Icalledandaskedifshewouldcome
A Smile RestoredNotes from the VCU School of DentistryBy:JosephL.Rodriguez,Classof2011
inforanappointment,andshereplied,“I’mnotsureifyoucandowhatIneeddone.”Susanhadlittleconfidenceincomingtothedentalschool,butaftermuchpersuasion,shedecidedtoscheduleanoralevaluationtodeterminehertreatmentneedsand to explore the treatment options available to her at theschool.
SusancameinfortheinitialappointmentandDr.Cleckner,anadjunctfacultymember,oversawthetreatment
planningsession.Aftermuchdiscussion,Susandecidedshewouldliketohaveporcelainveneersdoneonhermaxillaryan-teriorteeth,andpremolars#5and#12.Thetreatmentplanwasthenpresented toandapprovedbyDr.Janus,aprosthodon-tist and full-time facultymember.Although thiswould bemyfirstveneercase,IwasexcitedtoputintopracticewhatIhadlearned inDr. Janus’s crownandbridgeclass. I alsogainedconfidenceknowingIwouldbeundertheguidanceofDr.Chin,Dr.BaechleandDr.Cleckner,withwhomIhadworkedmostclosely.
At the secondappointment extensive pre-operativephotos,afacebow,andpreliminaryimpressionsfortwosetsofdiagnosticcastsweretaken,pouredinstoneandmountedonasemi-adjustableHanau®articulator.Itookonthetaskofwax-ingupteeth#5-12,andperformingmockenameloplastyonthemandibularanterior teeth to improveesthetics.Acustomtraywasfabricatedforthefinalimpressionandanimpressionwithpolyvinylsiloxanewasmadeasthetemplatefortemporaries.
WhenweshowedSusanthewax-upatthefollowingappointment,shewasthrilledandwaseagertoproceedwiththeproposedtreatment.Priortoveneerpreparation,shadese-lectionwasdoneusingtheVitapan®classicshadeguideandshadeA2wasselected.Severalofheranteriorteethhadfailingcompositerestorations,whichneededreplacement.Aftertheteethwererestored,theveneerpreparationswerecompleted,retractioncordwasplacedandthefinalimpressiontaken.TheteethweretemporizedwithveneersfabricatedwithIntegrity®.Susanwasthengiventhechancetoviewandcritiquethetem-porary veneers so that desired changes could bemade.Animpressionofthetemporarieswastaken.Thepindexedmastercastwastrimmedandthemarginsweremarked.Afterfacultyapproval, the completed case including pre-op photos, diag-nosticcast,wax-ups,mountedcasts,castsofthetemporariesandmasterimpressionsweresenttoDrakeDentalLaboratory.Dr. Larry Holt, the clinical director for Drake Lab, personallysupervised the production of the veneers. He also took ex-
cellent photos during the fabrica-tion process. The veneers weredeliveredtotheschoolsealedandpackaged, etched on the inside,andready tobeplaced.Ondeliv-ery day, Dr. Chin, a full-time fac-ulty member, guided me throughthe cementation process. Afterachieving local anesthesia, cordwas placed and the teeth wereisolated.Try-inoftheveneerswasaccomplished in pairs with try-inpaste, and they had an excellentfit. Etching,silanating,andbond-ingwereaccomplishedandtheve-neers were cemented with NX3®Third Generation resin cement.Susanwas very pleasedwith theresult and was ready to show offherbrandnewsmiletofamilyandfriends,andtellthemwhattheden-talschoolhadtooffer.
IamgratefultoDr.Boydfor referring Susan and makingpossiblethisrewardingexperienceinmydentaleducation.Thetreat-ment would not have been pos-siblewithouttheexcellentcommu-nicationwehadwithDrakeDentalLaboratory. Witnessing Susan’stransformation from being an ap-prehensive and anxious patientto being extremely confident andexcited about getting her dentaltreatmentdone in theVCUdentalschoolsettinghasmadethis jour-neyallthemoremeaningful.
Preoperative
Temporary Veneers
Permanent Veneers
A happy patient!
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Awards & Recognition
Volume87,Number1•January,February&March201046
Dr. Roger Wood, a pediatric dentist in Midlothian and President of the Virginia Dental Ser-vices Corporation, received the 2010 First Humanitarian Award for physicians. Given by Chippenham-Johnston Willis (CJW) Medical Center, the award recognizes a doctor “who demonstrates remarkable concern for the welfare and happiness of patients, has performed extraordinary acts of kindness, shows a level of commitment to community service…and whose contributions may be overshadowed by (his) modesty and humility.”
In Memory of Julie Kent (Pat) WatkinsJulie Kent (Pat) Watkins, 88 passed away January 27, 2010, in Virginia Beach, VA following a long battle with Alzheimer’s disease. Pat served for 24 years as Executive Director of the Virginia Dental Association before retiring in 1994. Her retirement banquet featured multiple letters of thanks from Virginia Congress members, former Virginia Governors, a U.S. Sentor, and featured a U.S. Congressman as one of the evening’s speakers. A memorial service was held on February 6, 2010 followed by internment at Blue Ridge Memorial Cemetery in Lenoir. Memorial donations can be made to the Alzheimer’s Association or charity of your choice.
Governance Meeting
The2010VirginiaDentalAssociationsGovernanceMeetingwillbeheldSeptember24-26th.Wehaveendeavoredtogiveyouvalueforyourtime.InadditiontodoingthebusinessoftheAssociationwiththeHouseofDelegatesandReferenceCommitteemeetings,wewillhaveDr.RonTanker-sley,ADAPresident,speakduringtheAnnualBusinessMeetingSaturdayafternoon.WewillalsohaveaDRupdatefromDr.RichardTaliaferro,DRCommitteeChair,attheBusinessMeetingopeningsessionFridayafternoon.
Thefellowshipopportunitiesincludetheverypopularcomponentreceptions,thebusinessmeetingandthewellreceivedawardsbanquet.Theseopportunitiesmaketheprocessalotmorecollegialastheyallowustodiscussitemsofinterestcasuallyandtheyallowustogettoknowothersfromaroundthestatemuchbetter.Longtermfriendshipshaveemergedfromthesegatherings.Pleaserememberthatthesemeetingsareopentoallmembers.ThisisanopportunitytoseehowyourVDAisrespondingtothechallengesofaccesstocare,workforceissues,governmentalintrusionandawholehostofrelatedmatters.Youmayfindthatyouwouldliketojointheprocessandhelpyourprofession.
TheHousethisyearpromisestobeengagingandmeaningfulfortheworkingoftheVDA.Thereshouldbemanyissuesthatneedtoberesolved.Fortunately,weshouldhavethetimetotalkabout,reflectupontheacttohelpourprofession.YourparticipationanddeliberationsarevitaltothememberdrivenVDA.
Seeyouthere,DavidC.Anderson,D.D.S.SpeakeroftheHouse
HOTEL RESERVATION INFORMATION
THE HOTEL ROANOKE & CONFERENCE CENTERROANOKE, VA
ROOMSAREAVAILABLEUNDERTHEVDAROOMBLOCKFORTHENIGHTSOFSEPTEMBER23rd–25th
ROOMRATE$145.00(Pricedoesnotreflectthelocalroomtax.)
RESERVATIONSMUSTBEMADEBYSeptember3,2010TORECEIVEBLOCKRATE
September 24-26, 2010Roanoke, VA
CALL:540-985-5900or866-594-4722(BeSureToAskForTheVDAGovernanceConference
RoomBlock)
ONLINE:HotelReservationLinkListedInGover-nanceMeetingInformationontheVDAWebsite
Sponsored by:
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2010 VDA GOVERNANCE MEETING SCHEDULEFriday,September24th7:30am-2:00pm BoardofDirectorsMeeting2:15pm-3:00pm HODRegistration3:00pm-4:30pm BusinessMeetingOpeningSession HouseofDelegatesOpeningSession2:00pm-6:00pm ElectionofOfficers4:45pm 16thDistrictDelegation6:30pm ComponentReceptions
Saturday,September25th7:30am-8:30am Breakfast7:30am-8:30am FellowsBreakfast8:00am-12:00pm ElectionofOfficers8:30am-10:00am ReferenceCommittee100010:15am-12:00pm ReferenceCommittee200010:00am-12:00pm VDSC12:00pm-1:00pm Lunch1:30pm-3:00pm AnnualBusinessMeeting 3:00pm Constitution&BylawsCommittee6:00pm Reception6:30pm AwardsBanquet
Sunday,September26th7:00am-8:00am Breakfast7:30am-8:30am ComponentCaucuses8:15am-9:00am HouseofDelegatesRegistration9:00am-11:00am HouseofDelegates11:15am-12:30pm BoardofDirectorsMeeting
VDA AWARDS BANQUET
When: Saturday,September25,2010 6:00PMReception6:30PMDinner
Where:TheHotelRoanoke&ConferenceCenter 110ShenandoahAve. Roanoke,VA24016
Cost: $20.00–HouseofDelegateMembers/BoardofDirectors$50.00–Allotherguests
TICKET SALES DEADLINE: SEPTEMBER 10, 2010 – NO ONSITE SALES
Name:_______________________________________________________________Numberattending:_____________
Amountenclosed:________________
Payment:CheckpayabletoVDA
CreditCard#______________________________________________ ExpirationDate:__________________________
Signature:___________________________________________ PrintName:___________________________________(Signatureindicatesapprovalforchargestoyouraccountandpayment (Asitappearsonyourcreditcard)underthecreditcardissuer’sagreement.)
CardBillingAddress:_________________________________________________________________________________Pleasemailorfaxto:VirginiaDentalAssociation,7525StaplesMillRd.,Richmond,VA23228,Fax:804-261-1660
Awards Banquet
CAN’T MAKE IT TO THE GOVERNANCE MEETING? VDA MEMBER VOTING OPTIONS
Therearetwomethodsofabsenteevotingavailable:
1. WrittenAbsenteeBallot:• AbsenteeballotsmayberequestedfromtheVDACentralofficebeginning30dayspriortotheelection(August
25th).AnAbsenteeBallotRequestFormwillbeintheJuly,August,SeptembereditionoftheJournal.• Anabsenteeballotwillbemailedtothememberandmustbereturned
totheCentralOfficenolaterthan12:00noontwobusinessdayspriortothestartoftheGovernanceMeeting(Wednesday,September22nd)intheenvelopesprovided.
2. Onlinevoting:• AsecureMemberVotingModulewillbeavailableontheVDAwebsite(www.vadental.org)beginningAugust25th.• Memberswilluseselectedidentifierstologinandprotectthesecurityofthevoteandtheprivacyofthemember.• Onlinevotingwillbeavailableuntil12:00noonSeptember25,2010.
InpersonvotingattheGovernanceMeetingwillalsobedoneonlineonsecurecomputersprovidedbytheVDA.
Itisimpossibleforamembertovotemorethanonce.
Intheeventofarunoffelection,electionswilltakeplaceattheAnnualBusinessMeetingwhichwillbeheldat1:30pmSatur-day,September25,2010.
VDA FELLOWS BREAKFASTFellowsoftheVirginiaDentalAssociationareInvitedtoAttendthe2010AnnualFellowsBreakfast
Date: Saturday,September25,2010When: 7:30am–8:30amWhere: TheRoanokeHotel 110ShenandoahAve. Roanoke,Virginia24016Cost: $18.00
TOATTENDPLEASECOMPLETETHEFOLLOWINGANDMAILORFAXTOTHEVDACENTRALOFFICEBYSEPTEMBER25,2010NOONSITETICKETSALES
.Name:___________________________________________________ Amountenclosed:________________________
Payment:CheckpayabletoVDA
CreditCard#______________________________________________ ExpirationDate:__________________________
Signature:________________________________________ PrintName:____________________________________(Signatureindicatesapprovalforchargestoyouraccountandpayment (Asitappearsonyourcreditcard)underthecreditcardissuer’sagreement.)
CardBillingAddress:_________________________________________________________________________________Pleasemailorfaxto:VirginiaDentalAssociation,7525StaplesMillRd.,Richmond,VA23228,Fax:804-261-1660
Fellows Breakfast
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IamannouncingmycandidacyandrequestingyourvoteforthepositionofVDAPresident-Elect. Ihavebeeninvolvedinorganizeddentistryallofmyprofessionalcareer.IbeganasthelocalchairofwhatwasthenChildren’sDentalHealthMonth.Sincethattime,Ihavebeenpleasedandhonoredtoserveinlead-ershippositionsatalllevelsoforganizeddentistry.Ihaveservedaslocalcommitteechaironseveralcommittees,aspresidentofourcomponent,asVDAdelegate,asanADAalternatedelegate,aschairoftheADACouncilonDentalEducationandLicensure,andasPresidentoftheVirginiaBoardofDentistry. HavingthehonorofthechairoftheADACouncilandthePresidencyoftheBoardofDentistrytaughtmehowimportantitwasforVDAmembersandtheirleaderstobeawareoflegislativeactionsthataffectourdentalpracticesonadailybasis.Iwasextremelyproudofthemembersofthedentalprofessionwhorespondedsowelltothemostrecentissuesdur-ingthepresentlegislativesession. Accesstocareisalsoapassionofmine.IwasamemberoftheVDATaskForceresponsiblefordevelopingtheMissionofMercy(MOM)project.Thisprogramcelebratedits10thAnniversaryin2009.Iamamem-beroftheDonatedDentalServicesandhavebeenthelocalchairofGiveKidsASmileforthepasteightyears.Duringthattimewehaveprovidedpreventivecareandfollow-updentalcare(includingcomprehensivedentaltreatmentundergeneralanesthesiainahospitalsetting)tochildrenwhoseparentsareunabletoaffordcarefortheirfamily. Iwillbeastrongadvocateforthedentalprofessionandfeelthatmyhistoryofservicewillhelpmerepresentandserveallmembersoftheprofession.IaskforyourvoteandyoursupportasPresident-Elect,andItakethatresponsibilityveryseriously.Thankyou.
11601RobiousRoad,Midlothian,Virginia23113(804)794-3498Component:4
Roger E. Wood, DDSCandidate for the Office of: President-Elect
IfeelthatwithmyexperienceasateacheratMCV,anactiveprac-titionerinthefieldandmyserviceasanofficerforseveraldentalassociations,thatIwillbeabletofacethechallengesassociatedwithbeingaDelegate.
IhavebeenactivelyworkingwithaDentalBenefitsCommitteetoaddressourongoingtrialsandtribulationsindealingwithinsurancecompanies;particularlywiththeprocessinganddenialofdentalclaims.Wearealsoworkingtoopenavenuestowardsprovidingadequatedentalbenefitsforpeoplewhohavepreviouslyhadnoaccesstodentalcare.Thisprocessissomethingthatwillneedconstantmonitoringonthelocal,state,andnationallevels.
IlookforwardtoworkingwiththeDentalBenefitsCommitteeandotherareasthatimpactdentistrytoday.Ihavecommittedmyselftothetimeandenergyneededtoaddresstheseissues.IalsoremaincommittedtotheVirginiaDentalAssociationandwillworkhardtocompletetasksathand.ItwouldbemyhonortoservetheADAasadelegatefromVirginia.
2240ColiseumDriveSuiteC,Hampton,VA23666(757)-826-1121Component2
Richard D. BarnesCandidate for the Office of: ADA Delegate
Iwishtothankyou,themembersoftheVirginiaDentalAssociation,forgivingmesuchawonderfulopportunitytoservetheprofessionasyourPresidentforthe2008-2009year.IthasbeenapleasuretoservetheAssociationandtheADAasanAlternateDelegatethesepastsixyears,andIseekyoursupporttocontinuemyserviceasanADADelegate.Ifeelthattherearemanyissuesthatweasaprofessionfaceonadailybasisandweneedleaderswhowillrepresentyourwishesandourinterestsonanationallevel.HavingservedasamemberoftheBudget,Finance,andAdministrativeMattersReferenceCommitteeandcurrentlyservingasamemberoftheADACERPCommittee,Ifeelmyexperi-encewillbeusefulinmakingmeaneffectiveDelegatetotheAmericanDentalAssociationandIhumblyaskforyoursupport.
102WesternAve,Suffolk,VA23434757-539-7695Component:1
Ralph L Howell, Jr., DDSCandidate for the Office of: ADA Delegate
2010 VDA Elected Leadership Candidates
Edward J. Weisberg, DDSCandidate for the Office of: ADA Delegate
AsaDelegatetotheADAIhaveusedmybudgetaryexperiencetohelpscrutinizetheADABudgetProposalsandensurethatourduesdollarsarespentinthebestpossiblemannerandthatanyduesincreasesarejustified.IhaveanunderstandingofhowtheADAHouseworkstovoicethedesiresofthemembership.IhavebeenactiveinmysupportofOrganizedDentistryandaskforyoursupporttoelectmeasaDelegate.
TheHouseofDelegatesofTheAmericanDentalAssociationadoptsthebudgetanddevelopsthepoliciesandprogramsofourAssociation.AsamemberoftheVDAandthe16thdistrictdelegations,IhavebeenactiveinthedelegationandIamseekingtocontinuethisasaDelegatetotheADA.IamcommittedtoabroaderinvolvementbasewhichwillenhancemycommitmenttotheVDAandservingmycolleagues,itsmembers.IwillbeopenmindedandlistentoanymemberwhohasanopinionandwillformulateapositionwhichwillbestbenefitourVirginiamembersnotjusttheneedsofonlyafew.
RespectfullyIaskyoutoreturnmetothepositionofADAalternatedelegate.OverthepasttwoyearsIhavetriedmylevelbesttorepresentVirginiaforcefullyattheADAhouse.Speakingbothonthefloorandinreferencecommittees,puttingVirginia’sideasbeforetherestofthedistrictshasbeenadistincthonorandprivilege.AndmayIsay,it’sbeenaheckofalotoffun.TocontinuetorepresentyouwouldbeajoyanditwouldmakemyworkwiththeVDAfarmorefulfilling.
5288DawesAveAlexandria,VA22311703-671-6060Component8
Dr. David AndersonCandidate for the Office of: Alternate ADA Delegate
No photo available
TheVirginiaDentalAssociationisuniquelypositionedtorepresenttheinter-estsofthousandsofdentiststhroughoutthestate.Theirconcernsregardingkeyissuessuchas:accesstodentalcare,dentaleducation,thedentalwork-force,membershipanddirectreimbursementmustbeaddressed.LeadershipthroughcooperationandaclearvisionoftheVDA’sfutureareessentialtoourcontinuedgrowthandprosperity.Ifnowelectedtoserveatwo-yeartermasanAlternateDelegatetotheADAHouse,Iwilldedicatemyyearsofprovenleadershipinthemilitary,academicsandcommunityservicetoadvancethegoalsoftheVDAandourprofession.
VCUSchoolofDentistry,POBox980566Richmond,VA23298804-828-2977Component:4
Alfred J. Certosimo, DMDCandidate for the Office of: Alternate ADA Delegate
801W.LittleCreekRoad,Ste103,Norfolk,VA23505757-440-0044Component:1
HavingservedontheVirginiaDelegationtotheADAforthepast14years,IhavedevelopedagoodrelationshipwithdentistsfromotherareasofthecountryandtheofficersoftheADA.Thisbecomesnecessarywhendebatingtheissuesinbothfindingoutwhatothersareconcernedwithandhowtogetwhatwe,inVirginia,wouldliketohave.Ilistentomyfriendsandcolleaguesthroughoutthestateandamawareoftheissuesthatareimportanttothem.Knowingwhatisimportanttoourmembers,andknowinghowtogetthejobdonemakemeanaffectiverepresentativeforVirginiadentists.IthasbeensuchapleasurerepresentingyoutheseyearandIhopeIcancountonyourvotetocontinuemyservicetotheVDAandADA.
14245-PCentrevilleSquareCentreville,VA20121703-830-9110Component8
Dr. Bruce HutchisonCandidate for the Office of: Alternate ADA Delegate
Curricula Vitae (CVs) for all candidates can be viewed online
at www.vadental.org
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Component 8Dr. Chris Spagna - Editor
Component NewsComponent 5
Dr. Gene Ayers - Editor
IhavehadthedistinctpleasureofrepresentingtheVDAasanAlternateDel-egatetotheADAforthepastsixyears,andIwouldbehonoredtobechosentodosoagain.Mythreetermshavebeenduringexcitingtimesfororganizeddentistry;wearefightingtomaintainourpracticeindependencewhiledoingeverythingpossibletoensurethatweattendtothedentalneedsoftheunder-served.Wecontinuetoputethicsatthetopofourprofessionalcommitments.Wecontinuetomakedifficultdecisionsthatwefeelareinthebestinterestofthedentalprofession.Wehavebeenabletoexperiencepoliticalsuccessstatewidewiththerecentpassageofthetwobillspreventingtheinsurancecompaniesfromdictatingfeesonnoncoveredservicesandwehopetohavethesamesuc-cessnationallywithrepealoftheMcCarran-FergussonActexemptionforhealthcarecompanies.ThistypeofmemberinvolvementiswhatmakestheADAsoeffectiveandimportanttoourprofession.Wedomakeadifference!IhavetrulyenjoyedmytermsasanADAAlternateDelegate,andIhopeyouwilloffermetheopportunitytocontinuemyservice.
6901PattersonAveRichmond,VA23226804-288-5324Component4
Dr. Elizabeth ReynoldsCandidate for the Office of: Alternate ADA Delegate
First,letmesaythatithasbeenaprivilegeandhonortorepresentyouattheADAoverthepastfouryears.IwouldliketoaskforyourcontinuingsupportasIseekre-electiontothepositionofADAAlternateDelegate.
Dentistrytodayfacesmanynewtrialsandtribulations.Someoftoday’smajorissuesareHealthcare,DHATS,ethics,thehygienemid-levelprovider,andthepatient’saccesstodentalcare.Inordertohavemeaningfulsolutionstoourproblems,weneedto“thinkoutsidethebox”.Aswehaveseenoverthepastfewmonths,Foundations,RepresentativesfromCongressandsomestateLegislatorsaretryingtocomeupwiththeirownsolutionsforourissues.Bycomingupwithourowninnovativeideas,weasadentalcommunitycanprovideaunifiedvoicetoaddresstheseproblems.Thewelfareofourprofes-sionisbestservedandprotectedwhenwejointogethertoproduceworkablesolutions.ThroughalloftheupcomingdebateswemustkeeptheDentistinchargeoftheDentalteam.
OurVirginiaDelegationhasprovidedstrongleadershipoverthepastyears.TheelectionofDr.RonTankersley’sasourADAPresidentisoneofourproud-estmoments.IfeelthatmyworkethicandpastexperienceontheVirginiaDelegationandontheVirginiaBoardofDentistryhaveprovidedastrongfoundationformycontinuedserviceontheNationallevel.
11007WarwickBlvdNewportNews,VA23601757-596-7000Component2
Michael J. Link, DDSCandidate for the Office of: Alternate ADA Delegate
Thesnowisfallingasthisbriefentryiscomposed.However,thisjournalshouldreachyouwhenaburgeoning,beautifulspringtimefedbythesnowmeltarrivesthroughouttheCommonwealth.Getoutthereandadmirethedaffodils!Asspringsettlesfirmlyintoplace,joinusinthePiedmontattheexcellentDanvilleAdvancedLearningInstituteforourcomponentmeetingonFriday,April30,featuringDr.RalphNicassiopresenting“AdvancesinOrthodonticsforGen-eralDentistry”.ForinformationorlastminuteregistrationcallExecutiveDirectorAnnHuffmanat276-673-6700.PiedmontPresidentChrisPayneannouncedtheopeninginFebruaryofa
HappybelatedNewYearfromcomponent8!Asthefirstfewmonthsof2010havecomeandgone,muchhasgoneoninNorthernVirginia.InDecemberourlegislativebrunchwaswellattended,asmuchconversationtookplaceregard-ingthemandatedfeesbill.LaterinJanuary,wewereabletofollowupwithaniceshowinginRichmondforthe“DayontheHill”.Thanksgoesouttoallthedentists(andespeciallythosefromNorthernVirginia)whowrotetheirlegislatorsregardingthisveryimportantsubject.Duetothegenerosityandsupportofourmembers,over$21,000wasraisedduringthe2009AnnualHolidayGreetingCardcampaign.Moniesraisedwillen-
newvolunteermanneddentalclinicinassociationwiththeDanvilleCommunityDentalHygieneSchool.AnotherresponsebydentistryintheCommonwealthtoaccesstocareissues.AtthesametimefinalplansareunderwayfortheRoanokeM.O.M.projectMarch26and27.Thelocalarrangementsandsupportforthisrecurringclinicaretopnotch.Comealongandenjoyserviceforothers.
abletheNorthernVirginiaDentalClinictocontinueassistingthosewhoaremostatneedinourcommunity.THANKYOU!InclementweatherforcedustorescheduleourFebruary5thGiveKidsaSmileeventtoApril9th.WearelookingforwardtothataswellastheupcomingMis-sionofMercyprojectonMarch12,13.Botharesuretobeasuccess!Theendtowintercouldn’tcomeanysoonerhereinNorthernVirginia,aswearelookingforwardtospringmorethaneverbefore.Takealookatourwebsite,nvds.org,formoreinformationontheupcomingCEprogramsscheduled.
Northern Virginia Dental SocietyDr.IbrahimAlhussaingradu-atedfromtheUniversityofPennsylvaniain2003.HeiscurrentlypracticinginFairfax.
Dr.NavidAsgarigraduatedfromTempleDentalSchoolin1996.HethencontinuedtoreceivehisGeneralPracticeResidencyCertificatein1997.Dr.Asgariiscurrentlypractic-inginSpringfield.
Dr.CharlesBrownIIIgradu-atedfromtheMedicalCollegeofVirginiain1996.HethenreceivedhisGeneralPracticeResidencyCertificatefromtheUniversityofMississippiMedicalCenterin1997.Dr.BrowniscurrentlypracticinginAlexandria.
Dr.JaniceDionisio-Magradu-atedfromTempleDentalSchoolin2007andiscur-rentlypracticinginAlexandria.
Dr.JosemariImaoiscurrentlypracticinginLakeRidge.
Dr.AnthonyMoawadgradu-atedfromBostonUniversityin2008andiscurrentlypractic-inginMcLean.
Dr.HamdiMohamedgraduatedfromtheHow-ardUniversityCollegeofDentistryin2008.ShethencompletedherGeneralPrac-ticeResidencyin2009.Dr.MohamediscurrentlylocatedinAlexandria.
Dr.JenniferKimgraduatedfromtheUniversityofFloridaDentalCollegein1999.SheiscurrentlypracticinginChantilly.
Dr.MignonetteLobogradu-atedfromTuftsUniversityin2000.Sheiscurrentlypractic-inginFallsChurch.
Dr.HowardMillergraduatedfromHowardUniversityin1979.HethencontinuedtoreceivehisMastersofBusi-nessAdministrationin2003.Dr.MilleriscurrentlyworkingwiththeVirginiaDepartmentofHealthinFredericksburg.
Dr.JamesMoshiergradu-atedfromtheTuftsSchoolofDentalMedicinein2009.HeiscurrentlypracticinginanAssociateshipinCentreville.
Dr.VladyslavOvcharenkograduatedfromtheNYUCollegeofDentistryin2009.HeiscurrentlypracticinginCentreville.
Dr.GeetikaTahimgraduatedfromtheNYUCollegeofDen-tistryin2001.SheiscurrentlypracticinginHerndon.
Dr.XiminYanggraduatedfromtheShanghaiDentalSchoolin1989.Afterathree-yearresidency,hethenreceivedhiscertificateinPeriodonticsfromtheNewJerseyDentalSchoolin2009.Dr.YangiscurrentlypracticinginanAssociateshipwithNeibauerDentalCareinFredericksburg.
Peninsula Dental SocietyDr.TammaraBellgradu-atedfromtheUniversityofTennessee.SheiscurrentlypracticingwithKoolSmilesCorporationinYorktown.
Dr.JoelleHairstongraduatedfromtheUniversityofMichi-ganin1998andcontinuedtoreceiveherGeneralPracticeResidencyCertificatefromWakeForestUniversityBaptistMedicalCenterin2000.Dr.HairstoniscurrentlylocatedinWilliamsburg.
Dr.JeffreyRaphaelgradu-atedfromtheUniversityofMarylandSchoolofDentalMedicinein1974.HethencontinuedontoreceivehiscertificatesinGeneralPrac-ticeResidencyandProsth-odonticsin1976and1983,respectively.Dr.RaphaeliscurrentlypracticinginWestPoint.
Piedmont Dental SocietyDr.MistyLenkgraduatedfromtheVCUin2002.ShethencontinuedtoreceivehercertificateinOrthodonticsandDentofacialOrthopedicsfromtheUniversityofFloridainGainesvilleandOhioStateUniversityin2006.Dr.LenkiscurrentlypracticinginDaleville.
Dr.YoungChulParkgradu-atedfromLomaLindaUniver-sityin2009.HeiscurrentlypracticingwithSmallSmilesDentalClinicinRoanoke.
Richmond Dental SocietyDr.AndrewEstillgraduatedfromVirginiaCommonwealthUniversityin2008.HethencontinuedtoreceivehisGPRfromtheUniversityofAlabama–Birmingham.Dr.EstilliscurrentlypracticinginMidlothian.
Dr.ElizabethMillergraduatedfromVirginiaCommonwealthUniversityin2007.ShethenreceivedherCertificateinPediatricDentistryfromtheUniversityofMichiganin2009.Dr.MilleriscurrentlypracticinginRichmondwiththeAtkins,MaestrelloandAs-sociatesPediatricDentistry.
Dr.AndreaMitmangraduatedfromMCVin1988andiscur-rentlypracticinginAylett.
Dr.AlexisOristiangraduatedfromVirginiaCommonwealthUniversityin2007.SheiscurrentlypracticingwithW.B.PerkinsonandAssociatesinMidlothian.
Dr.ShekhaPatelgraduatedfromtheUniversityofFloridain2008.SheiscurrentlypracticinginRichmond.
Shenandoah Valley Dental AssociationDr.RustyDavisgraduatedfromVCUin2007.Heiscur-rentlypracticinginWaynes-boro.
Dr.RichardKapitangraduat-edfromOhioStateUniversityin2002.Hethencompletedhisspecializationinoraland
maxillofacialsurgeryin2006.Dr.Kapitaniscurrentlyprac-ticingwithBlueRidgeOralSurgeryinFishersville.
Dr.ChandaAshleygraduatedfromVCUin2005.ShethencontinuedontoUniveristyofConnecticut,completingherspecializationinorthodonticsanddentofacialorthopedicsin2009.Dr.AshleyiscurrentlypracticinginStaunton.
Southside Dental SocietyDr.TimothyMarshallgradu-atedfromVCUin2008.HeiscurrentlypracticingwithKoolSmilesinColonialHeights.
Dr.TinaKao-Reasonergradu-atedfromtheUniversityofIowain2009andiscurrentlypracticinginBoydton.
Dr.JuanRojasgraduatedfromVirginiaCommonwealthUniversityin2008andwillcompletehisGeneralPracticeResidencyinJune,2010.
Tidewater Dental AssociationDr.PyeKyugraduatedfromVirginiaCommonwealthUniversityin2006.HethencontinuedtoreceivehisAEGDCertificatein2007thenhisEndodonticsCer-tificate,bothfromtheVCUSchoolofDentistry.Dr.KyuiscurrentlypracticingwithHamptonRoadsEndodonticsinChesapeake.
Dr.DavidTropgraduatedfromtheMedicalCollegeofVirginiain1977andiscur-rentlypracticinginNorfolk.
Welcome New Members!February 2010
In Memory Of...
DrGeorgeBarnett TidewaterDentalAssociation Suffolk December28,2009
Dr.JamesBoyd SouthsideDentalSociety VirginiaBeach December30,2009 Dr.JamesOHodgkin,III NorthernVirginiaDentalSociety Warrenton January25,2010 Dr.ArthurSiegel TidewaterDentalAssociation Norfolk January7,2010 Dr.RobertF.Jackson SouthwestVADentalSociety Salem January4,2010
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BoardofDirectors-ActionsinBriefJanuary14-16,2010
I. Itemsconsidered(requireactionbytheHouseofDelegates):
A. ThefollowingBy-lawchangewasconsidered:
1. Background:SincetheAssociationnowelectsitsofficersbyanonlinemethodandthereisnogeographicadvantageto holdingtheAnnualMeetinginarotatingfashionitisrecommendedthatmeetingsoftheAssociationbeheldinareasthat willprovidethebesteconomicadvantagetotheAssociation.Alsobydirectionofthe2009HouseofDelegates,the BoardofDirectorsischallengedwiththepossibilityofrecombiningtheVirginiaMeetingandtheAnnualMeeting ThereforeitisresolvedthefollowingchangestotheBylaws.
(Current)ARTICLEII Meetings
Section1. AnnualMembershipMeeting:TheAnnualMeetingshallbeheldeachyearasapprovedbytheBoardofDirectors.TheAnnualMeetingshallrotateinthefollowingorder:NorthernVirginia,EasternVirginia,CentralVirginia,andWesternVirginia.ItshallbethepurposeofthisMeetingtofostertheidealsoftheAssociationassetforthinARTICLEIIoftheCONSTITUTIONofthisAssociation.
The Bylaws of the Association shall be amended by substitution of Article II- Meetings with the following:
ARTICLEII Meetings
Section1. AnnualMembershipMeeting:TheAnnualMeetingshallbeheldeachyearasapprovedbytheBoardofDirectors.ItshallbethepurposeofthisMeetingtofostertheidealsoftheAssociationassetforthinARTICLEIIoftheCONSTITUTIONofthisAssociation.
The Board of Directors approved the above resolution with a recommendation the House of Delegates vote yes. II. Thefollowingissubmittedasinformationonly:
A. Thefollowingitemswereapproved:
1. Background:TheSonjaLaurenFoundationwasestablishedtoaidtheworkingpoorbyfillingthegapbetweenMedicaidandinsurance.
Resolution:TheVDAdonate$2,500.00totheSonjaLaurenFoundation.
2. Reaffirmationoftheresolutionadoptedbythe2009HouseofDelegatestoinitiatea legislativebillprohibitinginsurance companiesfromsettingfeesonnon-coveredservicesasdefinedbelow:
HouseofDelegatesAction–September13,2009:
Adopted:TheVDAHouseofDelegatesrecommendstheBoardofDirectorscreatelegislativeinitiativethatwouldopposetheinsurancecompaniesfrombindingfeesfornon-coveredservices.(Policy)
3. Background:LastyeartheBoardapproveda$1,000.00appropriationtodevelopahistoryoftheVirginiaDentalAssociation.Whileweareworkingontheproject,wehaveyettousethemoney.TheCouncilwouldlikethis$1,000.00toremainfortheiruseandremainalineitemintheVDAbudget.
Resolution:The$1,000.00appropriationfordevelopingahistoryoftheVDAwillremainalineiteminthebudget.
4. Background:MembersareaskedtopayduesandVADPACduesattheendoftheyear,possiblytheworsttimetowritealargecheck.ThismayresultinfewermemberscontributingtoVADPACorgivinglessthantheymightotherwise.
Resolution:TheVDAseekamethodofinstallmentpaymentsandworkoutthedetailstomakethispossibleassoonaspossible. 5.ReferraloftheMentorshipCommittee’srequestfor$15,000.00(budgetfor2010)toVDAServices.
6.TheVDAcommunicatewithallVirginiadentistsandlegislators,byall meanspossible(i.e.mail,fax,e-mailandVDAwebsite),aboutthelegislationintroducedtotheSenateontheMandatedFeesBill.TheNon-
coveredServicesTaskForceshallberesponsibleforcompilingallmaterial.
BudgetImpact:$7,500.00
Itwasdarkandcoldoutsidebutmorethan150dentistsanddentalstudentsgeneratedplentyofheatonJanuary15astheVDA’sannualDayontheHillgotunderwayatRichmond’sOmniHotel.WhentheselegislativestalwartscompletedtheirGen-eralAssemblyvisitsthreehourslater,thestate’sinsuranceindus-trywasonnotice:overreachingbydentalinsurerswouldnotbetolerated!
Alreadysteamedbytheopeningsalvoofastatewideinsuranceindustryadvertisingcampaign,
2010 Day on the Hill: Dentists and Dental Students Embark On a Long General Assembly SessionByLauraGivens
Delegate Chris Peace was the keynote speaker at the VDA Day on the Hill Breakfast.
From left: Dr. Ronnie Brown, Steven Lutz, Christopher Davenport, Dr. Cynthia Southern, Dr. Dana Chamberlain, Emily Kate Bowen, Dr. Gus Vlahos and Stephanie Vlahos (center) at the VDA Legislative breakfast. All are dentists and VCU dental students from southwest Virginia.
attendeesusedtheremarksofthisyear’skeynotespeaker,Del-egateChrisPeace(R-Mechanicsville),tostayfocusedduringtheirCapitolHillvisits.DelegatePeace,withasignificantbackgroundinadvocacyandpublicpolicy,advisedtheassembledVDAteamtoproceedmethodicallyasthebattlewiththeinsuranceindustrymovedintohighgear.Awarethatdentistshadbeenlobbyingtheassociation’smandatedfeeslegislationforseveralweeks,Peacerecommendedthat“…facts,notemotion…”carrytheprofession’sargumentsonCapitolHill.
VDAlobbyistChuckDuvallfollowedPeacetothepodiumandlaidouttheassociation’slegislativeobjectiveinstarkterms:“Withoutthislegislation,”Duvallsaid,“theprofessionisfacedwithgiv-ingovertoinsurancecompaniesdecisionsaboutpatientcarethatrightlyshouldbemadebydentistsinconsultationwiththeirpatients.”
ThankstoMessrs.PeaceandDuvall,theannualDayontheHilldidmorethansendanenthusiasticcadreofdentists,dentalstudents,andothermembersoftheVCUdentalcommunitytotheCapitol.January15alsomarkedtherealbeginningofanalmostunprecedentedhands-onlobbyingcampaigntopreservetheindependenceoftheprofession,acampaignthatcontinuesasthiseditionoftheJournalgoestopress.
From Left: Dr. John Marino, Chuck Duvall, Dr. Alonzo Bell, Au-drey Gamulo and Denny Gallagher gather at the VDA Legislative break-fast before head-ing to the General Assembly.
From Left: Dr. Nathan Houchins, Dr. Scott Miller, Dr. Cynthia Southern, Senator Phil Puckett, Dr. Ronnie Brown, Dr. Dana Chamberlain, Dr. Gus Vlahos, and Dr. Ron Jessup.
From left: Dr. Ronnie Brown, Dr. Gus Vlahos, Dr. Dana Chamberlain, Dr. Cynthia Southern, Dr. Ron Jessup, Senator William Wampler, Dr. Nathan Houchins, Dr. Scott Miller, Dr. Mike Abbott.
Delegate From Left: Alexandra Barton, Bud Phillips, Dr. Carole Pratt and Dr. Jim Revere.
56VirginiaDentalAssociation Volume87,Number2•April,May&June2010 57
You Gotta Put A Face On It! Dentists Rally to the CauseByChuckDuvallandDennisGallagher
Whatdothefollowinghaveincommon?Aetna VA Association of Counties
AFL-CIO Virginia Auto Dealers AssociationAnthem Virginia Bankers Association
International Brotherhood of Teamsters (BMWE Division) Virginia Association of Health PlansAmericas Health Insurance Plans Virginia Association of Health Underwriters
Delta Dental of Virginia Virginia Chamber of CommerceNFIB – National Federation of Independent Businesses Virginia Manufacturers Association
Northrop Grumman Shipbuilding (Newport News) VA Municipal LeagueVirginia State Employees Association
TheywereopposedtothelegislationintroducedattherequestoftheVirginiaDentalAssociationtostopinsurancecompaniesfromusingcontractstodictatefeesforservicesforwhichtheydonotpay.
WhenwemetwiththeVDAleadershipinthefalltodiscussthissituation,wenotedtheassociation’sneedto“putafaceontheissue”ifweweretosucceedinthelegislature.Bythis,wemeantthatdentistsneededtoshowlegislatorsthat,indeed,thisissuewasimportanttothem.Dentistsacrossthestatewouldneedtocontacttheirlegislatorstostressthattheyneededtheirhelp.SenatorWilliamWampler(R-Bristol)introducedSenateBill622andDelegateLeeWare(R-Powhatan)carriedidenticalHouselegislation,HB1263.DeltaDental,UnitedConcordia,Anthem,andtheVirginiaAssociationofHealthPlansactivatedthesupportoftheentitiesabovetoopposebothbills.
DentistsfromacrosstheCommonwealthrespondedinanhistoricfashion:literallyhundredsofemails,phonecallsandletterswerewritten.Scoresofdentists,staffmembersandfacultyanddentalstudentsvisitedtheGeneralAssemblyonadailybasisandcontactedone-on-oneeverymemberofthelegislature.
WhenhearingsonthebillswereheldintheSenateandHouse,itwasstandingroomonlywithsupportersofourlegislationpackingtherooms.
Ourargumentsweresimpleandstraightforward:
• Mandatingfeesfornon-coveredproceduresisanewconceptindentalinsuranceplansandabadidea.• Ourlegislationdealtwithnon-coveredservicesonly.Thefeeagreedtobyadentistforcoveredservicesremainsinplaceeventhoughthe
patientmayexceedthemaximumpaymentunderthedentalplan.• Thesenewcontractsshiftadentist’scoststopatientswithoutdentalinsuranceortopatientswhosedentalplansdonotcontainthe
provisionsbeingadvancedbyDeltaanditsallies.• Ifdentalinsurersbelievethatnon-coveredproceduresareimportant,theyshouldincludethemaspartofapolicy’scoveredservices.
Inspiteofaseriesoffull-pageadsruninatleastthreeofthestate’smajornewspapers,inspiteofasophisticatedInternetpetitiondrive,inspiteoftheretentionofsomeoutstandinglobbyistsfortheopposition,theGeneralAssemblyagreedwiththedentalcommunityandrespondedaccordingly.Bothbillspassedwithoverwhelmingsupport!
AswefilethisreporttomeettheJournal’searlyMarchdeadline,bothbillsareontheirwaytoGovernorBobMcDonnell.Simultaneously,wearereachingouttoVDAmembersstatewideaskingthemtoencouragetheGovernortosigntheseimportantbills.
Allofuswhohavehadtheprivilegeofworkingwithyouonthisissue-ChuckDuvall,DennyGallagher,MelanieGerheart,ScottJohnson-thankyouforyouroutstandingeffortsandthedignifiedfashioninwhichyoudeliveredyourmessagetotheGeneralAssembly.
Wealsowouldberemissifwedidnotthank:LauraGivensforhergreatworkinmakingalloftheintricatelogisticsinvolvedinourcampaignworkeffectively;Dr.TerryDickinsonforhisusualsteadyhandontherudder;Dr.AlonzoBellforhisleadershipasPresident;Dr.BruceHutchisonwhoheadedourgrassrootslobbyingeffort;andtheliterallyhundredsofdentists,staffanddentalstudentsandfacultyfromtheDentalSchoolwhoparticipatedinthiseffort.
Politicscanbeverycomplicatedbutinitssimplestform,itisaboutinvolvement.Everyonewhoparticipatedinoursuccessdemonstratedwhatinvolvementchanneledintherightdirectioncanproduce.
Thankyou.
Dentists, staff members, VCU dental students and other members of the dental community attended the House Commerce & Labor Committee meeting on February 2nd to show their support of HB1263.
Delegate Lee Ware presents HB1263 to the House Commerce & Labor Com-mittee while attorney Scott Johnson prepares to explain the purpose and legal implications of the bill on behalf of the VDA.
VCU dental students Barrett Peters (left) and Audrey Gamulo (right) gather with VDA President Alonzo Bell outside the General Assembly Building following the House Commerce & Labor committee meeting on February 2nd.
Over 150 VDA dentists, staff members ,VCU dental students and other members of the dental community attended the Senate Commerce & Labor Committee meeting on February 1st to show their support of SB622.
Senator William Wampler presents SB622 to the Senate Commerce & Labor Committee
Dr. Alonzo Bell, VDA President, awaits the Senate Commerce & Labor commit-tee meeting with a crowd of dental community supporters.
58VirginiaDentalAssociation Volume87,Number2•April,May&June2010 59
Dentist who visited the General AssemblyMikeAbbottAnneAdamsDavidAndersonRebeccaAngusCharlesAtkinsGaryBanajiChuckBarrettAlonzoBellBillBennettScottBermanSanjayBhagchandaniDavidBlackPaulBrinserRonnieBrownRobertCandlerSandraCatchingsFredCertosimoDanaChamberlainMaqsoodChaudhryJoAnnClarkJohnCokerGregColeSharonColvinTomCookeKenCopeland,Sr.KenCopeland,Jr.MarkCrabtreeCharlieCuttinoJeffCyrandstaffCraigDietrichVinceDoughertyRonDowneyAshleyEpperlyandstaffMonaFarrahiGiselaFashingKittFinley-ParkerJohnFlowersSteveForteandstaffCatherineOdenFultonSamGalstanCharlesGaskinsGarlandGentryPaulGibbermanAviGibbermanScottGoreMikeGormanShantalaGowdaBarryGriffinEdGriggsMichaelGrossoMonroeHarrisFarylHartNelsonHerringNathanHouchinsRalphHowellHerbertHughesBruceHutchisonFrankIuorno
RonaldJessupCharlesJewettCharlesJohnsonClaireKaugarsandstaffCarolynKellyRodKlimaJayKnightJohnKnightGregKontopanosLouKorpicsMarkKowalTrishaKrauseJamieKrochmalLannyLevensonJeffLevinMikeLinkBrockLivickDavidMajorJohnMarinoNormanMarksBenitaMillerandstaffMikeMillerandstaffScottMillerKevinMistryAndreaMitmanMikeMorganMarciMorrisChristaMorrisLawrenceMullerEdmundMullinsKirkNorboPaulOlenynVaCoraOliver-RaineyAnthonyPelusoCarolePrattMcKinleyPriceRickQuiggStephenRadcliffeDavidAlanReidJimRevereElizabethReynoldsChrisRichardsonRichardRoadcapRodRoggeNeilSmallEmilySmithCynthiaSouthernMelanieSpearsHenryDanielStockburgerKenStonerandstaffFrankStrausRobStraussRickTaliaferroDonTrawickBradTrotterBillViglioneGusVlahosGloriaWardSharoneWard
EdwardWeisburgClayWeisburgJohnWillhideRogerWoodGretchenZelazny
Other General Assembly ParticipantsLeeBradenMarthaBushongJimCurtisJimDoyleCarolGammonsCathyGriffantiKarenKrausSusanLaundreyLindaMooreRobbieShermanCatherineSillLindaSimonKellyWilliamsGrahamGardnerStaffMembersVDAstaffmembers
VCU Dental Student and Resident ParticipantsMinaAbdolahiZachAberthAshleyAbesamisMollyAdlerMattAldredKevinAllredAllieAngertCourtneyAshbyChelseaBaldersonTylerBallElviBarcomaRachelBaroneAlexandraBartonSanjayBhagchandaniPoonumBharalFawziaBhavnagriKevinBibonaCarlosBlackmonJamesBoltonEmilyKateBowenLaurenBowersoxJenBoylandCassidyBrayHeatherBrooksNabilBusharaRichardCarlileMeredithCashMariaChangDavidChesserAileenChynJamieClarkSteveClawsonMarkCrocker
DavidDallingChristopherDavenportDustinDavisBrookeDellingerStephenDePasqualeSpencerDixonJessicaDombrowskiDarrenDorfmanAndyDuncanSonnyDuongDavidDurhamSeanEschenbachTayeebFarukCaseyFeilingNancyFerrettiBrianFifeChadFlanaganGrahamForbesErikFoxJoshFurnissAudreyGamuloDavisGardnerMikeGigliottiThomasGlazierScottGreenKateHelfrichBrianHerodRachelHubbardJustinHughesAndrewHutchinsonDavidJonesSarahKandracNatashaKapoorEmilyKeetonKrisKeetonIdaKondoriJoKoontzLeeKregerJonKremserDavidLaiAaronLairdBrentLammPatrickLawrenceMagaretteLeGreysonLeftwichBobbyLenoirQuocLuStevenLutzMeganLutzJenLysenkoNickMadduxFatimaMashkoorElizabethMattesonKellyMayerBrianneMcGuinnessAmandaMeadeGardnerMeekJamesMeekJodieMeredith-SmithMikeMilburn
JoshuaMilesClayMillerWillMooreJeppyMossRyanMurrayAryaNamboodiriLizNealJoshNehringFranceNeilsonDianeNelsonRosieNoordhoekJustinNorboLindseyNorthJustinPaigeNickPappasCanaPasierbAnishaPatelChristianPeckMattPelaisBarrettPetersMaryRaulfsCarterReevesJohnReynoldsCollinRiceCameronRobertsLatashaSaulsLaurenSchiffJasonSchoenerLeoSchollGeoffSchreiberKristenSchwartzRichardSedwickShimaShadmanNateShermanGailSilveiraMilanSimanekWillSlackRyanSmagalskiChapinSmithDavidStaffordLydiaSumnerCarterTateBrianThompsonKellyThompsonJonMarkLauraTolussoPaigeTurnerDanielVacendakStephanieVlahosVictoriaWhiteKimeWhitmanAndrewWissinkPhillipWorthingtonJeffYelle
Special thanks to all those who took time to visit the General Assembly! WHAT IS VADPAC?By: Bruce R. Hutchison, DDS - Chair VADPAC
VDAmemberssupporttheVDA’sparticipationinthepoliticalprocessthroughtheVDAPoliticalActionCommittee,thebipartisanvoiceofVirginiadentistswhocaredeeplyabouttheirpatientsandtheirprofession.
VADPAC’ssolepurposeistoelectcandidateswhounderstandtheimportanceofdentistryandarecommittedtotheoralhealthofVirginians.VADPACisacriticalcomponentoftheVDA’spoliticalstrategyinRichmond.
Likeitornot,thepoliticalsystemaffectshowwepracticedentistryintheCommonwealth.Dentistsneedtobeheardbythelegislators.Regardlessofpartyaffiliationoryourviewsonthepoliticalsystem,dentistscannotaffordtoturntheirbacksandassumeproblemswillgoaway.Weallhavetobeplayers;wecannotassumeotherswillcarrytheload.WeneedallVirginiadentiststocontributetoourVADPACtoensurefuturesuccess.
ContributionsbyallVirginiadentistswillhelpensureourVADPACremainsstrongandourvoiceisheard.Considercontributingthefeeofonecrown,onerootcanal,afewfillings,orevenacoupleprophys.Thissmallinvestmentbyallwillmakeahugedifference.Yourvoicewillbeheardloadandstrong.
Itisyourobligationtokeepdentistrythehonestandethicalprofessionitis.Ifnotyou,thenwho?
Usetheformbelowtomakeyourcontributiontoday.
If you would like to join VADPAC or increase your previous contribution, please fill out the form below with your check or credit card information. Contributions to VADPAC are divided between a state account, controlled by VDA members and a federal account for support of candidates for federal office, affiliated with the American Dental Association. Election laws require that the two funds be kept separate.
Membership $99 (50 State, 49 Federal) Commonwealth Club $284 (235 State, 49 Federal) Governor’s Club $684 (435 State, 249 Federal) Apollonia Club $1,009 (760 State, 249 Federal) Capitol Club $200 (200 Federal)
Name Component: Address ________________________________________________________________ Payment Type
Check (payable to VADPAC) Credit Card Corp. Ind. VISA MasterCard #________________________________________________________________ Exp__________________
Signature_______________________________________________________________
Contributions not deductible for tax purposes.
Please complete this form and mail or fax to: Laura Givens
VADPAC 7525 Staples Mill Rd. Richmond, VA 23228 FAX: 804-261-1660
If you would like to contribute by phone, please call Laura Givens at 804-261-1610.
Thank you for your contribution in support of VADPAC!
2010
If you would like to join VADPAC or increase your previous contribution, please fill out the form below with your check or credit card information. Contributions to VADPAC are divided between a state account, controlled by VDA members and a federal account for support of candidates for federal office, affiliated with the American Dental Association. Election laws require that the two funds be kept separate.
Membership $99 (50 State, 49 Federal) Commonwealth Club $284 (235 State, 49 Federal) Governor’s Club $684 (435 State, 249 Federal) Apollonia Club $1,009 (760 State, 249 Federal) Capitol Club $200 (200 Federal)
Name Component: Address ________________________________________________________________ Payment Type
Check (payable to VADPAC) Credit Card Corp. Ind. VISA MasterCard #________________________________________________________________ Exp__________________
Signature_______________________________________________________________
Contributions not deductible for tax purposes.
Please complete this form and mail or fax to: Laura Givens
VADPAC 7525 Staples Mill Rd. Richmond, VA 23228 FAX: 804-261-1660
If you would like to contribute by phone, please call Laura Givens at 804-261-1610.
Thank you for your contribution in support of VADPAC!
2010
If you would like to join VADPAC or increase your previous contribution, please fill out the form below with your check or credit card information. Contributions to VADPAC are divided between a state account, controlled by VDA members and a federal account for support of candidates for federal office, affiliated with the American Dental Association. Election laws require that the two funds be kept separate.
Membership $99 (50 State, 49 Federal) Commonwealth Club $284 (235 State, 49 Federal) Governor’s Club $684 (435 State, 249 Federal) Apollonia Club $1,009 (760 State, 249 Federal) Capitol Club $200 (200 Federal)
Name Component: Address ________________________________________________________________ Payment Type
Check (payable to VADPAC) Credit Card Corp. Ind. VISA MasterCard #________________________________________________________________ Exp__________________
Signature_______________________________________________________________
Contributions not deductible for tax purposes.
Please complete this form and mail or fax to: Laura Givens
VADPAC 7525 Staples Mill Rd. Richmond, VA 23228 FAX: 804-261-1660
If you would like to contribute by phone, please call Laura Givens at 804-261-1610.
Thank you for your contribution in support of VADPAC!
2010
If you would like to join VADPAC or increase your previous contribution, please fill out the form below with your check or credit card information. Contributions to VADPAC are divided between a state account, controlled by VDA members and a federal account for support of candidates for federal office, affiliated with the American Dental Association. Election laws require that the two funds be kept separate.
Membership $99 (50 State, 49 Federal) Commonwealth Club $284 (235 State, 49 Federal) Governor’s Club $684 (435 State, 249 Federal) Apollonia Club $1,009 (760 State, 249 Federal) Capitol Club $200 (200 Federal)
Name Component: Address ________________________________________________________________ Payment Type
Check (payable to VADPAC) Credit Card Corp. Ind. VISA MasterCard #________________________________________________________________ Exp__________________
Signature_______________________________________________________________
Contributions not deductible for tax purposes.
Please complete this form and mail or fax to: Laura Givens
VADPAC 7525 Staples Mill Rd. Richmond, VA 23228 FAX: 804-261-1660
If you would like to contribute by phone, please call Laura Givens at 804-261-1610.
Thank you for your contribution in support of VADPAC!
2010
60VirginiaDentalAssociation
Classifieds
Practices For Sale/Lease
Miscellaneous
PARTNERSHIPSORDELAYEDSALESWehavemanysatisfiedclientswithassociatesinyourareathatwehavehelpedtoeitherbuy-in,buy-outorconductadelayedsalewiththecur-rentassociate.Withoutaqualityvalu-ationandplanupfrontthesetransac-tionsnormallyfail.CalloremailustoarrangeaFREECONSULTATIONtofindoutifyouareacandidateforthisservice.Theresultishigherincomeandahigherpracticevalueforthesellerandaclearfinanciallypositivepathfortheassociate.THEMCNORGROUP,[email protected],www.mcnorgroup.com.
PRACTICEBUYERSWANTEDForgreatpracticesintheVirginiaarea.Wehavemanypracticesavail-ableforsaleintheVirginiaarea.Areyoutiredofbeinganemployeeinadeadendjob?CallusforaFREECONSULTATIONtofindoutabouttheseopportunities.THEMCNORGROUP,[email protected],www.mcnor-group.com
SELLERS WANTEDWe have qualified buyers with 100% funding approval that want to buy a practice in Virginia. The baby boomers are starting to sell and this is a great time to transi-tion your practice. We get excel-lent prices and sell the practice in a timely, healthy manner. THE MCNOR GROUP, 888-273-1014 x 103 or [email protected], www.mcnorgroup.com
PRACTICE VALUATION APPRAISALWe are the only transition consult-ing company in the area that has a Certified Valuation Analyst CVA as a principal that focuses exclusively on the transition of DENTAL PRACTICES. Please see the article by CVA Karen Norris on page 82 of the April 07 issue of Dental Economics on this subject or call or email us for a FREE CONSULTATION and a copy of the article. If you are sell-ing, buying, creating a partnership or just want to find out the current value of your practice contact THE MCNOR GROUP, 888-273-1014 x 103 or [email protected], www.mcnorgroup.com
NEW OWNER REPRESENTA-TION: Our family and organization has represented over 1000 new owners over the last 65 years in the mid-Atlantic area that have purchased, started or became partners in a dental practice. Ownership is a decision that is too important to make without a qualified facilita-tor. We can get the new owner 100% financing plus working capital. Call us for a FREE CON-SULTATION and allow us to send you a list of our references. THE MCNOR GROUP, 888-273-1014 x 103 or [email protected], www.mcnorgroup.com
Job Opportunities
IN-OFFICE HEALTH AND SAFETY EDUCATION AND CONSULTATION
Experts with over 20 years of ex-perience educate and certify dental office staff in American Heart As-sociation-based Basic Life Support and First Aid for in-office medical emergencies. Consultation and edu-cational services are also available to guide dental practices in comply-ing with OSHA and CDC infection and hazard control regulations and guidelines. Contact RESPOND Con-sulting, 540.290.6911 or [email protected]. We come to you for all of your office safety and health maintenance needs.
Tri-Cities, TN Dentist Opportunity! EstablishedBluffCity,TNpracticeownerisreadytoaddadentisttoherstaff.Willingtoconsiderdentistswithfulltimeorparttimeinterest.Idealcandidatewillbecomfortableprovidingdentureandextractionservicesonadailybasis.On-site,fullystaffed,labdevotesfulltimetoservingthispracticeowner.Practicevisitandworkinginterviewareavailabletointerestedcandidates.ContactBrianWhitleyformoreinformation:[email protected]
Kentucky Practice Ownership OpportunitiesOwnadentalpracticewithNOpersonalfinancialinvestment.AffordableCareInc.providespracticemanagementservicestonearly150affiliateddentalpracticesin35states.EachpracticeisownedbyanindividualdentistandisfocusedonanichemarketbyprovidingExtractionServicesaswellasfullandPartialDentures(www.affordabledentures.com).Ifyouareseekinganextremelystableopportunityandwishtobeapartofawellestablishednetworkofdentalpracticeswithalong-standinghistory,youshouldtalkwithus.WearecurrentlyseekingdentistsfordevelopmentofadditionalnewaffiliatedpracticesinHazard, and Carrollton, Kentucky trade areas.Youtakecareofyourpatients;wewilltakecareofthepaperworkandmore.Weprovidethefundingsothatyoumayhaveacompetitivesalaryandafullcomprehensivebenefitspackagewithhealth/life/malpracticeinsurance,anda401(k)planalongwithunlimitedfinancialsuccess.Applyonlineatwww.affordablecare.comorcallBrianWhit-leyat1-800-313-3863,[email protected]
Are you missing out?
HermitageWealthManagement,Inc.offersGroup Discount Pro-gramsforLong-Term Care andDisability Insurance.Foreligibil-ity,pleasecontact:
J.CoryHoffer,CFP®
(804)[email protected]
Part-time dentists needed to review provider offices in managed care network in the northern VA, DC, MD area. Current license, travel, good communication skills, minimum 10 years practice experience required. Send resume to HRS, 1926 Hayes St., Nash-ville, TN 37203 or call 615-321-0707.
FOR SALE – EQUIPMENT FOR SALE - Twilite Ma-chine, Waterlase, Acclaim Intra-oral Camera w/ Control Module, GENERAL PRAC-TICES: General Practitio-ners - Falls Church – Rev.: $550,000, 2,800 sq ft, 7 ORs-3 equipped, Richmond Area –Rev.: $217,000, 1,000 active patients, blended insurance, no HMO’s, 2 Ors, Fairfax County - Endodontist and/or Orthodon-tist Wanted. Belvoir Area - turnkey dental office available for lease for specialists only (no prosthodontists), Lansdowne – Turnkey (no patient records) - 4 operatories, Alexandria - Revenue: $1,500,000+, 8 op-eratories, 2,600 square feet, 4 ½ days/week, La Crosse - Revenue: $200,000, 4 opera-tories, real estate appraised at $140,000. Specialists Only - Fort Belvoir –Turnkey (no records), 4 operatories - fully equipped, 1,500 square feet, 8 Ors, 2,600 square feet, 4 ½ days/week, La Crosse – Rev-enue: $200,000, 4 Ors – Fully equipped, 1,500 square feet. PRACTICE SALES & TRAN-SITIONS, (877) 539-8800, www.dentalsales.org
Wanted to Purchase.IfyouhaveaqualitygeneralpracticeinNorthernVirginiaarea(Fairfax),wouldliketoexitandhaveaqualifiedtransitionspecialistrepresentyou,wehaveaninterestedbuyer.ContactPPP412-673-3144–[email protected].
INTERIM PROFESSIONAL SERVICE:MaternityLeave,Vacations,Illness,Disability,Part-TimeAssociates.MaintainProduction&PatientAccess.Also,InterimJobOpportunities.For-estIrons&Associates800-433-2603www.forestirons.comDENTISTSHELPINGDENTISTSSINCE1984
Dentist to work 2-3 days per week at dental office in Amherst Co. Submit resume to [email protected] or mail to: Johnson Health Center, Attn: A. Jones, 320 Federal St., Lynchburg, VA 24504.
Virginia Dental Association7525 Staples Mill RoadRichmond, VA 23228
VISIT US ONLINE AT WWW.VADENTAL.ORG
*All gloves are sold by the case, with 10 boxes per case
To place an order, request free samples, or for more information please contact Dental Association Gloves: (877) 484-6149
To order gloves on the Web visit: www.vdaservicesgloves.com
VDA SERVICES GLOVE PROGRAMSuperior exam gloves at discounted prices for VDA members!
Powder-Free Latex Powdered Latex Nitrile
The VDA Services Glove Program has a comprehensive line of glove products available.
Microflex ComfortGripPF Textured Latex$6.47 a box
Microflex ColorTouch PinkPF Textured Latex, Scented$6.44 a box
Sempermed PolymedPF Textured Latex$4.99 a box
Microflex PowerGripPowdered Textured Latex$6.94 a box
Microflex Micro OnePowdered Latex$5.74 a box
Sempermed StarMedPowdered Latex$4.62 a box
Sempermed Tender TouchPF Textured Nitrile$5.44 per 100 gloves
Sempermed SemperCarePF Textured Nitrile$5.56 per 100 gloves
Microflex TranquilityPF Textured White Nitrile$6.40 a box