PUBLISHED BY AND FOR THE DENTISTS OF QUEENS COUNTYVolume 55 Number 3 May/June 2013

New State Health Department PrescriptionMonitoring Registry Coming This AugustThe New York State Department of

Health has begun implementation of thePrescription Monitoring Program Reg-istry (the Registry) in New York, a sys-tem designed to curb abuse ofprescription-controlled drugs. Beloware the key facts you must know if youintend to either prescribe a Schedule II,III, or IV controlled substance or if youintend to dispense any controlled sub-stance in any Schedule in any quantity,you should know:The Prescription Monitoring Pro-

gram Registry is one part of the I-STOP(Internet System for Tracking Over-Pre-scribing) law. The Registry is scheduledby the I-STOP law to take effect on Au-gust 27, 2013. Although no regulationshave yet been promulgated concerningthe Registry, the New York State De-partment of Health is already takingsteps to implement the law as written. Ifyou want to prescribe a Schedule II, II,or IV drug or you want to dispense anycontrolled drug in any Schedule, youmust be able to access the Registry.There is a required duty under the I-

STOP law to consult the Registry beforeprescribing any Schedule II, III, or IVdrug to a patient. The Registry will con-tain a minimum of a six-month patientcontrolled substance history and amax-imum of a five-year history that the pre-scriber can review. The I-STOP law doesallow for a health care professional todesignate a person to access and con-sult the Registry on his or her behalf,but the health care professional alwaysremains legally responsible for the re-sult and conduct of that process by thedesignee.While input to the Registrywill be by

pharmacists in real time from all thecontrolled substance prescriptions theyfill from any Schedule, there is also aduty for any health care provider whoactually dispenses any controlled sub-

stance on any Schedule to a patient, inany quantity, to input that drug dis-pensing information into the Registry.Key: prescriptions are input to the Reg-istry only by pharmacists, but all healthcare professionals who directly dispensecontrolled drugs to patients must inputthat information on their own.The New York State Department of

Health is sending out notices to advisepeople that access to the Registry isgoing to be accomplished through theHealth Commerce System (HCS) onlineaccount that they already use for re-newing and issuing official New YorkState prescription forms. While manydentists now opt to do those renewalsvia paper, the only way the Departmentof Health plans to allow access to theRegistry is via the HCS online accountsystem.If you cannot access the Registry be-

cause you just didn’t bother to sign upfor it, you will lose the ability to validlyprescribe Schedule II, III, or IV con-trolled substances and the ability to dis-pense any controlled substance directlyto a patient. Your license to practice willalso be at risk from the Office of Profes-sional Discipline if you attempt to evadeor violate the Registry system.These are the key points you need to

know at this time. For further informa-tion on the HCS online account system,go to https://hcsteamwork1.health.state.ny.us/pub/top.html or call theHCS account system at either: 866-529-1890, option 1; or 866-811-7957, option 1.They can also answer your questionsabout the Registry as it progresses to-ward the August go-live date.Do not sit by passively on this issue:

act now to ensure your ability to accessthe registry.

Once again, Dr. Chad Gehani hasbeen acknowledged for his distin-guished service, this time from thePierre FauchardAcademy. Having re-ceived a long list of service awardsand honors, his tireless efforts are nowbeing recognized by yet another well-known and prestigious organization.Dr. Gehani is known for gener-

ously giving his time and energy tohis profession and his colleagues.Locally, as well as nationally, he isrespected for setting an example ofsupport and generosity to both den-tists and the profession.The Pierre Fauchard Distin-

guished Serv-ice Citation,which he willreceive, recog-nizes a USA Fellow of the Academyfor loyal and dedicated service tothe Academy. A recipient is nomi-nated by the Awards Committeeand must have the unanimous ap-proval of the Academy’s Board ofTrustees.The Pierre Fauchard Academy is

an honorary dental service organi-zation, organized in 1936. Itsfounder was Dr. Elmer S. Best, a

—Continued on page 14

Dr. Gehani to ReceiveFauchard DistinguishedService Citation

Dr. Chad Gehani

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5

In the 2013 movie “Identity Thief,” Sandy Patterson, anaccounts representative, gets a call from a woman sayingsomeone attempted to steal his identity. She tells him aboutan identity protection service and asks him for his name,date of birth, and Social Security number. Little does heknow that his identity is actually about to be stolen. WemeetDiana, printing out credit cards with Sandy’s money, goingout to a bar and buying drinks for everybody. Sandy isshocked to learn that his credit score is in shambles and iseven arrested. He decides to embark on ajourney to Florida to find the person thatstole his identity. As in all good fairy tales,Diana eventually turns herself in andSandy’s name is cleared and his credit is re-stored. Unfortunately for us inhabitants ofthe Milky Way Galaxy, life is not a fairy talemost of the time.

Nearly 13 million U.S. adults were vic-tims of identity fraud in 2012, an increase ofmore than 1,000,000 victims over the pastyear, according to a new report from JavelinStrategy and Research. Identity fraudstersstole more than $21 billion from 12.6 millionvictims in 2012, the highest amount since2009, the research firm said in its 2013 Iden-tity Fraud Report. Identity fraud is definedin the report as “the unauthorized use of an-other person’s personal information to achieve illicit finan-cial gain.” It can range from using a stolen credit card totaking control of another person’s account, or opening newaccounts in someone else’s name.

According to the report, data breaches continue to play amajor part in identity fraud incidents. One out of four databreach notification letter recipients became a victim of iden-tity fraud last year, the highest rate since 2010. Moreover,those who had their Social Security number compromisedin a data breach were five times more likely to be a fraudvictim than the average consumer. Identity thieves will rakein billions this year in stolen tax refunds.

Javelin research found that users of LinkedIn, Google,Twitter and Facebook have the highest incidence of fraudand in 2011, 7 percent of smartphone users were victims ofidentity theft, a higher rate than the general public.

What to Do to prevent falling a victim•Always secure your personal and financial records behinda password or in a locked storage device• When possible, avoid mailing checks to pay bills

• Shred sensitive documents. “Dumpster Diving” is onthe rise• Regularly monitor your accounts and credit card state-ments. Thieves who steal credit card number often use yourcard for multiple small charges that may not be noticeableunless you check your statements on a regular basis.• Use up-to-date security software on your home computerand lock your wi-fi network• Be wary about sharing personal data such as your Social

Security number, especially online• Never transmit personal or financial in-formation when connected to a public wi-finetwork. Fraudsters are able to set updummywi-fi networks in public places andcollect your information• File your tax returns as early as possibleso identity thieves don’t beat you to thepunch and get your refund• Be sure to check your credit reports. Toget a free copy from the three credit bureausgo to freecreditreport.gov• Avoid falling victim to misleading infor-mation requests via e-mail, text or phonecalls• If you receive a data breach notificationletter, take it seriously! If the institution of-fers a free subscription for credit monitor-

ing services, take advantage of the offer and put a fraudalert on your credit report. If you suspect you have been thevictim of identity fraud, contact your bank or serviceprovider right away and ask about resolution services, lossprotections, and other methods to secure your account.• If it seems that someone has misused your personalor financial information, start to resolve the problem byfiling an Identity Theft Report with the Federal TradeCommission.

Contact 1-877-ID THEFT orhttp://www.consumer.ftc.gov/articles/0277-create-identity-theft-report

• Contact one of the three credit reporting bureaus and askto have an initial fraud alert placed on your credit report,which will also be passed on to the other bureaus. The fraudalert is free and can make it more difficult for an identitythief to open more accounts in your name. The alert lasts forat least 90 days and can be extended.

Equifax: 1-800-685-1111TransUnion: 1-800-916-8800Experian: 1-888-397-3742

From the President

Protecting Your IdentityBy Dr. Doron Kalman

2013 OfficersDoron Kalman, PresidentBijan Anvar, President-ElectSudhakar Shetty, Vice PresidentRonald Garrett, SecretaryEric Huang, TreasurerRichard Yang, HistorianBoard of Trustees

NYSDA Past-President Chad Gehani

NYSDA Trustee Joseph Caruso

NYSDA Delegates

Past Presidents

ADA DelegatesViren Jhaveri Prabha KrishnanRekha Gehani

Institute for Continuing Dental EducationJay Ledner, PresidentCraig Tischler, Vice PresidentKathryn Schirmer, Secretary/Treasurer

Publication Member of theAmerican Association of Dental Editors

Queens County Dental Society

86-90 188 Street | Jamaica, NY 11423718-454-8344 | fax: 718-454-8818

www.qcds.org | e-mail: qcds1@aol.com

Administrative AssistantGuadalupe Rodriguez

Co-EditorsBoris ArbitmanBijan Anvar

C.E. CoordinatorMercedes Rodriguez

Executive DirectorWilliam Bayer

The Bulletin is published six times a year, bimonthly. It is theofficial publication of the Queens County Dental Society. Nei-ther the Society nor the Bulletin assumes responsibility for thepoints of view or opinions of its contributions.

Deadlines for manuscripts is six weeks prior to the date ofpublication. For example, the deadline for March/April issueis January 10th. All Submissions must be typed as a word doc-ument and emailed to QCDSBulletin@gmail.com.

For more information about advertising, contact the Busi-ness Manager at 86-90 188th Street Jamaica NY 11423 or call(718) 454-8344. Inclusion of an advertisement does not implyendorsement of any firm, goods, or services unless such en-dorsement is specifically stated.

Subscription is included in the annual membership dues ofthe Queens County Dental Society. The Subscription rate fornon-members is $30 per year, or $5 per issue.

The QCDS Board of Trustees meets on the third Tuesday ofeach month (Except July andAugust) at QCDS Headquarters.For information about the Society, Call QCDS at (718) 454-8344.

H. AjmeraS. AkhtarC. BerkmanD. BhagatM. BhuyanA. FeigenbaumM. GandhiH. Gomez

A. GreenbergS. KesnerP. KoppikarL. LehmanA. LighterR. OlanS. QuarcooA. QueenR. Samuels

A. SantanaK. SchirmerI. SchwartzV. ShahR. ShermanL. TakhalovaC. TischlerB. Wasserman

B. AnvarR. GehaniM. Greenberg

V. JhaveriP. KrishnanJ. Ledner

R. ShpuntoffB. Wasserman

Beatriz VallejoMercedes Mota-MartinezAshok Dogra

Prabha KirshnanViren Jhaveri

“Nearly 13 millionU.S. adultswere victims

of identity fraudin 2012...

”

4

ADAAwards QCDSTwo Membership Program

For Growth GrantsThe Membership Program

for Growth (MPG), establishedby theADA’s Council onMem-bership, provides a process foridentification and support ofmembership activities that leadto an increase in overall marketshare.

Drs. Bijan Anvar and JayLedner, on behalf of QCDSPresident Dr. Doron Kalman,submitted anMPG grant appli-cation for 2013 QCDS pro-grams and were fortunate toeach have their program se-lected for funding. Thesegrants were two of the highestallotted in the country.

The objective of the MPG isto give the three levels of the tri-partite the ability to work to-gether to build uponmembership growth. Cus-tomized membership growthand retention plans are then im-plemented collaboratively withthe aim of increased recruit-ment and retention leading toan increase in overallADAmar-ket share. As this is a nationalprogram open to all constituentand component societies, thereis serious competition for thesegrants and not all programs canbe funded.

While the details of eachgrant proposal are too lengthyfor publication, Dr. Ledner’sgrant proposal focuses on di-versity. Dr. Anvar’s grant cap-italizes on his very successfulNew Dentist Conference. TheQCDS Diversity Forum pro-gram seeks a partnership with

the various ethnic associationsin conducting a CE program,which also provides membersof these associations with ex-posure to tripartite member-ship. Tripartite leaders willhave an opportunity to meetwith the ethnic associationleaders to exchange views andto see what can be done to en-courage those practitionerswho are not tripartite membersto give membership a try, aswell as to identify possible col-laborative activities.

The QCDS New DentistConference provides critical in-formation to new dentists, aswell as panel discussions, jobfairs, technology and informat-ics topics, as well as network-ing opportunities. It is meantto offer support to new den-tists, and help them succeed inpractice with the support of thetripartite.

Dr. Anvar’s previous confer-ence brought nearly 250 den-tists together for a full day oflearning, networking, and shar-ing. It was held as a model forother components, which alsorecognized the importance ofsupporting and helping newdentists.

While the preceding is anoversimplified overview ofeach program, the message ineach is to encourage member-ship. The strength of each levelof the tripartite rests with itsability to speak with a unitedvoice for dentistry and the pa-tients served.

QCDS, in partnershipwith the NewYork Mets, will be participating intheAnnual Health Fair Day, sched-uled for Tuesday, August 27. Thisannual event has allowed volun-teer dentists from QCDS to offeroral cancer screenings to the fansattending the game and to invitetheir patients, families and friendsto enjoy an evening at the sta-dium at a deeply discountedticket rate. Many dentists pur-chase blocks of tickets as gifts fortheir patients and staff.

Mark the date on your calendarand watch for additional informationas arrangements are finalized. This is alsoa perfect opportunity to update or provideyour e-mail address by calling QCDS, e-mail can be used as a timely andcost effective way to communicate with members.

Lets Go Mets!

A QCDS Scrapbook

Dr. Chad Gehani with colleagues from the Bronx County Dental Society, the sponsor of the Big Apple Dental Meeting

Dr. Gehani Represents QCDS at Big Apple Dental Meeting

QCDS andNew YorkMets TeamUp For AnnualCitifield Health Fair Day August 27th!

6

8

By Danielle R. ZimbardiThis case study exemplifies the potentially serious conse-

quences that can arise when a dentist allows a patient to dic-tate treatment by failing to undergo a recommendedpre-procedural study due to cost.

A 47-year old single male janitor had been a patient of aperiodontist for more than 20 years. His treatment had pri-marily consisted of general dental care and periodontal main-tenance. The patient’s medical history was essentiallyunremarkable, except for cigarette smoking.In November 2010, he came to the dentist’soffice complaining of mobility in tooth #24.At that visit, the dentist discussed treatmentoptions to replace the tooth. However, thedental record does not specify exactly whatoptions were discussedwith the patient. Thepatient agreed to pursue a plan for extractionof tooth #24, including placement of an im-plant. The dentist referred the patient to adental radiologist to undergo a 3D scan ofthemandible, prior to the planned treatment.

On a telephone call in January 2011, thepatient advised the receptionist that he couldnot proceed with the extraction and implantat that time. In April 2011, the patient wasagain seen, and the dentist’s documentationreflects that tooth #24 was extremelymobile.While it againwas not documented, the den-tist recalled that he oncemore discussedwiththe patient the proposed plan for extractionand placement of an implant. Additionallynot documented was a telephone conversation between thepatient and the dentist’s receptionist in mid-June of 2011. Thepatient told the receptionist he did not intend to undergo therecommended and prescribed 3D scan prior to the extractionand implant due to the added out-of-pocket cost. However,the patient requested that the replacement tooth be ready atthe time of extraction.

On June 30, the patient presented for the planned extrac-tion and implant. Although the dentist took a preoperativedigital X-ray of the anteriormandible, he then proceededwiththe implant, despite the fact that not having the 3D scan wasboth against the dentist’s custom and practice, as well as thedental standard of care. He gave the patient a local anestheticand extracted tooth #24 by forceps without complication. Theacrylic denture was tried and adjusted. The dentist then cre-ated a mucogingival buccal and lingual flap to expose thebone in the area of tooth #24. Based upon his visual inspectionof only a bone, the dentist determined that the bone was suf-ficient to proceed with a 10 mm x 3.3 mm implant.

The dentist drilled an access hole approximately 2 mmdeep utilizing a round surgical bur. This was then followedwith a 2mmbur to establish length.At approximately 10mm,the patient jumped, stating that he “felt something.” The den-tist observed excessive bleeding through the osteotomy holeand immediately applied pressure with gauze to the area.After about 10 minutes, the bleeding appeared to be under

CaseStudy:WhenaPatientDictatesTreatmentcontrol. The patientwas given Tylenol and an antibiotic. How-ever, the dentist observed that the floor of the patient’s mouthbegan to swell. It became quite apparent that the patient washemorrhaging. The dentist immediately contacted an oral sur-geon to see the patient, and the dentist’s officemanager drovethe patient several blocks to the oral surgeon’s office.

The oral surgeon quickly diagnosed a dissecting hematomaof the right and left sublingual spaces, and the right and leftsubmandibular spaces. He also documented the presence of an

apparent perforation into the sublingualspacewith a laceration of the left sublingualmucosa, possible perforation into thementalspace, and uncontrolled bleeding. Further,he documented bulging of the right and leftsubmaxillary glands, which suggested ac-celeration of the hematoma. The patient’stonguewas swollen bilaterally and elevated,partially occluding the oral pharyngeal air-way. He immediately called 911. The oralsurgeon gave right and left mental blocksbefore the EMTs arrived, but was unsuc-cessful in attempting to drain the accumu-lating blood from the submaxillary spaces.

The patient was taken by ambulance tothe nearest medical center, where a traumateam awaited him. The emergency depart-ment physician determined that he neededimmediate placement of an airway. The pa-tient was rushed to the operating room andunderwent an “awake” emergency tra-cheostomy.

He received “last rites” in the operating room. The patientwas then intubated and sedated. A head and neck angiogra-phy demonstrated extravasation in the distal perforatingbranch of the lingual artery. This was successfully embolized.The patient was then transferred to the ICU, where he re-mained sedated and on a ventilator, but was hemodynami-cally stable.

The following day, the patient was weaned to a tra-cheostomy collar. Initially, he could not take fluids or foodby mouth and received nutrition only through a nasogastrictube. On the fifth day post-tracheostomy, he was advanced topureed food. The swelling of his tongue and face graduallysubsided, and the patient progressed well without com-plaints except for anxiety, for which he received Xanax.Throughout the hospitalization, the dentist was in contactwith the patient’s family. The dentist also visited him severaltimes. On July 11th, the patient was discharged with a fenes-trated tracheostomy tube in place. He remained on a pureeddiet, and continued to take Xanax for anxiety. Following thepatient’s discharge from the hospital, there was no furthercontact between the dentist and the patient.

The patient continued to heal well at home. At the end ofJuly, the tracheostomy tube was removed and he was ad-vanced to solid foods. By mid-August 2011, he was able toreturn to work.As a result of this event, his treating physician

“This case studyexemplifies the

potentially seriousconsequences whichcan arise when adentist allows

a patient to dictatetreatment...

”

—Continued on page 10

EDPAC20 CORPORATE WOODS BLVD., STE. 602, ALBANY, NY 12211

Yes, I want to be a 2013 EDPAC Capitol Club member.______Enclosed is my check payable to EDPAC ______$250 Honor Roll ______ $100 Capitol Club

______Please charge my Capitol Club dues to my credit card (AMEX, VISA, MC):

CardNumber ____________________________________________ Exp. ___________ CVV Code ___________

(Signature) ______________________________________________________________________________________

Name ___________________________________________ Component ____________ADA # ________________

Dear Colleague:We need your help. In Albany, the state’s Capital, we are fighting to protect your practice, your patients and your fu-ture, as we have always done. But, while dentistry has many friends among the policy makers inAlbany, we also havefoes, and they are formidable – insurance companies, trial lawyers, hostile government bureaucracies, just to name afew. These entities pose threats as real as they are dangerous, and we, as concerned doctors, must be both vigilant andaggressive in defending our professional prerogatives.This year we defeated a proposal to reduce reimbursement to dentists providing services under Medicaid. Even if youdon’t participate in the program, this victory is important. In other states, when dentists can’t afford to treat the poor,mid-level providers have been brought in to the detriment of practicing dentists and patients alike. If you do participatein Medicaid, then our efforts relate directly to your ability to make a living. In addition, and perhaps of more signifi-cance, the inclusion of adult dental services in Medicaid was made statutory, making it an “Essential Health Benefit”thereby assuring the inclusion of adult dental services in Medicaid when Medicaid is moved into NewYork’s HealthBenefit Exchange.But with every “victory”, there arise more challenges.Already this legislative session, there have been eleven bills in-troducedwhich have some bearing on professional liability. Somewe support, most we oppose – but those are supportedby a strong Trial Lawyer’s lobby. In addition, bills relating to expanded hygiene, mid-level provider and denturologyare on the table. We are also supporting legislation to allow qualified dentists the opportunity to provide a broader arrayof facial cosmetic procedures for their patients who desire them – legislation opposed by our medical colleagues. Soyou can see, our profession cannot stand still and you cannot afford to be apathetic.Effective political action takes effort and it takes money. The NewYork State DentalAssociation will make the effort,but it relies on EDPAC for the resources necessary to give it a powerful voice. Your contribution to the EDPAC Capi-tol Club is critical to ensuring that organized dentistry’s efforts are effective and that our political strength is main-tained.Use the enclosed pledge form to send your Honor Roll ($250) or Capitol Club ($100) contribution today. Or, you cancontribute online atwww.empiredentalpac.com. Join the team andwear your Capitol Club pin with pride – for it rep-resents your commitment to the cause and serves as a reminder to your colleagues to also do their duty for their pro-fession.Thank you in advance for your generosity. If you have any questions, please give one of us a call.Sincerely yours,

Prabha Krishnan, DDS Joseph R. Caruso, DDS Chad P. Gehani, DDSEDPAC District Chair Vice Chairman Immediate Past President

Queens County Dental Society Empire Dental PAC NYS DentalAssociation &(718) 268-5777 (718) 353-2822 EDPAC Board Member

(718) 639-0192

10

By Lewis J. Altfest, Ph.D., CFA, CFP®

Some investors read one glowing article about a companyand rush to buy the stock. That’s a recipe for disaster.

By studying a few key financial figures, you can get a solididea of a company’s prospects and reduce the chances thatyou’ll make big mistakes. Stocks that shine according to thefollowing measures are well worth considering:

Price-earnings ratio: Historically, the PE ratio of the stocksin the Standard& Poor’s 500 Stock Index averages between 15

and 25. Bargain huntersshould focus on companieswith PEs relatively lowerthan the current PE or thosewith reasonable PEs whosegrowth rate exceedsmarketaverages.

� Price-cash flow: Somestock analysts are wary ofrelying on reported earn-ings alone.

Instead they study cashflow, which reflects earn-ings and depreciation. Cashflow data can give a morecomplete picture of a com-pany’s capacity to raise its

dividend and make capital investments. Divide the shareprice by the cash flow per share.

� Price-book: You calculate book value by subtracting a com-pany’s liabilities from its assets. That gives you a rough ideaof how much a company would net if it were to sell every-thing it owned. When assessing stocks, it is helpful to look atthe average price it typically trades for in comparison to itsbook value. I’m on the lookout for stocks that sell for muchless than that average and seem likely to improve earnings inthe future.

� Price-sales: Accountants can play games with earnings re-ports, but it’s hard to alter sales figures. To calculate a com-pany’s ratio, divide the share price by sales per share. Thelower the figure, the less investors are willing to pay for eachdollar of sales, and the better the chance that the stock’s priceis a bargain. I’d pay attention to stocks with figures that are afair amount less than the posted average price-sales ratio.

Screen out those with other factors that could preventthem from ever recovering, such as bankruptcy, loss of keypatents, or other problems that analysts cite as possibly beingterminal.

� Dividend yield: Thanks to the arithmetic of the stock mar-ket, hefty dividends often serve as signposts for underpricedstocks. The lower a stock’s price falls, the higher the rise in itsdividend yield—annual dividend divided by share price. Isearch for stocks that have reasonable dividend yields. How-ever, sometimes due to limited pickings, I’ve been forced to

settle for lower dividend yields. As stock prices fluctuate, theaverage dividend yield will increase or decrease accordingly.

� Relative strength: This indicates whether a stock has beenrising or falling lately and to what degree relative to an ap-propriate market benchmark. Some analysts swear by themeasure, buying only stocks that have been climbing fasterthan the overall market for the last six or twelve months.

Taken by itself, however, relative strength can be a trap.Too often, winners crash-land. But I combine relative strengthwith other measures suggesting a stock is underpriced. Thatway, I find cheap stocks that the market’s just discovering.

Altfest Personal Wealth ManagementSM is the nationally rec-ognized, fee-only investment management and financial planningfirm that is endorsed by NYSDASupport Services and the QueensCounty Dental Society for their members. Altfest contributes arti-cles to help members of the Queens County Dental Society plan andthink intelligently about their finances. To reach Altfest, call DavidNovak at 212-406-0850 or dnovak@altfest.com.This article was updated and adapted from an article the author

wrote for Medical Economics magazine. Copyright 2013 and pub-lished by Advanstar Medical Economics Healthcare Communica-tions. Reprinted by permission. All rights reserved.

Here’s How to Select Stocks Like a Pro

“. . . you canreduce thechances thatyou’ll makebig mistakes.

”

had diagnosed him with post-traumatic stress disorder andreferred him to a psychologist. However, at his later deposi-tion (EBT), the patient testified that he had not seen, nor didhe plan to see, a mental health professional. However, he ad-mitted he was now terrified of any further dental treatment.

The patient then commenced a lawsuit against the dentist.He alleged negligent implant surgery in the area of tooth #24,causing laceration of his tongue and lingual artery, which re-sulted in a hemorrhage, severe edemaof themouth and tongue,and obstruction of his airway. As a result of these injuries, thepatient required an awake emergency tracheostomywith place-ment on a ventilator, embolization of the lingual artery, and a 10-day hospitalization. The patient was left with a scar from thetracheostomy, tightness of his throat when swallowing, numb-ness in his lips, and post-traumatic stress disorder.

Experts who reviewed the case for the dentist felt there wassimply no possible defense to the lawsuit. Their criticisms of thedentist’s care focused on the patient’s refusal to undergo the 3Dscan, which would have provided the dentist with views of thebone not seen on the PAdigital X-ray. Further criticism includedthe dentist’s placement of the implant without first consideringbone augmentation. Additionally, the dentist should have im-mediately recognized the seriousness of the patient’s hemor-rhage and called 911, rather than sending the patient by car tothe oral surgeon. This delay in obtaining immediatemedical in-tervention placed the patient’s life and health at great risk. Ear-lier treatment may have prevented the patient’s need for a

tracheostomy.Because thisprocedurehad tobeperformedemer-gently and while he was awake, the patient had been addition-ally subjected to substantial physical and emotional distress.

Another crucial weakness in possibly defending the dentistwas the inadequate documentation in thepatient’s record. Therewas no discussion of the treatment plan, the potential optionsoffered, and, most importantly, the failure by both the dentist’sstaff to communicate, and the dentist to document, the patient’srefusal to obtain the 3D scan before the procedure.

In hindsight, the dentist might have opted not to proceedwith the implant. Further, by proceeding without the scan,which the patient allegedly refused due to its cost, the dentistdid not dictate the patient’s care. Rather, the patient did so. Thatis neither acceptable nor reasonable. Because the dentist clearlyhad no viable defense to any of the allegations, the litigationwas settled prior to the dentist’s deposition for $320,000.

Danielle R. Zimbardi is vice president, dental underwriting-Medical Liability Mutual Insurance Company.This article has been reprinted with permission from MLMIC

Dental Dateline (Fall 2012), published by Medical Liability Mu-tual Insurance Company, 2 Park Avenue, Room 2500, New York,NY 10016. Copyright ©2012 by Medical Liability Mutual Insur-ance Company. All Rights Reserved. No part of this article may bereproduced or transmitted in any form or by any means, electronic,photocopying, or otherwise, without the written permission ofMLMIC.

11

Case Study:When a Patient Dictates Treatment—Continued from page 8

1113

In February of this year, Dr. Albert Yoo had the incredi-ble opportunity to lead a team of three periodontists, 8 den-tal students and a certified surgical assistant on a dentaloutreach to Buff Bay, Jamaica. This trip marked his fourthyear of travel and serving this small community on a beau-tiful island. The outreach has expanded from the time heled this mission as a sole practitioner, to the place where itis today, as a team of dentists and a new partnership withStony Brook School of Dental Medicine.

Through fundraising efforts, Dr. Yoo was able to raise$6,850 in monetary contributions. The majority of supplies

were covered through a grant given by Henry Schein to theStony Brook School of Dental Medicine, totaling $3,400. Intotal, the donations amounted to $10,250.

The team of Doctors and staff worked tirelessly for fivedays in a clinic they had been granted permission to utilizethrough the Ministry of Health. Their clinical highlights in-cluded:� Patients treated: 481� Cleanings: 229� Teeth extracted: 439� Gum surgery: three quadrants on two patients

� Alveoplasty: two patientsThis trip marked a new beginning for the outreach ef-

forts to Jamaica—seeing a new generation of dental profes-sionals get involved with missions, utilizing theirknowledge and skills to serve and care for individuals inneed. The students worked non-stop without a single com-plaint. The community was grateful for the needed treat-ment, as well as the professionalism displayed by thestudents.

Other members of the team worthy of acknowledgmentfor their efforts include Dr. Alicja McCrudden, Bayside and

Dr. Anthony Ienna, Franklin Square, for their patience andsupervision of the dental students; Mrs. Cassandra Woodsfor her support with sterilization/turnover; and the dentalstudents of Stony Brook for their energy, skill, and most im-portantly, compassion to volunteer to partake in this out-reach.

Dr. Yoo reports that he had such a positive experienceboth organizing and participating in these missions. “I hopemy experience serves as an encouragement for all dentiststo donate their time and skill to serve a needy community,here or abroad.”

Be sure to check the QCDS website for the latestSociety events and news: www.qcds.org

QCDS Special Event

Dr. Yoo Leads Dental Mission to Buff Bay, Jamaica; Helps Many in Need of Oral Care

12

14

By Andrew E. Roth, Esq., and Irwin N. Rubin, Esq.The American Taxpayer Relief Act of 2012 expanded the

opportunities for individual taxpayers to convert existing tax-deferred accounts in 401(k) plans to Roth accounts within thesame plan.

Previously, in-plan Roth conversions were limited toamounts that could be withdrawn from the plan. Therefore,participants younger than age 59½ could not convert their401(k) account into a Roth 401(k).

Effective January 1, 2013, the new law permits any amountfrom a participant’s 401(k), matching, profit sharing or after-tax accounts to be converted to a Roth account within thesame plan even if the amount is not eligible for distribution.Therefore, employees under age 59½ may now convert their401(k) accounts to a Roth account.

The liberalized in-plan Roth conversion rules makes planadministration easier because sponsors no longer have to de-termine whether a request from a participant to convert hisaccount balance to a Roth account is eligible for an in-servicedistribution under the terms of the plan. Moreover, the liber-alized rules create new tax planning opportunities and flexi-bility in choosing when and how much to convert existingtax-deferred amounts, including elective deferrals, matchingcontributions and non-elective employer contributions

For tax purposes, an in-plan Roth conversion is treated asa taxable distribution from the individual’s tax-deferred ac-count. However, by paying tax on those accounts in the yearof the conversion, participants can save taxes in the futuresince both the principal amounts converted as well as futureinvestment gains may be distributed free of income tax. Inorder for a Roth account distribution to be exempt from tax,the amount distributed must have been held for five yearsand, in addition, must be made after the employee reaches

In-Plan Roth Rollovers Offer Tax PlanningOpportunities For Employers andParticipants

age 59½, becomes disabled or dies.While Roth conversions are subject to tax, they are not sub-

ject to the 20 percent mandatory withholding that applies totaxable distributions. Accordingly, an individual who electsto make an in-plan Roth conversion should consider increas-ing their withholding and/ormaking estimated tax paymentsto avoid underpayment penalties.

Plan sponsors desiring to add this feature must amendtheir plans and implement administrative procedures to fa-cilitate a participant’s election to convert existing account bal-ances. The planmust permit participants to make designatedRoth contributions, as well as to make in-plan Roth rollovers.Such amendments must be made prior to the end of the planyear in which the plan amendment is effective.

Employers desiring to implement a Roth contribution fea-ture, including an in-plan Roth conversion feature, should en-sure that ongoing administration of the Roth accounts iscoordinated with other administrative procedures (e.g.,recordkeeping, participant communications, nondiscrimina-tion testing, etc.). Employers should notify participants of thefeature.Also, recordsmust be kept on the individual Roth ac-counts in order to administer the accounts in accordance withtax laws and to satisfy the plan’s Form 1099-R reporting re-quirements.

Andrew E. Roth, Esq., and Irwin N. Rubin, Esq., are partners atthe White Plains, New York law firm of Danziger &Markhoff LLP.This firm is a business and tax-oriented law firm that has been rep-resenting dental practice owners in the New York metropolitan areafor over fifty years.Mr. Roth and Mr. Rubin may be reached at 914-948-1556 or by

email at aroth@dmlawyers.com or irubin@dmlawyers.com.

Dr.Gehani toReceive FauchardDistinguished Service CitationMinnesota dentist. Troubled by the proprietary nature ofmany dental publications, he wanted to help the profes-sion gain control of its own literature and assure its inde-pendence from commercial interests. His passionateconcern for the search for knowledge and the raising ofprofessional standards guided the beginnings of theAcademy, attracted outstanding dental researchers andteachers to its ranks, and led to a continuing role in fos-tering dental science.

Early on, the constitution of the Pierre Fauchard Acad-emy laid out a series of objectives intended to foster Dr.Best’s aims. These included a constant emphasis on pro-fessional integrity and ethics. One of the means adoptedby the Academy was to award medals and other honors topeople who had distinguished themselves by their con-tributions to dentistry and who were recognized as wor-thy role models for others in the profession.

The award to Dr. Gehani will be presented during thePierre Fauchard meeting held in conjunction with theNYSDA House of Delegates session at the Grand Hyatthotel in New York City. It will be presented at a breakfastceremony on Friday, May 31. The cost for the breakfast is$40 if paid prior to May15, and $50 if paid later. Due tospace limitations, reservations are required, as no ticketswill be sold at the door.

ADVERTISEIN THE QCDS BULLETIN!

For rates and information call 718-454-8344.

—Continued from page 1

1716

TAX TIPS FOR DENTISTS

There are exceptions to the 10% penaltyfor early distributions (before age 59.5)from qualified pension plans and IRAs.1. Medical expenses that are in excess of 7.5% ofadjusted gross income.

2. Up to $10,000 for first time homebuyer expenses

3. Higher education expenses for taxpayer, spouse,child or grandchild.

4. Direct rollover to a new retirement account.

5. You were permanently totally disabled.

6. You were unemployed and used the money forhealth insurance.

Stuart A. Sinclair CPA1120 Old Country Road • Plainview, NY 11803Phone (516) 935-2086 Fax (516) 935-1787

Is Your AED Obsolete?Warning: If you purchased an AED before 2005, it may

not be compliant with the current American Heart Associa-tion/European Resuscitation Council Guidelines for Resusci-tation. AEDs manufactured prior to 2005 are programmed toperform up to 3 sequences of analyzing and deliveringshocks. This process can take approximately 45 seconds to oneminute. This methodology of defibrillation was found to beless effective because CPR cannot be performed during thistime. Current guidelines require a pause in CPR to be lessthan 10 seconds. Depending on the unit you have, a simplesoftware upgrademay be all that is needed. Units unable to beupgraded must be replaced in order to meet the 2005 guide-lines.

Erik Zalewski, M.S., EMT-CC is the CEO of Have DummyWill Travel, Inc., a full service emergency training, equipmentand supply company. For over 25 years, Have Dummy WillTravel, Inc. has served the dental community in the GreaterNew York area.

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Support QCDS Bulletin advertisers.They support QCDS!

19

�New York StateMission of Mercy

June 13-14, 2014In Albany

At the Hudson Valley Community CollegeEdward F. McDonough Sports Complex

VOLUNTEERS NEEDED!A free two-day dental clinic to provide oral health services

and education to people who for many reasons, lack access to dental care.

For further informationvisit: nysmom.org

or call the New York State Dental Foundationat 800-225-2100

Save theDateCCoommee aanndd JJooiinn UUss!!IIff yyoouu hhaavveenn’’tt bbeeeenn ttoo QQCCDDSS llaatteellyy,, yyoouu aarree mmiissssiinngg aa lloott!!MMoonntthhllyy mmeemmbbeerrsshhiipp mmeeeettiinnggss aarree hheelldd oonn tthhee ffiirrsstt TTuueessddaayy oofftthhee mmoonntthh aanndd ooffffeerr mmeemmbbeerrss 22 CC..EE.. ccrreeddiittss,, ddiinnnneerr,, aanndd wwiinnee..SSppeeaakkeerrss aarree iinnssiigghhttffuull aanndd tthheerree iiss uussuuaallllyy ttiimmee ffoorr pplleennttyy ooffqquueessttiioonnss aanndd aannsswweerrss..

OOffffeerreedd ffrroomm SSeepptteemmbbeerr ttoo JJuunnee,, tthhiiss iiss aa ggrreeaatt mmeemmbbeerr bbeennee--ffiitt tthhaatt eevveerryyoonnee sshhoouulldd ttaakkee aaddvvaannttaaggee ooff.. IItt iiss aallssoo aa ggrreeaatt wwaayyttoo mmeeeett yyoouurr QQCCDDSS pprreessiiddeenntt aanndd ootthheerr eelleecctteedd lleeaaddeerrss.. MMeeeettoolldd ffrriieennddss,, mmaakkee nneeww oonneess,, ssttaayy iinnffoorrmmeedd aabboouutt tthhee llaatteesstt iinn--ffoorrmmaattiioonn iinnvvoollvviinngg yyoouurr pprrooffeessssiioonn aanndd ggiivvee yyoouurr iinnppuutt.. CChheecckktthhee QQCCDDSS wweebbssiittee ccaalleennddaarr oorr tthhee QQCCDDSS FFaacceebbooookk ppaaggee ffoorruuppccoommiinngg eevveennttss..

WWee llooookk ffoorrwwaarrdd ttoo sseeeeiinngg yyoouu!!

Save theDate

2120

CE CoursesPre-registration is required for all continuing education courses, except General Membership Meetings

Understanding the need for diagnostic case planning, isthe key to a predictable case.This presentation will review case planning techniquesand the prosthetic alternatives that are available in orderto achieve the desired result. To be discussed: diagnostictools, the pros and cons of pfm’s, all ceramic bonded andcemented crowns and new advances in cad-cam pros-thetics. Learn the guidelines that a can be followed inorder to communicate your requirements and those ofyour patients to the laboratory for a predictable case.

Instructor:Howard Friedman, Naor Labs

8:00 P.M.: Current EndodonticsPresentation will discuss endodontics as it is practiced in2013 with an emphasis on rotary instrumentation and con-tinuous wave obturation techniques. It will also exploretroubleshooting and problem solving in challenging cases.

Instructor: Dr. Mitchell Greenberg

Sunday June 9 9:00 a.m.Orthodontics for the General Practitioner 6 C.E. CreditsMorning session will address areas of diagnosis, ideal oc-clusion, ceph point, deep bites, open bites, Class I andClass II patients, anterior crowding, expansion vs. extrac-tion and red flags noting cases to avoid.Afternoon session will address ortho mechanics and de-velopment, bracket placement, band cementation, wire se-lection, pedo considerations, tooth eruption patterns,expansion, crowding, anterior cross bites and space main-tenance.

Instructor: Dr. Milton and Dr. Jean FuruyamaTuition:ADA member $35. Non-ADA member: $60

Friday, June 23 9:00 a.m.General Membership Meeting 4 C.E. CreditsTopic: Basic Cardiac Life Support

Certification will cover 1 and 2 rescuer CPR, HeimlichManeuver, child CPR and AED. The ability to recognizethe signals of a heart attack and provide stabilization ofthe victim at the scene of a cardiac arrest is a pricelesscommodity. Life over death may some day become a re-ality to someone you know or care for. Be prepared tohelp save a life.Class begins promptly at 9:00 a.m. Registration is at 8:30 a.m.

Instructor: Eric Zalewski, BLS InstructorTuition:ADA member/staff: $105. Non-ADA member: $260

Sunday, May 5 9:00 a.m.Creating Natural Looking Implant 4 C.E. CreditsRetained ProsthesisNatural looking implant retained prosthesis are beautifuland functional when they follow smile design principlesand replicate nature.

Instructor: Dr. Arnold Liebman

Tuesday, May 7 6:15 p.m.General Membership Meeting 2 C.E. Credits7:00 P.M.: “How to Avoid Dental Malpractice Lawsuits”

Program will focus on practical suggestions to dentists onsteps they can take in their day to day practice to avoidlegal actions and complaints to the Department of Educa-tion and/or make defending them easier for their defenseattorney. Things like turning a complainer away; keepinga detailed contemporaneous chart, informed consent, theinternet, and liability for the acts of ones partners, em-ployees or independent contractors are some of the topicsto be covered.

Instructor: Robert A. Rosenfeld, Esq.8:00 P.M.: Dental Impression Materials and Techniques

Speaker: David Hollis, 3M ESPE

Tuition:ADA member $85/staff $70. Non-ADA member: $260

Sunday May 19 9:00 a.m.Infection Control 4 C.E. CreditsTopic: Infection Control

In the past this course has had an overwhelming positiveresponse from those clinicians and their staffs whoearnestly want to stay informed of the latest infection con-trol recommendations out there, and does so through theeyes and thoughts of a speaker-clinician who well under-stands the nature and demand of the everyday dentalpractice. Bring your entire staff and satisfy OSHA’s annualstaff training requirements. Course qualifies for relicen-sure.

Instructor: Safety Compliance ServicesTuition:ADA member $85/staff $70. Non-ADA member: $260

Tuesday June 4 6:15 p.m.General Membership Meeting 2 C.E. Credits7:00 P.M.: “Make the Correct Choice for a More

Predictable Case”

Study Clubs May - June

Dr. Fialkoff Study Club CONTACT DR. FIALKOFF (718) 229-3838

May 8 7:00 -10:00 p.m.

Topic: “The Dentist’s Body - How Do We Avoid Painand What Needs to be Known to Protect Tt?”

Speaker: Rhiannon A. Reynolds, B.S. and Joseph Mascaretti, M.S.

Location: 47-10 Bell Blvd. Bayside

June 11 7:00 -10:00 p.m.

Topic: “Laser in Periodontics - Current Status”“How to Utilize Different Wave Lengths for Success”

Speaker: Dr. Les BinkleyLocation: 47-10 Bell Blvd., Bayside

Kalman Oral Surgery and Implant Study Club CONTACT DORIS REYHAN (718) 897-6400

June 12 6:30-9:00 p.m.

Topic: “TMD/Orofacial Considerations for the General Practitioner”

Speaker: Dr. Barry Rosenberg

Location: 60-70 Woodhaven Blvd., Unit C-2, Elmhust

NYC Interdisciplinary Study ClubCONTACT CARLY (917) 675-0109

May 22 6:30-9:30 p.m.

Topic: “Managing the Medically Complex Patient:An Update on Cardiovascular Disease and Bleeding”

Speaker: Miriam Robbins, D.D.S.

Location: Dopo Teatro

125 West 44th Street, New York

June 12 6:30-9:30 p.m.

Topic: “HPV Related Oropharyngeal Cancer, An Epidemic: What the Dental PracticionerNeeds to Know.”

Speaker: Brett Miles

Location: Dopo Teatro

125 West 44th Street, New York

Dietary ConcernsPlease note that QCDS wishes to accommodate the dietary needs ofattendees at our meetings and programs. It is requested that anyonerequiring kosher or other specialized foods notify the QCDS officeat the time of your registration so that proper plans can be made.

“Taking You fromResidency to Retirement™”

IInnssuurraannccee PPllaannnniinngg FFoorr tthheeHHeeaalltthhccaarree PPrrooffeessssiioonnaall

• Individual Disability• Business Disability• Life Insurance• Group Insurance• Liability Insurance

• Malpractice Insurance• Health Insurance• Retirement Protection• Financial Planning

Dr. Eric S. StudleyEric S. Studley & Associates, Inc.

234 West Jericho TurnpikeHuntington Station, NY 11746

Office: 631-673-9496Fax: 631-673-9497

EMAIL: drstudley@optonline.net WEBSITE: DrEricStudley.com

If you have not yet renewed your membership,

please do so as soon as possible.You will no longer be receiving

communications from the ADA, NYSDA, or QCDS unless you renew for 2013.

Please don't let your membership lapse!

Call the QCDS Executive Director at 718-454-8344 if you are experiencing temporary financial difficultiesto explore possible options.

PUBLISHED BY AND FOR THE DENTISTS OF QUEENS COUNTY

PUBLISHED BY AND FOR THE DENTISTS OF QUEENS COUNTY

Queens County Dental Society86-90 188 Street | Jamaica, NY 11423

22

BIG APPLE RADIATION SAFETYMartin Schnee

NYS Certified CRESO

�Former Chief of the NYC HEALTH DEPARTMENT’SRADIATION EQUIPMENT DIVISION with over

35 years of experience

Explanations & instructions are provided to staff during the inspection

Fees: First tube $80; additional tubes only $50 eachSPECIAL: 4 tubes or more at $50 per tube

Includes all paperwork and filing with NYC Health Dept.New registrations and CT slightly higher. Must Mentionthis ad for these prices. I lectured at the 2009 Greater NewYork Dental Meeting. In 2010, for members of QCDS and

for the Indian Dental Association.

OFFICE 718-373-6348 MOBILE 718-986-4996www.NYCRESO.com

. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .

. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .

CLASSIFIEDSDENTAL OFFICE - Available part-time or full-

time. Great opportunity for any specialist or generaldentist. Relocate your existing practice or open asatellite office in established Bayside medical center,centrally located on Bell Blvd., directly opposite busyBay Terrace shopping center. Available suite: reno-vated, plumbed for dental, analgesia, windows,move-in ready, private Bell Blvd. entrance. Excellentsignage! On-site valet parking! High visibility loca-tion!

Mgmt: 718-229-3598 www.2391bell.com

TAXES YOUR OFFICE. Business/personal. Spe-cialty: dentists. Personable CPA, references Stuart A.Sinclair, CPA 516-935-2086 1120 Old Country Road,Plainview, New York 18803.

THINKING OF RETIRING? Established GPdentist with 20+ years experience seeks practice inEastern Queens/Western Nassau for satellite/secondoffice. I will take good care of your patients. Call: 718-404-7364. Email: Queensdentist@aol.com

SENIOR DENTIST CONTEMPLATING FU-TURE TRANSITION - Wishes to rent and share 3windowed treatment room office (min. 2 days/week)on 57th St. between 6-7 Ave. Please contact Mariluz212-247-6150

I AM LOOKING TO HIRE A GENERAL DEN-TIST - If you have a list could you e-mail me or mailit to me. Thank you. hs293@aol.com Dr. Bilello: 65-34 Myrtle Ave., Glendale, NY 11385

LOOKING FOR PEDIATRIC DENTIST: fornewly renovated dental office in Jamaica Estates,Queens. Person should be willing to work with in-surance companies. Fax resume toqueensdds@gmail.com or call 718-523-7910.

ASTORIA: 470K long established FFS and PPOpractice. Space is located on the second floor with aground level entrance at an extremely busy intersec-tion. Practice has over 1,000 active patients and re-ceives15 new patients per month. Office iscomputerized and has great potential with room toadd a 4th operatory. Asking price 325K.If you are in-terested in either of these listings please call 212-223-2844 or visit our website: RMNdentalbrokers.com formore information.

Queens County Dental Society86-90 188 StreetJamaica, NY 11423

PRSRT STDU.S. POSTAGE

PAIDHICKSVILLE, NYPERMIT No. 842