inside women making a difference in dentistry making a difference in dentistry ... your wisdom teeth...

Winter 2014 • Oakland County Dental Society • Dental Review

InsIde:Women Making a Difference

in DentistryDental Trauma:

A Review and Case Presentationby Dr. Tiffeny Chimelak

Women In Dentistry Seminarby Dr. Lynne Moseley

Mother-In-Law Mentor and Friendby Dr. Franziska Schoenfeld

Winter 2014


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contents

Editor . . . . . . . . . . . . . . . . . . .Craig .DuhaimeManaging .Editor . . . .Franziska .SchoenfeldBusiness .Manager . . . . . . .Bonnie .CrowsonAdvertising .Manager . . . . . . . .Bonnie .CrowsonEditorial .Staff . . . . . . . . . . . . . Nick .Fontana . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .David .Thompson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .James .Wright . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Marvin .Jabero

Oakland County Dental Society OfficersPresident . . . . . . . . . . . . . . Steven .GustafsonPast .President . . . . . . . . . . . . .Larry .DuffieldPresident-Elect . . . . . . . . . . . .Laris .Stumpos .Secretary . . . . . . . . . . . . . . . . .James .NowickiTreasurer . . . . . . . . . . . . . . . . . . . Paul .Lange

CouncilJohn .DeCarolisKaren .FrankMarvin .JaberoPatrick .Smith

MDA TrusteesScott .Meldrum, .Bob .Tremblay

Editor’s Corner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 President’s Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Executive Director’s Update . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Dental Trauma: A Review and Case Presentation . . . . . . . . . . . . . . 7 Women In Dentistry Seminar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 My Mother-In-Law: Mentor and Friend . . . . . . . . . . . . . . . . . . . . . . 11 A Study in the Evolution of Dentistry . . . . . . . . . . . . . . . . . . . . . . 15 Trustee Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Members in the News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Young Dentists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Dinner Meeting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Mission StatementThe .Dental .Review .strives .to .serve .the .needs . .of . its . members . by: . publishing . news . and .articles .of .interest; .serving .as .a .sounding .board .for .ideas .and .opinions; .promoting .the .concept .that . Oakland . County . members . comprise . .a .dental .family .

Editorial PolicyAll .statements .or .opinions .and/or .supposed .fact .published .herein .are .those .of .the .author .under .whose .name .they .appear . .They .are .not .to .be .regarded .as .the .views .of .the .OCDS .unless .the . Society . has . adopted . such . statements . .Advertising . specialists’ . license . numbers . are .available .upon .request .

All . text . published . in . the . Dental Review .may . be . reproduced . or . reprinted . only . after .written .permission .has . been . granted . by . the .Oakland .County .Dental .Society . .The .Society .reserves . the . right . to . edit, . revise . or . reject . .any . manuscript . submitted . for . publication . .Manuscripts .must .be .typewritten . .The .Society .reserves . the . right . to . reject . any . advertiser . .or .advertising .copy .

How to ReacH Us

Executive DirectorJohn .Kamar, .DDS

Phone: . (248) .540-9333E-mail: . ocdsdental@aol .comFax: . . (248) .540-2016Mail: . . 16205 .W . .14 .Mile .Road, .Suite .201 . Beverly .Hills, .MI . .48025

Letters to the EditorLetters . to . the . Editor . are . welcome: . by . mail . .or .e-mail . .They .may .be .edited .for . .brevity .and .will .become .property .of .the .Oakland .Dental .Society .

The Oakland County Dental Review .(USPS .401-180) .is .published .quarterly . . .Non-Profit .postage .paid .at .

Birmingham, .MichiganPOSTMASTER .send .address .changes .to: .Oakland

County Dental Society, 16205 W. 14 Mile #201,Beverly Hills, MI 48025

Subscription .rate .for .OCDS .Dental .Review . .is .$15 .per .year .

Copyright .© .2011 .Oakland .County .Dental .Society

Winter 2014 • Volume 53 No. 2

Member Publication

About the Cover: . .A .sunny .day .in .Keystone, .Colorado . .Photo .by .Dr . .Jeffery . .Johnston


2

Editor’s Corner

. . . . . . .Although .much .has .been .said .about .the .focal .infection .theory .over .the .last .hundred .years, .seldom .do .we .discuss .the .implications .that .this .might .potentially .have .on .patient .care .today . .Patients .put .a .significant .amount .of .trust .in .their .dentist’s .knowledge .and .experience .on .deciding .whether .a .tooth .

should .be .extracted .or .retained . .However, .that .trust .is .sometimes .shaken .by .so .called .“experts” .who .may .sound .and .look .credible .despite .their .unorthodox ./ .radical .perspectives . . .

. In .the .early .1930’s, .Dr . .Weston .Price .advocated .the .practice .of .prophylactically .extracting .root .canal .treated .teeth .to .prevent .or .treat .systemic .disease . .He .claimed .that .bacteria .trapped .in .dentinal .tubules .during .root .canal .treatment .could .cause .almost .any .type .of .degenerative .systemic .disease . . . . After .an .era .of .aggressively .extracting .teeth .that .could .otherwise .have .been .saved, .the .Journal .of .the .American .Dental .Association .published .an .issue .in .1951 .that .reviewed .the .scientific .literature .and .shifted .the .standard .of .practice .back .to .retention .of .teeth . .via .endodontic .therapy . .The .conclusion .was .that . .“Dr . .Price’s .techniques .lacked .many .aspects .of .modern .scientific .research, .including .absence .of .proper .control .groups .and .induction .of .excessive .doses .of .bacteria .” . . . Despite .research .that .disproved .Dr . .Price’s .claims,there .is .a .group .of .doctors .who .still .believe .in .the .philosophy .of .prophylactic .extraction .of .all .diseased .and .endodontically .treated .teeth . .Some .of .these .practitioners .call .themselves .“biological .dentists ./physicians .” .Not .only .do .they .believe .in .extracting . .all .endodontically .treated .teeth, .they .also .advocate . .

the .removal .of .at .least .one .millimeter .of .the .surrounding .bony .socket .with .a .bur! . . The .following, .is .a .list .of .ten .basic .facts .regarding .the .focal .infection .theory .that .may .be .useful .today: . .• .Dental .extractions .are .the .most .traumatic . .

of .all .dental .procedures .causing .bacteremia .(bacteria .found .in .the .bloodstream) .in .up .to .100% .of .patients, .as .opposed .to .20% .during .endodontic .treatment . .Root .canal .therapy .causes .minimal .dissemination .of .bacteria .especially .when .canals .aren’t .over-instrumented .

. .• .Bacteremia .from .daily .living .is .more .frequent .than .bacteremia .from .endodontic .treatment: .brushing .(0-26%), .flossing .(20-58%), .mastication .(17-51%) .

. .• . .There .is .no .evidence .that .bacteria .present .in .the .dentinal .tubules .of .teeth .with .infected .and .necrotic .pulps .or .endodontically .treated .teeth . .cause .systemic .disease .

. .• . .Regardless .of .the .treatment .being .rendered, .a .healthy .immune .system .should .vanquish .a .transient .bacteremia .in .a .matter .of .minutes . . .

. .• . .The .use .of .bactericidal .irrigating .solutions, .such .as .NaOCl .help .to .eliminate .bacteria .and .its .byproducts .from .the .root .canal .and .dentinal .tubules . . .

. .• . .Despite .improved .methods .for .classifying .bacteria .in .distant .organs, .most .studies .attempting .to .link .oral .bacteria .to .systemic .disease .are .based . .on .correlation--not .causation . . .While .oral .bacteria .and .their .inflammatory .byproducts .have .the .potential .to .influence .systemic .diseases, .cause . .and .effect .relationships .are .difficult .to .establish . .

.

Focal Flashback by Dr. Craig Duhaime

continued on page 22


. Over .the .past .year .I .attended .two .conferences . .at .the .American .Dental .Association .headquarters . .in .Chicago, .and, .while .there, .heard .that .the .American .Dental .Association .offered .tours .of .their .building .and .facilities . . .In .October, .my .wife, .Dr . .Shari .Morningstar, .and .son .Robert, .and .I .were .in .Chicago .for .the .USC-Notre .Dame .football .game . .We .had .some .time .before .the .USC .pep .rally .at .Navy .Pier .and .I .recommended .we .tour .the .ADA .

. Located .at .211 .Superior .Ave . .in .the .heart .of .the .Magnificent .Mile, .the .ADA .building .is .one-half .block .from .Michigan .Avenue . .We .were .greeted .in .the .lobby .by .a .member .of .the .Member .Services .team .who .gave .us .a .brief .history .of .the .building . .Ground .was .broken .

on .November .11, .1963 .and .the .first .tenants .moved .in .on .October .1, .1965; .the .Association .offices .moved .into .the .building .November .26-28, .1965 . .In .the .nineties .the .building .went .under .extensive .renovation . .Besides .housing .the .ADA, .its .major .tenants .are .Northwestern .University .and .Children’s .hospital .

. Our .first .stop .was .the .products .catalog .call .center .and .store . .The .center .receives .hundreds .of .calls .per .

day .from .dental .professionals . .Next .on .the .tour .was .the .Research .Institute .which .was .most .interesting . .The .ADA .has .established .rigorous .guidelines .for .testing .and .advertising .dental .products . .The .first . .ADA .Seal .of .Acceptance .was . .awarded .in .1931 . .Today, .nearly .350 .manufacturers .participate .in .the .voluntary .program .and .more .than .1300 .products .have .received .the .Seal .of .Acceptance . .We .were .given .a .demonstration .on .testing .of .composite .strengths .

. My .son, .an .electrical .engineer, .found .this .area .intriguing .as .we .were .shown .a .robotic .device .designed .by .ADA .engineers .to .test .disposable .dental .handpieces . .These .handpieces .would .have .military .applications .along .with .use .on .humanitarian .missions .

. The .Research .Institute .conducts .investigations .on .emerging .oral .health .care .issues .relevant .to .the .general .health .of .the .public .and .the .occupational .health .of .the .dental .professionals . .Current .projects .include .investigations .on .aerosols .in .the .dental .operatory, .dental .unit .waterlines, .occupational .exposure .to .Legionella .and .dental .handpiece .sterilization .

. .The .Research .Institute .also .coordinates .the .Health .Screening .Program .(HSP) .held .each .year .during .the .ADA .Annual .Session . .The .ADA’s .Evidence-based .Dentistry .initiatives .are .also .housed .under .the .Research .Institute .

. Located .on .the .6th .floor, .the .Library .serves .the .needs .of .ADA .members .by .offering .access .to .

A Fascinating Visitby Dr. Steven Gustafson

President’s Page

3continued on page 4


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We WelcomeOur New Oakland Dental Society Member Dentists

Nathaniel Davis, DDS, MS

Antonela Dhamko, DDS

Sahar Fardous, DDS

Eva Fornos, DDS

Richard Friedman, DDS

Kevin Groth, DDS

Alejandra Gutierrez, DDS

Carolin Ibrahim, DDS

Morhaf Sadek, DDS, MD

James Shaheen, DDS

Basam Shamo, DDS

Aaron Tuchklaper, DDS

Marilyn Winningham, DDS

William Woodruff, DDS

electronic, .printed, .and .archival .material . .A .team .of .library .professionals .has .the .resources .and .expertise .to .assist .with .making .a .search .for .information .faster, .easier, .and .productive .

. On .the .second .floor .lies .the .conference .center .where .most .classes .and .symposiums .are .hosted . . .Two .courses .were .taking .place .on .our .visit . .The .third .floor .consisted .of .member .services .including .the .ADA’s .insurance .programs .

. .Our .final .stop .was .the .executive .offices .where . .we .caught .a .glimpse .of .ADA .Executive .Director .Dr . .Kathleen .O’Loughlin . .This .floor .also .includes .the .offices .of .the .President .as .well .as .the .Board .room .and .dining .room . .The .tour .lasted .over .one .hour .and .gave .us .a .glimpse .of .the .great .resources .the .American .Dental .Association .has .to .offer .

. I .strongly .recommend .this .visit .next .time .you .are .in .Chicago . .It .is .well .worth .your .time . .

A Fascinating Visit ... continued

4


5

Executive Director

General MeetinG notes:

• . Dr . .Kongkrit .Chaiyasate’s .presentation .at .our .November .19, .2014 .meeting .was .informative, .and .quite .frankly .- .AMAZING! . .The .surgeries .that .he .has .performed .were .documented .in .great .visual .detail .with .many .slides . . .Thank .you .for .sharing .your .incredible .work .with .the .OCDS .membership .

• . Our .March .14, .2014 .speaker .will .be .newly-hired .MDA .Executive .Director .Karen .Burgess . .We .are . .looking .forward .to .welcoming .our .new .E .D .

• . The .May .2014 .meeting .will .be .a .joint .meeting .with .the .Oakland .County .Dental .Hygienists .Society, .and .Dean .McCauley .from .the .University .of .Michigan .School .of .Dentistry .will .address .the .assembly .

• . Women .in .Dentistry .II .: . .The .second .annual .OCDS .“Women .In .Dentistry” .seminar .was .a .big .success, .with .45 .attendees .sharing .Char .Sweeney’s .“Pearls . .of .Wisdom .”

• . 2014 .OCDS .golf .outing--More .information .will .be .available .at .the .January .meeting .and .on .the .website .

• . Officers-Ballots .have .been .received .and .the .results .are .posted .on .page .22 .

PhilosoPhy of life by Dora

My .dear .friend .Harry .Pogats . .and .I .have .been .members .of .the .Lathrup .Village .Lions .club .for .nearly .37 .years . . .In .those .years .we .have .had .many .opportunities .to .share .our .life .thoughts . . .The .greatest .revelations .Harry .and .I .have .shared .were .the .thoughts .of .his .105 .year-old .mother, .Dora .Pogats:

. Dora’s .philosophy .was .not .complicated .or .excessively .esoteric, .but .her .message .was .poignant, .and .I .believe .useful .to .all . .The .basic .tenants .were .as .follows:1 . . . .If .a .problem .can .be .solved .by .money, .it .is .not .a .

REAL .problem . .2 . . . .The .only .REAL .problems .in .life .are .concerning .

health .and . .relationships .3 . . . .Don’t .sweat .the .small .stuff, .and .just .about .

everything .is, .“small .stuff .”

. In .summary, .Dora .was .telling .us .to .work .on .our .relationships, .and .our .health . . .Don’t .spend .our .days .worrying .about .material .issues .of .life . . .Dora’s .philosophy .of .life .must .have .had .some .validity, .as .she .lived .105 .wonderful .years .

Around the Countyby Dr. John Kamar

Mark Your Calendar Board Meetings 2014 dinner Meetings 2014

Tuesday, March 4, 2014Tuesday, May 6, 2014

At OCDS Headquarters

Tuesday, March 11, 2014MDA Executive Director Karen Burgess,

Novi Sheraton Hotel

Tuesday, May 13, 2014Dr. Laurie Mc Cauley, Dean of the University

of Michigan Dental SchoolNovi Sheraton Hotel

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Endodontics

7

Tiffeny Chimelak is an endodontist practicing with Endodontic Associates in Commerce, MI. She teaches at the University of Detroit Mercy School of Dentistry.

. Five .percent .of .injuries .people .seek .consultation .or .treatment .for .are .oral .injuries . .1 .Teeth .are .the .most .common .oral .injury, .followed .by .oral .soft .tissue .injuries, .and .subsequently .by .jaw .fractures .1 . .

. The .highest .risk .for .sustaining .an .oral .injury .is .for .children .under .12 .years .of .age . .2 .One .fourth .of .all .school .children .and .close .to .one .third .of .adults .have .suffered .trauma .to .the .permanent .dentition .2 .Studies .show .the .most .common .dental .trauma .to .permanent .teeth .is . .crown .fractures .and .the .most .common .teeth .injured . .are .the .maxillary .centrals .3 .However, .as .we .know, .serious .trauma .can .affect .any .tooth .at .any .age .

. The .prognosis .of .dental .injuries .often .depends .upon .early .and .correct .emergency .treatment . .A .recent .study .showed .less .than .3% .of .patients .who .experienced .a .dental .trauma .were .seen .within .one .hour .of .the .incident .3 .

. The .International .Association .of .Dental .Traumatology .(IADT) .has .developed .guidelines .for .management .of .traumatic .dental .injuries . .The .purpose .of .the .guidelines .is .to .provide .treatment .recommendations .based .on .the .best .available .evidence . .The .guidelines .were .recently .updated .in .2012 .and .can .be .accessed .on .the .Internet .(www .iadt-dentaltrauma .org) .4 . . . . Other .helpful .tools .created .and .endorsed .by .the .IADT .include .the .Dental .Trauma .Guide (Figure 1) .and .the .Dental .Trauma .First-Aid .App .(Figure 2) . . .The .Dental .Trauma .Guide .is .an .interactive .website .that .provides .dentists .with .guidance .and .information .regarding .different .types .of .dental .injuries .(www .dentaltraumaguide .org) .5 . .This .user-friendly .website .allows .the .dentist .to .develop .an .accurate .diagnosis, .treatment .plan, .and .follow-up .plan, .in .addition .to .identifying .a .risk .estimate .for .healing .complications . . .

Simply .click .on .the .type .of .dental .injury .you .are .treating .and .a .drop .down .menu .will .appear, .including .the .description, .etiology, .diagnosis, .treatment, .and .prognosis . . .By .clicking .on .treatment, .an .interactive .video .will .appear .guiding .you .through .each .step .of .treatment . . .The .Dental .Trauma .First-Aid .App .is .available .at .the .App .Store .and

Dental Trauma: A Review and Case Presentation

by Tiffeny Chimelak, DDS, MS

continued on page 8

Figure 1. The Dental Trauma Guide

Figure 2. Dental Trauma First-Aid App


8

Endodontics

Google .Play .6,7 .The .App .is .designed .to .help .with .dental .emergency .care .at .the .scene .of .the .accident .and .is .a .great .tool .and .reference .for .patients . . .

. Unquestionably, .the .goal .for .treating .all .traumatized . .teeth .is .to .reduce .the .risk .and .extent .of .unfavorable .outcomes . .The .main .goal .for .treating .traumatized .immature .teeth .is .to .preserve .pulp .vitality . .Maintaining .the .vitality .of .immature .teeth .ensures .continued .root .development, .including .further .root .length .and .increased .root .wall .thickness . . Outcomes .such .as .pulp .necrosis, .resorption, .and .tooth .discoloration .may .be .expected .in .some .types .of .trauma . . .In .such .cases, .root .canal .treatment .may .be .recommended .shortly .after .the .incident .to .reduce .the .risk .of .healing .complications . .For .other .cases, .endodontic .treatment .is . .only .indicated .if .there .are .signs .of .necrosis . . . Trauma .to .the .developing .dentition .can .result .in .pulp .necrosis .of .an .immature .tooth, .leading .to .infection .and .discontinued .root .development . .In .these .cases, .large .canals .and .open .apices .present .a .challenge .for .thorough .cleaning, .shaping, .and .obturating . .In .addition, .immature .teeth .with .short .roots .and .thin .root .walls .are .at .an .increased .risk .for .fracture .8

Different .approaches .for .treating .the .immature .tooth .with .pulp .necrosis .include .apexification .and .regeneration . . .Apexification .is .defined .as .“a .method .to .induce .a .calcified .barrier .in .a .root .with .an .open .apex .for .the .continued .apical .development .of .an .immature .root .in .teeth .with .pulp .necrosis .”9 .Such .techniques .include .the .traditional .use .of .long-term .calcium .hydroxide .placement .or .more .recently .the .use .of .mineral .trioxide .aggregate .(MTA) .as .an .apical .barrier . . . .Apexification, .by .either .calcium .hydroxide .or .MTA, .heals .apical .periodontitis, .but .does .not .promote .continued .root .development .and .immature .teeth .remain .at .risk .for .cervical .root .fractures .10

Regenerative .endodontics .is .“biologically-based .procedures .designed .to .physiologically .replace .damaged .tooth .structures, .including .dentin .and .root .structures, .as .well .as .cells .of .the .pulp-dentin .complex .”9 . .Although .there .are .various .methods .of .regenerative .endodontic .treatment, .those .involving .immature .teeth .with .necrotic .pulps .commonly .involve .minimum .instrumentation, .placement . .of .an .intracanal .medicament, .creation .of .a .blood .clot, .and . .an .effective .coronal .seal . . . .

. Regenerative .endodontic .treatment .has .the .potential .to .heal .apical .periodontitis, .regenerate .pulp .function, .and .subsequently .promote .further .root .growth .11 .Such .treatment .should .increase .the .probability .of .retaining .the .tooth .

. The .following .case .describes .an .immature .tooth .with .pulp .necrosis .due .to .trauma . .The .treatment .techniques .used .were .based .on .the .American .Association .of .Endodontists .Clinical .Considerations .for .Regenerative .Procedures .12

. A .6-year .old .female .presented .to .our .office .for .evaluation .and .treatment .of .tooth .#9 . .The .patient .experienced .trauma .three .months .prior, .which .resulted .in .uncomplicated .crown .fractures .of .teeth .#8 .and .9 . .According .to .the .patient’s .mother, .the .general .dentist .initially .placed .bonded .fillings, .but .her .child .had .fallen .again .and .re-chipped .both .teeth . . .Upon .initial .exam, .teeth .#7, .8, .and .10 .tested .negative .to .palpation, .percussion, .bite, .and .mobility, .and .exhibited . .a .positive .non-lingering .cold .response . .Tooth .#9 .tested .positive .to .palpation .and .percussion .and .negative .to .bite, .mobility, .and .cold . . .A .sinus .tract .associated . .with .tooth .#9 .was .also .noted . . .Radiographic .findings .showed .tooth .#9 .had .a .more .open .apex .compared .to .tooth .#8 .(Figure 3) . .Tooth .#9 .had .a .diagnosis .of .pulp .necrosis .with .chronic .apical .abscess, .and .pulp .regeneration .was .recommended . . .

Dental Trauma ... continued

Figure 3.Preoperative radiograph

Figure 4.Calcium hydroxide and Cavit


. The .patient .will .return .for .future .follow-up .exam .and .x-rays .in .6 .and .12 .months . . .Continued .healing .and .root .development .is .anticipated .

. Traumatic .dental .injuries .are .common . . .It .is .important .that .the .dentist .understands .what .procedures .are .necessary .to .ensure .the .most .favorable .outcome . .REFERENCES . 1 . . P .etersson .EE, .Andersson .L, .Sörensen .S . .Traumatic .oral .vs .non-

oral .injuries . .Swed .Dent .J . .1997;21(1-2):55-68 . . 2 . . .Glendor .U . .Epidemiology .of .traumatic .dental .injuries--a .

12-year .review .of .the .literature . .Dent .Traumatol . .2008 .Dec;24(6):603-11 . .doi: .10 .1111/j .1600-9657 .2008 .00696 .x . .Review . .PubMed .PMID: .19021651 . .

. 3 . . .Atabek .D, .Alaçam .A, .Aydintuğ .I, .Konakoğlu .G . .A .retrospective .study .of .traumatic .dental .injuries . .Dent .Traumatol . .2013 .Jul .9 . .

4 . . .International .Association .of .Dental .Traumatology . .www .iadt-dentaltrauma .org .

5 . . . . The .Dental .Trauma .Guide . . .www .dentaltraumaguide .org6 . . .Dental .Trauma .First-Aid .App .available .at .Google .Play .

https://play .google .com/store/apps/details?id=com .dentaltrauma&hl=en

7 . . .Dental .Trauma .First-Aid .App .available .at .the .App .Store .https://itunes .apple .com/us/app/dental-trauma/id527527459?mt=8

8 . . .Cvek .M . .Prognosis .of .luxated .non-vital .maxillary .incisors .treated .with .calcium .hydroxide .and .filled .with .gutta-percha . .A .retrospective .clinical .study . .Endod .Dent .Traumatol . .1992 .Apr;8(2):45-55 . .

9 . . .American .Association .of .Endodontists . . .Glossary .of .endodontic .terms . .http://www .nxtbook .com/nxtbooks/aae/endodonticglossary/index .php

. 10 . . .Jeeruphan .T, .Jantarat .J, .Yanpiset .K, .Suwannapan .L, .Khewsawai .P, .Hargreaves .KM . .Mahidol .study .1: .comparison .of .radiographic .and .survival .outcomes .of .immature .teeth .treated .with .either .regenerative .endodontic .or .apexification .methods: .a .retrospective .study . .J .Endod . .2012 .Oct;38(10):1330-6

. 11 . . .Hargreaves .KM, .Diogenes .A, .Teixeira .FB . .Treatment .options: .biological .basis .of .regenerative .endodontic .procedures . .J .Endod . .2013 .Mar;39(3 .Suppl):S30-43 . .

. 12 . . .American .Association .of .Endodontists . . .AAE .Clinical .Considerations .for .Regenerative .Endodontics . .http://www .aae .org/regenerativeendo/

9

The .tooth .was .anesthetized .using .4% .Articaine .with .1:100,000 .epinephrine .and .rubber .dam .isolation .was .placed . .The .tooth .was .irrigated .with .1 .5% .NaOCl, .followed .by .saline, .using .the .EndoVac .irrigation .system . .The .canal .was .dried, .calcium .hydroxide .was .placed .as .an .antimicrobial .medicament, .and .the .access .was .sealed .with .Cavit .(Figure 4) . .One .month .later, .the .patient .returned .for .her .second .appointment . .She .presented .with .slight .sensitivity .to .palpation .but .no .sinus .tract . . .Due .to .the .persistent .symptoms, .the .tooth .was .treated .similarly .to .the .previous .visit .and .the .patient .was .advised .to .return . .in .four .weeks . . .

The .patient .returned .with .no .signs .or .symptoms .of .infection . .The .tooth .was .anesthetized .using .3% .mepivicaine .without .vasoconstrictor .and .isolated .with .rubber .dam . .The .tooth .was .gently .irrigated .with .17% .

EDTA .and .dried .with .paper .points . . .In .an .attempt .to .create .bleeding .into .the .canal, .the .tooth .was .over-instrumented .using .a .file .2 .mm .beyond .the .apex . . .Although .the .goal .is .to .fill .the .entire .canal .with .blood . .to .the .level .of .the .CEJ, .only .half .of .the .canal .filled .in .this .case . . .Collacote, .a .resorbable .matrix, .was .placed .followed .by .white .ProRoot .MTA . .A .glass .ionomer, .Geristore, .was .placed .atop .the .MTA .and .light-cured .(Figure 5) . . .The .patient .returned .for .a .three-month .follow-up .appointment . .Tooth .#9 .tested .negative .to .palpation, .percussion, .bite, .and .mobility . . .Although .there .has . .been .little .change .on .the .radiograph, .tooth .#9 .now . .tests .positive .to .cold .(Figure 6).

Figure 5.Postoperative radiograph with MTA and Geristore

Figure 6.3-month follow-up

radiograph

Endodontics


10

. .Oakland .County .Dental .Society .held .its .second .annual .Women . .

in .Dentistry .Seminar, .October .24 .at .Maggiano’s .in .Troy . .Our .guest .speaker .was .Char .Sweeney . .She .is .a .wife, .mother, .tennis .coach . .and .former .chair .side .assistant; .and .is .married .to .Dr . .Dale .Sweeney, . .a .periodontist .in .Port .Huron .

Char .is .a .graduate .of .the .Dale .Carnegie .Institute .and .is .affiliated .with .Miles .Global, .a .highly .successful .dental .consulting .company . . .

That .was .all .the .advertisement .needed .to .gain .the .interest .of .45 .women .dentists .from .Oakland, .Macomb .and .Wayne .counties . .She .captured .our .attention .the .moment .she .began . .Her .delivery .was .polished, powerful .and .pertinent .to .the .needs .of .women .dentists .

Char .spoke .to .the .attendees .about .managing .a .dental .team .using .strategies .to .effectively .communicate .with .and .motivate .the .team . .She .offered .solutions .on .how .to .resolve .staff .conflict .and .how .they .could .be .good .team .players, .which .ultimately .leads .to .patient .satisfaction . .and .excellence .in .dental .care .

Char’s .experience .and .enthusiasm .for .dentistry .as .well .as .her .love .for .people .was .obvious . .She .emphasized .the .benefits .women .dentists .receive .when .they .support .each .other .

How .to .find .the .right .balance .between .career .and .personal .life .was .another .topic .that .held .everyone’s .attention . .This .was .a .very .worthwhile .evening .for .all .of .us .

“Women in Dentistry” SeminarBy Lynne Moseley, DDS

Speaker Char Sweeney, and Drs. Lynne Moseley and Julie Fattore

Drs. Stephanie Strange, Jennifer Murri, Jenna Prano and Dorothy Ramos

Drs. Niyali Patel-Parekh, Amanda Sheehan and Tiffeny Chimelak

Drs. Darcianne Miller and Johnna Daniels

Drs. Nahia Wadie Salem and Nidaa Abdal

Drs. Francine Greenfield, Carolyn John and Veronica Ng

Back row: Drs. Leslie Orzech and Bridget Miller Front row:

Drs. Katie Murphy and Nicole Meadows

Feature


. In .the .fifties .and .sixties .people .often .said .to .me, .“You .are .the .first .woman .dentist .I’ve .ever .met .” . .My .answer .was .always, .“You .should .meet .my .mother-in-law .”

Dr . .Marie .Euler .Schoenfeld .and .her .husband, .Dr . .Eric, .received .their .dental .degrees .in .the .early .nineteen .twenties .from .the .University .of .Wurtzburg .in .Germany . . .This .was .a .time .of .rampant .inflation .and .they .realized .developing .a .dental .practice .in .Germany .would .be .impossible . . . Leaving .their .families, .the .couple .immigrated .in .1924 .to .America .and .settled .in .Detroit . . .In .those .days, .to . .obtain .a .dental .license, .dentists .from .foreign .universities .were .required .to .study .one .year .at .an .American .dental .university . . .In .1925, .Eric .graduated .from .the .University .of .Michigan .School . .of .Dentistry .and .began .a .practice .in .Detroit . . .Ten .years .later, .when .their .son .was .five .years .old, .the .family .moved . .to .Ann .Arbor .so .Marie .could .take . .the .year .of .training .and .earn .her .dental .degree . . .There .were .four .women .in .her .graduating .class .(1934) . .

. Years .later .at .a .dental .meeting, .I .asked . .Dr . .Darl .Ostrander, .who .was .one .of .Marie’s .classmates, .if .he .remembered .her . . .“Yes,” .he .said . . .He .then .volunteered, .“I .remember .she .was .a .very .good .student .” .Dr . .Ostrander .was .professor .of .endodontics .and .pharmacology .at .Uof .M, .and .later .became .President .of .the .American .Dental .Association .

. While .building .a .practice, .Marie .was .on .the .staff .at .Grace .Hospital .in .Detroit .one .day .a .week, .and . .treated .indigent .patients .in .the .outpatient .clinic . .After .three .years, .she .became .proficient .in .handling .

emergency .dentistry, .which .included .extractions . .

. . From .the .thirties .to .fifties . .there .were .only .a .handful .of .women .dentists .in .the .metropolitan .Detroit .area . .Many .male .dentists .were .biased .against . .them . .One . .time .Marie .referred .a .difficult .case .to .a .local .oral .surgeon . .He .called .her .later .and .criticized .her .abilities .as .a .dentist . .She .told .me .about .the .incident .and .I .knew .she .was .upset . .Then .speaking .more .to .herself .than .me, .she .said .firmly, .“I .know .my . .own .worth .” . . . In .her .operatory, .attached .

to .their .home, .I .often .observed .Marie .at .work . .Her .hands .were .steady .and .deliberate . . .Her .voice, .low .yet .firm, .her .manner, .quiet . . .She .rarely .had .trouble .getting .a .centric .bite . .Men .as .well .as .women .felt .secure .under .her .care . .Once .she .said, .“Teenagers .talk .to .me .a .lot . . .They .tell .me .all .kinds .of .things .” . .When .I .questioned .her .about .this, .she .shot .back, .“Why, .because .I .am .interested .in .them, .of .course .” .

. Her .fine .hand .dexterity .extended .from .dentistry . .to .all .varieties .of .needlepoint, .crochet .and .knitting . .She .was .also .an .excellent .cook, .and .most .of .my .cooking .skills .developed .under .her .tutelage . . .In .addition .to .German, .she .was .fluent .in .French .and .English, .and .once .she .opened .a .book, .she .often .finished .it .that .day .

. It .was .comforting .to .have .a .friend .who .understood .my .struggle .to .balance .home, .children, .and .patients . .After .four .years .of .being .the .only .woman .in .a .class .of .95 .students, .I .had .found .a .kindred .soul .

Feature

11

Dr. Marie Schoenfeld and Me. circa 1980

My Mother-in-Law: Mentor and Friend

by Franziska Schoenfeld, DDS

Continued on page 12


12

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Marie .loved .her .profession, .her .husband, .her .son, .and .me . . .When .her .eighty-year .old .husband’s .arthritis .forced .him .to .retire, .it .was .her .cue .to . .step .away . .She .was .seventy-five .

Today, .women .dentists .flock .to .Oakland .County .Dental .Society .meetings . .They .write .articles .for .the .Dental .Review, .take .leadership .roles .in .our .Society, .the .Michigan .Dental .Association .and .at .the .national .level . .They .recently .sponsored .their .second .annual .women .in .dentistry .seminar . .Though .their .struggles .to .balance .home .and .career .remain, .they .have .each .other .for .support .

If .Marie .were .alive .today, .she .would .be . .proud .of .this .new .generation .of .women .dentists . . .I .certainly .am . .

My Mother-In-Law... continued

Morris Rubin, DDS Died: October 25, 2011

West Bloomfield, MichiganAge 86

Robert Preston, DDS Died: July 24, 2005

Minneapolis, MinnesotaAge 85

Donald Ambrose, DDS Died: August 20, 2013

Bloomfield Hills, MichiganAge 81

David J. Schwartz, DDS Died: Dec. 17, 2013

West Bloomfield, MichiganAge 76

In Memoriam


ALWAYS putting your patients first

www.Profendo.com

www.ProfEndo.comwww.ProfEndo.com

When an endodontic referral is best for your patient, we provide them an experience that will enhance their relationship with your office.

EXCEEDING STANDARDS FOR OVER 50 YEARS BY

Our doctors and staff make it easy for you to confidently refer your

patients to our offices. We are a completely digital office, offering

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their patient reports. At Professional Endodontics we go out of our

way to ensure we have a safe, relaxed environment that your

patients will appreciate.

Southfield29201 TelegraphSuite 110Southfield, MI(248) 358-2910

Clinton Township16151 19 Mile Road Suite 101Clinton Township, MI(586) 286-7000

St. Clair Shores23829 Little Mack Ave Suite 300 St Clair Shores, MI(586) 779-9690

Dr. Dominick Shoha Dr. Louis Shoha Dr. Jeffery Marderosian Dr. Steve Shoha

Dr. Gabrielle NooryDr. Andrew Schoelch Dr. Eric RichardsonDr. Vajra Bentur

Dr. Gabrielle NooryLicense #s

2901014745, 2901015908, 2901016218, 2901018575,

2901020134, 2901019680, 2901016091

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14

Save the Dateand Reserve Early!

Oakland County Dental Society Golf Outing

Friday, May 30, 2014Oakland Hills Country Club

At the newly re-designed North course

9:00 am shotgun start Barbeque lunch to follow

$200 per player Executive Director Dr. John Kamar

Email: [email protected] Phone: (248) 540-9333


In .2012 .the .American .Dental .Association .commissioned .a .study .to .analyze .the .key .forces .affecting .dentistry .currently .and .to .help .determine .the .strategic .planning .for .the .Association .and .its .members . .The .study .focused .on .critical .issues .affecting .the .profession . .On .an .individual .basis, .the .study .is .important .to .dentists .since .it .can .give .them .insight .as .how .to .examine .their .practices .currently, .and .what .changes .will .be .necessary .to .accommodate .the .changing .economic .landscape .of .the .future .

One .key .issue .that .the .study .determined .is .that .the .dental .economy .is .in .transition, .and .after .decades .of .growth, .dental .expenditures .have .flattened . .Not .surprisingly .for .most .practitioners, .dental .spending .began .to .slow .in .early .2000 . .From .1990-2002, .dental .expenditures .grew .an .average .of .4 .percent .per .year . . .That .rate .decreased .to .just .below .2 .percent .between .2008 .and .2011 . .Between .2008 .and .2011, .the .average .growth .rate .declined .by .0 .3 .percent . .Also, .the .study .indicates .that .dental .spending .suffered .a .larger .slowdown .than .health .care .spending .

There .has .been .a .decline .in .utilization, .which .was .not .offset .by .increases .in .per-patient .expenditures . . .“Since .2008, .per-patient .expenditures .were .flat, .contributing .to .the .slowdown .in .national .dental .expenditures .” .The .study .also .indicated .there .is .evidence .that .private .insurers .are .reducing .payment .rates .and .both .private .insurers .and .public .programs .will .continue .to .reduce .payments . .While .private-pay .patients .pay .more .than .insurers .or .public .programs, .this .will .not .affect .dental .payments .and .it .is .unlikely .there .will .be .a .rebound .to .earlier .levels .for .dental .expenditures .

The .study .examined .dental .care .utilization .for .various .subgroups .of .the .population .over .the .past .

decade . .It .found .that .dental .care .for .children .increased .more .than .9 .percent .in .the .last .decade . . .This .increase .was .“…driven .entirely .by .low-income .children . .Children .below .the .poverty .line .experienced .a .38 .percent .increase .in .dental .care .utilization .… .by .contrast, .utilization .rates .among .higher .income .children .were .relatively .unchanged .” .Utilization .rates .for .adults .peaked .in .2002-2003 .before .declining .10 .percent .over .the .remaining .part .of .the .decade . .This .decline .was .more .pronounced .for .younger .adults .(ages .19-34) . .Among .seniors .the .utilization .rate .remained .steady . . .Finally, .the .study .found .that .high .income .adults .showed .a .6 .percent .decline .in .utilization .

. Another .area .that .was .examined .by .the .commission .was .population .demographics . .The .study .found .that: . 1 . . .Per .patient .expenditures .were .relatively .flat .

over .the .last .decade .among .children .and .working .age .adults . .Seniors .have .the .highest .per .patient .expenditures .of .any .age .group .

. 2 . . .Per .capita .expenditures .are .expected .to .grow .over .the .coming .decades, .but .at .a .very .slow .rate . . .Projected .growth .rates .range .from .0 .22 .percent .to .1 .25 .percent .over .the .next .decade, .compared .to .3 .9 .percent .between .1996 .and .2002 .

. 3 . . .Older .Americans .are .expected .to .account .for .a .growing .share .of .dental .expenditures .in .the .next .decade .

. 4 . . .Growing .racial .and .ethnic .diversity .will .affect .dental .utilization . . .Minorities .are .less .likely .to .use .dental .care .than .whites . . .From .2000 .to .2050, .the .percentage .of .white .population .is .projected .to .drop .from .81 .percent .to .74 .percent .

15

ADA Study

A Study in the Evolution of Dentistry

by Dr. Nicholas A. Fontana



. The .study .concludes .that”… .the .growing .number .of .adults .without .benefits, .the .growth .of .public .financing .at .the .expense .of .private .insurance, .and . .the .increase .in .diversity .of .the .population, .all .point . .to .very .slow .growth .of .expenditures .during .the .coming .decades .” . Consumerism .will .become .prevalent .in .the .future . . .Patients .are .no .longer .passive .in .their .approach .to .health .care .and .want .to .become .knowledgeable .about .their .treatment . .They .expect .the .health .care .provider .to .inform, .and .not .depend .on .auxiliaries .to .explain .treatment . .They .also .expect .alternatives .to .treatment .and/or .no .treatment . .Active .consumers, .while .having .a .casual .attitude .toward .health .care, .are .more .likely .to .utilize .technology .and .shop .for .better .prices . .Dental .patients .who .will .pay .greater .out-of-pocket .expenses, .and .lack .dental .insurance, .will .have .a .tendency .to .shop .prices . . An .increase .in .the .number .of .dental .schools .and .an .increase .in .enrollment .will .have .a .definite .impact .on .manpower .issues .confronting .the .profession .in .the .future . .There .has .been .a .perceived .shortage .of .dentists .by .dental .schools .and .an .increased .demand .for .dental .education . .While .the .supply .of .dentists .remained .stable .for .the .past .few .decades, .the .profile .of .dentists .has .changed . .Female .and .older .dentists .account .for .a .larger .share .of .the .supply . .Over .the .past .two .years .the .number .of .dentists .has .increased . .(In .Michigan .the .supply .has .increased .by .about .3 .dentists .per .year .from .2000 .to .2011) . . .

. The .result .of .increased .numbers .of .dentists, .coupled .with .a .decrease .in .demand .for .dental .care, .measured .as .dental .spending .per .capita, .has .resulted .in .a .significant .decrease .in .dentist .net .income . .In .Michigan, .net .average .income .for .dentists .has .decreased .from .about .230,000 .dollars .in .2006 .to .about .170,000 .dollars .in .2011 . . .The .study .indicates .that .despite .expanded .dental .school .capacity, .the .future .labor .supply .of .dentists .is .subject .to .uncertainty . . .However, .with .major .increases .in .efficiency, .dental .care .delivery .systems, .advances .in .technology, .larger .dental .care .organizations, .and .incorporation .of .health .care .organizations, .fewer .dentists .may .be .required .to .deliver .the .same .amount .of .dental .care .to .the .

population . . .Further, .“…given .the .dental .economy .is .to .remain .sluggish, .any .further .major .ramping .up .of .supply .of .dentists .could .potentially .have .negative .effects .on .dental .earnings .”

. What .impact .will .the .rising .cost .of .dental .education .have .on .the .profession .is .a .question .that .may .have .significant .impact .on .the .practice .of .dentistry . .The .debt-to-income .ratio .in .1990 .was .76 .percent .for .graduates .from .private .institutions .and .46 .percent .for .public .institutions . .By .2011, .the .ratio .increased .to .119 .percent .for .private .and .90 .percent . .for .public .dental .schools . .The .average .interest .rate . .on .a .student .loan .is .approximately .8 .percent . .

. With .decreased .demand .for .dental .services, .decreased .net .income .for .practicing .dentists .and .increases .in .the .ages .of .practicing .dentists, .the .question .is, .will .new .graduates .be .faced .with .career .choices .fundamentally .based .on .positions .which . .meet .their .financial .needs .rather .than .their .ethical . .or .value .requirements? . .The .study .found .that .“ .…90 .percent .of .younger .dentists .are .experiencing .stress .over .educational .debt .and .more .than .60 . .percent .describe .their .stress .as .‘a .lot’ .or .‘extreme .’”

. Finally, .the .study .examined .changing .dental . .care .delivery .models . .It .found .that .multi-site .practices .are .small .but .are .a .growing .segment .of .dentistry . .The .largest .numbers .of .dentists .working .in .these .facilities .are .35 .years .old .and .younger, .followed .by .65 .and .older . .It .would .appear .that .the .expansion .of .group .practices .is .occurring .due .to .economies .of .scale .and .the .ability .to .serve .multiple .locations .within .a .community .

. In .reading .the .report .it .becomes .evident .that .the .profession .of .dentistry .is .truly .in .a .transition .and .the .future .will .bring .many .changes .in .the .traditional .delivery .of .dental .care . .Changing .demographics, . .a .flat .growth .rate .for .dental .care, .increased .numbers .of .graduates .burdened .with .staggering .debt, .and .fewer .dentists .retiring, .will .result .in .dentists’ .income .decreasing . .The .old .adage .of .dentistry .being .a .cottage .industry .will .probably .change .in .the .future . .Pressure .is .growing .for .an .expanded .dental .team .integrated .within .a .“patient .centered .medical .team .” .


16


As .the .2014 .MDA .annual .meeting .is .quickly .approaching, .many .questions .have .come .up .from .members .here .in .Oakland .County, .particularly .about .the .governance .changes .that .were .approved .by .the .special .MDA .House .of .Delegates .last .September . .Since .then, .the .MDA’s .Governance .Work .Group .(of .which .I .am .a .member) .has .gathered .all .input .from .our .membership .and .drafted .a .comprehensive .set .of .bylaws .changes . .These .bylaws .revisions .will .need .to .be .approved .by .this .April’s .MDA .House .of .Delegates .in .order .to .implement .the .governance .proposals .approved .last .September .

You .may .be .aware .that, .under .the .new .governance .system .the .House .of .Delegates .will .elect .the .Board .of .Trustees . .The .size .of .the .board .will .be .reduced, .and .trustees .will .be .elected .from .a .pool .of .statewide .candidates, .to .be .determined .by .a .new .House .nominating .committee .(see .sidebar) .

Two .areas .of .greatest .member .concern .have .been .the .nominating .committee .guidelines .and .exactly .how .the .Board .of .Trustees .will .be .reduced .in .size . .

To .address .the .first .issue, .the .MDA .Board .of .Trustees .is .requesting .names .of .nominees .to .the .initial .nominating .committee .for .each .region .to .be .submitted .be .June .15, .2014 . .This .date .was .set .so .that .all .names .submitted .could .be .approved .by .the .MDA .Board .at .its .June .meeting . .The .nominating .committee .will .be .a .committee .of .the .House .of .Delegates .and .will .be .funded .by .the .House .of .Delegates .budget . .It .is .hoped .that .this .committee .can .do .its .work .electronically, .with .one .or .two .in-person .meetings . .The .Nominating .Committee .will .be .looking .for .individuals .who .are .scanners .and .planners . .It .will .review .the .skill .sets .needed .to .make .the .MDA .Board .complete . .It .will . .also .make .an .effort .to .insure .regional .diversity .

. To .reduce .the .size .of .the .board, .the .number .of .trustee .positions .will .be .cut .from .17 .to .nine . .Board .reduction .will .be .accomplished .by .not .filling .upcoming .vacancies .when .trustee .terms .expire . .Current .trustees .will .continue .to .serve .on .the .board .in .2014 . .Next .year, .any .remaining .trustees, .if .interested, .would .apply, .along .with .any .interested .members, .to .the .nominating .committee .for .the .nine .positions .to .take .effect .in .2015 . .

. The .2015 .board, .and .all .future .boards, .will .be .elected .by .the .House .of .Delegates . .This .responsibility .is .a .great .opportunity .for .the .House .to .have .a .greater .involvement .and .say .in .the .choosing of .the .Board .of .Trustees . .The .membership .should .feel .a .much .greater .sense .of .ownership .and .input .into .the .make-up .of .the .board, .but .also .with .its .recommendations, .with .a .stronger .voice .in .the .direction .the .board .pursues . .The .delegates .to .the .House .should .take .great .pride .in .this .new .opportunity .to .shape .the .board .as .they .see .best .to .serve .their .needs . .We .all .want .what .is .best .for .Michigan .dentists . .

. Our .Oakland .County .delegates .can .stay .updated .by .reading .the .online .Delegate .Digest .newsletter .from .Speaker .of .the .House .Deb .Peters . .She .is .doing .a .wonderful .job .of .keeping .our .House .members .informed . .If .you .are .a .delegate, .please .take .the .time .to .read .her .updates, .as .they .will .contain .the .most .recent .and .informative .news . .If .any .member .who .is .not .a .delegate .would .like .to .see .a .copy .of .the .Delegate .Digest, .or .would .like .any .additional .information .on .the .governance .issue, .please .feel .free .to .contact .me .or .contact .the .MDA . .

17

Trustee Report

Update on MDA Governance Changes

by Dr. Robert Tremblay



Members In the News

18

Right: Members of the OCDS at the MDA Trustee’s Holiday Reception with new Excutive Director Karen Burgess. L-R: Drs. John Kamar, Larry DeGroat, MDA Executive Director Karen Burgess, Bob Tremblay, Steven Gustafson, Shari Morningstar, Nick Fontana.

Members In the News

Winter 2012

Ninth District Trustee Gary E. Jeffers, D.M.D.

Dr . .Jeffers .will .serve .on .the .ADA .Board .of .Trustees .as .the .trustee .from .the .Ninth .District, .which .encompasses .the .states .of .Michigan .and .Wisconsin .

Dr . .Jeffers .earned .his .dental .degree .at .the .University .of .Pittsburgh .School .of .Dental . Medicine . and . certificates . in . oral . and . maxillofacial . surgery . and .anesthesiology . at . Emory . University . Schools . of . Dentistry/Medicine . in .Atlanta . .He .is .the .director .of .Dental .Admissions .at .the .University .of .Detroit .Mercy .School .of .Dentistry . .

Dr. Craig Duhaime received . his . Certified .Dental . Editors . recognition . during . the . American .Association .of .Dental .Editor’s .meeting .in .New .Orleans .in .October .2013 .after .satisfying .all .the .requirements .for .certification . .He .is .currently .completing .his .fourth .year .as .editor .of .the .Oakland County Dental Review.


. The .first .annual .Oral .Cancer .screening .event .was .a .great .success . .

. Special .thanks .to .all .of .those . .involved .from .Mclaren .Oakland .Hospital: .Kate .Schumaker, .Raquel .Gumma, .and .Cheryl .Hubbard . .I .also . .want .to .thank .the .Oakland .County .Dental .Society .Doctors: .Dr . .Amanda .Boltwood .and .Dr . .Sarah .Najor, .for .their .time .and .efforts . .

. We .had .a .great .turnout .with .multiple .patients .needing .additional .treatment . .Without .our .efforts, .many .of .these .patients .would .have .a .difficult .time .accessing .these .health .benefits . .We .plan .on .making .this .an .annual .event .and .expanding .our .community .services .in .the .years .to .come .

. As .always, .we .continued .our .educational .component . .with .a .great .lecture .on .early .orthodontic .protocols .given .by .Dr . .Andrew .DeHaan .and .Dr . .Christian .Groth . .Both .events .had .a .great .turnout .as .usual .and .we .appreciate .the .support .of .the .young .dentist .at .our .meetings . .If .you .would .like .more .information .about .the .Young .Dentist .Society .please .contact .me .at [email protected] .

Young Dentists

19

Young Dentists on the Move

by Dr. Marvin Jabero

Drs. Christian Groth, Andrew DeHaan, Marvin Jabero, and Steven Gustafson

Drs. Sabrina Shaouni, Nick Fontana, Shelly Kitain, Marvin Jabero and Larry DeGroat

Drs. Marvin Jabero, Amanda Boltwoodand Sarah Najor

Upcoming Young Dentist Events

February 19Financial lecture - Centennial Group

March TBA Lecture with Dr. Larry DeGroat

April 23Advanced Prosthodontic - Dr. Lisa Kane

MaySocial event TBA


20

Dinner Meeting

OCDS November Dinner Meeting photos by Bonnie

Oakland . County . Dental . Society . held . its . dinner .meeting .on .November .19, .2013 .at .the .Centerpoint .Marriott .in .Pontiac . . .The .speaker .was .Dr . .Kongrit .Chaiyasate . and . his . topic . was . Advancements in Oral-Maxillo-Facial Surgery.

Above: Dr. Francine Greenfield with her assistant Maria Chodubski, RDA and Dr. Jennifer Wiens Priebe

Above: Drs. Walter Kubinski, Craig Wernette and John Warr

Above: Drs. Larry DeGroat, Nick Fontana, Robert Tremblay, Russell BowmanIn background: Drs. Larry Palmer, Larry Duffield and James Nowicki

Above: Drs. Kongkrit Chaiyasate (guest speaker), Steve Gustafson (President), Will Thompson and Paul Renke

Above: Drs. John Gaul, Craig Spangler and Nick Fontana


Above: Drs. Amanda Boltwood and Sarah Najor

21

Dinner Meeting

Above: Drs. Amanda Boltwood and

Above: Drs. David Banda and Jim Hoste

Above: Drs. Aaron Pokorny and James Hunter

Above: Drs. Aaron Pokorny

Above: Drs. Jennifer Wiens Priebe and Bruce Kennedy

Above: Drs. Jennifer Wiens Priebe

Above: Drs. Brian McLean, Joe Robertson, Kenneth Bonk, Walter Kubinski and Bruce Kennedy

Above: Drs. James David, David McChesney, David Backus and Jared Moberg (UDM Dental Student)

Above: Drs. Ray Flajole, Paul Renke, Larry Palmer and Laris Stumpos

Winter 2014 • Oakland County Dental Society • Dental Review Winter 2014 • Oakland County Dental Society • Dental Review

. . .• .In .2012, .the .American .Academy .of .Orthopaedic .Surgeons .(AAOS) .and .the .American .Dental .Association .(ADA) .found .no .direct .evidence .that .dental .procedures .cause .prosthetic .joint .infections .

. .• . .Infective .endocarditis, .one .of .the .most .morbid .distant .site .infections, .has .rarely .been .linked .to .oral .disease .(in .2003 .there .were .less .than .150 .cases .documented .to .date .with .an .incidence .of .nearly .11,500 .cases .annually) . . .The .majority .of .cases .are .caused .by .common .staphylococci . . .

. .• . .Extraction .of .infected .teeth .or .previously .treated .teeth .has .failed .to .decrease .the .severity .of .or .eradicate .systemic .disease .

. .• . .Restoring .health .and .function .to .teeth .helps .maintain .nutrition .which .helps .maintain .overall .systemic .health . .“Endodontic .treatment .is .a .safe, .successful .path .to .continued .good .health .”

. The .Internet .takes .no .stand .on .the .truth .and .background .of .its .listings . . .It .allows .for .the .rapid .and .irresponsible .delivery .of .misinformation .regarding .oral .health . . .Sadly, .extreme .messages .can .cause .those .who .have .minimal .science .background .to .believe .claims .that .lack .true .scientific .merit . . .Our .patients .aren’t .aware .of .the .levels .of .evidence .and .how .crucial .this .distinction .is .in .making .scientific .claims . . .Consequently, .radical .beliefs .based .on .epidemiologic .studies .(one .of .the .lowest .levels .of .evidence), .can .create .a .lot .of .unnecessary .fear ./ .anxiety . . . . While .most .of .us .don’t .subscribe .to .the .notion .that .sound .endodontically .treated .teeth .contribute .to .focal .infection, .one .day .a .colleague .or .patient .of .yours .might .be .the .victim .of .a .“focal .flashback” .after .talking .to .a .relative, .friend, .or .simply .checking .their .email . . . . As .evidence .based .health .care .professionals, .it .is .incumbent .upon .us .to .provide .our .patients .with .the .most .current, .scientifically .proven .information .and .treatment .methods . .Patients .can .then .decide .what .is .best .for .their .overall .health .and .well-being . . . . .References:AAE .Colleagues .for .Excellence: . .Oral .Disease .and .Systemic .Health: .What .is .the .Connection? . .Spring/ .Summer .2000 .

AAE .Fact .Sheet: .Focal .Infection .Theory .https://www .aae .org/uploadedfiles/clinical_resources/guidelines_and_position_statements/focalinfection .pdf

http://www .ada .org/2157 .aspx?currentTab=2

http://www .perio .org/consumer/heart_disease

http://articles .mercola .com/sites/articles/archive/2012/02/18/dangers-of-root-canaled-teeth .aspx

Lockhart .P .B, .Bolger .AF, .Papapanou .PN, .et .al .Periodontal .disease .and .atherosclerotic .vascular .disease: .Does .the .evidence .support .an .independent .association? .A .scientific .statement .from .the .American .Heart .Association . .Circulation .2012; .DOI:10 .1161/CIR .0b013e31825719f3 . . . .Pallasch .TJ, .Wahl .MJ, .Focal .Infection: .New .Age .or .Ancient .History? . .Endodontic .Topics .2003, .4, .32-45

Xiaojing .L, .Kolltveit .KM, .Tronstad .L, .Olsen .I, .Systemic .Diseases .Caused .by .Oral .Infection, .Clin . .Microbiology .Rev . .Oct . .2000, .p . .547-558

22

Focal Flashback ... continued

Congratulations to the new OCDS officers beginning

their terms on May of 2014 (not for the HOD in April)

President Dr. Laris StumposPres. Elect Dr. James NowickiTreasurer Dr. John DeCarolisSecretary Dr. Marvin Jabero Council Dr. Will Thompson Dr. Pat Smith Dr. Andrew DeHaan Dr. Amanda Boltwood Delegates Dr. Larry DeGroat Dr. Nick Fontana Dr. Ken Borovich Dr. Paul Renke Alternates Dr. Francine Greenfield Dr. James Wright Dr. Paul Lange Dr. Jessica Gaul Dr. Angela DeKock Dr. Karen Frank Dr. Shelly Kitain Dr. Dorothy Ramos Dr. Jerek Petrous

Winter 2014 • Oakland County Dental Society • Dental Review Winter 2014 • Oakland County Dental Society • Dental Review

. . . A .patient .centered .medical .team .would .be .similar .to .the .Mayo .or .Cleveland .Clinic .model .in .which .multiple .specialties .(both .medical .and .dental) .practice .within .a .facility . . .The .group .managing .the .practice .could .practice .independently .or .at .the .behest .of .insurance .groups .having .bid .for .patients .

. Payment .for .dental .services .is .shifting .from .commercial .dental .insurance .to .public .coverage .and .personal .out .of .pocket .payments . . .Commercial .dental .plans .are .increasingly .using .more .selective .networks, .demanding .increased .accountability .through .data .and .performance .measures, .and .pressuring .providers .to .reduce .costs . .While .the .Affordable .Care .Act .will .provide .millions .of .children .with .dental .benefits, .these .benefits .will .be .paid .at .considerably .less .than .standard .fees . . .

. The .study .found .these .implications .for .dental .practices: . 1 . . .With .the .increased .demand .for .value .in .dental .

care .spending, .practices .will .need .to .become .more .efficient,

. 2 . . .The .trend .towards .larger, .multi-site .practices .will .continue .to .be .driven .by .dental .plan .pressures .for .smaller .provider .networks, .patterns .of .new .dentists .and .increased .competition .for .patients,

. 3 . . .Health .care .reform .and .Medicaid .expansions .with .an .increasing .emphasis .on .outcome .and .cost-efficiency .will .encourage .alternative .models .of .dental .care .

. The .study .concludes .“this .is .a .critical .moment .for .dentistry .and .not .a .time .for .complacency .… .ignoring .what .is .happening .in .the .health .and .consumer .environments .will .mean .ceding .the .future .of .the .profession .to .others .” . .One .might .add .to .this .summary .that .the .time .for .individual .dentists .to .expect .others .to .take .the .mantle .and .fight .has .ended . . .Individual .dentists .must .evaluate .their .practices .for .now .and .the .future . . .They .must .also .demand .that .organized .dentistry .addresses .their .issues .and .be .proactive .rather .than .reactive . . .As .Sarah .Brown .once .said: .“The .only .one .who .sat .its .way .to .success .was . .a .hen .”

Editor’s Note: A Profession in Transition: Key forces Reshaping the Dental Landscape was a study commissioned by the American Dental Association (copyright 2013 American Dental Association). For more information contact the ADA’s Health Policy Resources Center at [email protected]. The full report is available at www.ada.org/escan.aspx.

23

Study in Evolution of Dentistry... continued

Medical and Dental CPA

Accounting • Income Taxes

Tax Planning • Small Business Taxes

IRS Representation

Dinner Meeting


. Being .a .member .of .the .Governance .Work .Group, .I .have .a .vested .interest .in .the .governance .bylaws .changes .being .presented . .I .believe .with .the .help .of .our .consultant, .Dr . .Michael .Gallery, .and .the .commitment .of .the .House .of .Delegates .members .on .the .committee .we .have .given .our .association .an .opportunity .to .make .major .changes .in .our .governance .structure .-- .changes .that .will .be .beneficial .to .our .organization .now .and .in .the .future . .

. Again, .if .you .have .any .questions .about .these .changes, .please .contact .me . .I .hope .to .answer .all .questions .so .that .our .membership .can .feel .comfortable .with .the .changes .being .proposed .

Contact .Dr . .Tremblay .at .248-543-3834 .or .via .email .at [email protected]

(SIDEBAR)Here .Are .the .MDA .Governance .Changes

The .special .session .of .the .MDA .House .of .Delegates .last .September .approved .proposals .that .will .change .the .way .the .MDA .governs .itself:

. • .the .House .of .Delegates .will .elect .all .the .association’s .officers .and .the .MDA .Board .of .Trustees . .The .new, .smaller .MDA .Board .of .Trustees .will .now .become .the .association’s .official .governing .body;

. • .a .House .nominating .committee .will .be .created .to .select .candidates .for .MDA .officers, .MDA .trustees, .and .delegates/alternates .to .the .ADA .meeting;

. • . .the .secretary .and .treasurer .officer .positions .will .be .combined .and .the .vice-president .position .eliminated;

. . • . .the .number .of .trustee .positions .will .be .reduced .from .17 .to .9 .and .will .be .at-large .positions .nominated .by .the .Nominating .Committee .and .elected .by .the .House;

. • . .the .MDA .Board .of .Trustees .will .become .the .governing .body .of .the .association, .with .the .House .serving .in .an .elective .and .representative .capacity;

. • . .the .House .and .Board .will .have .the .authority . .to .suspend .or .remove .Board .members;

. • . .the .Board .will .have .the .authority .to .form .an .Executive .Committee .as .needed, .to .be .comprised . .of .the .association’s .officers .

. The .MDA .House .in .April .will .vote .on .a .set .of .bylaws .changes .to .implement .the .new .governance .system .

24

Update on Governance ... continued

Hello Oakland County Dental Society members ...

Just a quick note to promote use of the OCDS website. Instructions are included to help you know how to access the web-site.

Remember your login will require your MDA ID number, not your ADA number. We will have dates for future meetings posted, as well as archiving future issues of the OCDS Dental Review. We are also able to post pertinent events, and information that you might want to share with the society members. Please have these informational pieces attached in a “pdf”, as we did with Dr. Foong’s presentation.

Thanks, Dr. John Kamar, E.D., OCDS

Winter 2014 • Oakland County Dental Society • Dental ReviewWinter 2014 • Oakland County Dental Society • Dental Review

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