north texas dentistry volume 1 issue 3

North Texas

Dentistrya business and lifestyle magazine for north texas dentists

MonarchDentalExperiencing Expansionand Growth in North Texas Profiles

Beaird Harris & Co.Dental Logic

Reflections on Radiology Dr. Pete Benson

Southwest DentalConferenceRecharge for a New Year

Know the RulesCurrent Government Initiatives Could Affect You

VOLUME 1 | ISSUE 3

convention issue

Jorge Fernandezcellular (214) 532-5253 [email protected]

Bruce C. Goodhartzcellular (214) 212-8033 [email protected]

(972) 250-1170(972) 250-0905 fax

www.esa-construction.com17806 Davenport, Suite 107 · Dallas, Texas 75252

Building Your Dream Office TodayYour Partner For The Future

ON THE COVER

Monarch DentalExperiencing Expansion and Growth in North Texas

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North Texas

DentistryPRACTICE MARKETING7 Reasons Your Website Needs a Blog

A blog can improve your search engine rankings, drive patients to your

website, and educate them about your services

PROFILEPaula W. Allgood, CPA

Tap into the expertise of a seasoned advisor who specializes in healthcare

BAYLOR COLLEGE OF DENTISTRYDr. Pete Benson is reflecting on the opportunities in radiology that

have led him to fill new roles in leadership

SMILES IN THE SPOTLIGHTA Case Presentation

In a multidisciplinary collaboration, Dr. Deji V. Fashemo puts a dazzling

new smile on a young face

MISSION DENTISTRY EthiopiaSmile Dental Mission Trip

Dr. Moody Alexander describes an inspiring journey that puts the

stresses and cares of this world in perspective

PROFILEJoseph C. Danna, CDT

Building partnerships between dentists and the laboratory

DENTISTRY IN THE FUTUREWhy DMSOs Will Dominate Dentistry in 2020

Gearing up to survive in a changing industry

COMMUNITY NEWS Recharge for a New Year

The 2012 Southwest Dental Conference will re-energize your new year

KNOW THE RULESHow Current Government Initiatives Could Affect You

What you and your staff should be doing to protect your practice

WINE CELLARSparklers for Special Times

Topping off the old year and the new year with a special sparkle

MONEY MATTERSDisability Income InsuranceWhat you need to know to prepare for your financial future

CONSTRUCTION & DESIGNBuilding or Remodeling on Your Horizon?

What to expect, what to look for, and what to ask

PRACTICE MANAGEMENTYou Can Do a “TON” for the New Year to Grow Your Practice

Don’t just wait to see what the future brings – be proactive!

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6 COVER FEATURE: Monarch Dental is

growing and expanding in North Texas.

As part of this expansion, Monarch Dental is

modernizing their centers in North Texas and

upgrading the technology, including the instal-

lation of digital radiography. Monarch Lead

Dentist Dr. Laura Bratcher (pictured) uses

digital images to help patients visualize their

diagnosis and treatment plan.

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www.northtexasdentistry.com | NORTH TEXAS DENTISTRY 3

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North Texas Dentistry is excited to

present the Convention Issue for the

Southwest Dental Conference. We will

strive to continue to bring the latest news

and information to the North Texas dental

community. I hope to see many of you at

the Southwest Dental Conference, January

12-14 at the Dallas Convention Center.

North Texas Dentistry will be in booth

#1308 so stop by to say hello and tell us

about your practice or business.

I believe 2012 will be a fascinating one for

readers of North Texas Dentistry. In

addition to our great cover features and

compelling editorial, The Special Issue for

2012 will be The Ultimate Dental

Practice. This Special Issue will showcase

all facets to developing the “ideal prac-

tice”… including design and building, den-

tal equipment, computer technology and

software, practice and personnel manage-

ment, specialty equipment and more. If

your business sells to or services the dental

practice, you NEED to be part of this issue.

For this issue’s cover story North Texas

Dentistry features the group dental prac-

tices of Monarch Dental. We examine

Monarch Dental and their expansion into

new locations and updating technology in

their centers.

This issue is packed with lots of great

editorials and information. The North

Texas Dentistry Custom Profile

presents Joseph Danna, CDT of Dental

Logic and Paula W. Allgood, CPA of

Beaird Harris & Co., Beaird Harris

Wealth Management, Inc.

Dr. Moody Alexander shares his experi-

ences with Ethiopia Smile Dental Mission

and this issue’s Smiles in the Spotlight

features an interesting orthodontic case by

Dr. Deji V. Fashemo. Enjoy these articles

and much more!

Don’t miss the Southwest Dental Con-

ference information inside this issue!

Dr. Danette McNew, the 2012 Chair, wel-

comes you to the convention and offers

some conference highlights. Check out the

Special Booth Listing for the North Texas

Dentistry advertisers who are exhibiting

at the conference. Plan to stop by their

booths to see what products and services

they are offering. Let them know you appre-

ciate their support of this publication.

Keep smiling and I will see you at the 2012

Southwest Dental Conference!

LuLu Stavinoha, RDH

LuLu Stavinoha, RDH

Publisher

[email protected]

(214) 629-7110

Use your Smartphone

to find us at

www. northtexasdentistry.com

from the publisher

Publisher | LuLu Stavinoha

Photographer | Ray Bryant, Bryant Studios

Contributing Writers | Dr. J. Moody Alexander,

Tina Cauller, Kim Clarke, Dr. Deji V. Fashemo,

Jorge Fernandez, Marc Fowler, Jenny Fuentes,

R. Kirk Huntsman, Dr. Richard V. Lyschik,

Bob Michaels, Dr. Danette McNew, Sarah Q. Wirskye

Although every effort is made to ensure the

accuracy of editorial material published in North Texas

Dentistry, articles may contain statements, opinions,

and other information subject to interpretation.

Accordingly, the publisher, editors and authors and their

respective employees are not responsible or liable for

inaccurate or misleading data, opinion or other informa-

tion in material supplied by contributing authors.

Copyright 2011. All rights reserved. Reproduction in

part or in whole without written permission is prohibited.

Advertise in North Texas Dentistry

For more information on advertising in North Texas

Dentistry, call LuLu Stavinoha at (214) 629-7110 or

email [email protected]. Send written

correspondence to:

North Texas Dentistry

P.O. Box 12623 Dallas, TX 75225.

North Texas

Dentistry

NORTH TEXAS DENTISTRY | www.northtexasdentistry.com4

North Texas Dentistry, a business and lifestyle

magazine for dentists, is the leader in providing

news and information to the North Texas dental

community.

North Texas

Dentistry1308

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AFTCOAFTCO is the oldest and largest national dental

transition network with over 150 programs customized

to meet your needs.

Med+Tech ConstructionSockIt! is a hydrogel wound dressing approved by FDA

for management of oral wounds. When directly applied

to the wound, SockIt! provides drug-free pain relief,

protects oral wounds from contamination, and promotes

optimal healing.

Beaird Harris & Co. is a Certified Public Accounting

firm providing tax, accounting and business

consulting services.

Beaird Harris Wealth Management, Inc. is an independent

fee-only wealth management firm providing sophisticated

financial planning and investment advisory services.

Structures and Interiors is a commercial general

contractor specializing in dental office construction

offering design-build services including new building

construction, interior finish out, office improvements and

renovations.

ESA Construction is a design-build dental general

contractor in the Dallas/ Fort Worth Metroplex specializing

in turn-key dental office solutions since 1994.

RT Edwards & Associates, P.C. is primarily an advisory

firm that also provides tax and accounting services to those

in the dental industry. In addition, the firm offers compre-

hensive, individually tailored, fee-only financial planning,

retirement guidance and investment services to its clients.

Destiny Dental Laboratory is a full service laboratory

specializing in dental implant cases, owned and operated by

Bob Moyer, CDT and Darrell Jackson, CDT.

Med+Tech Construction is a dental-specific general

contractor specializing in design, new construction and/or

renovation of dental, medical and veterinary offices across the

states of Texas & Oklahoma. Med+Tech also serves clients in the

Southeast including Alabama, Georgia and Tennessee, and will

soon be serving Florida. ia

Monarch DentalMonarch Dental offers dentists an alternative to private

practice while providing the latest in comprehensive quality

dental care to its patients.

TDA Financial Services Insurance Program works with

TDA members and their staff in providing life, health,

disability income, employee benefits, long term care

and malpractice insurance. Bob Michaels, CLU has

been an Associate with them for over eight years.

North Texas Dentistry Advertisers2012 Southwest Dental Conference Booth Listing

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617

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TRANSITION CONSULTANTS

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Monarch DentalExperiencing Expansion and Growth in North Texas

by Tina Cauller


For most dental professionals, a passion for dentistry

fueled the efforts that got them through the rigorous

training that underlies a dental career. However, some

graduates find that in a traditional private practice setting, the

number of “hats” a dentist is required to wear in order to main-

tain a vital, active practice can be daunting. The typical dentist

must continually manage and have some proficiency with busi-

ness, billing, insurance, bookkeeping, IT, interior design, per-

sonnel management, conflict resolution, payroll, equipment

maintenance, marketing, advertising, continuing education

(CE), and real estate – all while practicing dentistry and balanc-

ing family and personal life. Fortunately, most dentists are great

jugglers, but some find the everyday tasks that take them away

from actually practicing dentistry to be increasingly unsatisfy-

ing. After all, their passion is dentistry.

Not surprisingly, some dentists are embracing a different

model. Dr. Melissa Dean is a periodontist with Monarch Dental,

“When you’re following your energy and doing what you

want all the time, the distinction between work and

play dissolves.”– Shakti Gawain, author and teacher

cover feature

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There are currently 128 general dentists and 28 specialists with Monarch Dental in North Texas, and the group is growing to meet increasing demand for

their services.


which she joined after completing her training at Baylor College

of Dentistry in 2005. “I went into dentistry because I enjoy talk-

ing with people and sharing experiences. I was drawn to

Monarch because I liked the idea of a large practice with lots of

opportunity for professional interaction. And at Monarch, I

knew I would have the advantage of an established model where

the systems had already been proven to work. When I joined

Monarch, there were four other periodontists on staff and I have

benefitted tremendously from their experience and mentorship.

I have learned so much from their successes, and now I’m in a

position to help support other new dentists coming in.”

Dr. Dean finds her professional environment rewarding and

stimulating, noting, “No man is an island here – there is always

someone close at hand to weigh treatment options or discuss a

challenging case. The frequent discourse with my colleagues is

so helpful and keeps me energized about every patient,

every day.”

Dr. Dean also appreciates the opportunity to focus her attention

on great patient care. “At the end of the day, I follow up with a

call to every single patient I saw that day. I take pride in the per-

sonal care I give.”

While some might wonder if being part of a large group practice

requires a dentist to conform to the group model, Dr. Dean is

pleased by the active role she is able to take in decisions that

impact her practice. “This feels very much like my own practice.

I can tailor my schedule to meet my own personal needs, I am

able to take part in hiring and other staffing decisions, and my

decisions direct patient flow within my practice. I welcome sup-

port when it comes to ancillary operational duties and things

like equipment selection. The research is done and the kinks are

worked out before any new technology is integrated into the

practice, and I receive thorough training so I’m never left to fig-

ure things out on the fly. I have the very real luxury of being able

to focus on what I love doing, without distractions or compro-

mises.”

Dr. Ryan Gordon came to Monarch via a different path, but

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“I have the very real luxury of being able to

focus on what I love doing, without distractions

or compromises.”

Periodontist, Dr. Melissa Dean, finds her professional environment at Monarch Dental rewarding and stimulating and appreciates the opportunity to focus her

attention on great patient care.

shares Dr. Dean’s enthusiasm for the personal and professional

lifestyle his position with the Monarch team affords. After grad-

uating and completing a residency at the University of

Minnesota, he jumped aboard a large dental practice in

Minneapolis and married the love of his life, Ann-Marie. His

new wife, however, was not in love with the Minnesota winters.

The couple decided to make the move to Texas, where

Dr. Gordon joined a private endodontic practice as an associate

for a time before finding Monarch. “I came to Monarch looking

for a venue to become the best endodontist I can be, supported

by outstanding staff and general dentists, all working towards

a common goal of excellence in endodontics. I wanted to work

in a setting with an established referral base, where I could exer-

cise a unique practice philosophy, drawing from my own expe-

rience working for a large group practice. Monarch allows all of

its dentists to diagnose and recommend treatment they feel is

best and most appropriate for the patient. My mentors here

gave me the faith, trust and space to bring what had worked for

me in the past to my practice.”

Dr. Gordon’s practice philosophy is a good fit with the Monarch

model. “My patients are never treated like a number,” he notes.

“Rather than focusing on production, each patient is treated the

way I would want to be treated. There are no shortcuts.

I learned early on in my career that the slowest way is often the

fastest way. Taking the time to do things right the first time pays

off in great outcomes and reproducible results.”


“Taking time to do things the right way the first

time pays off in reproducible results.”

Dr. Ryan Gordon keeps his knowledge of new technologies and procedures

current and takes pride in what he has accomplished as an endodontist at

Monarch.

cover feature

A digital pan/ceph imaging system is used to assist dentists in diagnosing

and treating patients.

Dr. Gordon is constantly “immersed in the literature” and trav-

els frequently for CE, which he finds “fuels the fire” and sup-

ports his commitment to provide the best possible care. He

keeps his knowledge of new technologies and procedures cur-

rent and takes pride in what he has accomplished at Monarch.

“We recently completed a two-year follow-up for a challenging

trauma case in which we are helping a young patient to hope-

fully regenerate her nerve. This case represents some of the

most advanced regenerative techniques available.”

Now the proud father of a young baby, Dr. Gordon finds that

the Monarch model gives him the freedom to adjust his sched-

ule and enjoy a fulfilling family life as well as sustaining a busy

endodontic practice.

There are currently 128 general dentists and 28 specialists (rep-

resenting oral surgery, orthodontics, pediatric dentistry, peri-

odontics, endodontics, and prosthodontics) with Monarch

Dental in the North Texas area, and the group is growing to

meet increasing demand for dental services. “Patient demand

is strong, even in this economy,” states Dr. Roy Smith, Chief

Dental Officer with Smile Brands Inc., which provides business

support services to Monarch and its other affiliated dental

groups. “They are responding to the quality care, affordable

financing, and convenience Monarch provides.”

Fred Ward, Area Vice President with Smile Brands, describes

the expansion currently underway in North Texas. “We always

welcome input from our affiliated dentists. What we heard con-

sistently last year was that it was time to grow to meet the

increasing demand for dental services. Dentists enjoy being

busy, but never want to be so busy that it hinders their capacity

to provide great care. This meshes perfectly with what we hear

from patients – that they place a high value on Monarch’s con-

venient locations and their confidence in the providers’ com-

mitment to quality care. In response, we have invested $3

million to open three new conveniently located offices and mod-

Dentists have state-of-the-art technology at their fingertips.

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ernize five existing ones. We have added operatories and equip-

ment. We’re spending another $5 million to roll out digital radi-

ography and other technology across the area, and expect that

process to be completed by February 2012. Today, 25 of the 55

locations in the North Texas area have been modernized or are

less than three years old.”

According to Mr. Ward, agile response to feedback from the

professionals is just one of several factors that make the

Monarch model so attractive to general dentists and specialists

at all stages of their career. “We have a very low rate of turnover

among our affiliated lead dentists in the North Texas area – less

than 10 percent last year. They believe in the Monarch brand,

trust our leadership and enjoy their work. The new associate

dentists appreciate having access to this committed powerhouse

of peer mentors made up of lead doctors who “grew up” in the

Monarch system. We continue to provide the resources needed

to arm them with mentoring tools. As a direct result of our com-

mitments, we are able to attract and retain an incredible base

of talent for our affiliated dental groups, including local talent.

Twenty percent of the Monarch dentists in the North Texas area

are Baylor graduates.”

Dr. Smith adds, “Just like the original vision behind the

Monarch model, this expansion has tangible benefits for

patients. It allows us to maintain our dedication to high value,

high quality, comprehensive care and supports all the ingredi-

ents necessary to that success. We look forward to 2012 with

tremendous excitement.” n

For more information about Monarch Dental, visit www.monarchdental.com

or call Mike Duda at (972) 212-8222.

cover feature

The use of the intraoral camera enhances patient understanding of the necessary treatment plan.


“We have a very low rate of turnover among

our affiliated lead dentists in the North Texas

area – less than 10% last year.”

“Twenty percent of the Monarch dentists in the

North Texas area are Baylor graduates.”

In prior articles we discussed the importance of a strong web pres-

ence and mentioned the three key components of optimizing your

website for high rankings in the search engines:

u Title tags

u Inbound links

u Blogging

Today, we’ll look at how a properly utilized blog can improve your

search engine rankings, drive more prospective patients to your

website, and educate them about the benefits of your services,

which then helps build trust and credibility.

Why you need a blog

1) Content is King. You may have heard the phrase “content is

king”. Google and the other search engines are continually chang-

ing the formula they use to rank websites, however the one thing

that has remained constant since they said it over a decade ago is

the fact that they love fresh, relevant, original content. They do

not like stagnant websites where nothing changes. A blog will pre-

vent your website from getting stale.

2) Gain the trust of prospective patients. A blog can provide

valuable content to both current and prospective patients. In

addition to educating them, it also gives them a feel for how you

run your practice, the benefits of the services you provide and

what they can expect when entrusting you with their dental care.

3) Increases your website’s page count. if integrated prop-

erly, each article added to your blog will be treated as a separate

page by the search engines (additional indexed pages), which

improves your site ranking and increases your credibility and

authority with the search engines.

4) Provides original, unique content. Many dental website

design companies utilize the verbatim copy for describing services

across multiple dental websites. This leads to an issue called

duplicate content which negatively affects your website’s ranking

in the search engines. A blog provides content on your website

that doesn’t exist elsewhere on the web.

5) Increases traffic to your website. Good blog content will

bring your website more visitors. When we review website ana-

lytics for our clients, in many cases, their blog articles are the most

visited pages on their websites.

6) Creates content that can be repurposed. Not only can

the article be posted to your blog, but it can also be used as an

update to your Facebook, Twitter and Google+ accounts. We have

developed a process for automating this function so no extra steps

are required.

7) Attracts links to your website. Inbound links (other web-

sites pointing to yours) are an important factor in search engine

rankings. Often, other website owners will find your blog content

and link to it, providing you with a valuable one-way link.

A properly executed blogging strategy has always been a key

component to a successful online marketing strategy, but with

the recent round of updates by Google known as the Panda

Update and the Freshness Update, having an active blog is more

important than ever.

How to get started

Now that you know why blogs are a must-have, you’re probably

wondering how to make all this happen. The first decision is

whether you want to run a stand-alone blog or integrate it into

your existing website architecture. Without a doubt, you want

it integrated into your website. Avoid the free, instant setup

blogs such as Blogger.com.

Next is establishing a system for keeping your blog fresh. Ideally

you’ll create an editorial calendar and regularly add good quality

content. This can be done by you, assigned to someone in your

office or outsourced to an experienced dental writer.

If you would like information on how to properly integrate a

blog into your website or to learn how our team of professional

dental writers can manage your blog for you, please contact us

today. n

Marc Fowler is President of Bullseye Media, LLC, a McKinney, TX based

digital marketing agency that specializes in helping dentists leverage the

internet to grow their practices. He can be reached at 214-592-9393,

[email protected] or by visiting OnlineDentalMarketing.com.

7 ReasonsYour Dental Website Needs a

by Marc Fowler


To ensure compliance with Treasury Regulations (31 CFR Part

10, §10.35), we inform you that any tax advice contained in this

correspondence was not intended or written by us to be used,

and cannot be used by you or anyone else, for the purpose of

avoiding penalties imposed by the Internal Revenue Code. If

you desire a formal opinion on a particular tax matter for the

purpose of avoiding the imposition of any penalties, we will dis-

cuss the further Treasury requirements that must be met and

whether it is possible to meet those requirements under the cir-

cumstances, as well as the anticipated time and additional fees

involved.

Beaird Harris’s marketing material should not be construed by

any existing or prospective client as a guarantee that they will

experience a certain level of results if they engage the adviser’s

services. This announcement is only intended for interested in-

vestors residing in states in which the adviser is qualified to pro-

vide investment advisory services. Please contact the adviser

to find out if the they are qualified to provide investment advisory

services in the state where you reside. Past performance is no

guarantee of future results.

Paula W. Allgood, CPABeaird Harris & Co., P.C.

Beaird Harris Wealth Management, Inc.

12221 Merit Drive, Suite 750

Dallas, TX 75251

(972) 503-1040

[email protected]

www.bh-co.com

www.bhcocapital.com

Beaird Harris & Co., P.C. is a Certified

Public Accounting firm providing tax,

accounting and business consulting serv-

ices to dental practices of all sizes and

specialties across North Texas.

Beaird Harris Wealth Management,

Inc. is an independent fee-only wealth

management firm providing sophisti-

cated financial planning and investment

advisory services.

Q. Does Beaird Harris haveexperience working withdentists?Paula: Yes; for over twenty years Beaird

Harris has worked with dental practices of

all sizes and specialties. This includes re-

cent graduates working as associates,

sole practitioners as they launch a new

practice or buy an existing one and large

dental groups with multiple owners.

Realizing that our dental clients have spe-

cific tax and financial needs, we’ve assem-

bled a team of CPAs, CFP® Practitioners

and Quickbooks ProAdvisors® to serve this

niche. We provide a complete range of

services designed to address both per-

sonal and business issues, including:

• Tax Planning & Compliance

• Entity Selection & Practice Transitions

• Bookkeeping & Payroll

• Financial Statement Compilation

• Retirement Plan Services

• Financial Planning

• Investment Management

• Estate Planning

Our team provides practical, innovative so-

lutions that can help your company whether

you are a new entrepreneur or an estab-

lished professional.

Q. What makes the Beaird

Harris business model so

attractive to dental clients?Paula: Dentists are extremely busy and

appreciate having all of their tax and finan-

cial needs met under one umbrella.

Proactive tax and financial planning is a

coordinated effort between your tax and fi-

nancial advisors. The synergy created by

working with Beaird Harris provides in-

creased convenience, a deeper under-

standing of your overall financial situation

and peace of mind.

With a full staff of CPAs and CFP® Practi-

tioners, we’re in the enviable position of

being able to consider the tax ramifications

of every investment and financial planning

decision.

Q. What asset protectionstrategies do you recom-mend?Paula: Just as you would encourage a

patient to take preventative measures to

ward off gum disease, it’s prudent to or-

ganize your financial affairs and assets to

guard against risks in advance. This

process is very individualized and the

complexity of an asset protection strategy

will depend on the dentist’s unique

circumstances.

While making a recommendation is be-

yond the scope of this article, the key

point is to employ a strategy early and

work with an experienced advisor to walk

through the pros and cons of the various

alternatives.

Q. What message do youmost wish to communicateto dentists?

Paula: After more than twenty years in the

business, I can say with confidence that

the people who get good advice early in

their careers have a huge jump on those

who wait. There is simply no way to over-

state the importance of avoiding mistakes

that have negative repercussions for many

years to follow.

With regards to financial planning and re-

tirement plan services, it is important to

work with a “fee-only” investment advisor

who doesn’t sell any products and has a

legal, fiduciary duty to put your needs first.

Most dentists find that they make better

financial and tax decisions when they tap

into the expertise of a seasoned advisor

who specializes in healthcare.

Paula W. Allgood, CPABeaird Harris & Co., P.C. / Beaird Harris Wealth Management, Inc.

&AQ


Dr. Pete Benson still gets a chuckle from a conversation he had

years ago with his daughter Brittany’s elementary school

teacher. It was an interesting exchange, to say the least.

“I told her I was a dentist, and she looked at me very strangely.

She said, ‘I asked your daughter what you did, and she said you

played video games,’” says Benson, professor and vice chair of

Texas A&M Health Science Center Baylor College of Dentistry’s

Department of Diagnostic Sciences.

It may have been easy for his daughter to make that correlation

at the time, considering Benson spends his days scrutinizing

MRIs, CT scans, digital photographs and radiographs in his

work as director of the dental school’s Oral and Maxillofacial

Imaging Center.

“I also did explain to her what I did for a living,” Benson adds,

pointing out just what drew him to oral and maxillofacial radi-

ology, the newest of the nine recognized dental specialties.

“The best thing about radiology is it’s the most intriguing game

I’ve ever played,” says Benson. “It’s a mystery game.”

There’s no doubt Benson is passionate about what he does. He’s

been in the dental diagnostics and imaging field for more than

27 years, and 24 of those have been spent at TAMHSC-BCD as

a faculty member.

Drawing from past experiences,

filling new leadership roles

Over the years, Benson’s leadership roles in his field have taken

a decidedly upward turn. In May, he was appointed to a three-

year term as the Civilian National Consultant in Oral and

Maxillofacial Radiology to the U.S. Air Force Office of the

Surgeon General. This month, he also was installed as one of

the 30 Commission on Dental Accreditation commissioners

during the American Dental Association’s Annual Session.

It’s been a big year for Benson, and he links the opportunities

back to 1999 when he became president of the American

Academy of Oral and Maxillofacial Radiology and the “stars

lined up,” as he puts it.

“It was the 50th anniversary of the academy and it was the year

With an Air Force Surgeon General consultant appointment and a four-year CODAterm on the horizon, Benson reflects on radiology’s unique career opportunities

By Jennifer Fuentes

LeadershipBeckons


the American Dental Association recog-

nized radiology as a specialty,” Benson

recalls. “We were excited because we

were the first newly recognized specialty

in almost 40 years; it was a monumental

achievement.”

Benson, also a diplomate of the American

Board of Oral and Maxillofacial Radiology

and a past president of that organization,

acknowledges that the size and newness

of his specialty have played a role in his

leadership opportunities.

“It expands my opportunities for leader-

ship,” Benson says. “To me, that is one of

the advantages of a smaller specialty.”

Gaining a broader perspective

Benson’s four-year term with CODA

means he’ll participate in site visits,

review policies, and serve as the chair-

man of the commission’s oral and max-

illofacial radiology review committee.

While Benson won’t have any external

part in TAMHSC-BCD’s upcoming CODA

visit, he predicts serving on the commis-

sion will help him see how other institu-

tions have addressed problems and cre-

ated solutions.

“Gaining that broader perspective will

help me identify policies and procedures

that would increase our effectiveness,”

Benson says.

Benson’s appointment as an Air Force

Surgeon General’s consultant is a natural

extension of his leadership experience

but of a different sort. Benson, who has

two years of active duty experience as a

dental officer in the U.S. Navy and is a

retired Navy Reserve captain, comes

from a long family lineage of military

service.

“I had experience in military health care

so I was excited to do it, from that point

of view,” says Benson. It didn’t hurt that

he had Dr. Diane Flint, an assistant pro-

fessor in diagnostic sciences, oral and

maxillofacial radiologist, and retired

career Air Force dental officer, urging

him to accept the position.

Through it all, Benson has maintained

his teaching role at TAMHSC-BCD for

more than two decades. Among his

favorite memories is hooding his son, Dr.

Andrew Benson, during commencement

five years ago.

Having his son in the dental class pre-

sented some unique, if not humorous,

situations. Benson had started giving a

lecture with PowerPoint slides and

dimmed the lights. He asked if the class

had any questions and was met with

a pause.

“From the darkness I heard a voice say,

‘Hey Dad, I’ve got a question,’” Benson

says, recalling the laughter that res-

onated through the room.

“For the next three years, virtually his

whole class called me Dad,” Benson says

with a laugh. n

Jennifer Eure Fuentes is a communications spe-

cialist at Texas A&M Health Science Center Baylor

College of Dentistry. A 2006 graduate of Texas

Christian University, she has worked in the com-

munications and editorial field for five years.

Founded in 1905, Baylor College of

Dentistry in Dallas is a college of the

Texas A&M Health Science Center.

TAMHSC-BCD is a nationally recognized

center for oral health sciences educa-

tion, research, specialized patient care

and continuing dental education. The

TAMHSC serves the state as a distrib-

uted, statewide health science center

that is present in communities through-

out Texas.



SMILESin theSPOTLIGHTLEADERS IN NORTH TEXAS DENTISTRY

CREATING UNFORGETTABLE SMILES

CASE PRESENTATION

Teenage female patient referred by her dentist for orthodontic evaluation of chief

complaints of ‘underbite’ and ‘poor teeth alignment’. Oral examination revealed

maxillary arch constriction, missing upper right lateral incisor, microdontic left lateral

incisor, delayed exfoliation of mandibular molars, crowded & retroclined lower ante-

rior teeth, and Angle Class III molars. Esthetically and functionally, this patient was

dissatisfied with her occlusion.

Immediate post-op with surgical splint

Pre-treatment

After splint removal

Pre-surgery

After treatment

Pre-surgery

After treatment


TREATMENT PLAN

Detailed orthodontic cephalometric analyses showed that the

observed skeletal malocclusion was due to a combination of mild

maxillary hypoplasia and moderate mandibular prognathism.

Adequate, stable correction required combined orthodontic and sur-

gical procedures. Surgical intervention was timed to coincide with

cessation of facial growth. The peg-shaped lateral incisor required

restorative enhancement, and ideally, the missing upper right lateral

incisor required space creation and an implant replacement.

However, the patient/parents opted to accept substitution of the

missing incisor with the canine, the canine with a first bicuspid and

accept a molar Class II finish on the right side.

PROCEDURES

The over-retained lower deciduous molars were extracted, fixed

upper and lower orthodontic appliances were placed after a short

course of rapid palatal expansion. Dental compensations were

removed and progressively, space was created for the resolution of

the crowded dentition. The teeth were aligned, maxillary and

mandibular arches coordinated; orthodontic biomechanics also

ensured creating space mesial and distal to the upper left lateral

incisor for esthetic bonding. Progress/pre-surgical records and

re-evaluation revealed that the best results would be attained by a

2-jaw procedure of Le Fort I maxillary advancement and bilateral

sagittal split ramus osteotomy for mandibular set-back. A hand-wrist

x-ray film was also taken to confirm that the patient’s skeletal growth

has neared completion. Surgical hooks were placed pre-operatively.

An acrylic splint was inserted intra-operatively to aid maxillo-

mandibular positioning based on pre-determined movements as

planned on plaster models. Post-operative observation was done,

and vertical inter-arch elastics utilized for further teeth positioning

after removal of the acrylic splint. After debonding, the patient was

seen by the restorative dentist to build up the left lateral incisor and

re-shape and modify the right canine into a lateral incisor. Retainers

were delivered.

RESULTS

A very pleasing facial balance was achieved with excellent ortho-

dontic and occlusal results; the patient and her family were highly

satisfied with the attained results from a combined multi-disciplinary

collaboration of a restorative dentist, an oral & maxillofacial surgeon,

and orthodontist Dr. Deji Fashemo who coordinated the treatment.

Dr. Fashemo graduated from

University of Ibadan School of

Dentistry in Ibadan, Nigeria in 1992.

After a year at the orthodontic resi-

dency in Lagos University Teaching

Hospital, he moved to the United

States. At the University of

Rochester Eastman Dental Center,

Rochester, N.Y. he underwent two

years of Advanced Education in

General Dentistry (AEGD), and

eventually received the degree of

Master of Public Health (MPH) in clinical research.

In Rochester, Dr. Fashemo continued his clinical training with

a residency in orthodontics; this was followed by a year of clin-

ical fellowship in craniofacial & surgical orthodontics at the

Indiana University School of Dentistry.

Dr. Fashemo came to Texas in 2004 to pioneer a hospital-based

orthodontic program at Driscoll Children’s Hospital in Corpus

Christi and ran that program for five years. His professional

career continues in the Dallas area where he established

Fourth Dimension Orthodontics & Craniofacial Orthopedics –

a unique private orthodontic practice to cater to general ortho-

dontic patients while supporting the craniofacial anomalies

program within Medical City Dallas Hospital where he also

serves as the medical director of craniofacial orthodontics.

He is actively involved in clinical outcomes and health care

access research initiatives, gives lectures at national and inter-

national meetings, and serves on several professional associ-

ation committees and is a reviewer for the Cleft Palate-

Craniofacial Journal.

Dr. Fashemo’s professional memberships include:

• American Cleft Palate-Craniofacial Association

• American Association of Orthodontists & Southwest Society

of Orthodontists

• American Dental Association, Texas Dental Association, and

Dallas County Dental Society

While not fixing teeth, jaws and faces with braces, Dr. Fashemo

enjoys playing soccer and spending time traveling with his wife

and three daughters.

Deji V. Fashemo, DDS, MPH

For more information concerning this case, contact:

Fourth Dimension Orthodontics & Craniofacial Orthopedics

7777 Forest Ln, Suite C-770, Dallas, TX 75230

Tel: (972) 566-3100 e-fax: (214) 237-6522

www.4dorthodontics.com

AFTER

We thought adopting our new son from the country of

Ethiopia in 2008 was going to be the thing that

changed our family. Little did we realize, that was only

the beginning. Three years and two dental mission trips later, my

family’s life as well as hundreds of others will forever be changed.

The first EthiopiaSmile dental mission trip began as a group of

friends came around the idea using dentistry to love the people of

Ethiopia. In a country of 80 million people with under 100 trained

dentists in the entire country, dental needs are rampant to say the

least. Dental prevention and basic oral hygiene are not a part of the

national culture. Morbidity and even mortality, directly related to

dental infection, is a common occurrence, especially among the

millions living in extreme poverty.

This past September, eight dentists from various places across the

U.S. were joined by 40 other non-dental volunteers and traveled to

Addis Ababa, Ethiopia. Just under 1,000 patients were treated in

spite of the fact that the majority of our supplies ended up being

held up in customs the entire trip. Partnering with local ministries

and churches, we were able to care for those most vulnerable. In

light of the Biblical passage of James 1:27, we focused on caring for

orphans, widows, the elderly and those children with obvious den-

tal infection.

The majority of our treatment occurred in an incredibly impover-

ished part of Addis Ababa called Korah. Korah is a former leper

colony. Today it is the home to over 100,000 living in severe

poverty, many surviving by scavenging in the city dump.

A large open building with tin roof and walls was converted into a

MASH-style dental clinic. After waiting sometimes for hours, the

patients were screened and assessed for dental needs. Due to lack

of predictable electricity and instruments, our services were limited

to extractions. The patients were taken to an “anesthesia station”

then to the next open “chair” for their extraction or extractions.

Once the dental work was performed and had time to recover, the

patient was given analgesics, oral hygiene instructions and antibi-

otics if indicated.

Keeping with the mission to love the people of Ethiopia as we felt

Jesus would, we had a “buddy system” in place. Non-dental friends

partner with a patient and walk them through the various stations

as they receive treatment. Holding hands, rubbing their backs and

stroking their hair broke down the language barrier and calmed

their fears as most of them had ever seen a dentist before.

Another unique aspect of our trip is the sterilization process that

has been developed. A dear and talented friend reconstructed a

large pressure cooker into a fully functional autoclave. We used

three, continually running, butane-heated autoclaves to keep sterile

instruments available. This was especially important this year due

to the significant amount of supplies held up in customs, not to

mention the area we were serving in is rampant with HIV and other

communicable diseases.

Multiple things impact my life on the EthiopiaSmile trips. God has

EthiopiaSmileDENTAL MISSION TRIP by J. Moody Alexander, DDS, MS


a way of showing up there. He is seen in the

faces of the patients we treat. The joy that

radiates, in spite of their dire circum-

stances, is infectious. He is evident in the

team working together, with a common

purpose and goal. Seeing the many moving

parts that need to all come together to pull

off the operation is inspiring. It’s a beauti-

ful thing for a dentist to step in, graciously

care for patients in a less than ideal setting

with limited resources to do what he or she

knows how to do. It’s just as beautiful see-

ing an engineer, stay-at-home mom, sales-

man, grandmother or teenager work

outside of their comfort zone as an assis-

tant or patient buddy. All in the spirit of

love, being the hands and feet of God to

these dear people.

Traveling to Ethiopia has a way of chang-

ing you, putting the stresses and cares of

this world in perspective, helping break

out of the small world we live in to see a

larger world full of needs, needs we have

been blessed to be able to meet – at least

in some small way. Our next trip to

Ethiopia will be in June 2012. n

Dr. Moody Alexander is a graduate of the Baylor

College of Dentistry orthodontic program and

an orthodontist in private practice in Arlington

since 1995.

If anyone would like more information, feel free

to contact Dr. Alexander at drmoody@drsalexan-

der.com or visit www.drsalexander.com.

Dr. Alexander and his wife Emily are the proud par-

ents of seven children, three of whom were adopted

from Ethiopia. They are pictured here with Hill, Wick,

Avery, Isabelle, Eyasu, and Abe. Gigi is still in

Ethiopia until her adoption is finalized in the next

month or so.

Ph

oto

: M

ajo

r Im

ag

es P

ho

tog

rap

hy


Joseph C. Danna, CDTDental Logic, Inc.

112 Hampshire Lane Suite 105

Richardson, Texas 75080

(972) 234-2219

[email protected]

www.dentallogic-lab.com

Q. The partnership between

dentist and laboratory is so

crucial to good teamwork.

How do you build a rela-

tionship with your dentist-

clients and ensure clear

communication?

A. Getting to know a dentist personally is

central to developing a good working rela-

tionship. I spend one-on-one time with

new clients and visit their office to key in

on how they work and their style of prac-

tice. I also try to meet with the staff, espe-

cially the front desk personnel and lead

dental assistant to discuss how I can best

support their practice and interface with

the office.

Q. How do you support the

restoration goals of your

clients?

A. I try to develop a thorough familiarity

with the team, the patient, the materials,

the procedure, and the overall goals of the

restoration. I am available to visit the office

for a consult if needed on a specific case,

and offer recommendations based on my

experience. I sometimes even meet with

the patient to address any aesthetic consid-

erations. It’s important to be familiar with

the materials the dentist is using and main-

tain thorough, current knowledge of the

product. I spend time to research the pro-

cedure and understand the factors that

form a foundation for excellent results.

Q. How do you ensure qual-

ity and safety?

A. While the materials we use are high-

tech, we still work the old-fashioned way.

There is no assembly line here. All of our

technicians are trained to focus on one case

at a time and stay with the basics. This

means that our restorations take time, but

we keep our commitment to both quality

and timeliness and keep our clients

informed of the status of their product

along the way if needed.

From start to finish, I monitor all critical

stages of the process – from the case design

and impression, to die trim and delivery. I

personally look at each impression and

accompanying instructions within hours of

receiving it. Within the first 24 hours, I

analyze the prep design and spend a lot of

time on the wax-up. I oversee each casting

as the model is poured so there is adequate

time to identify any concerns or needs.

This allows us to order anything we might

need immediately and avoid delays or last-

minute issues. Because our quality is so

carefully controlled, we are able to offer a

5-year warranty on our craftsmanship.

We offer a wide range of dental laboratory

products, and all are manufactured only with

FDA-approved and ADA-accepted materials

purchased from a major, well-known supplier

to ensure the utmost safety, quality and purity

of our final products.

Q. Do you send laboratorywork offshore?

A. No. I prefer to have control over the

entire process rather than trying to com-

pensate for discrepancies in the product. In

order for the final product to be optimally

strong and of the highest quality, the sub-

structure must be perfect, not patched to

correct imperfections. Creating every stage

of every restoration in house directly

impacts our ability to deliver consistent

quality. I invite our clients to x-ray our

products so they can see for themselves

that the quality of the foundation is just as

high as the quality visible to the eye.

Q. Do you allow tours ofyour laboratory?

A. We not only allow them, we encourage

doctors and their assistants to visit our

facility. This almost always leads to a bet-

ter understanding of how we can work

together more effectively to achieve the

best possible results. In fact, we even

encourage patients to come to our facility

for precise shading. While they are here,

we show them how a crown is created, and

often take time to explain why their dentist

has chosen a particular material for their

restoration and discuss the advantages of

that material in language they can easily

understand. Patients are universally

appreciative of this opportunity and

impressed that their dentist has taken

such great care to select the best possible

material for their smile.

Dental Logic, Inc.Joseph C. Danna, CDT

&AQ


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No matter what your situation, andespecially if you have a large and thrivingpractice today, you need to know what wehave to share. Your future is at stake!

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They are corporate-owned and operated DMSO (Dental Management Service Organization) practices, with highly

successful and proven business models, very deep pockets and intent on targeting local patients just like yours! In the

greater DFW area alone, there are an estimated 218 corporate owned dental practices – up from less than half of that

just four years ago. Many more are coming in 2012! Over the last two years, New Patient Flow has held steady in these

practices, while independent practices experienced a decline of 50%! What happened in your practice?

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Featured Speaker:

R. Kirk Huntsmann 23 years dental industry experiencen Co-founder of Dental One Partnersn Founding member of Dental Group Practice Associationn CEO ReachOut Healthcare American Founder and CEO Nexus Dental Alliance

Like all professions, the practice of dentistry is evolutionary.

And based on what has happened in other professional

market sectors, the track of that evolutionary path is highly

predictable. What began in antiquity as a crude trade or craft that

could be plied by just about anyone, eventually morphed into a

profession, with clinical standards, regulations, licensing require-

ments, and oversight. Along the way, the charlatans were purged,

the public gained confidence, and the privileged few who met the

high standards for practice began to prosper. Eventually, as the

profession honed its services to the public and as the public came

to value those services as a truly indispensable part of life, the pro-

fessional pursuit evolved further into something far more com-

plex and commercialized. In today’s modern dental practice, the

commercial aspects and economic considerations come to the

forefront, and as already happened to pharmacists, optometrists,

veterinarians, and other professions, large and efficiently run cor-

porate models come to dominate the market as big money seeking

high returns pours in.

Dentistry in the 21st century has clearly moved from the back

alleys of antiquity, through the independent professional model

of the last century, and now finds its future in a corporate model.

Some may take issue with this assessment, but they do so at their

own peril, because the facts are not on their side. Corporate

Dental Management Services Organizations (DMSOs), flush with

huge amounts of capital from Wall Street and large private equity

funds, are expanding rapidly. According to the Dental Group

Practice Association (DGPA), the top tier 20-25 DMSOs alone will

account for over $4 billion in revenues in 2011—and that just

scratches the surface, as smaller DMSOs (under $40 million in

annual revenues) outnumber their large corporate brethren by an

estimated 20 to 1. Overall, an estimated 25-30% of all dental serv-

ices rendered in the US will soon come by way of corporate DMSO

practices.

Why Corporate Dentistry Is Growing

As to why the corporate sponsored DMSO model is winning the

battle for market share, one need look no further than what they

offer the consumer. First, they typically accept all insurance plans

and offer patients convenient appointment times before and after

work in highly visible, modern, well designed facilities with easy

access. Simply put—they are easy to do business with. Second,

many DMSOs offer one-stop, single point of service dental care,

where all specialty services can be obtained. Third, because of

their size and purchasing power, they have lower operating

costs—often a full 20-25% lower than their solo practice competi-

tors. Thus, they can compete on price far more effectively—with-

out compromising quality of care or service. Ironically however,

DMSOs typically receive higher PPO fees than local solo doctors,

again due to their size and negotiating leverage. Fourth, these

companies run like finely tuned business machines, led by pro-

fessional businessmen and women who are smart, focused, and

bring many years of success to their jobs. Fifth, these companies

have huge marketing budgets and have now moved well beyond

their traditional managed care, low end type focus. Modern

DMSOs target the same cross section of Middle America that tra-

ditional solo practices have monopolized for the past 100 years.

Their marketing programs are targeted, sophisticated, and well

executed. Finally, DMSOs have been infused with hundreds of

millions of dollars, and they need to deploy that capital either in

The Future of Dentistry

Why DMSOs WillDominate Dentistry in 2020

by R. Kirk Huntsman


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Disability Life Health Long Term Care Malpractice

purchasing existing practices or growing them from scratch. Not

many solo practices offer anything close to the total value propo-

sition these corporate competitors offer patients. No wonder more

and more patients are leaving their solo doctors behind in favor

of the corporate practice model.

Options for Solo Doctors

Solo practitioners facing this corporate tsunami basically have two

options: sell out or remain independent and try to compete. Some

few will make that trade by exchanging their independence for a

W-2 from a DMSO. Others will hold out and hope these guys go

away. They won’t. My bet is that the vast majority will actively seek

out ways and means to retain their independence and compete.

Independent solo dentists who wish to compete against the big

boys are not without their options. Nothing prevents them from

partnering up with the right people to form their own multi-loca-

tion, multi-specialty practices. That’s one way they can begin to

operate their practices more like a business, with the same kind

of systems, processes, and disciplines that will allow them to gen-

erate more production at lower cost. With the right team, they’ll

gain access to the same kinds of leveraged discounts that the large

DMSOs enjoy on everyday purchases. One piece of advice—don’t

try to do this without first having a good plan and getting the very

best professional advice available. When put together properly

with the right partners, group practice can be both professionally

and financially rewarding—and in this case it may just be the only

way to survive what’s coming! n

R. Kirk Huntsman has been

active in the dental industry for

over 23 years. In 1988, he

became the Dallas/Ft. Worth

licensee for AFTCO Associates,

a dental practice brokerage

company with over 65 offices

nationwide. Within two years, his

was the top performing office in

the nation. In 1991, he acquired

the Houston license and contin-

ued to rapidly expand. By 1995,

he was ready to begin owning and operating practices, so he

launched Dental One as a dental management services organization,

or DMSO. Under Mr. Huntsman’s leadership and direction, Dental

One (now Dental One Partners) grew from scratch to over 150 offices

in 14 states.

After leaving Dental One Partners in the spring of 2010, Kirk began

working closely with Morgan Stanley Private Equity in their acquisition

of ReachOut Healthcare America, the nation’s largest mobile den-

tistry provider. Mr. Huntsman recently left ReachOut in order to form

Nexus Dental Group, a virtual DMSO providing a wide range of

DMSO-type resources and services to independent dentists.

Mr. Huntsman is a 1981 graduate of Brigham Young University’s Mar-

riott School of Management.


The Southwest

Dental Conference

began in 1927 by a

visionary group of

dentists. I can only

imagine that they

were innovative, dar-

ing, and had high

hopes for this dental conference. And their

dreams have come true! Of course it has

changed names through the years but what

we now know as the Southwest Dental

Conference has become the preeminent den-

tal meeting of the southwest. Eighty-five

years since its inception, we are celebrating

the vision of our dental forefathers who pre-

pared the way for its success today.

REGISTER NOW!

Mark your calendars for January 12-14, 2012.

Registration online at www.swdentalconf.org

or you may mail in the registration form in the

2012 SWDC brochure. Make sure you check

out all the speaker choices and topics.

I invite you to start 2012 with an educational

meeting that will set the tone for your dental

practice in this coming year. Come and join

me and your fellow dentists in celebrating the

85th Anniversary of the Southwest Dental

Conference.

Danette McNew DDS

Chairman SWDC 2012

Have you noticed that as the years march

on, trying to keep perspective, energy

and passion alive for our wonderful pro-

fession gets a little harder? The economy

also continues to take a hit and may

assist in driving this downward spiral.

Then why not take advantage of this time

to broaden your dental knowledge and

return to your practice with the excite-

ment of bringing new information, prod-

ucts and services to offer your patients?

Here are 85 reasons to recharge your

New Year by “practicing in the present

while focused on the future”:

6 course updates on sedation and anes-

thesia which prepares you for the recent

changes in sedation regulation in Texas

4 sessions teaching dentists how effec-

tively to manage “more mature” patients

8 courses designed to improve our

esthetic planning and adhesive resin

applications by 10 unique speakers.

5 sessions to help you battle the econ-

omy and be more profitable, productive

and prepared to exit your practice at the

appropriate time

7 current concept courses in implant

dentistry

11 speakers focusing on the health of

the practitioner, the patient, and team

member

4 specialized forums addressing trau-

matology, missions, women health con-

cerns, and new dentist challenges

3 live-patient demonstrations showcas-

ing the latest in dental advancements

1 mobile phone app to try your hand at

3 sessions to learn how sleep apnea

treatments can be a part of your dental

practice

3 courses to incorporate pediatric den-

tistry in 2012

9 topics to boost hygiene productivity

utilizing ultrasonics, new products,

implant maintenance, and oral fluid

diagnostics

7 sessions to improve our endodontic

performance

13 courses for the dental assistant to

manage radiographs, photography, mate-

rials, bleaching, provisionals, and stress,

and

1 celebration of the 85th Anniversary

of the Southwest Dental Conference with

over sixty speakers providing both lec-

tures and hands-on workshops to benefit

the entire team.


85 REASONSto attend the

2012 SOUTHWEST DENTAL CONFERENCE

Healthcare fraud has been a prior-

ity since the Health Insurance

Portability and Accountability

Act established a National Healthcare

Fraud and Abuse Control Program to

coordinate Federal, State, and Local law

enforcement regarding healthcare fraud

and abuse in 1996. Since that time, the

federal government has recovered over

$18 billion for healthcare fraud and

abuse, $2.5 billion of which was won or

negotiated in fiscal year 2010.

The states have also ramped up their

enforcement efforts in this area in recent

years. In 2010, Texas Medicaid recovered

$418 million and avoided costs of approx-

imately $333,000 due to healthcare fraud

enforcement.

It is no surprise that Medicaid orthodon-

tics have come under attack in Texas

based upon the amount of money paid to

orthodontists. In 2010, providers in Texas

were paid $184 million for Medicaid

orthodontics, and 34 clinics received more

than $1 million during that period.

The conduct being examined in these

investigations is no different than what

the government examines in all health-

care fraud cases. However, there are some

twists based upon how these issues are

applied in the orthodontic and dental

contexts. In light of that, there are some

things that you can do in order to mini-

mize your liability if you find yourself

under audit or investigation. (It is impor-

tant to note that if you are currently under

audit or investigation, you need to retain

an attorney experienced in this area of the

law to guide you through this process and

any changes you may be implementing).

POTENTIALLY PROBLEMATIC

CONDUCT

Services Not Rendered

The government often examines whether

or not services that were billed were actu-

ally rendered. One of the government’s

favorite techniques for doing so is exam-

ining the amount of time the doctor

spends with each patient. In other words,

they divide the number of hours the doc-

tor is in the office by the number of

patients seen during that day. If the time

per patient is unreasonable in the govern-

ment’s opinion, they frequently take the

position that the doctor did not see all of

the patients and/or did not see the

patients long enough to adequately pro-

vide the service. The government has an

even stronger case in situations where the

billing codes are time based. The govern-

ment also often examines a doctor’s travel

records to determine which days he or she

was in the office.

Services not rendered are perhaps one of

the most critical issues that the govern-

ment will examine. If the government

feels that unqualified personnel, such as

dental assistants, instead of doctors must

be treating patients because of the num-

ber of patients seen and/or the doctor is

not spending adequate time with each

patient, the government views this as a

quality of care issue. When there is a qual-

ity of care issue, the government is much

more likely to suspend payments or shut

a clinic down, as opposed to a situation

where there is merely a billing issue.

In the orthodontic and dental context, the

doctor needs to ensure that he or she

is spending adequate time with each

patient. It is helpful to have the doctor

sign the charts contemporaneously upon

treatment. You also need to ensure that

each doctor has a Medicaid provider

number for each clinic in which they

are working.

Necessity

Necessity is another critical issue in gov-

ernment investigations. In certain areas,

such as orthodontics, home health, and

hospice care, if the government can suc-

cessfully challenge the determination

of necessity, they can take the position

that all charges paid for a patient

were improper.

In the orthodontic field, patients who are

under age 12 receiving full braces have

been an area of focus. It is imperative that

with all patients, but particularly these,

necessity be adequately documented.

Upcoding

The government often examines whether

a provider is consistently coding a more

How Current Government Initiatives May Affect Your Practice

by Sarah Q. Wirskye


complex procedure, for which the reim-

bursement is higher, rather than a less

complex version of that same procedure.

This is called upcoding. This has been

applied in dental cases when the govern-

ment is examining the types and/or mate-

rials of sealants or fillings being used. The

government has focused on upcoding in

orthodontic cases with appliances.

Unbundling

Unbundling is a situation when there is

one procedure that is split up to maximize

reimbursement. For example, two proce-

dures can be performed separately and

are reimbursed at $100 each. However,

when those two procedures are per-

formed together, there is one billing code

which pays $150. When those procedures

are performed together, the third code

must be used instead of “unbundling”

those procedures and billing the two

other codes separately in order to obtain

higher reimbursement. Appliances are an

area that has been an issue in recent den-

tal and orthodontic investigations.

Kickbacks

Kickbacks can be gifts or benefits to refer-

ral sources, beneficiaries, or employees.

These are easier cases for the government

than cases that turn largely on expert tes-

timony regarding complex medical proce-

dures. It is good practice not to make any

substantial gifts to referral sources or any

gifts at all to beneficiaries, such as rebates

or gift cards.

The government could also take the posi-

tion that employee compensation based

upon revenue is a kickback. While this

may not seem as obvious as the conduct

discussed in the previous paragraph, this

is not a good practice and should be dis-

continued.

PROACTIVE MEASURES

Because of what is at stake, it is imperative

that providers are very careful when work-

ing with the government. In addition to

severe monetary sanctions, the govern-

ment has the ability to require a provider

to have a corporate monitor, place a mon-

etary hold or suspend payments to a

provider, exclude a provider from govern-

ment programs, and even put a provider

in jail. The collateral consequences from a

government investigation may also impli-

cate licensure issues with the State Board.

One of the most basic things a provider

can do to minimize liability is to accu-

rately chart. Often, because a provider is

busy, the level of detail in patient records

does not support what was billed. This is

an issue in all healthcare cases. The clini-

cal staff needs to understand that patient

treatment is only half of their job and the

other half is accurately and adequately

documenting the chart.

Providers and their staff must take the

time to learn and follow the often com-

plex Medicaid rules. If an office is big

enough, hire an in-house compliance offi-

cer. If not, find a competent consultant to

advise you. You need to make sure you

are following every procedure in order to

minimize your liability if you find yourself

in the government’s sights. n

Ms. Sarah Wirskye has represented numerous

individuals and entities in civil and criminal dis-

putes with federal and state governments and

private insurers. She is currently representing

several healthcare providers, including den-

tists and orthodontists, in inquiries by both the

state and federal authorities.

For more information contact Ms. Wirskye

at [email protected] or call

(214) 749-2483.



There’s something special about sparkling wine. The word

itself, “sparkling” is a cool word. So is Champagne, an

extra-special sparkling wine from a certain special part

of France. The Holidays always seem to bring out that seasonal

desire to do something special with a bottle of sparkling wine –

give one to a special friend or drink some with special friends.

Behind that special sparkle, however, lie some interesting and

somewhat complicated details about wine-making and labeling.

There’s also the question of which one to buy as there are some

that are more special than others.

History and Process

Wine that sparkled was not always considered a good thing –

cause unknown, it was attributed to faulty winemaking and often

caused the bottles to burst. As it turns out, cold winter tempera-

tures sometimes halted the wine’s original fermentation, leaving

residual sugar and dormant yeast in the wine. Once bottled,

warmer temperatures reactivated the yeast and a secondary fer-

mentation of the wine created the bubbles. This discovery, cou-

pled with the production of stronger glass bottles, gave late-17th

century winemakers better control of the process and allowed

them to deliberately make sparkling wine.

The traditional method (methode traditionnelle or methode cham-

penoise) of making sparkling wine involves adding yeast and sugar

to bottled wine, capping the bottle and allowing the fermentation

to produce carbon dioxide that dissolves in the wine. The bottles

are then placed in racks with the necks slanted downward and

given a slight shake and turn several times a day, allowing the dead

yeast cells (lees) to gravitate toward the bottle opening. When all

the lees have settled out, the neck of the bottle is frozen, the cap is

removed and the pressure pushes the frozen lees plug out of the

bottle, at which time the bottle is topped off with a wine/sugar

mixture and corked to preserve the carbonation.

The amount of sugar used in the “topping off” mixture deter-

mines the sweetness of the sparking wine: “Brut” will have a

small amount of sugar, “Extra Dry” will be sweeter and “Dry”

even sweeter.

Champagne

While many people refer to sparkling wine as Champagne,

European Union laws only allow sparkling wines from the Cham-

pagne province of France to be labeled Champagne.

There are five legally defined wine-producing districts covering

76,000 acres of vineyards around 319 villages that are home to

more than 19,000 grape growers and 5,000 wine producers.

The main business centers are the towns of Reims and Epernay.

The Champagne house of Gosset was founded in 1584 and is the

oldest Champagne house still in operation today. Other well

known houses include Ruinart (1729) Taittinger (1734), Moet

et Chandon (1743) ,Veuve Clicquot (1772), Roederer (1776),

Piper Heidsick (1785), Krug (1843) and Mumm (1847).

Sparkling wines from these historical houses are not inexpensive,

with entry-level prices in the range of $40. The Yellow Label

from Clicquot is a great example of Brut Champagne. The White

Star from Moet et Chandon is an Extra Dry, a bit sweeter than

a Brut with floral and peachy notes that would go great with a

fruit dessert. The Moet Nectar Imperial and the Clicquot

Demi-Sec are dessert-style champagnes with pear, vanilla and al-

mond notes and a long finish – perfect on its own or with choco-

lates after dinner.

Expect premium Champagnes to cost $150 or more. Some of the

more famous ones include Dom Perignon from Moet et Chan-

don, Cristal from Louis Roederer, Belle Epoque from Per-

rier-Jouet, Grand Cuvee from Krug and La Grande Dame

from Veuve Cliquot.

Sparklersfor Special Times

by Kim Clarke

wine cellar


Rest of the World

Sparkling Wines

Spanish Cava, French Cremant, Australian

Sparkling Shiraz, Bubbly from New Mexico

– these and thousands more make up the

Sparkling Wine “not Champagne” cate-

gory. The wines are great – in fact, many of

the Champagne houses have outposts in

the new world. Roederer purchased 580

acres in the Anderson Valley of California

in 1982 and today produces 80,000 cases

of Roederer Estate Brut, a perennial 90-

pointer with a price tag of around $20.

Mumm also owns acreage in Napa Valley

and makes 150,000 cases of non-vintage

Brut Prestige selling for around $15 that

always seems to land on the Wine Specta-

tor Top 100 List. Domain Chandon,

owned by Moet et Chandon, was

founded in 1973 and now farms over 1,000

acres of California Pinot Noir, Chardonnay

and Pinot Meunier used to craft a wide

range of sparkling wines. Other outstand-

ing California sparkling wine producers in-

clude Iron Horse, J Vineyards (part of

the Jordan family) and Schramsberg.

Gruet, a New Mexico winery, makes a

variety of sparkling wines that represent

some of the best values of the genre. The

non-vintage Blanc de Noir (around $13)

was recently named #43 on the 2011 Wine

Spectator Top 100 List.

Spanish sparklers, called Cava, are inex-

pensive and good choices to drink on their

own or use for making mimosas or cham-

pagne punch. One of the best I’ve had was

a 2007 Naveran Dama (around $20).

Cordoniu and Segura Viudas are reli-

able producers as well.

Great sparkling wines at reasonable prices

are widely available and worth trying.

Champagne or not, they make any occasion

more festive, unique and, well, special!

Happy Holidays! n

When you educate your patients about the basics of pre-

ventative dentistry, you’re not only showing them how

to keep their smiles beautiful for life. You’re also help-

ing them avoid learning the hard way about the most common

dental disasters—up to and including the loss of their teeth.

But have you prepared as well for your own future—in particular,

your financial future? What if, for example, you suddenly become

disabled—through an accident, an injury, or an illness—and are

unable to work? Are you fully prepared for such a scenario?

Statistics show that disability is much more commonplace than

most people think: In a recent survey more than half of employees

surveyed felt they had less than a 2% chance of becoming disabled

during their working years, but in reality more than 25% of Amer-

icans entering the work force today (1 in 4) will become disabled

before they retire.2

Perhaps you believe that you’re fully covered by a group policy or

the association coverage you may have purchased. While group

DI is often relatively inexpensive and easy to administer, it can

also fall short just when you need it most—leaving you in for some

unpleasant surprises when it’s too late to correct the situation.

Want to be better prepared? Consider the following:

Learn to speak the lingo

The right disability income policy can help you keep your house-

hold going if you suffer a long-term disability. But before you go

shopping for a DI policy, you need to know what features to look

for—and the language the insurance industry uses to describe

them. The following terms are part of the language describing

high-quality policies, and are what you should look for to get cov-

erage you can count on:

Non-cancellable and Guaranteed Renewable. To avoid the

possibility of losing your coverage just when you need it most,

choose a policy that’s non-cancellable and guaranteed renewable

to age 65. This will also guarantee premiums until age 65. With a

group policy, you run the risk of being dropped and left unpro-

tected at a time in your life when, due to your age or to a change

in your medical condition, it could be very difficult to qualify for

coverage with another provider. The premiums for your classifi-

cation can also be increased at any time.

Conditionally renewable for life. Although premiums may

Disability Income InsuranceWhat Every Dentist Needs to Know by Bob Michaels, CLU


money matters

Bob Michaels, CLU has been in the in-

surance business in Dallas, Texas for

over forty years. He has been an Asso-

ciate with the TDA Financial Services

Insurance Program for the last eight

years. Bob’s scope of operation in the

TDA Insurance Program includes life,

health, disability income, employee

benefits, long term care, and malprac-

tice insurance.

For more information, visit www.TDAmemberinsure.com. You can contact

Bob at [email protected] or call (214) 696-5103.

increase after age 65, your policy should be guaranteed renewable

for life, as long as you are at work full time.

Own-Occupation definition of disability. Own-occupation

coverage defines “totally disabled”—and therefore eligible for ben-

efits—as not able to work in your own occupation even if you are

at work in some other capacity. As a highly skilled professional

who has invested much into your education and training, you

want to make sure you have genuine own-occupation coverage so

that even if you can teach, for example, in your field—but cannot

practice dentistry—you are still eligible for benefits. A few

companies even consider your ADA-recognized specialty your

own occupation.

Residual Disability coverage. Through a rider, a good indi-

vidual DI plan can provide you with a benefit when you suffer a

loss of income as a result of partial disability—even if you have

never suffered a period of total disability. The best policies con-

tinue to pay a benefit even after you have returned to work full-

time so long as you have suffered a 20% loss of income.

A choice of Riders. Riders offer optional additional coverage

such as annual Future Increase Option, Automatic Increase and

Cost of Living Adjustments, or “COLA”.

Protecting your practice, as well as yourself

As a dental professional, you must also protect the source of your

income: the practice you’ve worked hard to establish and grow.

Special business DI policies, available from the same DI providers

who offer high-quality individual coverage, offer your practice

protection while you recover from a disability.

For example, to help meet the expenses of running the office while

you are disabled, consider a separate type of disability coverage

known as Overhead Expense (OE). OE benefits reimburse your

practice for expenses such as rent for your office, electricity, heat,

telephone and utilities, as well as interest on debts and lease pay-

ments on furniture and equipment.

Overhead expense insurance specifically designed for profession-

als reimburses some additional costs not included in regular busi-

ness overhead expense policies—including the salaries of all

regular employees who are not members of your profession. In a

practice such as yours, for example, salaries for your receptionist

and assistant would be covered, but not the salary of your dental

professional partner(s) or employee(s). However, high-quality

professional overhead policies will cover at least part of the salary

of a professional temporary replacement for you, such as a dentist

retained to fill in during your total disability.

Dentists who are partners in a group practice will want to consider

a policy known as a Disability Buy-Out (DBO). In much the same

way that life insurance benefits can be set aside to fund a buy-out

by the remaining partner if the other partner dies, this type of pol-

icy is designed to fund the healthy partner’s purchase of the dis-

abled partner’s share of the practice. With the proper agreement

in place before disability occurs, hard feelings and the conflicts of

interest that can result from a partner’s disability can be avoided.

The fact is, as part of your overall planning, you owe it to yourself

to look into protection for the one thing that makes all the other

planning possible: your ability to earn an income. n

1 CDA 2010 Consumer Disability Awareness Survey.

2 Social Security Administration Fact Sheet, January 2011.


Call 1-800-232-3826 today for a free practice appraisal, a $2,500 value!

AFTCO is the oldest and largest dental practice transition

consulting firm in the United States. AFTCO assists dentists with

associateships, purchasing and selling of practices, and

retirement plans. We are there to serve you through all stages of

your career.

Brandon S. Burgar, D.M.D. has acquired the practice of

(Boston University 1999)

Walter J. Thomas, D.D.S. - Mineral Wells, Texas

(University of Texas - Houston 1960)

AFTCO is pleased to have represented both

parties in this transaction.

Helping dentists buy & sell practices for over 40 years.

WWW.AFTCO.NET

“I have learned that an AFTCO analyst is the most

important person in the world when it comes time to

do a proper practice transition. I have been a buyer

and a seller with AFTCO and I am exceptionally

impressed by how dual representation works to the

considerable benefit of BOTH the buyer and the

seller at all times.”

Alan S. Martin, D.D.S. (Duncanville, TX)

If you have considered completing

a build out in a new space, or a

remodel in your existing space or

in a new location, read on for some

helpful guidelines.

This article will help educate you on

what to expect, what to look for in your

space, and some questions to ask dur-

ing your decision process.

It is advised you first choose a lender,

realtor, and contractor with a proven track record in the dental

community. All of those who will work with you should be famil-

iar with the specifics and unique requirements of a dental office.

Part of the process will include establishing a relationship with

one of the many dental equipment companies in the DFW

metroplex. You will also need to choose a lender. It is strongly

suggested you evaluate those who participate in, and are famil-

iar with your field. You will also need to choose a realtor who

can provide updated information and location opportunities.

This will be a critical element of your eventual success.

Numerous items can affect your build out costs, as well as your

monthly utility bills and construction expenses. Is there natural

gas to the building for heating? Electric heat is generally more

expensive, but you may offset some of the electric costs by using

more efficient heat pump units. Does the building have post ten-

sion cables? If so, this can prolong the construction and add to

the costs. Will your drains have sufficient drop based on your

design and expectations? If you are looking at an existing space,

do investigate if asbestos is present. Finding asbestos in an

existing space can be costly to remove. Be sure and inquire

about the age of an existing A/C unit or units. Will the landlord

provide a warranty for the existing unit, or units?

There are several other significant areas you will want to con-

sider, including the following: If the project is a remodel, the

state comptroller’s office requires sales tax paid on the entire

cost of the project, or “sales price”. If the project will be in a new

space (and one never occupied), then only materials’ sales tax

applies. This difference can equate to many thousands of dollars

in costs. Will the project be subject to Road Impact fees levied

by the city as it is being permitted? This has come as a surprise

to clients in the past several years. Make sure you know the

answer on the front end so you can plan for the fees if necessary.

These guidelines and questions are considerations as you move

forward with your objectives and goals of locating, building and

financing your new practice. It is highly recommended you

spend the quality preparation time today to evaluate the indi-

vidual specialists who can assist you in making your dream

office the reality of tomorrow. n

ESA Construction is one of the most experienced and leading design

build dental general contractors in the DFW Metroplex. Specializing in

turn-key dental office solutions since 1994, they truly strive to be “Your

partner for the future”. Jorge Fernandez and Bruce Goodhartz, principals

of ESA, are a step above your typical general contractors. Offering site

selection evaluation, in-house design and engineering, Realtor, financing,

architectural and dental equipment company referrals along with budget

compilation, ESA will ensure that your project runs smoothly from start

to finish. Please check out the many projects completed and services

offered by ESA on the website www.esa-construction.com or call for a

FREE no-obligation consultation or site visit at (972) 250-1170. We can

also be contacted at [email protected]. Our offices are located

at 17806 Davenport, Suite 107, Dallas, TX 75252.

by Jorge Fernandez, Principal, ESA Construction

Is Building or Remodeling

a Practice in Your Near Future?

new office dreams will come tru

e.

Jorge Fernandez


construction & design

Case PresentationsProvided by Leading Doctors

in North Texas

SMILESin theSPOTLIGHT

n High Resolution Photography

n Step by Step Details of Treatment

North Texas

Dentistry

For more information on sharing your expertise

in a future Smiles in the Spotlight contact

[email protected] 214-629-7110


bringing your practice

to the next level

by Richard V. Lyschik, DDS, FAGD


The news is generally positive. Are you cautiously optimistic?

Or are you just waiting to see what the future brings to your

practice without doing something about it yourself? Why not

take a different approach; be pro-active! There are a “TON” of

things you can do to improve your practice:

T: TEAM

Is the practice a “zoo” at times? Who “puts out the fires”? Who

starts them? Do you have a “Million Dollar Team” or not? No,

that is not the combined total of their salaries, but the produc-

tion they can easily help your office generate if they are very well

trained, professional, and goal-oriented! Recognize the leaders

on your team. Who can you depend on the most? Everybody?

Somebody? Anybody? Nobody?

O: OPERATIONS

The average dental office is only operating at 40% of its poten-

tial because the dentist is “too busy” in the back. “Being busy”

and “being productive” are not the same thing! Time manage-

ment is the key. Put time on your side! Did you know there are

doctor-hours, patient-hours, and staff-hours that need to be

considered when running a dental office? How well do you keep

those concepts separated to maximize your efficiency? Time

management with creative scheduling can make for a further

efficient and more productive business model. Is there an oper-

ations manual? Are there job descriptions? Is your office run-

ning at its peak efficiency? How would you know?

N: NUMBERS

What are the goals for the day, the week, for the month, for the

year – for the future? Will you exceed last year’s numbers? You

should! Do you read your practice reports at the end of the

month? How many new patients are coming in the door? Is your

average annual production per patient close to $700? Have you

ever looked at your list of incomplete treatment plans? Last

month, over one million dollars in incomplete treatment plans

were found in a Duncanville practice that was for sale. When this

was discovered, the Buyer, without hesitation, offered full price

for the practice! The Seller left a lot of dentistry behind for the

new Buyer. Doctor, don’t let your numbers get away from you!

Do you recognize some of these issues might apply to your prac-

tice? How do you get help to solve the problems, and how do

you get answers to some of the tough questions? Is there any-

one you can turn to and trust enough to point you and your

“baby” in the right direction?

IT’S CONVENTION TIME!

Be sure you take advantage of your exclusive membership to

attend. There are many great minds, creative concepts, and

technological innovations to help your practice rise to the top!

All you need to do is add discipline, structure, and direction.

And if you think you are already doing everything the right way,

then get that second opinion to see if you are on track!

How do you improve your practice’s TEAM, OPERATIONS, and

NUMBERS to get a TON of rewards? Most importantly, how

do you make the positive changes last permanently? Speak to

the experts… the Convention is full of them! n

Richard V. Lyschik, D.D.S., FAGD is one of

AFTCO’s leading innovative Senior Analysts

who has helped over 2,900 dentists in

associating, buying, expanding, or merging and

guided older, disabled and/or “burned out”

dentists to sell their practices. Dr. Lyschik’s

clients have seen the considerable benefits of

incentive programs, pension funding plans and

increased productivity through his guidance.

There is no substitute for experience in this

business. Who better could you choose to talk to about your future transition

plans than a seasoned fellow dentist, a recognized premier transition expert, and

AFTCO Analyst of the Year Award winner? Check out the impressive AFTCO

website at www.AFTCO.net, then call for a free appraisal and a no-obligation

consultation with Dr. Lyschik at your office or the AFTCO office in Dallas, TX at

(214) 893-0410 or 1-800-232-3826.

You Can Do a “TON” for the New Year to Grow Your Practice

practice management

ADVERTISER’S INDEX

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Dental Keynote Concepts .......................................15

Dental Logic ............................................................31

Destiny Dental Laboratory ......................................38

Edwards & Associates ............................................36

ESA Construction ............................inside front cover

Med Dent Advisors..................................................29

Med+Tech Construction .............................back cover

Nexus Dental Alliance .............................................21

Ray Bryant Photography .........................................11

Sockit! .............................................inside back cover

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north texas dentistry volume 1 issue 3

Documents

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