vda journal vol 87 number 2 april-june 2010

Volume 87, Number 2 • April, May & June 2010

www.vadental.org

Volume 87, Number 2April, May & June 2010

Headlines & ArticlesPage5 LettertotheEditor-MoreMedications-MoreProblems! By: Dr. Marvin E. Pizer, DDS

7 MessagefromtheEditor

9 GuestEditorial-RogersHornsbyandtheGecko, By: Dr. Kerry Carney

11 MessagefromthePresident

13 Trustee’sCorner

14 Ethics-WhatAreWeSayingAboutOurselves? By: Melissa Wolfe, DDS

14 ADAStatementonZincinDentureCream

15-16 Achingtoothturnsintoa$44,000bill By: Frank Delano

17 VirginiaOralHealthPlan2010-ExcellentOralHealthForAll.... By: Sarah B. Holland

18-19 AnInterviewWith:SonjaLauren22 JackandTheMortgageMaster By: E. Wayne Bullis

24-25&27 PediatricAbstracts

29-30 UnderstandingDeltaDental’sNewPaymentPolicies By: Dan Schulte, JD

38 PewReportFindsMajorityofStatesFailtoEnsureProperDental... By: The Pew Center on the States

39 Extraoral By: Dr. Elizabeth Wilson

40-41 WhenShouldYouCallYourMed-MalCarrier’sRiskManagement... By: Kathleen M. Roman

44 Non-PatientBasedLicensureComingtoaStateNearYou? By: Richard Carlile, D-2011

45 ASmileRestored,NotesfromtheVCUSchoolofDentistry By: Joseph L Rodriguez, Class of 2011

58 YouGottaPutAFaceOnIt!DentistsRallytotheCause By: Chuck Duvall and Dennis Gallagher

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DepartmentsPage3 *New*ContinuingEducationCalendar

15-21 Outreach

23&27 PathologyPuzzler By: Dr. John Svirsky

31-37 VirginiaMeeting

43-45 UniversityConnections

46 Awards&Recognition

47-54 Governance&Membership

56-59 Legislative

60 ClassifiedAds

Member Publication

Volume87,Number2•April,May&June2010 3

REPRESENTING AND SERVING MEMBER DENTISTS BY FOSTERING QUALITY ORAL HEALTH CARE AND EDUCATION.

Virginia Dental Association7525 Staples Mill Road . Richmond, VA 23228804-261-1610 . Email: [email protected]

Editor-in-Chief RichardRoadcap,D.D.S.BusinessManager TerryD.Dickinson,D.D.S.ManagingEditor Mrs.ShannonJacobsGraphicDesign Mrs.ShannonJacobs

Virginia Journal Editorial BoardRalphL.Anderson,CarlM.Block,CramerL.Boswell,JamesH.Butler,GilbertL.Button,B.EllenByrne,CharlesL.CuttinoIII,CraigDietrich,FrankH.Farrington,BarryI.Griffin,JeffreyL.Hudgins,WallaceL.Huff,LindsayM.Hunt,Jr.,ThomasE.Koertge,JamesR.Lance,DanielM.Laskin,KarenS.McAndrew,TravisT.PattersonIII,W.BaxterPerkinson,Jr.,LisaSamaha,DavidSarrett,HarveyA.Schenkein,JamesR.Schroeder,HarlanA.Schufeldt,JamesL.Slagle,Jr.,NeilJ.Small,JohnA.Svirsky,RonaldL.Tankersley,DouglasC.Wendt,RogerE.WoodVDA Component - Associate EditorsBenT.Steele,MichaelR.Hanley,GregoryCole,GeneAyers,JaredKleine,ChrisSpagna,RichardCarlile-StudentLiason,VCUClassof2011.

VDA OfficersPresident: AlonzoM.Bell;AlexandriaPresidentElect: MichaelAbbott,SalemImmediatePastPresident: RalphL.Howell,Jr.;SuffolkSecretary-Treasurer: J.TedSherwin;OrangeExecutiveDirector: TerryD.Dickinson,D.D.S.Board of DirectorsAlonzoM.Bell,President-MichaelAbbott,President-Elect;J.TedSherwin–Sec.Treasurer;RalphHowell,ImmediatepastPresident;JamesE.Krochmal–Comp1;MichaelJ.Link–Comp2;SamuelW.Galstan–Comp3;BenitaA.Miller–Comp4;CraigB.Dietrich–Comp5;ScottieR.Miller–Comp6;RonDowney.–Comp7;NeilJ.Small–Comp8AdvisoryMembers:DavidSarrett;CharlieGaskins;RichardRoadcap,SarahKandrace,VCUD-2011

Volume 87, Number 2 • April, May & June 2010

THE VIRGINIA DENTAL JOURNAL(PeriodicalPermit#660-300,ISSN00496472)ispublishedquarterly(January-March,April-June,July-September,October-December)bytheVirginiaDentalAssociation,7525StaplesMillRoad,Richmond,VA23228,Telephone(804)261-1610.

SUBSCRIPTION RATES:Members$6.00includedinyourannualmembershipdues.Members–AdditionalCopy:$3.00Non-Members-SingleCopy:$6.00Non-MemberoutsidetheUS:$12.00Annual Subscriptions intheUS:$24.00 outsidetheUS:$48.00

SecondclasspostagepaidatRichmond,Virginia.CopyrightVirginiaDentalAssociation2010

POSTMASTER:Sendaddresschangesto:VirginiaDentalJournal,7525StaplesMillRoad,Richmond,VA23228.

MANUSCRIPT AND COMMUNICATION FOR PUBLICATION: Editor,7525StaplesMillRoad,Richmond,VA23228

ADVERTISING COPY,insertionorders,contractsandrelatedinformation:BusinessManager,7525StaplesMillRoad,Richmond,VA23228

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Letter to the EditorMORE MEDICATIONS – MORE PROBLEMS!

Fiftyplusyearsofpracticeinadentalspecialtywithmostpatientsreferredbyphysiciansanddentistshasal-lowedmetorecognizetheproblemsrelatingtonewandoldermedications.

Thedramaticincreaseinnewdrugshasnecessitatedthatdoctorshavemoreknowledgeregardingpharmacol-ogy,drugeffectiveness,side-effectsandinteractionswithothermedications.Knowingfrequentaswellasrareside-effectsareessential.Doctorsmustdifferentiatebetweendruginducedside-effectsfromthepatient’sal-teredphysiology.Occasionally,unsuspectedlifethreateningsymptomswillrequireemergencyinterventionandthisalsoistheprescribingdoctor’sresponsibility.

Somesuggestionsfordoctorsprescribingordispensingmedications,includingover-the-counterdrugs,arepre-sented:

(1)Everynewpatientshouldbringallbottleswithmedicationstheyarepresentlytakingtotheoffice.Thislistshouldbereviewedperiodically.

(2) Reducingunpleasantside-effectsmaybeaccomplishedby reverting toa recentPDR(PhysiciansDeskReference)oritsequivalent,beforeadvisingorprescribingnewand/oroldermedications.

(3)Adoctor’sjudgmentmustbeprudent.RiskversusBenefitsofmedicationsprescribedisanessentialfactorforalleviatingapatient’sillnessanddiscomfort.

(4)Somemedicationsrequiremonitoringwithperiodiclaboratorystudiesandclinicalobservation.Adoctorwhoignoresthisaspectofprofessionalhealthcareisnotcompetent.

(5)Manypharmacies,whendispensingmedications,includeapamphletforthepatient.Thisusuallyexplainsthepurposeofthisdrugaswellasproperdosage,precautions,andusualandrareside-effects.Thepatientwillrespondwithconfidenceiftheyknowoftheirdoctor’savailability.Therearealwayssomepatientswhocannotrememberorreadtheinstructionsofthenewmedications.Frequently,thepharmacistcanhelp–ifnotaphonecalltothepatient’sspouse,relativeorfriendwillalleviatethelanguagebarrier.Atelephoneserviceisavailableinmanyclinicsandhealthprofessional’sofficewhereEnglishistranslatedintowhateverlanguageisnecessaryforthepatient.

(6)Thepatientmaynothavethefinancialmeanstopurchasethedesiredmedication.Itisveryimportantthatthedoctorrealizetheapproximatecostoftheprescribeddrug.Thedoctorcanalleviatethiscrisisbyprescribinganothermedicationwithequaleffectiveness.Thisshouldbedoneinconjunctionwiththepharmacist.Usinggenericnamesonascriptwillalsolowercostofdrugs.

(7)Somepatientsstoptheirmedicationswhensymptomsdisappear–onlytofindthemrecurringtwoorthreeweekslater.Anon-compliantpatientwillfrequentlyrefertothisdoctorasincompetentandseekanotherdoctor.Thisinformationshouldberecordedinthepatient’schart–evenifnotverified.

(8) Pharmaceuticalsales representativescanbeavaluableassetwith theirnewmedication. Seeing theserepresentativesbetweenpatientsisnotadvisable.Ipreferafifteen(15)minuteappointmentbeforeorafterallpatientshavebeenseen.Mostsalesrepsarepersuasive,well-trainedandarmedwithpositivestudiesabouttheirproducts.Itisimperativethatthedoctorcollaborateswithpharmacists,PDR,internetandrespectedcol-leaguesbeforeprescribingnewdrugs.

Competentmedicineanddentistryistimeconsumingforthedoctor–butsoistimespentinacourtroomasthedefendant.Moreimportant,itistimethatthepatientiseffectivelytreatedandcomfortable.

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Message from the EditorDr. Richard F. Roadcap

Thisshouldonlytakeafewseconds,Ithought.TypeIIIalloy,micronsthick,perfora-

tionshereandthere…afewsecondslater,astheburslidthroughthecrown,myrighteyebegantosting.Pacingthefloor,Iwonderedhowthemetalcouldcircumventsafetyglasseswithsideshieldsandlandinmyeye.SoonIwasseatedintheophthalmologist’schair,rollingmyeyeinvariousdirectionswhileabrightlightlookedfordebris.Theoffending

particleswereflushed,eyedropsdispensed,andIwasbackchairsidethesameday,withonlyasoreeyetoaccountfortheincident.

We’renumbinglyfamiliarwithuniversalprecautions:mask,gloves,gowns,protectiveeyewear.Whataboutourpatient’seyes?TheCen-tersforDiseaseControlrecommendssafetyglassesbewornbypatientsduringtreatment1.Doyouofferglassestopatientsbeforethehandpieceturns,or,instead,askthemtoclosetheireyeswhentheproceduregetsmessy?Theliteratureisthinonthissubject,andthefewarticlesinthearchivecontainonlyanecdotalevidenceofeyeinjuriestopatients.Onlyone-halfofUSdentalschoolsrespondedtoa2006surveyoneyeprotection,withthree-fourthsofthoserespondingsayingeyeprotectionforpatientswasrequired;one-fourthdidnotrequirestudentstodoso.2IposedthequestiontoDr.B.EllenByrne,SeniorAssociateDeanatVCUSchoolofDentistry,andshesaidclinicpolicyrequireseyeprotectionforpatients.

Ireadyourthoughts.“I’vepracticedalltheseyearsandneverhadaproblem.”“Thiswouldn’thappenifproperfour-handedtechniquewereused.”Bothcommentsringtrue,butIsuspecteyeinjuriesarelikethepalatalburnswithwhichwearefamiliar:thepatientcan’trecalltheincident.Manygounrecognizedandunreported,assymptomsmaynotappearforseveraldaysafterdentaltreatment.Thinkaboutourpotions–phosphoricacid;hydrofluoricacid;bondingagents;primers;calciumcarbonate.Theycarrygreatpotentialforinjuries,asdohandinstruments,burs,andsharpsofalldescriptions.Ioncebounceda#301elevatoroffapatient’swraparoundsafetyglasses,gratefulIwasthattheywereinplace.

Considerthemtobeaproductivityenhancer–timesavedbynothavingtodivertourfocustoseeifthepatient’seyesareclosed,andnothavingtoremindthemtodoso.Haveyoutriedtokeepyoureyesclosedforanhour?It’sdifficult.Protectiveeyewearisavailableinmanyforms,frommirroreddarklensestoindustrial,I-work-in-a-laboratoryframes.Dentalsupplierssellthem,andmosthomeimprovementstoreshaveasafetydepartment.Lookontheinsideofthetemplesfortheinscription

1 http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1htm2 Hill,E.E.:EyeSafetyPracticesinUSDentalSchoolRestorativeClinics,JDentEduc2006;70(12)1294-1297

“Z87”,theANSIstandardforeyeprotection.3Ifyoudon’tbelievetheyserveapurpose,lookatthelensesafteracrownpreparation(orsimilarprocedure).There’llbeaconstellationofdebris,eachparticlecarryingmanyscionsofthegenusStreptococcus.

Neitherdoctorsnorstaffwouldconsideroperatingwithouteyeprotection–OSHAwon’tallowit.Whynotprovidethesameprotectiontoourpa-tients?Almostalleyeinjuriesarepreventable.Itonlytakesamomentforanaccidenttooccur:thefidgetingpediatricpatient,theunexpectedmovement,theinstrumentsquirtingfromourwetgloves.Doyourselfafavorandrequirepatientstouseeyeprotection.Theywillappreciateyourconcern.ManytimesIhavebeenaskedbypatientsiftheycouldkeeptheglasses,orwheretheycouldgetapairtomatch.Aslight,elderlyladyonceremarkedshecouldseemoreclearlywithoursafetyglassesthanher(prescription)lenses.Irecommendedaneyeexam.

3 www.osha.gov/pls/oshaweb/owadsip.show_document?p_table=STANDARDS&p_id…

Eight year-old patient wearing eye protection.

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WWW.AFTCO.NET Guest EditorialRogers Hornsby and the GeckoBy: Kerry K. Carney, DDSReprinted by permission of the California Dental Association.

c d a j o u r n a l , v o l 3 7 , n º 2

f e b r u a r y 2 0 0 9 69

Editor

Thinking Criticallykerry k. carney, dds

e don’t know what we don’t know.

Some decisions are dif-ficult to make even when we know all the facts. Some de-

cisions are difficult to make because we can-not know all the elements of the problem. Some decisions are a matter of conjecture based on assumption, but most decisions are better when based on good evidence. That is, of course, the rationale behind an evidence-based practice of dentistry.

This is not about evidence-based dentistry per se; this is about gathering good evidence and making good decisions about dentistry and oral health care in the future. It is easy to think we already know everything we need to know to make a good decision. In many ways, the less we know, the easier the decision. Dr. David Nash, of the University of Kentucky, Col-lege of Dentistry, recently told the Board of Trustees, “We don’t know what we don’t know.” We need more information to make good decisions about dentistry and the future of oral health care.

The first step in critical thinking is to understand the scope of a problem. The second is to gather the pertinent informa-tion. The third is to remain skeptical and critically evaluate information before incor-porating it into a well-justified conclusion. Finally, one needs to be able to tolerate a considerable level of chaos. By this, I mean that answers are frequently untidy. Life is messy and conclusions are equally so.

I had a classmate in a geography course in college who was always frustrated because she wanted each topic wrapped up with a proper answer and no loose ends. Instead, each system we studied began with some beautifully simplified representation

that, upon research and reflection, proved to be far more complex and unpredictable.

There are those who maintain that money is all we need to eliminate oral health disparities and access to care prob-lems. In a very simple sense that is true. Unlimited funds applied in unrealistic manners could possibly solve the prob-lem. But oral health disparities and access to care are not simple problems. It is re-ally misleading to use the word “problem,” because that implies, like a puzzle, there exists a “solution.” It is more like a “dilem-ma” because there is no simple answer. We must choose among alternatives, each of which may have associated unattractive ramifications. It is a multifaceted issue with no single silver bullet solution.

The Surgeon General’s 2000 Report documented advances in the oral health status of the U.S. population over the past five decades. We know how to deliver excellent oral health care. Dentistry is health care that works, but it is not work-ing for everyone.

Oral health disparities in the United States are not simply a supply side prob-lem. Improved reimbursement would clearly improve provider participation, but there are so many other aspects that need to be addressed.

There are patient-related access barri-ers. These include, but are not limited to, geographic, linguistic, mobility, cultural,

and transportation barriers, family in-come, lack of insurance, education level, child-care services, health care literacy, patient age, case complexity, fears and phobias, health fragility, and economic exigencies. The coordination of services may present a health care system too complex to successfully navigate.

Each practice owner is familiar with the provider-related barriers. We not only provide oral health care; we must operate our practices in a sustainable manner. Dental practices exhibit demand-based market distribution. Inadequate economic support means the traditional economic model cannot be sustained. This makes it impractical for new dentists, trying to re-pay student loans, to locate their practices in high-need/low-income communities. Low reimbursement rates, administrative burdens, patient compliance issues, and the dentist’s fear of loss of control over his/her exposure to low reimbursement all work against attracting more providers to participate in current programs.

The constellation of barriers may vary from place to place and over time. An effec-tive program in one area may not be effec-tive in another. What works in urban Cali-fornia may not work in remote, rural areas. What works in a culturally homogeneous community may be useless in a multicul-tural context. What works in a target group of individuals of high oral health literacy

w Oral health disparities and access to care

are not simple problems.

WhatcouldRogersHornsbyandtheGeicogeckohaveincommon?Theyarebothiconsofindustriesthatshareanunusualcom-monality:antitrustlawexemption.

In1922,RogersHornsbyplayedsecondbasefortheSt.LouisCardinalsandhadoneofthebestyearsever.Inthatyear,hebecametheonlyplayerinhistorytohitmorethan40homerunsandbatover.400inthesameseason.Thatwasthefirstyearthathewonbase-ball’striplecrown:battingaverage(.401),homeruns(42),andrunsbattedin(152).Whilehewasbusyonthefield,MajorLeagueBaseballwasbusyinthecourtroom.

In1922,theSupremeCourtruledintheFederalBaseballClubofBaltimore,Inc.v.NationalBaseballClubscase.Theissuewaswhetherbaseballwasaninterstateoranintrastateevent.ThesuithadbeenbroughtbythefederalleagueclaimingthatitwashinderedinitsabilitytosignplayersasaresultofantitrustviolationsbytheNationalandAmericanLeagues.JusticeOliverWendellHolmeswroteinthedecisionthatthoughtheteamstraveledfromstatetostatethattheessentialbusinessoccurredwithinthatstate.Atthetime,“therewasnorevenuesharing,noradioortelevisionandnonationalsponsorsorlicensingdeals.”1Interstatecommerceissubjecttofederalregula-tion’intrastatecommercefallsunderstateregulation.,MLBenjoysanexemptionfromantitrustlawsuniqueinitsbreadthandduration.

Nowhowaboutthatgecko?Before1944,insurancehadbeendefinedasasimplecontractofindemnityandwassubjecttostateregulation.In1944,thatchangedwhentheUnitedStatesSupremeCourtaffirmedalowercourt’sdecisionthat“thebusinessofinsurancedidindeedaffectinterstatecommerceandthiswassubjecttocongres-sionalauthoritypursuanttotheCommerceClauseoftheUnitedStatesConstitution.”2

Everyonelikestobethebeneficiaryofregulation,butnoonelikestotheregulated.TherulingontheUnitedStatesV.South-EasternUnderwritersAssociation,322U.S.533(1944)settheinsuranceindustryinmotion.ItlobbiedCongressandsucceededinconvincingPatMcCarran,asenatorfromNevada,andHomerFerguson,asena-torfromMichigan,tosponsorabillthatwouldexempttheinsuranceindustryfromsomefederalantitrustlaws.Unlikethebaseballexemptionthatcamefromthejudicialbranch,theinsuranceexemptionwastheresultoflegislation.

TheMcCarran-FergusonBillwasintroducedwithintwoweeksoftheSouth-EasternUnderwritersdecision.VersionsofthebillpassedintheSenateandtheHousewithoutanyhearingandlittledebate.Whentheconferencecommitteeconsideredtheversions,thefollowingphrasewasinserted,“insurersareexemptfromfederalanti-trustscrutinysolongastheyare‘regulatedbystatelaw.’”Judicialinter-pretationofthatphrasehastransformedatemporarymoratoriumonfederalscrutinyandprosecutionintoapermanentantitrustexemption.“Courtshaveinterpretedthisphrasetorequireonlythatstateregulatorshavejurisdictionoverparticularconduct,regardlessofwhetherthatauthorityiseverexercised…Asaresult,anticompetitiveconductmay

1 ESPN:Baseball’santitrustexemption:Q&ADec5,2001.Sports.espn.go.com/espn/print?id=1290707&type=story.AccessedOct.13,2009.

2 ADAAlertRe:HR1583McCarran-FergusonAct-KeyPointsforADAMembers,May2009.

escapebothregulatoryoversightandantitrustscrutiny.3TheMcCarran-FergusonActof1945wassupposedtobeastop-

gaptoallowtheinsuranceindustrytogetitshouseinorderbeforeitcameunderfederalantitrustlaws.ThiswassoclearlyarticulatedintheCongres-sionalRecordthatPresidentRooseveltprovidedthefollowingpressreleaseaftersigningthebill,“Afteramoratoriumperiod,theantitrustlaws…willbeapplicableinfullforceandeffecttothebusinessofinsurance.”3

Duringthepast64years,theinsuranceindustryhasforestalledattemptstorepealormodifyMcCarran-Ferguson.DuringtheaftermathofHurricaneKatrina,billS168wasintroducedinanattempttoallowtheFederalTradeCommissionregulatorycontrolandjurisdictionoverareasofthebusinessofinsurance.Thisbillfailedin2007.TheInsuranceIndustryCompetitionActof2009,HR1538,wasintroducedinMarch.Thetwobillsarevirtuallyidentical.TheADA’sstanceonthebillisclear,“Thefactisthatdentists,theirpatientsandthepublichealthareallvictimsofMcCarran-Fer-guson’snegativeimpactonrobustcompetitionamonginsurancecompanies,andallwouldbenefitfromitsrepeal.”2

Theargumentformaintainingtheinsuranceexemptionspringsfromthenotionthatthepoolingofhistoricalandprojectedlossexperiencehelpssetratesmoreaccuratelyandtherebybenefitsconsumers.Itisalsoproposedthatsmallercompaniesmaycompetemoreeffectivelybasedonpooledinformationthantheycouldbasedontheirownlimitedexperience.Finally,opponentsofliftingtheantitrustexemptionsforthebusinessofinsur-ancearguethestatusquo.Ifithasoperatedwellforthepast64years,whychangenow?

Theproponentsofeliminatingtheinsuranceexemp-tionpointoutthereareothermechanismsthatallowcompetitiveexchangesofinformationbyindustriesthatdonotenjoythesameexemptionastheinsuranceindustry.TheyalsoremindusthattheMcCarran-FergusonActwasproposedandpassedin1945forthebenefitofconsumers.Specifically,theADApointstothepotentialforunfairandbiasedindustrycalculationsforusual,customary,andreasonablefeesthatmayresultineconomicdisadvantagesforconsumers.4TheADAconcluded,“thelimitedantitrustexemptionenjoyedbytheinsuranceindustrydistortsmarketstotheseriousdetrimentofbothconsumersandbusinesses.”2

InCalifornia,wehaveanotherfactortoconsider.Inthespiritoftransparencyofpurposeandpotentialconflict,thereisourrelation-shipwithTDIC.Thefor-profitsubsidiaryofourassociationisintheinsur-ancebusiness.Theinsurancebusinesshasbeen,inlargepart,responsibleforthestabilitywehaveenjoyedinourdues.Wehaveadisincentivetoinviteamoreonerousregulatoryenvironmentforthatbusiness.

Thingsareseldomassimpleastheyinitiallyseem.Sothenexttimeyouseethatgeckoadvertisinginsurance,imaginehimbeingtaggedoutatsecondbasebyHornsby,Takeamomenttowonderabouttheiranomalousantitrustlawexemptionsandwhatthatmighthavetodowithdentistry..

3 Statement,UnitedStatesSenateCommitteeontheJudiciarytheMcCarran-FergusonActandantitrustimmunitygoodforconsumers?March7,2007.Hon.TrentLott,UnitedStatesSenator.4 ADA2009a.ADAAmericanDentalAssociation,America’sleadingadvocatefororalhealth,2009WashingtonLeadershipConference,HR1583InsuranceIndustryCompetitionActof2009.

Everyone likes to be the beneficiary of regulation, but

no one likes to be regulated.


DD_Shine_girltree_8.5x11_VDA_4C_3.1F.pdf 3/1/10 3:04:32 PM

Dr. Alonzo BellMessage from the President

Despiteawinterofhistoricsnowstorms,wehavebeenverybusyduringthethreemonthssincethelastprintingofourJournalinJanuary.Asmostofyouknow,themajorityofoureffortshavebeenfocusedonpromotingthepassageofourlegislativeinitiativeconcerningthefeesettingofnon-coveredservicesbydentalinsurers.IampleasedtoreportthatasIwritethismessage,ourbilllooksverypromisingandthatallwenowneedisthesigna-turebytheGovernorandthisbillwill

thenbecomelaw.Onceagain,Isaythankyoutoallwhoparticipatedinanywayinthismonumentaleffort.

AsIreflectontheseefforts,Ican’tthinkofabettertimetoremindyouoftheimportantrolethatADVOCACYplaysinthefutureofourprofession.ThetwomostcriticalfactorsintheadvocacyprocessareadequateresourcesinourPACandstrongmembershipnumbers.Ifyouhavenotalreadydoneso,IaskthatyougivegenerouslytoourVADPAC.Ifyouhavenotalreadydoneso,IaskthatyoumakecontactwithsomeonethatyouknowisnotaVDAmemberandaskhimorhertojoin.Wehavejustwitnessedthepowerandthevalueofmembershipinourdentalas-sociationandwemustcontinuetostaystrongtofacethenextchallengethatwillinevitablycometoourprofession.

Notsurprisingly,therehavebeenotheractivitiestakingplaceinadditiontoourlegislativeactions.Duringthisperiod,Ihavehadtheopportunitytotraveltoseveralofourcomponents,andinJanuary,wehadourcom-mitteemeetingsinRichmond.OnehighlightofourcommitteemeetingswasthecombinedworkshoponmembershipfacilitatedbyDr.BruceDeGinder.AcommonthemethatIseefrombothmyvisitstocompo-nentsandourcommitteemeetingsisthedifficultywefaceinidentifyingmemberswiththewillingnessanddesiretoserveinourcommittees.Sincethecommitteestructureisthebackboneofourassociation,Iimploreanyonereadingthismessagetomakeitknowntoyourcompo-nentleadersifyouhaveinterestinservingonanyofourcommittees.Evenifyouwanttoservebutareunsureofwhere,makethecontactandwewillfindaplaceforyou.Ifyoudon’tknowwhomtocontactinyourcomponent,pleasefeelfreetocallore-mailtheVDAofficesandwewilldirectyoutotheproperperson.Iamabigbelieverinthe“deepbenchtheory”andthereforewecanalwaysfindaplaceforyoutoserveourassociation.

Asthedaysarenowgettinglonger,weknowthatspringisfastap-proachingandsoIaskyoutorememberourupcomingVirginiaMeetinginJune.Pleasemakeplanstoattend;bringyourstaffandinviteyourfriends.Thisyear’smeetinginWilliamsburgpromisestobeanexcit-ingopportunityforfellowshipwithcolleaguesandexcellentcontinuingeducationatthesametime.

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Mid-level providers – are they effective?Youcannotopenanydentalpub-licationthesedayswithoutread-ingsomearticleabouttheuseofmidlevelproviderstoaddressaccesstocaredeficiencies.Ifyouarelikeme,youhavetobetiredofnon-dentistsproposingasolutionforthedentaldeliverysystemwhentheyknowverylittleaboutourprofession.Ofcourse,proponentspointtotheirappar-entsuccessfuluseworldwide

asavalidreasontosupporttheirusehereintheUS.Infact,thereisnoconsistencyoftraining,accreditation,scopeofpractice,oruseinthede-liverysystemamongstthecountriesusing“midlevels”.So,howcanyouevaluatetheirrolesinthedentaldeliverysystemortheireffectivenessinaddressingdentaldiseaseandaccessdisparities?ThereasontheUShasthebestdentalcareintheworldisbecausewedohavestandardsforeducation,accreditation,andlicensurethataresupportedwithsoundscienceandatrackrecordofsuccess.Standardizationandaccredita-

tionoftheeducationalprogramsrequiredforscopeofpracticeofbothdentistsandtheparafunctionalauxiliariesunderoursupervisionarethepillarsonwhichthequalityofourprofessionwasestablished.Let’sexaminewhatwereallydoanddonotknowabouttheuseofdentalextenders,theirroleindeliveryofdentalservices,andhowweevaluateworkforceproposalsinthefuture.First,whatisamidlevelprovider?Basedonthegoalofprovidingmorecaretomorepatientsattheleastcost,Icontendthatlikeourmedicalcounterparts,dentistryhaslongrecognizedthatthedelegationofsometasksofpatientcareisthemostefficientandcosteffectivewaytoex-tendthecapabilitiesofadentist.TheADAsupportstheexpansionofdu-tiestotraineddentalauxiliarieslikehygienistsandEFDAstosupportthedentalteamandfreethedentist’stimeformorecomplicatedprocedures.Today,withgraduatesofaccreditedtrainingprogramsthroughouttheUS,mostdentalofficesutilizestafftoprovideexcellenttreatmenttoafargreaternumberofpatientsthanwasthecaseintheearlytomidfifties.Asaconsequence,dentaldiseaseratesintheUShavefallendramati-callyinthelastfiftyyears.

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14VirginiaDentalAssociation

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Aching tooth turns into a $44,000 bill By:FrankDelanoReprintedwithpermissionfromtheFreeLanceStarPublishingCompany

KennethC.VanDeusenisa32-year-oldWestmorelandCountylaborerwithbadteeth.Heliveswithhismother,sisterandnephewnearMontross.

VanDeusenisalsopoor.Hetakesworkwhenhecanfindit.Hereckonsheearned$2,000doingoddjobslastyear.Helacksmedicalanddentalinsurance.

InSeptember,atoothachesentVanDeusentotheNorthernNeckFreeHealthClinicinKilmarnock.

Itwasthefirst50milesofamedicalordealthatcostnearly$44,000.Hereceivedrapid,lifesavingcare,butmostofitscostwillbepaidbyeverybodyinonecomplexwayoranother.

Hisjourneyalsoillustratestheplightofthepoorinobtainingdentalcare.HealthcarereformsnowbeingdebatedinWashingtonappeartoofferlittlehopeforbetterdentalcareforthemillionsofpeoplelikeVanDeusen.

AttheKilmarnockclinic,VanDeusenpaid$25toseeadentist,whooutlinedaplanfor10ofhisteeth,includingextractionsandrootcanals.Hesaidthedentisttoldhimeachtoothwouldrequiretwoorthreevisitsatacostof$25pervisit.

“Itain’talot,butitisawholelotwhenyouain’tgotnothing,”VanDeusensaid.“ItjuststartedaddinguptothepointthatIcouldn’taffordit.”

Theclinicaskedhimtopay$25inadvanceforaseconddentalappointmentinOctober.“Ididn’thaveit,soIdidn’tmaketheappointment,”hesaid.

VanDeusen’stoothacheworsened.HewokeupSept.27withpainfulswellinginhisjawandneck.Theswellinginhisthroatmadeithardforhimtobreathe.HissisterdrovehimtotheemergencyroomatRiversideTappahannockHospital.

“Assoonasthedoctorsawme,hesaidthathe’dhavetosendmetoRichmond.Hecalledanambulance,butfoundoutitwouldtaketheambulanceanhourtogettothehospitalandanotherhourtogettoRichmond.HesaidIwassobadoffthathecalledthehelicopter,”VanDeusensaid.

Theambulancethattookhimaquarter-miletoRiverside’shelipadcost$457.The41-mileLifeEvacflighttoRichmondcost$16,298.52.TheambulanceinRichmondthattookhimonemiletoVCUMedicalCentercostanother$500.

Hewasadmittedtotheintensive-careunitatVCU.Insurgerythenextmorning,doctorsextractedthreeofhisteethandinstalledatubetodraintheabscessinhisthroat.Hewasdischargedthenextafternoon.

“WhenIleftthehospital,theytoldmetofollowupwithmyregulardentist,butIdon’thaveone,”hesaid.

Thebillssoonstartedtoarrive.ForhisthreedaysoftreatmentintheRichmondhospital,thebillwas$25,012,“plusbillsontopofthatforotherdoctors,”VanDeusensaid.

“Itjustaddedupsofast.Nowthetotalismorethan$43,000,andthebillsarestillcomingin.

“Nobodytoldmehowmuchallthiswasgoingtocost.Nobody.ButIreallyneededtreatmentatthatpointanddidn’thaveachoice.Icouldhavediedandbeenburiedfourtimesforthatamountofmoney,”hesaid.

ADESPERATENEED

DentalordealssuchasVanDeusen’s“aresituationsfacedbymanyadultsinVirginiaeveryday.Someofthemaresodesperateandinsomuchblindingpainthattheypulltheirownteeth,”saidDeborahD.Oswalt,executivedirectoroftheVirginiaHealthCareFoundation.

VanDeusenisoneofmorethan100millionpeopleintheUnitedStateswithoutdentalinsurance.HeisalsoavictimofwhattheU.S.surgeongeneralcalleda“silentepidemicofdentalandoraldiseases”causedby“profound”disparitiesindentalcare.

“Thosewhosuffertheworstoralhealtharefoundamongthepoorofallages,withpoorchildrenandpoorolderAmericansparticularlyvulnerable.Membersofracialandethnicminoritygroupsalsoexperienceadisproportionateleveloforalhealthproblems,”thesurgeongeneralwroteina2000report.

Locally,dental-careneedsareespeciallygreatamongthegrowingHispanicpopulation,saidDr.CathieH.Butterworth,aFredericksburgdentistwhoorga-nizesanannualfreedentalcliniccalledDentistrywithaHeart.

Dr. Stuart Martin of Richmond (left) and VCU dental student Matt Chapman (right) talk to Kenny Van Deusen about a treatment plan for his teeth. Van Deusen’s dental problems resulted in a $43,991 bill

Chapman shows Van Deusen the problems with his teeth. Van Deusen has no dental care insurance.

Ethics – What Are We Saying About Ourselves? By: Melissa L. Wolfe, D.D.S., Chair, Ethics & Judicial Affairs CommitteeIhaveovertimeobservedthevariouscommu-nicationsandadvertisementsplacedintothepublicview,andIamleftwithsomequestions.Whatdeterminesprofessionalethics?Bywhatimplementareweabletogaugetheappropri-

atenessofanaction?IwenttotheInternettolookforananswer.InanarticlewrittenfortheAcademyofGeneralDentistrybyDonaldPatthoff,D.D.S.,F.A.G.D.,andDavidOzar,Ph.D.onthetopicofethics,theywrotethat“...thecontentofaprofession’sethicsisnotdeterminedsolelybythemembersofthatprofession,butratherindialoguewiththelargercommunityinwhichitserves.”

Iinferfromthatstatementthatifwearelisteningtowhatourcommuni-tiesaresayingandrespondingtotheirneeds,wearetakingappropriateaction.Wealwaysmakesurethatourpatientsarereceivingthebestclinicalcare,butdoweallmakecertainthatwearecommunicatingasclearlyandpurelyasweshouldbe?Ifourpatientsfindamessageoradvertisementpresentedbyamemberofourprofessiontobemislead-ingorconfusingandnoattemptismadetoclarifytheissue,thenweareallowingthecreationofanunethicalsituation.Itfollowsthenthatallcommunicationneedstobeclear.TheproliferationoftheInternetwithin

thelasttenyearshasresultedinvirtualbombardmentofthepublicwithinformationandgreatlyexpandedthedialoguebetweendoctorsandpa-tients.Istheinformationandadvertisingweusetodistinguishourselvesfromotherdentistshealthyforthisdialogue?

Inordertopreservetheintegrityofthisdialoguethereexiststheneedtoimplementasetofguidelinestobefollowed.Thiswillensurethatwespeakwithacommonvoicewhichisconsistentwiththecurrentlan-guageusedbyourgoverningorganizations.Materialwrittenbymem-bersoftheseorganizationsthatisinconsistentwithorcontradictsthecurrentinformationgraysthedialoguewearestrivingtomaintainanddestabilizespublicperceptionofourprofessionandgoverningbodies.Ifwearen’tinagreementwithstandardsorinformationheldtobecurrentbestpractice,weneedtopresentfactualinformationthatbringschangeratherthanpublicizeinformationthatcontradictsit.Weneedtosupportourgoverningbodiesinordertosendacommonandthereforeclearermessage.Arewedoingeverythingwecantosendaclear,consistentmessagetomakesurethatourpatientsarestilllisteningtous?Hereinliesthevitalimportanceofethics.

American Dental Association Statement on Zinc in Denture CreamCHICAGO,Feb.19,2010—Millionsofpeopleusedenturecream(alsoknownasdentureadhesive).Some,butnotall,denturecreamscontainzinc.Afewrecentcasereportsinthescientificliteratureindicateapossibleassociationbetweenexcessiveuseofzinc-containingdenturecreamsandneurologicalandhematologicalproblems.

Ineachsituation,thepatientshadill-fittingdenturesandreportedusingexcessiveamountsofdenturecreamwithzincforyears.Severalpeoplereportedusingtwoormoretubesofdenturecreamperweekforyears,whenonetubewouldnormallylastfor3-10weeks,whenusedasdirected.Theauthorstheorizethatthepatientsprobablyswallowedexcessdenturecream,andthatoveryearsofuse,zincmayhavebuiltupintheseindividual’sbodies.Itiswelldocumentedthatswallowingexcessiveamountsofzinccanraisebloodlevelsofzincwhichcanleadtolowerbloodlevelsofcopper.Thelowerbloodlevelofcoppercanthenleadtoneurologicalandhematologicalproblems.

Moreinformationisneededtodetermineifthereisacauseandeffectrelationship.TheU.S.FoodandDrugAdministrationhasnotissuedanadvisoryorrecallofzinc-containingdenturecreamsatthistime.AsofFeb.19,2010,GlaxoSmithKline,amajormanufacturerofdenturecream,voluntarilydecided,asaprecautionarymeasure,tostopusingzincinthefollowingdenturecreambrands:SuperPoligripOriginal,

SuperPoligripUltraFreshandSuperPoligripExtraCare.TheADAadvisesdenturewearerstoseetheirdentistiftheirdenturesdonotfitwelloriftheyhavequestionsabouttheuseofdentalcream.Dentalexaminationsandappropriatecarecanreducetheneedfordentureadhesiveproducts.

Regulardentalcheckupsareimportantforeveryone,includingdenturewearers.TheADA’sCouncilonScientificAffairswillcontinuetomonitorthisissueonbehalfofourmemberdentistsandthepatientstheyserve.AbouttheAmericanDentalAssociationThenot-for-profitADAisthenation’slargestdentalassociation,representingmorethan157,000dentistmembers.Thepremiersourceoforalhealthinformation,theADAhasadvocatedforthepublic’shealthandpromotedtheartandscienceofdentistrysince1859.TheADA’sstate-of-the-artresearchfacilitiesdevelopandtestdentalproductsandmaterialsthathaveadvancedthepracticeofdentistryandmadethepatientexperiencemorepositive.TheADASealofAcceptancelonghasbeenavaluableandrespectedguidetoconsumerdentalcareproducts.ThemonthlyJournaloftheAmericanDentalAssociation(JADA)istheADA’sflagshippublicationandthebest-readscientificjournalindentistry.FormoreinformationabouttheADA,visittheAssociation’sWebsiteatwww.ada.org


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“Patientsstartliningupat3a.m.,”shesaid.

InJuly,2,715peoplefrom16statesshowedupatafreeweekendmedicalanddentalclinicstaffedby1,800volunteersinWiseCounty.Dentistsconducted1,850exams,pulled3,857teethandfilled1,628cavities.

TheVirginiaDentalAssociationwaspartoftheWiseCountyclinic.Inthepast10years,theVDAhasfielded41MissionsofMercyinmostlyruralsectionsofthestate.Themissionshaveprovided$16.5millionindentalservicesto32,000Virginiansseekingrelieffromthepainandembarrassmentoftheirteeth.

“Icallthisgroup‘thesilentvoicesofneed,’”saidDr.TerryD.Dickinson,execu-tivedirectoroftheVDA.“Youwon’tseethemdownattheGeneralAssemblyaskingforadultbenefits,astheywouldlosetheirjobsiftheymissedadaytoadvocateforthemselves.Thisistrulyapopulationthat,forthemostpart,isunseenandunheard.”

RegulardentalcaremighthavepreventedVanDeusen’stoothache.Buttheneedtofindadentist,highout-of-pocketfees,andtransportationandchild-careissuesoftenpreventlow-incomepeoplefromobtainingdentalcare,accordingtoa2008reportoftheKaiserCommissiononMedicaidandtheuninsured.

TheVirginiaDepartmentofHealthprovidesdentalcare,mostofitforchildren,in39ofthestate’s134countiesandcities.Asafety-netsystemof57commu-nity-baseddentalclinicsprovided43,976visitslastyear,“butthat’sjustadropinthebucketconsideringthehundredsofthousandsofpeoplewithnodentalinsuranceinVirginia,”saidtheVirginiaHealthCareFoundation’sdirector.

“There’sanunbelievableunmetneed,”saidOswalt.Somecommunityclinicsareopenonlyanightortwoaweek.Waitinglistscanbemonthslong.OswaltsaidoneclinicrecentlyreportedtotheVHCFthat“painisnotanemergency.”

HOLESINTHENET

ItwasintothisflimsysafetynetthatVanDeusenjumpedwhenhistoothacheforcedhimtoseekhelpattheNorthernNeckfreeclinicinSeptember.Itwashisfirsttriptothedentistsincehewasingradeschool,hesaid.

Theclinic’ssixdentalchairsarefullfourdaysaweek.Twopaiddentists,vol-unteerdentistsanddentalstudentsseelow-incomepatientslikeVanDeusen.“We’reprettyclosetomaximumcapacity,”saidJeannieNelson,theclinic’sdirector.

Shesaiditcoststheclinicabout$375,000ayeartoprovidenearly$2millionindentalservicestothepoor.Inall,theclinicprovides$6millioninmedical,dentalandpharmacyservicesona$1.2millionbudgetthatdependsondona-tionsandvolunteers.

Thebadeconomyhascutdonationsandincreaseddemandforservices.“Somedonorsarenowpatients.Thisyearwe’refacinga$250,000deficit.Itcouldbethefirsttimeinourhistorythatwe’vebeeninthered,”Nelsonsaid.

Shesaidthe$25feefordentalappointmentshelpsensurethatpatientswillshowupforappointments.Thefeecanbewaived,shesaid.

VanDeusensaidnobodyattheclinictoldhimaboutthewaiverwhenhewasthere.

ThemisunderstandingresultedinVanDeusen’semergencytreatmentthatcost$43,991.88.

Thebillwaspaidbyothers,throughtaxesandhighercostsformedicalcareandcoverage.

FrankDelano:804-761-4300 Email:[email protected]

Dr. Matthew Storm, a Spotsylvania dentist, was one of the volunteers at the 2007 free dental clinic in Southwest Virginia. The huge turnout at the annual event illustrates the need for better dental care for low-income people.

Richard Barnette, 50, was among the thousands of people treated at the free dental clinic in Wise County.

Upcoming M.O.M. Projects

Piedmont Regional M.O.M.May 1, 2010

Wise M.O.M.July 23-225, 2010

Grundy M.O.M.October 2-3, 2010

Register to Volunteer at www.vadental.org

TheThreeRiversHealthDistrict,oftheVirginiaDepartmentofHealthisa10countyHealthDistrict.FiveofitscountiesfallwithintheGreaterWilliamsburgservicearea(Gloucester,King&Queen,KingWilliam,Mathews,andMiddlesex).ThesearetheserviceareasforthedentalvanwhichwillbecomeanadditiontotheVDHsafetynetclinics.

Greater Williamsburg area added to the VDH Safety Net Clinics. By: R. Lynn Browder, DDS, MBA - Quality Assurance Manager, Division of Dental Health

Thevanisa40ftArmorMobilecoachwithtwofulloperatories,lab,x-rays,wheelchairaccessibleandshorepowerorgeneratoroperationcapability.ItisverysimilartotheoneinusebytheRichmondCityHealthDepartmentandstaffedwithafulltimedentist,assistant,dentalhygien-ist/programcoordinatorandaparttimedriver.ItwaspurchasedandmanagedthroughtheVDHwithconsultationandtechnicalsupportfromtheOfficeofCommunityHealthServicesandtheDivisionofDentalHealthandfundedbyagrantfromtheWilliamsburgCommunityHealthFoundationawardedasaresultofDr.Irungu’sef-forts.Theproject’sgoalistotakedentalservicestothecommunityusingamobiledentalclinic.Serviceswillincludepreventive,emergencyandcomprehensivecareforbothchildrenandadults.TheserviceareaandpopulationtobeservedwillbealltheresidentsofthefivecountiesintheWCHFservicearea;wewillspecificallytargetlow-incomeuninsuredandunderinsuredchildrenandadults,childrenwithMedicaid/FAMISandthosewithoutadentalhome.Thevanwillpartnerwithlocalnonprofits,schools,privateprovidersandtheVDAinsupportofthelocalMOMprojects.

Virginia Oral Health Plan 2010 - Excellent Oral Health for All VirginiansBy: Sarah B. Holland, Virginia Health Care Foundation

InOctober2009leadersinoralhealthfromthroughoutthestategatheredatanoralhealthsummittocreateafive-yearstateplandesignedtobearoadmaptobringallVirginiansexcellentoral

health.SummitparticipantscontributedtheirexpertiseandexperiencesinbreakoutsessionstoidentifygoalstowardachievingexcellentoralhealthforallVirginiansandtooutlinenecessarystepsandobjectivestomeetthosegoals.

TheVirginiaOralHealthCoalition(VOHC),agroupofindividualsandorganizationsfromthroughouttheCommonwealthwhoarecommittedtoimprovingtheoralhealthofeveryoneinVirginia,convenedasteeringcommitteeofrepresentativesofawidevarietyofgroupswhocareaboutoralhealthtosynthesizetheinformationfromthesummit.TheresultistheVirginiaOralHealthPlan,alivingdocumentdesignedtobeusedasaroadmaptomeettheultimategoalofexcellentoralhealthforallVirgin-ians.Theplanisdividedintosixstrategicareas:StrategicAreas:

I. PublicAwarenessII. AdvocacyIII. OralHealthDataIV. EducationV. NewOralHealthProgramsVI. VirginiaOralHealthCoalitionDevelopment

Theplan’soverarchinggoalsare:educateandengagethepublicabouttheimportanceoforalhealth;makecertainthelawsandregu-lationsinVirginiasupportoralhealthaccessandeducation;ensurethataccurate,comprehensiveoralhealthdataexists;andpreparedentalprovidersandfuturedentalproviderstomeettheneedsoftheunderservedinVirginia.TheplanwillbemanagedbyVOHC,whichhascreatedworkgroupsforeachstrategicarea.Membersoftheworkgroupswillactivelymanagetheactionstepstomakecertaintheobjectivesandgoalsoftheplanaremet.

IfyouareinterestedinimprovingoralhealthinVirginia,VOHCseeksyourparticipationinoneoftheworkgroups.FormoreinformationabouttheVirginiaOralHealthCoalitionortheVirginiaOralHealthPlan,pleasecontactSarahBedardHollandat:[email protected]


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Editor’s Note: “An incredible tale of abuse, neglect, parenting and triumph…” says Lynn Mouden, DDS, MPH, founder of P.A.N.D.A.. Dr. Terry Dickinson calls it “A story of hopelessness that turns into a story of hope.” Past ADA President Kathleen Roth says “…the facts behind her dental saga are…important for all of us in dentistry to hear and understand.” Since its publication in 2003 The Covered Smile has touched the lives of many dentists and their patients. The VDA Journal spoke with author Sonja Lauren as she prepared to launch her founda-tion dedicated to helping victims of dental neglect and abuse.

How has your life changed since The Covered Smile was pub-lished in 2003?I’veworkedharderthanIeverimagined.Networking,publicspeak-ing,volunteering,lecturingtostudents,andtryingtofindwaystohelpthoseinneed.Iwentfromworkingasanophthalmologist’sassistanttoworkinginthedentalfield,beingthepresidentofTheCoveredSmileInc.,andthePresidentoftheSonjaLaurenFoundationInc.Lifeisneverboring.Also,mydaughtergraduatedfromtheChesterfieldTechCenterandearnedherD.A.,andrecentlyhasbecomeanoralsurgeryassistant.Mydaughter’slifeandminewerechangedwhenwevolunteeredatourfirstMOMProjectin2006,inWiseCounty.Forthefirsttime–IfoundouttherewerepeoplewhotrulycaredandthatIwasnotalone.Mydaughter’sdesiretohelpotherswasbornatthisMOMproject.I’vechangedfrombeingabeggartobeingsomeonewhocannowhelpothers.Mydaughter’sdentalassistingteacherre-quiresherstudentstoreadthebookandattendaMOMProject.Everyfall,IaminvitedtospeaktotheChesterfieldTechCenterstudentsaftertheyhavereadThe Covered Smile-theyaretrulymyfavoriteaudience.Has writing this book led to any unexpected consequences? IttookmuchlongerthanIthought.Istruggledlongandhardtocom-pletethis.Itellpeoplewhowanttobepublished:walkintoBarnesandNobleandlookaround.That’syourcompetition.Also,published

An Interview With:Sonja Lauren

authorsareexpectedtobepublicspeakers.IjoinedToastmasters–itwasveryhardformeatfirst,speakinginpublic,infrontofpeople.IgavemyfirstlecturetothestudentsatMCV,onClinicDay,theclasswasaskediftheywantedtohearalecturefromafacultymember,orhearaboutapatientwhohadallherteethextractedatagethirteen.Theyvotedtohearmystory-“apatient’spointofview”.

What encouraged you to start your own foundation?JohnRandall,whowasontheboardofPreventChildAbuseVirginia,metmeatacharityeventandIsenthimacopyofmybook.He’sbe-comeamentortome,providinghelpandencouragementateveryturn.WhenItoldhimIwantedtohelpmorepeople,butIhaveadayjob,hesaid,“Youneedafoundationsoyoucancombineyourpassions!”LatertheShoeCarnivalcompanycontactedmeandwantedtomakeadona-tiontomyfoundation,butItoldthemIdidn’thaveone.FinallyIadmittedJohnwasrightallalong,andbegantheprocessofdevelopingtheSonjaLaurenFoundation,Inc.Sofar,myefforthasnotfreedmetodootherthings,butithasexpandedmycontacts,speakingengagementsandabilitytohelpothers.What makes the Sonja Lauren Foundation unique?I’vebeentoldbymanywehaveafreshnewwayofdoingthis.Iaskmyself:whatcouldhavehelpedtwelveyear-oldSonjaLauren?IdeeplyunderstandtheimportanceofthisissuebecauseIhaveworndenturessincetheageofthirteen.Wewillprovideeducation,exams,cleanings,prevention,andalso,wewillaskclientstobepartoftheeducationalprocessandbefollowedforoneyearaftertreatment.Dentistscancon-tactusandapplyonbehalfofapatient–wewillhelppayfortreatmentswhenthefundsareavailable.Wewantchildrenandeachsucceedinggenerationtohavegoodoralhygienepractices.Wewanttohelpthosepatientswhodon’thaveMedicaidordentalinsurance.Thosewhoarestuckinthemiddle,ifyouwill,thosewhoarewhereIoncewas.

Over the past ten years, has abuse and neglect of children gotten worse or better? Why?Icontactedtheexpertsonthisone.JohannaSchuchert,atPreventChildAbuseVirginia,sayssexualabuse,physicalabuse,andemo-tionalabusehavedeclinedsincethe‘90s,butemotionalneglecthasincreased.BothsheandDr.LynnMoudenofPANDAsayabuseandneglecthaveincreasedinthelasttwoyearsduetotheeconomy.Abuseandneglectalwaysgoupwhenunemploymentincreases.Ithoughtitwasgettingbetter,butitisstillaverybigproblem.I’venevergivenalecturewhenatleastonetothreepeopledidnotcomeuptomeafter-wardsandsay,“thatwasme”.

Do you have mentors? Who are they?Yes,IhavesoverymanywonderfulmentorswhoIamthankfulfor!I’vealreadymentionedMr.JohnRandall,andthere’sDr.BillieUnger,mypurple-pennedwritingprofessorwhotaughtmefarmorethanhowtowrite,shetaughtmetonevergiveup.DeborahHatchell,executiveassistantatChickenSoupfortheSoul,calledmebackafterIleftames-sage,andhassincetookmeunderherwing–andprotectedmewhenIwasnegotiatingwithpublishers.Iwasblessedtofindher.Dr.LynnMoudenfounderofPANDA(PreventAbuseAndNeglectThroughDentalAwareness)hasbeenamentor,alongwithLindaMiles(she’sfromWestVirginia,too),andofcourseDr.Dickinson,DavePelzer,whowroteAChildCalledIt,andDr.KathyRoth,whowaspresidentoftheADA.Therearemanymorewhohavehelpedalongtheway.My“adoptedmomanddad”asIcallthem,havelovedme,guidedmeandsupportedmesincetheageof18.

In what ways is the dental profession failing its patients? Idon’tfeeltheprofessionisfailingitspatients.Dentistsanddentalor-ganizationsareworkinghardtoincreaseaccesstocare,butthere’sstillsomuchtobedone.Nowwehavedentistsnotwantingtohavepooraccesstooralhealthcareanditsconsequences:there’sGiveKidsASmile,MOM,OralHealthAmerica.Theyareallreachingouttolegisla-torsandourcountrytobringawarenessofhowimportantoralhealthistotheoverallhealthofone’slife.

From your perspective as a patient, has the dental profession redeemed itself? Asforthegroupofdentiststhatwrote“situationhopeless”onmydentalchartandremovedallofmyteethforcingmetoweardenturesattheageof13yearsand3monthsofage–Idon’tassociatethemwithotherdentists.Somehow,Ineverhave.Duringmyadulthood,Ihavebeentreatedwithkindnessandrespectbymanydentists.EspeciallybyDr.JohnWardwhothroughkindnessandgenerositymademebeautifuldentureswhichnotonlygavemysmileback,butalsomyselfesteemandlifebackforthefirsttimesinceIwasthirteenyearsold…

Do you have any advice for new dentists? WhenIlecturetodentalstudents,Isuggestthattheyconsiderbuildingtheirpracticeontheconceptof“word-of-mouth”typemarketing.Whilemarketingagenciesandstrategiescanbehelpful,themostimportantfactorofallisthesatisfactionofthepatient.IsuggestnewdentistsvolunteerwiththeMOMProjects,GiveKidsASmile,orotherformsofcommunityservice,becausepatientsandtheircommunitywillknowthemasadentalpracticewhotrulycares.Ialsobelievedentalstudentsneedtoreadandunderstandthedentalcreedfully.

What changes should be made in the education of dentists? One,dentistsshouldberequiredtoattendaMOMorsimilarprojectbeforetheyareallowedtograduate.Two,dental(students)shouldberequiredtoreadThe Covered Smile.IspoketothestudentsatWestVirginiaUniversity(SchoolofDentistry)andthedeanmadeitrequiredreadingforthird-yearstudents.Onestudent(intheclassof2013)didhismaster’sthesisonthebookbeforeheenrolled.IhavebeentoldrepeatedlythatThe Covered Smileismakingadifference,notonlyinthelivesofthoseinneed,butalsointhelivesofthosewhoserveasprofessionalsinallmedicalanddentalfields…

Mrs. Linda Miles, Dr. Terry Dickinson and Sonja Lauren.

Visit the Sonja Lauren Foundation website at:www.sonjalaurenfoundation.org

DONATIONS NEEDEDDr.TaraZierandDr.GraceLeeofSmilesatFairfaxCorneraregoingonamissionstriptoRwanda,AfricaJune28ththroughJuly9th.Wewillbeprovidingdentalcaretoanindigentcom-munityinKigali,Rwanda.Currentlytherearenoinstrumentsorsuppliesavailable.Ourplanistosetupafacilitywithinstru-mentsandequipmentforfuturemissiontrips.Ourclinicalfocusfortheinitialtripissurgeryandoralhygiene.Weareinneedofextractionsetups,localanesthetic,needles,syringes,Tylenol®,Motrin®,penicillin,sutures,toothbrushes,toothpaste,floss,masks,gauze,smallandextrasmallgloves.Anydonations

aregreatlyappreciated.Ifyouhaveanyquestions,feelfreetocontactDr.TaraZierat(703)222-3245oremailherattzier@

fcsmiles.com.Pleasesendanysuppliesto:

SmilesatFairfaxCorner4210FairfaxCornerWestAvenue

Suite220Fairfax,Virginia22030

Thankyouforyoursupport!

Looking for your “Patient’s Page”?

Thumb Sucking and Pacifier UseSimply go to the ADA website

at this address:

http://www.ada.org/prof/resources/pubs/jada/patient/patient_77.pdf


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Middle Peninsula/Northern Neck M.O.M. ProjectBy: Phyllis Bryant Harris The25°tempera-turedidnotdeterpatientsfromliningupintheearlymorninghoursofSatur-day,February13,2010atGloucesterHighSchoolforthefirsteverMiddlePenin-sula/NorthernNeckM.O.M.Project.Theprojectwasheldfrom7a.m.to5p.m.withsetupandpre-regis-trationof125individualsonFridayafternoon.ItwasfundedbytheGloucester/MathewsFreeClinicandtheNorthernNeckFreeHealthClinic. AsthiswasourfirstMOMProjectintheGloucesterarea,theplan-ningstartedoverayearagointheofficeofDr.Charles(Chuck)R.Harris,Jr.ofHayeswithKellyCooperandSharonHargisleadingthe

charge.Wewereblessedwithanoverflowofvolunteers,havingtoturnawaymorethanwecaredto. AVolunteerDinnerwasheldFridaynightaftersetup.Thedeliciousfarewasdonated,preparedandservedbymembersoftheAbingdonRuritanClub.ManyoftheirmembersalsovolunteeredtimeinotheraspectsoftheM.O.M.Project.Atotalof367volunteerswerefedandleftfulloffood,fellowship,andfilledwithexcitement. I’membarrassedtoadmitthatI’veneverparticipatedinaMOMProjectpriortoMPNNotherthandroppingChuckoffatthedoor.I’velistenedinaweabouttheEasternShore,Emporia,andNagsHeadprojectsbut,asaretirededucator,neverfeltIhad

theskillstocontribute.Boy,wasImissingthespiritoftheproject. ItwasAWESOME!Dr.CarolBrooks’sVCUdentalstudentstransformedourauxiliarygymintoadentalextravaganzalikeawell-oiledmachineonFriday.AfterafewinitialbumpsSaturdaymorning,patientsmovedthroughregistrationandx-rayandwerebandedaccord-ingtotheirdentalneeds.ChildrenwerefortunatetobethefirsttousetwobrandnewNavymobiledentalunitsandtheThreeRiversmobileunit,whichhadonlybeeninusetwomonths.Alocalchildcareprovider

TheNumbers...

Totalpatientstreated:501

549Volunteers!Amazing!!

Totalvalueofcareprovided:$323,827

To date: 44 Completed projects

Patients treated: 34,398

Total value of donated care: $17.4 million

entertainedandcaredforchildrenwhiletheircaretakerswerebeingseenbyourwonderfulprofessionalvolunteers. Alongwiththe86studentsandfacultyfromVCU,wehad57doctors,24hygienists,65dentalassistantsandotheramazingindividualstotaling385cheerfulvolunteersgivingoftheirtimeandtalentstohelpserveourarea.Wewerehonoredtohaveasoneofourvolunteers,Dr.RonTankersley,presidentoftheAmericanDentalAssociation. Weservedatotalof501patientsonSaturday,442adultsand59childrenandturnedaway300people.OurpatientsnotonlycamefromtheMiddlePeninsulaandNorthernNeckbutfromChesa-peake,CharlesCity,Lynchburg,Hampton,NewportNews,YorkCounty,andManassas.Therewere129cleanings,630fillings,and709extractionswithanestimatedvalueofcareat$323,827.That’salotoffastmovingfingers! OursincerethankstoDr.TerryDickinson,executivedirectoroftheVirginiaDentalAssociation,forhisguidanceandvisionfortheMOMProject;toBarbaraRollinsforherexpertiseanddata;toDr.CarolBrooks,whohasmytotaladmirationasaneducator;toBillHall

formakingitallhappen;andtoGloucesterCountyPublicSchools&EdBerryformakingthemiracleofelectricityoccurwithoutahitch.SpecialthanksalsotoChuck’sofficefortheirdedicationandforincludingmeaspartthismomentousendeavor. DidImentionourphenomenalvolunteers?Wewereblessedwiththemostgiving,enthusiastic,pleasant,andwonderfulgroupofvolun-teers.TheentireMOMprojecthasbeenaneventthathasunitedourcommunity,workingtogethertohelpeachotherinatimewhentherearesomanyinneed.

Dr. Ron Tankersley, president of the American Dental Association and Dr. Ralph Howell, past president of the Virginia Dental Association at the MPNN MOM Project.

Dr. Nathan Vogt performs restorative work on a patient during the MPNN MOM Project at Gloucester High School, of which he is an alumni.

Sylvia Ransome, hygienist

Dr.MikeAbbottDr.AnaMayaAdkinsDr.HeathAllenDr.SethAndersonDr.BaughnDr.SidneyBeckerDr.BerryDr.BobDr.BrickhouseDr.DavidBurnsDr.DonnaBurnsDr.HenryCatheyDr.MichaelClarkDr.DennisClecknerDr.GregColeDr.CharlesCountsDr.BenjaminCrowleyDr.WilliamDavenportDr.BobbyDavisDr.CrisDedmondDr.TerryDickinsonDr.WilliamDodsonDr.RobertDreelinDr.RodneyDukartDr.EdwardsDr.StevenForteDr.BobbyGarofalisDr.IraGoldsteinDr.ChuckHarrisDr.RalphHowellDr.MarkHuieDr.AlfredHurtDr.HussonDr.ThomasIrunguDr.CharlesJohnsonDr.KordisDr.TrishaKrauseDr.AnnLagonegroDr.RandyLazearDr.RayLeeDr.TimothyLeighDr.CaseyLeserDr.LannyLevensonDr.JosephLombardDr.PrestonLovingDr.StuartMartinDr.KatieMartinDr.KristinMastrosDr.BenMcCartyDr.RodneyMcDanielDr.DanielMesserschmidtDr.EricMillerDr.ShanailMoormanDr.DavidMorrisDr.StephenMurphyDr.AubreyMyersDr.SusanO’ConnorDr.JohnOwenDr.DarrylPirokDr.DanielPouchotDr.ReedDr.ScottReidDr.PhilipRenderDr.MelvinResslerDr.RichardRoadcapDr.JuanRojasDr.NoelRootDr.MichaelShuckDr.JeremyShulmanDr.HarrySimpsonDr.Maria-PazSmithDr.JohnSpeelgeDr.PatrickSpragueDr.JamesStevensDr.DanielStockburgerDr.MatthewStormDr.KennethTankersleyDr.RonaldTankersley

Dr.MichaelTrudeauDr.CassidyTurnerDr.NathanVogtDr.WarrenWestDr.ThomasWittyDr.HollisWolcottDr.HarveyWoodruffDr.JamesWoodsonDr.GregZoghbySiobhanAbbottAshleyAbesamisMollyAdlerDarleneAebodiczAmenAlemayehuCheleAllenZaidAl-SamirKhalidAminKatherineAndersonLorettaAndersonRitaAndersonBrendaAsheMelodyAshleyTinaBaileyBethBarryEdBarryBrendaBazemoreAngelaBeachyDickBeasleyDorenaBeckJonBeckAdamBeckerAmyBelloliSanjayBhagchandaniTamaraBishopGrahamBlakeSueBlakeTaylorBlakeLeighBlakistonPamBlankenshipKatieBlanksDonBlazekJenniBobbiJohnBoonMollyBoonPamBowensJenniferBoylandLindaBradfrodKayBradleyRobertBradleySharonBrinkleyNicoleBrooksNilkaBrownTaylorBrownLisaBrownCarolBruceRonBruceAmandaBurakKristyBurakRandyBurakSusanBurakMarshallButlerRoseMarieButzJudyCahillReneeCallisAnnCarterBridgetCarverDanielCarverBrandonCastorJudyCatheyBettyCerroKathyChandlerRachelCharltonCindyCheelyEddieChoiMinChoiMatthewChroustJamieClarkJessicaClark

SteveClawsonCarolClecknerSylviaCliftonAndyCoalterMarkCockerhamSusanCockerhamFrankCollinsPatCollinsSelenaCollinsCrystalColwellRobinCombsCindyComerMikeComerAshleyComptonK.D.CooperKaitenCooperKamrynCooperKellyCooperDonnaCowherdanddaughterDarleneCoxChristinaCramerMariannaCrossBenCrowlyDavidDallingSharonDarnellJeffDavidsonLindyDaviesCherieDavisReneeDavisRoyDavisChuckDawsonJoanDawsonBrittneyDedmondAnnDeLusaJulieDeLusaStephenDePasqualeChantelDevalkRogerDickKimDisilvaYvonneDodsonBrittanyDossLindaDouglasChristineDragooVickiDreelinNeilDrumhellerSusannaDrumhellerAnnDugasSidDugasBettyJaneDuncanMichelleDunlevyMitchellDunstonDavidDurhamJohnDuttonRennieDuttonCourtneyDyeDoraDyeAnneDyleMalindaEdgecombAshleyEdlinAhmedEldibJodyEmersonRitaEngleLibbyEppsJoyceEstesCindyEubanksEdEwellJanetEzzellMaryFaryBrittanyFieldWandaFletcherRachelForemanLindsayForteStevenForteTammyFortuneJohnFosterPamFosterKurtFrancisElizabethFreeman

DonnaFunkhouserMaryGallowayJessicaGardnerLindaGaskinsDanaGeorgeCarolGiffordFrankGillerlainWilliamGoldenMichaelGoldsteinTomGoyneDoreenGrannissChristineGraybealKellyGreetKarenGreggSeanGreggFredGrossDottieGujuLoriHackettBarbaraHaleyLeighHaleyBillHallLydiaHallTiffanyHallAshleyHansinCherylHansinLeighHargisPamelaHarrellCherylHarrisChrisHarrisKathyHarrisNickHarrisPhyllisHarrisSaraHarrisChestonHarrisDianHartleJudyHartmanCindyHastingsJoanieHauryLisaHayesLizHayesCindyHaynesRudyHeinatzStephanieHeinatzTiffanyHellebranatBridgetHengleDavidHerceBrianHerodHeidiHessler-AllenAndreHintermanMaryHintermanAliceHockadayElliottHoggeWendyHoggePamHollisMichelleHoltBeckyHorsleyNedaHovaziJeanHowardDanielHowellTammyHowellConnieHudginsBettyHundleyJenniferHuntCathyIveyDonnieJacksonAveJappinenMichaelJeffersSusanJenkinsNatalieJohnsonPatJohnsonCharlesJohnson,Jr.KathleenJonesDavidJonesEdwardTJordanKarenJowersCindyKahleSarahKandracChelseaKanodeGailKerns

CarolineKerseyLisaKerseyHelenKietzCindyKillingerJanetKingStephenKingMaryJaneKipperErinKnouseJoKoontzKarenKrausThomasKrebsTommyKrebsJonathanKremserPatKurovicsNancyLaLandAllenLaRocheTheresaLatesMaryHelenLayneDennisLeFeverGailLeFeverAnnieLeffingwellBonnieLeffingwellJimmeLeifferSandraLeifferMegLemasterCaroleLewisDebraLillyScottieLovingPeytonLovingRaquelLovingJenLysenkoCathyMackerneyNickMadduxChavonneMarionSusanMasclatBrittanyMasiclatCorneliaMayesKimMazzolaBaileyMcBrideBillMcCoreyLaurenMcCoreyDianeMcGannonMaryCatherineMcGinnStephanieMcGowanRuthieMcNamaraJulietMeansGeneMedkiffAmyMelvin-WardKathyMenefeeWilliamMenefeeChrissyOguraMeyersSandyMikuleckyMarshaMillerPaulMillerRobertMillerSixiemeMillerBillMinnickPaigeMitchellCourtneyMooreMichelleMooreAnthonyMorandeGusMorandeIsabellaMorandeJacquelynMorandeSueMorecockPatsyMorganDanaMorrisMarilynMorrisPerryMorrisLissaMorrisonJeppyMossGlennahMoyKarrieMurphyJudyMyersElizabethNealSteveNeilJeanNelsonTaylorNelsonMelissaNewsome

PeggyNewsomeBrendaNicholsJuliaNiculescuJustinNorboDavidOnestyNickPappasLourdesParkerBruceParmiterDavidParmiterJanetParmiterArianaParodiSuzanneParodiJimPerryAmberPhelpsMaryAnnPhilyawTysonPickettBeckyPirokChrisPopeWilliamPotterMelissaPouchotKelliPrattBarbaraPreistWalterPreistValeriePrincePeatPruntyAnnQuinnKathleenRachelMargaretRandolphSylviaRansoneKevinRasmussenEmilyRatliffReneeRatliffSaraRatliffRobertaRayDawnReeseEllieReidMichelleResslerJohnReynoldsJosephRiceLeeRicePattyRichardsBerkleyRichardsonTraceyRichieBuddyRileeMaryRileeShannonRoaneGuenivereRobbinsEmilieRobertsKathyRochelle-BernhardtMichaelRoddyBarbaraRollinsJoeRollinsKimRonanLauraRoweJessiRowseyPatrickRuckAmanSabharwalCarolynSalmonGeraldSalmonLauraSamsEuNieceSamuelDonaldSandridgeTashaSaulsJackieSaundersAlexSchickLeoSchollGeoffSchreiberGlendaSchroederCharlieSchwabeCarolynScottJessieSeeleyEloiseShankleChristySharpePeteShepardSueSheppardAlexShickEmilyShuckHowardShye

RyanSimoneLaTonyaSladeDawnleighSlaughterAnthonySmithBeckySmithEthelSmithGordonSmithMichelleSmithRoseSmithMarySmitheRoySnowdenJohnSnyderSusanSolesBetseySoulsbyJanetSouthTiffanySpeasBettySpeegleJohnSpruillValindaStairsAmberStephensonBarbaraStevensJenStevensRobinStewartStephanieStewartHeatherStoddardDebraStodgehillAprilStricklandMichelleSwartzKristenSwartzAdamTaylorJoyceTaylorKentTaylorKerryTaylorLouTaylorMeghanTaylorShelbyTaylorRonTaylorKelleyTenhagenRupertThomasCoreyThompsonSylviaThompsonHarperAThompsonJessicaThompsonPamTokarzColeTomlinsonMatthewTTomodaCharlesTowmleyAmyTrnDorothyValentineLuzMarinaVaughnOscarVegaHuixinWangBillWarnerWilliamWarnerMaryWarrenTonyaWeaverWyattWeaverEllaWebsterDeenaWestAustinWestoverManaWestoverJulieWhiteToriWhiteCandaceWhiteheadArleneWillAngelaWilliamsBobbyWilliamsPriscillaWilliamsRachelWilsonDanielLukeWinterStephanieWisniewskiDeborahWoodMarthaWoodruffDianaWootenGrayWootenLaurenWunderMelissaYardLindaYoungRobinZophy

Thank you to the Gloucester M.O.M. Volunteers...


Onceuponatimeinalandnotsofarawaylivedayounglad(well,maybenotsoyoung)namedJack.Jackhelpspeopleplanfortheirfinancialfuturesandmanagetheirassets.Hisburningdesireistomakecertainthathisadviceisalwayssoundandcutting-edge.So,hesurroundshimselfwithotheradvisorswhohavethesamephilosophy.Asapartofhiswork,Jackalwayswantstomakesurethathiscli-entsarepreparedtomanagetheMortgageBeast,sohisfriend,Charles,theMortgageMaster,isonesuchadvisor.Thisbeastalwaysseemedtobesolarge,complex,andever-changing,andJackwantstobecertainthathisclientscanalwayskeepthebeastundercontrol.So,offJackgoesonajourneytofindoutwhattosaytohisclientswhentheyask,“WhatmortgagecanIafford?”Jackskipsmerrily(actually,hedrives)toCharles,TheMortgageMaster’smountain.HefindsCharlesathisdesk,calmlyreviewingrates,signingpapers,andtalkingwithhisclients.“Charles,myfriend,”Jacksays,“IhavesomequestionsthatIthinkonlythegreatMortgageMastercanhelpmewith.Willyou?”“Certainly,Jack.Whatwouldyouliketoknow?”repliedCharles,TMM.“Well,first,greatMortgageMaster,I’moftenaskedtheques-tion,HowmuchmortgageshouldIhave?WhatdoIsay?“Jack,youalreadyknowtheanswer.They’reaskingthewrongquestion!”“GreatMortgageMaster,whatdoyoumean?”“Jack,therightquestionsare:HowmuchmortgagecanIaf-ford?HowmuchmortgagecanIqualifyforcomfortably?”“Yes,you’reright.Theyaretherightquestions,butwhataretheanswers?”“Well,Jack,asofJanuary1,2010,therearenewrulesforqualifyingforaresidentialmortgage.Theyarebasedonratios;forexample,howmuchincomeyouhaveversushowmuchhomevalueyouwanttobuy.Or,saidanotherway,whatistheproposedhousepaymentplusyourtotaldebtinrelationtoyourgrossincomeorabilitytopaywithoutpotentialdefault?”“Ah,Isee,GreatMortgageMaster.Youhavetohavetheincometobeabletoultimatelypayoffalldebtthatyouincur.Therearenolongeran‘unbelievablefreeorhighlyleveraged’mortgagepackages.”“That’sright,Jack.Whiletherearesomegreatdealsavailable,theeconomicenvironmenthasfinallyrealizedthatdebtisanissueandyouhavetobeabletopayforwhatyouget.So,keepingyourcreditrecordcleanisimportant.Therearesomecompensatingfactorsthatweconsider,though.Forexample,goodcredit,incomestability,andliquidassetsareallareasweconsiderpositivelywhenwe’rereviewingarequest.”“O.K.,then.Nextquestion.Whatarethebiggestproblemsyouencounterwhenyoutrytohelppeoplegetresidentialmortgage.I’veaskedthequestion,butIbetIcantellyoutheanswers.”“Asafinancialadvisor,Jack,Ibetyoucan.Ofcoursethebig-gestproblemsweencounterare:1.Excessivedebt,and2.Unrealisticexpectationsaboutwhattheywanttobuyversuswhattheycanafford.”“GreatMortgageMaster,that’sexactlywhatIwouldhavesaid.Unfortunately,Ithinkthattheeconomicexuberanceandleveragingprogramsofthemid-1990scausedfolkstobeabitgreedyandthinkun-realistically.Someforgotthatdebthastoberepaid,regardlessoffutureeconomiccircumstances.Whenthemarketsbegantowhirloutofkilter,

debtwasstilltheretobepaid,eventhoughtherewassubstantialloss.So,what’syouradvicenowtofolksseekingresidentialmortgages?”“Jack,IthinkI’dtellfirsttimehomebuyerstoseekamortgagewithwhichtheyfeelcomfortablemakingthemonthlypayments.Havingabigfirst-timehomethatyoureallycan’taffordoraresqueezedinotherareasinordertopaywillprobablygetyouintrouble.Ifyou’rerenting,considerthecomfortoftherentlevelyou’repayingnow.Inwhateveryourcircumstance,buildyourmortgagepaymentaroundyourcomfortzone.Ifyou’rea‘mid-life’typeofpersonseekingalargerhome,againknowyourcomfortzonewithsomeupgrading.Remember,thereareadditionalcostssuchasinsurance,taxes,maintenance,upgrades,andcontinuingissues.Considerallpotentialcosts.Ifyou’refacingretirementyouhavevariousoptions.Youmightwanttopayoffyourmortgageasquicklyaspossibletohaveadditionalincomeinretirement.Butcheckwithyourfinancialadvisortomakecertainthat’sbestforyou.Oryoumightwanttoconsiderareversemortgageorsecondhome.Eachoptionhasotherfactorsthatneedstrongconsideration.Research,askquestions,gettoknowthefacts.Baseyourdecisiononyourcomfortzoneandthefacts.“Goodinformation,GreatMortgageMaster.Butwhatwouldbeyourfinaladvicetogivesomeoneseekingahomemortgage?”“Knowyourcredit-worthinessandprotectit.Makesurethatyouhaveanincomeandassetstopayyourdebts,includingyourmortgage,regardlessofeconomiccircumstances.Andaboveall,knowyourfinan-cialcomfortzone.”Ifyouworkwithallofthesefactors,you’llbeO.K.”“Thanks,GreatMortgageMaster.You’veconfirmedmythoughts.Icangonowinpeace,knowingthatmyclientswillreceivegoodadvice.”

Note:Ifyou’dliketogettoknowCharlestheMortgageMaster,pleasecontacthimat:CharlesA.Merrill,II,SeniorMortgageConsultant,DominionMortgageCorporation,2810N.ParhamRoad,Suite245,Richmond,Virginia23294,Office:934-9500,ext.113,tollfree;877-542-8500,ext113,[email protected]

Jack and The Mortgage MasterBy:E.WayneBullis,Ed.D.,CSA,CRFA

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PathologyPuzzlerwith Dr. John Svirsky

A42-year-oldCaucasianmalewasreferredfromageneraldentisttoanoralsurgeonforevaluationofaradiolucentlesionoftheanteriormandiblebetweenteethnumbers26and27(figure1-3).Thelesionmeasured1.0cmby0.8cmandextendedfromthedistaloftoothnum-ber26andoverlappedtherootoftoothnumber27.Theteethwerevitalandthelesionwasasymptomatic.Therewasslightdivergenceoftheroots(figures1-2)ofteethnumbers26and27withslightexpansiontothelingualonthesagittalcrosssectionoftheCTscan(figure3).

Yourdifferentialdiagnosiswouldinclude:

A. LateralperiodontalcystB. OdontogenickeratocystC. Ameloblastoma.D. CentralgiantcellgranulomaE. CalcifyingepithelialodontogenictumorF. CalcifyingodontogeniccystG. CentralossifyingfibromaH. Adenomatoidodontogenictumor

Figure 1

Figure 2

Figure 3


Continued on page 27


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Volume87,Number2•April,May&June2010 2524VirginiaDentalAssociation

Pediatric AbstractsDiversity of asthma, evolving concepts of pathophysiology and lessons from genetics. Lilly, C. J Allergy Clin Immunol 2005;115(4-S1):S526-531.

Inthedevelopedworldasthmaisnowanepidemicwithasmanyasoneinfoururbanchildrenaffected.Asthmaisassociatedwithsubstantialmorbidity,mortality,andaneconomicburdentothemedicalinfrastructure.Asthmaisacomplexdisorderofbronchialhyperresponsivenessandisadiseaseofgeneenvironmentinteractionwithcompleximmunobiology.Allergicasthmaisinitiatedearlyinlifebythedeliveryofanallergentotheairwayresultinginasubsequentimmunerecognition.Anothercomponentofasthmaisthegeneticmakeupofanindividual.RecentadvancesinhumanDNAsequencinghasmadeitpossibletoidentifyasthmagenesandtheirasthmamediators.Expressionarraytechnol-ogyallowscomparisonoftheexpressionofthehumangenomeincellsfromasthmaticsandhealthyindividuals.Theauthorshaveidentified141sequencesashavingincreasedexpressionand8thathavedecreasedexpression.Severalgenesareknowntobeassociatedwithallergenexposure,theseincludelipocortin,thep65subunitofNFKP,IL3,IL4andIL5receptorsubunits.Alargepercentageoftheidentifiedgenesareknowntobeafactoringrowth,differentia-tion,andproliferation.Theresultsimplyasthmaisnotonlyadiseaseofairwayinflammationbutinvolveschangesinthegrowthandtissueresponsivenesstoantigenexposurewhichevolveoveranextendedtimeperiod.

Dr.JamesDibelkaisaresidentinpediatricdentistryatVirginiaCommonwealthUniversity

Sporadic Burkitt’s Lymphoma of the Jaws: The Essentials of Prompt Life-saving referral and Management. Jan A, Vora K, Sán-dor GK. Journal Canadian Dental Association. 2005;71(3):165-8.

ThispurposeofthisarticlewastogiveabriefreviewofBurkitt’slymphoma(BL),presentacasereport,andtohelpcliniciansrecognizesuchcases.

Burkitt’slymphoma(BL)isamalignanttumorofB-celllympho-cyteoriginandisclassifiedasanon-Hodgkin’slymphoma(NHL).Threeclinicalvariantsarerecognized:African(endemic),American(sporadic)andHIV-associated.EachBLsubtypehasdifferentcharacteristics.EndemicBLisusuallydiagnosedbetweenagesof5and7yearsandinvolvesthejawsaswellasotherfacialbonesin60%to80%ofcases.Also,endemicBLisstronglyassociatedwiththeEpstein-BarrVirus(EBV).SporadicBLisassociatedwithslightlyolderchildren,averageage12years.Theabdomenisthemostcommonsiteofpresentation.About25%ofsporadicBLcasesinvolvetheheadandneck,mostcom-monlyintheformofcervicallymphadenopathy.AdultBLpatientsareal-mostalwaysafflictedwithAIDS.BLaccountsfor40%ofHIV-associatedNHLcases.UnlikeendemicBL,bothsporadicandHIV-associatedBLhavelowassociationwithEBV.

SignsandsymptomsoforalBL,whichincludemobileteeth,toothache,oralmasses,gingivalenlargement,pain,jawexpansion,swellingandsensorydisturbances,havebeenrecordedwithpainbeingthemostcommonpresentingsymptom.

Apatientmaybereferredtoyouforaconsultationfromanotherdentistorphysicianandmaypresentwithavarietyofworrisomesignsandsymptoms.Ahighlevelofsuspicionshouldcauseadentisttoactappropriatelyandpromptlytoavoidanydisastrousconsequences.Athoroughdentalandmedicalhistoryisimportantalongwiththeappropri-ateradiographs,includingacomputedtomographyscantolookforanyactivelesions.

JustinEdwards,DMD,isaresidentinpediatricdentistryatVirginiaCom-monwealthUniversity

An evidence-based assessment of the clinical guidelines for re-planted avulsed teeth. Part II: prescription of systemic antibiotics. Hinckfuss, S., Messer, L..; Dent Traumatol. 2009;25(2):158-64.

Approximately30%ofchildrenhaveexperiencedadentalinjury.Dentalavulsioninjuriesoccurmostfrequentlyinchildrenbetweentheagesof7and9,anagewhenthealveolarboneismorepliableandaccommodat-ingoftraumaticinjuries.Injuriesinvolvingthepermanentteetharealmosttwiceascommon inschool-agedboys,ascompared to femalesof thesameage.Sportsaccidentsandfightsare themostcommoncauseofdental trauma in teenagers.Themaxillarycentral incisorsare themostcommonlyinjuredteeth.Maxillaryteethprotrudingmorethan4mmaretwotothreetimesaslikelytosufferdentaltraumathannormallyalignedteeth.Currentclinicalguidelinesrecommendsystemicantibiotictherapyforpatientswhohaveanavulsedpermanenttoothreplanted.Theobjec-tive of thismeta-analysiswas to use the principles of evidence-baseddentistry toanswer thePICOquestion. (PICO=procedureorcondition,intervention,comparisontointervention,andoutcome)Theprimaryques-tionis:whenreplantingavulsedpermanentteeth,doesprescribingsys-temicantibioticsresultinanincreasedlikelihoodofsuccessfulperiodon-talhealingascomparedtoreplantinganavulsedtoothwithoutantibioticcoverage?The authors performed a literature search for relevant cita-tions. Inclusioncriteriawereappliedandthreepapersreportingon326total teethwere included in the analysis.Results:Meta-analysis foundnostatisticallysignificantdifferencebetweenprescribingornotprescrib-ingantibioticsforacceptableperiodontalhealingwithoutprogressiverootresorption(commonoddsratio=0.90,SE=0.29,95%confidenceinter-

Fused Teeth: A Review of the Treatment Options. Tuna E, Yildir-im M, Seymen F, Gencay K, and Ozgen M. Journal of Dentistry for Children 2009; 76(2): 109-116

Thepurposeofthisarticlewastoreviewtreatmentoptionsforfusedteethbydescribingtwoclinicalcasesshowingdifferenttreatmentmethodologies.Fusionisdefinedastheunionoftwoormoresepa-ratedevelopingtoothgermsatthedentinallevel,yieldingasinglelargetooth.Thetreatmentoffusedteethmaybeinterdisciplinaryandincludeendodontic,surgical,andperiodontalinvolvement.Inthefirstcaseatenyear-oldfemalepresentedinthemixeddentitionwithclassImolarrelationship,andfusionofthepermanentmaxil-laryrightcentralincisortoasupernumerarytooth.Thecasewastreatedintraorallybyseparatingthetwofusedteethandextractingthedistallypositionedsupernumerarytooth.Thecrownwasrestoredwithcompositeresinandorthodonticallysplinted.Systemicantibiot-icsweregivenandchlorhexidinerinsewasrecommended.At3,6,and12-monthfollowupappointmentsthetoothwasasymptomaticwithnopulpalnecrosisorrootresorption.Thesecondcaseconsistedofaneightyear-oldfemalepresentinginthemixeddentitionwithananterioropenbite,severemaxillarycrowdingandthepermanentmaxillaryleftlateralincisorfusedtoasupernumerarytoothalongthelengthoftheroot.Thecasewastreatedbyextractingthefusedteethandextraorallyseparatingthem.Thedistalportionwasreimplantedandorthodonticallysplinted.Systemicantibioticsweregivenandchlorhexidinemouthrinserecommended.At1,2,6and12-monthfollow-upappointmentsthetoothwasasymptomaticandbonehealingimproved.Atfour-yearfollowupthetoothwasvitalandtheperiapicalandperiodontalhealthwaspreserved.Bothpresentedtreatmentsyieldedfavorableesthetic,periodontal,andperiapicalresultsforpatientswithfusedteeth.

Dr.AndrewJ.Zima,Jr.,isaresidentinpediatricdentistryatVirginiaCommonwealthUniversity

Indirect Pulp Capping and Primary Teeth: Is the Primary Tooth Pulpotomy Out of Date?Coll, J. Pediatric Dentistry 2008;30(3):230-6

Theaimofthisarticleistoreviewthedentalliteratureandnewresearchinvitalpulptherapyto(1)determineifthepulpotomyisindicatedforatruecariouspulpexposure,(2)identifyadiagnosticmethodtoreliablyidentifyteeththatarecandidatesforvitalpulptherapyand(3)determineiftheindirectpulpcaptechnique(IPT)shouldreplacethepulpotomy.Primarytoothpulpotomiesshouldbeperformedonlyonteeththataredeterminedtohaveavitalpulp.Currentagentsusedinpulpotomiesincludeformocresolwhichworksby‘fixing’thevitalpulp,ferricsulfate,whichformsaclotbarriertopreservedeeperpulptissue,andmineraltrioxideaggregate(MTA)andcalciumhydroxidewhichactbyhealingtheradicularpulpandaidinginformationofadentinalbridge.Shoveltonfoundthatinpermanentteeth,ascariesapproximated0.25-0.3mmofthepulp,hyperemiaandpulpitiswereseen,thusimpairingthepulp’srepaircapacity.Inthisarticle,Collconcludesthatprimarytoothpulp-otomiesshouldnotbeperformedonteethwithcariouspulpexposuresbecausethoseteethhavealowlikelihoodofbeingtotallyvitalandthusarepoorcandidatesfortheprocedure.Likewise,ifapulpotomyisperformedonteethwithoutcariousexposures,thereisagreatchanceofdisplacingaffecteddentinchipsintothepulpwhichwillaffectthepulp’srepaircapacitybyincreasingtheriskofpulpalinflammation.Theuseoftheglassionomer-cariescontrolmethod(GICC)isindicatedinteethwithcavitatedcariouslesionstodiagnosevitality.Thismethodisusefulintreatingteethwithsignsandsymptomsofreversiblepulpitisorasymptomlesstooththoughttohavenopulpitisbeforeinstitutingpulptherapy.TheuseoftheGICCmethodhasbeenshowntodecreasetotalbacterialcountandcariesexcavationsignificantlyreducedthemutansstreptococcipresentinthelesion.Moreover,sealingthecavitatedlesionwithglassionomercontributestoremineralization.TheGICCtechniqueinvolvesminimallyremovingouter,superficial,decayusingaslow-speedwitha#4or#6roundbur,oraspoonexcavator.Then,aglassionomertemporaryfillingmaterialisused,suchasFujiIX®(GCAmericaInc,Alsip,IL),KetacMolar®(3MESPE,StPaul,MN),oraresin-modifiedglassionomer.Nomatrixbandisneededbuttherestorationmustnotbeinocclusion.After1-3monthsofGICC,ifthetoothisasymptomaticandshowsnoclinicalorradiographicsignsofirreversiblepulpitis,thenvitalpulptherapycanbeinstitutedusingIPTorpulpotomy.ThereareseveralfactorstoconsiderwhendeterminingwhethertotreatacariouslesionusingIPTversuspulpotomy.IPT’slong-termsuccess(3-4years)surpassesallotherpulpotomystudies,withtheexceptionofMTA.CollmentionedthatmostdentistsincludingpediatricdentistsfailtoutilizetheIPTsimplybecausethemethodwasneithertaughtnoremphasizedinthedentalschoolcurriculum.Studieshavealsoshownthatinthecaseofreversiblepulpitispain,IPThasbeenshowntohaveahighersuccessratethanthoseteethtreatedwithformocresolpulpotomy.Moreover,pri-maryteethtreatedwithformocresolpulpotomywereshowntoexfoliatesignificantlyearlier(>6months)thannonpulpotomizedteeth,whereasIPT-treatedteethexfoliatenormally.Lastly,IPTislessexpensivethanapulpotomy,requiresnopulpalentry,andthusdoesnotrequireprofoundanesthesia.

Dr.LatriceFosterisaresidentinpediatricdentistryatVirginiaCommon-wealthUniversity.

Local Anesthesia Affects Physiologic Parameters and Reduces An-esthesiologist Intervention in children Undergoing General Anes-thesia for Dental Rehabilitation. Watts, A., Thikkurissy, S., Smiley, M., McTigue, D., Smith, T. Pediatric Dentistry 2009;31(5):414-9.

Background-Painstemsfromavarietyofeventsandisaconscious,emotionalandindividualexperience.Nociceptionisphysiologicactivityresultingfromtissuedamage.Thebalancebetweennociceptionandantinociceptioniscommonlybasedonnonspecificautonomicreactionssuchashypertension,tachycardia,sweating,ortearing,aswellaspatientmovementinresponsetopain.PreviousliteraturereportsthatinconjunctionwithGeneralAnesthesia(GA),regionalanesthesiacanproduceamorehemodynamicallystablepatient,andcontrolspainintheimmediatepostoperativeperiod.Thereisapaucityofliteratureontheuseofintraoperativelocalanesthesia(LA)asanalgesia.TheAmeri-canSocietyofAnesthesiologistsandtheAmericanDentalAssociation(ADA)currentlyhavenorecommendationsastotheuseofLAduringGAanddentaltreatment.NodirectivestatementsexistintheAmericanAcademyofPediatricDentists(AAPD)guidelinesregardingtheuseofLAwithGA;theysuggestonlythatLA“maybeused”toreducepaininthepostoperativerecoveryperiod,andpractitionersmaychoosetouseLAduringGAcasesbasedonanecdotalexperiencesortraining.

Purpose-Thepurposeofthisstudywastoevaluatetheuseofintra-operativelocalanestheticsinpediatricoutpatientdentalsurgery.Theobjectivesincludedexaminingthephysiologiceffectsoftherepresen-tativepediatricdentalprocedure(rubberdam[RD]clampplacement,pulpotomy,cementationofastainlesssteelcrown[SSC],andextrac-tions)onchildrenundergoingGeneralAnesthesia,andtodetermineifthereisarelationshipbetweenLAusageandtherapeuticinterventionbyananesthesiologist.

Methods-Thestudyincluded48children12to84monthsofage,requiringatleastoneextractionofaprimarymaxillarytooth,useofaRDclamp,andonemaxillarytoothrequiringpulptherapyandaSSC.Operatorsused2%lidocainewith1/100,000epinephrine,andnopatientexceeded4.4mg/kgtotal.Thestudyusedthesamedentistanesthesi-ologistthroughouttoallowforstandardizationoftheanestheticregimen.Patientswereassignedtoacontrolgroup(noLA)oratreatmentgroup(LA),priortothestudy.Datawasbasedonobjectivereadingfromthephysiologicmonitors,andrecordedwhetherornotinterventionbytheanesthesiologistwasnecessary,duetovitalsignchangesduringtheprocedure.

Conclusions-PatientswhowerenotgivenintraoperativeLAweremorelikelytoexperiencevitalsignfluctuationsthatrequiredanesthesiaintervention.

Dr.MalindaHussonisaresidentinpediatricdentistryatVirginiaCom-monwealthUniversity.

Contemporary Perspectives on Vital Pulp Therapy: Views from Endodontists and Pediatric Dentists. Seale,N.; Glickmann, G. Pediatric Dentistry 2008; 30(3): 261-7.

ThepurposeofthisstudywastodeterminethelevelofagreementbetweenpediatricdentistsandendodontistsatthepulptherapysymposiumsponsoredbytheAAEandAAPDinNovember2007.Twosurveysweregiveninvolvingquestionsaboutpulptherapyforcariouslyinvolvedpermanentteeth,indirectpulptreatment(IPT)forcariouslyinvolvedyoungpermanentteeth,pulprevascularizationandregenera-tion.Onesurveywasapretest,theotherwasgivenafterpresenta-tionsviaelectronicrealtimeaudienceresponsesystem.Respondingtothesurveyswere231pediatricdentistsand79endo

Continued on page 27

vals=0.51–1.58).Conclusion:Theevidenceforanassociationbetweenprescribingsystemicantibioticsandanincreasedperiodontalhealing isinconclusive.Upon review of the available literature, there is inconclu-siveclinicalevidencetoeithercontradictorsupporttherecommendationofsystemicantibiotics.Pendingfutureresearchtothecontrary,dentistsarerecommendedtofollowcurrentantibioticguidelineswhenreplantingavulsedteeth.

Dr.AndyReed is a resident in pediatric dentistry atVirginiaCommon-wealthUniversity.


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Continued from page 25

dontists.Resultsonformocresolshowedthat37%oftheendodontistsand18%ofthepediatricdentistssaiditisacarcinogenandshouldnotbeusedonpatients.Fivepercentofthepediatricdentistsand15%oftheendodontiststhinkthatformocresolisadangertopatients.MineralTrioxideAggregatewasthefavoritepulpotomyagentof30%ofthepediatricdentistsand34%oftheendodontists.Ifcostwasnotanissue85%ofpediatricdentistsandendodontistssaiditwouldbeusedintheiroffices.Ninety-fourpercentofpediatricdentistsand69%ofendodontistssaidtheyperformIPTonyoungpermanentteeth.Amongallrespon-dents87%agreedthatrevascularization/regenerationwouldbeaviabletreatmentoptioninthenexttenyears.Conclusionsrevealedpediatricdentistsandendodontistsagreethatformocresolwillbereplacedasaprimarytoothpulpotomyagent,whileMTAisthefirstchoicetotakeitsplacewhenitbecomesaffordable.Also,IPTisanacceptablepulptech-niqueforcariouslyinvolvedyoungpermanentteethwithopenapices,andIPTincariouslyaffectedprimaryteethholdshopeforreplacementofthepulpotomy.Revascularization/regenerationwillbringexcitingnewtreatmentoptionsinthenearfuture.

Dr.HeathWhitfieldischiefresidentinpediatricdentistryatVirginiaCom-monwealthUniversity

Topical Anesthesia for Rubber Dam Clamp Placement in Sealant Placement: Comparison of Lidocaine/Prilocaine gel and Benzo-caine. Yoon, R., Chussid, S. Pediatric Dentistry 2009;31 (5): 377-381.

Abstract:Purpose:Topicalanestheticsareusedcommonlyindentistryformanypurposes,themostcommonbeingapplicationtonon-kera-tinizedoralmucosapriortolocalanestheticinjection.Theobjectiveofthisarticlewastocomparetopicalanestheticgeleffectivenessandpainperceptionwithrubberdamclampplacementforsealantsusing

Oraqix®(2.5%Lidocaine,2.5%Prilocaine,DentsplyPharmaceutical)non-injectablegeland20%Benzocainegel.Methods:Asingleoperatortreatedallparticipantsaged7-12yearsold(N=45)recruitedfromregu-larlyscheduledpatientsinapostgraduatepediatricdentalclinic.UseofasplitmouthdesignwithOraqix®gelplacedononesideand20%Benzocaineontheother.ThechildrenwereaskedtoratetheirpainaftertopicalanestheticandrubberdamclampplacementusingtheFacialPainScale(FPS).Results:Subjectpopulation;27female,and18malewith15lessthan9yearsand30greaterthan9yearsold.TheoveralldifferencesinmeanFPSratingsbetweenOraqix®andBenzocainewasnotstatisticallysignificant(P=.27)aswellasthechildrenlessthannineyearsold(P=.77).Nostatisticaldifferencewasnotedbetweengenders.TherewasastatisticaldifferenceinchildrengreaterthannineyearsoldwithOraqix®beingslightlymoreeffectivethanBenzocaine.Conclu-sions:Oraqix®applicationfor2minutesbeforeclampplacementdidnotsignificantlyreducepainwhencomparedto20%benzocaine.Oraqix®wasslightlymoreeffectiveinpainreductionforthe9-12year-oldgroup.Morestudieswithalargersamplesizeareneededtodeterminetheef-fectivenessofthisnewnon-injectabletopicalanestheticanditsapplica-tionindentistry.

LarryShults,DDS,isaresidentinpediatricdentistryatVirginiaCom-monwealthUniversity.

MostlikelypossibilitiesincludeA,B,C,andDsinceallareradiolucent.Sincethelesionisexpansilewithoutascleroticborder,anodontogenickeratocystisunlikely.Lateralperiodontalcystsnormallydonotoccurinthisarea(mostcommonlocationisbetweenmandibularbicuspids)andonlyonrareoccasionsareexpansile.Bothameloblastomaandcentralgiantcellgranulomacancauseexpansion.Thelocationfavorsacentralgiantcellgranulomasincetheameloblastomaisfoundmorefrequentlyintheposteriormandible.Theageistypicalforanamelo-blastoma.Calcifyingepithelialodontogenictumor,calcifyingodonto-geniccyst,centralossifyingfibromaandadenomatoidodontogenictumorwouldnormallybemixedradiolucentandradiopaquelesions.Earlylesionsthatinducecalcification,nevertheless,canappearradio-lucentuntiltheymature.Mydifferentialdiagnosisinorderofprobabilityis:1)ameloblastomabasedonageandexpansion;2)centralgiantcellgranulomabasedonlocationandexpansion;3)odontogenickerato-cyst;and4)lateralperiodontalcyst.CGCGtendstocrossthemidlineandfavorstheanteriormandible.Adenomatoidodontogenictumorhasapredilectionforyoungfemalesandtheanteriormaxilla.

Thebiopsyfindingsprovedthislesiontobeanameloblastoma(figure4).Therecommendedtreatmentwouldbelocalsegmentalresectionremovinginvolvedteeth.Withreconstructivesurgeryandimplantsthispatientshouldhavecompleteestheticandfunctionalrehabilitation.

ThiscasewassubmittedbyDr.AmirNaimi,anOralandMaxillofacialsurgeoninNorthernVirginia.

Figure4

Thehistologyshowsmultipleislandsofodontogenicepitheliumshowingreversepolarizationofthebasalcelllayerwithacentralzoneofstellatereticulumappearingtissue.

Continued from page 23


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BabyAd_VA_DentalAssoc.indd 1 12/3/09 11:06:30 AM

Understanding Delta Dental’s New Payment PoliciesBy:DanSchulte,J.D.MDALegalCouncilReprinted, with permission, from the Journal of the Michigan Dental Association, November 2008 issue. The author’s comments relate to the Delta policy as it exists in Michigan.

ThissummerDeltaDentalannouncedpaymentpolicychangesaffectingitsMichiganparticipatingdentists.Apparently,inconnectionwitha“systemupgrade”DeltaDentalhasestablishedamaximumfeeparticipatingdentistsmaychargeforcertainprocedures.Thismaximumfeeiscalledthe“MaximumPlanAllowance.”Forexample,feeschargedforcompositefillingsandporcelaincrownsarenowsubjecttoaMaximumPlanAllowance.

ThismeansMichigandentistswhoparticipatewithDeltaDentalmaynolongerchargeanypatientenrolledinaDeltaDentalunderwrittenoradministereddentalplanafeeexceedingtheMaximumPlanAllowanceifonehasbeenestablishedforaprocedure.Contrarytopastpractice,theMaximumPlanAllowanceapplieswhetherornotthepatientactuallyhascoverageprovidedbytheDeltaDentalunderwrittenoradministeredplan.DeltaDentalhastakencontrolofthefeesparticipatingdentistschargethesepatientsevenwhenonlythepatientisliableforpaymentofthefeeandwouldbewillingtopayahigheramountforanon-coveredservice.

Forexample,let’sassumeyourpatientisenrolledinaDeltaDentalunderwrittenoradministereddentalplan.TheplanprovidesthateitherDeltaDentalortheplan’ssponsor(usuallythepatient’semployer)willpay$50fortheprocedureyoujustcompletedonthispatient.TheMaximumPlanAllowanceforthisproce-dureDeltaDentalhasestablishedtobe$135.Thefeeyoucustomarilychargeforthisprocedureis$150.UnderDeltaDental’snewpaymentprocedures,themostyoucanbalancebillthepatientis$85(thedifferencebetweentheMaxi-mumPlanAllowanceandtheamountDeltaDentalpays)andisnolonger$100(thedifferencebetweenyourcustomaryfeeandtheamountDeltaDentalhaspaid).The$15youusedtocollectfromthepatient(andpresumablythepatientagreedtopayfortheprocedure)isnowlost.DeltaDentalisprohibitingyoufromcollectingit.

Questions raisedManyquestionshavebeenaskedregardingDeltaDental’snewpaymentpolicies.WhatmemberswanttoknowiswhetherDeltaDentalcanlegally:(1)establishamaximumfeeforservicesthatarenotcoveredbyaDeltaDentalunderwrittenoradministereddentalplan;(2)restrictparticipatingdentistsfrombalancebillingforservicesthatarenotcovered;and(3)unilaterallyamendtheparticipationagreementstoimposethesenewrestrictions?

TheanswerstoallofthesequestionsdependonthetermsofthecontractsinplacebetweenDeltaDentalanditsparticipatingdentists.WehavereviewedtheDeltaPremierFee-For-ServiceParticipationAgreementandtheUniformRequire-mentsbyDeltaDeltaPremierParticipation.Iwillrefertothesetwodocumentscollectivelyinthisarticleasthe“Contract.”

DeltaDentalisliterallyconstruingandbroadlyinterpretingtheContract.Whetherandtowhatextentdentistsunderstoodand/orintendedtheContracttohavesuchabroadapplicationcanonlybedetermineduponareviewofthefactsandcircumstancesofeachindividualcase.Thecircumstancessurroundingeachindividualdentist’sinteractionswithDeltaDentalbothatthetimetheContractwassignedandfollowingitssigningmaygiverisetodefensestoenforcementoftheContractonanindividualbasis.

TheContractrequiresparticipatingdentists“toprovidedentalcaretoEnrollees”inaccordancewiththetermsoftheContract.TheContractisnotlimitedtoonlythatdentalcarethatiscoveredinsomefashionbytheEnrollee’splan.Instead,itappliestoalldentalcareprovidedtoanyEnrollee.“Enrollee”isdefinedintheContracttoincludeanypatienteligiblefordentalbenefitspursuanttoanydental

programthatiseitheradministeredorunderwrittenbyDeltaDentaloranotherentitythatpursuanttoanagreementwithDeltaDentalhasmadetheContractapplicable.

Therefore,theContractapplieswhenDeltaDentalis:

• actuallyunderwritingthefundingofthebenefitsprovidedtotheenrollee;

• whenDeltaDentalismerelyprocessingclaimsandotherwiseadministeringthedentalplanforathirdparty(usuallythepatient’semployer)whoisfundingthebenefits;and

• whenDeltaDentalmerelysellstoathirdpartytherighttouseitsnetworkofdentists.DeltaDentalclaimsithasnotsoldtherighttousethenetworktoathirdparty.However,theContractgivesDeltaDentaltherighttodosoatanytime.

Whenreadliterally,theContractallowsDeltaDentaltosetmaximumfeesforservicesprovidedbyparticipatingdentistseventhoughthereisnocoverageoronlypartialcoveragebyadentalplanfortheservice.

Balance-billing limitedTheextenttowhichparticipatingdentistsmaybalancebillapatientisalsogov-ernedbytheContract.Specifically,theContractrestrictsaparticipatingdentist’sabilitytobalancebillapatientforanamountinexcessof“themaximumfeethatDeltaDentalapprovesfortheservice.”Again,theContractmakesnodistinctionbetweencoveredservicesandservicesthatarenotcovered.

Finally,theContractgivesDeltaDentalpowertoamendthetermsofparticipa-tion.Includedis“therighttomakechangesinitsProcessingPoliciesandtheUniformRequirementsofDeltaPremierParticipation.”Therefore,DeltaDentalhasthecontractualrighttochangeat-willanyofthetermsofparticipationincludingthesettingofthefeesyouchargeanypatientenrolledinaDeltaDentalunderwrittenoradministereddentalplan.

Obviously,manymemberdentistsareupsetaboutthesechanges.ManyhavesaidthattheyhaveneverbeensubjecttofeelimitationsbyDeltaDentaloranyotherpayorapplicabletonon-coveredservices.EvenmorehaveindicatedthattheyhadnoideatheContractcouldbeappliedinthiswayandthatthiswasneverexplainedtothematthetimetheysignedtheContract.

Participatingdentistshavefourchoices,asexplainedbelow:

1.ThefirstistoacceptthenewDeltaDentalpoliciesandlimittheamountofyourbalancebillingtotheMaximumPlanAllowance.

2.Thesecondistocontinuebalancebillinguptoyourcustomaryfeeasyouhaveinthepast.TheriskyourunobviouslyisthatDeltaDentalwillterminateyourContractandtakeactionagainstyouforbreachoftheContract.DeltaDen-talhastherighttoterminateyourContractatwillupon30dayswrittennotice.

3.Third,youmaylikewiseterminateyourContractbyproviding30dayswrittennoticetoDeltaDental.

30VirginiaDentalAssociation Volume87,Number2•April,May&June2010 31

4.Finally,youmaystopprovidingcertainservicestoDeltaDentalEnrolleesiftheMaximumPlanAllowanceisnotatalevelacceptabletoyou.

Selling a networkAnotherquestionthathasbeenfrequentlyaskediswhyDeltaDentalwouldlimitfeesforservicesthatpatientsknowarenotcoveredbythetermsoftheirdentalplanandforwhichpatientshavebeenwillingtopay?Theanswertothisques-tionhasmoretodowithhowDeltaDentalusesthenetworktogenerateincomethenitdoesthedeliveryofdentalcareand/orpatientchoice.

DeltaDentalgeneratesincomeprimarilyfromthesaleofdentalplanproductsanddentalplanadministrativeservices.Theabilitytocontroltheamountspaidfordentalcare(whetherbyDeltaDentaldirectlyorbythesponsorofadentalplanadministeredbyDeltaDental)makesitsinsuranceproductsandadministra-tiveservicesmoreattractivetoitscustomers.DeltaDental’sabilitytocontrolthecostofdentalcarevariesdirectlywiththesizeofthenetworkofdentistsandthescopeofthefeelimitationstheparticipatingdentistshavecontractuallyagreedto.

Therefore,havingalargenetworkofdentistswhohaveagreedtoabroadscopeofdentalservicesforwhichcontroloffeeshasbeengivenup,resultsinasignifi-cantcompetitiveadvantageforDeltaDentalinthesaleofitsunderwrittendentalinsuranceproductsanddentalplanadministrativeservices.

ThisadvantageisthecenterpieceofDeltaDental’srecentadvertisements,whichstate:

“Your Company Deserves a Deeper NetworkThe Delta Dental system includes three of every four dentists -- which makes our network the biggest in the nation. Offering your employees access to the deepest networks improves the chance that their pre-ferred dentist participates in one or more of our plans. That, in turn, helps us deliver greater plan savings to you. So if you are not with Delta Dental, shouldn’t you be? To learn more about Delta Dental, please contact your broker or visit DeltaDentalMI.com.”

DeltaDentalisacknowledgingthatgreaterplansavingsfortheircustomersresultdirectlyfrom“thedeepestnetworks.”

IndividualdentistsmustmaketheirowndecisionhowtoreacttoDeltaDental’spaymentpolicychanges.TheMichiganDentalAssociationcannotlegallyandwillnotfacilitateanyjointresponsetothesechangesonbehalfofMDAmembers.Todosoisillegal,violatingfederalandstateantitrustlaws.Thepurposeofthisar-ticle(andfuturecommunications)istoeducateMDAmembersaboutwhatthesechangesmeanandwhyitisinDeltaDental’sinteresttoimplementthechanges.

Mark YourCalendar

Financial Boot Camp

a VDA event

Sheraton - Richmond, VA

October 15-16, 2010

Details coming soon!

7:00A8:00A9:00A10:00A11:00A12:00P1:00P2:00P3:00P4:00P5:00P6:00P7:00P8:00P9:00P10:00P

Golf Tournament 9:00am-2:30PM Opening Reception 4:00-5:00PM

ACD Dinner & Dance 6:30-10:30PMGhost Tour

9:00-10:00PM

Frid

ay, J

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8

AGD Breakfast7:00-8:00AM

MCV/VCU Reception5:00-6:00PM President’s Party 6:30-10:00PM

Pierre Fauchard Lunch

12:00-1:30PM

Exhibit Hall Hours 9:30AM-6:00PM

Satu

rday

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e 19

ICD Breakfast7:30-8:30AM

VDA Registration 7:00AM-5:00PM


ACD Lunch &Learn

11:30AM-1:00PM

VDA Past President’s Breakfast7:30-9:00am

Exhibit Hall Hours 9:30AM-1:00PM


VDAA Board Meeting5:00-7:00PM

CPR 2:00-4:00pm

Kay 8:00-11:00am Wilder 1:00-4:00pm

Swift 8:00am-4:00pmAfternoon Tea

1:00pm

Goldfaden 9:00am-Noon

Breiding 8:00am-3:00pm

Wahl 8:00am-3:00pm

Wilder 8:00am-11:00am

Blackwell 8:30am-4:30pm

Lambert 9:00am-Noon

Hooper 8:00am-4:00pm

Blackwell 9:00am-Noon

Breiding 8:00am-4:00pm

Byrne 8:30am-4:30pm

CPR 9:00-11:00am

Reynolds 8:30am-4:30pm

BOD Meeting 2:00-6:00pm

Hawkins 9:00am-Noon

Thur

sday

, Jun

e 17

Goldfaden 2:00-5:00pm

Wilder Noon-3:00pm

Hawkins 8:30am-11:30am Hawkins 1:30-4:30pm

Lambert 2:00-5:00pm

CPR 8:00am-NoonSolmeteX -

Exhibit Presentation12:15-1:15pm

SunriseYoga

6:30-7:30amVA Board of DentistryExhibit Presentation

12:15-1:15pm

Virginia Meeting At A Glance

JUNE 17-19, 2010Williamsburg Lodge

Williamsburg, VA

REGISTER ONLINE AT WWW.VIRGINIAMEETING.ORG


Hotel Information

HOTEL RESERVATION DEADLINE: MAY 17, 2010

Williamsburg Lodge:Southernhospitalitywithimpeccableserviceandachoiceofcomfortablelodgings.YouwillenjoyambienceofafamilyhomehereattheWil-liamsburgLodge.

Williamsburg Inn:ThecrownjeweloftheColonialWilliamsburgResortCollection.Revelinsimplyoneoftheworld’sgreatluxuryhotels.

Woodland Suites:Contemporaryroomsandsuiteswithseparatemasterbed-roomsandconveniencekitchencounters.Recreationaloptionsincludeminigolf,shuffleboard,andswimming.TheWoodlandSuitesoffersafunhavenforfamilies.WilliamsburgLodge

310SouthEnglandStreetWilliamsburg,VA23185 Reservations:

By Phone:1-800-HISTORY(1-800-447-8679)Meeting Code:VIRF10A

Online: https://resweb.passkey.com/go/virf10a

Virginia Meeting room rates:WilliamsburgLodge:Deluxe$229;Superior$199WoodlandsHotel&Suites:Superior$139WilliamsburgInn:MainBuilding$395;ProvidenceHallWing$289

Rates listed do not include 10% and $2.00 per room per night occupancy tax.

Photo courtesy of The Colonial Williams-burg Foundation, Williamsburg, VA

MakingitHappen...

2010 Council On SessionsChair: Dr.ClaireKaugars Dr.SharonColvin Dr.ElizabethReynolds Dr.AnthonyPeluso

2010 Local Arrangements CommitteeChair: Dr.MelanieLoveSocial: Dr.KittFinley-ParkerGolf: Dr.BruceHutchisonHosts: Dr.BrendaYoung

Dr.VinceDougherty Dr.MichaelAbbott PamMaciejewski,RDH Dr.SharonCovaney

The Virginia Dental Association is an ADA CERP Recognized Provider

ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

Detailed course listings can be found on our web site at www.virginiameeting.org by clicking on Education.

01 Kay - OSHA 8:00-11:00am Free w/ Badge

02 Swift - Materials 8:00am-4:00pm $79

03 Wilder - Providing WOW Ser... 1:00-4:00pm Free w/ Badge

30 Opening Reception 4:00-5:00pm Free - ticket required

32 Annual VDA Golf Tournament $125.00 9:00am (Fill out additional information section on registration form)

33 Ghost Tour $15 9:00-10:00pm Recommended for ages 6 and up.

41 Afternoon Tea $35.00 1:00-2:30pm

34 AGD Breakfast* n/c 7:00-8:00am

35 Pierre Fauchard Luncheon* $40.00 Noon-1:30pm

36 VDA President’s Party (Adult) $30.00 6:30-10:00pm

36A VDA President’s Party (Child 2-12 yrs old) $10.00

37 MCV/VCU Reception* $0 5:00-6:00pm

38 ICD Breakfast* $25 7:30-8:30am

40A-G ACD Luncheon For Learning $40.00 11:30am-1:00pm

Table Topic 40A- Al-Anezi - Review of the Masticatory System and Its Function 40B- Archer - Problem Solving in Dental Anesthesia 40C- Brickhouse - Clinical Management of the Challenging... 40D- Carter - Digital Radiography Update 40E- Haselton - CAD-CAM and Your Practice 40F- Imbery - Advanced Topics In Restorative Dentistry 40G- Tufecki - Etiology, Prevention and Treatment... 42 Sunrise Yoga $17.00 6:30-7:30am

44 Colonial Williamsburg Historic Area Ticket $22.00 Tickets good for length of conference

* Only members from these groups can attend these functions

Continuing Education Tickets Event & Affiliate Group Tickets

Code Course Title/Speaker Cost Code Event CostThursday, June 17, 2010

Friday, June 18, 2010Code Course Title/Speaker Cost

Saturday, June 19, 2010

Code Course Title/Speaker Cost

Thursday, June 17, 2010

Friday, June 18, 2010Code Event Cost

Saturday, June 19, 2010Code Event Cost

Admission TicketsCode Event Cost

Category Fee RegistrantsList Primary Registrant on first line

Friday Lunch Option Saturday Lunch Option Course #1Code/Fee

Course #2Code/Fee

Course #3Code/Fee

Event #1Code/Fee

Event #2Code/Fee

Subtotal

1. + $16 Veg Opt Out Trky RB

+ $16 Veg Opt Out Trky RB

$



$



$



$



$



$

04 Wilder - Periodontal Procedures 8:00-11:00am Dentist: $65 All others: $45

05 Wilder - Products & Promises Noon-3:00pm Dentist: $65 All others: $45

06 Wahl - Leading Change... 8:00am-3:00pm Free w/ Badge

07 Healthcare Provider CPR 8:00am-Noon $60 Hands On

08 Breiding - Sorry, Customer... 8:00am-3:00pm Free w/ Badge

09 Blackwell - Implant Dentistry 8:30am-4:30pm Free w/ Badge

10 Hawkins - Oral Sedation... 8:30-11:30am Dentist: $35 All others: $25

11 Lambert - Smile Design... 9:00am-Noon Free w/ Badge

12 Lambert - Conservative Prep... 2:00-5:00pm $195 Hands On

13 Goldfaden - Endodontics 9:00am-5:00pm Free w/ Ticket Hands On

14 Hawkins - Local Anesthesia 1:30-4:30pm Dentist: $35 All others: $25

15 SolmeteX - Amalgam Separators 12:15-1:15pm Free w/ Badge

46 Heartsaver Adult & Child CPR 2:00-4:00pm $50 Hands On

16 Hooper - Contemporary Funct... 8:00am-4:00pm Dentist: $65 All others: $45

17 Breiding - Turning Patience ... 8:00am-4:00pm Free w/ Badge 18 Byrne - Pharmacology Update 8:30am-4:30pm Free w/ Badge 19 Blackwell - Treatment Plan... 9:00am-Noon Free w/ Badge

20 Reynolds - Vitality & Youth... 8:30am-4:30pm Free w/ Badge

21 Hawkins - Medical Emergen... 9:00am-Noon $225 Hands On

22 VA Board of Dentistry Update 12:15-1:15pm Free w/ Badge

26 Heartsaver Adult & Child CPR 9:00-11:00am $50 Hands On


Virginia Meeting mailing list opt out (see page 18 for details): Yes, I would like to opt out of the Virginia Meeting mailing list. Leave this blank if you would like to be included in our meeting mailings.

30 Opening Reception 4:00-5:00pm Free - ticket required

32 Annual VDA Golf Tournament $125.00 9:00am (Fill out additional information section on registration form)

33 Ghost Tour $15 9:00-10:00pm Recommended for ages 6 and up.

41 Afternoon Tea $35.00 1:00-2:30pm

34 AGD Breakfast* n/c 7:00-8:00am

35 Pierre Fauchard Luncheon* $40.00 Noon-1:30pm

36 VDA President’s Party (Adult) $30.00 6:30-10:00pm

36A VDA President’s Party (Child 2-12 yrs old) $10.00

37 MCV/VCU Reception* $0 5:00-6:00pm

38 ICD Breakfast* $25 7:30-8:30am

40A-H ACD Luncheon For Learning $40.00 11:30am-1:00pm

Table Topic 40A- A;-Anezi - Review of the Masticatory System and Its Function 40B- Archer - Problem Solving in Dental Anesthesia 40C- Brickhouse - Clinical Management of the Challenging... 40D- Carter - Digital Radiography Update 40E- Haselton - CAD-CAM and Your Practice 40F- Imbery - Advanced Topics In Restorative Dentistry 40G- Tufecki - Etiology, Prevention and Treatment... 42 Sunrise Yoga $17.00 6:30-7:30am

44 Colonial Williamsburg Historic Area Ticket $22.00 Tickets good for length of conference

* Only members from these groups can attend these functions

Event & Affiliate Group Tickets

Code Event CostThursday, June 17, 2010

Friday, June 18, 2010Code Event Cost

Saturday, June 19, 2010Code Event Cost

Admission TicketsCode Event Cost

Virginia MeetingREGISTRATION FORM FOR ALL REGISTRANTS

Please use a ballpoint pen. Feel free to make additional copies as needed.

Contact Name: ________________________________________________________

Mailing Address: ______________________________________________________

City: ______________________________ State: __________ Zip: ____________

Phone: ____________________________ ADA#: ___________________________

E-Mail: __________________________________________ Component #: _______

Primary Contact for Conference Registration (If questions arise, VDA will contact this person) 1

2 Registration Categories: (Dentists many only register as a dentist)

First Time Attendee DentistVDA Member Dentist*ADA Dentist (non-VDA)*VDA Member Dentist (1st Yr Out of Dental School)*NON Member DentistActive Military Dentist (non-VDA)ODDS Member (non-VDA)*Retired Life VDA Member*Assistant - VDAA Member*Assistant - non-VDAA MemberSpouse/Guest of registrantGuest (ages 12 and under)Student (Dental, Hygiene & Assisting)Office StaffLab TechnicianHygienist *Membership verification will be required

$110 $160 $210$195 $245 $295$295 $345 $395$35 $47 $60$495 $530 $565$195 $245 $295 $195 $245 $295$0 $0 $0$50 $55 $60 $60 $65 $70$25 $30 $35$5 $7 $10$0 $0 $0$50 $55 $60$50 $55 $60$75 $80 $85

On or Before 4/30 5/1-6/4 Onsite Rates 6/17-6/19

40A- Al-Anexi 40B- Archer 40C- Brickhouse40D- Carter

ACD Luncheon For Learning: (Only for those attending luncheon)

Category Fee RegistrantsList Primary Registrant on first line

Friday Lunch Option Saturday Lunch Option Course #1Code/Fee

Course #2Code/Fee

Course #3Code/Fee

Event #1Code/Fee

Event #2Code/Fee

Subtotal



$



$



$



$



$



$

VDA Golf Tournament - In Honor of Dr. Donald MartinCode: 32 - Additional Information (only for those playing in tournament)

Handicap: _____________I would like to be grouped in a team with the following people:

_______________________________________________________

3 4 5 6

Grand TOTAL

Check (payable to VDA - Enclosed)Credit Card # __________________________________________________________________ Exp. Date: _________________

Security Code: _______________ Address on credit account: __________________________________________________

Signature _________________________________________________ Print Name: ___________________________________ (Signature indicateds approval for charges to your account and payment (As it appears on card) under the credit card issuer’s agreement)

8

A.B. C.D. E.F.G.H.i.J.K.K2.L.M.N.O.

7

9

Friday & Saturday Lunch Option

The Virginia Meeting will be offering a boxed lunch option for Friday, June 18, 2010, and

Saturday, June 19, 2010. For $16 per person you can enjoy a boxed lunch (Veggie, Turkey

or Roast Beef) with a drink. Lunch choices are on a first come, first served basis. Lunches will be available in the exhibit hall on Friday

from 11:30am-1:45pm and Saturday from 11:30am-1:00pm. If you opt not to have lunch on either Friday or Saturday, please indicate

that on the form below in section 4 or 5 . Your name badge will indicate if you purchased a

lunch and will be your ticket to pick it up.

Complete Details on page 25

40E- Haselton 40F- Imbery 40G- Tufecki

Choices: 1st ______ 2nd ______ 3rd ______

Refund if choices are not available

Payment Options:

2010 Exhibit Marketplaceas of March 18, 2010

ExhibitHours: Friday,June18,2010 9:30am-6:00pm Saturday,June19,2010 9:30am-1:00pm

3M ESPEA-dec, Inc.ADS SouthAFTCOAnthem Blue Cross Blue ShieldAsset Protection Group, Inc.B&B Insurance Assoc., Inc.Banc of America Practice SolutionsBenco DentalBioHorizonsBiomet 3i, LLCBrasseler USACareCreditDelta Dental of VirginiaDental DirectDentaQuest - Smiles For ChildrenDENTSPLYDentsply Tulsa Dental SpecialtiesDesigns for Vision, Inc.Discus Dental, LLCDMG AmericaDonated Dental ServicesDoral Refining CorporationDrake Precision Dental Laboratory

Elsevier/Mosby/SaundersFederal Bureau of PrisonsGazz ConsultingGendex Dental SystemsGive Kids A SmileHayes Handpiece Repair of Eastern Virginia LLCHenry Schein DentalHermitage Wealth Management, Inc.Ivoclar Vivadent, Inc.Kerr CorporationMacPractice, Inc.MDE - Mercury Data ExchangeMedical ProtectiveMedicus StaffingMidmark CorporationMissions of MercyNobel BiocareP&G Professional Oral HealthPatterson Dental Supply Co. Inc.PDT & TuttnauerPhilips SonicarePlanmecaPorter Royal SalesPracticeWorks / Kodak Dental Systems

Professional Sales Associates, Inc.Professional Solutions Insurance CompanyRBS WorldpayR. K. Tongue Co., Inc.RGP DentalRose Micro SolutionsSciCan Inc.SolmeteXSunstarSurgitel/General Scientific CorpTotal Medical ComplianceTransworld SystemsUltradent Products, Inc.Ultralight OpticsVADPACVDA ServicesVDA Services Glove ProgramVidentVirginia Board of DentistryVOCO America IncYodle Dental MarketingZimmer DentalZOLL Medical Corporation

Friday & Saturday Lunch OptionBack by popular demand...for your convenience.

For$16perpersonyoucanenjoyaboxedlunch(Veggie,TurkeyorRoastBeef)withadrink.Lunchchoicescanbeindicatedonyourregistrationformbutareonafirstcome,firstservedbasis.

LuncheswillbeavailableintheexhibithallonFriday from 11:30am-1:45pm and Saturday from 11:30am-1:00pm. Grab a boxed lunch and join us in the Exhibit Hall for a 1 hour timely dental update and 1 hour CE opportunity.

Ifyouoptnottohavelunchoneitherdaypleaseindicatethatonyourregistrationforminsection5orduringonlineregistration.Yournamebadgewillindicateifyoupurchasedalunchandwillbeyourtickettopickitup.

There will be NO on site lunch sales.


Tita

nium

Plat

inum

Diam

ond

Gold

Bron

ze

Pierre Fauchard AcademyLife Net

The Virginia Dental Association would like to thank the following individuals/companies for their generous

support of the Virginia Meeting!!! (Sponsorshipsasof3/18/10)

Virginia Association

of Endodontists

B&BFull Service Personal & Business Insurance Agency

B&B Insurance Associates, Inc. 1-877-832-9113 • www.bb-insurance.com

Drs. Shiver, Peluso & Andersen

Fairfax Oral & Maxillofacial Surgery

R.L. Tankersley, DDS, W. Les Davenport, DDS & Kenneth L. Tankersley, DDS, MD

3M ESPE

3M ESPE

Associated Printing Services, Inc.Keiter, Stephens, Hurst, Gam & ShreavesDr. Melanie Love

Even

t

Golf

Over

all

Spon

sor

Golf

Lunc

heon

Golf

Hole

Spon

sor

Prod

uct

Dona

tion

Coltene WhaledentPin Crafters

Henry ScheinVirginia Dental Laboratories

Frid

ay C

offe

e B

reak Drs. Kaugars &

Miller, PC

Satu

rday

Co

ffee B

reak

Commonwealth EndodonticsPRACTICE LIMITED TO ENDODONTICS

American Associationof Endodontists

3107 Hungary Spring Road, Richmond, Va. 23228804.501.0501 Fax: 804.501.0509

www.commonwealthendo.com

Steven G. Forte, D.D.S.

Harold J. Martinez, D.D.S.

Ronald N. Vranas, D.D.S.

Madelyn G. Gambrel, D.D.S.

Steven J. Barbieri, D.D.S.

ComEndo Ad:Layout 6 2/2/09 6:05 PM Page 1


Pew Report Finds Majority of States Fail to Ensure Proper Dental Health & Access to Care for ChildrenAuthor:ThePewCenterontheStatesWASHINGTON,Feb.232010-AnestimatedoneinfivechildreninAmericagowithoutdentalcareeachyearandtwothirdsofstatesdonothaveeffectivepoliciesinplacetoensureproperdentalhealthandaccesstocare,accordingtoareportbythePewCenterontheStates.TheCostofDelay:StateDentalPoliciesFailOneinFiveChildren,releasedwithsupportfromtheW.K.KelloggFoundationandtheDentaQuestFoundation,gradeseachstate’spolicyresponsestotheurgentchallengesindentalhealthamongAmerica’slow-incomechildren.FebruaryisNationalChildren’sDentalHealthMonth.“Millionsofchildrengowithoutdentalcareeachyearbutthegoodnewsis,it’sfixable,”saidShellyGehshan,directorofthePewChildren’sDentalCampaign.“Byenactingahandfulofeffectivepolicies,statescanhelpeliminatethelong-termhealthandeconomicconsequencesofuntreateddentalproblemsamongkids.Severalstatesareleadingtheway--butallstatescanandmustdomoretoensureaccesstodentalcareforthe17millionchildrenleftoutofthesystem.”Pewscoredall50statesandtheDistrictofColumbia,usinganA-Fscale,onwhetherandhowwelltheyareemployingeightprovenpolicysolutionstoensuredentalhealthandaccesstocareforchildren.Thesepoliciesfallintofourcategories:cost-effectivewaystohelppreventproblemsfromoccurringinthefirstplace;Medicaidimprovementsthatenableandmotivatemoredentiststotreatdisadvantagedchildren;newworkforcemodelsthatexpandthenumberofqualifieddentalproviders;andgatheringdatatogaugeprogressandimproveperformance.Onlysixstatesmerited“A”grades:Connecticut,Iowa,Maryland,NewMexico,RhodeIslandandSouthCarolina.Thesestatesmetatleastsixoftheeightpolicybenchmarksandhadpoliciesinplacethatmetorexceededthenationalperformancestandards.Thesehighgradesdonotmeanthatallpeopleinthestatehaveaccesstoqualitydentalcareservices.Severeaccessproblemsstillexistinstatesthatreceived“A”grades,butthesestateshavepoliciesinplaceneededtoimprovedentalcare.Ninestatesreceivedagradeof“B”:Alaska,Colorado,Idaho,Illinois,Maine,NewHampshire,Ohio,TexasandWashington.Twentystatesreceivedagradeof“C”becausetheymetfourorfeweroftheeightpolicybenchmarks.SixstatesandtheDistrictofColumbiaearneda“D”grade:Alabama,Indiana,Mississippi,Montana,NevadaandUtah.Ninestatesearnedan“F,”meetingonlyoneortwopolicybenchmarks:Arkansas,Delaware,Florida,NewJersey,Hawaii,Louisiana,Pennsylvania,WestVirginiaandWyoming.Nostatemetalleighttargets.NewJerseyrankedlowestinthenation,meetingonlyonebenchmark.“Thechallengeofensuringdisadvantagedchildren’sdentalhealthandaccesstocareisonethatcanbeovercome,”saidRalphFuccillo,president,theDentaQuestFoundation.“Wehopestateswillusetheinformationinthisreporttomakeimprovementsindentalcareforchildren.Thereareavarietyofsolutionsthatcanbeachievedatrelativelylittlecost;thereturnoninvestmentforchildrenandtaxpayersispromising.”“Unfortunately,whilesomestatesareimprovingaccesstooralhealthcare,therearestillmillionsofchildrenandfamilies-especiallythosewhoarepoorandliveincommunitiesofcolor-whocan’tgainaccesstothecarethatexists,”saidSterlingK.Speirn,presidentandCEOoftheW.K.KelloggFoundation.“Statesneedtoexplorecreativeworkforcesolutions,suchasthedentaltherapistmodel,foraddressingthisglaringgapinourhealthcaresystem,andimprovingaccesstoqualityoralhealthcareforallchildren.”Therearemanysolutionsthatcanbeachievedatrelativelylittlecostandthereturnoninvestmentforchildrenandtaxpayerswillbesignificant.Americansareexpectedtospend$106billionondentalcarein2010.Thisincludesmanyexpensiverestorativetreatments-fromfillingstorootcanals-thatcouldhave

beenmitigatedoravoidedaltogetherwithearlier,easierandlessexpensivewaysofensuringadequatedentalcarewhentheywerechildren.ReportShowsNeedforLow-CostSolutionsThePewreporthighlightsfourprovensolutionsthatcanimproveboththedentalhealthofchildrenandtheiraccesstocare:--Sealants:Protectivecoatingsappliedtotheteethbyadentistorhygienistcostonethirdasmuchasfillingacavityandhavebeenshowntoprevent60percentofcavities.School-basedprogramsarethemostcost-effectivestrategyforprovidingsealantstodisadvantagedchildren,yetthisstrategyisvastlyunderutilized.--Communitywaterfluoridation:IdentifiedbytheCentersforDiseaseControlandPrevention(CDC)asoneof10greatpublichealthachievementsofthe20thCentury,fluoridatedwatercounteractstoothdecayandstrengthensteeth.Fluorideoccursnaturallyinwater,butthelevelvarieswithinstatesandacrossthecountry.Inadditiontobeingthemostfar-reachingpreventivemeasurestatescanenact,fluoridationalsooffersanunmatchedreturnoninvestment,saving$38indentaltreatmentcostsforeverydollarspent.About30percentofthepopulationoncommunitywatersystemsdoesnotyetreceivefluoridatedwater.--Medicaidimprovements:Makingminorchangestothisfederalprogramcanenableandmotivatemoredentiststotreatlow-incomechildren.Only38percentofMedicaid-eligiblechildrenreceiveddentalcarein2007,largelybecausetoofewdentistsarewillingtotreatthem.ThenumberofchildrenreceivingdentalservicesmorethandoubledoverjustfouryearsinseveralstatesthathaveincreasedMedicaidreimbursementrates.--Moredentalproviders:Newprofessionals,similartonursepractitionersinthemedicalfield,canexpandthenumberofqualifieddentalproviderswhocanfilltheunmetneedsofchildren.Agrowingnumberofstatesareexploringnewmodelsthatincreasetheinvolvementofphysicians,hygienists,andnewtypesofdentalprofessionals.Thereportcanbefoundat:www.pewcenteronthestates.org/costofdelay

ADAResponselink:www.ada.org/public/media/releases/1002_release04.asp

ExtraoralBy: Dr. Elizabeth M. Wilson

IS WASHINGTON BROKEN??GAMECHANGEObama and the Clintons,McCain and Palin, and the RaceofaLifetime*By:JohnHeilemannandMarkHalperin-NewYork,HarperCollinsPublisher,2010ISBN:978-0-06-173363-5,$27.99

GAMECHANGEObamaandtheClintons~McCainandPalin.andtheRaceofaLifetime*islikethekidinclass,armwavingandsquealing“ooh,ooh,Iknow,Iknow....“

Iadmitit,Iwantedtoreadthisbook.Yes,it’sgossipyandreallysortofunseemly,butifyouareapoliticaljunkie,itisalso“data”.Amidstthemanyshockers(andtherearemanyifyouhaven’theard),JohnHeilemannandMarkHalperingiveusthebroadback-groundofthelastPresidentialelection,beginningwiththeleadup.Asthetitlereferences,noonegetsabye.

Thetonetheauthorsusereflectsthepaceofunfoldingevents,keepingthereaderengagedandinvolved.Manydetails,quotes,andopinionsareincluded.Consequently,the“process”oftheelectionisrevealedforalltoexamine.AndlikeCongressandtheirsausagemakingbusiness,itisnotpretty.

Inthefirsthalfofthebook,theauthorsnarratethedemocrat-icraceforthenomination.Sometimesdepressing,othertimesoutrightfunny,butalwaysilluminating,thekeyplayersdukeitout.Wemightrememberthebasicsofthedemocraticnominationfight:thedebates,NewHampshire,Mrs.Clinton’stears,“You’relikeableenoughHillary”,thepost-racialspeech,andsoon.Thebookthoughisnosketch.And,again,notpretty.

Inthehighestheatofit,theauthorsdescribeBillClin-ton’sthoughtsasherealizestheClintonsideislosingtoObama:“ToBill,thepicturewasalltooclear.ByaccusinghimandHillaryofslappingtheracecardonthetable,theObamacampaignwasdoingexactlythatitself.Andthoughitinfuriatedhim,hecouldn’thelpbutrespecttheartfulnessoftheplay.”

Iwonderifanyonerealizeswhattheywroterightthere.Raceasa“play”,andrespectingit?Fromamoresoberperspective,trivial-izingraceisnolongeracceptable,eveninabookofthisnature.

Asthebookcontinues,momentumdashesabout,lurchingthiswayandthat,someegossoar,somecrashandburn.Oh,andyes,theEdwardsdebaclegetsplentyofattention.AlthoughEdwardsasaseriouscandidatedoesnot.

Also,weknowwhowon.

TheauthorsmoveontotheRepublicannominationsinthemiddlesectionofthebook.Abroaderbrushisusedinthisportion;

perhapswewouldallagreetheDemocraticracewasabitmoreeventful,certainlymorehistoric.

Thenationalpresidentialraceplaysoutnext.Here,theau-thorspresenttheMcCain/Palincampaignasatrainwreck.FollowingtheCouricinterview,andTinaFeyonSaturdayNightLive,theywriteofPalinspecifically:

“....intheeyesofthebroaderpublic-andevenmoresothoseofthenationalmediaandpoliticalEstablishment-anytracesofherimageasamaverickreformerhadbeenerased.Forthem,Palinhadbeenreducedtonothingmorethanahickonahighwire.”Shouldwewaitforhistory’sjudgmenthere?

Obamasurvivesreallyunscathed.Oneinterestinglineneartheconclusionfromtheauthors:

“ButwhatBidenquicklydiscoveredwasthatObama’spolicieswereawfullythin,notterriblyspecific,morerhetoricthansubstance.”

Imentionthatbecause,although,noonesayssointhebook,Bidenmustnothaveminded.

Afterfinishingthebook,mythoughtsdriftedtothequestiondominatingtheairwaves...isWashingtonbroken?

Basedonthe“data”,onemightconsidernotWashington,butthosewhopeopleit.

Anintriguingandfunbook,Iencourageyoutoreadit.Nodoubtitwillbefollowedbyothersfilledwith“allknowing”comments.

Currently,howdowerelatethisbooktothe“TeaPartyMovement”,totheprovocativeresponsestoitandtoourforth-comingelectionbattles?

Politicsisafascinatingarena-verydifficulttostayinthemiddleandviewitdispassionately.

*HarperCollinsPublishers

Editor’sNote:Dr.ElizabethWilsonhasbeenapracticingdentistinRich-mondsince2001.SheisadelegateoftheVDA,amemberoftheBoardofDirectorsfortheRichmondDentalSocietyandisadjunctfacultyatVCUSchoolofDentistry.Emailher:[email protected].

Virginia = C


Articles of Interest Articles of Interest


Dr.Michaelhasjusthadanunpleasanttelephoneconversationwithaformerpatient.Originally,thepatienthadexpressedsatisfactionwiththeresultsofhertreatment.Butheraccountisnowsixmonthsover-dueandshestillowesasubstantialamountofmoney.Dr.Michael’sbillingteamispressingthepatienttohonorthepaymentscheduleshesignedandsuddenlyshe’sbeguntoclaimthattheresultsare“hor-rible”andDr.Michaelshouldwriteofftheremainderofherbill.Theconversationendedwiththepatient’scommentthatshehopesthemattercanberesolved“withoutmyhavingtocontactanattorney.”

Dr.Michaelunderstandsthethreatbutisn’tatallcertainabouthowtorespond.Shouldhetellthepatienthe’lltalkwithhislawyer--withhismalpracticecarrier?Shouldhetellherhe’dliketoreviewherfileandgetbacktoher?Shouldhetellher,“Fine!Seeyouincourt!”?Shouldheignoreherdemandandhopeshe’lljustgoaway?

ThefactisthatDr.Michaeldoesn’treallyknowwhattodosincehe’sapleasantmanandagooddentist–andhereallydoesn’tliketogetinvolvedinconflict.Manyofhispatientshavebeenwithhimforyearsandspeakhighlyofhimandhisstaff.He’shadverylittleexperiencedealingwithunreasonablecomplaints.And,becausehehasacleanslatewhenitcomestolawsuitsordentalboardcomplaints,he’safraidthatifhecallshismalpracticeinsurer,hisrateswillberaisedorhisinsurancewillbecancelled.

Asisoftenthecasewhenwefeelrushedtomakeadecisionortakeaction,thiswouldbeagoodtimeforDr.Michaeltostepbackandgivehimselfsometimetothink.Hemightreplytothepatientthathe’dliketoreexamineherfileandthathe’llbegladtogetbacktoherwithinaspecificperiod.Thistimeframemayvaryfrommaybeacoupleofdays,toaboutaweek.Thespecificsituationwillusuallydictatehowaggressivethedoctorshouldbeaboutsettingafollow-update.Oncethisinformationhasbeencommunicatedtothepatient,heshouldpromptlycalltheriskmanagementdepartmentofhismalpracticeinsurancecompany.Hereareseveralreasonswhy:

1.Mostcarriersprovideriskmanagementconsultingtotheirinsureds;it’sgenerallyconsideredapartoftheinsuranceserviceandisusuallyavailabletothedoctoratnoadditionalcharge.There’sawin-winresultforboththedentistandtheinsurancecompanywhenapatient’scomplaintcanbepreventedfromturningintoalawsuit.Forthedoctor,it’smuchlessstressfultoworkwithanexpertriskmanager,someonewhodealswiththiskindofsituationonadailybasis,andwhoknowstheinsandoutsofthistypeofinteraction.Inaddition,theinsurercantypicallyreduceexpensesbypreventingalawsuit,ascomparedtodefendingone.

2. Dr.Michaelmightinadvertentlymakethesituationworseifhetriestohandleitonhisown.Hisverbalresponsestothepatient,orhisdocumentationofthediscussionwiththepatient,mightmuddythewaters.Whatif,forexample,hepromisedthepatientthathe’d

When Should You Call Your Med-Mal Carrier’s Risk Management Team? By: Kathleen M. Roman - ©MedicalProtectiveAllrightsreserved2010.

“takecare”ofthesituation?Fromhisperspective,he’dmeantthathe’dlookintothematterbutthepatientmightopportunisticallyinterpretthisstatementtomeanthathe’lldiscountherbill,writeoffthebalancedue,orpossiblyevenrefundherpartialpayment.

3. Evenwhenthequalityofthedentalworkisperfectlysound,manydentistsaresoafraidoflitigationthattheybendoverbackwardstoaccommodatedemandingpatients.Lackingexperienceinthesematters,thedoctormaynothavetheabilitytothoroughlyevaluatetheindividual’smotivation.Throughlisteningtothedoctor’sstoryandask-ingquestions,theriskmanagermaybeabletouncoverdetailsthedoc-tormaynothaveconsidered–andtohelpdeveloparesponsestrategy.Toooften,thedoctorisreadytoflingmoneyatthepatientinordertoclosethematter,withoutthinkingthroughalloftheramificationsofsuchaplan.Asavvyriskmanager,however,maylookatthedemandwithadispassionatefocus–andtheresultingresponseislikelytobemorefavorabletothedoctor.

4.Knowing“whentofold‘em”isanotherbenefittothedoctorwhohasariskmanagerhelpingtomanagethistypeofdemand.Theriskman-agermayaskthedoctorquestionsaboutthepatient’shistorywiththepractice,thenatureofthetreatmentplan,whetherornotthepatienthadbeencooperativeandcompliantatsomepointorwhethertherelation-shiphadbeendysfunctionalrightfromthestart.Theriskmanagermayaskaboutdocumentationinthepatient’srecordofinformationsuchasdiagnosticdiscussions,treatmentoptions,patienteducation,informedconsent,andpatientcompliance.Theriskmanagerisn’tthinkingonlyabouttheclinicalintegrityoftherecordbutalsoevaluatingitspotentialascourtroomevidence.InDr.Michael’scase,forexample,hisriskman-agerwillwanttoknowifthepatient’srecordincludesanystatementsaboutherearliersatisfactionwiththeresultsofthedentaltreatment.AnastutedefenseattorneywillbequicktopointouttoajurythatthepatienthadbeenpleasedwiththeresultsofDr.Michael’sworkatthetimeitwascompleted.“Isn’titodd,”theattorneywillinquire,“thatMs.Patientwasperfectlysatisfied–untilshewasaskedtopayherbill?”

Ifthedocumentationissound,thedoctormayhavegreaterleewayinforestallingthepatient’sdemands.If,ontheotherhand,keyelementsoftherecordaremissing,inadequate,orinaccurate,theriskmanagermaybeabletohelpthedoctornegotiateareasonableresolutionforthesmallestpossibleoutlay–andobtainasignedreleasefromthepatientacknowledgingthatthematterhasbeensatisfactorilyresolved.

Inonerecentexample,adentistattemptedtoplacateamoney-seekingpatientbyofferingheracashsettlement.Sheacceptedandpromptlycashedhischeck.Thenshesenthimaletterdemandingmoremoneybecausesheclaimedtohavelostadditionaldaysofworksubsequenttothesettlement.Atthispoint,hesawthelightandcalledhisriskmanager.

Bythistime,therewaslittletheriskmanagercoulddoexcepthelpthedoctorofferasmalladditionalsum–andrequireasignedrelease.


Ratherthanagreetothis,however,thepatientpromptlyfiledacomplaintwiththestatedentalboard.

Thisbattlemighthavebeenpreventedhadthedoctorcalledhisriskmanagerafterthepatient’sfirstdemand.Awell-wordedreplyatthattimemighthaveweakenedthepatient’sresolve.Alternatively,acashsettlement,accompaniedbyasignedrelease-from-liabilitystatement,wouldhavepreventedanyfurtherfinaglingbythepatient.

5. Sometimesdoctorsreportthatthey’vebeenreluctanttocontacttheircarrier’sriskmanagementteamoutoffearthattheissueathandwouldleadtoanautomaticpremiumincreaseornon-renewal.Obviously,thisarticlecannotattempttoexplaineveryinsurer’sphiloso-phyonthismatterbutarigidstanceisgenerallynotineitherparty’sbestinterests.

Insurersunderstandthatdelayinrespondingtoacomplaintincreasesthelikelihoodthatitmaybecomealawsuit.Fromthisperspective,itisclearlytotheadvantageofbothdoctorandinsurertocollaborateinaresponsetothepatient’sdemands.

Further,riskmanagershaveaccesstothetechnicallanguagethatwilldocumentacloseddisputeinawaythatcanfoilapatient’sattempttoreopenthematter.Riskmanagersaremorelikelythanthepracticingdentisttobeawareofinsurancedepartmentmandates,stateboardrequirements,andpeerreviewprocesses.Theycansteerthedoctorthroughlegalisticlanguageandobscureregulations.Theycanhelpthe

doctorstrategizeresponsestopatients’demandsandtheycanhelpthedoctorswithdocumentationandwrittencommunications.Agoodriskmanagershouldknowwhentogetanattorneyinvolvedinadisputeandwillhelpthedoctoraccessgoodlegalrepresentationviatheinsurer’sclaimsinitiationprocesses.

6. PeaceofmindisperhapsthemostcompellingreasonwhyDr.Michaelshouldcallhisriskmanager.Often,doctorswillendaconversationwiththeirriskmanagerbysaying,“Oh,thankyouforyourhelp!IamsogladIcalledyou.IfeelsomuchbetternowthatI’vehadachancetotalkwithyou.”Iffornootherreasonthanithelpstoknowthatanexpertisonthedoctor’sside,itisasoundideatomakethecall.RuleofThumb:Ifthedoctorisworriedaboutsomethingthat’sgoingoninhisorherpracticethatisrelatedtopatientsafetyand/orsatisfaction,thenit’sprobablybettertocalltheinsurer’sriskmanagerthantolieinbedatnightworrying.

KathleenM.RomanisRiskManagementEducationLeaderforTheMedicalProtectiveCompany.Shecanbereachedatkathleen.roman@medpro.com

GPR General Dentist - Pediatric/Adolescent PracticeRoanoke, Va.

Carilion Clinic Dental Care is expanding its faculty of residency-trained hospital-baseddentists. This service was established in 1980, and expanded in 2001 to include pediatricdental care for children with little or no access to dental care. Located on the campus ofan 835-bed academic tertiary medical center, the service has experienced steady growthand seeks to add a Dentist with special training and interest in providing comprehensivedental care to pediatric and adolescent patients. Potential exists for academic affiliationthrough the new Virginia Tech Carilion School of Medicine (Fall 2010) and participationin research projects.

Carilion’s Dental Care program is a unique service provided by Carilion Clinic, the largest,nonprofit integrated health system in southwest Virginia, with eight hospitals, 110+practice sites and fifteen GME programs. A five-time All America City, the Roanoke Valleyis a metropolitan area of over 300k located at the southern tip of Virginia’s ShenandoahValley, surrounded by the Blue Ridge Mountains. The region offers recreational, culturaland professional opportunities, including mild weather and four seasons, award-winningschools and internationally acclaimed colleges and universities.

• DDS/DMD degree from accredited dental school• Completion of an accredited general practice residency • Interest in hospital-based pediatric dental practice, plus sedation skills desired• Current unencumbered dental license & DEA• Eligible for Virginia dental license

Submit cover letter outlining work history and CV to the attention of Rhonda Creger,Senior Consultant, Physician and Professional Staffing, Carilion Clinic, POB 40032,Roanoke, VA 24002-0022, or email documents to [email protected].

EEO/AA

Dental Recruit 8.5x5 K 2010_Layout 1 2/24/10 12:58 PM Page 1


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Get your CE at the beach in sunny South Carolina!

Keynote Speakers • Dr. Harald Heymann – Bread and Butter

Adhesive and Esthetic Dentistry • Dr. Charlie Hook – 2010 OSHA Guide-

lines• Dr. Patick Sammon – Prescription Drug

Abuse and Meth Mouth • Dr. Kelly Jones – Pharmacotherapy Re-

view for Dentists • Ms. Stacy McCauley – Practical Informa-

tion on Teen Health Issues & Customized Care for Healthy Patients and a Healthy Practice

• And many more…

Special Events • Welcome Reception and Beach Dance

featuring the Ninth Row Band on Thurs-day night

• Annual Golf Tournament • President’s Social Event – Lowcountry

Boil on Saturday night

Convenient Online Registration • Visit www.scdaannualsession.com to learn

more about this year’s event and to regis-ter yourself and your staff!

South Carolina Dental Association 120 Stonemark Lane Columbia SC 29210

803.750.2277

Dean Ron Hunt Moves OnBy:MarthaBushong,DirectorofCommunicationsandPublicRelations,VCUSchoolofDentistry

VirginiaCommonwealthUniversityandtheSchoolofDentistrybidDr.RonHuntfarewellat

areceptionheldinhishonoronFriday,February12.

Inhisremarksduringthegathering,Dr.MichaelRao,presidentofVCUsaid,“Weareheretocelebrate12yearsoftremendoussuccess.Thisbeautifulfacilityandotheraccomplishmentsleavealastinglegacy.ItisaprivilegeandapleasuretosaythankyoutoRon.”

Dr.HuntwillleaveVCUtotakeonnewchallengesatMidwesternUniversity’sSchoolofDentistryinGlendale,Arizona.Thenewlyestab-lishedschoolispartofahealthsciencesonlycampusinthesuburbsofPhoenix.

“My12yearsatVCUhavebeenthemostrewardingofmylife,”saidDeanHunt,“butIfoundthechallengeofbuildingsomethingbrandnewirresistible.MidwesternUniversityfocusesentirelyoneducatingprimarycarepractitioners–fordentistrythatmeansgeneraldentists.”

WhileVCUconductsanationalsearchforanewdean,Dr.DavidC.Sarrett,associatevice-presidentforhealthscienceswillserveastheschool’sinterimdean.Dr.Sarrettknowstheschoolwellasaformerdepartmentchair,academicdeanandcurrentpresidentofthefacultypracticeassociation.

“Iampleasedtobeabletohelptheschoolinthisrole,”saidDr.Sar-rett.“Ilookforwardtogettingreacquaintedandmakingthetransitionapositiveonefortheschool.”

The comprehensive web home for Dental

Direct plans in VA makes DR and DA

easier to research online.

The Direct Reimbursement Committee invites you to visit their website dedicated to Dental Direct

Reimbursement and Assignment dental plans at:

www.VADentalDirect.com On the site, information is available for

dental offices, employers, employees and

brokers.

Links to resources, articles and other sites

about DR plans are all available at

www.VADentalDirect.com.

Up to date news about Dental Direct in

Virginia is easy to access at the site!

The Dental Direct website has great resources available for your office. Check out the

Frequently Asked Questions section to get a better understanding about Dental Direct and

what it can mean for your office. If you or anyone at your office would like more information

about Dental Direct, please contact Elise at the VDA - [email protected]; 800-552-3886.

Standing, L-R: Drs. John Gunsolley, David Sarrett, Michael Rao, Sheldon Retchin. Seated: Dr. Ronald Hunt.


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Amalgam Separators Make School of Dentistry GreenerBy:MarthaBushong-DirectorofCommunicationsandPublicRelations,VCUSchoolofDentistry

Reduce,reuse,recycle.Thesefamiliarwordstakeonnewmean-ingwhenplacedinthecontextoftheVCUSchoolofDentistry.Evenbeforetheuniversity’spresident,Dr.MichaelRao,kickedofftheYearoftheEnvironmentinfall2009,thedentalschoolhadimplementedsomeimportantearth-friendlypractices.

Amongmanyactionstomaketheschoolgreener,onemajordecisionwastheinstallationofamalgamseparatorsfortheclinicsineachoftheschool’sthreebuildings.

“Noonerequiredtheirinstallation.”saidDeanRonHunt.“AswebuiltthePerkinsonBuilding,however,wethoughtifwecouldlessenanyenvironmentalimpactbyinstallingseparatorsinallthreeofourbuild-ings,itwastheresponsiblethingtodo.”

Now,threeseparators–oneineachbuilding--collectamalgamwastefromtheschool’sclinics.Theseparatorstheschoolneededaremuchlargerthatwhatadentalofficewouldrequire.Theircostwasover$39,000,butstudentsandfacultyremoveorplacemanytimesmoreamalgamrestorationseverydaythandentistsintheirprivateoffices.

AccordingtotheAmericanDentalAssociation,eightstatesandsomecitiesalreadyrequiredentiststoinstallamalgamseparators.Thismandateappearstobeanationaltrendaslocalwastewatertreatmentplantsseektoreducetheconcentrationofmercuryineffluentfromtheirplants.

CurrentlyVirginiadoesnotmandatetheuseoftheamalgamsepara-tors,butsomeofthecommonwealth’sdentistsareonboard,andliketheschool,haveinstalledthemintheiroffices.

“Alltheseparatorssoldnowareover99percentefficient.”saidDr.CraigDietrichofMartinsvilleandmemberoftheVirginiaDentalAs-

sociation(VDA)BoardofDirectors.“Thecostisreallyminimal;Ipaidaround$700formineandinstalleditmyself.Allthingsconsidered,itistherightthingtodo.TheVDAandtheADAhaveenvironmentalguidelinesintheir‘BestManagementPracticesforAmalgamWaste’,”Dietrichcontinued,“Sowearejustdoingwhatourassociationalreadyrecommends.”

LastyeartheVDABoardofDirectors,recognizingitspoliticalimportance,proposedaresolutioncallingforanamalgamseparatormandatethatwouldbecraftedbydentists,ratherthanstateregula-tors.ButtheVDAHouseofDelegatesdidnot

The largest of the three newly installed amalgam separators resides on the ground floor of the Perkinson Building. This unit collects amalgam waste from the Douglas and Graduate Periodontic Clinics.

supportit.

“Theseparatorsarerelativelyinexpensiveandfairlyeasytomaintain,”concurredDr.TerryDickinson,VDAexecutivedirector.“Eventually,ifwedon’tdoit,thestatewillrequireit.IampleasedDeanHuntandthedentalschooltooktheleadandimplementedthisbestpractice.”

Non-Patient Based Licensure Coming to a State Near You?By:RichardCarlile,VCUSchoolofDentistry,D-2011

WhenyouthinkofMinnesotayoumaythinkofsnow,peoplewithfunnyaccents,orevenAlFranken.OnJune26,2009MinnesotaalsobecameknownasthefirststateintheUniontoinstituteanon-patientbasedlicensureexam.

TheMinnesotaBoardofDentistryhasapprovedusingtheNationalDental

ExaminingBoardofCanada’stwo-partexamasameansfordentalstudentstoobtainalicenseinMinnesota.Thistwo-partexamconsistsofawrittenportionandanon-patientbasedObjectiveStructuredClini-calExamination(OSCE).Alongwithpassingtheexam,studentsmustgraduatefromaschoolaccreditedbytheCouncilonDentalAccredita-tion(CODA),passPartIandIIoftheNationalBoards,andtakeaMin-nesotajurisprudenceexamination.1

DentalstudentsaroundthecountrywhoareactivelyengagedintheAmericanStudentDentalAssociation(ASDA)areveryexcitedaboutthenewdevelopments.TheexamalignsitselffairlywellwithASDA’sL1policy,whichcallsforanon-patientbasedlicensureexam.2

LicensureboardshaveofficiallybegunattheVCUSchoolofDentistry,andatdentalschoolsacrossthenation.AsstudentsbegintogetfrustratedoverfindingtheidealClassIIorIIIlesiontheymaywanttoaskthemselves-“ShouldImovetoMinnesota?”

1 http://www.dentistry.umn.edu/news/CanadianLicensureExam/home.html2 http://www.asdanet.org/_AboutPage.aspx?id=1568#L-1

Midwaythroughthefirstsemester of my thirdyear of dental school

Iwasassigned“Susan”,aprospec-tive patient referred by Dr. ReedBoyd,whopractices inPetersburg.Icalledandaskedifshewouldcome

A Smile RestoredNotes from the VCU School of DentistryBy:JosephL.Rodriguez,Classof2011

inforanappointment,andshereplied,“I’mnotsureifyoucandowhatIneeddone.”Susanhadlittleconfidenceincomingtothedentalschool,butaftermuchpersuasion,shedecidedtoscheduleanoralevaluationtodeterminehertreatmentneedsand to explore the treatment options available to her at theschool.

SusancameinfortheinitialappointmentandDr.Cleckner,anadjunctfacultymember,oversawthetreatment

planningsession.Aftermuchdiscussion,Susandecidedshewouldliketohaveporcelainveneersdoneonhermaxillaryan-teriorteeth,andpremolars#5and#12.Thetreatmentplanwasthenpresented toandapprovedbyDr.Janus,aprosthodon-tist and full-time facultymember.Although thiswould bemyfirstveneercase,IwasexcitedtoputintopracticewhatIhadlearned inDr. Janus’s crownandbridgeclass. I alsogainedconfidenceknowingIwouldbeundertheguidanceofDr.Chin,Dr.BaechleandDr.Cleckner,withwhomIhadworkedmostclosely.

At the secondappointment extensive pre-operativephotos,afacebow,andpreliminaryimpressionsfortwosetsofdiagnosticcastsweretaken,pouredinstoneandmountedonasemi-adjustableHanau®articulator.Itookonthetaskofwax-ingupteeth#5-12,andperformingmockenameloplastyonthemandibularanterior teeth to improveesthetics.Acustomtraywasfabricatedforthefinalimpressionandanimpressionwithpolyvinylsiloxanewasmadeasthetemplatefortemporaries.

WhenweshowedSusanthewax-upatthefollowingappointment,shewasthrilledandwaseagertoproceedwiththeproposedtreatment.Priortoveneerpreparation,shadese-lectionwasdoneusingtheVitapan®classicshadeguideandshadeA2wasselected.Severalofheranteriorteethhadfailingcompositerestorations,whichneededreplacement.Aftertheteethwererestored,theveneerpreparationswerecompleted,retractioncordwasplacedandthefinalimpressiontaken.TheteethweretemporizedwithveneersfabricatedwithIntegrity®.Susanwasthengiventhechancetoviewandcritiquethetem-porary veneers so that desired changes could bemade.Animpressionofthetemporarieswastaken.Thepindexedmastercastwastrimmedandthemarginsweremarked.Afterfacultyapproval, the completed case including pre-op photos, diag-nosticcast,wax-ups,mountedcasts,castsofthetemporariesandmasterimpressionsweresenttoDrakeDentalLaboratory.Dr. Larry Holt, the clinical director for Drake Lab, personallysupervised the production of the veneers. He also took ex-

cellent photos during the fabrica-tion process. The veneers weredeliveredtotheschoolsealedandpackaged, etched on the inside,andready tobeplaced.Ondeliv-ery day, Dr. Chin, a full-time fac-ulty member, guided me throughthe cementation process. Afterachieving local anesthesia, cordwas placed and the teeth wereisolated.Try-inoftheveneerswasaccomplished in pairs with try-inpaste, and they had an excellentfit. Etching,silanating,andbond-ingwereaccomplishedandtheve-neers were cemented with NX3®Third Generation resin cement.Susanwas very pleasedwith theresult and was ready to show offherbrandnewsmiletofamilyandfriends,andtellthemwhattheden-talschoolhadtooffer.

IamgratefultoDr.Boydfor referring Susan and makingpossiblethisrewardingexperienceinmydentaleducation.Thetreat-ment would not have been pos-siblewithouttheexcellentcommu-nicationwehadwithDrakeDentalLaboratory. Witnessing Susan’stransformation from being an ap-prehensive and anxious patientto being extremely confident andexcited about getting her dentaltreatmentdone in theVCUdentalschoolsettinghasmadethis jour-neyallthemoremeaningful.

Preoperative

Temporary Veneers

Permanent Veneers

A happy patient!


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Awards & Recognition

Volume87,Number1•January,February&March201046

Dr. Roger Wood, a pediatric dentist in Midlothian and President of the Virginia Dental Ser-vices Corporation, received the 2010 First Humanitarian Award for physicians. Given by Chippenham-Johnston Willis (CJW) Medical Center, the award recognizes a doctor “who demonstrates remarkable concern for the welfare and happiness of patients, has performed extraordinary acts of kindness, shows a level of commitment to community service…and whose contributions may be overshadowed by (his) modesty and humility.”

In Memory of Julie Kent (Pat) WatkinsJulie Kent (Pat) Watkins, 88 passed away January 27, 2010, in Virginia Beach, VA following a long battle with Alzheimer’s disease. Pat served for 24 years as Executive Director of the Virginia Dental Association before retiring in 1994. Her retirement banquet featured multiple letters of thanks from Virginia Congress members, former Virginia Governors, a U.S. Sentor, and featured a U.S. Congressman as one of the evening’s speakers. A memorial service was held on February 6, 2010 followed by internment at Blue Ridge Memorial Cemetery in Lenoir. Memorial donations can be made to the Alzheimer’s Association or charity of your choice.

Governance Meeting

The2010VirginiaDentalAssociationsGovernanceMeetingwillbeheldSeptember24-26th.Wehaveendeavoredtogiveyouvalueforyourtime.InadditiontodoingthebusinessoftheAssociationwiththeHouseofDelegatesandReferenceCommitteemeetings,wewillhaveDr.RonTanker-sley,ADAPresident,speakduringtheAnnualBusinessMeetingSaturdayafternoon.WewillalsohaveaDRupdatefromDr.RichardTaliaferro,DRCommitteeChair,attheBusinessMeetingopeningsessionFridayafternoon.

Thefellowshipopportunitiesincludetheverypopularcomponentreceptions,thebusinessmeetingandthewellreceivedawardsbanquet.Theseopportunitiesmaketheprocessalotmorecollegialastheyallowustodiscussitemsofinterestcasuallyandtheyallowustogettoknowothersfromaroundthestatemuchbetter.Longtermfriendshipshaveemergedfromthesegatherings.Pleaserememberthatthesemeetingsareopentoallmembers.ThisisanopportunitytoseehowyourVDAisrespondingtothechallengesofaccesstocare,workforceissues,governmentalintrusionandawholehostofrelatedmatters.Youmayfindthatyouwouldliketojointheprocessandhelpyourprofession.

TheHousethisyearpromisestobeengagingandmeaningfulfortheworkingoftheVDA.Thereshouldbemanyissuesthatneedtoberesolved.Fortunately,weshouldhavethetimetotalkabout,reflectupontheacttohelpourprofession.YourparticipationanddeliberationsarevitaltothememberdrivenVDA.

Seeyouthere,DavidC.Anderson,D.D.S.SpeakeroftheHouse

HOTEL RESERVATION INFORMATION

THE HOTEL ROANOKE & CONFERENCE CENTERROANOKE, VA

ROOMSAREAVAILABLEUNDERTHEVDAROOMBLOCKFORTHENIGHTSOFSEPTEMBER23rd–25th

ROOMRATE$145.00(Pricedoesnotreflectthelocalroomtax.)

RESERVATIONSMUSTBEMADEBYSeptember3,2010TORECEIVEBLOCKRATE

September 24-26, 2010Roanoke, VA

CALL:540-985-5900or866-594-4722(BeSureToAskForTheVDAGovernanceConference

RoomBlock)

ONLINE:HotelReservationLinkListedInGover-nanceMeetingInformationontheVDAWebsite

Sponsored by:


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2010 VDA GOVERNANCE MEETING SCHEDULEFriday,September24th7:30am-2:00pm BoardofDirectorsMeeting2:15pm-3:00pm HODRegistration3:00pm-4:30pm BusinessMeetingOpeningSession HouseofDelegatesOpeningSession2:00pm-6:00pm ElectionofOfficers4:45pm 16thDistrictDelegation6:30pm ComponentReceptions

Saturday,September25th7:30am-8:30am Breakfast7:30am-8:30am FellowsBreakfast8:00am-12:00pm ElectionofOfficers8:30am-10:00am ReferenceCommittee100010:15am-12:00pm ReferenceCommittee200010:00am-12:00pm VDSC12:00pm-1:00pm Lunch1:30pm-3:00pm AnnualBusinessMeeting 3:00pm Constitution&BylawsCommittee6:00pm Reception6:30pm AwardsBanquet

Sunday,September26th7:00am-8:00am Breakfast7:30am-8:30am ComponentCaucuses8:15am-9:00am HouseofDelegatesRegistration9:00am-11:00am HouseofDelegates11:15am-12:30pm BoardofDirectorsMeeting

VDA AWARDS BANQUET

When: Saturday,September25,2010 6:00PMReception6:30PMDinner

Where:TheHotelRoanoke&ConferenceCenter 110ShenandoahAve. Roanoke,VA24016

Cost: $20.00–HouseofDelegateMembers/BoardofDirectors$50.00–Allotherguests

TICKET SALES DEADLINE: SEPTEMBER 10, 2010 – NO ONSITE SALES

Name:_______________________________________________________________Numberattending:_____________

Amountenclosed:________________

Payment:CheckpayabletoVDA

CreditCard#______________________________________________ ExpirationDate:__________________________

Signature:___________________________________________ PrintName:___________________________________(Signatureindicatesapprovalforchargestoyouraccountandpayment (Asitappearsonyourcreditcard)underthecreditcardissuer’sagreement.)

CardBillingAddress:_________________________________________________________________________________Pleasemailorfaxto:VirginiaDentalAssociation,7525StaplesMillRd.,Richmond,VA23228,Fax:804-261-1660

Awards Banquet

CAN’T MAKE IT TO THE GOVERNANCE MEETING? VDA MEMBER VOTING OPTIONS

Therearetwomethodsofabsenteevotingavailable:

1. WrittenAbsenteeBallot:• AbsenteeballotsmayberequestedfromtheVDACentralofficebeginning30dayspriortotheelection(August

25th).AnAbsenteeBallotRequestFormwillbeintheJuly,August,SeptembereditionoftheJournal.• Anabsenteeballotwillbemailedtothememberandmustbereturned

totheCentralOfficenolaterthan12:00noontwobusinessdayspriortothestartoftheGovernanceMeeting(Wednesday,September22nd)intheenvelopesprovided.

2. Onlinevoting:• AsecureMemberVotingModulewillbeavailableontheVDAwebsite(www.vadental.org)beginningAugust25th.• Memberswilluseselectedidentifierstologinandprotectthesecurityofthevoteandtheprivacyofthemember.• Onlinevotingwillbeavailableuntil12:00noonSeptember25,2010.

InpersonvotingattheGovernanceMeetingwillalsobedoneonlineonsecurecomputersprovidedbytheVDA.

Itisimpossibleforamembertovotemorethanonce.

Intheeventofarunoffelection,electionswilltakeplaceattheAnnualBusinessMeetingwhichwillbeheldat1:30pmSatur-day,September25,2010.

VDA FELLOWS BREAKFASTFellowsoftheVirginiaDentalAssociationareInvitedtoAttendthe2010AnnualFellowsBreakfast

Date: Saturday,September25,2010When: 7:30am–8:30amWhere: TheRoanokeHotel 110ShenandoahAve. Roanoke,Virginia24016Cost: $18.00

TOATTENDPLEASECOMPLETETHEFOLLOWINGANDMAILORFAXTOTHEVDACENTRALOFFICEBYSEPTEMBER25,2010NOONSITETICKETSALES

.Name:___________________________________________________ Amountenclosed:________________________

Payment:CheckpayabletoVDA

CreditCard#______________________________________________ ExpirationDate:__________________________

Signature:________________________________________ PrintName:____________________________________(Signatureindicatesapprovalforchargestoyouraccountandpayment (Asitappearsonyourcreditcard)underthecreditcardissuer’sagreement.)

CardBillingAddress:_________________________________________________________________________________Pleasemailorfaxto:VirginiaDentalAssociation,7525StaplesMillRd.,Richmond,VA23228,Fax:804-261-1660

Fellows Breakfast


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IamannouncingmycandidacyandrequestingyourvoteforthepositionofVDAPresident-Elect. Ihavebeeninvolvedinorganizeddentistryallofmyprofessionalcareer.IbeganasthelocalchairofwhatwasthenChildren’sDentalHealthMonth.Sincethattime,Ihavebeenpleasedandhonoredtoserveinlead-ershippositionsatalllevelsoforganizeddentistry.Ihaveservedaslocalcommitteechaironseveralcommittees,aspresidentofourcomponent,asVDAdelegate,asanADAalternatedelegate,aschairoftheADACouncilonDentalEducationandLicensure,andasPresidentoftheVirginiaBoardofDentistry. HavingthehonorofthechairoftheADACouncilandthePresidencyoftheBoardofDentistrytaughtmehowimportantitwasforVDAmembersandtheirleaderstobeawareoflegislativeactionsthataffectourdentalpracticesonadailybasis.Iwasextremelyproudofthemembersofthedentalprofessionwhorespondedsowelltothemostrecentissuesdur-ingthepresentlegislativesession. Accesstocareisalsoapassionofmine.IwasamemberoftheVDATaskForceresponsiblefordevelopingtheMissionofMercy(MOM)project.Thisprogramcelebratedits10thAnniversaryin2009.Iamamem-beroftheDonatedDentalServicesandhavebeenthelocalchairofGiveKidsASmileforthepasteightyears.Duringthattimewehaveprovidedpreventivecareandfollow-updentalcare(includingcomprehensivedentaltreatmentundergeneralanesthesiainahospitalsetting)tochildrenwhoseparentsareunabletoaffordcarefortheirfamily. Iwillbeastrongadvocateforthedentalprofessionandfeelthatmyhistoryofservicewillhelpmerepresentandserveallmembersoftheprofession.IaskforyourvoteandyoursupportasPresident-Elect,andItakethatresponsibilityveryseriously.Thankyou.

11601RobiousRoad,Midlothian,Virginia23113(804)794-3498Component:4

Roger E. Wood, DDSCandidate for the Office of: President-Elect

IfeelthatwithmyexperienceasateacheratMCV,anactiveprac-titionerinthefieldandmyserviceasanofficerforseveraldentalassociations,thatIwillbeabletofacethechallengesassociatedwithbeingaDelegate.

IhavebeenactivelyworkingwithaDentalBenefitsCommitteetoaddressourongoingtrialsandtribulationsindealingwithinsurancecompanies;particularlywiththeprocessinganddenialofdentalclaims.Wearealsoworkingtoopenavenuestowardsprovidingadequatedentalbenefitsforpeoplewhohavepreviouslyhadnoaccesstodentalcare.Thisprocessissomethingthatwillneedconstantmonitoringonthelocal,state,andnationallevels.

IlookforwardtoworkingwiththeDentalBenefitsCommitteeandotherareasthatimpactdentistrytoday.Ihavecommittedmyselftothetimeandenergyneededtoaddresstheseissues.IalsoremaincommittedtotheVirginiaDentalAssociationandwillworkhardtocompletetasksathand.ItwouldbemyhonortoservetheADAasadelegatefromVirginia.

2240ColiseumDriveSuiteC,Hampton,VA23666(757)-826-1121Component2

Richard D. BarnesCandidate for the Office of: ADA Delegate

Iwishtothankyou,themembersoftheVirginiaDentalAssociation,forgivingmesuchawonderfulopportunitytoservetheprofessionasyourPresidentforthe2008-2009year.IthasbeenapleasuretoservetheAssociationandtheADAasanAlternateDelegatethesepastsixyears,andIseekyoursupporttocontinuemyserviceasanADADelegate.Ifeelthattherearemanyissuesthatweasaprofessionfaceonadailybasisandweneedleaderswhowillrepresentyourwishesandourinterestsonanationallevel.HavingservedasamemberoftheBudget,Finance,andAdministrativeMattersReferenceCommitteeandcurrentlyservingasamemberoftheADACERPCommittee,Ifeelmyexperi-encewillbeusefulinmakingmeaneffectiveDelegatetotheAmericanDentalAssociationandIhumblyaskforyoursupport.

102WesternAve,Suffolk,VA23434757-539-7695Component:1

Ralph L Howell, Jr., DDSCandidate for the Office of: ADA Delegate

2010 VDA Elected Leadership Candidates

Edward J. Weisberg, DDSCandidate for the Office of: ADA Delegate

AsaDelegatetotheADAIhaveusedmybudgetaryexperiencetohelpscrutinizetheADABudgetProposalsandensurethatourduesdollarsarespentinthebestpossiblemannerandthatanyduesincreasesarejustified.IhaveanunderstandingofhowtheADAHouseworkstovoicethedesiresofthemembership.IhavebeenactiveinmysupportofOrganizedDentistryandaskforyoursupporttoelectmeasaDelegate.

TheHouseofDelegatesofTheAmericanDentalAssociationadoptsthebudgetanddevelopsthepoliciesandprogramsofourAssociation.AsamemberoftheVDAandthe16thdistrictdelegations,IhavebeenactiveinthedelegationandIamseekingtocontinuethisasaDelegatetotheADA.IamcommittedtoabroaderinvolvementbasewhichwillenhancemycommitmenttotheVDAandservingmycolleagues,itsmembers.IwillbeopenmindedandlistentoanymemberwhohasanopinionandwillformulateapositionwhichwillbestbenefitourVirginiamembersnotjusttheneedsofonlyafew.

RespectfullyIaskyoutoreturnmetothepositionofADAalternatedelegate.OverthepasttwoyearsIhavetriedmylevelbesttorepresentVirginiaforcefullyattheADAhouse.Speakingbothonthefloorandinreferencecommittees,puttingVirginia’sideasbeforetherestofthedistrictshasbeenadistincthonorandprivilege.AndmayIsay,it’sbeenaheckofalotoffun.TocontinuetorepresentyouwouldbeajoyanditwouldmakemyworkwiththeVDAfarmorefulfilling.

5288DawesAveAlexandria,VA22311703-671-6060Component8

Dr. David AndersonCandidate for the Office of: Alternate ADA Delegate

No photo available

TheVirginiaDentalAssociationisuniquelypositionedtorepresenttheinter-estsofthousandsofdentiststhroughoutthestate.Theirconcernsregardingkeyissuessuchas:accesstodentalcare,dentaleducation,thedentalwork-force,membershipanddirectreimbursementmustbeaddressed.LeadershipthroughcooperationandaclearvisionoftheVDA’sfutureareessentialtoourcontinuedgrowthandprosperity.Ifnowelectedtoserveatwo-yeartermasanAlternateDelegatetotheADAHouse,Iwilldedicatemyyearsofprovenleadershipinthemilitary,academicsandcommunityservicetoadvancethegoalsoftheVDAandourprofession.

VCUSchoolofDentistry,POBox980566Richmond,VA23298804-828-2977Component:4

Alfred J. Certosimo, DMDCandidate for the Office of: Alternate ADA Delegate

801W.LittleCreekRoad,Ste103,Norfolk,VA23505757-440-0044Component:1

HavingservedontheVirginiaDelegationtotheADAforthepast14years,IhavedevelopedagoodrelationshipwithdentistsfromotherareasofthecountryandtheofficersoftheADA.Thisbecomesnecessarywhendebatingtheissuesinbothfindingoutwhatothersareconcernedwithandhowtogetwhatwe,inVirginia,wouldliketohave.Ilistentomyfriendsandcolleaguesthroughoutthestateandamawareoftheissuesthatareimportanttothem.Knowingwhatisimportanttoourmembers,andknowinghowtogetthejobdonemakemeanaffectiverepresentativeforVirginiadentists.IthasbeensuchapleasurerepresentingyoutheseyearandIhopeIcancountonyourvotetocontinuemyservicetotheVDAandADA.

14245-PCentrevilleSquareCentreville,VA20121703-830-9110Component8

Dr. Bruce HutchisonCandidate for the Office of: Alternate ADA Delegate

Curricula Vitae (CVs) for all candidates can be viewed online

at www.vadental.org


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Component 8Dr. Chris Spagna - Editor

Component NewsComponent 5

Dr. Gene Ayers - Editor

IhavehadthedistinctpleasureofrepresentingtheVDAasanAlternateDel-egatetotheADAforthepastsixyears,andIwouldbehonoredtobechosentodosoagain.Mythreetermshavebeenduringexcitingtimesfororganizeddentistry;wearefightingtomaintainourpracticeindependencewhiledoingeverythingpossibletoensurethatweattendtothedentalneedsoftheunder-served.Wecontinuetoputethicsatthetopofourprofessionalcommitments.Wecontinuetomakedifficultdecisionsthatwefeelareinthebestinterestofthedentalprofession.Wehavebeenabletoexperiencepoliticalsuccessstatewidewiththerecentpassageofthetwobillspreventingtheinsurancecompaniesfromdictatingfeesonnoncoveredservicesandwehopetohavethesamesuc-cessnationallywithrepealoftheMcCarran-FergussonActexemptionforhealthcarecompanies.ThistypeofmemberinvolvementiswhatmakestheADAsoeffectiveandimportanttoourprofession.Wedomakeadifference!IhavetrulyenjoyedmytermsasanADAAlternateDelegate,andIhopeyouwilloffermetheopportunitytocontinuemyservice.

6901PattersonAveRichmond,VA23226804-288-5324Component4

Dr. Elizabeth ReynoldsCandidate for the Office of: Alternate ADA Delegate

First,letmesaythatithasbeenaprivilegeandhonortorepresentyouattheADAoverthepastfouryears.IwouldliketoaskforyourcontinuingsupportasIseekre-electiontothepositionofADAAlternateDelegate.

Dentistrytodayfacesmanynewtrialsandtribulations.Someoftoday’smajorissuesareHealthcare,DHATS,ethics,thehygienemid-levelprovider,andthepatient’saccesstodentalcare.Inordertohavemeaningfulsolutionstoourproblems,weneedto“thinkoutsidethebox”.Aswehaveseenoverthepastfewmonths,Foundations,RepresentativesfromCongressandsomestateLegislatorsaretryingtocomeupwiththeirownsolutionsforourissues.Bycomingupwithourowninnovativeideas,weasadentalcommunitycanprovideaunifiedvoicetoaddresstheseproblems.Thewelfareofourprofes-sionisbestservedandprotectedwhenwejointogethertoproduceworkablesolutions.ThroughalloftheupcomingdebateswemustkeeptheDentistinchargeoftheDentalteam.

OurVirginiaDelegationhasprovidedstrongleadershipoverthepastyears.TheelectionofDr.RonTankersley’sasourADAPresidentisoneofourproud-estmoments.IfeelthatmyworkethicandpastexperienceontheVirginiaDelegationandontheVirginiaBoardofDentistryhaveprovidedastrongfoundationformycontinuedserviceontheNationallevel.

11007WarwickBlvdNewportNews,VA23601757-596-7000Component2

Michael J. Link, DDSCandidate for the Office of: Alternate ADA Delegate

Thesnowisfallingasthisbriefentryiscomposed.However,thisjournalshouldreachyouwhenaburgeoning,beautifulspringtimefedbythesnowmeltarrivesthroughouttheCommonwealth.Getoutthereandadmirethedaffodils!Asspringsettlesfirmlyintoplace,joinusinthePiedmontattheexcellentDanvilleAdvancedLearningInstituteforourcomponentmeetingonFriday,April30,featuringDr.RalphNicassiopresenting“AdvancesinOrthodonticsforGen-eralDentistry”.ForinformationorlastminuteregistrationcallExecutiveDirectorAnnHuffmanat276-673-6700.PiedmontPresidentChrisPayneannouncedtheopeninginFebruaryofa

HappybelatedNewYearfromcomponent8!Asthefirstfewmonthsof2010havecomeandgone,muchhasgoneoninNorthernVirginia.InDecemberourlegislativebrunchwaswellattended,asmuchconversationtookplaceregard-ingthemandatedfeesbill.LaterinJanuary,wewereabletofollowupwithaniceshowinginRichmondforthe“DayontheHill”.Thanksgoesouttoallthedentists(andespeciallythosefromNorthernVirginia)whowrotetheirlegislatorsregardingthisveryimportantsubject.Duetothegenerosityandsupportofourmembers,over$21,000wasraisedduringthe2009AnnualHolidayGreetingCardcampaign.Moniesraisedwillen-

newvolunteermanneddentalclinicinassociationwiththeDanvilleCommunityDentalHygieneSchool.AnotherresponsebydentistryintheCommonwealthtoaccesstocareissues.AtthesametimefinalplansareunderwayfortheRoanokeM.O.M.projectMarch26and27.Thelocalarrangementsandsupportforthisrecurringclinicaretopnotch.Comealongandenjoyserviceforothers.

abletheNorthernVirginiaDentalClinictocontinueassistingthosewhoaremostatneedinourcommunity.THANKYOU!InclementweatherforcedustorescheduleourFebruary5thGiveKidsaSmileeventtoApril9th.WearelookingforwardtothataswellastheupcomingMis-sionofMercyprojectonMarch12,13.Botharesuretobeasuccess!Theendtowintercouldn’tcomeanysoonerhereinNorthernVirginia,aswearelookingforwardtospringmorethaneverbefore.Takealookatourwebsite,nvds.org,formoreinformationontheupcomingCEprogramsscheduled.

Northern Virginia Dental SocietyDr.IbrahimAlhussaingradu-atedfromtheUniversityofPennsylvaniain2003.HeiscurrentlypracticinginFairfax.

Dr.NavidAsgarigraduatedfromTempleDentalSchoolin1996.HethencontinuedtoreceivehisGeneralPracticeResidencyCertificatein1997.Dr.Asgariiscurrentlypractic-inginSpringfield.

Dr.CharlesBrownIIIgradu-atedfromtheMedicalCollegeofVirginiain1996.HethenreceivedhisGeneralPracticeResidencyCertificatefromtheUniversityofMississippiMedicalCenterin1997.Dr.BrowniscurrentlypracticinginAlexandria.

Dr.JaniceDionisio-Magradu-atedfromTempleDentalSchoolin2007andiscur-rentlypracticinginAlexandria.

Dr.JosemariImaoiscurrentlypracticinginLakeRidge.

Dr.AnthonyMoawadgradu-atedfromBostonUniversityin2008andiscurrentlypractic-inginMcLean.

Dr.HamdiMohamedgraduatedfromtheHow-ardUniversityCollegeofDentistryin2008.ShethencompletedherGeneralPrac-ticeResidencyin2009.Dr.MohamediscurrentlylocatedinAlexandria.

Dr.JenniferKimgraduatedfromtheUniversityofFloridaDentalCollegein1999.SheiscurrentlypracticinginChantilly.

Dr.MignonetteLobogradu-atedfromTuftsUniversityin2000.Sheiscurrentlypractic-inginFallsChurch.

Dr.HowardMillergraduatedfromHowardUniversityin1979.HethencontinuedtoreceivehisMastersofBusi-nessAdministrationin2003.Dr.MilleriscurrentlyworkingwiththeVirginiaDepartmentofHealthinFredericksburg.

Dr.JamesMoshiergradu-atedfromtheTuftsSchoolofDentalMedicinein2009.HeiscurrentlypracticinginanAssociateshipinCentreville.

Dr.VladyslavOvcharenkograduatedfromtheNYUCollegeofDentistryin2009.HeiscurrentlypracticinginCentreville.

Dr.GeetikaTahimgraduatedfromtheNYUCollegeofDen-tistryin2001.SheiscurrentlypracticinginHerndon.

Dr.XiminYanggraduatedfromtheShanghaiDentalSchoolin1989.Afterathree-yearresidency,hethenreceivedhiscertificateinPeriodonticsfromtheNewJerseyDentalSchoolin2009.Dr.YangiscurrentlypracticinginanAssociateshipwithNeibauerDentalCareinFredericksburg.

Peninsula Dental SocietyDr.TammaraBellgradu-atedfromtheUniversityofTennessee.SheiscurrentlypracticingwithKoolSmilesCorporationinYorktown.

Dr.JoelleHairstongraduatedfromtheUniversityofMichi-ganin1998andcontinuedtoreceiveherGeneralPracticeResidencyCertificatefromWakeForestUniversityBaptistMedicalCenterin2000.Dr.HairstoniscurrentlylocatedinWilliamsburg.

Dr.JeffreyRaphaelgradu-atedfromtheUniversityofMarylandSchoolofDentalMedicinein1974.HethencontinuedontoreceivehiscertificatesinGeneralPrac-ticeResidencyandProsth-odonticsin1976and1983,respectively.Dr.RaphaeliscurrentlypracticinginWestPoint.

Piedmont Dental SocietyDr.MistyLenkgraduatedfromtheVCUin2002.ShethencontinuedtoreceivehercertificateinOrthodonticsandDentofacialOrthopedicsfromtheUniversityofFloridainGainesvilleandOhioStateUniversityin2006.Dr.LenkiscurrentlypracticinginDaleville.

Dr.YoungChulParkgradu-atedfromLomaLindaUniver-sityin2009.HeiscurrentlypracticingwithSmallSmilesDentalClinicinRoanoke.

Richmond Dental SocietyDr.AndrewEstillgraduatedfromVirginiaCommonwealthUniversityin2008.HethencontinuedtoreceivehisGPRfromtheUniversityofAlabama–Birmingham.Dr.EstilliscurrentlypracticinginMidlothian.

Dr.ElizabethMillergraduatedfromVirginiaCommonwealthUniversityin2007.ShethenreceivedherCertificateinPediatricDentistryfromtheUniversityofMichiganin2009.Dr.MilleriscurrentlypracticinginRichmondwiththeAtkins,MaestrelloandAs-sociatesPediatricDentistry.

Dr.AndreaMitmangraduatedfromMCVin1988andiscur-rentlypracticinginAylett.

Dr.AlexisOristiangraduatedfromVirginiaCommonwealthUniversityin2007.SheiscurrentlypracticingwithW.B.PerkinsonandAssociatesinMidlothian.

Dr.ShekhaPatelgraduatedfromtheUniversityofFloridain2008.SheiscurrentlypracticinginRichmond.

Shenandoah Valley Dental AssociationDr.RustyDavisgraduatedfromVCUin2007.Heiscur-rentlypracticinginWaynes-boro.

Dr.RichardKapitangraduat-edfromOhioStateUniversityin2002.Hethencompletedhisspecializationinoraland

maxillofacialsurgeryin2006.Dr.Kapitaniscurrentlyprac-ticingwithBlueRidgeOralSurgeryinFishersville.

Dr.ChandaAshleygraduatedfromVCUin2005.ShethencontinuedontoUniveristyofConnecticut,completingherspecializationinorthodonticsanddentofacialorthopedicsin2009.Dr.AshleyiscurrentlypracticinginStaunton.

Southside Dental SocietyDr.TimothyMarshallgradu-atedfromVCUin2008.HeiscurrentlypracticingwithKoolSmilesinColonialHeights.

Dr.TinaKao-Reasonergradu-atedfromtheUniversityofIowain2009andiscurrentlypracticinginBoydton.

Dr.JuanRojasgraduatedfromVirginiaCommonwealthUniversityin2008andwillcompletehisGeneralPracticeResidencyinJune,2010.

Tidewater Dental AssociationDr.PyeKyugraduatedfromVirginiaCommonwealthUniversityin2006.HethencontinuedtoreceivehisAEGDCertificatein2007thenhisEndodonticsCer-tificate,bothfromtheVCUSchoolofDentistry.Dr.KyuiscurrentlypracticingwithHamptonRoadsEndodonticsinChesapeake.

Dr.DavidTropgraduatedfromtheMedicalCollegeofVirginiain1977andiscur-rentlypracticinginNorfolk.

Welcome New Members!February 2010

In Memory Of...

DrGeorgeBarnett TidewaterDentalAssociation Suffolk December28,2009

Dr.JamesBoyd SouthsideDentalSociety VirginiaBeach December30,2009 Dr.JamesOHodgkin,III NorthernVirginiaDentalSociety Warrenton January25,2010 Dr.ArthurSiegel TidewaterDentalAssociation Norfolk January7,2010 Dr.RobertF.Jackson SouthwestVADentalSociety Salem January4,2010


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BoardofDirectors-ActionsinBriefJanuary14-16,2010

I. Itemsconsidered(requireactionbytheHouseofDelegates):

A. ThefollowingBy-lawchangewasconsidered:

1. Background:SincetheAssociationnowelectsitsofficersbyanonlinemethodandthereisnogeographicadvantageto holdingtheAnnualMeetinginarotatingfashionitisrecommendedthatmeetingsoftheAssociationbeheldinareasthat willprovidethebesteconomicadvantagetotheAssociation.Alsobydirectionofthe2009HouseofDelegates,the BoardofDirectorsischallengedwiththepossibilityofrecombiningtheVirginiaMeetingandtheAnnualMeeting ThereforeitisresolvedthefollowingchangestotheBylaws.

(Current)ARTICLEII Meetings

Section1. AnnualMembershipMeeting:TheAnnualMeetingshallbeheldeachyearasapprovedbytheBoardofDirectors.TheAnnualMeetingshallrotateinthefollowingorder:NorthernVirginia,EasternVirginia,CentralVirginia,andWesternVirginia.ItshallbethepurposeofthisMeetingtofostertheidealsoftheAssociationassetforthinARTICLEIIoftheCONSTITUTIONofthisAssociation.

The Bylaws of the Association shall be amended by substitution of Article II- Meetings with the following:

ARTICLEII Meetings

Section1. AnnualMembershipMeeting:TheAnnualMeetingshallbeheldeachyearasapprovedbytheBoardofDirectors.ItshallbethepurposeofthisMeetingtofostertheidealsoftheAssociationassetforthinARTICLEIIoftheCONSTITUTIONofthisAssociation.

The Board of Directors approved the above resolution with a recommendation the House of Delegates vote yes. II. Thefollowingissubmittedasinformationonly:

A. Thefollowingitemswereapproved:

1. Background:TheSonjaLaurenFoundationwasestablishedtoaidtheworkingpoorbyfillingthegapbetweenMedicaidandinsurance.

Resolution:TheVDAdonate$2,500.00totheSonjaLaurenFoundation.

2. Reaffirmationoftheresolutionadoptedbythe2009HouseofDelegatestoinitiatea legislativebillprohibitinginsurance companiesfromsettingfeesonnon-coveredservicesasdefinedbelow:

HouseofDelegatesAction–September13,2009:

Adopted:TheVDAHouseofDelegatesrecommendstheBoardofDirectorscreatelegislativeinitiativethatwouldopposetheinsurancecompaniesfrombindingfeesfornon-coveredservices.(Policy)

3. Background:LastyeartheBoardapproveda$1,000.00appropriationtodevelopahistoryoftheVirginiaDentalAssociation.Whileweareworkingontheproject,wehaveyettousethemoney.TheCouncilwouldlikethis$1,000.00toremainfortheiruseandremainalineitemintheVDAbudget.

Resolution:The$1,000.00appropriationfordevelopingahistoryoftheVDAwillremainalineiteminthebudget.

4. Background:MembersareaskedtopayduesandVADPACduesattheendoftheyear,possiblytheworsttimetowritealargecheck.ThismayresultinfewermemberscontributingtoVADPACorgivinglessthantheymightotherwise.

Resolution:TheVDAseekamethodofinstallmentpaymentsandworkoutthedetailstomakethispossibleassoonaspossible. 5.ReferraloftheMentorshipCommittee’srequestfor$15,000.00(budgetfor2010)toVDAServices.

6.TheVDAcommunicatewithallVirginiadentistsandlegislators,byall meanspossible(i.e.mail,fax,e-mailandVDAwebsite),aboutthelegislationintroducedtotheSenateontheMandatedFeesBill.TheNon-

coveredServicesTaskForceshallberesponsibleforcompilingallmaterial.

BudgetImpact:$7,500.00

Itwasdarkandcoldoutsidebutmorethan150dentistsanddentalstudentsgeneratedplentyofheatonJanuary15astheVDA’sannualDayontheHillgotunderwayatRichmond’sOmniHotel.WhentheselegislativestalwartscompletedtheirGen-eralAssemblyvisitsthreehourslater,thestate’sinsuranceindus-trywasonnotice:overreachingbydentalinsurerswouldnotbetolerated!

Alreadysteamedbytheopeningsalvoofastatewideinsuranceindustryadvertisingcampaign,

2010 Day on the Hill: Dentists and Dental Students Embark On a Long General Assembly SessionByLauraGivens

Delegate Chris Peace was the keynote speaker at the VDA Day on the Hill Breakfast.

From left: Dr. Ronnie Brown, Steven Lutz, Christopher Davenport, Dr. Cynthia Southern, Dr. Dana Chamberlain, Emily Kate Bowen, Dr. Gus Vlahos and Stephanie Vlahos (center) at the VDA Legislative breakfast. All are dentists and VCU dental students from southwest Virginia.

attendeesusedtheremarksofthisyear’skeynotespeaker,Del-egateChrisPeace(R-Mechanicsville),tostayfocusedduringtheirCapitolHillvisits.DelegatePeace,withasignificantbackgroundinadvocacyandpublicpolicy,advisedtheassembledVDAteamtoproceedmethodicallyasthebattlewiththeinsuranceindustrymovedintohighgear.Awarethatdentistshadbeenlobbyingtheassociation’smandatedfeeslegislationforseveralweeks,Peacerecommendedthat“…facts,notemotion…”carrytheprofession’sargumentsonCapitolHill.

VDAlobbyistChuckDuvallfollowedPeacetothepodiumandlaidouttheassociation’slegislativeobjectiveinstarkterms:“Withoutthislegislation,”Duvallsaid,“theprofessionisfacedwithgiv-ingovertoinsurancecompaniesdecisionsaboutpatientcarethatrightlyshouldbemadebydentistsinconsultationwiththeirpatients.”

ThankstoMessrs.PeaceandDuvall,theannualDayontheHilldidmorethansendanenthusiasticcadreofdentists,dentalstudents,andothermembersoftheVCUdentalcommunitytotheCapitol.January15alsomarkedtherealbeginningofanalmostunprecedentedhands-onlobbyingcampaigntopreservetheindependenceoftheprofession,acampaignthatcontinuesasthiseditionoftheJournalgoestopress.

From Left: Dr. John Marino, Chuck Duvall, Dr. Alonzo Bell, Au-drey Gamulo and Denny Gallagher gather at the VDA Legislative break-fast before head-ing to the General Assembly.

From Left: Dr. Nathan Houchins, Dr. Scott Miller, Dr. Cynthia Southern, Senator Phil Puckett, Dr. Ronnie Brown, Dr. Dana Chamberlain, Dr. Gus Vlahos, and Dr. Ron Jessup.

From left: Dr. Ronnie Brown, Dr. Gus Vlahos, Dr. Dana Chamberlain, Dr. Cynthia Southern, Dr. Ron Jessup, Senator William Wampler, Dr. Nathan Houchins, Dr. Scott Miller, Dr. Mike Abbott.

Delegate From Left: Alexandra Barton, Bud Phillips, Dr. Carole Pratt and Dr. Jim Revere.


You Gotta Put A Face On It! Dentists Rally to the CauseByChuckDuvallandDennisGallagher

Whatdothefollowinghaveincommon?Aetna VA Association of Counties

AFL-CIO Virginia Auto Dealers AssociationAnthem Virginia Bankers Association

International Brotherhood of Teamsters (BMWE Division) Virginia Association of Health PlansAmericas Health Insurance Plans Virginia Association of Health Underwriters

Delta Dental of Virginia Virginia Chamber of CommerceNFIB – National Federation of Independent Businesses Virginia Manufacturers Association

Northrop Grumman Shipbuilding (Newport News) VA Municipal LeagueVirginia State Employees Association

TheywereopposedtothelegislationintroducedattherequestoftheVirginiaDentalAssociationtostopinsurancecompaniesfromusingcontractstodictatefeesforservicesforwhichtheydonotpay.

WhenwemetwiththeVDAleadershipinthefalltodiscussthissituation,wenotedtheassociation’sneedto“putafaceontheissue”ifweweretosucceedinthelegislature.Bythis,wemeantthatdentistsneededtoshowlegislatorsthat,indeed,thisissuewasimportanttothem.Dentistsacrossthestatewouldneedtocontacttheirlegislatorstostressthattheyneededtheirhelp.SenatorWilliamWampler(R-Bristol)introducedSenateBill622andDelegateLeeWare(R-Powhatan)carriedidenticalHouselegislation,HB1263.DeltaDental,UnitedConcordia,Anthem,andtheVirginiaAssociationofHealthPlansactivatedthesupportoftheentitiesabovetoopposebothbills.

DentistsfromacrosstheCommonwealthrespondedinanhistoricfashion:literallyhundredsofemails,phonecallsandletterswerewritten.Scoresofdentists,staffmembersandfacultyanddentalstudentsvisitedtheGeneralAssemblyonadailybasisandcontactedone-on-oneeverymemberofthelegislature.

WhenhearingsonthebillswereheldintheSenateandHouse,itwasstandingroomonlywithsupportersofourlegislationpackingtherooms.

Ourargumentsweresimpleandstraightforward:

• Mandatingfeesfornon-coveredproceduresisanewconceptindentalinsuranceplansandabadidea.• Ourlegislationdealtwithnon-coveredservicesonly.Thefeeagreedtobyadentistforcoveredservicesremainsinplaceeventhoughthe

patientmayexceedthemaximumpaymentunderthedentalplan.• Thesenewcontractsshiftadentist’scoststopatientswithoutdentalinsuranceortopatientswhosedentalplansdonotcontainthe

provisionsbeingadvancedbyDeltaanditsallies.• Ifdentalinsurersbelievethatnon-coveredproceduresareimportant,theyshouldincludethemaspartofapolicy’scoveredservices.

Inspiteofaseriesoffull-pageadsruninatleastthreeofthestate’smajornewspapers,inspiteofasophisticatedInternetpetitiondrive,inspiteoftheretentionofsomeoutstandinglobbyistsfortheopposition,theGeneralAssemblyagreedwiththedentalcommunityandrespondedaccordingly.Bothbillspassedwithoverwhelmingsupport!

AswefilethisreporttomeettheJournal’searlyMarchdeadline,bothbillsareontheirwaytoGovernorBobMcDonnell.Simultaneously,wearereachingouttoVDAmembersstatewideaskingthemtoencouragetheGovernortosigntheseimportantbills.

Allofuswhohavehadtheprivilegeofworkingwithyouonthisissue-ChuckDuvall,DennyGallagher,MelanieGerheart,ScottJohnson-thankyouforyouroutstandingeffortsandthedignifiedfashioninwhichyoudeliveredyourmessagetotheGeneralAssembly.

Wealsowouldberemissifwedidnotthank:LauraGivensforhergreatworkinmakingalloftheintricatelogisticsinvolvedinourcampaignworkeffectively;Dr.TerryDickinsonforhisusualsteadyhandontherudder;Dr.AlonzoBellforhisleadershipasPresident;Dr.BruceHutchisonwhoheadedourgrassrootslobbyingeffort;andtheliterallyhundredsofdentists,staffanddentalstudentsandfacultyfromtheDentalSchoolwhoparticipatedinthiseffort.

Politicscanbeverycomplicatedbutinitssimplestform,itisaboutinvolvement.Everyonewhoparticipatedinoursuccessdemonstratedwhatinvolvementchanneledintherightdirectioncanproduce.

Thankyou.

Dentists, staff members, VCU dental students and other members of the dental community attended the House Commerce & Labor Committee meeting on February 2nd to show their support of HB1263.

Delegate Lee Ware presents HB1263 to the House Commerce & Labor Com-mittee while attorney Scott Johnson prepares to explain the purpose and legal implications of the bill on behalf of the VDA.

VCU dental students Barrett Peters (left) and Audrey Gamulo (right) gather with VDA President Alonzo Bell outside the General Assembly Building following the House Commerce & Labor committee meeting on February 2nd.

Over 150 VDA dentists, staff members ,VCU dental students and other members of the dental community attended the Senate Commerce & Labor Committee meeting on February 1st to show their support of SB622.

Senator William Wampler presents SB622 to the Senate Commerce & Labor Committee

Dr. Alonzo Bell, VDA President, awaits the Senate Commerce & Labor commit-tee meeting with a crowd of dental community supporters.


Dentist who visited the General AssemblyMikeAbbottAnneAdamsDavidAndersonRebeccaAngusCharlesAtkinsGaryBanajiChuckBarrettAlonzoBellBillBennettScottBermanSanjayBhagchandaniDavidBlackPaulBrinserRonnieBrownRobertCandlerSandraCatchingsFredCertosimoDanaChamberlainMaqsoodChaudhryJoAnnClarkJohnCokerGregColeSharonColvinTomCookeKenCopeland,Sr.KenCopeland,Jr.MarkCrabtreeCharlieCuttinoJeffCyrandstaffCraigDietrichVinceDoughertyRonDowneyAshleyEpperlyandstaffMonaFarrahiGiselaFashingKittFinley-ParkerJohnFlowersSteveForteandstaffCatherineOdenFultonSamGalstanCharlesGaskinsGarlandGentryPaulGibbermanAviGibbermanScottGoreMikeGormanShantalaGowdaBarryGriffinEdGriggsMichaelGrossoMonroeHarrisFarylHartNelsonHerringNathanHouchinsRalphHowellHerbertHughesBruceHutchisonFrankIuorno

RonaldJessupCharlesJewettCharlesJohnsonClaireKaugarsandstaffCarolynKellyRodKlimaJayKnightJohnKnightGregKontopanosLouKorpicsMarkKowalTrishaKrauseJamieKrochmalLannyLevensonJeffLevinMikeLinkBrockLivickDavidMajorJohnMarinoNormanMarksBenitaMillerandstaffMikeMillerandstaffScottMillerKevinMistryAndreaMitmanMikeMorganMarciMorrisChristaMorrisLawrenceMullerEdmundMullinsKirkNorboPaulOlenynVaCoraOliver-RaineyAnthonyPelusoCarolePrattMcKinleyPriceRickQuiggStephenRadcliffeDavidAlanReidJimRevereElizabethReynoldsChrisRichardsonRichardRoadcapRodRoggeNeilSmallEmilySmithCynthiaSouthernMelanieSpearsHenryDanielStockburgerKenStonerandstaffFrankStrausRobStraussRickTaliaferroDonTrawickBradTrotterBillViglioneGusVlahosGloriaWardSharoneWard

EdwardWeisburgClayWeisburgJohnWillhideRogerWoodGretchenZelazny

Other General Assembly ParticipantsLeeBradenMarthaBushongJimCurtisJimDoyleCarolGammonsCathyGriffantiKarenKrausSusanLaundreyLindaMooreRobbieShermanCatherineSillLindaSimonKellyWilliamsGrahamGardnerStaffMembersVDAstaffmembers

VCU Dental Student and Resident ParticipantsMinaAbdolahiZachAberthAshleyAbesamisMollyAdlerMattAldredKevinAllredAllieAngertCourtneyAshbyChelseaBaldersonTylerBallElviBarcomaRachelBaroneAlexandraBartonSanjayBhagchandaniPoonumBharalFawziaBhavnagriKevinBibonaCarlosBlackmonJamesBoltonEmilyKateBowenLaurenBowersoxJenBoylandCassidyBrayHeatherBrooksNabilBusharaRichardCarlileMeredithCashMariaChangDavidChesserAileenChynJamieClarkSteveClawsonMarkCrocker

DavidDallingChristopherDavenportDustinDavisBrookeDellingerStephenDePasqualeSpencerDixonJessicaDombrowskiDarrenDorfmanAndyDuncanSonnyDuongDavidDurhamSeanEschenbachTayeebFarukCaseyFeilingNancyFerrettiBrianFifeChadFlanaganGrahamForbesErikFoxJoshFurnissAudreyGamuloDavisGardnerMikeGigliottiThomasGlazierScottGreenKateHelfrichBrianHerodRachelHubbardJustinHughesAndrewHutchinsonDavidJonesSarahKandracNatashaKapoorEmilyKeetonKrisKeetonIdaKondoriJoKoontzLeeKregerJonKremserDavidLaiAaronLairdBrentLammPatrickLawrenceMagaretteLeGreysonLeftwichBobbyLenoirQuocLuStevenLutzMeganLutzJenLysenkoNickMadduxFatimaMashkoorElizabethMattesonKellyMayerBrianneMcGuinnessAmandaMeadeGardnerMeekJamesMeekJodieMeredith-SmithMikeMilburn

JoshuaMilesClayMillerWillMooreJeppyMossRyanMurrayAryaNamboodiriLizNealJoshNehringFranceNeilsonDianeNelsonRosieNoordhoekJustinNorboLindseyNorthJustinPaigeNickPappasCanaPasierbAnishaPatelChristianPeckMattPelaisBarrettPetersMaryRaulfsCarterReevesJohnReynoldsCollinRiceCameronRobertsLatashaSaulsLaurenSchiffJasonSchoenerLeoSchollGeoffSchreiberKristenSchwartzRichardSedwickShimaShadmanNateShermanGailSilveiraMilanSimanekWillSlackRyanSmagalskiChapinSmithDavidStaffordLydiaSumnerCarterTateBrianThompsonKellyThompsonJonMarkLauraTolussoPaigeTurnerDanielVacendakStephanieVlahosVictoriaWhiteKimeWhitmanAndrewWissinkPhillipWorthingtonJeffYelle

Special thanks to all those who took time to visit the General Assembly! WHAT IS VADPAC?By: Bruce R. Hutchison, DDS - Chair VADPAC

VDAmemberssupporttheVDA’sparticipationinthepoliticalprocessthroughtheVDAPoliticalActionCommittee,thebipartisanvoiceofVirginiadentistswhocaredeeplyabouttheirpatientsandtheirprofession.

VADPAC’ssolepurposeistoelectcandidateswhounderstandtheimportanceofdentistryandarecommittedtotheoralhealthofVirginians.VADPACisacriticalcomponentoftheVDA’spoliticalstrategyinRichmond.

Likeitornot,thepoliticalsystemaffectshowwepracticedentistryintheCommonwealth.Dentistsneedtobeheardbythelegislators.Regardlessofpartyaffiliationoryourviewsonthepoliticalsystem,dentistscannotaffordtoturntheirbacksandassumeproblemswillgoaway.Weallhavetobeplayers;wecannotassumeotherswillcarrytheload.WeneedallVirginiadentiststocontributetoourVADPACtoensurefuturesuccess.

ContributionsbyallVirginiadentistswillhelpensureourVADPACremainsstrongandourvoiceisheard.Considercontributingthefeeofonecrown,onerootcanal,afewfillings,orevenacoupleprophys.Thissmallinvestmentbyallwillmakeahugedifference.Yourvoicewillbeheardloadandstrong.

Itisyourobligationtokeepdentistrythehonestandethicalprofessionitis.Ifnotyou,thenwho?

Usetheformbelowtomakeyourcontributiontoday.

If you would like to join VADPAC or increase your previous contribution, please fill out the form below with your check or credit card information. Contributions to VADPAC are divided between a state account, controlled by VDA members and a federal account for support of candidates for federal office, affiliated with the American Dental Association. Election laws require that the two funds be kept separate.

Membership $99 (50 State, 49 Federal) Commonwealth Club $284 (235 State, 49 Federal) Governor’s Club $684 (435 State, 249 Federal) Apollonia Club $1,009 (760 State, 249 Federal) Capitol Club $200 (200 Federal)

Name Component: Address ________________________________________________________________ Payment Type

Check (payable to VADPAC) Credit Card Corp. Ind. VISA MasterCard #________________________________________________________________ Exp__________________

Signature_______________________________________________________________

Contributions not deductible for tax purposes.

Please complete this form and mail or fax to: Laura Givens

VADPAC 7525 Staples Mill Rd. Richmond, VA 23228 FAX: 804-261-1660

If you would like to contribute by phone, please call Laura Givens at 804-261-1610.

Thank you for your contribution in support of VADPAC!

2010





Signature_______________________________________________________________






2010





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2010





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2010


Classifieds

Practices For Sale/Lease

Miscellaneous

PARTNERSHIPSORDELAYEDSALESWehavemanysatisfiedclientswithassociatesinyourareathatwehavehelpedtoeitherbuy-in,buy-outorconductadelayedsalewiththecur-rentassociate.Withoutaqualityvalu-ationandplanupfrontthesetransac-tionsnormallyfail.CalloremailustoarrangeaFREECONSULTATIONtofindoutifyouareacandidateforthisservice.Theresultishigherincomeandahigherpracticevalueforthesellerandaclearfinanciallypositivepathfortheassociate.THEMCNORGROUP,[email protected],www.mcnorgroup.com.

PRACTICEBUYERSWANTEDForgreatpracticesintheVirginiaarea.Wehavemanypracticesavail-ableforsaleintheVirginiaarea.Areyoutiredofbeinganemployeeinadeadendjob?CallusforaFREECONSULTATIONtofindoutabouttheseopportunities.THEMCNORGROUP,[email protected],www.mcnor-group.com

SELLERS WANTEDWe have qualified buyers with 100% funding approval that want to buy a practice in Virginia. The baby boomers are starting to sell and this is a great time to transi-tion your practice. We get excel-lent prices and sell the practice in a timely, healthy manner. THE MCNOR GROUP, 888-273-1014 x 103 or [email protected], www.mcnorgroup.com

PRACTICE VALUATION APPRAISALWe are the only transition consult-ing company in the area that has a Certified Valuation Analyst CVA as a principal that focuses exclusively on the transition of DENTAL PRACTICES. Please see the article by CVA Karen Norris on page 82 of the April 07 issue of Dental Economics on this subject or call or email us for a FREE CONSULTATION and a copy of the article. If you are sell-ing, buying, creating a partnership or just want to find out the current value of your practice contact THE MCNOR GROUP, 888-273-1014 x 103 or [email protected], www.mcnorgroup.com

NEW OWNER REPRESENTA-TION: Our family and organization has represented over 1000 new owners over the last 65 years in the mid-Atlantic area that have purchased, started or became partners in a dental practice. Ownership is a decision that is too important to make without a qualified facilita-tor. We can get the new owner 100% financing plus working capital. Call us for a FREE CON-SULTATION and allow us to send you a list of our references. THE MCNOR GROUP, 888-273-1014 x 103 or [email protected], www.mcnorgroup.com

Job Opportunities

IN-OFFICE HEALTH AND SAFETY EDUCATION AND CONSULTATION

Experts with over 20 years of ex-perience educate and certify dental office staff in American Heart As-sociation-based Basic Life Support and First Aid for in-office medical emergencies. Consultation and edu-cational services are also available to guide dental practices in comply-ing with OSHA and CDC infection and hazard control regulations and guidelines. Contact RESPOND Con-sulting, 540.290.6911 or [email protected]. We come to you for all of your office safety and health maintenance needs.

Tri-Cities, TN Dentist Opportunity! EstablishedBluffCity,TNpracticeownerisreadytoaddadentisttoherstaff.Willingtoconsiderdentistswithfulltimeorparttimeinterest.Idealcandidatewillbecomfortableprovidingdentureandextractionservicesonadailybasis.On-site,fullystaffed,labdevotesfulltimetoservingthispracticeowner.Practicevisitandworkinginterviewareavailabletointerestedcandidates.ContactBrianWhitleyformoreinformation:[email protected]

Kentucky Practice Ownership OpportunitiesOwnadentalpracticewithNOpersonalfinancialinvestment.AffordableCareInc.providespracticemanagementservicestonearly150affiliateddentalpracticesin35states.EachpracticeisownedbyanindividualdentistandisfocusedonanichemarketbyprovidingExtractionServicesaswellasfullandPartialDentures(www.affordabledentures.com).Ifyouareseekinganextremelystableopportunityandwishtobeapartofawellestablishednetworkofdentalpracticeswithalong-standinghistory,youshouldtalkwithus.WearecurrentlyseekingdentistsfordevelopmentofadditionalnewaffiliatedpracticesinHazard, and Carrollton, Kentucky trade areas.Youtakecareofyourpatients;wewilltakecareofthepaperworkandmore.Weprovidethefundingsothatyoumayhaveacompetitivesalaryandafullcomprehensivebenefitspackagewithhealth/life/malpracticeinsurance,anda401(k)planalongwithunlimitedfinancialsuccess.Applyonlineatwww.affordablecare.comorcallBrianWhit-leyat1-800-313-3863,[email protected]

Are you missing out?

HermitageWealthManagement,Inc.offersGroup Discount Pro-gramsforLong-Term Care andDisability Insurance.Foreligibil-ity,pleasecontact:

J.CoryHoffer,CFP®

(804)[email protected]

Part-time dentists needed to review provider offices in managed care network in the northern VA, DC, MD area. Current license, travel, good communication skills, minimum 10 years practice experience required. Send resume to HRS, 1926 Hayes St., Nash-ville, TN 37203 or call 615-321-0707.

FOR SALE – EQUIPMENT FOR SALE - Twilite Ma-chine, Waterlase, Acclaim Intra-oral Camera w/ Control Module, GENERAL PRAC-TICES: General Practitio-ners - Falls Church – Rev.: $550,000, 2,800 sq ft, 7 ORs-3 equipped, Richmond Area –Rev.: $217,000, 1,000 active patients, blended insurance, no HMO’s, 2 Ors, Fairfax County - Endodontist and/or Orthodon-tist Wanted. Belvoir Area - turnkey dental office available for lease for specialists only (no prosthodontists), Lansdowne – Turnkey (no patient records) - 4 operatories, Alexandria - Revenue: $1,500,000+, 8 op-eratories, 2,600 square feet, 4 ½ days/week, La Crosse - Revenue: $200,000, 4 opera-tories, real estate appraised at $140,000. Specialists Only - Fort Belvoir –Turnkey (no records), 4 operatories - fully equipped, 1,500 square feet, 8 Ors, 2,600 square feet, 4 ½ days/week, La Crosse – Rev-enue: $200,000, 4 Ors – Fully equipped, 1,500 square feet. PRACTICE SALES & TRAN-SITIONS, (877) 539-8800, www.dentalsales.org

Wanted to Purchase.IfyouhaveaqualitygeneralpracticeinNorthernVirginiaarea(Fairfax),wouldliketoexitandhaveaqualifiedtransitionspecialistrepresentyou,wehaveaninterestedbuyer.ContactPPP412-673-3144–[email protected].

INTERIM PROFESSIONAL SERVICE:MaternityLeave,Vacations,Illness,Disability,Part-TimeAssociates.MaintainProduction&PatientAccess.Also,InterimJobOpportunities.For-estIrons&Associates800-433-2603www.forestirons.comDENTISTSHELPINGDENTISTSSINCE1984

Dentist to work 2-3 days per week at dental office in Amherst Co. Submit resume to [email protected] or mail to: Johnson Health Center, Attn: A. Jones, 320 Federal St., Lynchburg, VA 24504.

Virginia Dental Association7525 Staples Mill RoadRichmond, VA 23228

VISIT US ONLINE AT WWW.VADENTAL.ORG

*All gloves are sold by the case, with 10 boxes per case

To place an order, request free samples, or for more information please contact Dental Association Gloves: (877) 484-6149

To order gloves on the Web visit: www.vdaservicesgloves.com

VDA SERVICES GLOVE PROGRAMSuperior exam gloves at discounted prices for VDA members!

Powder-Free Latex Powdered Latex Nitrile

The VDA Services Glove Program has a comprehensive line of glove products available.

Microflex ComfortGripPF Textured Latex$6.47 a box

Microflex ColorTouch PinkPF Textured Latex, Scented$6.44 a box

Sempermed PolymedPF Textured Latex$4.99 a box

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Sempermed StarMedPowdered Latex$4.62 a box

Sempermed Tender TouchPF Textured Nitrile$5.44 per 100 gloves

Sempermed SemperCarePF Textured Nitrile$5.56 per 100 gloves

Microflex TranquilityPF Textured White Nitrile$6.40 a box

vda journal vol 87 number 2 april-june 2010

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