THE VIRGINIA DENTAL ASSOCIATION

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VDAINSURANCEINCLUDES Programs Contacts

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Choice of individual auto, Vickie Roberts homeowner insurance, and umbrella coverage

Choice of life insurance, estate Gene Bedsole planning, long term care, long term Larry Bedsole disability, and pensions Mike Bedsole, CLU

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Leslie S. Webb, Jr., D.D.S. Susan P. Lionberger Terry D. Dickinson, D.D.S. Editor Director of Publications Business Mana er

ASSOCIATE EDITORS 1. Barry I. Einhorn 4. Kathryn Finley-Parker 7. Mac Garrison 2. Sharon Covaney 5. Lori Snidow 8. Scott McQuiston 3. Michael R. Hanley 6. Robert G. Schuster School of Dentistry James Revere

Volume 80 October-December 2003 Number 4

TABLE OF CONTENTS 4 Editorial 5 Message From The President 6 Letter ToThe Editor 7 A Personal Memoir of Dr. Harry Lyons - Gentleman and Scholar 8 Abstracts 12 2003 VDA Meeting Review 14 2003 VDA MOM Project - Wise 16 Give KidsASmile 17 VDHF 2003 Tooth Fairy Ball 18 Researchers Link Maternal FolicAcid Intake To Childhood Cancer 18 Smart Smiles 19 Family Limited Partnerships - On Shaky Ground? 20 ADPAC Washington Update 23 Direct Reimbursement Dental Benefits Plan 24 Dental Board Investigations May Be Triggered By Issues Beyond Patient Complaints 26 VDSC Raffle Winners 26 Attention VDAAnthem Health Insurance Policyholders 27 VDSC Proudly Presents Our Newest Endorsed Vendors 27 LifeServers 29 What Is The "Tax Smart Annuity?" 30 VDAStaff 31 VDANews 32 Legislative Update 33 Student News 34 New VDA Members 37 Continuing Education, Meetings and Events 39 Component and Speciality News 46 Classified Advertisements

COVER: Dr. Ted Sherwin of Orange. VA's Winning Photograph from the VDA Photo Contest © 2003 All Rights Reserved. PUBLICATION TEMPLATE: C:\Change

THE VIRGINIA DENTAL JOURNAL (Periodical Permit #660-300. ISSN 00496472) IS published quarterly (January-March, April-June. July­September. October-December) by the Virginia Dental Association. 7525 Staples Mill Road. Richmond. Virginia 23228, Telephone (8041 261-1610 SUBSCRIPTION RATES Annual: Members, $600 Others $12.00 in U.S.. $24.00 Outside U.S Single copy $6.00. Second class postage paid at Richmond, Virginia. Copyright Virginia Dental Association 1996 POSTMASTER Send address changes to Virginia Dental Journal, 7525 Staples Mill Road. Richmond. VA 23228. MANUSCRIPT AND COMMUNICATION for publications Editor, 7525 Staples Mill Road, Richmond. VA23228. ADVERTISING COPY. insertion orders conlrad< ?nd .~I~'-'" '_'UH' ­

VIRGINIA VDA COMMITTEE CHAIRMEN JOURNAL

EDITORIAL BOARD

Ralph L. Anderson James R. Batten Carl M. Block Cramer L. Boswell James H. Butler Gilbert L. Button B. Ellen Byrne Charles L. Cuttino III Frank H. Farrington Barry J. Griffin Jeffrey L. Hudgins Wallace L. Huff Lindsay M. Hunt, Jr. Thomas E. Koertse James R. Lance Daniel M. Laskin Karen S. McAndrew Travis T. Patterson III W. Baxter Perkinson, Jr. Lisa Samaha David Sarrett Harvey A. Schenkein James R. Schroeder Harlan A. Schufeldt John A. Svirsky Ronald L. Tankersley Douglas C. Wendt RogerE.Wood

Annual Meeting A. CarolePratt

Budget & Financial Investments David R. Ferry

Caring Dentists Harry D.Simpson, Jr.

Communication & Infonnation Technology Lanny R. Levenson

Constitution & Bylaws Rodney]. Klima

Dental Benefits Programs Richard D. Barnes

Dental Health & Public Infonnation Kathryn M. Roberts

Dental Practlce Regulation Roger E. Wood

Direa Reimbursement Theodore P. Cocoran

Ethics & Judicial Affalrs Charles E. Gaskins III

Fellows Selection Donald L. Martin

FOUNDATIONS

Relief Foundation ScottH. Francis

Infection Control & Environmental Safety W. Vincent Dougherty III

Institutional Affairs Elizabeth A. Bernhard

Legislative Dana H. Chamberlain

Membership David B. Gra,ham \ c.-'\.?I \ Curn

(LA. ~),\J)\ \ I CA 'CJ ().u' , New Denusr Elizabeth C. Reynolds

Nominating Rodney J. Klima

Peer Review & Patient Relations Alan Robbins

Planning Thomas S.CookeIII

VADPAC Gus C. Vlahos

Virginia Dental Health Foundation Ralph L. Howell, Jr.

2004 ADA DELEGATION

Delegates: 145th ADA Session, September 30 -October3,2004' Orlando, Florida

Anne C. Adams (2005) Wallace L. Huff (2004) Ronald L. Tankersley (2005)

Alternate Delegates: Richard D. Barnes (2004) Ronald J. Hunt (2005) Gus C. Vlahos (2004)

David C. Anderson (2004) Bruce R. Hutchison (2005) Leslie S. Webb, Jr. (2006)

Bruce R. DeGinder (2004) Kirk Norbo (2005) Edward K. Weisberg (2004)

Charles L. Cuttino III (2004) Rodney J. Klima (2006) Andrew J. Zimmer (2005)

M. Joan Gillespie (2005) William ). Viglione (2005) Roger H. Wood (2005)

Representing and serving member dentists by fostering quality oral health care and education.

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BOARD OF DIRECTORS OFACERS Bruce R. DeGinder - President President: Bruce R. DeGinder, Wililamsburg Bruce R. Hutchison - President-Elect President Elect: Bruce R. Hutchison, Centreville Edward J. Weisberg - SecfTreasurer Immediate Past President: Rodney J. Klima, Burke Rodney J Klima - Immed Past Pres. Secretary- Treasurer: Edward J. Weisburg, Norfolk James E. Krochmal - Comp 1 Executive Director: Terry Dickinson, D.D.S. McKinley L Price - Comp 2 7525 Staples Mill Road, Richmond, VA 23228 H Reed Boyd III - Comp 3 Anne C Adams - Comp 4 Mark A Crabtree - Comp 5 VDASTAFF Ronnie L Brown - Comp 6 Dr. Terry Dickinson - Executive Director J. Darwin King, Sr. - Comp 7 Stephanie Arnold - Director of Outreach Programs AI Rizkalla - Comp 8 Bonnie Anderson - Administrative Assistant

Linda Gilliam - Director of Finance Advisory Members: Laura Kenny - Director of Events & Publications Parliamentarian: James R. Lance Leslie Pinkston - Dir. of Membership Recruitment & Retention Editor: Leslie S Webb, Jr. Nicole Pugar - Director of Public Policy Speaker of the House: Ralph L. Howell, Jr. Barbara Rollins - Asst. Director of Outreach Programs Dean, School of Dentistry: Ronald J. Hunt Elise Woodling - Director of Marketing and Programs

SOCIETY

Tidewater, I

Peninsula, II

Southside, III

Richmond, IV

Piedmont, V

Southwest, VI

Shenandoah Valley, VII

Northern Virginia, VIII

PRESIDENT

David P. Mueller 968 First Colonial Rd #102 Virginia Beach, VA 23454

Scott H. Francis 2038 Nickerson Blvd. Hampton, VA 23663

David R. Ferry 610 W Hundred Rd Chester, VA 23836

Kimberly Swanson 8503 Patterson Avenue Richmond, VA 23221

Garland G Gentry 103AnnjoCt forest, VA 24551

Michael A Abbott 403 E Main si Abington, VA24210

Harry M Sartelle III 625 Virginia Avenue Front Royal. VA22630

Alonzo M. Bell 1755-B Duke Street Alexandria, VA22314

SECRETARY

Michael S. Morgan 3145 VA Beach Blvd #104 Virginia Beach, VA 23452

Elizabeth K. Bernhard 600 Wildwood Circle Smithfield, VA 23430

C. Sharone Ward 12290 Ironbridge Rd. Chester, VA23831

Kathryn Finley-Parker PO Box15188 Richmond, VA 23227

Randy J Norbo 1414 Franklin Rd, SW #3 Roanoke, VA 24016

Joseph P Schn~der

Route 1 Box 560 Cana, VA24317

Robert B Hall, Jr (Treasurer) 130 W Piccadilly si Winchester. VA24401

A Garrett Gouldin 101 West Broad St #601 Falls Church. VA 22046

PATIENT RELATIONS

Carl Roy 2100 Lynnhaven PWky #200 Virginia Beach, VA 23456

Kent Herring 122700 McManus Blvd#102B Newport News, VA 23602

C. Sharone Ward 12290 Ironbridge Road Chester, VA 23831

Jerry L. Jenkins 400 Old Hundred Road Midlothian, VA23114

Craig B. Dietrich 604 E Church Street Martinsville VA 24112

Paul T Umstott 300 W Valley Street Abingdon, VA 24210

Alan RobbinS P.O. Box602 Timberville. VA 22853

Neil J Small 9940 Main Street Fairfax VA 22031

lIL~DITORIAL~IJ

Leslie S. Webb, Jr. DDS VA Dental Journal Editor

Dentistry was most fortunate when the Samuel D. Harris National Museum of Dentistryopened in Baltimore, Maryland in June 1996. This museum celebrates the heritage of dentistry and serves as a resource for scholars and the dental profession. Its exhibits and programs, housed in its 7,000 square foot exhibi­tion space, relate dentistry's history and promote public awareness of oral health. Over 10,000 visitors come to the museum each year.

Dr. Harris provided the 1 million dollar naming gift to start the museum. Sup­port to operate is now comes from indi­viduals, corporations, foundations, and dental organizations including the American DentalAssociation and many of its constituent societies. Its Board of Visitors and National Advisory Com­mittee are composed of dentists and corporate and community leaders from every state.

The museum's collection includes 40,000 objects related to the history of dentistry. These include George Washington's dentures, Queen

Victoria's gilded dental instruments, 18th and 19th century extraction instru­ments and the world's only "ToothJuke­box," playing vintage dental commer­cials. Besides its permanent exhibi­tions, changing exhibitions highlight current dental topics as well as dental history. The museum also features in­novative oral health educational pro­grams for children. Its interactive exhi­bition "Branches, Bristles and Batter­ies: ToothbrushesThrough Time" is cur­rently at the Children's Museum of Vir­ginia in Portsmouth, VAthrough Decem­ber 2003 and will reach nationwide mu­seum audiences over the next three years.

Recently, the National Museum of Den­tistry became an affiliate of the Smithsonian Institute. Membership in the museum includes the added ben­efit of Smithsonianaffiliate membership. Become a member or take time to visit the museum. This is a very special place for dentistry.

For more information,visit the museum's website at WWIN.dentalmuseum.org

Ie MESSAGE FROM THE PRESIDEN'T"I~

Charles Darwin once said, "it is not the strongestof the speciesthat survive, nor the most intelligent, but the one most responsive to change."

This yearwill be a very challenging one for the Virginia Dental Association as we attemptto streamlineourgovemance structure with the new Board of Direc­tors, enhancing our efficiency and ef­fectiveness in serving our membership. A governance task force will continue exploring our committee structure for other possible improvements.

As we continue to explore issues of concern to our membership, we would value your input and feedback. Please send your e-mail address to Leslie Pinkston at pinkston@vadental.org or fax it to her at (804) 261-1660. We will only use your e-mail address for VDA information; it will not be sold or distrib­uted to any other company.

Please join many of your fellow VDA members by utilizing some of the prod­ucts endorsed by the Virginia Dental Services Corporation -take advantage of their hard work to save your dental practice money while helping the asso­ciation at the same time. The VDSC is constantly adding new products and services. Call Elise Woodling at the central office for the latest information.

I would like to personally ask each of you to help recruit a new member to the VDA during this next year. When we have a strong market share, we are able to lobby effectively in the general assembly and U.S. Congress with is­sues of concern to dentists in their daily practice, as well as effectively imple­ment new member benefits with our sig­nificant bargaining power

Our grassroots membership initiative seeks opportunities to expand our di­versity and our community of dental pro­fessionals by sharing our camaraderie, practice pearls, and ever expanding benefits of membership. Feel free to contact Leslie Pinkston with any mem­bership leads.

Recognizing that many Virginians do not have access to the dental care they need, please consider becoming a par­ticipant in the Take Five Medical Pro­gram - an innovative program that al­lows your to help those in need by agreeing to see up to five Medicaid pa­tients with minimal paperwork. The VDA's Missions of Mercy Projects, & Donated Dental Services Program have provided over 4.9 million dollars in free dental services since 1997. I encour­age each of you to become an active participant in either of these programs, be part of the solution to the access problemand I promiseyou itwill be more rewardingto you and your staff than you can possibly imagine. Future MOM projects are highlighted on our website at www.vadental.org.

Congratulations to our annual meeting and local arrangement committees for making the Virginia meeting in Rich­mond a tremendous success. The at­tendance figures represent our second best meeting ever, please mark your calendarsnowfor September8-12,2004 when the Virginia meeting returns to Norfolk with a terrific line up of speak­ers including Ms. Linda Miles, Dr. Stephen Schwartz, Dr. Joe Dillon, Dr. B. Ellen Byrne, Mr. Steve Blaising, Mr. Derek Hein, Dr. Barbara Steinberg, Dr. Alan Fetner, and many more. Contact Laura Kenny at the VDA Central Office for any additional information you might need.

Have you recognized one of your col­leagues or dental students that you believe would be a good future leader in our profession? If so, now is the time to act. Our leadership conference this spring will be specifically devoted to try­ing to provide the skills and experience these future leaders will need to be suc­cessful. Or if you would be interested personally, please contact me

I would also like to thank all of the vol­unteers dentists who participated in this year's House of Delegates-we all owe them a debt of gratitude for their dedi-

Bruce R. DeGinder, DDS VDA President

cation and time commitment on our behalf. Please take the opportunity to thank Rod Klima for his outstanding leadership over this past year, and to the entire VDA staff for their daily ef­forts to serve the best interests of our members and our profession.

Thank you forthe opportunity to serve as your President this year-please feel free to e-mail me anytime @ brucedeginder@cs.com with any sug­gestions, questions, or concerns.

LETTER~I THE EDI~

Dear Editor:

I wish to extend a person and collective Thank You to the many people who made the 2003 VDA House of Delegates a success. First there is the VDA staff. All members of the staff participate and work together to make the meeting run smoothly. Bonnie Anderson, Nicole Pugar, and Linda Gilliam were espe­cially helpful in sitting in on reference committees, typing and editing the re­ports, and getting them ready for distri­bution. I also want to thank the mem­bers who served on Reference Commit­tees and the Credentials Committee. They are listed here and deserve a great deal of thanks for facilitating the busi­ness of the House of Delegates. They are:

Credentials Committee: Peter K. Cocolis, Chair; Samuel W. Galston;

John Knight, Jr.; David P. Mueller; and Elizabeth C. Reynolds.

Reference Committee 1000 BUdget, Financial and Administra­tive Matters: Harvey H. Shiflett, III, Chair; Elizabeth A. Bernhard; Samuel W. Galston; Susan F. O'Connor; and Neil J. Small.

Reference Committee 2000 Membership & Public Affairs C. Mac Garrison, Chair; Michael A. Abbott; Kathryn S. Finley-Parker; John A. Marino; and Edward P. Snyder.

Reference Committee 3000 Governance Alonzo M. Bell, Chair; Craig B. Dietrich; David P. Mueller; AI J. Stenger; and C. Sharone Ward.

And finally, a big Thank You to the del­egates and alternate delegates who participated in the meeting. There was good attendance at the Reference Com­mittees, good discussion of the issues and good participation all around. I think

the process went very well and as de­signed. Delegates got the chance to voice opinions and we came to consen­sus on the issues. I trust that the mem­bers of the House left tired and yet, ful­filled, knowing they accomplished their duty and purpose of keeping the VDA a vital, thriving, and meaningful organiza­tion for the dentists of Virginia. Please take the time to thank your delegates for keeping your organization moving forward.

I have enjoyed serving as Speaker of the House for the past four years and will indeed miss the opportunity to guide the debate on the many issues we have faced and will face in the future. The House is in very good hands for the fu­ture and I ask that next year, all del­egates participate and be prepared on the issues as they did this year. I thank you for the opportunity to serve the Vir­ginia Dental Association.

Bruce R. Hutchison, DDS Speaker, VDA House of Delegates

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To learn more about this program, contact your local Cincinnati independent agent. To locate an agency nearest you, log on to www.cinfin.com or call Mike Terre] at (800) 769-0548.

Stabllity THE

CINCINl\ATI I\iSlINA;IITF COfl.W,,1'iIES

A PERSONAL MEMOIR OF DR. HARRY LYONS GENTLEMAN AND SCHOLAR

At the southwest corner of Twelfth and Leigh Streets in historic downtown Rich­mond stands the Harry Lyons Building of the Virginia Commonwealth Univer­sity School of Dentistry. This building was constructed in 1969 in honor of the school's most illustrious graduate. He would retire as dean emeritus a year later in 1970. In the near half century of his pre-retirement career, he had been chosen to serve as president of the top organized dentistry and dental academia. These included the Ameri­can Dental Association, American Col­lege of Dentists, Pierre Fauchard Acad­emy and significant others.

I first met Dr. Lyons at a meeting of the Peter B. Ramsey Dental Society of Richmond and Petersburg in the mid­fifties. The mission of the group was to secure opportunities for courses in con­tinuing education such as was being made available for white practitioners at the Medical College of Virginia. The meeting became hot when Dr. Lyons stated that we were in our present posi­tion because unfair state laws had tied his hands. Dr. Julian Conway Wilson, a Howard graduate, spoke out vocifer­ously against the prevailing 'damned Byrd Machine." Dr. Lyons stated that he could very well empathize with him because he was a member of a group that was discriminated against when he first sought membership in the Rich­mond Dental Society. However, since we were all gentlemen together, this was no place for cursing or profanity. Dr. Lyons did offer some courses to be given at the colored St. Phillips Hospi­tal. But they were declined by the group as a protest again continuing segrega­tion.

Some years later I motored to Roanoke for an annual Virginia State Dental As­sociation meeting. As I passed through the lobby heading forthe steps I heard a faint call, "Dr. Foster?" I looked over to the side and saw Dr Harrv Lvons

Francis M. Foster, D.D.S.

beckoning to me. I turned and immedi­atelywalked overto him. He extended his hand and said, "Dr. Foster, I would like for you to meet my very best friend, Dr.Abram Kobrin, the president-elect of the American Dental Association." As I shook his hand I expressed my plea­sure of this special introduction. Dr. Kobrin noticed that I was looking at a small gold image of the statute of lib­erty on his lapel and said, "I see that my young lady has caught your atten­tion." I smiled and noted that the first time I had written anything that had ap­peared in a major publication was a poem about his spiked-wreathed young lady with her torch ... I added that my poem "To A Certain Statue," had ap­peared in P.M., a special New York tab­loid with no advertising, subsidized by merchandising magnate, Marshall Field. It's editors were Max Lerner and Ralph Ingersall. It appears that my English professor at Virginia Union University had sent a copy of the school paper with the poem therein to a contributing edi­torfriend, Louis Lautier, who decided to publish it in his column.

It was titled:

To a Certain Statue:

Dear Mother of Exiles, Help me understand! Are you carrying that torch too For a jim-crowed man?

Dr. Kobrin was touched and said, "Fos­ter, I can empathize with you. You see, my parents were immigrants from Lithuania and I still vividly remember my father telling me that the trip over the ocean was like being in a cocktail shaker most all of the way. When the ship finally stopped and anchored in America, it was now difficult for them to walk on the now still and level deck. It took some time forthem to regain their equilibrium. It was very dark except for a faint linht in thp. mist ::It thp. f::lir prlnps

of their vision. Then someone came up and said it was so dark because they were in the shadow of a gigantic statue. He said, that they too were later to feel the burden of discrimination and oppres­sion. I expressed to him my bestwishes for his upcoming quest and bid them good night.

The next morning, when I arrived at the dining room for breakfast, the head waiter beckoned to me and said that Dr. Lyons was in the adjoining dining room and wanted me to have breakfast with him. I went to the next room and Dr. Lyons greeted me as I sat down. We placed our orders and after a mo­ment he reached into his inside pocket and withdrew a small coin envelope from which he poured out a small gold statue of liberty pin. He said, "Dr. Kobrin told me to give this to you with his compli­ments. His close friend, Lee lococca, on the occasion of the centennial cel­ebration of the gift of the Statute of Lib­erty to America, gave it to him and he wanted you to have it. "

I cherish it as a memento of a great meeting with a "dynamic dental duo." Two great Lithuanian legends in den­tistry.

Francis Merrill Foster, DDS Richmond, VA

[~~~~~~~~I~ABSTRACTS

The following abstracts were pro­vided by the Department of Oral & Maxillofacial Surgery at VCU School of Dentistry. We appreciate the con­tribution that these individuals have made to the Virginia Dental Journal.

Intermediate Alveolar Ridge Distraction After Tooth Extraction - A Preliminarv Report. Gaggl A, Schultes G, Rainer H, Karcher H. Br J Oral Maxillofac Surg. 40:110­115,2002.

Atrophy of the alveolar ridge or a local defect due to trauma or periodontal dis­ease often presents a significant prob­lem in implant restoration of an edentu­lous space. One option available to the surgeon to address this problem is mechanical distraction of an osteotomized bony segment. Osteo­genesis occurs in the space generated behind the mobile segment, effectively elevating the level of the alveolar ridge at the chosen site. Most commonly the teeth in the area to be restored are ex­tracted, the extraction sites allowed to heal, the distraction device is placed on an osteotomized bony ridge, and im­plants are placed once the ridge has been adequately distracted and the de­vice removed. These authors, however, present the results of 7 cases in which a combination distractor-implant device is used. In these cases, patients with severe alveolar ridge bone loss due to periodontal disease were treated with tooth extraction and immediate inser­tion of an implant distraction device. The device functions as a typical distractor until adequate ridge height is achieved and bony healing occurs. The device is then loaded with an implant head and eventually restored. After a mean fol­low-up duration of 1.5 years, the authors reported no significant complications and no failure of the restored implants. Promising results of this study indicate that this device may be clinically useful and warrants further study.

Reprint requests to Univ-Prof. Dr. A ~::lnnl Aht Fllr Mllnrl- Kip.fp.r- lind

~;:~36 Graz,Austria Tel +43 3t 6385

Dr. Stephen Brandon is a third year resident in Oral and Maxillofacial Surgery at MCVNCU. He received his D.D.S. degree from the Univer­sity of Tennessee, Memphis.

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McCarthy C, Patel R, Wragg P, Brook I: Dental Implants and Onlay Bone Grafts in the Anterior Maxilla: Analysis of Clinical Outcome. Int J Oral Maxillofac Implants 2003; 18: 238-241.

Implant rehabilitation in the anterior maxilla represents a challenge for clini­cians as the loss of teeth results in re­sorption of alveolar bone from the labial aspect, leaving a palatally positioned alveolar ridge. As a result, implant po­sitioning is affected and the overall es­thetics will be compromised. To opti­mize esthetic implant placement, aug­mentation may be required. While the success of osseointegrated implants has been well established, there are only preliminary reports of implants in grafted bone in the anterior maxilla. The aim of this study was to report the outcome of buccal onlay bone grafting in the ante­rior maxilla in routine dental implant practice. Seventeen consecutive pa­tients with a mean age of 31.4 years received autogenous bone grafts from the mandibular symphysis to the ante­rior maxilla. Ten patients received corticocancellous block grafts and 7 had particulate cancellous grafts. A total of 35 Branemark System MK II implants were placed in the grafted bone. Si­multaneous implant placement was performed in 2 patients where there was adequate residual bone to provide pri­mary stability. The remaining 15 pa­tients had a mean recovery time of 19.7 weeks to allow for graft consolidation prior to implant placement. At second stage surgery (mean 30.5 weeks), im­plants were clinically assessed for in­tegration by testing for mobility using percussion following manual tightening of the abutment. The specific outcome criterion was that only patients who achieved functional loading were judged to be successful. Of the 35 implants olaced. onIv one irnolant failed. The

tients with simultaneous graft and im­plant placement. This represents a survival rate of 97.1% of implants in func­tional loading after a mean follow-up period of 153.6 weeks from occlusal loading. Mandibular block grafts appear to be a predictable method for augment­ing the width of the anterior maxilla prior to implant placement.

Dr. Steven Fallon is a third year Oral & Maxillofacial Surgery resident at the Medical College of Virginia and will be completing his training in June 2005.

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Office-Based Ambulatory Anesthesia: Outcomes of Clinical Practice of Oral and Maxillofacial Surgeons David H. Perrott, DDS MD,MBA, Judy P. Yuen MA, Randi V Andresen, BS, and Thomas B. Dodson, DMD, MPH Journal of Oral and Maxillofacial Sur­

gery 61 :983-995,2003

The treatment of the dental patient so frequently requires the use of anesthe­sia that it has become an integral part of the profession ever since the very in­ception of anesthetics. This article sought to outline the methods used in treating dental patients in an office­based ambulatory setting and correlate other variables relating to patient satis­faction, as well as complication rates. This study looked at patients who were treated in oral and maxillofacial surgery offices in the United states and received either local anesthesia, conscious se­dation, or deep sedation/general seda­tion. These types of anesthesia were statistically analyzed against predictor values including demographic, anesthe­sia technique, staffing, adverse events, and patient-oriented outcomes. The sample size was 34,191 patients, of whom 71.9% received deep sedation/ general sedation, 15.5% received con­scious sedation and 12.6 % received local anesthesia alone. Of the patients in this study, very few had any signifi­cant complication. The types of com­plications varied from syncopal epi­sodes (0.1%) to vomiting (0.1-0.3%) and respiratory complications (0.3%). The total risk of complications was 1.3%. Onlv 2 patients had complications re­

gic reaction and another for aspiration pneumonia. Overall, the risk of hospi­talization was 1.8 for every 100,000 cases. The lowest complication rate involved using local anesthesia alone (0.4%), with conscious sedation having the next most frequent complication rate (0.9%), and the most complications arising from general anesthesia/deep sedation (1.5%.) Patients were very sat­isfied with their mode of anesthesia and th is study reported that 94.7% of aII pa­tients would recommend these anes­thetic techniques to a family member. In summary, this study showed that of­fice-based administration of anesthesia when performed by well-trained practi­tioners is safe and has a high level of patient satisfaction. T.NEDBALSKI

Dr. Nedbalski is a 1st year oral and maxillofacial surgery resident at the Medical College of Virginia in Rich­mond, Virginia.

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Retrospective Cohort Study of the Clini­cal Performance of 1-Stage Dental Im­plants, AB Carr, DMD, MS et aI., lnt. J. of Oral and Maxillofacial Implants, Vol. 18, No.3, pp 399-405, 2003.

One-stage implant systems allow the restorative dentist to more accurately alter and control the attached gingival architecture and emergence profile, and also eliminate the need for the patient to have a second surgical procedure for uncovering of the fixture. However, the one-stage systems do not have as long a history of clinical follow-up in order to determine implant survival and restora­tion function. The purpose of this study was to measure the survival character­istics of the implants and prostheses of a one-stage dental implant system. The study retrospectively included 674 single-stage implants placed in 308 patients from 1993-2000. The variables reviewed were age, sex, need for aug­mentation, implant location, implanttype and geometry, abutment type, prosthe­sis type, and condition of the opposing arch. The overall implant survival rate at 78 months was 97%, while the inci­dence of prosthetic complications was low « 4%). Implant failures occurred within the first 13 months of placement,

after prosthesis placement. Of the vari­ables reviewed, itwas shown that 4.8mm wide-diameter implants were 3.4 times more likely to fail than 4.1 mm stan­dard diameter implants, implants placed into augmented sites were 5 times more likely to fail than those placed into na­tive bone only, and a heterogeneous bone graft source was 4.8 times more likely than an autogenous source to be associated with implant failure. This study shows that single-stage dental implants share a similar success rate when compared to the standard two­stage method.-D. SQUIRE

Douglas Squire is a chief resident at the Medical College of Virginia's Department of Oral and Maxillofa­cial Surgery. Upon completion of his residency this spring he plans to join a private practice in Kalispell, Montana.

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Can Third Molar Surgery Improve Qual­ity of Life? A Six Month Cohort Study Colman McGrath, Margaret B. Comfort, Edward C. M. Lo, Yan Luo J Oral Maxillofac Surg 61: 759-764, 2003

Research is now focusing on assess­ing patients' perceptions of the risks and complications of lower third molar ex­tractions and its effects on day to day living and quality of life. This study at­tempted to assess the perception of quality of life after third molar surgery in patients who were asymptomatic and symptomatic preoperatively.

One hundred patients were interviewed preoperatively, given a daily log to be answered each post-op day for one week, and interviewed at one, three, and six months post-op. All patients received the same anesthetics, post-op instruc­tions, and post-op medications. Eighty­eight patients completed the study, the majority of who were female.

Post-operatively patients stated de­creases in functional limitation, physi­cal pain, psychologic discomfort, physi­cal disability, psychological disability, social disability, and handicap. Given the results of this study. the authors

significant increase in the quality of life at one, three, and six months after third molar surgery.

Dr. Truitt is a preliminary intern on the oral and maxillofacial surgery service at the VCU School of Den­tistry.

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Burning Mouth Syndrome (BMS): Double Blind Controlled Study of Alpha­Lipoic acid (Thioctic Acid) Therapy. Femiano F,Scully C. J Oral Pathol Med 31:267-269,2002

Burning Mouth Syndrome (BMS) is a common dysesthesia that is associated with an intraoral burning sensation in the absence of mucosal lesions. It been described as feeling that the mouth has been burnt by hot liquid. Women, par­ticularly post menopausal women, are much more likely to be affected than men. It has been suggested that BMS is linked to free radical production. This study evaluated the effect of alpha-lipoic acid (a free radical scavenger) in treat­ment of BI\/IS. Potential patients were screened for alterations in laboratory parameters that could be responsible for BMS. These tests included: whole blood folate, serum vitamin B12, serum ferritin, serum glucose, and thyroid hor­mone levels. Agroup of 96 patients was selected that had no relevant past medi­cal ordrug history and no laboratory find­ings consistent with BMS. Half of the patients received 200 mg of alpha-lipoic acid three times a day, and half received 100 mg of cellulose starch three times a day. The patients were medicated for 2 months. Evaluation of the patients occurred every 15 days and patients showing a reduction of symptoms at 4 months were given an additional one month course of medication. The pa­tients were then evaluated at one year following the commencement of the study. Statistical analysis showed sig­nificant improvement with alpha-lipoic acid compared to the placebo. 87% of patients taking alpha-lipoic acid reported resolution or improvement compared to 0% improvement reported by patients taking the placebo. One yearfollow-up showed 73% of patients maintained the level of improvement in symptoms while

shows that alpha-lipoic acid therapy does reduce symptoms associated with burning mouth syndrome and suggests BMS may be a neuropathy associated with free radical production.

Reprint requests to: Dr. Femiano Felice via Francesco Girardi 2, S. Antimo (NA), 80029, Italy.

Dr. Michael Wilson is a 2nd year resi­dent in Oral and Maxillofacial Sur­gery at the Medical College of VA Hospitals.

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Reinert S, Konig S, Bremerich A, Eufinger H, Krimmel M. Stability of bone grafting and placement of implants in the severely atrophic maxilla. British J of Oral and Maxillofac Surg, 2003; 41:249-255.

The severely atrophic maxilla remains one of the greatest reconstructive chal­lenges due to both the scarcity of dense bone and the pneumatization of the maxillary sinuses. In this investigation, the authors present thirty consecutive patients who demonstrate Class VI maxillary atrophy on the Caewood and Howell scale that are reconstructed with both inlay maxillary sinus and onlay al­veolar grafts followed by endosseous implant placement. All patients under­went maxillary sinus floor augmentation consisting of anterior iliac crest corticocancellous blocks with cancel­lous bone packed between the sinus floor and the cancellous block. In addi­tion, the anterior alveolar ridges were augmented with onlayed corticocancellous blocks. Following a waiting period of fourto six months, the graft stabilizationhardwarewas removed and 200 implants were placed. Seven implants in the antral graft sites failed to integrate (3.5%) with another four fail­ures during the follow-up period. Tomo­graphic studies showed a mean bone increase of 14mm postoperatively with a remaining mean increase of 11.4mm after three years. These results indicate that a staged approach at reconstruc­tion of the severely atrophic maxilla with a combination of onlay and inlay autog­enous bone grafts followed by second­ary implant placement is an effective

Dr. Ross Wlodawsky is chief resident of Oral and Maxillofacial Surgery at the Virginia Commonwealth Univer­sity Health System in Richmond, VA. Following completion of his resi­dency he plans to practice in Rich­mond.

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Influence of estrogen status on endosseous implant osseointegration M. August, K. Chung, Y. Chang, J. Glowacki J Oral Maxillofac Surg 59:185-89,2001.

Menopausal status and estrogen lev­els are associated with osteopenic bony changes which can eventually progress to osteoporosis. Menopause as related to implant success is not well docu­mented. This retrospective study inves­tigated the impact of post-menopausal estrogen status on the success of im­plant osseointegration in the maxilla versus the mandible. Five study groups were established from retrospective re­view of records: 1) post menopausal women with estrogen hormone replace­ment (ERT),2) post menopausalwomen with ERT, 3) pre-menopausal women, 4) men under 50, and 5) men older than 50. The latter two groups were meant to act as controls. Exclusion criteria included concurrent illness, metabolic bone disease, active smoking history, EtOH use, bone graft at time of implan­tation, and other treatment or preven­tion of osteoporosis besides ERT. All patients received Branemark type im­plants and success was defined as sta­bility at stage II uncovering. Stability was measured with manual torque wrenching and radiographic review.

An estimated 25% of women between 50 and 65 are affected by type I os­teoporosis. Type I osteoporosis is as­sociated with accelerated loss of trabe­cular bone and is difficult to establish on plain film since greater than 40% loss in bone mineral content must be present before radiographic changes can be seen. Previously, bone mineral density of the craniofacial skeleton was not thought to be significantly impacted by osteoporosis. However, one may argue that the maxilla, which is largely made up of trabecular bone, would be suscep­

with high trabecular content (e.q. verte­bral bodies which are often damaged by osteopenic changes). Similarly, be­cause the mandible is mostly cortical bone, less impact would be expected than in the maxilla.

Results demonstrated that postmeno­pausal status with or without ERT had no effect on implant integration in the mandible even when compared to male controls. However, in the maxilla, sta­tistically significant implant failure was found in post-menopausal women not on ERT when compared to pre-meno­pausal women. Postmenopausal women without ERT had the highest maxillary implant failure rate of any group studied. Statistically significant difference was not seen between post­menopausal women with ERT versus those without ERT but the authors ar­gue that the 41% decrease in failure rate with ERT still suggests that bony changes associated with estrogen sta­tus puts patients at risk for implant fail­ure.

The authors recommend referring high risk women not on estrogen therapy to appropriate health care practitioners for evaluation of osteoporosis and direct measurement of bone mineral density prior to implant placement.Thus, women may be informed of possible increased implant failure risk and the use of hor­mone replacement therapy may be con­sidered.

Dr. Dorcha Wojtkowski is a 1st year resident in Oral and Maxillofacial Surgery at the Medical College of VA Hospitals

L ~003 WISE MOM PROJECT - RECORD SET AT WISE FAIRGROUNDS JI]

Barbara Rollins, Assistant Director of Outreach Programs

The Virginia Dental Health Foundation (VDHF) teamed up with Remote Area Medical (RAM) forthe fourth M.O.M. project in Wise on JUly 25-27,2003. Wise County Fairgrounds of­fered the new site for the three day dental clinic. Over 285 volunteers joined together to provide dental care for a record 1,449 patients. These patients received 1,101 fillings, 2,730 extractions, 382 cleanings, 48 root canals and pulpotomies, 31 stainless steel crowns, 20 x-rays, 18 sedations, 68 seal­ants, 32 alveoloplasties, 10 denture repairs, 27 denture re­lines, 25 complete dentures, 3 partial dentures, and 8 den­ture adjustments and consults valued at $689,8101 The ex­treme need for access to dental care in the Southwestern part of Virginia was viewed first hand by Governor Mark Warner as he visited with area patients at the fairgrounds.

Since the first M.O.M. project was held at the Lonesome Pine Airport in Wise in 2000, dental professionals have pro­vided 4,198 area patients with $1.7 million worth of dental services. To date, the eight M.O.M. projects held in Wise, Eastern Shore, and Northern Virginia have donated over $2.5 million of services to 6,814 Virginians- a national record for a model dental clinic of this type!

Partnering organizations include Delta Dental Plan of Vir­ginia, Virginia Department of Health - Dental Division, VCU School of Dentistry and Dental Hygiene, St. Mary's Health Wagon, Virginia Chapter, March of Dimes, and the Virginia Lion's Club.

Another happy patient shows off his new smile I

Trying to stay warm on a chilly sum­mer morning.

Long lines waiting for dental care

Upcoming MOM Project Dates

Petersburg Mini MOM - November 15, 2003 Martinsville MOM - November 21 & 22,2003 Eastern Shore MOM - March 20 & 21, 2004 Northem VA MOM - March 26-28, 2004 Wise MOM - July 23 -25,2004 Grundy MOM - October 16 & 17, 2004

Register on-line at www.vadental.org

In the past the Wise MOM Project was held in an airport hanger but in 2003, we moved it to the Wise County Fairgrounds l

Making A Difference!

The VDA would liketo than the following volunteers for theirparticipation at the Wise MOM Project

David Abbott Rob Eye David Lewis Sherman Pillis Christy Testerment Leslie Webb Omar Abubaker Jackson Faircloth Tina Lewis Daryl Pirok Brad Thweatt JoAnn Wells Anne Adams Steve Fallon Sharon Logue Becky Pirok Lou Tracy MelanieWexel Deborah Adams Andy Feagans James Londrey StephaniePirok Tina Trogden MilesWilhelm Olorunfemi Afe Julie Ferguson Eric Lovell LalitaPittman/contact Neil Turnage MarthaWilhelm Guarav Agarwal Justin Ferguson Bobby Lunka Carole Pratt Bonnie Turnage MilesWilhelm Shamen AI-Aneiz Cindy Fero Dwayne Lunsford Bob Price Stephen Tuttle Jonathan Williams David Anderson Marissa Fiddyment-Mule Sally Lupia Sherron Prillamon Bill Viglione Joe Wilson Sandy Anderson Robert Findley Bernadette Mabanglo Cameron Quayle Laura Viglione TerriWingfield Kelly Andrews Carol Finnerty Sheree Madison Chrystal Randolph Jo Viglione Roger Wood Stephanie Arnold Patrick Finnerty Raymond Mallinak Jonathan Rasnake Gus Vlahos David Woodruff JeffArrington Katherine Fischer EmilyMallinak Mark Raymond Deborah Vlahos Jane Woods Kathy Arrington Harrison Fischer Laura Mallinak Linda Reynolds Cheryl Wagstaff Pedram Yaghmai Lori Atkins Craig Flaherty Anna Manilla Elizabeth Reynolds Sherri Walker Linda Zack Ellen Austin Terry Fletcher Ron Manilla Princess Rhoads Vanessa Walker Stan Zack Maude Baltzegar Christine Frasse Dom Manilla Mary Richard Jennifer Walkup DrewZima Robert Barnes Sharon Freeland Harris Danny Manilla Stephen Riggs Mark Warner Andrew Zimmer Brenda Berg John Friedman Joey Manilla Heather Rigney James Webb Theresa Zinn B.J. Berry Graham Gardner Megan Mansell Richard Roadcap Angela Blankenship Lee Gontry Diana Marchibroda Kathryn Roberts Darnell Boff Greg Gray Peggy Marietta Patrick Roberts Bryan Brassington Ed Griggs M.L. Martin Chandra Roberts Betsy Brinker Heather Gross Mrrn Martinez Barbara Rollins Wise 2003 Statistics Carol Brooks BillHall Danny Mason Neal Rollins Kendra Brown Donna Hall Eli Mayes Anna Nichole Rollins Patients- 1,449 Lauren Brown Lee Hall Karen McAndrew Noel Root

Routine Exams - 1,449 Ronnie Brown Stephanie Hall Aaron McCrady Mike Russell Jeannie Brown BrookeHammelman Angela McElreath Jose Saarez Cleanings - 311 Tim Bryan NikiHammond George McGuire David Savage GrossDebriments- 71 Tia Bryson Patty Harris MikeMcMunn Robbie Schuremann Extractions - 2,730 Gibby Button Dawn Harris Leigh Anne Melton Sarahena sccto Fillings - 1,101 Lourna Cabrebros'Deano Marissa Mikolich Eugene Sekiguchi DentureRepairs- 10 TammyCahoon Ed Harvey Faye Miles Vicky Semtner

DentureRelines- 27Laura Callas Bridget Hengle Benita Miller Roy Shelburne Jacqueline Carney Sandy Henn Mike Miller Ross Shelburne CompleteDentures - 25 Deanna Causey Catherine Hitt Jeanie Morgan Ted Sherwin Partial Dentures- 3 Latesha Chambliss Sheilandice Holmes LeAnn Morris Suzanne Sherwin DentureAdjustments - 5 Joan Chappell Jennifer Horton Veldon Moser Vali Shoop DentureConsults - 3 TomChildrey Rebecca Howard Richard Mower CorinnaSimms

RootCanals/Pulpotomies - 48 Elizabeth Clark Wallace Huff Angela Moyer Christine Slagle SS Crowns - 31 Ryane Clarke Carla Jacube Anita Mullins Steven Slott

Gregory Cole Nandaka Jayaweera James Muncy MelissaSmith X-Rays-20 Thomas Cooke Linda Jayaweera Bonnie Nickerson MichelleSmith Sedation - 18 Jill Cooke Priscilla Jessee StephanieNorman Marci Smith Sealants- 68 Matthew Cooke Claire Kaugars Clinton Norris Tonia Socha-Mower Alveoloplasties - 32 Ben Crowley Carla Keene Leonard Nunley Monica Soler De Vega Charles Cuttino Debbie Keller Hannah Oakland Betsey Soulsby Sheila Dalton Curt Killar Susan O'Connor Robin Sparks Total Value of Services: Becky Davis Shera Kite Esther Oh Brian Spears $689,810 Rhea Davis Rodney Klima Bruce Overton Richard Stanford David DeViese Carol Klima Fred Palau-Hernandez Jim Stanley Coral Diaz MichelleKlima Faith Parker AI Stenger Terry Dickinson Lou Korpics Ajit Patel Kathy Stewart Cherryl Dickinson Luiza Kruezer Priya Patel Matthew Storm Sarah Dowdy Maria Kunk Susan Patton Lisa Storm Melissa Dragoo James Lance Margo Payne Charity Storm Art Dubie Randy Lazear Emily Payne Virginia Storm Arlene Duncanson Taylor William Pearlman Zac Strauss Chuck Duvall Victoria Lazear Bonnie Perkins KIt Sullivan

Amanda Ellinger Chad Ellsworth Joyce Estes

Linda Duvall Michael Lazear Susan Pharr ROSie Sumrell Bonnie Leffingwell Lee Phillips Sharon Swanson Lanny Levenson Jacquelin Phoenix Kim Swanson Jeffrey Levin Julia Pillis Josh Swanson

CGIVE KIDS A SMILE 2004 Photos from 2003 Give Kids A Smile ::JI Drs. C. Sharone Ward & Samuel W. Galstan

DearV.DA member,

We are really excited about this years start ofthe "Give Kids a Smile!" initiative. This is a nationwide program that is sponsored by the ADA, that is attempting to have simultaneous events in every state on Friday, February 6, 2004. The focus of this program is to increase access to dental care in underprivileged children, through education, treatment, and helping these children to find a dental home. Last year Virginia was one of two states to receive honorable mention for their activities, we hope to learn from last years experiences and makes this year's event better.

It is important to note that we want each component, and within each component every interested dentist to participate in this event, and that there are a number of different ways possible to help. Many of you already do events in February, we just want to make sure that the VDA central office is aware of these, so that we can include these as V.D.A. "G.K.A.S.!" events.

Last yearwe focused primarily on screenings and education. This year we would like to add some treatment. What we have discussed is perhaps having a central person in each area or each component perform some pre-screenings, and then assign a certain number of patients to each volunteer dentists, so that the volunteer dentist could then treat these patients in their own office where they feel most comfortable. It is essential that we coordinate publicity and p.r. for this event. .. remember our recentbattlewiththe legislatureoverthe definition of dentistry...our efforts with the Mission of Mercy project proved invaluable in showing how well organized dentistry gives backto our constituency.Mostof you alreadydo some volunteer work during February for Children's Dental Health month-let's just all do it on the same day!

Below are some ways you can participate in "Give Kids A Smile" in your area!

1). Volunteer to screen and educate and treat patients in your own office.

2). Volunteer to help at a children's dental health fair. 3). Volunteer to work at a free clinic in your component. 4). Volunteer to speak at a school.

In orderto make this event a success, we need your help, and once again, thanks to the many volunteers who helped last year, and to those who will help this year!

Please call the VDA office (804-261-1610) for more information on how you can help!

C. Sharone Ward, DDS Samuel W. Galstan, DDS r,,_t:h::lir

Component 3

Component 2

Component 4

ComponentS

VDHF 2003 TOOTH FAIRY BALL[II II]

Stephanie Arnold, Dir. of Outreach Programs & Elise Woodling, Dir. of Marketing

CELEBRATING THE PROFESSION, MAKING A DIFFERENCE

On October 3, 2003 the Virginia Dental Health Foundation (VDHF) hosted the first annual Tooth Fairy Ball, a charity event that raised money for the Foun­dation. The event was held at the Rich­mond Marriott West in Glen Allen, VA. Over 60 attendees enjoyed a social hour, presentations from members ofthe VDHF Board, dinner, and dancing.

The Tooth Fairy Ball raised money for the VDHF which supports a number of charitable functions such as Donated Dental Services and the Missions of Mercy projects. Donated Dental Ser­vices is a program in which VDA mem­bers and dental labs donate their time and services to disabled and elderly

patients who are in need of comprehen­sive dental care. The Mission of Mercy projects are held several times annu­ally in various areas of the state to pro­vide dental care to individuals who are in need. To find out more about these programs, or to become a volunteer, please contact StephanieArnold, Direc­tor of Outreach Programs, at 804.264.9010.

The Virginia Dental Health Foundation Board and the VDA would like to thank all of the attendees of the first annual Tooth Fairly Ball and those who helped to support the event with their donations. We look forward to holding this event in the future and to your continued sup­port.

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RETURNING WITH A BRAND NEW COURSE:

Dr. John C. Kois Presenting a Brand New "Advanced" Course critical to enhance the longevity of your restorations, designed for Every Patient, Every Day in Every Practice. This outstanding educator will present a new paradigm integrating a current scientific basis for clinical practice without perpetuating existing dogma so you can realize in advance the potential for disastrous results along with concepts to minimize occlusal related failures. As LAB ONE says, " The Choice is Kois , "

"Functional Occlusion: Science Driven Management"

Coming Friday and saturday, Feb. 6th 81. 7th « 2004

at the New Norfolk Airport Holiday Inn Select Hotel! Priced at just $895.00, the course includes 16 AGD Approved Credit Hours,

Valuable lohn Kois Study Guide, Continental Breakfasts and Seated Luncheons Both Days!

NOTE: Special Reduced Rates available for your Practice Team Auxiliaries, and for out of to,," ,-i,iton Special Reduced Norfolk Airport Holiday Inn Select Hotel Accommodation rates have been arranged:

Dr Kois Presentations are always a Sell Out I Assure yourselfa place at this Important Course VIIAL to the Successof' Your PracuceI

CALL Tom Williford at LAB ONESeminars 455-8686 or toll-free 1 (888) 448-7889

"Bringing the Very BestContinuing Education to the DentalPro~ion"

RESEARCHERS LINK MATERNAL FOLIC ACID INTAKE TO CHILDHOOOD CANCER

VA Chapter of the March of Dimes

A study published in the journal Clini­cal Pharmacology and Therapeutics re­ports that folic acid food fortification in Canada has resulted in a 60% reduc­tion in the incidence of neuroblastoma, a deadly childhood cancer. A research team at The Hospital for Sick Children (HSC) and the University ofToronto no­ticed a decrease in the incidence of neu­roblastoma and investigated the cause of the decrease. They looked at the incidence of neuroblastoma in Ontario using the Pediatric Oncology Group of Ontario registry, a database that cap­tures information on 95% of all pediat­ric cancers in Ontario.

Neuroblastoma is the second most common pediatric tumor and the most prevalent solid tumor that occurs out­side of the brain in children under the age offive, affecting one in every 6,000 to 7,000 children in North America. Be­cause this cancer develops in utero, neuroblastoma is the most commonly diagnosed malignant tumor of infancy. The aggressive nature of this tumor also makes it the most common cause of cancer-related death among children one to four years old.

"Our research indicates that this is the first pediatric cancer that can be pre­vented through maternal diet," said Dr. Gideon Koren, the study's principal in­vestigator, director of HSC's Motherisk Program, a senior scientist in the HSC Research Institute and a professor of Pediatrics, Pharmacology, Pharmacy and Medicine and Medical Genetics at University of Toronto. "The role of folic acid in preventing neural tube defects such as spina bifida was already known. This study also suggests a link between folic acid and neuroblastoma."

The research team also looked at the effect maternal folic acid intake had on infant acute lymphoblastic leukemia and hepablastoma, two childhood can­cers that also have embryonal origins. However, no decline in these cancers '''"c nf"\torl <:>ftor tho fnlif' <:>"irl fnnrl fnrti_

fication program was introduced.

"We need to investigate further the role of metabolism in the formation and pre­vention of neuroblastoma and other can­cers that develop in utero. We will also

look at whether folic acid has an im­pact on neuroblastoma after the cancer hasalreadydeveloped,"addedDr.Koren.

For more information, please visit http:/ /www.sickkids.ca

t3Q6;e81Jee~ FOLIC ACID EVEN BEFORE YOU KNOW )j.c9U·~e .er~nant

U' Your baby needs folic acid (a B vitamin) at the verv beginning of pregnancy to help the baby's brain and spinal cord develop.

Visit us at www.modimes.org to find out more.

TIlE MARCH OE DIMES _

Materials funded by the Virginia Council on Folic Acid.

SMART SMILES - BOYS & GIRLS CLUB ~I II] Lisa Spector, Executive Director, Smart Smiles

A Dental Clinic at the Boys & Girls Club? Yes, you read it correctly. Smart Smiles®, a partnership between the Boys & Girls Clubs in Virginia and Delta Dental Plan, will provide dental care to children and youth who otherwise do not have access to care.

Delta Dental Plan of Virginia established Smart Smiles as a pilot project in the Roanoke Valley in 2001. Since then, approximately575 members of the Boys & Girls Clubs of the Roanoke Val­ley have been treated by a dentist at no cost. Now, Delta Dental has provided the Virginia Alliance of Boys and Girls Clubs a seed grant to expand Smart Smiles, beginning in Richmond. By 2005 these services will be replicated in Boys & Girls Clubs in Hampton Roads and Northern Virginia.

Forthe past 20 years, Dr.Ward Mustian has nrnvirlArl frAA r.:HP. to members of

The Boys & Girls Clubs of Metro Rich­mond. Last year, he was able to help the club secure funding for a new, fully equipped, one-chair dental clinic.

Here's how YOU can help - If you live in Richmond: 1) Volunteer at our clinic, clubs are open until 8pm, Monday through Friday; 2) Medicaid participat­ing dentists - give us a Y2 day per month for our kids and we'll guarantee a 0% no show rate; 3) Donate supplies; 4) Participate in Give KidsA Smile Day on February 6, 2004 in Richmond and throughout the state. Outside of Rich­mond, you canwork with your local clubs to make sure that the 50,000 Boys & Girls Club members throughout the state have access to dental care.

For more information, contact Lisa Spec­ter, Executive Director, Smart Smiles, 804/359-5250 ext. 243 or Isoecterm>bacmr.ora.

FAMILY LIMITED PARTNERSHIPS - ON SHAKY GROUND? [Ii , David S. Lionberger, Esquire - Christian & Barton LLC

Since issuing a series of technical ad­vice memorandums beginning in 1997, the Intemal RevenueService hasactively sought to attack the use of family lim­ited partnerships in which the founder claims discounts (for lack of control and lack of marketability) on the interests transferred to family members. The Service has argued to disregard the entity altogether, to reduce or eliminate any claimed discounts on the value of limited partnership interests transferred to family members, to impose gift tax upon the formation of the entity, and to keep the value of the assets placed into the limited partnership in the founder's estate subject to estate tax despite the transfer of the limited partnership inter­ests to family members. The latest in a series of Tax Court decisions involv­ing family limited partnerships hasgiven the Service a winning theory, at least based on certain similar facts, by which the value of the limited partnership's assets are kept within the founder's tax­able estate despite the transfer of the assetsto a valid limited partnership rec­ognized under state law.

A series of recent Tax Court decisions (Estate of Schauerhamer v. Comr., Es­tate of Reichardt v. Comr., Estate of Thompson v. Comr., Estate of Harper v. Comr., Estate of Strangi v. Comr.) and a federal district court decision (Kimbell v. U.S.) considered family limited part­nership situations where the founder placed assets in a limited partnership (typically passive assets such as real estate, stocks, bonds, annuities or in­surance policies), received limited part­ner interestsin the entity,and transferred general and limited partner interests in the entity to family members, either in connection with formation of the limited partnership or at a later time. In deter­mining the value of these interests for gift tax reporting, the founder applied discounts for lack of control and/or lack of marketability, reducing the value of these interests below the value of the net assetswithin the entity. The founder also claimed that the assets were no

longer within the founder's estate and were not subject to estate tax upon the founder's death.

The Tax Court seized upon certain ad­ditional facts found in these cases to conclude that the taxable estate of the founder continues to include the full value of the assets placed in the entity. These "bad" facts include that:

• the founder transferred all or very nearly all of his or her assets to the entity,

• the founder continued to personally use and receive income from as­sets contributed to the entity,

• the assets contributed were sub­stantially passive assets ratherthan an operating business,

• the other family members did not contribute significant assets to the entity,

• the founder and other partners failed to follow the requirements of the partnership or other agreement pur­portedly governing the entity,

• the founder directly retained control or approval over distributions from the entity, or indirectly controlled distributions by retaining sufficient ownership interest to replace the general partners at the founder's discretion, and

• distributions from the entity to the founder (or founder's estate) were disproportionate and made in re­sponse to personal needs of the founder (including payment of es­tate taxes and expenses on the founder's death).

The TaxCourt concluded in these cases that the value of the assets placed in the limited partnership nonetheless are included in the founder's taxable estate because, based on these facts, an im­plied or express agreement existed be­

tween the founder and other family members that the assets contributed to the entity would remain available to the founder for the founder's personal needs. In the most recent decision, the Tax Court also concluded that the power of the founderto act in combination with the other family members to control dis­tributions from and liquidation of the entity (apart from any implied agreement as to the use of such assets) consti­tuted sufficient control over the entity by the founder to include the value of the entity's assets in the founder's tax­able estate. This decision reached this conclusion despite recognizing the va­lidity of the formation and funding of the limited partnership under state law.

In light of these decisions, the Service will continue to argue that a founder serving alone, or in conjunction with oth­ers (particularly family members or en­tities controlled by the founder), as a general partner of a partnership, man­aging member of a LLC, or as a partial owner of a corporation, trust, LLC, part­nership or other entity that serves as the general partner or managing mem­ber, has retained control over the as­sets, triggering inclusion of those as­sets in the founder's estate. To reduce the risk of such a result, persons who have formed such entities should con­sult counsel to review the operations and documentation of the entity and changes required to reduce the num­ber of facts similar to the above deci­sions. In addition, counsel should peri­odically review the operations of any such entities to check compliance with the ever changing judicial landscape.

ADPAC WASHINGTON UPDATE -Ill ADPAC has just concluded its annual summer Board meeting. It was again very successful and as your ADPAC Director, Iwish to share with you what I have leamed.

Here is a summary of current political events in Washington. Congress is pre­paring for its month-long summer vaca­tion with one of the most important pieces of legislation considered so far still in conference committee. The Medi­care prescription drug bill (H.R. 1) is a high priority for President Bush and con­gressional Republicans, but GOP strat­egy for passing the legislation is still up in the air; although the administration is happy with the Senate language, House conservatives have some ideas of their own regarding issues like com­petition between traditional Medicare and private plans. Meanwhile, Demo­crats are worried that they will be shut out of the negotiating process alto­gether. The president met this week with conferees to discuss the negotiations, which are proceeding at a snail's pace. As of this writing (July 27), conferees have not yet discussed any details of the major points of controversy in the legislation.

The ADA is hopeful that a provision al­lowing dentists the right to opt out of Medicare will remain in the final bill, but we are less sure about the fate of lan­guage included in the Senate version that would reverse the impact that a CMS proposed rule would have on graduate medical education (GME) resi­dency training programs.The rule,which would in effect eliminate much off-site dental residency training, could cut den­tal residency programs drastically.

To keep this in perspective, many ob­servers view the bill's ultimate prospects for passage to be slim. The huge price tag associated with a Medicare prescrip­tion drug bill-more than $400 billion over 10 years-is not conducive to easy passage, especially in a time of yearly deficits of more than $450 billion. That c:",in it ic: imnllrt::lnt til n1lrC;llp. thp. ont-

Rodney J. Klima, DDS

out and GME provlsions vigorously, be­cause it sends a powerful message about their importance to the profession and increases the likelihood of our find­ing other legislative vehicles for their passage in the future

A sluggish economy combined with certain reductions in govemment spend­ing on domestic programs is having a severe impact on many health programs. Over the next few budget cycles we expect to see cuts in federal commit­ments to nearly every program affect­ing dentistry. Of course, the cutbacks we are currently witnessing at the state level have already severely limited oral health care to some of the neediest populations.

Although one would expect Democratic presidential hopefuls to use the rickety economy as ammunition against Bush, few of them are getting any appreciable traction on the issue. And it's not likely that the argument will work later this year, especially as middle class voters begin cashing their tax rebate checks.

Below are some of the current issues important to dentistry:

• The full House and Senate each have passed legislation (H.R. 531, S. 312) that would redistribute billions of dol­lars in unspent SCHIP funds to the states. The bills are now in confer­ence.

• The House last month approved ADA­supported H.R. 660, legislation that would create association health plans. The legislation, which passed the House 262 to 162, is now await­ing action in the Senate where its fate is uncertain.

• As of this writing, Rep. Burton re­mains the only cosponsor of Rep. Watson's Mercury in Dental Filling Disclosure and Prohibition Act (HR. 1680). Rep. Burton, chairman of the House Government Reform Committee's Subcommittee on Hu­

man Rights and Wellness, has prom­ised more hearings on this issue, but so far none have been announced.

• ADA staff met with EPA representa­tives last week to discuss developing a guidance intended to reduce amal­gam in dental office wastewater. The guidance, based on voluntary compli­ance, will emphasize recycling, re­search and the Association's "Best Management Practices" (BMPs). The meeting went well, with agency offi­cials promising additional meetings.

• Washington Office staff met recently with OSHA officials to discuss our pro­posed alliance agreement with the agency. Chicago staff participated via telephone. The agreement is under­going a rigorous approval process at the ADA, but staff that participated in last week's meeting feel that the pro­posed alliance will meet the Association's requirements.

• Sen. Jeff Bingaman (D-N.M.) reintro­duced his Children's Dental Health ImprovementAct (S. 1142)on May 23. The ADA hopes to see a House com­panion introduced soon.

• Sen. Debbie stabenow (D-Mich.) in­troduced companion legislation (S.Res. 182) to Rep. Eric Cantor's (R­Va.) Give Kids A Smile resolution (S. Res. 136) congratulating dentists and the American DentalAssociation, and emphasizing the need to improve ac­cess to dental care for children. As of this writing, the total number of co­sponsors on the Cantor resolution is 33. Continuinq work by ADA action teams should boost this number sub­stantially in the coming weeks.

• Reps. Michael Ferguson (R-N.J.) and steny Hoyer (D-Md.) recently intro­duced the Medically Necessary Den­tal Care Act (HR. 2182). This legisla­tion would amend the Social Secu­rity Act to provide coverage under Medicare for dental care provided to suruerv patients with the following dl­

agnoses or undergoing the following procedures: prosthetic heart valve re­placement surgery; cancer of the head or neck; lymphoma; leukemia; organ transplantation. Current law does not provide sufficient guidance for Medi­care carriers to determine when den­tal care is medically necessary. For example, Medicare currently covers dental extractions prior to head and neck radiation therapy, but does not cover similar dental treatment prior to a kidney transplant and/or prosthetic heart valve replacement. The bill awaits action in the Ways and Means Committee.

• Although the House passed its bill Iim­iting medical malpractice awards and lawyer fees (HR. 5) late last year, the legislation remains languishing in the Senate. GOP leaders have tried to en­tice moderate Democrats into support­ing the measure, but so far none has agreed. The issue remains the level of proposed caps on non-economic and punitive damages.

• Rep. Rob Simmons (R-Conn.) last month introduced his Dental Officer Retention Act (H.R. 2287), which cur­rently has 10 cosponsors. The bill would allow dental officers in the uni­formed services to continue to receive additional special pay (ASP) while undergoing dental internships or resi­dency training. The loss of ASP dur­ing dental training programs exacer­bates the financial burden of military dentists, many of whom are still struggling to payoff large dental school debts. Dental officers with 3 to 10 years of service could lose $6,000 in ASP, while those with 10 years of service stand to lose $15,000.

• Rep. Elijah Cummings (D-Md.) intro­duced his resolution (H.J.Res. 52) to recognize the Dr. Samuel D. Harris National Dental Museum as the "na­tional dental museum." The resolu­tion has 11 cosponsors to date. Sen. Paul Sarbanes (D-Md.) introduced the companion bill (S.J.Res. 12) in the Senate.

Dentistry must continue to be vigilant and at the table in Washington to pro­tect itself from ovelLealous and bad

government regulations and legislation and to promote its own legislative agenda for our patients and the profes­sion. The best way for this to continue and improve is for every dentist to be a member of ADPAC. Our membership inADPAC occurs through our member­ship in our state's Dental PAC. It is ex­tremely important that organized Den­tistry have enough support to provide the advocacy necessary for success. Mem­bership in ADPAC supplies the funding and our volunteers and professionalstaff

supply the manpower for this advocacy. We in Dentistry continue to face many challenges in Washington.

Thank you for your support in the past and please continue to supportADPAC through our state Dental PAC member­ship this year and every year, it's very important.

Dr. Rod Klima ADA District ADPAC Director

Healthy Communities Loan Fund

Thinking of practicing where patients really need you, and they wait months for dental appointments?

The Healthy Communities Loan Fund encourages dentists to practice in dental shortage areas!

Word of mouth conveys how satisfying it is to:

• Develop long term relationships with individual patients and their families

• Set up and run your own clinic; or share the workload with appreciative colleagues

• Participate in the life of a community where you really mat­ter and people care about you

If these factors appeal to you, we urge you to consider the long term benefits of practicing in a dental shortage area of Vir­ginia.

To finance relocating, building, expanding a facility, or adding new equipment to accommodate another dentist or to hire a dental hygienist. ....

Call:

Lilia Mayer/ Healthy Communities Loan Fund at the Virginia Health Care Foundation

(804) 828-7494 or Email:loanfund@vhcf.org

Virginia Dental Association First Virginia Banks, Inc.

The Robert Wood Johnson FOlmrl;:\tinn

"My practice merger purchase could not have been a more successful venture. I experienced immediate results and, in fact, would not hesitate to look into another merger transaction in the future. AFTCO is a professional organization with things to say that are truely worth listening to. II

Jeffrey B. Wetter, DDS Bridgewater, Virginia

"1 really appreciate the fact that AFTCO was there to keep everything on a fair and equitable basis. They were truly interested in and attentive to my needs and goals. I recommend AFTCO's dual representation approach without qualification. "

James H. Pauley, DDS Portsmouth, Virginia

AFfco

YOLl( ViirgJn ia ,">c,-"'" ".', ....

:Representatlyes: ... ,804]S2.276~

DIRECT REIMBURSEMENT DENTAL BENEFITS PLAN J Elise Woodling, Director of Marketing & Programs

Direct Reimbursement Benefits

Direct Reimbursement is a freedom-of­choice self-funded dental benefits plan. The benefits of a DR plan are numerous for dentists, patients, and their employ­ers. In the dental office, Direct Reim­bursement plans preserve fee for ser­vice practices, reduce paperwork and insurance hassles, and eliminate third party interference in the development and implementation of treatment plans. For patients, Direct Reimbursement al­lows for the freedom of choice for den­tal care providers, easily understandable benefitswith prompt reimbursement, and the ability to prioritize dental procedures in orderto gain the maximum personal satisfaction from their dental benefit. Additionally, Direct Reimbursement pro­vides a number of benefits for employ­ers who utilize the plan including cost savings, flexibility to determine the spe­cifics of their benefit program, and an improvement in employer/employee re­lationships due to a simplified dental benefits plan.

What You Can Do

With all of the benefits of a Direct Re­imbursement plan, it is easy to under­stand why DR is supported by both the VDA and the ADA. The VDA is asking that you do your part to endorse and promote the Direct Reimbursement pro­gram to your patients who are business owners, human resources managers, and employees. As a dental heath care professional, your opinion and recom­mendation about a dental benefits plan will be highly regarded by your patients.

Where To Get Information

It is essential to educate yourself and your office staff about the benefits of a Direct Reimbursement program. With your help, Direct Reimbursement will get both attention and consideration as a high quality, effective dental benefits plan for businesses across Virginia. If you would like information about Direct

Reimbursement, or if you have a refer­ Reimbursement, please contact Elise ral or contact that is interested in re­ Woodling at the VDA Central Office at ceiving more information about Direct 800.552.3886.

Having Troubles Collecting Your Receivables?

Stamp out those unpaid bills!

The Virginia Dental Association has partnered with l.C. System to provide members

with intelligent collection solutions.

[U jl.C. Systems, Inc.P.O. Box 64639 Call Today!

, • St. Paul, MN 55164-0639 1-800-279-3511LC~I·STD,.l www.icsystem.com

DENTAL BOARD INVESTIGATIONS MAY BE TRIGGERED BY ­ -I ISSUES BEYOND PATIENT COMPLAINTS ~

Kathleen M. Roman, GE Medical Protective

The dental board's role: Dentists know that they can contact their professional liability insurers for advice about how to address patient complaints. Often, the doctor is concerned because a patient has threatened to sue. However, pa­tients are just as likely to report their dissatisfaction to the state dental board. And when this occurs, the doctor may be surprised to discover that a board investigation can, and often does, ex­tend beyond the specifics of the patient's complaint.

Each state's dental board seeks to en­sure that a level of acceptable care is available to citizens. It accomplishes this by providing feedback to dentists about the appropriate standards-and where/how these may have been breached. While the dental board serves as a resource for dentists, the natureof itsduties may also result in dis­ciplinary action. It is beneficial for den­tists to have the opportunity to hear the issues and concerns of their state boards-from aneducational perspective.

cation from a physician. In these in­stances, other health care profession­als will have an obligation to seek addi­tional information and may become ob­ligated to report their suspicions/find­ings. Unfortunately, numerous state dental boards have reported similar is­sues related to prescription activities.

Nearly every dental board has now re­ported disciplinary actions related to dentists writing prescriptions for Viagra. As a representative of the Florida den­tal board said, "I wish somebody would explain to me the clinical efficacy of this drug in relationship to the provision of dental care!" Whether self-prescribing or writing orders for others, this drug is not within the scope of practice for den­tal care.

In many instances, dentists get into trouble because of their desire to do a favor forsomeone. However, afavormay not always be in the patient's best in­terests-and it comprises a risk for the dentist. Just because a dentist has a

DEA license, he is not allowed to write prescriptions that have no basis in clini­cal care he is providing. The dental board may review a dentist's prescrip­tion records and note a higher-than-av­erage number of orders for antibiotics. When questioned, the doctor responds that the drugs were ordered for family or friends who were suffering from flu or ear aches or sinus infections, etc. This kind of "generosity" is problematic for several reasons. First, the conditions and the lack of ongoing dental care mean that the dentist is actually prac­ticing medicine. Second, the drug pre­scribed may not be appropriate for the patient's condition-if one is warranted at all. This increases the risk of com­plications related to the provision of the drug. It may also complicate the ongo­ing course of care if the patient decides to see a physician and ends up taking two prescriptions or one that is contra­indicated with the drug ordered by the dentist. Also, because the patient knows that he obtained the prescription under false pretenses, he will be less

One common source of reports to the dental board may involve the prescrip­ The Virginia Dental Services Corporation has teamed up tion habits of dentists. Because of their with Dell to offer VDA members special discounts and of­important role in protecting the public fers not available to the general public. health, pharmacists are obliged to re­port drug- and medicine-related issues

Shopping with Dell's Employee Purchase Program has many that do not appear to comply with ap­benefits.propriate standards. They are even

more likely to take this step when at­ • VDA members receive a 5-10% discount on all consumer ma­tempts to clarify the situation have not

chines (Dimension desktops and Inspiron notebooks)met with adequate response from the

• 5% discount on all consumer machines with a 1 or 2 year war­dentist in question. ranty

The dental board's concerns: Scope • 10% discount on all consumer machines with a 3 or 4 year war-of practice issues may elicit the board's ranty (on-site) attention. Dental licensure allows each • Discounted shippingdoctor the right to provide and prescribe • 24 hour Dell hardware telephone technical supportmedications that are appropriate to his • Dell Preferred Account available to well qualified customersor her scope of practice and DEA au­

• Award-winning service and supportthority. These activities are expected to fall well within the clinical activities of

, VDA members can seek purchasing advice or place an order dentistry. Troublesome prescribing pat­terns raise red flags when pharmacists by calling 1-800-695-8133 and speaking with a sales represen­see them orwhen a patient is concerned tative. Be sure to mention our Member 10 HS30392560 to re­,..h,." 1+ "hl"'l. rY\nM.it"'~+if\n -:lnrl c:::~~k-c::: ('I~rifi_

likely to tell others what he is taking, compounding the opportunity for drug mix-ups, reactions, double-doses, etc. Third, drug-resistant pathogens consti­tute an international health concern. Prescriptions should be written only as part of a thoughtful clinical plan, not as a favor.

Dentists generally understand and ac­cept their responsibility to ensure that employees cannot use prescription pads, except as directed by the doctor. But as an employer, dentists need to resist the temptation to address em­ployee-related health issues. One com­mon example that has caused problems in a number of states is the dentist's provision of pain medication to employ­ees. If an employee has symptoms of carpal tunnel syndrome, the prescrip­tion of pain medication, without treat­ment by a physician, may ultimately exacerbate the employee's symptoms by delaying appropriate interventions.

Odd prescribing habits are also likely to attract the attention of the state den­tal board. Very few dentists could sup­

port the contention that OxyContin is a drug that has acceptable uses in den­tistry. Whatever the medication a doc­tor prescribes, its use, dosage, and the treatment rationale may be called into question-and deviation from standard­of-care approaches to prescribing is dif­ficult to explain, or defend. Along this same line, even medications that are frequently prescribed during dental care may raise suspicions if they are pre­scribed in higher-than-acceptable quan­tities or doses, or over extended peri­ods of time. In a recent case, for ex­ample, a pharmacist reported as suspi­cious a patient's receipt of Vicodin-for three years. The board's investigation resulted in disciplinary action for what was termed "supervised negligence."

Whenever medication-relatedquestions occur, dentists should consult with phar­macists and physicians to ascertain the correct uses of drugs. These queries may cover, not only the drugs the den­tist might wish to prescribe to her pa­tients, but also possible interactions with drugs the patients might already be taking. Dentists should also con-

suit with trusted colleagues to learn more about the local standard of care for the use of specific drugs and medi­cations. State and local societies and other professional associations will also help dentists stay tuned to changes in standards for drugs. And finally, dental boards themselves are excellent re­sources for dentist who have questions along these lines. Better to ask early on and prevent a disciplinary action than to play it by ear and be slapped with a fine and a disciplinary action.

The doctor's best interests are served if he notifies his professional liability car­rier whenever he receives a notice of a complaint to the state dental board. While monetary penalties assessed by the board are not covered bythe doctor's malpractice policy, most carriers will provide legal assistance for the doctor during the course of the review by the board.

The author wishes to acknowledge the exper­tise and sound advice contributed by: James D. Bentler, DDS. PhD, Marquetta Poynter, DMD, and Joseph Radowski, DDS, MS.

~ VirginiaDENTAL SERVICES

I-----Corporation-PRESENTS

HEALTHCARE COMPLIANCE SERVICE

Waste Compliance Service plus OSHA/Bloodbome Pathogen Compliance Training

How would you like to pick and choose what services you want. When you want it. and at your convenience from one source')

Health care Compliance Service is a nationwide full service company endorsed by the VDA providing waste management and compliance services for the hcalthcare industry

We specialize in hazardous and bio-hazardous waste removal service as well as OSHA compliance training programs • New Photo Chemical Filtration Units with waste removal • Lead and Lead Foil waste removal service • Amalgam Filter and Trap waste removal service • Mercury waste removal service • New ISO approved Mercury 'Amalgam Filtration Units • Bio-Hazard Sharps removal service

• OSHAfBloodbome Pathogen Training Finally, one easy method for total compliance from one source. For more information or to order choose from below:

E-mail: WWW.HCSTODAY.COM Website: WWW.HCSTODAY.COM Phone: 610-518-5299 Fax: 610-518-2995

VDSC RAFFLE II This year at the VDAAnnual Meeting, the VDSC held a raffle. Prizes were donated from several endorsed vendors.

The winners are listed below:

Dr. Fred Kessler of Richmond - 2004 VDA Dues donated by Sky Financial Solutions.

Dr. Thomas Ishorn of Chesapeake - Ping Putter donated by GE Medical Protective.

Dr. Vince Dougherty of Alexandria- Palm m500 Handheld donated by B&B Insurance Associates Inc.

Dr. Robert Dail of Hampton - $100 American Express Gift Cheque donated by LifeServers, Inc..

Dr. Paul Patterson of Manassas -Toshiba DVD Player do­nated by C & F Investment Services.

Dr. Donald L. Martin of Pulaski- Golf shirt, Hat, Towel, and a Dozen Titleist DT Distance Golf Balls donated by Paychex.

Dr. Larry D. Hensley of LaCrosse- Gift Basket donated by Anthem.

ATTENTION VDA ANTHEM HEALTH INSURANCE

POLICYHOLDERS

It has come to the attention of the Virginia Dental Services Corporation's that many Virginia Dental Association mem­bers are not receiving the Anthem Value Added Benefits outlined in the terms of our negotiated VDA contract with Anthem.

After researching this issue we found that many of the healthcare providers are not submitting your claims with the proper codes. In order to receive the 100% coverage for Preventive Care Services and Routine Well ness Benefits, then preventive care and routine wellness diagnosis and pro­cedure codes must be used. There may be confusion be­cause this benefit is not included with most health insur­ance policies. Therefore, please remind your physician not to code for a medical symptom and problem related visit which would be payable at less than 100%.

If you are enrolled in one of the VDAlAnthem health plans and have not received your allowed benefits, then please contact either the B&BNDSC Insurance Service Center at 877-832-9113 or your agent. Our agents at the Service Cen­ter will gladly assist in the resubmission of your claim to obtain all the Anthem Value Added Benefits negotiated for VDA members.

DENTx[g~~aRVICES I------Corporation-

Listed below are the endorsed products and services. Please support our efforts on your behalf to allow the Association to continue to provide the benefits neces­sary to constantly maintain and grow our member­ship.

+ B&B Insurance Associates, 877-832-9113 Various Types of Insurance (including endorsed Anthem)

+ C&F Investment Services, 888-453-2033 Investments, financial planning, management services

+ Dell,800-695-8133 Computers

+ GE Medical Protective, 800-344-1899 Malpractice Insurance

+ Healthcare Compliance Services, 610-518-5299 Waste services, OSHAlHIPAA compliance training

+ Hertz, 800-654-2200 Car Rental (CDP# 1220431)

+ I.C. System, 800-279-3511 Collections

+ JoS. A. Bank, 800-285-2265 Clothing

+ LifeServers, 866-543-3500 Automated External Defibrillators

+ MBNA,800-457-3714 Credit Card

+ Paychex, 800-729-2439 Payroll services

+ S&K Menswear - Visit VDA Website Clothing (W'NW.vadental.org)

+ Sky Financial Solutions, 800-340-7460 Practice & EqUipment Financing

+ SunTrust Merchant Services, 877-488-8454 Credit Card Processing

+ Top Quality Manufacturing, 800-483-8559 Gloves

+ WebMD,888-309-9784 Electronic claims processing

L VDSC PROUDLY PRESENTS OUR NEWEST ENDORSED VENDORS I~

Elise Woodling, Director of Marketing and Programs

Top Quality Manufacturing (TQM)

Top Quality Manufacturing is your full service examination glove VDSC end orsed vendor. To p Qua lity represents a full line of powdered and powder free latex and latex free examination gloves, all of which are provided to the membership at competitive pricing with no shipping or handling charges. All glove orders will also be shipped the same day the order is placed and delivery will be within two days of order placement. As a manufacturer, Top Quality is capable of strictly monitoring the quality and consistency of the product delivered. In addition, many of our products have both the ADA seal of Acceptance as well as the SMG seal. The SMG logo represents Standard Malaysian Glove which is a quality standard imposed by the Malaysian Rubber Glove Manufacturers.

TQM is the only glove company endorsed by the VDSC.

For more information about Top Quality Manufacturing, please call 800.483.8559.

JOS.A. BANK

JoS. A. Bank Clothiers specializes in Professional, Corporate Casual, and Casual men's clothing. VDA members may apply forthe JoS. A Bank Corporate Card and receive a 20% discount on all regularly priced merchandise. The discount is valid for in-store, catalog, and Internet orders.

To receive your free Corporate Card, simply visit the JoS. A. Bank store nearest you and request your card, or call toll free 800.285.2265. Remember to present your ADANDA membership card in order to receive the VDSC Corporate Card.

In Virginia JoS. A. Bank Stores are located in:

* Charlottesville - 434.244.0015 * Clarendon - 703.243.3097 * Fair Oaks - 703.352.6525 * Falls Church - 703.573.2800 * Fredericksburg - 540.786.9803 * McLean - 703.356.7767 * Pentagon City - 703.418.6214 * Reston - 703.834.711 0 * Richmond - 804.741.4346 * Roanoke - 540.776.3243 *Tysons-703.356.1198 * Virginia Beach - 757.425.0071

S & K MENSWEAR

S & K Menswear, America's Men's Store has over 240 locations across the United States. Offering a wide range of men's clothing from suits to outerwear, S & K Menswear is a complete men's clothier.

VDA Members will soon be able to download valuable discount coupons for S & K Menswear from the VDAwebsite, www.vadental.org, by visiting the VDA member section of the site. These coupons can be used at any S & K Menswear location or when shopping online. For more information, please visit the VDA website.

LlFESERVERS~I Lisa Fratkin, LifeServers

The Virginia Dental Services Corpora­tion has purchased a MEDTRONIC PHYSIO- CONTROL L1FEPAKAUTO­MATED EXTERNAL DEFIBRILLATOR (AED) for two reasons ... protecting the staff at the Virginia Dental Association's corporate office and as an additional safety precaution for the MOM's VE­HICLE which travels to remote locations in Virginia to provide dental care to those in need.

The unit they selected is the Lifepak 500 AED, an electronic device which ana­lyzes a person's heart rhythm, deter­mines if they are in cardiac arrest, tells the user what to do with voice and vi­sual prompts, and can be transported to different locations because it weighs only 9 pounds.

The new CR PLUS AED is available for dental offices, with a semi-automatic or "brand-new" automatic shock feature. Please call LifeServers, Inc., the VDSC Endorsed Vendor, at (804) 360-1217 for orderinq information.

LifePak 500 - Automated External Defibrilator

II

What's the reason for our

f:)SUCCESS •

We could give you j

Why is Delta Dental one of the leading and largest providers of dental care coverage

in Virginia? A major reason is the participation of 2400 of the finest dental care

providers in the state. Delta Dental was started by dentists, so it's only logical that

we understand what works best for patients and dental care providers alike.

At Delta Dental, our reputation is built on a tradition of success.

4 DELTA DENTALGt

DeltaDentalPlanof'Virginia 4818 Starkey Road Roanoke, Virginia 24014 1-800- 237-6060 www.de ltadentalva.corn

Richard Howard, The Foundations Company

The Virginia Dental Health Foundation is a 501(c) 3 public charity and this standing underthe tax code affords spe­cial benefits to our dentists. The Foundation's tax-exempt status under IRS law permits a dentist in the Com­monwealth of Virginia to use the Foun­dation to get a unique investment and tax- planning tool with benefits not avail­able from other sources. The Founda­tion has the same status under the tax code that the Cancer Society, Girl Scouts or a church or synagogue has. It also establishes a long-term funding mechanism forthe Foundation and will benefit dentists and dental health pro­grams in the future.

The dentist makes a gift to the Founda­tion and receives a tax deduction for the current year. The Foundation legally obligates itself to take this money and place it in an annuity for the dentist. Since the money goes through the Foundation-a 501(c) 3 charity-the annuity purchased becomes a "gift an­nuity" and a special vehicle under IRS law. The money is then sent from the Foundation to a major insurance com­pany where it goes into an annuity in the client's name. The company must have at least a financial rating of A+ Superior by A.M. Best. The insurance company then becomes a legal guar­antor of the income stream paid annu­ally to the dentist and/or his spouse. Very simply, the dentist gets to buy a tax-deductible annuity that is twice guaranteed with other tax advantages with a rate higher than a commercial annuity. The rate is higher because it is based on age and the Council on Gift Annuity rate chart and not commercial annuity rates.

The gift annuity has been in use in the United States for 160 years this year and is well recognized under IRS law. The first recorded gift annuity was is­sued in England in 1331, so it has a long history as a financial vehicle.

The younger dentist who does not need income now can defer taking the income by using the deferred annuity plan. He gets a current-year tax deduction with a legally guaranteed rate of return, usu­ally in excess of 9% and a retirement plan without expenses or need for ad­ministration. If the dentist waits 10 years to take the income he or she gets a 25% match of benefits, which increases the income coming out at retirement by 25%. There are no fees, charges, back­end loads or expenses to the dentist. When the dentist's spouse is the sec­ond income beneficiary, the money go­ing into the plan is outside the estate for estate and inheritance tax purposes. This means the dentist is doing some defacto estate planning without the at­tendant fees and is ultimately saving and additional 50% of the money con­tributed to the plan in estate taxes.

For the dentist who is approaching re­tirement and is considering retirement plan distributions, the Tax SmartAnnu­ity? has some definite tax, estate and planning advantages. It can also be funded with almost any asset such as, cash, appreciated securities-(avoids the 15% long term capital gains tax), variable annuities, mutual funds, land and variable life insurance. The taxable equivalent yield available through the immediate annuity including the tax deduction and the tax-free income is usually in excess of 10%.

To recapture the asset that is contrib­uted, the Foundation will assist the den­tist in setting up an Irrevocable Life In­surance Trust (lLlT). There are no fees to the dentist in this process. A small portion of the income (which is paid in advance each year) from the immedi­ate annuity is used to insure the den­tist for his/her life and at his/her demise, the full amount of the asset usedto fund the annuity comes back to the Trust for disbursement to the dentist's heirs tax­free, according to his or her directions to the Trust

The Care Act 2003 just passed the House by a vote of 408 to 13 and has previously passed the Senate by a vote of 95 to 5. It now goes to conference committee for final revision before go­ing to the President for signature. This bill is surely going to pass because it has broad bi-partisan support. This is a significant piece of legislation and will benefit those dentistswho are approach­ing age 70 and must take distributions from their retirement plans or those who are already taking distributions.

This legislation allows an individual to gift their IRA to a 501(c) 3 charity (The Virginia Dental Health Foundation) in exchange for a gift annuity without any taxes on the distribution. This means that the dentist will not pay any taxes when the money comes out of the IRA, either Federal or State and will save approximately 42% of their retirement monies in taxes. The money that goes to the Foundation will be put into a gift annuity that pays income for life based on the individual's age.

All that is needed to run individual tax deduction and income numbers is the name and birth date of the dentist and his or her spouse. To obtain an indi­vidual proposal and illustration, contact Mr. Richard Howard, President of The Foundations Company, at 1-800-692­6893 or email a request to sec170@bellsouth.net.

The Foundations Company also offers Accounts Receivable Financing for dentist's practices with a major bank loaning 100% of receivables and pro­tecting this asset in the process. The dentist turns his receivables into a re­tirement plan with tax advantages. Please indicate which program you are interested in when you respond

LEGISLATIVE UPDATE

As this article for the VDA JOURNAL is prepared, we are still in the mist of sort­ing out the upcoming November4th elec­tions. In reality, few seats are in play. If you ask each individual legislator, they obviously would disagree with that state­ment ifthey have opposition; but in most cases, the districts are in excellent shape for those incumbents that are seeking re-election.

With that said, we are glad to report that VADPAC has participated actively in key primary as well as general elections. A big "thank you" goes out to those indi­vidual VDA members who helped orga­nize local fundraisers in key districts all across the state.

Specifically, VADPAC participated in challenge fundraisers for the following individuals:

• Delegate H. Morgan Griffith, Salem • Delegate Phillip Hamilton, Newport

News • Speaker of the House William

Howell, Fredericksburg • Delegate W. Benny Keister, Dublin • Delegate Robert McDonnell, Vir­

ginia Beach • Senator Bill Bolling, Hanover

County • Senator John Chichester,

Fredericksburg • Senator Charles J. Colgan,

Manassas • Senator Edd Houck, Spotsylvania • Senator Benjamin Lambert, Rich­

mond • Senator Tommy Norment,

Williamsburg • Senator Russ Potts, Winchester

As you have heard said many times previously, Virginia is one of the most expensive states in which an individual can seek elective office. But, as a former member of the Senate used to say, "That's the price of two-party politics."

Chuck Duvall, VDA Lobbyist

Aside from those individuals who helped organize these challenge fundraisers, I would also like to thank each of you who participated in VADPAC overthe course of this past year. VADPAC has enjoyed continuing support from the VDA mem­bership and for that you should con­gratulate yourself. It is imperative that VADPAC stay healthy and stay in a position to assist legislators.

What lies ahead in the 2004 General Assembly? Unless some unforeseen situation develops, Republicans will still control the Virginia Senate as well as the House of Delegates. The showdown ahead will be over the budget. That's the case every even-numbered year, when a bUdget is proposed, but it will be even more significant in 2004.

Though Virginia finished the last fiscal year with a small surplus, budqet pro­jections are still tight and the demands on the budget continue to escalate. Education, public safety, Medicaid, transportation, the list goes on and on.

All of thiswill be debated against a back­ground of tax reform. A legislative com­mission is looking at ways to "modern­ize" our so-call agrarian-based tax sys­tem. The Governor has his own ideas. All of this will be put into play post No­vember 4th elections.

As far as the VDA and our 2004legisla­tive package, there are several key is­sues that we will need to address:

Dental School Preceptorship Program:

Legislation will be introduced at VDA's request to amend Virginia Dental Prac­tice Statutes permitting dental and den­tal hygiene to participate in preceptorships at private dental prac­tices.

Dental School Training Simulation Equipment Update:

Secure state revenue to assist with up­grades for dental simulation equipment at the Dental School.

Tax Reform:

There is a movement among certain leg­islators calling for a broadening of the Virginia Sales and Use Tax statute to include services. Dental care could be included underthe definition of services.

That issue has not gained broad sup­port in the legislature. Hopefully it will not, but we may have to call upon each of you to contact your legislator to see that such a bill is not enacted.

Peer Review:

VDA will be introducing legislation to allow for immunity for a Peer Review Program.

Medicaid Funding:

The hospitals and nursing homes have a major push with the General Assem­bly to increase Medicaid funding. They have done a good job of presenting in­formation as to why it is important that Virginia adopt health care as a core func­tion of government. With the descrip­tion of the budget listed above, it re­mains to be seen whether Medicaid will indeed receive any additional funding in 2004.

Again, we want to extend our gratitude to each of you for your participation in VADPACandfor your continued involve­ment in the legislative process. Stay tuned. We may be calling on you as the cold weather gets closer and the legislators truck to Richmond for the upcoming session.

[ STUDENT NEWS

Leslie Pinkston, Director of Membership

On July 31st, Dr. Klima, Clay Weisberg and Rob Eye met with the incoming dental students during Freshman Ori­entation. They each spoke about the VDA and ASDA and invited all students to the Annual Meeting held in Septem­ber. The New Dentist Committee spon­sored a welcome bag for each student, which included a steel coffee mug.

On August 15th, Dr. Klima and family, Dr. Tom Cooke and wife Jill, and Dr. Elizabeth Reynolds all attended and spoke briefly to the students during the first VCU School of Dentistry Annual Kickoff Picnic. The VDA helped spon­sor the cost of the picnic. Cameron Qualye did a great job organizing this event; we thank him for including the VDA. There was lots of food, music and two pie eating contest!

On September 5th, the VDA sponsored a Smart/Start Program for the first year

dental students. Dr.Wilson Jewell, 16th District Rep from Wilmington, NC and Dr. Tim Golian came and spoke to the students. A financial power point pre­sentation was made, explaining among many things, what money borrowed to­day cost 10 years from now. Dr. Golian told a true story on the financial impact the decisions the students make today have on their choices and opportunities in their future.

On September 9th, the VDA met with residents from all School of Dentistry post-graduate programs at the Alumni House. The VDA distributed bags that included ADA Graduate Student appli­cations, as well as the VDA steel cof­fee mugs. The residents were invited to participate in VDA events, and were informedaboutthe Dinnerand Leam and other programs sponsored by the VDA.

On September 13th, during the Annual

Meeting, the VDA sponsored the Presi­dents Lunch for all dental students. Dr. Klima, Dr. Dickinson, Dr. Cooke, Dr. Reynolds and Dr.DeGinder all attended. It was great seeing all the dental stu­dents attending the 2003 Annual Meet­ing!

On September 15th, the VDA spon­sored its first Dinner and Learn series for the new academic year for all dental students. Karin Guye, from Virginia Primary Care, brought dinner from the Olive Garden and spoke to the students about positions available across the state in the medically underserved ar­eas.

The New Dentist Committee sponsored the purchase of business cards for all 3rd year dental students. The students seemed very pleased and all signed a thank you card expressing their appre­ciation.

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Customized solutions and resources for dentists, by dentists to maximize performance in these, and other important areas:

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Leslie Pinkston, Director of Membership

RICHMOND DENTAL SOCIETY

Dr. Janis Stein-Fuller received her D.o. S. from University of Tennessee College of Dentistry in Memphis. Dr. Stein-Fuller is currently practicing in Midlothian, VA.

Dr. Elizabeth T. Nance received her DD.S. from the VCUI MCV School of Dentistry. Dr. Nance is currently teaching and practicing at the MCVNCU School of Dentistry Faculty Practice.

Dr. Frank Lee Angus, Jr. received his DD.S. from MCVNCU School of Dentistry in May 2003. Dr. Angus is practicing in Midlothian, VA, with his father Dr. FrankAngus, Sr.

Dr. Cheryl Billingsley received her D.D.S. from MCVNCU School of Dentistry. Dr. Billingsley is currently practicing in Richmond, VA.

Dr.KimberlyBoyle received her DD.S. from MCVNCU School of Dentistry. Dr. Boyle completed her AEGD Program at the University of Maryland. Dr. Boyle is currently practicing in Mechanicsville, VA.

Dr. Amy Baluyut received her D.D.S. from the University of Kentucky. Dr. Baluyut completed her 2-year GPR at the University of Virginia. Dr. Baluyut is currently practicing in Ashland, VA.

Dr. Christopher Cios received his DD.S. from MCVNCU School of Dentistry. Dr. Cios is currently practicing in Midlothian, VA.

Dr.Gloria Femandez-Wardreceived her DD.S. from the VCUI MeV School of Dentistry in May of 03. Dr. Fernandez-Ward completed an Advanced Education Program in Periodontal Prosthesis and has a MSD in Periodontal Prosthesis. Dr. Ward is currently on faculty at VCU/MCV School of Den­tistry.

Dr. Tegwyn Hughes received her DD.S. from the University of Nebraska Medical Center. She also received a certificate in Pediatric Dentistry from the University of North Carolina­Chapel Hill. Dr. Hughes was awarded her PHD from Univer­sity NC in Public Health. Dr. Hughes is currently a taculty member at VCU/MCV School of Dentistry.

Dr.Audra Jones received her DD.S. from Howard University School of Dentistry. Dr. Jones is currently practicing in Rich­mond, VA.

Dr. Jason Lipscomb received his DD.S. from VCU/MCV School of Dentistry. He is currently practicing in Fredericksburg, VA.

TIDEWATER DENTAL ASSOCIATION

Dr. Rita Frazier received her D.D.S. from West Virginia Uni­versity. Dr. Frazier is currently practicing in Norfolk, VA.

Dr. Barry Orman received his DD.S. from the University of Colorado. Dr. Orman is currently practicing in Norfolk, VA.

Dr.RichardGrundyreceived hisDD.S. from VCU/MCV School of Dentistry. He completed his GPR at NC-East Carolina University. Dr. Grundy is currently practicing in Virginia Beach, VA.

Dr. Carrie N Clarkson graduated in May 2003 with her DD.S. from Case Westem University. Dr. Clarkson is currently prac­ticing in Virginia Beach, VA.

Dr. Dean Elattrache received his D.D.S. from the University of Pittsburgh School of Dentistry. He completed his AEGD from UCSF. He then went to West Virginia University where he completed his Endodontic residency and received his MS in Endontonics. Dr. Elattrache is currently practicing in Virginia Beach, VA.

Dr. Patricia Lott received her D.D.S. from VCU/MCV School of Dentistry. Dr. Lott is currently practicing in Norfolk, VA.

Dr. William 0 Tabor, Jr. received his D.D.S. from Louisiana State University. Dr. Tabor is currently practicing in Norfolk, VA.

Dr. Sheila Vacendak received her D.D.S. from VCU/MCV School of Dentistry. Dr. Vacendak also received her GPR from VCU/MCV School of Dentistry. Dr. Vacendak is cur­rently practicing in Virginia Beach, VA.

PENINSULA DENTAL ASSOCIATION

Dr. Phillip Milton Cook, Jr. graduated from VCU/MCV School of Dentistry in May 2003. Dr. Cook is currently practicing in Smithfield, VA at Smithfield Family Dentistry.

Dr. Golnaz Miamee received her DD.S. from VCU/MCV School of Dentistry in May 2003. Dr. Golnaz is currently practicing in Yorktown, VA.

SOUTHSIDE DENTAL ASSOCIATION

Dr. Steven A Castro received his DD.S. from VCUlMCV School of Dentistry. He is currently practicing dentistry in Chester, VA.

Dr. Ronald E. Terry received his DD.S. from the University of Medicine and Dentistry New Jersey -New Jersey Dental ~,..h ........1 IIr Tprrv i~ currentlv oracticino in Ettrick, VA.

Dr. Benjamin 1. Overstreet received his D.O. S. from VCUI MCV School of Dentistry. Dr. Overstreet also received his Certificate in Periodontics and Masters in Science from VCUI MCV School of Dentistry. Dr. Overstreet is currently work­ing in Richmond, VA.

Dr.Jeffrey David Rogers received his D.D.S. from VCU/MCV School of Dentistry. Dr. Rogers received his Certificate in Periodontics from State University of New York at Buffalo. Dr. Rogers is currently practicing at MCV Dental Faculty Practice.

Dr. Neil Snow received his D.D.S. from VCU/MCV School of Dentistry. Dr. Snow received hisAEGD Certificate from UAB School of Dentistry. Dr. Snow is currently practicing in Rich­mond, VA.

Dr. John Unkel received his D.D.S. from Northwestern. Dr. Unkel received his Certificate in Pediatrics from Children's Hospital Pittsburgh/University of Pittsburgh. Dr. Unkel is currently practicing at MCV Dental Faculty Practice.

SOUTHWEST DENTAL SOCIETY

Dr. Mark Raymond received his D.D.S from the University of Kentucky College of Dentistry in May 2003. Dr. Raymond is currently practicing in Bristol, VA.

SHENANDOAH VALLEY DENTAL ASSOCIA­TION

Dr. Christie Hagert received her D.D.S. from the University of Maryland. She completed herAEGD at VCU/MCV School of Dentistry in Dental Education. Dr. Hagert is currently practicing in Charlottesville, with Viglione, Haines and As­sociates.

Dr. Joel Evans received his D.D.S. from VCU/MCV School of Dentistry. Dr. Evans is currently practicing in Chantilly, VA.

Dr. Merinda Hamblin received her D.M.D. from the Univer­sity of Kentucky. Dr. Hamblin is currently practicing in Bridgewater, VA.

Dr. Karrie N. Howard received her D.D.S. from VCU/I\IICV School of Dentistry in 2002. Dr. Howard is currently practic­ing in Lovettsville, VA.

Dr. Benjamin Guy Hughes received his D.D.S. from VCUI MCV School of Dentistry. Dr. Hughes completed a two­year residency program in General Practice from Wake Forest University. Dr. Hughes is currently practicing in Warrenton, VA.

Dr. Donald E. Rellins, Jr. received his D.D.S. from VCUI MCV School of Dentistry. Dr. Rellins also completed his MAGD and FAGD at VCU/MCV School of Dentistry. Dr. Rellins is currently practicing in Broadway, VA.

Dr. Erik Lee sutt received his D.D.S. from the University of

Kentucky. Dr. Sutt is currently practicing in Harrsionburg, VA, with Dr. Stephen Brown.

Dr. Janice Usnick received her D.M.D. from the Medical College of Georgia. Dr. Usnick also did her GPR at the Medical College of Georgia. Dr. Usnick is currently practic­ing in Elkton, VA with Dr. Jon Trabosh.

NORTHERN VIRGINIA DENTAL SOCIETY

Dr. DouglasAlderman received his D.D.S. from Ohio State University. He is currently practicing in Reston, VA.

Dr. Wahn Khang received his D.D.S. from Tufts School of Dentistry. Dr. Khang then went to the University of l\IIaryland and received a certificate in Periodontics. Dr. Khang is cur­rently practicing in Reston, VA.

Dr. Jamie Kim received her D.D.S. from the University of Maryland at Baltimore. Dr. Kim is currently practicing in Fairfax, VA.

Dr.Annah Phung received her D.D.S. from VCU/MCV School of Dentistry in May 2003. Dr. Phung is currently practicing in Arlington, VA.

Dr. Scott Synnott received his D.D.S. from VCU/MCV School of Dentistry. Dr. Synnott is currently practicing in Reston, VA, at the Dental Arts Center.

Dr. Kevin Truong received his D.D.S. from VCU/MCV School of Dentistry in May 2003.

Dr. Anthony Black received his D.D.S. from Howard Univer­sity in May 2003. Dr. Howard is currently practicing in Chantilly with Dr. William Babington.

Dr.ShadiShareghireceivedher D.D.S.from VCU/MCV School of Dentistry in May 2003.

Dr. Faline Phucas received herD.D.S. from VCU/MCV School of Dentistry In May 2003. Dr. Phucas is currently practicing in Gainsville , VA with Dr. Thea Batistas and Associates.

Dr. Shahram Sabet received his D.D.S. from Shadid Beheshti­Tehran, Iran in 1996. Dr. Sabet received his AGO from Howard University in 2001. Dr. Sabet is currently practicing in Spotslvania, VA, with Dr. M. Alayssami.

Dr. Gonzalo Barrantes received his D.D.S. from Universidad Peruana Cayetano Heredua-Peru. Dr. Barrantes completed a two-year residency program in Advanced Education in General Dentistry in June 2003. Dr. Barrantes is currently practicing in Gainsville, VA with Dr. Robert Leipzig.

Dr. John Jones, III received his D.D.S. from Howard Univer­sity. He received his Certificate in Orthodontics from Georgetown University. Dr. Jones is currently practicing in Sterling, VA.

Dr. Tuan D. Pham received his D.M.D. from Temple Univer­c:it\f nr Dh':lrY\ i e- "".,.-.- .......... +1., ............. ,...4: ....:~_ :- ,......I: __~_-- .........

lor. Karen Runey McPherson received her D.D.S. from ;the Medical University of South Carolina. Dr. McPherson completed her AEGD at Camp Pendelton, CA. Dr. McPherson is currently practicing in Fredericksburg, VA.

Dr. Zahra Kavianpour received her DD.S. from the Uni­versity of Maryland. Dr. Kavianpour is currently practic­ing in Sterling, VA.

Dr. Arjang Rooufinia graduated from VCU/MCV School of Dentistry in May of 2003. Dr. Rooufinia is currently residing in Springfield, VA.

Dr. Risa Bastien graduated from University of Missouri Kansas City School of Dentistry. Dr. Bastien is currently residing in Herndon, VA.

Dr. Christine Gathecha graduated from LVOV State Den­tal School and Howard University. Dr.Gathecha received her AGO Certificate and AGO Degree from the Univer­sity of Maryland. Dr. Gathecha is currently practicing in Fairfax, VA, with Drs. Leipzig and Geldart, PC.

Dr. Faranak Khasraghi graduated from the University of Pennsylvania in May 2003. Dr. Faranak is currently prac­ticing in Burke, VA, with Dr. Jones.

Dr. Niloofar Mofakhami received her D.D.S. from VCUI MCV School of Dentistry in 2001. Dr. Mofakhami re­ceived her Certificate in Pediatric Dentistry from Children's National Medical Center, in Washington, DC. Dr. Mofakhami is currently practicing in McLean, VA, with Dr. Michael and Chris Ternisky.

Dr. Monica Neshat received her D.D.S. from VCU/MCV School of Dentistry in May 2003. Dr. Neshat is currently practicing in Sterling, VA, with Ruocco Family Dentistry.

Dr. Tracey Nguyen received her D.D.S. from VCU/MCV School of Dentistry. Dr. Nguyen is currently practicing in Annandale, VA, with Dr. Trung D. Ho.

or.xeera Gokli appointed to the Virginia Board of Dentistry

Gover or Mark Warner has appointed Dr. Meera Gokli to serve as a mem­ber of the Virginia Board of Dentistry until 2007.Dr. Gokli practices pediat­ric dentistry in Richmond, VA. Con­gratulations Dr.Gokli and thank you for your service!

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CONTINUING EDUCATION ~I II]

NOVEMBER 2003

November7 Piedmont (5) Dr. Joe Blase Pearls For Your Practice Wyndham Roanoke

November 14 Tidewater (1) Jennifer de St Georges Scheduling For Success Holiday Inn Select - Norfolk

November 20 Richmond (4) Dr Norman Marks The Paperless Office Capital Club - Richmond

November 21 Richmond (4) Dr. Steven Lewis Osseointegration. A Restorative Update Sheraton Park South - Richmond

JANUARY 2004

January 15 Richmond (4) Dr. J. Gary Maynard, Jr. Periodontics Today Capital Club - Richmond

January 23 Richmond (4) Annette Ashley Linder, RDH How to Reduce Failures and Cancella­tions - Unhealthy for the Patient, Unhealthy for the Practice Sheraton Park South - Richmond

FEBRUARY 2004

February 6 Richmond (4) Dr Joe Steven, Jr Ettictent-aontic« - Efficiency in the Dental Office Sheraton Park South - Richmond

February 19 Richmond (4) Dr Frank luorno HIPAA Update Capital Club - Richmond

MARCH 2004

March 18 Richmond (4) Dr J. Ross McClung Head and Neck Anatomy

Capital Club - Richmond

APRIL 2004

April 2 Piedmont (5) Topic and Speaker TBD Holiday Inn Select, Lynchburg

April2 Richmond (4) Dr. Kit Weathers, Jr Taking The Stress and Mystery Out of En­dodontics Sheraton Park South - Richmond

April15 Richmond (4) Dr. James F Nelson Implants Past and Present Capital Club - Richmond

Component CE Programs - For registration information, contact the appropriate person below:

Component I (Tidewater) Component II (Peninsula) Component III (Southside) Component IV (Richmond) Component V (Piedmont) Component VI (Southwest) Component VII (Shenandoah) Component VIII (Northern VA)

Virginia Donne (Executive Secretary) Kathy Harris (Executive Secretary) Dr. Samuel Galstan (President) Linda Simon (Executive Secretary) Ann Gillespie (Executive Secretary) Sonya Ferris (Executive Secretary) Patricia Fuller (Executive Secretary) Susann W. Hamilton (Executive Director)

(757) 491-4626 (757) 565-6564 (804) 796-1915 (804) 379-2534 (540) 732-3789 (276) 628-4934 (804) 985-1939 (703) 642-5297

VAGD Programs - please contact Frances Kimbrough (Executive Secretary) at 804-320-8803.

VCU School of Dentistrv - please contact Martha Clements at 804-828-0869. www.dentistry.vcu.edu/ce/courses.shtml

VCU School of Medicine (Anatomy Dept) - please contact Dr. Hugo Seibel at 804-828-9791.

VAE - please contact Dr. Timothy J. Golian at 703-273-8798.

VSOMS and VAO - please contact Nicole Pugar at 804-261-1610.

AIDA C·E·R.·P CONTINUING EDUCATION ~rnoN PROGRAM

The VDA IS recognized as a cer-nf led sponsor of contmumq dental education by both the ADACERP and the Academy of General Dentistry.

MEETINGS & EVENTS[I II]

January 22-25, 2004 VDA January Committee Meetings Sheraton Park South - Richmond, VA

June 10-13, 2004 VDA June Committee Meetings The Cavalier Hotel - VA Beach. VA

Sept. 8-12, 2004 VDA Annual Meeting Waterside Marriott - Norfolk, VA

Sept. 14-18, 2005 VDA Annual Meeting Marriott - Richmond. VA

September 13-17, 2006 VDA Annual Meeting Hotel Roanoke & Conference Center

June 16 & 17, 2007 VDAAnnual Meeting (Exhibits. CE & Social) \/Vaters/de Marriott - Norfolk, VA

Implant Dentistry. This will be a great course for the whole staff - everyone needs to understand implants. On Janu­ary 23, 2004 Ms. Annette Lender, R.D.H.will explain how to "SuperCharge Your Hygiene Department". On Febru­ary 6,2004 Dr.Joe Steven of Kisco Den­tal will speak about the dentistry we do every day, the bread and butter treat­ment our patients need. Another great CE forthe whole staff will be onApril2, 2004 when Dr. Kit Weathers returns for an Endo Update - he brings the latest technology to make this a highly enter­taining and tremendously informative lecture.

That is it for now - hope this finds all of you well- see you soon!

Component V Piedmont

Dr. Lori Snidow, Editor

No News To Report

Component VI Southwest

Dr. Robert G. Schuster, Editor

No News To Report

Component VII Shenandoah Valley

Dr. Mac Garrison, Editor

No News To Report

Component VIII Northern Virginia

Dr. Scott McQuiston, Editor

Northern Virginia started up its engines with our annual business meeting in September. Elections for offices/chairs were conducted with the following re­sults; Vice-president-Frank Portell, Peer Review Chair-Kirk Norbo, Councilor to the VDA-AI Rizkalla, Elected Executive Committee Member-Pat Dolan, and Executive Committee At-Large Member Under 40-David Palmieri. Best wishes for a great year! Bruce Butterfield from the Forbes Group spoke to the mem­bership at the annual meeting on a most interesting subject entitled, "The Gen­erational Joust". A most apropos sub­ject as new members and existing mem­bers intermingled. While on this sub­ject, as Iwas leaving the business meet­ing with a group of colleagues I turned and noticed a newly inducted member (as was clearly stated on the red name badge) walking alone. Behind her, there was another group of colleagues. I don't know how anyone in our group would have noticed her unless we had eyes in the back of our heads or even how the group of people behind her could of known she was a new member unless she was wearing her name tag in the back like a license plate. Nevertheless, remembering how lonely it was to be in new surroundings and not knowing any­one I invited her to join in our group "Walking the Fairview Marriot Mile, (to the parking deck)". I met 3 new mem­bers out of 25 inducted that night. How many do you meet on new member in­duction night?

One of the biggest topics to date is the funding of additional students to the l\Iorthern Virginia Community College dental hygiene program. Given the fact that there is a shortage of hygienists in this area it's a seemingly worthwhile venture. The bestway to overcome short supply is to kick up production. Al­though the college should be ultimately responsible to the community for train­ing adequate numbers of hygienists, it

the state. Our component is in the pro­cess of discussing ways in which we can increase the number of first year hygiene students.

September was NVDS member appre­ciation month. Throughout the month of September members were encour­aged to stop by the central office, meet the staff and pick up a token of appre­ciation for there continued support of organized dentistry. Dr. Kenneth Haggerty, one of our most distinguished members was given a Life Time AchievementAward by our component. Dr. Haggerty has a list of credentials that are too numerous to list here but hasserved dentistry,the community and our component for over 40 years. Con­gratulations and thank you Dr. Haggerty, you are an inspiration to us all. Dr. Brendan stack was given a Life Time Achievement Award by Tufts University Orofacial Pain Society for his contribu­tions to TMJ dysfunction and craniofa­cial pain. The National Academy of Practice has elected Dr. David Cantor as a distinguished practitioner member. Well done! In appointments, governor Mark Warner appointed Dr Paul Zimmet to a four-year term on the Virginia Board of Dentistry and Dr. Joan Gillespie was appointed to the ADA Council for Ac­creditation. The stars are out tonight!

Our thoughts and prayers go out to our Southern colleagues who have endured the fury of Isabel.

~II ALLIANCE NEWS

~~~~~~~~~~~~;;;;;;;;;;;;~

Shirley S. lVIeade, President

The Virginia Dental Alliance enjoyed the outings and camaraderie of the Virginia State Meeting in Richmond. There, I was installed as your newAlliance Presi­dent for an office term of two years. am most grateful and most privileged to have been installed by our national AADA President Jocelyn Lance, who was present with us as our special guest atthe Richmond meeting. Jocelyn is of course no stranger to us, but we are so proud of her accomplishments asAADA President and were glad to have her

I

cial thank you is extended to our im­mediate past-president,Barbara Yandle. Barbara has spent the past two years representing the Virginia Alliance, and we greatly appreciate the time and com­mitment she has devoted to her job.

By the time you read this, the AADA Annual Session in San Francisco will have taken place. There Jocelyn Lance will step down as President, and Jerilyn Bird from Florida will be installed as our new AADA President. Jocelyn will be honored on Friday, October 24th at a Presidents' Reception sponsored by MBNA in the Renaissance Parc Hotel Ballroom. Jim will certainly be glad to have Jocelyn back home in Richmond after her year of travels. Jocelyn has been an excellent ambassador for the Alliance and for organized dentistry throughout the year. She will be a hard act to follow, but her leadership and or­ganizational skills will certainly be of benefit to Jerilyn. Thank you, Jocelyn, for a jobwell done!

The Virginia Alliance was the recipient of one award at the AADA annual meet­ing in San Francisco for our participa­tion in the Legislator Dental Care Kit Distribution Program. Plans are now underway for our participation in this same project during the VDA Legisla­tive Day to be held on Friday, January 23, 2004. Barbara Yandle will once again serve as our Legislative Chairman for this project, but several volunteers are needed to help visit the legislators on this day and distribute our kits and apples. Please mark this date on your calendars and join us in Richmond that morning. Let Barbara know that you are willing to assist and to participate in this day of advocacy for dentistry.

The Virginia Alliance Executive Board will meet the following day, Saturday, January 24, 2004 for our mid-winter board meeting. Please let Brenda Gor­don, our Philanthropy Chairman, know of any special projects or programs of which you are aware that could benefit by some amount of funding by the AVDA It is at that meeting that we will considerdisbursement of the monies set aside for philanthropy for this fiscal year. At this meeting we will also be making final plans for our participation in the AADA LeadershipConference which will

be held February 26 - 28,2004 in Salt Lake City, Utah. I strongly encourage you to consider attending. AADA/ADA Grants of up to $600 are available to first-time attendees.

There is a lot to look forward to in the coming year! I look forward to the privi­lege of serving as your state president.

~-------

Dear Members of the Virginia Alliance,

It has been a wonderful experience this year representing the Alliance as your president. Without your support as friends and fellow alliance members I would not have had this chance to ex­perience this amazing year.

I will have managed to visit states from California to Massachusetts, Florida to Washington State, sugary beaches of the Gulf Shores in Alabama to 11,000' peaks in Wyoming, with other stops at the Pennsylvania, North Carolina, Geor­gia, Kentucky, Tennessee, Ohio, Indi­ana, Illinois, Oklahoma and Texas An­nual Sessions but the best will be home in Virginia in September.

Conferences with the American Student Dental Association (Philadelphia), New DentistCommittee (Baltimore),ADA DC Leadership and Well-Being Institute in Chicago were adjunct trips and hope­fully beneficial to ourgrowth. I have been given the opportunity to talk about our Alliance wherever I have been and the dentists have been most responsive to the message. I am very pleased to an­nounce the expansion of AADA that will include the affiliation of a new constitu­ent group in Wyoming. Another state has plans to follow along soon.

Our own spring leadership Conference in Lincoln, Nebraska was a huge suc­cess as noted in the last issue of Key (also check it out on www.AllianceADAorg) and I look for­ward to a terrificAnnual Session in San Francisco and hope to see many of you there. I would like to extend a special presidential invitation to all of you who plan to attend this meeting to come to the AADA Reception on Friday, Octo­ber 24,7 - 9 in the ballroom at the Parc

Most of all I do hope that the Virginia Meeting will bring you to the Marriott and new Richmond Convention Center in September. Barbara Yandle has been a joy to have as AVDA president these past two years and I have felt honored to have her represent our state. I am so proud to be installing Shirley Meade as new AVDA President and look to you for support of her leadership.

ARDS president Dr.Anne Adams is the VDA Local Arrangements Chairman. Anne and I have had full plates this year and asARDS Program Chairman I hope our Richmond members will understand the inactivity of our group of late and do look forward to putting a fresh face on our alliance this coming year. I want to extend special thanks to Anne and Maureen Hunt for holding the positions of Richmond president and treasurer for much longer than they expected and we all appreciate what you have done.

In the latest VDA Journal is a formal let­ter of gratitude to the AVDA and VDA who graciously hosted my Incoming President's Reception in New Orleans, which was exquisitely arranged by Sandy Parks with Barbara Yandle and Shirley Meade.Aspecial thank you dear friends! It was an incredible, wonderful, well-attended event and I savored every moment of it.

I thank you all for giving me this plat­form to support the dental family and chance to blatantly enjoy so much of America!

Jocelyn Lance, President Alliance of the American Dental Asso­ciation Richmond, Virginia

VAE NEWS JI] Dr. Timothy J Golian, President

No News To Report

~I PUBLIC HEALTH NOTES I) Dr. Karen C. Day Dir. Division of Dental Health

Dr. Donald G. Crabtree Dr. Don Crabtree has served as an As­sistant Professor in the Department of Prosthodontics since 1974. He earned his DDS ('66) at Northwestern Univer­sity School of Dentistry and completed his prosthodontic training at the Veter­ans Administration Wadsworth Hospi­tal in Los Angeles, CA. Dr. Crabtree most recently served as the Course Di­rector for the Complete Denture Pros­thodontics. In addition to his academic commitments, Dr. Crabtree dedicated time to st. Joseph's Home where he provided dental care forthe elderly. Dr. Crabtree is best known for his commit­ment to the students' education in re­movable prosthodontics. He will con­tinue to serve as a part-time faculty member in the Department of Prosth­odontics.

Dr. Frank Farrington Dr. Frank Farrington served as Chair­man of the Department of Pediatric Den­tistry from July 1977 - December 2002 and was promoted to Full Professor in December 2002. Dr. Farrington at­tended Marquette University were he completed his DDS ('65) and a Master of Science in Anatomy ('69) and a Cer­tificate in Pedodontics ('69). He has been very active in the Southeastern Society of Pediatric Dentistry having held various elected positions since 1983 and currently serving as the Ex­ecutive Director. He has also been a member of numerous other professional societies including the American Acad­emy of Pediatric Dentistry, American Association of Dental Research, the American Dental Education Associa­tion, American Association of Public Health Dentistry, and theAmerican So­ciety of Dentistry for Children. Dr. Farrington has also served on state, regional and national associations in­cluding FAMIS ProviderAdvisory Com­mittee for the Virginia Department of Medical Assistance Services, the VDA's Child Abuse Coalition, and the Medic­aid Dental Advisory Committee and the National Governors Association Policy Academy on Children's Oral Health. He has conducted numerous presenta­tions at the state, national and interna­tionallevel and has conducted research and published extensively. Dr. Farrinaton is best known for his com­

area of Pediatric Dentistry. He will con­tinue to teach part-time in the Depart­ment of Pediatric Dentistry.

Dr. James E. Hardigan Dr. James Hardigan has served as the Assistant Dean and Associate Dean for AdministrativeAffairssince 1980 andthe President of the Dental Faculty Prac­tice Association since 1976. Dr. Hardigan received his BS ('68) and Mas­ters in Business Administration ('70) from Northeastern University and com­pleted his PhD in Organizational Behav­ior ('75) at Cornell University. He has served as a coursedirector for the Prac­tice Administration course since 1976. Dr. Hardigan has been very active on a national level having served as a con­sultant forthe ADA's Commission on Dental Accreditation and the National Councilor for the American Dental Education Association's Section on Business and Financial Administra­tion since 1994. He has conducted numerous national presentations on fi­nancial issues impacting dental educa­tion and the practice of dentistry. Dr. Hardigan is best known for advising den­tal students and private practitioners on practice transitions. Dr. Hardigan plans to begin a new career as a starter on the first tee at the Venetian Golf Course in Venice, Florida.

Dr. Walter G. Harrington Dr. Gerry Harrington has been a mem­ber of the Department of General Prac­tice since 1975. He received his DDS ('69)from CaseWestem ReserveSchool of Dentistry. In addition to serving as the Director of the Preclinical Curricu­lum, Dr. Harrington has served as the Course Director for the Preclinical Lec­ture and Laboratory Operative course. Dr.Harrington is best known for his com­mitment to promoting the current sci­ence of operative dentistry in the cur­riculum. Dr. Harrington will continue to serve as a part-time faculty member in the Department of General Practice.

Dr. Art P. Mourino Dr.Art Mourino has served as the Post­graduate Director of Pediatric Dentistry since 1976. He reactivated the program that had been inactivated in 1968. He earned his DDS ('72) at Georgetown 11_:.• :..... ,...._'- __ 1 _.r""' __ .L:_"'_. __ -.I _

pleted an MSD in Pediatric Dentistry ('74) at Indiana University and Board Certified in 1981. He has served as a consultant for the Headstart Dental Pro­grams under the Department of Health, EducationandWelfare andforthe ADA's Commission on Dental Accreditation for Postgraduate Programs. He has been actively involved with Delta Sigma Delta Dental Fratemity having served as the faculty advisor since 1975 and as the Supreme Grand Master in 1995-96. Dr. Mourino served as a member and chair of the American Board of Pediat­ric Dentistry in the role as an examiner of pediatric dentists for board certifica­tion. Dr. Mourino is best known for his commitment to the needs of the spe­cial patients and the first to provide re­storative treatment in an operating room in the metro Richmond area. Dr. Mourino will continue to serve as a part­time faculty member in the Department of Pediatric Dentistry.

Dr. James H. Revere Dr. James Revere began his tenure at the School of Dentistry in 1968 as an instructor in the Department of Prosth­odontics and upon retirement was serv­ing as the Executive Associate Dean for Extemal Affairs. Dr.Revere received his DDS ('65) and Certificate in Orth­odontics ('89) from the VCU School of Dentistry. Dr. Revere is the consum­mate administrator having served as the Assistant Dean for Student Affairs, the Associate Dean for Clinical Affairs, the Executive Associate Dean forAcademic Affairs, and Acting Dean. He most re­cently received the Harry Lyons Out­standing Alumni Award of the MCV Alumni Association. He has served on numerous national, state and university committees. Dr. Revere is best known for his commitment to his leadership roles and longstanding service to the School of Dentistry and the advance­ment of information technology within the school. Dr. Revere has agreed to once again serve as Assistant Dean for Admissions on an interim basis.

Dr. John E. Ward Dr. John Ward has been a member of the Department of Prosthodontics since 1973. He received his DDS ('66) and MSD in Prosthodontics ('78) from Indi­!1n!1 I Ini\l~rcihl ~("'hl"\r" nf r"'\Antictnl r"'\r

Ward served as the Course Director for the Preclinical Removable Partial Den­ture course and the Prosthodontic Di­agnosis and Treatment Planning course. He is a member of the Ameri­can Board and American College of Prosthodontics and has served as the SecretaryfTreasurerforthe Virginia Sec­tion of the College. Dr. Ward is best known for his commitment to the indi­vidual student and their education in removable prosthodontics. Dr. Ward is practicing part-time in one of Dr. Baxter Perkinson's offices and plans to spend more time with his grandchildren.

From left to right - Dr. Frank Farrington, Dr. Jim Hardigan, and Dr. Jim Butler

From left to right - Dr. Art Mourino, Dr. Marshall Brownstein, Dr. Don Crabtree, Dr. Jim Revere, and Dr. Gerry Harrington

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classified ads Classified advertising rates are $40 for up to 30 words. Addi­tional words .25 each. The classified advertisement will be in the VDA Journal and on the VDA Website ­www.vadental.org. It will remain in the Journal for one issue and on the website for a quarter (3 months) unless renewed. All advertisements must be prepaid and cannot be accepted by phone. Faxed advertisements must include credit card information. Checks should be payable to the Virginia Dental Association. The closing dates for all copy will be the 1st of January, April, July, October. After the dead­line closes, the Joumal cannot cancel previously ordered ads. This deadline is firm. As a membership service, ads are restricted to VDA and ADA members unless employment or continuing education related. Advertising copy must be type­written and sent to: Journal & Website Classified Depart­ment, Virginia Dental Association, 7525 Staples Mill Rd., Richmond, VA 23228 or fax (804) 261-1660.

The Virginia Dental Association reserves the right to edit copy or reject any classified ad and does not as­sume liability for the contents of classified advertising.

PRACTICES FOR SALE Williamsburg: #7008, Gross $233,387; 4.5 days, 3 operatories; 1200 sq. ft. office space, assistant, receptionist, condo office for sale with practice in professional park, Excel­lent potential. 100% financing available. Winchester Area: #7042, Gross $254,639; 4.5 days, 3 operatories; 1200 sq. ft. office space, assistant, hygienist (pt), receptionist, Excellent potential, close to D.C., 100% fi­nancing available. Tappahannock Area: #7077, Gross $265,089; 3 days, 2 operatories; 850 sq. ft. office space, assistant (pt), reception­ist (pt) Boat, sail, and grow with the beautiful people in the Northern Neck. Room for expansion., 100% financing available. Hampton #7007, Gross $406,640; 5 days, 3 operatories; 1600 sq. ft. office space, assistant, bookkeeper (pt), office manager, 3 additional plumbed but unequipped operatories, 100% fi­nancing available. Richmond: #7006, Gross $146,094; 4 days, 30peratories; 750 sq ft. office space, assistant (pt), receptionist (pt), Excel­lent merger opportunity, 100% financing available. Northern #7035, Gross $608,006; 5 days, 5 operatories; 3700 sq ft. office space, assistant, additional plumbed but un­equipped operatory, 100% financing available. Danville Area: #7018, Gross $310,365; 3.5 days, 4 operatories, 2150 sq. ft. office space, assistant (ft), assistant (pt), office manager; Beautiful office, large lot, computer sys­tem, Excellent potential, 100% financing available. Hampton: #8107 Gross $743,949; 4 days; 6 operatories; 2,400 sq ft office space; office manager, bookkeeper, 2 as­sistants, 2 hygienists, Great opportunity. 100% financing Roanoke Area: #7076 Gross $671 ,878; 4 days; 40peratories, plus 1 plumbed but unequipped; 2,000 sq ft office space; 2 receptionists, 2 assistants, hygienist Great opportunity 100% financing. For more information on any practice listed above, call Pro­fessional Practice Consultants, Ltd. Dr Jim Howard @ 910­t::"")") 01 A ")('\

EMPLOYMENT OPPORTUNITIES Charlottesville #8077 Associate - Busy GP needs associate, Eastern Shore #8041 Equity Associate - Very busy GP needs equity associate immediatelyl Fairfax County #8110 Associate - Pedo associateship avail­able immediately in brand new office. Manassas #8091 Associate - Join group practice for long term associateship in Manassas with excellent staff and work­ing conditions. Possible buy-out in future. For more information, call Professional Practice Consultants Ltd. Dr. Jim Howard @ 910-523-1430, '

PART-TIME DENTIST Lunenburg Correctional Center is looking for a part-time den­tist This is a medium security Correctional Center that houses approximately 1,100 inmates. We have an excellent working environment with a staff that includes a full-time dentist and two dental assistants, This position is a 20 hour a week position We offer flexible hours. Provide primary dental ser­vices. Starting salary $24,900 (negotiable) Please send a complete State application to Lunenberg Correctional Cen­ter, P,O, Box Y, Victoria, VA 23974 or call Human Services at 434-696-2045 for more information.

ASSOCIATE POSITION NEAR HARRISONBURG, VA General dentist needed for an associate position leading to buy-out of busy, progressive practice located in the beautiful Shenandoah Valley. Excellent opportunity; 22 year old family practice in fast growing local community. Great earning po­tential. Contact Thomas M. LaTouche, DDS, 4167 E. Point Road, Elkton, VA 22827 or email mosestom@shentel.net

ENDODONTIST/PERIODONTIST - PART-TIME We are looking for an endodontist and a periodontist to join practice in Tysons Corner, VA. Schedule is flexible, needed 2 days/month Please contact Kellye at 703-827-8282 or fax us at 703-827-8787

OFFICE SPACE - RICHMOND Office space available in busy West End shopping center. Two operatories - ideal for new dentist Valued at 25K, asking 18K, Ready for move-in, practice relocated. Contact Faryl K. Hart, DDS (804) 266-2074

DENTIST NEEDED n excellent full-time position for a dentist is available at a

pu health clinic in Augusta County, VA. Provide primary dental rvices, including restorative dentistry, pe' ontics and oral gery. Provide clinical instructio dental stu­dents, No anistrative res onsibilities weekend/on-call duty Excellent wing environment, 'h a well-qualified staff that includes a full-t e assista , ygienist and office man­ager. New facility with r 0 ratories, sterilization room and panorex. All e ui ment ures and instruments are brand new. Excellent com nsati with guaranteed salary and comprehensive befits packa including medical, disabil­ity and malpr tice insurance, co 'nuing education, retire­ment plan d paid vacation and sick ave, Fishersville is in Virgini' beautiful Shenandoah Valley, irty minutes from C ottesville. Recent graduates welcom Contact Linda Cornelius, Executive Director, ARFC, P.O. Box 1 ,Fishersville, VA 22939-0153. 540-332-5606, email auoustafreclinicfanetscaoe.net EOE.

DENTIST Free clinic located in Christiansburg, VA seeks staff dentist to join award-winning Dental Program to provide general den­tistry to uninsured, low-income patients. Full e, competi­tive salary, benefits, and a positive wo env 0 ment. High quality of life in scenic mountains of sout A, with easy access to 1-81, Roanoke, Blacksburg, VA ~ Radford Uni­versities. Contact Richard Pantaleo at 540- 1-0820 or fcpsmc@naxs.net.

PARTNERSHIP IN FREDERICKSBURG Offered one-fourth Partnership in growing, thirteen year-old group General Dentistry Practice with collections of $2.79M and overhead of 52% Purchaser will net $10K or $12K from the first month in a 24-25 hour work week. Contact Marvin Marshall (540) 786-2531.

CAREER OPPORTUNITIES Outstanding career opportunities in Virginia providing ongo­ing professional development, financial advancement and more. Positions also available in FL, GA, IN, MI, MD and PA For more information, contact Jeff Dreels at 941-955-3150 or fax CV to 941-330-1731 or e-mail to dreels@dentalcarealliance.com.

DENTIST NEEDED An excellent opportunity for a Dentist who is licensed to prac­tice in VA, and is interested in prevention oriented dental prac­tice for children. This position is located in the southwestern part of VA (Wise County). The ideal candidate should have experience working with children, be an effective communi­cator, should be willing to perform required supervisory du­ties, and be involved with the local community for the enhance­ment of mmunity's oral health. Some local travel required. Mu 1 pr v de own transportation This position depends on a succ s I background check. This position is a classified fulltim osition with all VA state benefits Salary is nego­tiabl I rested candidates need to submit a state applica­tion for em oyment for position #2854 to Lenowisco Health District, 134 Roberts St, SW, Wise, VA 24293 For questions contact HR at 276-328-1 020, email bcassell@vdh.state.va.us. The VA Dept of Health is an EOE.

RICHMOND, VA Excellent Location for Dental Practice in Richmond, VA area. Approximately 2,000 sq. ft. office space, ample parking, ex­cellent retail location surrounded by rapid residential growth For more information, call Charles A Lytton @ 804-794-5888 x 18.

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