Diastema Spring

SPRING 2012 | VOLUME 9 | ISSUE 1

FEATURE STORIES

ASDA Welcome Address

UCLA School of Dentistry

ASDA Special Needs Committee

Research: Mouthwash Eliminates Caries

What Lies Behind Clinic Doors?

Faculty Interview: Dr. Fisher

The Diastema

Dental Education: New Oral Surgery Requirements

When Dr. John Yagiela passed away on February 21, 2012, the UCLA School of Dentistry com-munity lost one of its most endeared members. Dr. Yagiela was a Distinguished Professor in

the field of Dental Anesthesiology until his retirement last year. A revered lecturer and passionate mentor, he also served on the American Dental Board of Anesthesiology and was President of the American Society of Dentist Anesthesiologists. He was recognized for his immense contributions to the field by receiving a myriad of awards, and his textbook, Pharmacology and Therapeutics for Dentistry, was considered the standard reference for dental students alike across the country.

When asked about Dr. Yagiela’s contributions to the school, Dr. Barrie Kenney, a colleague of his for over thirty years, said that: “Dr. Yagiela was integral in developing the reputation of this school and making it one of the best in the world. He also played a central role in developing the renowned dental anesthesiology program here at UCLA and worked to make dental anesthesiology an ADA recognized specialty.”

As those in the Dental Anesthesiology community will mourn the loss of a great mind, his students will also miss his passionate lectures and mentorship. What made him a great educator, however, was not only intellectual prowess and his unique ability to communicate complex subjects to stu-dents, but it was also his upbeat personality, sense of humor, and passion for teaching. “Dr. Yagiela was one of the biggest names walking around UCLA. At the same time, he was still one of the most approachable,” recalls Sarah Koyama, a second-year dental student.

Dr. Yagiela is survived by his son, daughter, and five grandchildren. A memorial service was held on Saturday, April 7th at the UCLA Neuroscience Research Building Auditorium.

By Kent Lau

ASDA Welcome AddressUCLA ASDA Members,

On behalf of the executive cabinet of UCLA ASDA, it is my great pleasure to welcome all students, faculty and staff to

another great year at the UCLA School of Dentistry. UCLA ASDA has been working diligently to launch an extensive slate of events this year designed to help students navigate dental school and to advocate on behalf of dental students at the local, state and national level.

From health fairs and school visits to the newly created special needs outreach events, UCLA ASDA is committed to providing plentiful opportunities for students to reach out and support the community, both locally and abroad. In the last year alone, our ASDA chapter has increased the schedule of Lunch-and-Learn seminars and informational sessions solely to make sure you are receiving information about the important issues affecting the dental profession beyond dental school. ASDA is also commited to easing the burden of dental school by increasing the number of tutorials, student panels and stress-relieving morale events. All members are encouraged to get involved and to bring new ideas or suggestions to the Executive Cabinet so ASDA can continue to improve.

It is with great pride that I am able to report that the UCLA ASDA chapter was honored with the prestigious Ideal ASDA Award in 2011, receiving this recognition for the second consecutive year. This award recognizes UCLA as the overall strongest chapter of all 61 dental schools across the country. This year, we were awarded for our achieve-ments with the prestigious Gold Crown in Fundraising and also received 1st Place in the ASDA/Crest Oral-B Commu-nity Dentistry Category. The Executive Cabinet would like to congratulate all UCLA ASDA members, as their dedica-tion to becoming leaders in the community and advocates of organized dentistry enables UCLA to be an example for other dental schools and a continued source of optimism for the future of the profession.

Thank you again for your dedication and involvement in ASDA and we look forward to another outstanding year!

Best Regards,Matt Sandretti UCLA ASDA PresidentUCLA SOD Class of 2013

Table of ContentsASDA Welcome Address.............................................................................................................................................................................................2Health: Piercings of the Oral Cavity and Oral Health........................................................................................................................................3Opposing Cusps: Anti-Mid-Level Provider...........................................................................................................................................................4Opposing Cusps: Pro Mid-level Provider..............................................................................................................................................................4ASDA: Big-sib ASDA program...................................................................................................................................................................................6Main Story: ASDA Special Needs Committee.....................................................................................................................................................7What Lies Beneath Clinic Doors...............................................................................................................................................................................8Events: American Association of Women in Dentistry.....................................................................................................................................9Faculty Interview: Dr. Fisher....................................................................................................................................................................................10Games – Factual Faculty Factoids.........................................................................................................................................................................12Research: Mouthwash eliminates caries.............................................................................................................................................................13Dental Education: New Oral Surgery Requirements......................................................................................................................................14Taking Off the Loupes: Seeing the bigger picture of ASDA........................................................................................................................15

2 UCLA School of Dentistry | ASDA

Whether through the lower lip, tongue, or cheek, oral and perioral piercings have un-doubtedly become increasingly popular among the adolescent and young adult popu-lation. These rings, studs, and loops have not escaped the attention of oral healthcare professionals who question the short-term and long-term effects of this jewelry on den-tal and systemic health. As a result, dentists should be informed of these sequelae because patients may present either before acquir-ing a piercing to inquire about the risks or in need of urgent care immediately afterwards. While most patients are well aware of the lin-gering pain of a newly inserted piercing, few are familiar with some of the potential short-term consequences of even a correctly placed piercing into such a highly vascularized and in-nervated part of the body. In addition to the potential to develop major hemorrhage, lasting paresthesia, or permanent hypogeusia, 50% of patients will experience painful ulceration and inflammation that last 3-5 weeks and that may affect deglutition, mastication, and respi-ration. Furthermore, the continued presence of jewelry in the oral cavity (especially that made of stainless steel) facilitates the entry of pathogens such as Staphylococcus aureus, A group and beta-hemolytic Streptococcus, Pseu-domonas aeruginosa, and Erysipelas. These infections can easily spread through nearby lymph nodes and subsequently to vital or-gans, for instance in the case of endocardititis.

In addition to experiencing mild to serious al-lergic reactions (such as contact dermatitis) to the jewelry itself, patients also risk con-

tamination by infectious diseases as a result of improperly sterilized equipment. Such dis-eases include hepatitis B and C, HIV, tetanus, syphilis, and tuberculosis, as well as a variety of conditions caused by herpes simplex vi-rus, Epstein-Barr virus, and Candida albicans.

Moreover, the constant presence of a foreign object in the mouth may cause lasting conse-quences on both the dentition and surround-ing soft tissues. One study found enamel loss in 80% of patients with tongue piercings, due to constantly playing with the jewelry. Unin-tentional orthodontic movement has also been reported to occur. In one interesting case, a woman with a barbell-shaped piercing pre-sented with a midline diastema between the maxillary central incisors (see image). Patients should be aware of these long-term risks prior to acquiring a piercing, if possible, as removal of the piercing if so desired may become dif-ficult if epithelial tissue (for instance, in the form of hypertrophic or cheloid scars) grows over the insertion wound. Furthermore, the metal piercing provides a greater surface area for food particles, plaque, and calculus to col-lect, resulting in halitosis and gingivitis, espe-cially in the region of the piercing. Constant irritation of tissues by jewelry may also lead to localized gingival recession, horizontal bone loss, and increased periodontal pocket depth, depending on the location of the piercing.

Finally, dentists must consider how oral and perioral piercings may impact dental work. First and foremost, dentists should remember to remove all metal objects above the neck, including piercings, prior to x-ray examina-

tions to avoid inclusion of interfering artifacts. Second, when considering large restorations (especially those of porcelain) in patients with piercings, clinicians should remember that piercings increase the risk of cusp fractures. Thirdly, when selecting a material for a direct restoration, dentists should opt for compos-ite instead of amalgam since the discrepancy in reduction potential between certain met-als and amalgam may lead to corrosion of the restoration and pulpal sensitivity. Finally, even though patients may not always wear their piercings to dental appointments, piercings should be considered in differential diagno-ses for both soft and hard tissue alterations.

Though the effects of perioral and oral piercings may not have been covered extensively in Peri-odontics or Oral Pathology, bearing these consid-erations in mind will allow dental students (and future dentists) to provide their patients with the comprehensive care that UCLA emphasizes.

Piercings of the Oral Cavity and Oral HealthBy Khushbu Aggarwal

ORAL HEALTH

The Diastema Winter 2012 Vol. 9 Issue 1 3

OPPOSING

Mid-level Providers – NovelSolutionor UnethicalShortCut?By Stephanie Cappiello The discussion surround-ing the implementation of dental mid-level providers in states such as Alaska, Minnesota, and even Califor-nia, has been one of the most hotly debated controversial topics to affect dentistry in years. There is no doubt that there are significant barriers to care for almost 35% of the popula-tion in the United States. Geographic isolation, financial barriers and dis-abilities are among the most com-mon reasons people cannot access adequate dental care. In response, the idea of mid-level dental providers has flourished as an alternative work-force model to combat the barriers to care and offer “acceptable” dental

services to the underserved popula-tions. Unfortunately, many of the proposed models create environ-ments where undertrained dental surgeons perform irreversible proce-dures without direct dentist supervi-sion. The term “mid-level provid-ers” has been tossed around the den-tal community like a hot potato for the past few years. However, this term is actually a misnomer. Some states al-low people who are being trained as these so-called “mid-level providers” to have less training than Registered Dental Hygienists. For example, the Alaskan Dental Health Aid Therapist, or DHAT, is a two year program pro-viding one year of medical training and a second year of clinical training. Therapists will provide oral exams, preventive dental services, restora-

tions, stainless steel crowns, extrac-tions and take x-rays without direct dentist supervision. However, some of these are irreversible procedures being performed by undertrained providers. This short-term educa-tional program does not qualify them as a mid-level provider, but a subpar provider with little educational and clinical experience. Ultimately, they may become a liability to the dental community. The DHAT is not the only ex-ample of a mid-level provider pro-gram. A more promising model is Minnesota’s Authorized Dental Ther-apist. These providers are required to obtain a four year bachelor’s degree or two year master’s degree in Dental Therapy. Direct dental supervision is required for the first 2000 hours un-til they are allowed to work offsite. These therapists can diagnosis oral

The Case for Mid-Level Oral Healthcare ProvidersBy Jared Kenney The former U.S. Surgeon Gen-eral, David Satcher famously named oral disease the “silent epidemic;” it has now become a universally accept-ed access-to-care conundrum. Pover-ty, geography, lack of oral health edu-cation, language and cultural barriers, fear of dental care, and the misguid-ed belief that only pain necessitates dental care are the main barriers to oral health care for tens of millions of Americans. Though the problem has been thoroughly analyzed and universally agreed upon, sharp divi-sions exist among oral health care providers regarding the solution to

this problem. One of the biggest barriers to care is the lack of an adequately sized workforce in the midst of an exponentially growing population. The demographic group representing people aged 65 and older in the Unit-ed States is growing at a rate three times that of the general population, and increasingly more of the elderly are maintaining their dentition. This increasing demand for dental care re-minds us of the situation our country faced 65 years ago when the medical field realized that physicians needed to delegate a particular scope of their practice so that they could focus on higher-level care, making the whole system more efficient. Their solution of mid-level providers—physician’s assistants and nurse practitioners—

has worked extremely well as long as these mid-level providers stay within their designated scope of practice. The situation in dentistry is largely the same. Jack Dillenberg, dean of Arizona School of Dentistry and Oral Health, believes that the dentist-supervised mid-level provid-ers can be successful doing simple restorations, and will allow dentists to perform more sophisticated re-storative dentistry, which many pre-fer to do anyway. The important dif-ference between the medical and dental models is that in dentistry, mid-level dental providers would be performing many more irreversible operations than medical mid-level providers. Indeed, this issue of quali-ty of care is the principle argument of those that oppose current measures


weeee its gonna rain tonite!! i hate sunshine!!

CUSPSTWO OPPOSING OPINIONS ON MID-LEVEL PROVIDERS

In 2003, Alaska created the Dental Health Aide Therapist (DHAT) position, a community driven work-force system to improve access to care in rural Alaska. A DHAT works in conjunction with a dentist through real-time teledentistry to perform preventive care, restorations, pulpot-omies, and simple extractions. These mid-level providers practice within their boundaries, and provide a high quality of care within those limits. In a 2011 study of several DHATs and their supervising dentists, Williard and Fauteux found that quality assur-ance is integral to the DHAT model. The system requires a DHAT to have a lengthy preceptorship with their supervising dentist, so that dentist is fully aware of the capabilities of the DHAT and adjusts his or her stand-ing orders accordingly. Daily two-way

communication facilitated by tel-edentistry promotes continual guid-ance and trust in the DHAT/dentist re-lationship. Also, all of the interviews in this study indicated that DHATs know their scope of practice and err on the side of caution. A study by Bader et al. evaluated the clinical technical performances of DHATs and found that they are performing at an acceptable level, with short-term restorative outcomes comparable with those of dentists treating the same populations. Bolin et al. found similar results. With strict adher-ence to DHATs’ limited practice and continual communication with their supervising dentists, the system is largely seen as a success. Other simi-lar models of limited-care mid-level providers are at beginning stages, so no data is available yet on the quality

of their work or their effectiveness. Despite the uncertainty that surrounds the dilemma of mid-lev-el oral healthcare providers, a few things are certain. Additional stud-ies are needed to evaluate the qual-ity and longevity of the work of these mid-level providers as well as their effectiveness in improving access to care. Also, as desires for mid-level provider programs become more popular across the country, efforts should be made to standardize these programs to prevent the creation of too many different types of pro-grams. Meanwhile, the dental com-munity should guide the creation and implementation of these pro-grams to ensure access to the qual-ity of care that all Americans deserve.

provide “limited” restorative proce-dures. In addition, the Advanced Den-tal Hygiene Practitioner in Minnesota and Washington State expands the scope of practice for dental hygienists that complete further training and clinical experience. Both the ADA and ASDA have firm policies against the implemen-tation of dental mid-level providers. The ASDA C-1 policy states that only a dentist should perform the follow-ing functions: examination, diagnosis and treatment planning, prescribing work authorizations, performing ir-reversible dental procedures and pre-scribing drugs and/or other medica-tions. Furthermore, ASDA is strongly opposed to independent dental hy-giene or mid-level provider practice and believes that it is “incumbent on the profession to assure that expand-ed functions for dental auxiliaries

will not adversely affect the health and well-being of the public.” These strongly worded policies reflect the voice of the dental profession. It is unfair to compare dental mid-level providers to their medical community counterparts: Physician’s Assistants and Nurse Practitioners. Dentists must diagnose disease and perform surgical, irreversible pro-cedures on a daily basis. Allowing undertrained people to decide the treatment plan and perform these procedures without dentist supervi-sion does not live up to the Dentist’s Pledge that all dentists take and the dental community assumes as their responsibility to do no harm to pa-tients while providing the best care possible. It is reasonable to believe that the current dental model is not providing enough care for our coun-

try. Therefore, in the near future, it may be necessary for dentists to del-egate a certain scope of their practice to these so-called mid-level provid-ers. However, the current models and legislation surrounding this issue are not the answer. The dental communi-ty must go back to the drawing board and establish a dental teammate that knows their boundaries, will practice within their boundaries and will pro-vide a high level of care within these boundaries to their patients while be-ing supervised by a dentist.



By Mona Derentz and Rebecca Paddack

Applying to dental school can be a daunting task. Undergraduate stu-

dents can feel lost or unsure about the process. In an effort to remedy the sit-uation, the ASDA Pre-Dental Commit-tee held a Big Sib/ Little Sib Dinner on November 22, 2011. At this event, first year dental students met one-on-one with pre-dental students to share their experiences and to answer any ques-tions that the undergrad-uates may have had.

The event drew over 120 pre-dental students from the UCLA Pre-Dental Stu-dent Outreach Program (PDSOP). Each pre-dental student met with a men-tor to discuss and tailor a specific ‘plan of attack’ for his or her application. “Before meeting with my mentor, my application was all over the place… I really didn’t know how to strategize my ideas. My mentor helped me streamline some of my ideas so that I really highlight my strengths,” says Clo-

ris Castro, fourth year undergraduate student. Following the one-on-one sessions, first year dental students David Lind-

sey, Alex McMahon, and Rebecca Pad-dack presented a statistical breakdown of the Class of 2015, highlighting the diversity of the UCLA School of Den-tistry and its students. In regards to its purpose, second year student Allie

Inouye stated, “I thought it was really helpful for students to know what ad-missions committees were looking for in an applicant.”

This presentation is part of the ASDA Pre-Dental Committee Lecture Series (headed by second year students Allie Inouye and Ryann Walker). Future events planned include: mock interviews, shadow days, application and per-sonal statement work-shops, and Q&A panels with dental students. Second year co-chair Ry-ann Walker strongly be-lieves that “upon gradu-ation these students will be extremely competitive candidates with strong applications because they are so well-informed and

prepared by their mentors.”

ASDAPre-Dental Committee helps UCLAPre-Dental students through the

Big Sib/Little Sib Program


Breaking Down the Barriers to Care: UCLA ASDA Introduces Committee to Address Patients with Special Needs

By Katy Rosen and Matt Sandretti

As the gap between need and ac-cess to care widens, it becomes

increasingly more essential to bridge this discrepancy. Barriers to care are traditionally regarded as products of geographical hindrances, financial re-strictions, and cultural differences. A barrier often ignored in these discus-sions, however, is the accomodations required for patients with special needs. These patients may be blind, hard of hearing, physically or men-tally disabled; un-fortunately, they face many obsta-cles that prevent them from seeking and receiving ad-equate care. Disheartened by the plight of these patients, Farnaz Kohanbash, a third year dental student at UCLA, ap-proached the ASDA Executive Cabinet last May with a vision to reach out to this community in need: “While in un-dergrad, I volunteered at a therapeutic center for the blind. I felt compelled by the hardships of their lives to pro-vide them with service and to reassure them that dental students do care.” The Executive Cabinet re-sponded to Kohanbash’s passionate plea by founding the Special Needs and Access to Care Committee, with Kohanbash as its Inaugural Chair. “We were moved by Farnaz’s fierce dedica-tion and by her insight into the oral health problems of this population,” says UCLA ASDA President Matt San-dretti. Sandretti added: “with their physical considerations aside, we must even consider the strain of transporta-tion and finances for these individuals when they’re seeing their healthcare providers.” The Committee works closely with its founding faculty mentors: Dr. Kel-ly Pierson and Dr. Evelyn Chung. Dr. Chung welcomed her new responsi-bility as mentor for the committee

remarking: “when I was a student, special needs patients were very in-timidating to me. I didn’t even know where to start. Now that I have been exposed to so many… I wanted to be a mentor to help others gain the con-fidence that I have obtained so that [students] will be able to provide care to these patients.” Since its formation in Septem-ber 2011, Kohanbash has expanded

the scope of the Special Needs and Access to Care Committee to pa-tients with developmental disabilities, stroke, spinal cord injuries, Alzheim-er’s, arthritis and other congenital diseases. Its mission statement has become to encourage dental students to practice effective communication with and treat individuals who have intellectual disabilities or are affected by other medical, physical, and emo-tional issues. In order to achieve its goal, the committee has created a dual-faceted program directed at arming students with the knowledge and skills to interact with patients with special needs. The first component focuses on teaching students how to interact and treat these patients. Lunch-and-learn seminars with engaging lecturers aim to increase awareness, guide proper communication, and tailor more ap-propriate treatment planning. One such lecture was given by Drs. Pierson and Chung who discussed the appro-priate way to treat and manage autis-tic and visually-impaired patients. The second facet of the com-mittee builds on the first by giving stu-dents the opportunity to practice their

newly learned skills. Sanda Yen, sec-ond year co-chair, explains, “Students get to interact with patients with spe-cial needs, give instruction and begin to understand those factors that in-fluence compliance. They also have a chance to remind care givers of the importance of oral health.” In the past quarter, the committee has already hosted a number of events aimed to accomplish their mission. These

events include a session on how to give oral hygiene instructions to blind patients, a visit to the Thera-peutic Living Cen-ter for the Blind in Reseda, CA, a visit

to Vista Del Mar Elementary School, which is a school for orphans, an in-structional session about autism, and a visit to Summit View West School, which is dedicated to serving special needs children. Since its inception, the Special Needs and Access to Care Committee has been met with unique excitement. The student response in particular has touched Kohanbash who was im-pressed by “an overwhelming turn-out” during its first Lunch-and-Learn in which “even the professors and fac-ulty were eager to learn about how to work with these patients.” Though only in its infancy, the efforts of Kohanbash and the Special Needs and Access to Care Committee have not gone unnoticed. In fact, it was recently recognized with a pres-tigious award from Proctor and Gam-ble. The response in the community and amongst students has been over-whelmingly positive, and the greater LA community can look forward to many more amazing outreach oppor-tunities in the coming weeks.

“I volunteered for a therapeutic center for the blind during my undergrad and felt compelled by the hardships of their lives to return to them and to reassure them that dental students do care.” ─Farnaz Kohanbash, 2013

Every first and second year student must be wondering what lies behind those clinic doors… Armed with an ar-senal of questions, second year student Jessica Woo probes upperclassman about some of their experiences in clinic. Their responses reveal what to expect in clinic, and how to best prepare for upcoming years at UCLA Dental School:

Q.Whatwouldyouhavedonedifferentlyorthesame,ifyouhadachancetostartyourclinicexperiencesfromthebeginning?A: I would have definitely finished all the ODs [Oral Diagno-sis] and PEs [Periodic Exams] that were due in summer [of my third year] because those take anywhere from 1-3 ap-pointments where you don’t get any credit. They also take up time during the rest of the year when you could be doing an actual procedure or working up new patients given to you by your Group Practice Director or fourth year. In short, jump on clinic as soon as you can! I know it’s pretty scary at first, because clinic is something completely different from anything you’ve done before. The sooner you get your hands in it, the quicker you will become comfortable, and the quicker you can start knocking off requirements. (2013)

Q:What’sthemostcommonproblemyourunintointheclinicandhowdoyoumanageit?A: In the beginning, it’s really tough coordinating appoint-ment openings when you still are in class and lab during your second year and beginning of third year. Just make it very clear to the patients when you are available. I know it’s tempting to miss lab and class, but in the end, you will have more than enough time to see them. It’s not something to stress over…Every time I try to accomplish two things, I al-ways warn my patients ahead of time that we will try to get everything done but might not be able to. That way if you don’t accomplish everything, they will not get mad and if you do, you seem really efficient in their eyes! (2013)


tipsonhowtosurviveinclinic by Jessica Woo

Q:What’syourpersonalsecrettosuccessinpre-doctoralclinic?A: I’m an obsessive list-maker. You might not need it but lists keep me sane. I make lists of everything I need from Central [Services] because getting back in that line ages you… don’t be afraid to ask questions! I could not have sur-vived some days without asking third and fourth years who were around me. Ask upperclassmen and ask the floor fac-ulty; you will be surprised at how willing people are to help you. (2013)

Q:HowcloselydoyouworkwithyourComprehensivePa-tientCare(CPC)team?Andwhatarethebenefitsofhav-ingacloserelationshipwithyourteammembers?(Com-prehensivePatientCare(CPC)teamisateamcomprisedof second, thirdand fourthyear studentswhowork to-gethercloselywithsamegroupofpatients)A: When I was a third year, I did not work that closely with my fourth year and, in turn, I met with a lot of surprises be-cause I was unaware of his patients and their needs. In my fourth year now, to prevent that as much as possible, I have been working very closely with my third year. We meet and talk on a regular basis and she keeps me updated on her patients and I keep her in the know about mine. I think we

have a really good system going and I would feel comfort-able treating any of her patients if she were in a bind, and she mine. As the year continues, we will begin to incorpo-rate our second year, so that the transition at the end of this school year will go as smoothly as possible. (2012)

Q: Is there abetterway tomanage your graduation re-quirementssothatyoudon’thavetorushtofinishthemattheendofyourfourthyear?A: If you get moving right away and communicate your needs clearly to your Group Practice Director, you will be well on your way to accomplishing most of your require-ments. …. When you start third year, make sure you have some good active patients to see. When I started, I had five active patients. Two of them never called me back or wanted to come in, one needed just a prophylaxis, and one needed only a single filling. That left me with essentially one active patient to see, which is not a great place to start. Don’t be afraid to ask for simple restorative patients right away, so you actually can get some regular work done in addition to seeing recall patients. (2012)

AmericanAssociationofWomenDentists

While some have mistakenly labeled it a feminist club, the American As-

sociation for Women Dentists (AAWD) is in actuality one the most resourceful and active student groups at the UCLA School of Dentistry. After a long hiatus, the UCLA chapter of the American Asso-ciation of AAWD was recently reinstated two years ago, under the mentorship of Dr. Fariba Younai. Since its reintroduction, AAWD has quickly established its young roots as a communi-ty-centered organization that enriches the professional and personal lives of its members and the community they serve.

The organization commenced the 2011-12 school year with its annual visit to the Downtown Women’s Center (DWC), a nationally recognized program support-ing homeless women. The Center sup-ports over 2000 women per year who become homeless as a result of the

by Misoo Cho old age, mental illness, physical disability, domestic violence, poverty, and dismissal from foster care. This year, the AAWD ful-filled its yearly commitment to serve the DWC by providing Oral Hygiene Instruc-tion (OHI) and establishing the UCLA SOD as a dental resource for the community.

In addition to outreach programs, AAWD also entertains its members with special dinners hosted by influential women in the dental community. At the end of fall quarter, members were invited to dine at the resi-dence of UCLA’s very own, Dr. Fariba You-

nai. Along with its current co-presidents, Dr. Younai has been instrumental in the revival of the UCLA SOD chapter of AAWD –a feat AAWD never fails to appreciate. Of Dr. Younai, the co-presidents Melissa Ota and Michelle Okamoto say, “Dr. Younai is wonderful and we are very fortunate to

have her as a mentor. Our club could not be what it is today if it were not for the guidance of our mentor.”

Though most events are attended by female stu-dents, all events and club membership are open to all students regard-less of gender. The club has many more upcom-ing events including HIV/AIDS clinic visits, pre-natal presentations where the

UCLA SOD will team up with the David Geffen School of Medicine, finance semi-nars for dentists, and more faculty talks.


FACULTY INTERVIEW

Dr. Donald Fisher is one of the most dedicated and experienced faculty members at the UCLA School of Dentistry. After graduating from Northwestern University Dental School in 1962 and serving three years in the U.S. Army Dental Corps near Washington D.C., he began teaching at UCLA in 1965. During his time at UCLA, he headed Fixed Prosthodontics as the Chair for 20 years and was the Director of the Faculty Group Practice for eight years. He is the only faculty member to have taught every student at the dental school! He continues to mentor students in the preclinical laboratory and general student clinic since retiring from his full-time teaching position in 2000. Dr. Fisher’s notable contributions to the UCLA School of Dentistry include conceiv-ing the Advanced Treatment Planning protocol and clinic, as well as writing (with Dr. Grenfell) the Policy for the Student Perfor-mance Committee. He was the first chair of that committee for 10 years. Dr. Fisher’s notable achievements extend far beyond the campus. He is the co-author of two dental textbooks, one on fixed prosthodontics preparations with Dr. Shillingburg and Dr. Hobo, and another on preservation and correction of existing restorations with Dr. Morgan. Dr. Fisher has also contributed his insights to another book, written by Dr. Caputo. He has helped shape UCLA into one of the best dental educational institutions in the world, and his legacy will last for years to come.

You’ve taught at UCLA since the begin-ningwhen the school started.Wereyouinvolved inestablishmentof theschool?How did you get involved in teaching?Whyareyousoattachedtothisschool?The establishment of the school began in 1960 and took 4 years to plan and get the building started. The first students came in 1964, and I started in ’65, so I’ve taught every student start-ing with the first second year class. In terms of planning, I was not included in the initial plan-ning, but I helped developed the fixed prosth-odontics program as it evolved over the years.

When I first came, I started with oral biology and fixed prosthodontics. Most of the student contact was in fixed prosthodontics. For about the first 3 years I worked full time, then I went part time, started a private practice with an-other faculty member for 7 years. After Dean Caldwell died, I was asked to come back full time as I have been ever since. I stayed at the school because I really enjoy teaching.

Howhas dental education changedovertheyears?Patient population has changed. Over the years what’s changed is the third party payment plans and made it possible for many of our patients to pay for their treatments. We get more com-plex cases, which often approach full mouth reconstructions. These cases many times push the limits of what can be accomplished in the school environment. But new technologies have also emerged, such as implants, ceramics, bonded restorations, CAD/CAM, and which are constantly improving, making it easier to care for patients better.

What’sthefutureofdentistry?Well I think that the future is going to involve much more technology such as CAD/CAM and improved tooth colored restorative materials. The technology is advancing...so fast that some of what we are teaching this year will be differ-ent next year. You have some restorations that you guys have been doing up until now, I think in time will replaced by better ceramic tech-nology. Also, I think a lot more emphasis will be placed on implants for replacing individual teeth, and also for replacing teeth

in periodontic cases. You still need metallic res-torations, but I see the trend going more and more toward stronger aesthetic restorations as the systems improve.

Any advice for new graduates withoutdentalrelativestostartcareerwith?If you are going into general practice, find a rapidly growing area of the country, one where you would like to live in, and practice there. Once the office gets busier, and the economy becomes more stable, you can basically have a successful practice there. Or, you can try mili-tary services. Today is a very different situation than we were in. In my time, most graduates in the United States joined the services. Only a few people in my class did not join the mili-tary. I found it to be the best possible way that I could have to start off as a dentist. It gives you confidence, you work with your own patients, and there is mentoring to help you with any problems, and you develop some speed. You don’t have to worry about the management problems in the office, but just concentrate on learning how to do treatments correctly and providing care for your patients. Also today, the uniformed services provide many opportunities for advanced education.

By Vickie Lai


Whatwasthemostcomplicatedorexcit-ingcaseyoueverworkedon?There was this interesting case where I was able to make a difference in the patient’s life, which does not happen too often in dentistry as opposed to medicine. This was a young per-son who had been out of work for years due to anxiety problems. He could not keep his job because he was troubled with eating, sleep-ing, headaches and other systemic problems because he had no teeth to function on. And he had amelogenesis imperfecta , with no coro-nal tooth structure. I spent about 6 months determining centric and VDO using reposi-tioning appliances, then did a full mouth re-construction using all pin retained crowns as there were not enough coronal tooth structure for normal preparations. And every year af-ter his treatments he would come to visit me, and he really felt that I had given his life back.

I had a similar case of a lady who was the princi-pal of a continuation school program in Reseda High School, where students were sent if they were too disruptive in normal class-rooms. It was a very high tension and high stress job. She had been out of work as well. She had a lot of work and crowns done when she was a teenager, but the occlusion

was very poor. She ould not work because she was in too much pain and discomfort. We did extensive reconstruction, and eventually had to do some implants to replace the teeth that were lost permanently. So these were a few interesting cases that I will never forget. One of the more challenging and rewarding case was a man who had been a prisoner in one of Hitler’s death camps at age 15. It was another full mouth reconstruction, but I think I learned more about history than he did about dentistry. Finally, I always had something of a sub-spe-cialty practice treating musicians, since being a musician myself, I was able to relate to and understand their dental needs with respect to their ability to play their instrument. It was very gratifying to be able to help well known professional players to continue playing long after they would otherwise have had to retire.

Anyhobbiesyouwouldliketosharewithus?

AUTOMOBILE RESTORATION:I have completely restored 8 cars and work-ing now on a 1948 Lincoln Continental. Old-est car in collection is a 1916 Detroit Electric. Cars I have restored have won car shows as far away as Washington DC and have been featured in some books. I do all the me-chanical, body, paint, interior work myself.

MUSIC:I was soloist on the Weber Bassoon Concerto with the Pasadena Community Orchestra which is a 75 member full symphony orchestra. The per-formance was videotaped and posted online at: https://www.facebook.com/pages/Pasadena-Community-Orchestra/125809577468516

Dr. Fisher’s Shop, photo courtesy of Dr. Donald Fisher.


FACTUAL FACULTY FACTSBy Sandra YenThe impressive faculty members at UCLA School of Dentistry boast more than just formidable resumes: can you match the correct faculty member with his or her factoid? Match correctly to answer the question: WhatdoestheDentistoftheYearwin?

Answers:

1Dr. Ronald Mito. 2) Dr. Jeff Goldstein. 3) Dr. Earl Freymiller. 4) Dr. Carol Bibb. 5) Dr. Fariba Younai. 6) Dr. Richard G Stevenson III. 7) Dr. Chris-

tine Quinn. 8) Dr. Carice Law. 9) Dr. Alan Felsenfeld. 10) Dr. Craig Woods. 11) Dr. Paulo Camargo. 12) Dr. Evelyn Chung. 13) Dr. Angy Wong.

1. Growing up in the hometown of Martinelli’s apple cider, I raced street cars as a teenager, and am one of 10 US dentists to be inducted without examination into the Royal College of Surgeons, Edinburgh.2. I wake up at 4:15 am to go the gym five days a week.3. I own a miniature zoo in my house consisting of 4 dogs, 5 cats, 1 rat, and 1 bird.4. My ideal vacation includes cross country skiing and also visiting remote destinations in Alaska accessible only by small boat or bush plane.5. I am an accredited gourmet chef with a culinary degree and I also have studied Chi Kung with an “O-Dan” Master.6. I am an ambidextrous inventor, swimmer in college and a former commander in the Navy.

7. I went to junior high and part of high school in Puerto Rico and the rest of high school years in Switzerland.

8. I rock the bass guitar and am married to a stuntman that has been in Spiderman and Indiana Jones.9. I’m an avid theater lover who enjoys flying my airplane during free time.10. I play in a comedy improv troupe and am avid fan of Luna Lovegood from Harry Potter.11. I once had a teaching award check stolen and cashed in to buy a car.12. I swam for my high school swim team and played the oboe and piccolo.13. I was a foreign exchange student at the University of Copenhagen School of Dentistry in Denmark, and was the Clinic Director for ten years at UCLA.

Dr. Richard G. Stevenson III LDr. Alan Felsenfeld LDr. Christine Quinn EDr. Jeffrey Goldstein LDr. Carol Bibb TDr. Craig Woods ADr. Ronald Mito ADr. Evelyn Chung UDr. Fariba Younai T

Dr. Paulo Camargo QDr. Andy Wong EDr. Earl Freymiller IDr. Clarice Law P

Faculty members-

Descriptions-


2 3 4 5 6 7 8 9 10 11 12 131

UCLA RESEARCHUCLA Mouthwash to Eradicate CariesBy Camron Fakhar


Move over fluoride –A new mouth-wash developed at UCLA School of

Dentistry promises to eliminate micro-granisms responsible for dental caries, raising hopes that tooth decay may soon meet the same fate as small pox and polio. Though some may overlook the importance of this discovery, few can deny the implications of eradicating the world’s most prevalent infectious disease. It is with overwhelming pride, therefore, that researchers at UCLA SOD are eager to submit their names behind arguably the most groundbreaking contribution to modern dentistry.

This project, spearheaded by UCLA SOD microbiologist Dr. Wenyuan Shi, culmi-nates nearly a decade’s worth of work and research into targeted antimicrobial thera-py. Unlike modern antiseptic mouthwash-es which indiscriminately kill both harmful and benign microbiota, Dr. Shi’s alterna-tive works by singling-out the bacteria S. mutans, thereby eliminating the primary culprit in caries without unnecessarily eliminating harmless organisms. Dr. Shi was able to isolate the specific antibiotic compound by utilizing a newly developed technology called STAMP or Specifically Targeted Anti-microbial Peptides. The peptide discovered by Dr. Shi, C16G2, acts as a “smart bomb” that specifically binds and neutralizes S.mutans.

According to Dr. Shi, the ‘smart bomb’ works in a manner analogous to modern weed removal: “If you want to kill the weeds but you still have your lawn there as well [i.e., natural flora], the general herbicide [e.g., antiseptic] that you use will not only kill the weeds, but will destroy the lawn in the process. The mo-ment the herbicide is stopped, the weeds tend to come back first.” The ‘smart bomb’ therefore will amend a glaring shortfall of popular (and widely advocat-ed) mouthwashes.

Dr. Shi supports the success of this new mouthwash by citing a recent clinical trial in which 12 subjects who rinsed with the mouthwash containing the antimicrobial peptide over a four day period had es-sentially no trace of S.mutans remaining in their oral cavities. With such promis-ing results, Dr. Shi and the U.S. Food and Drug Administration are currently working together to introduce more clinical trials expected early this year.

Dr. Shi also reassures clinicians who may worry about how this new discovery might effectively eliminate the need for dental treatment (and therefore the dental profession altogether). To these needlessly concerned few, Dr. Shi em-phasizes that dentistry will not end as we know it. In fact, he relates his discovery to the blood lipid tests introduced to the medical market, whose introduction had sent a panic amongst heart surgeons about the future of their profession as well. Although these new tests dramati-cally decreased the incidence of heart surgeries, they also spurred a multi-billion dollar industry of prevention in the medi-cal field.

In addition, Dr Shi adds to the matter, “if the ‘smart bomb’ is successful, it will add another resource that will change the way dentistry is practiced rather than render it obsolete. Dentistry will take much more of a medical approach. Right now too much time is spent on mechani-cal repair and surgical procedures. Now we will be able to run diagnostics, treat infections and take preventive measures in the same fashion that medicine works today. Therefore, it will not be eliminat-ing dentistry, but rather changing our approach.” Perhaps most reassuring of all, the drug will not be accessible from any store as an over the counter, rather “it will be exclusively administered by dentists only, making the new resource profitable for dentists.”

New Requirements for future Oral Surgery Applicants By Josh Elyahouzadeh

eficial for 4-year residents “who are so busy in the beginning of residency that they do not have enough time to study individually.” She adds this will definitely give them that oppor-tunity “to study medicine, and go through rota-tions without having gone to medical school.”

Both Drs. Aghaloo and Freymiller believe the NBME CBSE will receive the same emphasis as the previous NBDE Part 1 scored exam. They caution, however, that students should not find comfort in the score alone. In response to how the new exam will change assessment criteria, Dr. Freymiller states, “I don’t even believe this exam or the NBDE scored Part 1 could ade-quately predict how a student will perform dur-ing residency… there are so many other factors, in particular, personality factors, that are im-portant that will show how someone performs in residency.” Instead, he indicates that the ideal applicants are those who are self-starters who “take it upon to themselves to do outside studying… take on more work than what just assigned to do…. go the extra yard [sic] and are really willing to give 110%.” In regards to this matter, both Dr. Aghaloo and Dr. Freymill-er agree that these applicants will more likely perform better regardless of their board score.

Prometric centers will be offering the CBSE for dental students only once a year, at vari-ous locations. Though the exam will be of-fered only once a year, students will be al-lowed to take the exam as many times as they please and only the highest score will be considered. The CBCE consists of 200 mul-tiple choice questions. Twelve versions of the exam are available on the NBME website.

and weaknesses before taking the official USMLE part 1 by giving test takers diagnostic feedback following completion, as well as a “self-assessment score” to estimate a score on the USMLE scale. The CBSE, is in a sense, analo-gous to the PSAT taken by high school students used to gauge their achievement on the SAT.

The exam is divided into two sections: Gen-eral Principles and Individual Organ Systems. In the General Principles sections, students will be tested on behavioral sciences, bio-chemistry, immunology, microbiology and general pharmacology. The Individual Organ Systems section will evaluate knowledge of embryology, anatomy, physiology and pathol-ogy of the cardiovascular, endocrine, gastro-intestinal, hematological, neurological, re-nal, reproductive, and respiratory systems.

With the exception of psychiatry, the UCLA School of Dentistry curriculum addresses the content of the CBSE and students should be well prepared. As expected, there is no section dedicated to dental anatomy or an emphasis on head and neck anatomy. As Dr. Freymiller con-tends, “we are concerned about a candidate’s knowledge of head and neck anatomy; however not having that on the new exam is not crucial, as that is one area where residents will certain-ly reinforce their knowledge during residency.”

The CBSE will be a benefit not only to OMFS residency admissions committees, but also to applicants themselves. Residents will find themselves more adequately prepared for Step 1 of the USMLE, a major obstacle of most sur-gery residencies. Applicants to both 6-year and 4-year OS programs will benefit, though Dr. Tara Aghaloo, part of the faculty at UCLA’s OMFS program, posits the exam may be more ben-

In response to the recent conversion of the National Board Dental Examination (NBDE)

to pass/fail score reporting, the American Association of Oral and Maxillofacial Sur-geons (AAOMS) has announced that all future applicants to OMFS residency pro-grams must also take the Comprehensive Basic Science Examination (CBSE) of the Na-tional Board of Medical Examiners (NBME).

The new pass/fail scoring system was intended to dilute the over-emphasis placed on a single numerical value and allow for other important factors such as interpersonal skills, extra-curric-ular achievement, leadership responsibilities, and letters of evaluation, to be taken into ac-count. Despite the benefits of the new scor-ing system, the AAOMS has expressed some concern with the challenge of fairly assessing candidates without any means of standard-ized scores. Dr. Earl Freymiller, Chair of the Oral Surgery explains, “OMS programs tend to put a lot of weight on scores because a strong ba-sic science knowledge is required. Now that there is no measurable resource, one of the major factors that we look at is gone, and we felt hard-pressed to try to determine the qual-ity of someone’s educational background.” In its search for a replacement testing system, the AAOMS consulted with the NBME, an or-ganization designed to create national board exams for medical students. After much col-laboration, the two organizations selected the CBSE as a valid means to assess and standard-ize an applicant’s basic science education.

The exam which, according to the NBME web-site, “places emphasis on second year medical school courses,” was originally designed for medical students to evaluate their strengths


At UCLA, ASDA (American Student Dental Association) is ubiquitous. Our school en-

rollment rate is close to 100%. A huge percent-age of school activities are sponsored by our ASDA chapter – everything from Dental Olym-pics, local health fairs and school visits, pre-dental mentoring, to our tri-annual Honduras mission. However, in spite of all of this, I believe that few really recognize or appreciate all that is ASDA. In the past months, I have been fortu-nate enough to attend both the ASDA District 11 Meeting at Western University of Health Sci-ences and the ASDA Western Regional Meeting in San Antonio. These meetings have given me insight into what ASDA is beyond our chapter

According to the mission statement, “The American Student Dental Association is a na-tional student-run organization that protects and advances the rights, interests and welfare of dental students. It introduces students to lifelong involvement in organized dentistry and provides services, information, education, rep-resentation and advocacy.” ASDA works to fight for dental students’ and dentists’ interests in the political sphere. As one student speaker at the Regional meeting put it, ASDA is “insurance for the profession” – we invest in it to protect our fu-ture as dental practitioners. Much of the power of ASDA is in numbers. A whopping 87% of den-tal students nationwide are enrolled, giving the organization clout within the ADA and ADEA.

ASDA serves to inform dental students about the political issues that affect our education and profession. For example, the mid-level provider debate: many law-makers cite access to care issues for certain populations as the reason that there needs to be a new category of dental professionals trained to go to these populations and perform simple preventive

Taking Off the LoupesSeeing the Bigger Picture of ASDABy Lindsay Graves

and restorative procedures. While ASDA rec-ognizes the care discrepancies, they work to-wards alternate solutions for the mutual ben-efit of the patients and dentists. They argue that we have enough, or more than enough, dentists to go around - there just need to be more incentives for them to practice in less-than-desirable areas for potentially less money. Inadequate training by the mid-level providers is their other major concern. Another hotly discussed issue at the recent meetings was licensure: portfolio, vs. traditional patient-based examination, vs. postgraduate residency.

As emerging dentists, we also will be faced with many non-political issues, for which we have no training in dental school. ASDA recognizes that in order to be successful, we must know more than just treatment of oral maladies. Both meetings included talks by business professionals, provid-ing insight into leadership, debt management, associateship/partnership contracts, starting your own practice, and large-group practices.

Perhaps the greatest, if not, the most enjoy-able, benefit of ASDA is the connections it fosters among dental students from schools across the nation. Ideas are exchanged and friendships are formed at the meetings. ASDA creates unity among us as American student-dentists, in both identity and purpose, to speak as a whole on issues that concern us.

“As emerging dentists, we also will be faced with many non-political issues, for which we have no training in dental school. ASDA recognizes that in order to be successful, we must know more than just treatment of oral maladies.”

ASDA EDITORIAL


UCLA ASDA The Diastema StaffSPRING 2012 | VOLUME 9 | ISSUE 1

EDITORS- IN-CHIEF Samir Farhoumand | 2014

Lindsay Graves l 2014Sapna Lohiya l 2013

WRITER Cameron Platinum Sponsors for ASDA Vendor Fair

EDITORS Khushbu Aggarwal | 2014

Sandra Yen | 2014Jennifer Sun | 2015

LAYOUT EDITORS Kent Lau | 2014

Jessica Woo | 2014Catherine Kim | 2015

WRITERS & CONTRIBUTING WRITERS

LAYOUT-EDITOR- IN-CHIEF Vickie Lai | 2014

SUBMISSIONS

If you would like to submit an article for The Diastema or have suggestions for us, please email the editor at [email protected].

EDITORIAL DISCLAIMER

The opinions contained herein do not necessarily reflect those of UCLA or of the UCLA School of Dentistry in particu-lar.

SPECIAL THANK YOU

We would like to thank the following faculty for their sup-port and mentorship: Dr. Carol Bibb, Dr. Karen Lefever, Dr. Tara Aghaloo, Dr. Donald Fisher, Dr. Earl Freymiller, Dr. Wen Yuan Shi.

TheDiastema2011-2012 StaffPHOTOGRAPHER

Robert Banh |2013

Stephanie Cappielo | 2013Misoo Cho | 2014Mona Derentz | 2015

Josh Elyahouzadeh | 2014Camron Fakhar | 2014Lindsay Graves | 2014

Jared Kenney | 2014Rebecca Paddack | 2015 Katy Rosen | 2013

Matt Sandretti | 2013


CONGRATS UCLA SOD c/o 2012 and best of luck for the future!

Diastema Spring

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