Virginia Dental Journal

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Contents ForJuly-September 2004

VIr .. a~

News and Headlines

Departments

Number 3

I we. . >'",

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~\Missions~ifMercy 'ir~inia Dental lIealth Foundation

From The Editor

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

In the recent VD:\ membership survey. 21.8% of respondents rare third party dental insurance issues a major concern. Interestingly, while dental insurance issues rate this high, dentists are not using major tools available to them in dealing with these issues.

The American Dental Association offers a contract analysis service which will evalu­ate contracts offered bv a dental insur­ance carrier to the dentist. This service is offered by the ADA for a nominal fee. However. if the dentist submits the contract for review through the Virginia Dental Association, there is no charge. The VDA keeps copies of these reviews so that if another member submits this same contract, a response can be given quickly.

The Dental Benefits Committee of the VDA has forms available so that dentists can report a third party problem and get aid from this committee. Complaints

CAN YOU HELP?

can also be sent to the 1\D/\ through its Dental Benefit Programs Committee. The VDA, ADA and their committees need to know about the problems dentists are encountering in dealing with third party carriers so they can help the individual dentist and the entire profession.

Are procedures being bundled (grouped together) to lessen payment? Are com­panies modifying treatment plans? Are requested reviews being done by dentists? Are contracts being honored? Are pay­ments being disallowed? Are payments made promptly?

Organized dentistry can help you under­stand the third party contract before you sign it and help you deal with third party problems. Your obligation is to become informed about third party matters. Re­port the problems you are experiencing and ask the questions yOU may have; you will help yourself and vour profession.

The Board ofDirectors isforming a BioterrorismlMass Disaster Sub­committee to formulate the VDA 5

emergency response to mass disasters and needs volunteers. Ifyou have

an interest in bioterrorism orforen­sic dentistry and would like to serve on this subcommittee, please contact

Dr. Bruce DeGinder, VDA Presi­dent, at [email protected] or

by fax 757-229-8979.

NOTE: If you have a latex-free practice or are aware of one, please contact

Dr. Terry Dickinson at the VDA office at (804) 261-1610.

1\Im 1(l, 2004

I hope all of you have made plans to attend this year's Virginia Meeting on September 9-12, 2004 at the Norfolk Marriott. The Annual I\Ieeting and

Local Arrangements Committee have

been working tirelessly to ensure a fun and educational experience for all par­

ticipants. Our keynote speaker, Dr. Art Dugoni, is one of the most respected dentists in the country-I think YOU

will find his message both insightful

and motivating. I'm personally \-ery excited to have someone of his caliber

highlighting our meeting. Bring your entire family as we have many entertain­

ing activities planned.

It has been an active and contentious year in the Virginia General Assembly. We are indeed very fortunate to have

such a knowledgeable lobbyist in Chuck Duvall, great VDA Legislatiye staff sup­

port in Nicole Pugar, and such an active

grassroots membership of legislati\'e contacts and liaisons. As a result of their hard work, we had a very successful

year. We were able to help secure fund­

ing for virtual simulation equipment for the VCU School of Dentistry, and were

able to get Dental Medicaid taken out of the managed care arena plus obtained

funding for the administrative costs as­sociated with this 'carve out'. \\ie also

successful!v lobbied for two bills, one

created preceptorships for dental and dental h\'giene students to expand their

clinical practice opportunities in privnr« offices, and qualit , assurance and peer review protections for dentists.

Please remember much of our success is direct II linked u) C iur strong market

shan: in membership. 1 once again ask vou t() acrivclx cnc. Jurage n: in-mcmlx-r­

to loin the a'c;oCLltion that i' \\'C lrktng c;o hard on behalf of the dental prr,fes sion. Pcr:« malk 1c>11h refer m, patient'

to specialist" who are member" of the i\DA/VDA became I know they are

bound by the ADA Code of Ethics and

through their involvement in organi%ed dcntistrv they are activclv participating in shaping our future destiny, If the

specialists YOU refer to are not members,

perhaps you should point out to them how much you would appreciate them

contributing their fair share as we all strive to improve and better represent

the profession.

In just a few days, our next Mission

of Mercy project will be held in Wise county. Log onto our new website at

wwwvadental.org to register and come participate in an experience that will

forever touch your heart. In the next few months, you will be receiving a

CD-ROM on Direct Reimbursement Programs. This CD will be an excellent

educational source of information for

both you and your staff as we continue to promote the many benefit" of direct

reimbursement plans for employers and

your patients.

It is hard for me to believe my year of service to the Virginia Dental As­

sociation is almost at an end. It has

truly been an honor and lots of fun as well-l would encourage any of the

111a11\' capable leader" in our association

to take that next "tep and become more involved.

1\\'ould like to thank the 200,) delegates

that appr<,yed our new streamlined f( '1'111 c)f g( l\TrnanCe, The dedicati( In

and cooperation exhibited 1)\ \ our Board of Directors this vcar has bee-n

phenomenal as \\T hav« made the leap inti) kn(J\dedge based g(l\ernance. j

\\ould also like to l·specialh thank all

of r iur participant-, in our flr'l leader­

ship dC\Tlopnll'nt conference held in Charlotte",ille this \pri!. I belin'e our prim.u. re,ponsibilit\ a, le:lder, is [()

1cmT the association better than when \\'e started and \\'ith strong leaders to continue that pursuit of excellence. J

would like to reassure our member­ship that if these participant' are anx

indication of c.ur future l" .tcntial, we

are indeed looking at an excitin,L': age in dcnri str v, Thank \(JU for allc)\\'­

inC! me the pri\'ilq!e tr) sene a' \( iur President'

Abstracts Of Interest

The following abstracts were pro­vided by the Department of Pediatric Dentistry at VCU School of Den­tistry for the April edition but due to space restrictions, were held until this month. We appreciate the con­tribution that these individuals have made to the Virginia DentalJournal.

Gastroesophageal reflux disease and dental erosion in children Dahsban A, Patel H, Delaney J, Wuerth A, Thomas R, Tolia V. Gas­troesophageal reflux disease and dental erosion in children. Journal of Pediat­rics 2002;140:474-478.

This prospective study was done to

evaluate the presence of gastroesopha­geal reflux disease (GERD) and dental erosions in children with primary and permanent teeth. Gastroesophageal reflux (GER) is a relatively common condition in infants and children. Dental erosion is the irreversible loss of dental hard tissue by a chemical process in the absence of bacteria. It is characterized as a hard "dished out" area with a smooth, glistening base. This problem is particularly harmful in young children in whom the enamel and dentin layers of the primary teeth are much thinner than in adults. The facial, occlusal, and lingual surfaces are more commonly affected. Extrin­sic factors (mostly affecting the facial surface of the anterior teeth) include the consumption of acidic foods, beverages, and acidic contaminants in the workplace. Intrinsic factors include salivary flow, eating disorders, and acid regurgitation. The study focused on 37 children (18 males) 2 to 18 years old who were un­dergoing elective esophagogastroduo­denoscopy (EGD) for possible GERD. Dental examination was performed before the endoscopic procedure by one of 2 pediatric dentists. The teeth were evaluated for the presence or

dental erosions, stage of dentition, and location of involved teeth. Standard EGD examination of the upper gas­trointestinal tract was performed and biopsy specimens were obtained from the duodenum, stomach, and esopha­gus. The severity of reflux esophagitis was graded as mild, moderate, or severe according to established criteria. Patients with dental erosions were compared with patients without ero­sions for the presence and severity of reflux esophagitis in each group as well as age distribution, symptoms, acidic food intake, and dental hygiene. Endoscopic and histologic evaluation revealed that 24 patients had GERD. Of these, dental erosions were present in 20 patients (83.3%). Fifty percent had mild erosion, 30% had moder­ate and 20% had severe erosion. The pattern of erosion revealed that the posterior teeth were primarily involved in 17 of 20 patients (85%). A large proportion of patients (84.5%) noted to have GERD and dental erosions had pain and indigestion from eating fried and/or spicy foods. Other factors besides GERD, in­

cluding dietary habits and the degree of the individual salivary buffering capacity are also believed to influence the occurrence of dental erosion. Ero­sions involving primary teeth could be prevented from progressing into permanent teeth if identified early and adequately treated. Current manage­ment of dental erosions include the use of fluoride rinses, sodium bicar­bonate mouth rinse several times a day, and periodic dental assessment. It is also important note that if dental erosions are detected in otherwise asymptomatic children, especially involving posterior teeth, they should be evaluated for GERD.

Dr. Ajit A. Patel received his D.D.S. degree from VCU School of Dentistry. He is currently a 2nd year pediatric dentistry resident at VCU.

Premature loss of the maxillary pri­mary incisors: Effect on speech production Theresa Ott Gable, MA,Ann W Kummer, PhD,Linda Lee, PhD,Nancy A. Ceaghead, PhD,LisaJ. Moore, MA Journal of Dentistry for Children, May-June 1995

Background and Significance: The maxillary incisors, maxillary and mandibular canines, and the first mo­lars are the teeth most susceptible to "baby-bottle caries". Studies by Dil­ley et al and Johnsen et al report that the maxillary primary incisors are the most severely affected teeth. These teeth are at a greater risk for decay because they are the first to etupt and are maximally exposed to the liquids during prolonged or excessive nursing habits.

Baby-bottle caries is usually not detected by the parents or profession­als until approximately eighteen to twenty-two months of age. Extrac­tion of the maxillary primary incisors is usually the treatment of choice. Parents usually have several questions to ask prior to maxillary primary incisor extractions. Such questions are: "How will my child's speech be affected?" or "Will my child need speech therapy before or after the per­manent teeth erupt?" These questions are difficult to answer.

Purpose: The purpose of this article is to edu­cate dental professionals about the possible effects of early incisor extrac­tion on normal speech production.

Methods: Twenty-six subjects, with a history of early loss of the maxillary inci­sors by means of extraction before the age of 5 years old were selected for this study. All subjects had their four maxillary permanent incisors at the time of study. The subject's ages ranged from 8 years and 1 month to I

age was 9 years and 5 months. The mean age of extraction was 3 years

old and 5 months, 3 years and 10 months, and 3 years and 2 months for the eight-, nine-, and ten-year-olds,

respectively.

The control group consisted of twenty­

six subjects with a history of normal exfoliation of their four maxillary

primary incisors.

Results: Subjects with premature extraction demonstrated more articulation errors,

however t-test comparisons revealed that the differences were not statisti­

cally significant. In word and sentence contexts, distortion of the sibilants/s,

z, 3, ,sp, st, sk, t , d31 were the most

commonly occurring errors for subjects with premature loss group. The second

most common error were in the form of substiturions and omissions of frica­

tives I , f, vi. The eight-year-old subjects in both

groups produced more total errors than the other age groups.

Discussion: Children with normal exfoliation of

their primary incisors manage to com­pensate and produce correct sounds. Although, some children produce

distortions in fricatives while their front teeth are missing. Parents are rarely concerned with speech develop­

ment, because they assume speech will

be corrected once the permanent teeth

erupt.

Early loss of the primary central and lateral incisors during the time of

speech acquisition is a more complex issue for parents, dentists, and speech­

language pathologists. This study showed no statistically significant dif­

ferences in the articulatory abilities of

children with and without premature maxillary incisor extractions. Both

subject groups revealed a maturation effect. The number of articulation

errors decreased as the subjects aged. Very few residual speech problems remained by the time the child was 10

years old.

Conclusions: This study reports that children who lose their primary central and lateral

incisors due to extraction before the age of 5 years will probably make no greater number of articulation errors,

once the permanent teeth erupt, than

children with normal exfoliation.

The majority of children will acquire

normal speech development without speech therapy intervention by the age

of 10 years old.

Dr. Jennifer Dixon is a first year ad­vanced education student in Pediatric

Dentistry at MCV/VCU, School of

Dentistry. She received her D.D.S.

from Virginia Commonwealth Uni­

versity, School of Dentistry in May of 2003.

MakeADiJfer~nceWithoutEver Leaving lDur···Office!

Become A Donated Dental Services Volunteer!

Contact Stephanie Arnold at (804) 264-9010 or via Email at

arnold@vadentaLorg

~Donated Dental Services \i'l:illiil Ih·lIlillllt-allh Fuundalillll Ruthanne Daluisio - DDS Patient

VDAAwards Dr. Bennett A. Malbon Prize

Ms. Suravi Sircar of Mills E. God­win High School in Richmond, VA is the VDA's 2004 recipient of the "Dr. Bennett A. Malbon Prize." Ms. Sircar's project entitled "Japanese Medake as an Alternate Vertebrate Model for Human Ag­ing and Cancer," was a winner of the Nineteenth Annual Virginia State Science and Engineering Fair in the Medicine and Heath cat­egory as well as the VDA's category winner. The Malbon Prize rec­ognizes Ms. Sircar's excellence in scientific research and community spirit. Sircar is shown below with Dr. Jackson Payne who was both a presenter and judge at this year's fair which was held on April 17, 2004 at Randolph-Macon College.

Dental Students Participate In First Annual VDA Leadership Development Retreat

On April 3-4, the VDA invited introduced strategies to cultivate future role of the VDA within the

some of its members as well as the leadership skills of both current profession. Thanks to the VDA

students and faculty from the VCU and future members. During dis­ for involving the students in this

School of Dentistry to attend the cussion the ideas of strategic plan­ event. We truly appreciate your ef­

first annual VDA Leadership De­ ning and membership involvement forts to involve us in the profession

velopment Conference in Charlot­ were viewed as critical for the con­ which you love.

tesville, VA. The meeting provided tinued success of the organization.

a forum for the students to become In between the numerous breakout Submitted By: Clay Weisberg

more familiar with both the short sessions and lectures, the group

and long term goals of the associa­ found time to get better acquainted ... :,.... ..... Ih.o ""..,r;AllC \r-pvnotp <;,:np~kprs and share their ideas about the

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I HAVE HAD ENOUGHI restorations. If treatment plans containing By: Gordon]. Christensen, DDS, MSD, PhD all of the treatment alternatives are pre­

Where has the professionalism of my "profession" gone) I have seen a major degeneration in the ethics of the dental profession over the past several years. Until recently, I have had the opinion that dental professionals and those companies involved with them were working for the good of the public; that service was a major purpose for a profession-not money; that advertising in professional publica­tions was observed carefully by editors to

weed out any hint of dishonesty; that the "peer reviewed" dental literature contained only scientifically acceptable, non-com­mercially oriented information; that the public trusted the dental profession; and that dentists treat their patients like they would like to be treated themselves. WOW-have I been misinformed!

On the positive side, as I start this written tirade, dentistry has made unbelievable progress during my career so far. As I look back at the profession when I became a dentist, the ability of dentists to serve patients was only partially developed when compared to today. The introduction of high-speed tooth cutting, implants, tooth­colored restorative materials, porcelain­fused- to-metal restorations, staff involve­ment in clinical procedures, advanced surgical procedures, and great strides in preventive dentistry have made dentistry fulfill my three favorite words for patient care-dentistry is now faster, easier, and better than it was when I became a dentist. However, in my opinion, the ethics of the dental profession has taken a real "dive" during the same time. At the beginning of my career, dentists and dentistry used to be ranked by pollsters at the top of the list of professions the public trusted. Now, in numerous surveys of pub­lic respect, we are reported to be far down on the trust scale.

This editorial discusses the relatively recent and obvious degeneration of ethic, in the dental profession and calls for a change of direction by all parties involved. The following actual documented examples do not name specific individuals or companies to avoid confrontations. I present the following information as examples of the problems I see in the ethics of our profes­sion. If the shoe fits-wear it! Let's exam-

contributing to this degeneration.

OVERTREATMENT I was one of the original instigators of the recognition of esthetic dentistry, over 25 years ago. However, my pet subject has turned into a monster with unbelievable overtreatrnent of unsuspecting patients. This problem of overrreatment is not limited to esthetic dentistry.

It is spread throughout the profession. I will list a few current examples. Convinc­ing patients that removal of amalgam res­torations is mandatory for systemic health reasons is not a legitimate or logical prac­tice in most situations. Yet, many patients go through that elective procedure with the hope that some miraculous cure of a systemic condition will be accomplished. Of course, there are a few situations in which amalgam removal may actually be indicated for reasons other than esthetics.

Recently, a patient was examined by me and my staff for a second opinion on an "esthetic upgrade". She had traveled sev­eral hundred miles to have the exam, and she did not inform me of her reasons for requiring a "second opinion" until later. We suggested a treatment plan that in­cluded scaling, polishing, at home bleach­ing, minor esthetic tooth recontouring, few anterior and posterior toothcolored resin-based composite restorations, and two elective veneers. When the plan was presented, she sighed in disgust. Just a few hundred miles from Utah, she had received a treatment plan for twenty-eight veneers and a total occlusal rehabilita­tion, equal to the cost of a very good new automobile. If this were a singular occurrence from one less-than-reputable dentist, I could understand it, but this has happened to me several times in the recent past from various practitioners.

Dentists are actually being taught by popular speakers on how to do the same overtrearrnent to their own patients. I have had the unfortunate challenge to redo several of these overtreated cases after the fracture failure of the ceramic restorations, debonding of veneers placed over grossly overprepared dentin surfaces, or degenera­tion of the occlusion that appeared to have littl.. occlusal adjustment after seating the

sented to patients, including the advantag­es, disadvantages, risks, and COSts of each alternative, and if the consenting patient accepts and demands a radical plan, the treatment becomes more understandable. It is well known that patients elect to have radical esthetic plastic surgery on various parts of their bodies, knowing that the procedures are elective. But, oral over treatment in the name of esthetic dentistry without total informed consent of patients, primarily for dentist financial gain, is nothing less than overt dishonesty in its worst form. You cannot put tooth structure back after it has been removed.

The solution-dentists should evaluate their diagnosis and treatment planning procedures to ensure that all of the various treatment options are presented to pa­tients. If patients choose a radical, elective treatment plan, primarily for appearance purposes, they should be told all of the negatives before they choose to initiate the treatment plan, including potential premature failure, occlusal problems, and need for re-rreatment in just a few years. Informed consent should be thorough and complete. Treatment plans should be separated into mandatory treatment and elective treatment, and patients should have a complete understanding of the dif­ference. Financial income to the practi­tioner should be related to the needs and decisions of the informed patient, not the needs of the practice.

ADVERTISEMENTS IN DENTAL JOURNALS/MAGAZINES As I thumbed through a current "cos­metic" magazine, I noted the presence of ads for several light enhanced in-office bleaching devices, touting their superior­ity to other bleaching techniques. It must not matter to some manufacturers that it has been proven and published that the tested bleaching lights do not effect a greater tooth color change than the bleach solution alone. I find it amusing that one manufacturer actually advertised that his product could be used with or without the light. Dentists are not without guilt in this situation. Recently, I talked to a practitio­ner in a course who blatantly told me that he knew the lights did not improve the bleaching, but the thought that patients accepted bleaching fees better ifbleach­

l' 1 . - --- .• ~ ... ...J 6. .... ,... ....... mop r-in-lp in thp

What Makes A GOOD DR Lead? Elise \\!oodling, Director of Marketing & Programs

If you have ever wondered what the VDA is looking for when we request that you call in "leads" for DR, check out the list below that outlines what the best DR leads have in common.

I. A lead is best when it is a personal contact of our members; friends, patients, business contacts, etc. will highly value your opinion on dental benefits as a dental professional.

2. The best leads are those for companies that have over 10 employees (over 50 employees is even better!).

3. Benefits decision-makers are among the best people to call in as leads to the VDA. Company owners, human resource professionals, benefits administrators, etc.

DIRECT E I

are the people most likely to be in a position to rv1 implement a DR plan.

B U4. Before calling the lead into the VDA, talk to

them about the DR program and let them know R that the VDA will be sending them additional information about the Direct Reimbursement 5 program. E Hopefully the list above will help you and your M office staff identify potential DR leads in your area. Remember, the more companies who adopt E DR as their dental benefit, the more fee-for-ser­ N vice patients you will see in your office!

T

DR in the Office A Look at How DR has Impacted a VDA Member Seeing the result of eight years of Direct Reimbursement promotion in the state of Virginia is great for VDA mem­bers. Sometimes it is difficult to recognize a DR patient from someone who simply pays at the time of service, but there are currently over 6,000 people in Virginia who have a Direct Reimbursement or Direct Assignment plan in place. Currently, for employees of Virginia companies with DR and DA plans in place there is $1,450,000 paid out annually in unrestricted, fee-for-service dentistry!

One VDA member who has experienced Direct Reim­bursement first-hand is Dr. Christian Tabor in Glen Al­len. VA. In his new office, Dr. Tabor supports DR and is excited to have the plan used in his office. "DR patients are the best type to have" says Dr. Tabor, "they are no­hassle because they pay for services immediately; there is no need to track them down after treatment for out­standing payments." As more companies adopt DR as their dental benefits plan, more dentists in Virginia will experience a return to fee-for-service dentistry. In addi­tion to the quick and easy payments from DR patients. there are typically no procedure exclusions (other then cosmetic) allowing dentists and patients to develop the best treatment plan for each situation.

Since he has seen the results of Direct Reimbursement in his office. Dr. Tabor now works to educate businesses about the alternative dental benefits plan. "1 wish all

of my patients had DR, that would be great!" says Tabor about the possibility of getting more patients in his prac­tice with a DR plan. In order to expand his DR patient

base, Dr. Tabor has been talking to businesses in his area about the DR plan and the

II many advantages it can have over traditional dental insurance. He hopes that with persistence and a good understand­ing about the DR program, he will

Dr. Christian Tabor in his Glen be able to Allen, VA office.

influence more Virginia businesses in their dental benefit selection.

If you would like more information about Direct Reim­bursement for local businesses or to educate your office staff, please contact Elise Woodling at the VDA at 800­552-3886.

Catch a Glimpse OfSome OfThe Exciting CE Speakers Planned For This Y The VDA is proud to present to you with highlights of the 135th Annual Meeting of the Virginia Dental As­sociation in Norfolk, VA September 8-12,2004. It is our great pleasure to be offering over 100 hours of contin­uous education seminars along with a wide range of family friendly social events! Take a moment to see why you should follow us to Norfolk!

Keynote speaker announced for the opening session of the

VDA House of Delegates

Dr Arthur A. Dugoni, Dean fessor of Orthodontics at the School of Dentistry at the University of the Pacific, will give the keynote address the opening session of the VDA House of Delegates. Dr Dugoni has been at the University of the Pacific since 1978. He is a past president of the ADA and the American Association of Denal Schools. He currently serves as treasurer of the Federation Dentaire Internationale World Dental Federa­tions (FDI).

Dr. Dugoni graduated from the Col­lege of Physicians and Surgeons (now University of the Pacific) and main­tained a private practice for some 40 years. He has been awarded the honor ofAlumnus of the Year by universi­ties: GonzaQ"a Universirv. Universirv

ofWashington, University of San Francisco, and the University of the Pacific. He has received the Hinman Medallion for Leadership, the Albert H. Ketcham Orthodontic Award from the American Board of Orthodon­tics, the Medallion and Merit Award from the Orthodontic Education and Research Foundation, the Chairman's award from the American Dental Trade Association, the Presidential Citation and the Distinguished Service Award from the ADA and the Pierre Fauchard Academy Gold medal.

Dr. DLlgg~i isafounding member of the National Academies of Practice, He is ~~·hon?ra.ty member and recipi~ ent of an honorary fellow~hip from the Academy of General[)entist~ytpq.

an honorary member of the American Academy of Oral Medicine. Heg3f presented more than 500 lectures,

papers, clinics and assays thr9J:!;g~out

his career and is the author ofl00

published articles. Dr. D~9?~i and his wife have seven children ~ndfifteen grandchildren.

In Dr. Dugoni's words "We are com­mitted (at the University of the Pacific) to excellence in education, research

and service, al1cl{oiesponding to our students' neeclSii~ their pursuit of knowledge andprofessional skills. Ac­centuating-the positive, respecting the :ihdividualandempowering our dedi­cated faculty to provide the best pos­

sibl~l~a,r~~l1~envlronme~t fo~ e~ery dental student are among our primary goals. I'm confident thatPacificwill continue to graduate dentists who, by virtue of their diverse training, caring attitude and clinical experience, will be leaders in the dental profession.

The title of Dr. Dugoni's presenta­tion is "Did you come to play? Did you come to make a difference?" His

address will center on his thoughts about the profession of dentistry and our country, in the present and in the future. He will talk about challenge, chanze and commitment and about

getting involved and taking risks, and about unity and teamwork. His questions (and challenge) to the audi­ence will be "What role will you take? What will be the measure of your commitment?"

Seldom do we have the honor to hear someone of Dr. Dugoni's stature and from someone who loves and cares about this profession we call den­tistry. Please join us in celebrating what's right about our great profes­sion.

,A.1J,a~el1dees and guests are invited to he(iU-'~l't Dugoni.

For The First Time Ever! CE Comes To Thursday!

Dr. Jack Shirley presents Occlusal Based Restorative Dentistry

and

Robert Marbach presents Mastering the Art of Cosmetitc and Restorative Dentistry: A Technician's Perspective

These sessions are brought to you by the Virginia Dental Association and the Virginia Academy of General Dentistry.

Pay one fee of $95 for both lectures!

DUal Meeting In Norfolk! Contracting and Legislative Matters For Dentists Patrick C. Devine, Jr., Esquire

The program will discuss contracting and legislative issues which are important to Vir­ginia dental practices.

The first portion of the program will attempt to address a variety of contract related issues faced by dental

practices. The initial discussion will involve managed care contracts. We will review important contract provisions and negotiating strategies which may be helpful to you in your

practice. We will also discuss various reimbursement alternatives.

We will then present an overview of important internal practice contract

documents including employment agreements, shareholder or operating agreements and other governance doc­

uments. With respect to employment agreements, we will review a variety of relevant concepts, including covenants

not to compete, compensation ar­rangements, deferred compensation on retirement and indemnity. We will also consider differences between employment agreements with dentists who have an ownership interest in the practice and those who do not.

We will follow with a short overview

of shareholder or operating agreement issues. Among the provisions we will consider are buy-in arrangements foe new owners, restrictions on transfer, voting and governance rights and buy-out provisions on retirement or termination of employment.

The second segment of the program will involve a discussion of Virginia legislation affecting dentists. We will discuss existing Virginia managed care legislation, including the Managed Care Health Insurance Plan law, the Virginia Fair Business Practices Act, the Virginia Patient Protection Act, the Virginia Any Willing Provider Act and the Virginia Assignment of Pay­ment law. We will also consider other important legislation, including the recent changes to the laws affecting the Board of Dentistry. We will then

discuss possible legislative opportuni­ties.

As time permits, we will conclude the program with a question and answer

period on business issues facing Vir­ginia dentists, and we will try to offer practical solutions to your concerns.

Come See Me. Devine's lecture on this topic on Friday, September 10,2004 from 1:30pm - 4:30pm.

The Keys To Maximum Dental Performance

By:Joe Dillion

"Staying on Balance" (www.Znaturallws.corn)

You are what YOU eat. You can look better, feel better, and even live longer

by changing whar you pur into you mouth. The besr way to eat healthy and sray in shape rakes a little bit of discinline. FoocJ xrnarrx. and rhe will

is found in nutrient rich foods. Your body needs amino acids (protein) to rebuild you cells, essential fats, glucose (carbohydrates) for energy, vitamins and minerals and plenty of water. Start the year by paying atten­tion to what you put in your mouth. All too often we choose what tastes good or is easy and convenient. It's

not enough to feel good. It's time to feel good about your food choices!

Protein: Choose lean sources of pro­tein. lhe quality of a protein source is determined by the amount of pro­tein it contains, the number of amino acids and the ease of assimilation.

Whey protein isolate powder is the best source of protein! Egg whites are second followed by cage-free whole

eggs; salmon; ahi tuna; white meat, skinless chicken; skinless turkey; water-packed tuna; and non-far milk

products.

Essential Fat: While you want to

avoid the fat that comes in most meat

or is added to foods when you fry, you don't want to avoid fat. Your body needs it. Up to 1/3 of your calories can be from fat it you choose the right fats. Raw fats are best (high heat turns good fat into badl). Eat

some raw fat with each meal for brain and eye health, to aid in digestion, boost your immune system, balance

your blood sugar and even help your body to burn fat! Good sources are avocado, extra virgin olive oil, raw seeds & nuts and Udo's Choice Oil Blend.

Carbohydrates: Just as not all fats are bad, not all carbs are to be avoided. Locarb diets have replaced la-fat diets

as the eating plan for success. Bur you don't have to give up all carbohy­drates-in facr, you shouldn't give up all carbs. Your body will feel better with a balance (up to 1/3 of your

choice) of unprocessed carbs (whole vegetables and fruits). 'these foods are your best source of fiber, antioxidants, phyro-nutrients (health-producing substances found only in plants) and glucose (the only fuel your brain can use). 'The key work is unprocessed. Choose foods as grown carbohydrates that come directly from nature to your plate with minimal processing.

Water: Drink as much as you can! You wouldn't go without showering! Keep your insides clean with pure fresh liquid (distilled water is best, followed by filtered, spring, sparkling, herbal tea and decaffeinated coffee).

The Thrill of the Grill!

While food is usually best eaten as close to natural as possible, meat is preferred cooked. The challenge with meat is to minimize the fat content of the meat. You can do this by choosing lean selections and by cooking it with a minimum of added fat. Meats that yield the most protein and the least bad fat are white meat chicken, turkey, and fish and lean cuts of red meat. Grilling as opposed to frying reduces the amount of added fat. Using a George Froeman Grill reduces the fat even further by draining it away, Like Shakes for breakfast, grilled meat is a quick and easy way to create a high

protein meal for lunch or dinner. Grilling is a great alternative to steam­ing for vegetables as well. Cook your whole meal in minutes with the flavor and moisture sealed in, It's as quick and easy as the microwave and better for you!

Sometimes you want more than ef­ficiency when you cook. Preparing meals is part of nuturing yourself and your family. Healthy eating can feel like giving up the comfort and the car­ing. Let the George Forman Grill be part of your new vocabulary to say "I love you/me!" with food.

Heavy Hands are Herd!

Conditioning is one of the 7 Natural Laws. While what you put in your mouth is the biggest part of the health equation, how active you are signifi­cantlyaffects the quality of your life and contributes to your longevity. The best exercise for over-all health is cross-country skiing. It is an aerobic activity using the whole body (this means using the upper and lower body simultaneously). The more work you do at or above the level of your heart, the more improvement you get in you cardioyasc,ll1ar fitness. CC Skiing also puts a. min'imum of stress on the joints, In addition, it is weight-bear­ing (as opposed to swimming) and therefore stimulates your bones as well

as your muscles, reducing the risk of osteoporosis.

What do you do when you don't live where it snows, or during the summer months? There are several pieces of equipment that have been developed to simulate the movement. One of these is Heavy Hands Walking. Leonard Schwartz originally designed Heavy Hands when he was in his late 50s. He was sedentary and out of shape. He was a smoker and had been a non-ath­lete all his life. Within a year he was 8% body fat. He looked and felt great. Today he is 76 years old, 2% body fat, with a resting heart rate of 32 beats per minute. Heavy Hands were designed to be so easy to use, that anyone-even overweight, out of shape, middle-aged guy- could use them.

Heavy Hands walking combines the ease and aftey (injury protection) of walking with the cardiovascular conditioning of cross-country ski­ing. It is convenient to carry with you (although you won't get these through airport securiryl) to the office or gym. Even better, it makes trips to the gym unnecessary, turning your walk around the neighborhood into and effective workout.

Come hear Mr. Dillion on Friday, September 10, 2004 from 8am-llam and Saturday,September 11,2004 from 9am-Noon.

A Financial Prescription For Uncertain Times By: Steve Blaising

Recent economic and political events have made many people anxious and fearful about their futures. At the Blaising Group, our business is help­ing successful dentists increase their sense of direction, confidence and capability in all areas of their financial lives. The following is a discussion of our approach to transforming the un­certainty of the current economic and market environment into an opportu­nity for growth and progress toward an ideal future.

focus on creating value. Periodically, you may be concerned about not sell­ing as much dentistry. People may not be responding to the best advice for treatment. When times are uncertain, they turn off, hang up and slam shut. But, what patients want at all times is value creation- that is, solutions that help them eliminate their fears, cap­ture their potential and reinforce their

strengths. Focus on deepening the power and possibility of the patient re­lationship. Every time you strengthen this relationship, the viability of your _________ .__ . L.' __ . __,11 ,_ ...

Second, forget about your regrets, focus on your opportunities. Things you had, things you took for granted may have disappeared. Some people never get over this. Financially speak­

ing, many regret the portfolio losses from 200 to 2002. But you can recov­er and eliminate the risk of this kind of setback. How? By realizing that the most important governing variable in investment returns in real life isn't cost, or active vs. passive investing.

It is wildly inappropriate investment behavior (choosing the hot dot, panic, market timing, excessive switching). The proof of this conclusion was presented in The Economist's July 5th 2003 issue. The magazine presented results from a recent study conducted by DALBAR and the Bogle Financial Center. Here is the most powerful statistical argument for professional advice over self-managed investments.

Between ] 984 and 2002, the Standard and Poor's 500 stock index returned 12.9% a year. During this same period the average equity fund owned by a professionally guided investor is a better way to go. But, there is one final statistic that obliterates the index. John Bogle, the founder of Vanguard funds, found that the average investor in the same time period (1984-2002) only received a 2.7% average an­nual return. This is due to multiple

changes made inside a portfolio over

an eighteen year time span. In other words, the index averaged 12.9% annually, but the people who owned the index fund only got 2.7% a year. This is what people do in reaction to

chaotic events in their lives and in the world. The professionally ad­vised investor would have been more that 350% better that the self-guided investor. Once and for all investors don't get investment returns, they get investor returns, which are orders of magnitude worse, unless they hire a professional behavioral advisor.

Third, forget about your difficulties and focus on your progress. Yes, port­folio values may be half of what they were four years ago. On top of this, family demands on cash flow grow every year from rising healthcare costs, college tuition and long-term care

for aging parents. These challenges will either defeat you or force you to improve your financial condition. The best way to improve financially with­out working more and overloading your schedule is smart tax planning. For example, there are two different business structures that allow you to

withdraw more money tax-free out of your dental practice. More money can be invested with pre-tax dollars and more benefits such as education,

healthcare, disability and severance can be paid tax-free. Our LifePlan

analysis combs through the financial details of your practice to determine the best business structure for mini­mizing all taxes. Remember, markets face increasing uncertainty. Soc, the best way to make progress toward a secure financial future is (0 eliminate as much tax as possible on current income as well as future retirement cash flow.

Don't be anxious about the future by focusing on today. The future doesn't exist as an idea. It is an abstraction.

The future is what you create through each day's contributions, achieve­ments and results. 'This is a great time to ignore all those experts who never

prepared you for the unexpected.

Focus on what you can do in you relationships, your money decision

and your own talent over the course of each day and you will be prosperous even when times are uncertain.

The Blaising Group is the creator of LifePlan, a comprehensive program for transforming a professional's sense of direction and capability into a secure financial future.

Come hear Mr. Blaising on Friday, September 10, 2004 from 9am­Noon and again from 2pm-5pm.

Take This Job and LoveIt! By: Mark Hyman, DDS

Imagine a day in your practice when

everything is going right. Now, imag­ine that a key teammate sheepishly approaches you and says, "Doc, can I have five minutes of your time after work?"

Oh no! Our dental colleagues would rather hear from the IRS or the State Board of Dental Examiners than imag­ine where this conversation may lead.

At best, we may anticipate a request for time off. At worst, it may turn out

to be a staffing crisis or the opening line of a resignation!

11 , I

seen this coming? Isn't it hard enough

to be CEO/CFO/personnel director and head cheerleader? Fortunately, there is a simple questionnaire that can give you and your team a thumbnail sketch of the practice at any moment. It allows you to focus on areas of concern, study the cause, brainstorm all possible solutions, and institute real

change.

discover 12 key questions that can predict success and happiness in the workplace. For you next staff meet­ing, consider handing out the survey! In a safe and professional fashion, ask the entire tern from 1 to 5 strongly disagree to strongly agree:

• Do I know what is expected of me at work? Are job descriptions written, understood and owned by the entire team? What type of follow-up occurs when we "drop the ball"? • Do I have what I need to do the job right? Does the doctor want a cut­ting-edge periodontal program, but fails to provide modern ultrasonics? Do you want higher case acceptance, but lack intraoral cameras or educa­tional DVD programs? • At work, do I have the opportu­nity to do what I do best every day? Does the doctor delegate duties along with the appropriate training? Is the clinical team doing all the allowable delegated duties? • In the past seven days, have I re­ceived recognition or praise for good work? Does the doctor constantly "catch the team doing things right," instead of criticizing? Do you cel­ebrate small victories daily? Do you feel there is enough appreciation?

• Does my supervisor, or someone at work, seem to care about me as a person? Do we ask and listen with the intention of understanding? Do we encourage time off for special family events such as All Star games, award

ceremonies, or the first day of school? Do we celebrate happy occasions together, such as birthdays, weddings, and anniversaries?

• Is there someone at work who encourages my development? Do we encourage and pay for quality continu­ing education - even outside dentistry

- such;::s Dale Carnegie or Toastrr:;as­

ters? R8we~h~~f:B?ndental self-im­provcmcnt books and tapes?

• At work, do my opinions seem to count? Does the doctor ask for and re­ceive advice? Or is it, as I heard once, "We keep talking about all these things and nothing ever changes!"

• Does the mission/puf1:'8se of the office make me feel like my work is important? Are all~eammates a value piece of the puzzle?

• Are my co-workers committed to doing quality work? Is excellence the standard in our office? What may

be going on that we are not privy to? These may include OSHA rules, quality of provisional restorations, and other duties.

• In the past six months, have I talked with someone about my progress? Do we have consistent, scheduled, written performance reviews, or is this critical growth opportunity relegated to an impromptu five minutes after work one day?

• At work, have I had opportunities to learn and grow? Does the team share ideas with each other after continu­ingdenral education courses? Do out teammates support our dreams?

How to Score Toral the answers to these 12 ques­

tions, .. r~~~ ~5~l'l1at~ will have a scorer~~ng'trom 12 to 60. If we are serious abq~!improving our practices and the OPpo!t~l1ityto quickly iden­tifY and solve pr~ctice management issues, we'll share the results with the team!

Come hear Dr. Hyman on Friday, September 10, 2004 from 8am­l1am and Saturday, September 11, 2004 from 9am-Noon.

Bone Grafting For The ·~-··Bonegraftingwas once performed ·..-restoraeien-of-the vertical bone height only by specialists. and protection of the papilla; all while General Dentist Now conscientious clinicians are ob­ gaining remarkable pontic contoursBy: Dennis Thompson, DDS taining predictable results in sockets, on ridges and with perio defects utiliz­ The socket graft is initiated with ing a new generation of bone graft an atraumatic , Periotome assisted materials and inexpensive guided tissue extraction. For all extraction sites, the (bone) barriers. aggressive debridement is a key to re­The result is improved esthetics, generation. The surgical spoon curette simplified prosthetics, and salvaged and large round burs assure proper dentitions for everyday, happy pa­ removal of all granulation tissue and tients. Join your colleagues in utilizing decortication of the socket wall. Vig­this exciting technology by reading the orous bleeding is a frequent complica­following synopsis and attending the tion of the decortication procedure Virginia Dental Association hands on that can be controlled with lint-free course, Saturday, September 11, 2004. gauze prior to placement of the graft Begin your grafting with the highly material. Load the syringe with 1 inch predictable extraction socket preser­ of graft material, hydrate and gently vation. The rewards are enormous: fill to the crest of bone. Cover with

When you are looking for more than just a crown,

when high-level technical skills and experience are teausea. think of Baran Dental Laboratory

The all-cera same chara CAD/CAMt best fit Imagl

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CAD/CAM technology for all-ceramic crowns

and bridges on a zirconium oxide basis

Ideal for four unit bridges rior strength with high

fracture resistance.

ghly trained hnicians are

ble of working on all the major

acturers' fixed .ant orooucts,

contain the particulate graft. Several suture techniques will be described in­cluding a four corner crisscross suture approach that holds the GBR mem­brane and simultaneously protects the papilla. Examination of a wide range of graft material will give the clinician an insight into product selection for every specific application. Emphasis will be place on using a resorbable graft material which will stabilize the

socket, while allowing a wide variety of prosthetic and implant options not available with dense, non-resorbable materials.

Restoration of the lost ridge can be accomplished with gingival grafts or bone grafting. The benefit of bone grafting is the ability to add dimen­sion in both a horizontal and vertical dimension. Admittedly, some pa­tients will requirea-two stage proce­

dure utilizing bot~techniques. The keys to ridge graft;in,gsuccess are the

preservati0.l1;()f~;~*~g§*~lvn, creation of "space" and"p~~i~eRa.p manage­ment.

.. 'Mastering the Art of

the hands on s~rrii:riar. Every practice has examples of the vertical bone loss

All fac~~~.~~ll be addressed in

Cosmetic and Restorative Dentistry: A Technician's Perspective

By:Robert Marbach

associated with the surgical extraction of the third molar. These defects can

be effectively treated with the new generation of bone graft materials that provide scaffolding, mineraliza­tion potential and utilization of host supplied growth factors and BMP's. These tissue engineered products have added an unprecedented predictability to these simplified graft therapies. Following the principles of good surgical technique, the root surface

wit

tion.

The violation of can emit a sense of te .

unsuspecting clinia~~;' Now advent of biocom~~~ib1egraft carriers,

the doctor can,peE()oly be confident

of a quality cJ~~~r.e, he/she might use

preparation becomes the#

iJ'IlP~I~:nt variable for~g! success;:,Jn addition, ade't{1.1

.. "litates prope~t:ie~~r~ic .ng and ab4~c.t,;

the opport~~.~osecure additional implant s ',.. \ by hydraulically

elevatin ihus membrane. An hnique is commonly

are the apical osteotome

area for placement of the flowable graft material. The resulting dome­like bone formation at the apex of the implant affords additional implant stability.

A masrerful approach (0 solving the problem of voids around the immedi­ate implant placement is the use of hone grafting. The clinician atrau­matically removes the tooth, prepares the osteotomy sire and inserts the appropriate grafr material just prior co placing the implant. The gel like con­sistence assures all voids are properly filled for more complete osseoinregra­

These and other bone grafting tech­niques will be thoroughly discussed

incus clinical examples ar course. Join us, please, d seminar that will kick fting success.

Come hear Dr. Thompson on Saturday, September 11, 2004 from 8am-5pm.

CE On Thursday! Brought To You Through e Virginia Academy()f Ye.Q.~al Dentistry and The

always pleasantly surprised:b : Perspective along with a description

edback. we get after our Ie,. ofthe problems that can actually be i~gj;h~:Ai:tofC:;osmetic.an· ."

Restotative Dentis9Y:ATechnician's Perspective. It'seems the perspective of a technician is unique and valuable on a practical level that dentists and their

staffs can appreciate.

In my estimation, the appreciation comes from the realization that the

information they are being given can actually change the specific things that cause them stress on a daily basis. What causes those stresses? Let's

examine:

The following is the course outline of Mastering the Art of Cosmetic and

solved:

A. Lab Communication - Achieving Optimal Results on Every Case

• Rx Communication - Tips on how (0 let the lab know what you are try­ing to accomplish. Better Rx commu­nication can eliminate misunderstand­ings, missed instructions, incorrect assumptions, and can also help ensure that you have given enough informa­tion. Prevents remakes.

• Sofe Tissue Model - How to fabri­care soft tissue replication to ensure gingival embrasure correctness. Elirni­

• Shade Communication - Conven­tional and digital shade-taking tech­

niques. What Kelvin Temperature should you request to take the best shades? What is CRT (Color Rendering

Index) and how does it affect shades? What bonding materials affect shades?

Discussion on every aspect of shade­

taking communication in dentistry. Reduces shade remakes and adjust­

ments.

• Incisal Edge Matrix - Will show the

laboratory where to place the incisal

edge, thickness, width of teeth, midline

and pitch. Very helpful, patients will enjoy the natural feeling of their new

restorations. Increases patient satisfac­

tion and reduces remakes and adjust­

ments.

• Custom Temps - How to fabricate custom temps that will hold the posi­

tion of your interproximal and occlusal contacts. This step can drastically

reduce contact and occlusion adjust­

ments.

• Impression Troubleshooting - Dis­

cussion on different types of impres­sion materials and techniques. How to

be sure your impression will lead to a

restoration that fits. What commonly

used materials and processes cause dis­tortion of impression materials? Which

trays work best? How to eliminate

the guesswork in impressions. Reduce remakes and frustration.

• Fabricating a Crown Under a Partial - What is the best method? Whether

your patient tells you that they must keep their partial or they allow you to send their partial to the lab. Tips to

avoid problems.

• Model Discrepancies - How you and your laboratory can eliminate this com­

monly missed cause of high occlusion

and adjustments.

• Porcelain Crown/Veneer Checklist - List of criteria that is recommended f('"\r C'11rrpc:c-h,1 nnrrp]'"1;n rrn"'l;);rn/"lfPnpp.r

cases for the best possible esthetics,

predictability and communication.

B. Advanced Restorative Systems

- What's Available, How to Choose One of the most frequent comments we hear from dentists is that they have

a difficult time keeping up with all the

new porcelain systems available. We will break down all restorative systems

as to their indications, conrraindica­tions, strengths, weaknesses, etc. By

the end of the seminar we will sim­

plify the process of materials selection,

preparation and cementation.

• Aluminum Oxide Ceramics - Proc­era, In-Ceram, Wol-Ceram

• Zirconia Ceramics - Procera Zirkon,

In-Ceram Zirconia, Cercon, Lava

• Pressable Ceramics - Empress, Eris, Finesse, Authentic

• Polychromatic Feldsparhic Ceramics - Chromatech

• Polyglass/Indirect Composites - Cristobal +, Sculpture, Tescera

• Advanced Crown and Bridge Materi­als - Captek

C. Building a Successful Cosmetic Practice

What do successful cosmetic practices

have in common? We will recom­

mend tips and techniques in the areas of:

• Marketing/Patient Education

• Marketing/Image

• Clinical Skills

• Laboratory/Dental Office Relation­ships

We are looking forward to our presen­

tation at the 135th Annual Meeting of

the Virginia Dental Association.

Yours For Better Dentistry,

Robert P. Marbach, BA, CDT

Authentic Dental Laboratory, Inc. 1-800-683-1025 [email protected]

Come hear Mr. Marbach on Thurs­day, September 9,2004 from Ipm­5pm.

This session is co-sponsored by the Virginia Dental Association and the Virginia Academy of General Dentistry.

I t,

i " ,,:',::,,:,'

like sure to send

.' ",-,

. ,&.7':£'.'.IV7I" '~'"'.,',''.". ',-',. .. " ~~j[J ~t1'.... . ','" ',-" , ....,•.

on ,the wel1,gj' 1DJII1l1.uadental: o.rgl

"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 truly worth listening to. "

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 recommendAFTCO's dual representation approach without qualification. "

James H. Pauley, DDS Portsmouth, Virginia

Ameo

Your Virginia Represeqtativ~s;

,804~752.2'Z6

Jeff A. Thor~be~~

GaryT.Hollender

Dental Practice Owners Allowed To Protect

Assets Using Retirement Plan

David S. Lionberger, Esquire - Christian & Barton LLC

A recent decision of the United States Supreme Court confirms that a work­ing owner of a business may participate in an employee benefit plan covered under ERISA (Employee Retirement Income and Security Act), such as a retirement plan, so long as the plan covers at least one employee besides the owner and his or her spouse. As a participant under such a plan, the owner (as with any other employee) is entitled to the rights and protections afforded under ERISA.

ERISA contains numerous require­ments, including how and when certain information regarding the operation and benefits under employee benefit plans be communicated to

employees. In addition, an important protection for employees is required by and provided under ERISA retire­ment plans. Under ERISA the funds

in the account of a participant are not subject to garnishment, alienation or attachment by creditors, either of the employer business or of the employee, while such funds are part of the retirement plan. Even in the event of a bankruptcy by the participant, the funds in the account of an ERISA plan participant are generally not sub­ject to the claims of the participant's creditors.

Because of the protection afforded to assets held in an ERISA retirement plan, this decision provides another incentive for dental practice owners and other small businesses to consider adopting retirement plans for the ben­efit of their employees as well as them­selves. In addition to the protection of plan assets, many retirement plans are structured to be tax qualified under the Internal Revenue Code, meaning

that amounts contributed to the plan by the employer may be immediately deducted by the employer, but are not included in the taxable income of the participant until the participant later begins receiving distributions of their plan account balance or benefit payment amount (depending on the type of retirement plan). Annual costs of administration should also be considered, but these tax qualified retirement plans can provide valuable incentives of tax deduction and tax deferral for employers and employees, while also keeping employers com­petitive in the labor market to both attract and retain needed employees.

Wednesday, September 8, 2004

11:OO-S:OOpm Board Of 0 irectors Noon-6:30pm Golf Lunch,

Tournament, and

Reception

Thursday, September 9, 2004

7:00-S:00pm Registration 7:1S-7:4Sam Credentials

Committee 7:45-8:1 Sam House of Del­egares Registra­rion 8:1S-10:1Sam Opening Sessionl

House of Del­egates 8:00-Noon "Occlusal Based

Restorative

Dentistry"

Dr. Jack Shirley 10:30-Spm Reference

Committees Noon-Spm VDHF/VADPAC

Silent Auction I:OO-S:OOpm "Mastering the Art

ofCosmetic and

Restorative

Dentistry: A

Technician's Perspective "*

Robert Marbach 10:00am-7pm Reference

Com. 1000 Reports

10:00am-7:pm Reference Com. 2000 Reports

10:00-7:00pm Reference Com. 3000 Reports

6:00-11 :OOpm ACD Dinner and Dance

All Day Board of Dentistry Meeting

Friday, September 10, 2004

7:00-S:00om Rezistration

8:00-S:00pm VOHF/VADPAC Silent Auction

8:00-11 :OOam "Maximizing the

World ofEsthetic Dentistry?"

Dr. Gerald Kugel 8:00-11 :OOam "Pre-Term Birth and

Periodontal Disease?"

Dr. Majorie Jeffcoat 8:00-11 :OOam "Bone

Grafting" *

(Hands On) Part 1

Dr. James Grisdale 8:30-11 :30am "Producing Peak

Performance"

Joe Dillion 8:30-1 1:30am "Treating the Female

Patient: Medical

and Dental Considerations ,,*

Part 1

Dr. Barbara Steinberg 9:00-12:00pm "Dam-It, It's

Easy!"* (Basic) Mary Costello

9:00-12:00pm "The Next

Financial Shock,

Are lOu Ready?"

Steve Blaising 9:00-12:00pm "HelpfUl Hints For

Building and

Starting A New Dental Office"

Sky Financial! Dave Lionberger

9:00-4:00pm VADPAC Shoeshine

9:00-4:00pm VDA Logo Shop 10:00-Noon Adult Heartsauer

CPR"'

Vivian Biggers 9:00-S:00pm Exhibit Hall open 11:00-2:30pm Alliance Board

Meeting II :30-1 :30pm ACD Luncheon

for Learning 11:30-1 :OOpm Fellows Lunch I:30-4:30pm VAO Board

1:30-3:30pm

1:00-4:00pm

1:00-4:00pm

1:00-4:00pm

I:30-4:30pm

1:30-4:30pm

1:30-4:30pm

2:00-S:00pm

2:00-S:00pm

2:00-4:00pm

3:00-4:30pm

4:00-6:00pm

4:00-6:00pm

4:30-6:30pm

Adult Heartsaver CPR*

Vivian Biggers "Maximizing the

World ofEsthetic Dentistry'?

Dr. Gerald Kugel "Great Question ­

Glad lOu Asked That!"*

Dr. Ellen Byrne "Perio Surgery For

The General Dentist" * (Hands On)

Dr. James Grisdale "Treating the

Female Patient:

Medical and

Dental Considerations ,,*

Dr. Barbara Steinberg "Dam-It, It's Easy!"

(Advanced) *

Mary Costello "Dentists

Contracting and

Legislative Matters"

Pat Devine "infection and

Trauma For The General Dentist'?

Col. John Leist "The Next Financial

Shock, Are lOu

Ready?"

Steve Blaising Constitution &

Bylaws Comm. Speaker of the House Hours ADA 16th District Delegation

VDSC Board Meeting

VAGD Board

5:00-6:30pm MCV/VCU Reception

6:30-10:30pm VDA Friday Party

Saturday, September 11, 2004

7:00am-5:00pm Registration & Ticket Sales

7:30-8:30am lCD Breakfast

8:00-3:00pm Exhibit Hall

Open 8:00-9:00am VAE Board

Meeting 8:00-11 :OOam "Memoirs OfAn

Oral Pathologist?" Dr. John Svirsky

8:00-11 :OOam "The Team

Approach to Periodontal

Therapy"*

Alan Fetner

8:00-11 :OOam "Alveolar Ridge

Preservation,,*

(Hands On)

Dr. Dennis Thompson

8:30-1l:30am "Take ThisJob And Love It!"

Mark Hyman 8:30-11:30am "Endodontic Uh­

os. and No-No's"*

Dr. Stephen Schwartz

9:00-12:00pm "Cutting Edge

Products For

Clinical Excellence"

Derek Hein 9:OO-12:00pm "Producing Peak

Perjormance "

Joe Dillon 9:00-4:00pm VADPAC

Shoeshine 9:OO-4:00pm VDA Logo Shop 1l:30-1:30pm Pierre Fauchard

Luncheon Noon-2:00pm CDHS Lunch and

Meeting 1:OO-4:00pm "Druvs I haue

for Diseases That we Catch"*

John Svirsky 1:00-4:00pm "The Team Approach

to Periodontal Tberapy'" (Continuation)

Dr. Alan Fetner

1:00-4:00pm 'Alveolar Ridge

Preservation ,,*

(Hands On)

Dr. Dennis Thompson

1:30-4:30pm "Take ThisJob And

Love It!" Mark Hyman

1:30-4:30pm "Endodontic Uh­Oh'sand No-Nos?"

(Continuation)

Dr. Stephen Schwartz

2:00-5:00pm "Cutting Edge Products For

Clinical Excellence" (Continuation)

Derek Hein 2:00-5:00pm "Great Question ­

Glad }OU Asked That!"*

Dr. Ellen Byrne 4:30-6:00pm Relief Fund 6:00-9:00pm President's Party

Nauticus

Sunday, September 12, 2004

7:30am Past President's Breakfast

7:30-9:00am Voting 8:00-9:00am Mtg and HOD

Registration 9:00-11 :OOam Old Dominion

Dental Society 9:00-1O:00am VDA Business

Meeting 10:00-1 :OOpm House of Delegates

1:00-3:00pm Board Of Directors

The meeting schedule is current as of May 2, 2004. Please double check event times when you get to the meeting for any changes.

Due to limited seating in all

continuing education lectures,

seating will be available on a "£1rst come, £1rst serve"basrs.

AIDA C·:E.~.:P CONTINUING EDUCATION RECOGNITION PROGRAM

The VDA is recognized as a certified sponsor of continuing dental education by both the ADA CERP and the Academy of General Dentistry.

The Virginia Academy of General Dentistry is proud to be the co­sponsor with the VDA of both of the Thursday, September 9. 2004 CE sessions.

•• •

stration materials will be sent to the Primary strant. Make the Primary Registrant the first entry on ·egistration form.

srrations dealines: •ugust 25 Pre-Registration deadline •ugust 25 Requests for Refunds/Cancellation deadline -prernber 8 Onsite Registration Begins At Marriott

efund requests must be submitted in writing; erence badges must accompany request. Workshops Special Events are not refundable. All refunds are ect to a $10 per registrant fee. Refunds will be essed after the conference.

t names clearly, include preferred first name for each on.

:t registration category and enter corresponding letter ach person registering. Include appropriate fee rding to registration date.

tists may only register as dentists. Dentists may not ter as guests.

ses must be worn and visible at all times.

eted events are on a first-come, first-served basis.

stration will not be processed until payment is ved.

nit registration by fax, mail or online at v.vadental.org.

'egistrations will be accepted by phone or email.

. confirmation letter and registration materials will railed three weeks after you submit your registration payment.

.pelled name badges will be reprinted on-site at 110

ge.

Tours of the USS Wisconsin mrs of the Wisconsin are available of Friday 9/10 and

1 9/11, please pick the correct date and time code from

xlow, Space is limited.

Friday 10:00 am 11:15pm 12:30pm ABC

~""rrl",v 1 0·00"... 11·1'n... "-.'lOn...

Code 01

Code

03 04

Code 05

Code

06

Code 07 25

Code

08

Code 09 10

Code 11 12

Code

13

Code 14 26

Code

15

Code

16

Code 17

Code

Workshop Title Cost Class Limit Code Ridge Restoration and Perio-Defects (VDNnon·VDA)

Occlusal Based Resorative Dentistry $95/$95 200 Thursday, 8:00 a.m. - Noon

and Mastering the Art ofCosmetic and Restorative Dentistry Thursday; 1:00 p.m. - 5:00 p.m.

Maximizing the World ofEsthetic Dentistry Badge 200 Friday; 8:00 a.rn. - 11:00 a.m. Friday; 1:00 p.m. - 4:00 p.m.

Pre-Tenn Birthand Periodontal DIsease Badge 200 Friday;8:00am. - 11:00am.

Perio~ForThe GeneralPractioner (Hands-On) $325/$395 30

Friday;8:00am. - 11:00am. and Firday, 1:00 p.m. - 4:00p.rn,

Producing Peak Performance Badge 200 Frida)! 8:30 a.m. - 11:30 a.m. Saturday; 9:00 a.m. - 12:00 p.m.

1i'eat:in2 the FemalePatient: Medical and Badge 200 Dental"tonsiderations (all-day) Friday; 8:30 a.m, - 11:30 p.m. and Friday; 1:30 p.m. - 4:30 p.m.

Dam-It, It's Easy! (Basicand Advanced) $25/$25 30 Friday; 9:00 a.m. - 12:00 p.m. Friday, 1:30 p.m. - 4:30 p.m. *

TheNextFmancial Shock,AreYou Ready? Badge 200 Friday, 9:00 a.m.- 12:00 p.m. Friday, 2:00 p.m. - 5:00 p.m.

Hel ful Hints For Building and Starting Badge 120 A f.!'ew Dental Practice Friday, 9:00 a.m. - 12:00 p.m.

Great Ouestion•••GladYou Asked That! Badge 120 Frida)! T:O~ p.m. - 4:0~ p.m. Saturday, 2.00 p.m. - 5.00 p.m.

Dentists Contracting and LegisIame Matters Friday; 1:30p.m. - 4:30 p.m.

1reatmentofMmlofucial Infectionsand Thuuna for the GeneralDentist Friday;2:00p.m. - 5:00p.m.

MemoirsOfAn Oral Pathologist Saturday, 8:00 a.m. - 11:00am.

TheT(::r-Lr~ to Periodontal }herapy ~ ~n n~

Badge 120

Badge 200

Badge

Badge

200

200

AFFILIATE EVENT TICKETS:

$325/$395 30

Badge 200

Badge 300

Badge 300

$35/$50 30

Badge 200

$80/$100

$30

Badge

(a)Adults- $20/ (b)Children - $5

Badge

19

Code 20 21

Code 22 23

Code

24

Code 27 28

Code

29

(Hands-On) Saturday; 8:00a.m, - 11 :00a.m. and Saturday, 1:00 p.m. - 4:00p.m.

TakeThisJob and love It Saturday; 8:30a.m. - 11:30a.m . Saturday; 1:30p.m. - 4:30p.m.

Endodontic Uh-Oh's and No-No's Saturday; 8:30a.m. - 11:30a.m. Saturday, 1:30 p.m. - 4:30 p.m.

Cu~ Edge ProductsForOinicd ExceUence [all-day) Saturday, 9:00am. - 12:00p.m. and Saturday, 2:00p.m. - 5:00p.m.

Adult HeartsaverCPR Friday; 10:00a.rn. - Noon Friday; 1:30 p.m. - 3:30p.m.

Drugs I HaveKnownAnd UnOO For DiseasesWe Catch Saturday 1:00p.m.. - 4:00 p.m.

VDA EVENT TICKETS:

Code 41

Code 42

Code 43

Code 44

Code 45

Code 31

Code 32

Code 33

Code 34

Code 35

VDAGolfTournarnent Wednesday; Noon - 6:30 p.m. Elizabeth Manor golfCoUISe

Fellows Lunch* Friday; 11 :30am. - 1:00p.m.

VDAFridayNtght Party Friday,6:30 p.m. - 10:30p.m.

Presidents Party at Nauticus Saturday; 6:00 p.m. - 9:00 p.m.

Past Pr-t5ident's Breakfust* Sunday, 7:30am. - 8:30 a.m.

Badge

$40

Badge

Badge

$40

VAGD Breakfast'" Friday;7:00a.m. - 8:30a.rn,

ACD LunchForLeamiog** Friday; 11:30am. - 1:30 p.m.

MCVNCU Reception Friday; 5:00 p.m. - 6:30 p.m.

ICD Breakfast* Saturday, 7:30 a.m. - 8:30 a.m.

PierreFauchard Luncheon* Sanudav. 11:30 a.m. - 1:30 nrn,

8 Totals:

$

$

$ $ $ $

$ .-$ $ $

10 Grand Total:

$--

Processed By:

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Registration Materials to:

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~cgistrant

mber Email

\ddress

State Zip

rrnber (__) __ - __ Fax Number (__) __ - __

mes For Badges: 5 Registration: It or type- please be neat, errors can lead to delays in processing.

y Registrant On First Line- Listdencisr's name first if attending) Category

------

----_.--_.

.__._.

---'

-

~ Use Only ID ---~ 9 Payment Method:

"

0 General Practice

0 Endodontics

0 Oral Pathology

0 Oral!Maxillofacial!

Radiology

0 Oral Surgery

0 Orthodontics

0 Pediatrics

0 Prosthodontics

0 Public Health

0 Military

6 Fee Code/Fee

o Check (Payable to VDA) Check #

o Visa o MasterCard

Credit Card #

Signature (Signature Indicates approval for charges to your account)

Print Name r ,_ J\

VII')' 1.U vu, • l<-l ....... ,' ...... ~ lUU,"'"

Attending the Luncheon (Code 42)

(on or before (after 8/23/04) (A) Local Anesthetics

8/23/04) (B) Bleaching (A) First Time Attendees .'/;70· S170 (C) CrackedTeeth (B) VDA Member Dentist $140 $190 (0) Pre-Med (C) ADA Denrist (non-VDA) $250 $300 Contriverices

(D) Non-Member Dentist $450 $500 (E) Sedationand Special

(E) Dental Hygienist $'55 $65 NeedsFor Children

(F)Temporomandibular (F) VDAA Member Assistant $25 $35 Joint (G) Non-VDAA Member $35 $45 (G) Serial Extractions

Assistant Dernysrified

(H) Other Office Staff $35 $45 (H) Preparations For

(I) Lab Technician $100 $150 Irnpants

(J) Dental, Hygiene & $0 $0 Choices: 1st Assisting Student

--nd ,~rd

(K) Spouse/Guest $0 $0 -- -

(L) Exhibitor $0 (paid booth fee) $0 (paid booth fee) CJ Refund If ChoicesAre Not

(M) VAGD Dentist (non-VDA) $200 $250 vailable.

Individual Tickets: 7 VDA and Affiliate Event Tickets:

Code/Fee Code/Fee Code/Fee Code/Fee Code/Fee Code/Fee Code/Fee

On 1lle Web: jwww.vadental.org Ivisit our Web site to register or for up-dated information.

Mail To: Before August 23, 2004! Virginia Dental Association

Exp. Date 7525 Staples Mill Road Richmond, VA 23228

Fax To: (804) 261-1660 Credit Card registration Only! If you fax ~'our registration, DO NOT MAIL THE

Please-take-o: ~"to-v~~yect¥'~~o-Y\¥n'"~~~~of 't:h013 5th-A ~/v1eetf¥l~r()f't:h0 VLY~Vet'\t""c«"A~UW\I.Plecue. n.ot"0'

that-~ l.Mt: ~ up "to- date: Ct1' ofJ lM'te' 8, 2004. For cv 1'J'1OY0' C«¥vet'\t"" us:of meet"'~~01I\4rOV~~~ov¥,p~~'t:h0VLY~Vet'\t""c«"

A~Uh1/w~0'Cltwww.vcuiettt"~ovfr

Sponsors Include:

President's Party Virginia Academy of Endodontists Drs. Niamtu, Alexander, Keeney, Harris, Metzger & Dymon

Bronze Virginia Academy of Orthodontists Lab One Pierre Fauchard Academy The Virginia Academy of General Dentistry Drs. Karesh, Shivar and Peluso

Silver Sky Financial Solutions, An MBNA Company

Gold American College Of Dentists BrassIer USA Commonwealth Oral and Facial Surgery International College of Dentists, Virginia Chapter Commonwealth Oral and Facial Surgery

Platinum Bayview Dental Laboratory Delta Dental Plan of Virginia

Titanium Virginia Dental Services Corporation

Totebag Sponsors Anthem Blue Cross/Blue Shield Baran Dental Laboratory B & B Insurance

Lanyard Sponsor Benco

Exhibitors Include:

3i, Impant Innovations, Inc. 3M ESPE ADC Group Financial Services A-DEC AFTCO Anthem Blue Cross/Blue Shield Asset Protection Group, Inc. Authentic Labs B&B Insurance Associates, Inc. Belmont Equipment Benco Dental Biolase Technology, Inc. Brasseler USA C and F Investment Services, Inc. Colgate CollaGenex Pharmaceuticals Delta Dental Plan ofVirginia Den-Mat/Rembrandt DENTSPLY Caulk Dentsply Gendex DENTSPLY/Tulsa Dental Products Designs For Vision, Inc. Direct Reimbursement Discus Dental, Inc. Dodd Dental Laboratories Doral Refining Drake Precision Dental Laboratory Garfield Refining Company GE Medical GE Medical Protective Hannover Dental Refiners Healthy Communities Loan Fund HPSC Financial Services International Dental Products John Hancock Financial Services KaVo America Corp. Kerr Corporation Lifeservers March of Dimes MCVIVCU New Image Dental Laboratory Nobel Biocare OMNII Oral Pharmaceuticals

Oral B ORASCOPTIC Patterson Dental Supply Paul Banditt Inc. Pauline Grabowski and Associates Pelton and Crane Pittman Dental Laboratory Planrneca, Inc. Porter Instrument and Royal Dental Group PracticeWorks/SoftDent/Trophy Premier Dental Products Company Procter and Gamble Professional Practice Consultants, Ltd. Professional Sales Associates, Inc. R.K. Tongue Co., Inc. RGP Dental Rx Honing Machine Satterfield Computer Services, LLC Sheer Vision Inc. Sherer Dental Laboratory, Inc. Silent Auction/Photo Contest Sky Financial Solutions, An MBNA Company SMARTMOVETO

•

Sonicare/Philips Oral Healthcare Southern Dental Industries Sullivan-Schein Dental Sunstar Buder Surgitel/General Scientific Corp. SybronEndo Televox Software, Inc. Thayer Dental Laboratory, Inc. The McNor Group Top Quality Manufacturing U.S. Air Force Dental Recruiter Virginia Health Practitioners'

Intervention Program

Is there anything in the world happier than a kid's smile? At Delta Dental, it's always been our mission to work with Virginia's outstanding dentists to make children's smiles as bright and healthy as possible.

One way we do it is through our Smart Smiles" program. Pannering with Boys & Girls Clubs, we make sure children get regular dental check-ups, learn

how to take care of their teeth through educational programs, and receive transportation to dental appointments. This help is provided to those children who are under­insured or who have no insurance.

Teeth on the Go!" is another innovative approach to children's dental care. Working with the Virginia Department of Education, Delta Dental is making an educational "tool kit" available to elementary schools across Virginia, free of charge. It helps kids make a commitment to taking care of their teeth ­now and for a lifetime.

We'd like to thank all the Virginia dentists who help make these programs succeed.

c) DELTA DENTAl: Delta Dental Plan of Virginia

(800) 237·6060 www.deltadentalva.com

Have You Seen The VDA website Lately?

Have you seen the new website? In April of this year, www.vadental.org came on line. We redesigned our website in order to make it more user friendly for the membership and public.

Using the Navigation bar, you will find links to general calendar listing events, meetings, seminars, com­ponent dental societies and topics such as amalgam waste and direct reimbursement. We particularly hope that you will participate in

our dental discussion area. While national sites are interesting, we believe Virginia dentists will use this area to explore our own local interest and issues. We developed this site with the goal of being easy to use for all our members. The internet has become a critically important com­munication device. It's ability to rapidly disseminate information and communicate with the mem­bers allows us to move in new directions such as online sur­

veys. We can also update you on General Assembly news in order to maximize our impact.

I would like to recognize Drs. Tom Cooke, Terry Dickinson, and Bruce DeGinder and Robert Hall, the Information & Technol­ogy Committee along with Leslie Pinkston.

If there are any questions or ideas to improve our site, contact me at [email protected].

Become A Mentor To A veu Dental Student!

Mission: To give back to the pro­fession and to playa positive and educational role in the develop­ment of a new dentist.

VDA's mentorship program will include:

1. Forming a personal relationship with one (or more) student/so

2. Inviting this student to your practice for practical experience in the professional and economic management of a dental practice.

3. Attending the professional con­ferences with your student at the dental school, the Virginia Annual Meeting, and your local dental society functions.

4. Maintaining an open-door policy with frequent personal com­

munications between you and your student mentor.

5. Assisting your student in the transition from dental student to the practice of dentistry with a continued interest in organized dentistry.

Please visit our website @ www. vadental.org to sign up! The mentoring program is listed un­der the navigation side...double dick - go to the bottom of the page and dick on - Sign up to

become a mentor! Easy! Ques­tions? Email: Leslie Pinkston at [email protected] or call (804) 261-1610.

NET30~nc Toll-Free: 1 (877) 30NET30 • Tel: (804) 716-9070

e-mail: [email protected] • www.net30.net

Abstracts Of Interest

The following abstracts were pro­vided by the Department of Peri­odontics at VCU School of Dentistry. We appreciate the contribution that these individuals have made to the Virginia DentalJournal.

Wound healing of degree III furca­tion involvements with GTR and/or Emdogain. A histologic study. Donos N, Sculean A, Glavind L, Reich E, Karring T. J Clin Periodontol2003; 30: 11061­1068.

Aim: To histologically evaluate the healing of class III furcation defects in mandibular molars following therapy using GTR, emdogain, or a combina­tion of both modalities.

Methods: The study included first and second molars from 3 monkeys. Sec­ond premolars and third molars were extracted 2 months prior to experi­mental period. Surgical defects created in molar furcations, 4 X 3 mm in size and completely removing buccal and lingual plates as well as interradieular bone. Mesial and distal bone left at original height. Impression material in defects to prevent spontaneous healing, second stage of surgery 6 weeks later. At second stage, after dcgranulating defects and conditioning root surfaces with EDTA, roots were notched for reference. Then one molar in each monkey was treated by either GTR using resorbable membrane alone, em­dogain alone, a combination of GTR and emdogain, or resutured at CE]. After 5 months of healing, animals were sacrificed and the teeth removed in block resection, sectioned for serial slides. Results: Furcations and/or membranes were exposed in two out of three teeth in the emdogain and CTR groups and in one out of three in the combination group. New bone formation ranged from 28 - 9] % in the GTR group, 51 ­92% in the emdogain group, 65 - 87%

the control group. New attachment, defined in this study as new cemen­tum and connective tissue insertion into that cementum, was seen in the order of 31 - 89% gain in the GTR group, 42 - 87% in the emdogain group, 61 - 93% in the combo group, and 25 - 62% in the controls.

Conclusions: GTR therapy, alone and in combination with emdogain, may result in inreased amounts of true regeneration used in experimen­tal defects and compared to em­dogain alone and no treatment.

By: Dr. David Johnson, 3rd year periodontal resident at Virginia Commonwealth Unviersity. He was born on November 4, 1970 in Provo, Utah. He received his Bachelor of Science degree from Brigham Young University in 1996 and he earned his D.D.S. from the University of Colorado in 2001.

Effect of non-surgical periodontal therapy on glycemic control in pa­tients with type 2 diabetes mellitus Rodrigues D, Taba M, Novaes A, Souza S, and Grisi M. J Periodontol2003; 74: 1361­1367

Aim: To monitor the effect of non-surgical periodontal therapy on glycemic control in patients with type 2 diabetes mellitus (DM). Materials and methods: 30 patients with type 2 OM were divided into two groups for treatment of peri­odontal disease defined by the pres­ence of on site having at least 5mm PD and 2 sites with at least 6mm AL. Group 1 received full mouth scaling and root planing as well as amoxicillin/davulanic acid 825mg. Croup 2 was treated with full mouth scaling and root planing alone. Blood samples and clinical measure­ments were taken at baseline and 3 months. Measurements were taken with a computerized probe and us-

BOP, PO, CAL, supperation, and PI. Blood was analyzed for fasting glucose level and glycated hemoglobin (HbA 1c). Patients were placed on 2 week recall interval for three months following completion of initial therapy.

Results: Both groups showed significant reduction in PO, with a reduction of 0.8mm and 0.9mm for Group 1 and 2, respectively. However, neither group demonstrated a significant gain in CAL. BOP, PI, and supperation were reduced significantly in both groups. HbAlc values were reduced by 0.3% in group 1 and by 1.2% for group 2, with a lot of variability. It was found to be signifi­cant for group 2 only. Baseline fasting glucose levels were statistically differ­ent between groups, but there was no significant change in fasting glucose level for either group.

Conclusions: Effective periodontal treatment lowered blood glucose levels and reduced clinical parameters of periodontal infection. Therefore, peri­odontal treatment should be included in diabetes preventative measures.

By: Dr. R.Lee Fletcher, III, 3rd year periodontal resident at Virginia Commonwealth University. He was born in 1974 in Orlando, Florida. He received his Bachelor ofScience degree in Microbiology in 1997 at the University of Florida and earned his D.M.D. at NOVA Southeastern University in 2001.

Eruption of Palatal Canines Follow­ing Surgical Exposure: a Review of Outcomes in a Series of Consecutively Treated Cases Ferguson JW, Parvizi F Br J Orthod 2003; 24: 203-207

Aim: To review 72 patients records following surgical exposure of palatally impacted canines to determine outcome success.

Methods: The clinical records of 72 con­

secutive patients who had undergone excisional exposure of one or more palatal canines were reviewed. An approximately full-thickness incision was made and soft tissue and/or bone overlying the crown was removed as needed to expose the entire palatal surface from cusp tip to cingulum, but leaving the cementoenamel junction undisturbed. The wound was then packed with Barricaid light-cured periodontal dressing. Outcome was assessed and judged as successful (5) if the tooth erupted to the extent that bonding of an attachment to the buc­cal surface was possible, without the need for any further orthodontically assisted eruption. 'The outcome was deemed partially successful (P) if suf­ficient tooth enamel still remained ex­posed to permit the bonding of an at­tachment on the palatal aspect which could be used to assist eruption, and as a failure (F) if a degree of gingival regrowth had taken place that would necessitate surgical re-exposure. Also, prognosis according to tooth position on the panorex was determined-vthe closer the canine lies to the midline in the horizontal plane and to the apical third of the incisor root in the vertical plane, the poorer the prognosis. Results: Results were recorded for 78 teeth. The outcome was deemed (5) for 66 teeth (84.6%), (P) for 8 teeth (10.2%) requiring some orthodonti ­cally assisted eruption before a bond could be placed on the buccal surface, and (F) for 4 teeth (5.1 %) requir­ing some re-exposure. There was no significant difference in groups related to age, however, the mean age for the (5) group was 15.1 years, compared to 17.1 for the (P) and (F) groups. For those who were in the (5) group, mean time between exposure and bonding an attachment to the buccal surface was 67.6 weeks. Results were statistically significant as related to the position of the canine on the panorex in the horizontal and vertical planes.

Conclusion: Excisional exposure of palatally impacted canines canines is successful in the great majority of cases. Total failure is rare. With a suit­able exposure technique there seems to

be little indication for bracket bonding at the time of surgery.

By Dr. Bindu Reddy, 3rd year peri­odontal resident at Virginia Com­monwealth University. She was born on April 27, 1974 in Saskatchewan, Canada. She received her Bachelor ofArts degree from the University ofVirginia in 1996 and earned her D.D.S. from Columbia University in 2001.

Crown Lengthening in Mandibu­lar Molars: A 5-year Retrospective Radiographic Analysis Dibart S, Capri D, Kachouh I, Van Dyke T, and Nunn M. J Periodontol 2003; 74: 815-821.

Aim: To evaluate the outcomes of crown lengthening surgery in lower molars and determine a critical value for avoiding evidence of furcation involvement in these teeth. Methods: A retrospective analysis of bitewing radiographs was done to compare the furcation area of crowned lower moloars that underwent crown lengthening (26 teeth) or did not undergo crown lengthening (24 teeth). A grid was overlaid on the radiograph to determine pre-crowning and post

crowning distances from the edge of the decay or restoration to the bony crest at the tip of the furcation. Radiographs were taken 5 years after crown placement.

Results: In teeth that were treated with crown lengthening in 10 of the 26 teeth that underwent the surgery and were then crowned (38.5%). No crowned teeth that did not have crown lengthening showed radio­graphic furcadon involvement. All teeth that showed furcation involve­ment had less than or equal to 4 mm of distance from margin to bone prior to surgery.

Conclusion: If the distance to the furcation in lower molars is less than 4 mm from the margin of the restora­tion, crown lengthening surgery is more likely to result in radiographic furcation involvement within 5 years.

By Dr. Trang Salzberg, a 2nd year periodontal resident at Virginia Commonwealth University. She was born on November 28,1970 in Saigon, Vietnam. She received her Bachelor ofArts degree from University ofVirginia in 1993 and a Masters ofScience degree from Vir­ginia Commonwealth University in 1997. She earned her D.D.S. from Virginia Commonwealth University in 2001.

Some post-op complications occurred including post-op bleeding and super­ficial infection, but the outcome was

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is not only a recipe for a healthy smile Congratulations Erin Collins: 2004 Give Kids it's also a recipe for a healthy life.

A Smile Essay Contest Winner!

A recipe for a healthy smile DENTIST by: Erin Collins, 5th grade NEEDEDPCI Grange Hall Elementary School

Vernon J. Harris East End Com­The health of teeth and gums can munity Health Center, located affect your overall health. Everyone in historic Church Hill, seeks has plaque bacteria in their mouths. full-time dentist for established When plaque bacteria meets up with practice. Provide comprehensive sugars and starches that are found in (children and adults) dental caresnacks, toothpaste containingsnacks, like cookies, candies, dried in community-based practice.fluoride, and maybe even mouth­fruits, soft drinks or even potato chips, Competitive salary and benefitswashes. Also tools we use in ourthe plaque reacts to create acid. The with no buy-in required. Join thisrecipe like soft bristle toothbrushesfact is, most snacks that you eat con­ well-equipped, progressive practice or electric toothbrushes and flosstain either sugars or starches that give where you are needed and appreci­make a healthy smile. And finally,plaque the opportunity to make acid. ated!when combining all of our ingre­During this period the plaque acid is

dients and tools together to make aattacking the tooth's enamel, making

healthy smile it's important that weit weak. That's when cavities can start For more details, please contact:

follow our directions very carefully and the process of tooth decay begins. Tracy Causey, Executive Directorand limit the number of snacks we

Ph. (804) 253-1968 take in between meals; drink lots ofSo, a recipe for a healthy smile truly Fax: (804) 253-1979 water; brush at a 45 degree angle for depends on whether you are using e-mail: [email protected] 2 minutes twice a day and floss. Thisthe right ingredients, such as, healthy

ARE YOU DISCUSSING FOLIC ACID WITH YOUR PATIENTS?

In 2003, the Virginia Department of Health Division of Dental Health, Vir­ginia Folic Acid Council, and the March of Dimes developed a collaboration with the Virginia Dental Association to

encourage all women of childbearing age to take a multivitamin with folic acid and eat foods that contain folate or folic acid daily.

The Virginia Folic Acid Campaign was developed in response (0 the following recommendation, published in 1992 by the U.S. Public Health Service.

• All women of childbearing age need (0

consume 0.4 mg (400 micrograms) of folic acid dailv to prevent two common and serious birrh defects, spina bifida

and anencephaly.

The Centers for Disease Control and Prevention estimates that 50 - 70% of these birth defects could be prevented if this recommendation is followed before and during pregnancy.

Health care providers are recognized to be important motivators of health behavior change. The dentists, dental hygienists, and their support staffs' par­ticipation in the Folic Acid Campaign is most welcome. Efforts to reach the target population not aware of the im­portance of folic acid are patients whom receive dental services. Your influence can have a significant impact on making folic acid consumption an everyday lifestyle habit for your patients.

"The colorful display and cards, available in English and Spanish, 'Babies Need Folic Acid', were designed as an edu­cational (001 to initiate discussing and reinforcing the folic acid message. The

display and cards can be obtained from:

Sharon Logue, R.D.H., M.PH. Virginia Department of Health Division of Dental Health - 9th floor 109 Governor Street Richmond, VA 23219 (804) 864-7788 (804) 864-7783 fax [email protected]

The Virginia Department of Health, Division ofWIC and Community Nutrition is dedicated to sustaining your efforts. Further information on folic acid is available by contacting: Kathy Orchen, PA., M.PH. Virginia Department of Health Division of WIC and Community Nu­trition - 9th floor 109 Governor Street Richmond, VA 23219 (804) 864-7841 (804) 864-7854 fax Kathy.0 [email protected]

Virginia Dental Journal 33

The Spatial Distribution of Dental Facilities in Virginia Co-authors: Stephen E. Wright Ph.D. Associate Professor of Integrated Science and Technology James Madison University

David E. CockIey Dr.PH Associate Professor of Health Sciences James Madison University

Background: Adequate oral health requires accessible dental services. Little attention has been given to the spatial distribution of dentists, including the variables that predict why dentists locate where they do. The U.S. Surgeon General, the Centers for Disease Control, and Virginia's Joint Commission on Healthcare have all paid atten­tion recently to the importance of dental health to the public's well­being. Of significance in this study is the distribution of active dental practices in the Commonwealth of Virginia in 2001. Specifically the study assessed the spatial distribu­tion of dentists, that is, what are the variables that predict or explain why dentists locate where they do, and whether that distribution impacts utilization of dental services or measures of oral health. Nationally there is a ratio of 1724 population per active dentist according to the American Dental Asso­ciation . This ratio how­ever overlooks the spatial variation of dentists within states that is more critical to local population access. Moreover state-based dentist to population ratios fail to extract consequential factors that enhance or inhibit

34 Virginia Dental Journal

population access to active dentists at the local level. Virginia has a population to dentist ratio of 1609 population per active dentist2. Methods: The study's dependent

variable (DV) was Dental Radio­logical Units, a proxy variable for dental facilities, dentist number and dentist location, and thus dental service potential. The DV was defined as the professional place where dental radiological units were located and therefore dental services were rendered. The Virginia Department of Health, Office of Radiological Health (VDHORH) is re­quired to routinely inspect all dental radiology equip­ment in use in the Com­monwealth. Radiological inspection and certification occurs every three years and is documented in the Virginia Department of Health's database. The data­base is updated regularly as information on equipment es­tablishment and termination are reported. Radiological suppliers rather than dental practitioners are required to notify the Virginia Department of Health whenever a

Virginia Denial Radiologkal Unill, 2001

...~.~..::...... ~' ;'~h.

new or refurbished radiology unit is installed or removed. There were 13,182 dental radiological units documented in the study's database in 2001 (Figure 1).

Virginia Dental Radiological Units, 2001

Figure 1 Of the 135 Virginia counties and independent cities, 11 did not have licensed radiological equipment. The counties with zero radiology licenses were Charles City, Green­ville, Highland, King and Queen, Rappahannock, Richmond, Rockbridge, Surry, and Sussex. The independent cities with zero radiology licenses were Bristol and Manassas Park (Figure 2).

Counties and Independent Cities wllh Zero Dental Facllltles, 2001

Figure 2 This study used nine independent variables. They were: Population Change, Population Density, Urban Population, Rural Popula­tion, Median Family Size, Median Age of Population, Residential Stability, Educational Attainment; High school graduate (includes equivalency), and Median Family Income. Choropleth maps, loca­tion quotients (LQs), Z-scores, and regression analysis were the analyti­cal tools used in analyzing the data. Dental radiological units' LQ's and dental radiological units' Z-scores were selected as the descriptive techniques because they both used standardized methods for visual­izing the data.

Regression analysis was selected as the inferential analysis technique.

four of the eleven counties or The multiple regression Binary Z-scores of Virginia Dental Radiological Units. 2001 independent cities with zero dental procedure was selected

because the primary Binaryz.scores

-046(01,99goals of multiple regres­• 20010666

sion is to investigate the relationship between the DV and several IVs and the ability to assess "the importance of each of the IVs to the relationship" . Results: The mapping of the Den­tal Radiological Units' location quotients revealed that of the 135 Virginia counties and independent cities 38 (28.1 %) had LQ's greater than 1. Of these 28 enumeration units, 6 (21.4%) were counties and 22 (78.6%) were independent cities, suggesting a geographical link between urban places and higher magnitudes of dental units. The LQ map did not illustrate or suggest a locational trend that was regional in character. The Z-score map of Virginia dental radiological units showed four Independent Cities with unusual deviational values (greater than 2 standard deviations from the mean of dental units). Alexandria City, Fairfax City, City of Richmond, and Virginia Beach City had Z-scores of 6.65, 2.03, 5.77, and 4.10 respectively (Figure 3). All of the enumeration units were ur­ban places. Combined, these four Independent Cities represented 31. 9 percent (4,203) of all Virginia Dental Radiological Units. Binary Z-scores of Virginia Dental Raadiological Units, 2001

Figure 3 The first stepwise model explained 70.6 percent of the variance with one predictor, Urban Population, while the second stepwise model explained 72.4 percent of the variance with two independent

variables, Urban Population and Population Density respectively. Discussion: Dentists are more likely to be found and in greater nu~bers by the prevalence of large populations. However, the lack of indication of other population measures is relevant to issues of population access. Adding other refining measures to gross popula­tion to dentist ratios, as is preva­lent in other health professional shortage designations, appears to hold limited value. Measures of Education Status and Economic Level, found in other studies, did not add significant amounts of predictability to the regression model. Since utilization of general dental services is gener­ally discretionary, the researchers expected a greater relationship of dental facilities to the population indicators of education status and median family income. Neither of these was found to be a predictor of dental radiological unit distri­bution. The study does call attention to

the importance of determinants of dental need in policies of den­tist distribution. Recent Virginia Department of Health, Center for Primary Care and Rural Health assessmenr of health professional shortage areas. identified 36 counties and 5 independent cites as dental shortage areas. Three ad­ditional counties and five indepen­

dent cities had portions designated as areas of dental shortage. Only

facilities were designated as Den­tal Shortage Areas by the Virginia Department of Health. The predominance of dental ra­diological units location in a few urban areas in Virginia, as noted in the Z-score distribution, raises access questions across the rest of the Commonwealth. Eighty-nine percent of the population of Vir­ginia resides outside of these four urban areas. They are served by only sixty-eight percent of the dental radiological units. Moreover, 99 percent of the Commonwealth's geographic area is outside these four locations. Access to dental care can­not be guaranteed for the balance of the Commonwealth's population. Practice Implications: The spatial distribution of dental facilities has direct relationship to public access to dental services. Public health planners have responsibility for establishing incentives or limita­tions to augment such distribution concerns.

Complete results of the study and further analysis are available on request from the Virginia Dental Association.

Virginia Dental Journal 35

Welcome New Members! Tidewater -

Dr. Jamie Ramsay graduated from the Medical University of South Carolina Dental School in 1999. He is cur­rently practicing dentistry in Suffolk, VA.

Dr. Peter Adams graduated from the VCU/MCV School of Dentistry in 1986. He then completed a one year Ad­vanced Clinic Program with the US navy in Norfolk, VA in 1993. Dr. Adams is currently practicing in Virginia Beach, VA.

Dr. Peter Kuenzli graduated from VCU/MCV School of Dentistry in 1988. Dr. Kuenzli is now practicing den­tistry in Virginia Beach.

Dr. Mark Sarin received his D.D.S. from Temple Univer­sity in 1976. He then received his Certificate in Pediatric Dentistry from the Medical College of VA in 1990. Dr. Sorin is currently on active duty in the Navy and practic­ing dentistry in Portsmouth, VA.

Dr. Mary Dooley received her D.D.S. from VCU/MCV School of Dentistry in 1985. She then received her Certificate in Prosthodontics in 1988. Dr. Dooley is cur­rently practicing dentistry in Virginia Beach, VA.

Dr. Robyn K. Marshall graduated from VCU/MCV School of Dentistry in 1995. Dr. Marshall is a general dentist in private practice working as an associate in Virginia Beach, VA.

Peninsula -

Dr. Ben Steele - Dr. Steele graduated from the Univer­sity of Kentucky in 2003, where he received his D.D.S. degree. Dr. Steele is currently practicing dentistry in Hampton, VA with Dr. James D. Watkins.

Dr. Curtis W Dailey received his D.D.S. from the University of North Carolina in 1996. Working his way north, he attended the University of Virginia where he completed his CPR in 1998. Dr. Dailey then attended the University of Rochester where he received a Certifi­cate in Pediatric Dentistry in 2000. He then received a Certificate in Orthodontics from the National Children's Medical Center in 2002. Dr. Dailey is currently practic­ing orthodontics in Hampton, VA.

Southside -

Dr. John Ji graduated from the University of Pennsylva­nia in 1999. He then attended Howard University where

36 Virginia Dental Journal

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he received his Certificate of Ortho­dontics in 2001. Dr. Ji is currently practicing orthodontics in Colonial Heights, VA.

Dr. Daniel Rhodes graduated from VCU/MCV School of Dentistry in 1995. Dr. Rhodes is currently practic­ing dentistry in Colonial Heights, VA.

Richmond-

Dr. Michael Webb - Dr. Webb gradu­ated from Northwestern University in 1985. He then completed his Ad­vanced Education at the Children's

Hospital of Pittsburg Pediatric Den­tistry in 1989, and Dental Anesthesia from the University of Pittsburg in 1991. Dr. Webb is currently on faculty at VCU/MCV School of Dentistry and is also practicing under the Faculty Practice Plan.

Dr. Stephanie Sawyer - Dr. Sawyer graduated from the University of Missouri dental school in 2000. Dr. Sawyer is currently practicing at the Vernon J Harris Community Health Center in Richmond.

Dr. Mark Diefenderfer received his D.D.S. from VCU/MCV School

of Dentistry in May of 2003. Dr. Diefenderfer is currently practicing dentistry in Richmond, VA with W.

Baxter Perkinson and Associates.

Piedmont -

Dr. W. Lee Phillips - Dr. Phillips

graduated from MCV/VCU School of Dentistry in 1990. He is curren tly practicing dentistry in Lynchburg, VA.

Southwest Dental Society

Dr. Cameron Heydari received his D.D.S. from Meharry Medical College in 1997. He also completed an Intern­ship from the Oral Surgical Institute in 2002. Dr. Heydari is currently practic­ing denristrv at the Free Clinic of the New River Valley in Christiansburg, VA.

Shenandoah -

Dr. Steve Breeden graduated from the University of Kentucky in 2000. Dr. Breeden is currently practicing

dentistry in Stephens City with Dr. Richard Taliaferro.

Dr. David Maybee graduated from the University of Maryland Dental School in 2002. He then received a certificate in 2003 from the University of Con­necticut for completing the AEGD

Program. Dr. Maybee is currently practicing dentistry in Scottsville, VA.

Northern Virginia Dental Society-

Dr. Cudah Bogollagama graduated from M CVNCU School of Dentistry in 2002. She is currently practicing dentistry in Chantilly, VA.

Dr. Jane Delaney graduated from the University of Detroit in 1981. She then received her Pediatric Dentistry Certificate and Master of Science in

Dentistry in June, 1984. Dr. Delaney is currently practicing in Northern Virginia.

Dr. True Duong graduated from the Medical College of Virginia in 1999.

Dr. Duong is currently practicing dentistry in Sterling, VA.

Dr. Joyle Fernandes graduated from GOA Dental College and Hospital in

Goa, India in 1992. She then attended Louisiana State University School of Dentistry and received her Pediatric

Dentistry Certificate in 1999. Dr. Fer­nandes is currently practicing dentistry in Burke, VA.

Dr. John Kim received his D.D.S. from New York University in 1999. He then attended the Medical Col­lege of Virginia where he completed a two-year residency in 2001. Dr. Kim is currently practicing dentistry in Steding, VA.

Dr. Hvue Kwon received her D.D.S. from the University of Maryland in ('omullIea Oil Page3R

Continuing Education

October 2004

October 22-23,2004 Hotel Roanoke, Roanoke VA Realworld Endo.com Dennis Brave, DDS (Saturday session will be hands on)

Meetings & Events

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 VDA Annual Meeting (Exhibits, CE & Social) Waterside Marriott - Norfolk, VA

~nent CE Programs - For registra­

tion information, contact the appropriate person below:

Component I (Tidewater) Virginia Donne (Executive Secrc-rarv) (707) 491A62()

Component 11 (Pl'nin~ula) Kathy Harris (Executive Secretary) (757) 565-6564 Component III {Southside) Dr. Samuel Galstan

(President) (HII4)7%-1915 Componcnr lV (Richmond) LInda Simon (Executive Secretary) (HII4):123-.1191 Component V (Piedmont) Ann Huffman (Executive Secretary) (276) 732-37H9 Component VI (Southwest] Sonya Ferns (l .xecutivc Secretarv) (276) 62H-'19.14

Cnmpcmenr V11 (Shenandoah) Patricia Fuller

(Executivt- Secrerarv) (H04) 9HS-193') Component Vlll (Northern \'j\) Susann \\~ t Iamiuor (J~x(,clJtin' DIrector; 0(3) 642-5297

VAC;!) Pn)!'ra111~ pk-asc contacr L'rancvs Kimbrough

(Executive- Sccrnary) ar H04-320-HKO]

vel' SclViOI of Dentl";lTY rll'~I~L' contact Martha Clements at H04-H2H-IIHW. W"\\'\\·.L1e11 nvtrv. vco. cdn.' ct- ,/ (f lur:-c .... shrm)

IT.L~ch(J()1 ()( ,\luhul\L: /:\nal0m) D<.:pt P1C;I':>l' contact Dr. I Ju,l';o \u1)(:'] af k()4_H2f'vr"t ') I

\'S( )\J". ,lm1 y",) - 1'iL':I'-l' C()llt;ICI "JUl!c Puca- ill KfI4-2(lj

!(I1(1

AIDA C·E·R·P CONTINUING EDUCATION RECOGNITION PROGRAM

The VDA IS recognized as a certified sponsor of continuing dental edccctron by both the ADA CERP and the Academy of General Dent,stry.

Virginia Dental Journal 37

___

1998. She then received her Ortho Certificate and Masters in Dental Sci­ence from the University of Pittsburg in 2001. Dr. Kwon is currently practic­ing in Vienna, VA.

Dr. Robert McCall received his D.D.S. from UNC, Chapel Hill in 1973. He then did a General Dentist Residency at the National Naval Dental Center where he received his certificate in 1982. Dr. McCall is currently practic­ing dentistry in Culpeper, VA.

Dr. Evan Sapperstein received his D.D.S. from the University of Mary­land in 1998. He then did a General Practice Residency at Baltimore Hospi­tal, which he completed in 1999. Dr. Sapperstein is currently practicing in Reston, VA.

Dr. Pariana Tung received her D.D.S. in 2003 from Howard University. Dr. Tung is currently practicing dentistry in Fairfax, VA.

Dr. Cecilia Ykeda received her D.D.S. in 1992 from Peru. She then attended the University of Maryland where she received her Master of Science and

.......... ..............

AEGD Certificate in 2001. Dr. Ykeda is currently practicing dentistry in Springfield, VA.

Dr. Young Yoo received his D.D.S. from Howard University in 2002 and is currently practicing dentistry in Woodbridge, VA.

Dr. Timothy Sumner received his D.D.S. in 1981 from VCU/MCV School of Dentistry. Dr. Sumner is currently practicing dentistry in Manassas, VA.

Dr. Michael Grosso received his 0.0.5 in 2003 from VCU/MCV School Of Dentistry. Dr. Grosso is currently practicing dentistry in Falls Church, VA.

Dr. Wesley Creamer received his

D.D.S. in 203 from Tufts School of Dental Medicine. Dr. Creamer is cur­rently dentistry practicing in Wood­bridge, VA.

Dr. Keith Kallas received his D.D.S. in 1989 and a Certificate of Pediatric Dentistry from Howard University in

Florida School of Dentistry Orth­odontic fellowship, Gainsville, FL

Edward Kim - working some­where in Northern Virginia

Keith Van Tassell- Pediatric Den­tistry at Sunrise Children's Hospi­tal, Las Vegas, NV

Josh Rubinstein - Opening a practice in Richmond, VA

2004 Graduating DentistsJ SOl & M '11ason traw - ra axl 0­

The VDA is happy to present a facial Surgery Residency at Lorna listing of newly graduating den- Linda University in CA tists, The VDA asked all graduat­ing students to please email us Brad Thweatt - AEGD University their personal information for of Florida, St. Petersburg inclusion in this list. Many re­sponded - some did not. Paul Hudson - Will be practicing Melanie Wexel- University of dentistry in Short Pump, VA with

38 Virginia Dental Journal

1993. Dr. Kallas is currently practic­ing dentistry in Vienna.

Dr. Cesar Montalvan received his D.D.S. from the Universidad Pcrvana Cayerane Heredia in 1995. He then received a Certificate in Advanced Education and General Dentistry from the University of Maryland. Dr. Montalvan is currently practicing dentistry in Centreville, VA.

Dr. Marjan Partovi received her 0.0.5 from the University of Mary­land in 2000. She then received her certificate in Advance Education in General Dentistry in 200 1. Dr. Par­tovi is currently practicing dentistry in Rockville, MD.

Dr. Kamran Tavakkoli received her D.D.S. from Temple University in 2002. Dr. Tavakkoli is currently prac­ticing dentistry in Woodbridge, VA.

Dr. Arwa Zeineh received her D.D.S. from Lorna Linda University in 1998. Dr. Zeineh is currently practicing dentistry in Reston,VA.

his father, Dr. Tom Hudson.

Cameron Quayle - Pediatric Dentistry Residency at Primary Children's Medical Center in Salt Lake City, Utah. Mter the residency Cam and Mandie, plan to find a location to open/partner and start a family.

Christabel Sweeney - AEGD Vir­ginia Commonwealth University

Benjamin Webber - Army AEGD, Ft. Campbell, KY and Clarksville, TN

Sheila R. Gillespie - Hampton, VA

Flora Phipps - AEGD Residency atVCU

Gregory W Gatrell - will be mov­ Florida/Shands Hospital, Gainsville,

Lisa Danielle Hoffman - will be ing to Portsmouth, VA, where he Florida.

joining her father, Dr. Richard will be doing a GPR at Portsmouth

Hoffman in his dental practice in Naval Medical Center. Julie Ferguson - Private practice in

Hampton, VA. Southwest VA/Northeast TN Shane Costa - AEGD - Dallas,

Eric Kerbs- will be doing an in­ Texas Justin Ferguson - Private practice

ternship with Dr. Baxter Perkinson in Southwest VA/Northeast TN

and Associates. Jo-Marie Maniwang - Joining

Sarah Sharpley Konikoff Family Dentistry in Vir­

- private practice in ginia Beach, VA.

Loudon Co, VA. Darren Gardner - G PR - Univer­

Sharon Robinson - will be doing Zachary Casagrande - Orthodon­ sity of Utah an internship in Oral and Maxil­ tic Residency at Virginia Common­

lofacial surgery at Shands Hospital, wealth University

an affiliate of the University in

Jacksonville, FL. Christopher Loveland - Pediat­

ric Residency at the University of

LAB ONE Presents: !

Dr. Bill McHorris The "Olde Master" Educator from Memphis, Tennessee

Past. Pres.: American Acad. of Restorative Dentistry and International Acad. of Gnathology

Coming Fri. & Sat. March t tv & 12th, 2005 to the Beautiful Norfolk Airport Holiday Inn Select

Dr. William McHorris, B.S., D.D.S, F.A.C.D. F.I.CD

"Occlusal flfJnllideratiBns It: Pia".,Techniques Plus _r' "'h 0 ~" "J ~

In the tradition of Dr. Jack Turbyfill and Dr. John Kois, another one of the world's true MAster Dentist will show you how proper management of the occlusion for compromised patients can significantly help to alleviate or even resolve some or all individual or collective problems such

as tooth loss, disease entities of the teeth or peridontium, sever attrition, mechanical over-loading, trauma, tmd, or iatrogenic dental treatments. A real learning bonus to your practice will come as Dr. Bill McHorris shares on day two of his program his famous "STUFF THAT

WORKi2", a collections of valuable insights and tricks of the trade which he has gathered over almost 40 years as a "wet Fingered" restorative dentist You will learn in the presence of an Olde Master Dentist how to practice SMARTER, instead of HARDER!

Call coordinator Tom Williford at LAB ONE Seminars 455-8686 or Toll Free 1 (888) 448-7889

e.mail: [email protected]

Paid Advertisement

Virginia Dental Journal 39

DDS Contributor Enjoys Successful Seminar

One of the DDS participating labora­tories serving our profession recently extend-ed their scope of influence in the dental community. LAB ONE, the certified full service dental labora­

tory located in Norfolk, sponsored a two day continuing education seminar hosting Dr. John Kois from Seattle,

Washington. It was attended by 175 dentists, dental hygienists, dental assis­tants and dental technicians from many states throughout America and from Canada. Attendees came from South Carolina, North Carolina, every corner of Virginia, Maryland, Pennsylvania,

New Jersey, all over New York state, New Hampshire, Ohio, Illinois, Cali­fornia, and Toronto, Ontario. It was

the largest seminar to date sponsored by LAB ONE.

The event took place at Norfolk's new

Free Clinic Reaches New Heights

The Free Clinic of the New River Valley's Dental Program is reach­ing new heights in bringing qual­ity care to people who lack health insurance, and are low income.

Last year, the Clinic provided $285,630 worth of care for over 1,000 patients. This care was pro­vided by our part-time dentist, Dr. John Hurt, and a group of dedicat­ed professional volunteers*. Most recently, the Clinic was awarded a sub-contract from a Radford Uni­versity HRSA grant to establish a full-time practice. We welcome Dr. Cameron Heydari from Nash­ville, Tennessee to help implement this bold initiative. The full time dental practice will now double it treatment capacity, as well as add­ing renewed emphasis to preventa­tive care.

40 Virginia Dental Journal

Holiday Inn Select Hotel on Friday and Saturday, Febru-ary 6th and 7th. Dr. Kois, a world renowned prosth­odontist, delivered an impressive advan-ced program entitled "Func­tional Occlusion: Science Driven Managemenr''. The overwhelming

and vocal response from those in at­tendance has been very positive.

Laboratory spokesperson, Tom Wil­liford, stated, « Just like DDS, LAB ONE has long been involved in

sponsoring programs which benefit the dental profession. Our participa­tion in Donated Dental Services has not only given us the opportunity to

serve the needs of certain Virginia patients who otherwise might not enjoy the benefits of good dental care, but has allowed us the ability to speak with many dentists from across the

Volunteer Dentists *:

Matt Ankrum, DDS Michael Ankrum, DDS Richard Anthony, DDS A. Carole Pratt, DDS William Armour, DDS Krieg Pursifull, DDS Richard Boyle, DDS Dennis Schnecker, DDS Graham Hoskins, DDS John Semones, DDS Chris Huff, DDS Wallace Huff, DDS Roger Kiser, DDS Damon Thompson, DDS Peter MacDonald, DDS Daniel Thompson, DDS Richard Newton, DDS Barry Wolfe, DDS Glenn Young, DDS

state."

"We know that our exposure to den­

tists outside of our immediate area has furthered our reputation and added to our ability co reach a much broader market base", he added. "Our origi­nal altruism in offering assistance to a need based dental community has been well rewarded by an excellent

show of support from the profession. It's been a business blessing any dental laboratory would appreciate", Willi­

ford concluded.

Lab One's president, Bill Willits

added, "The DDS program is such a worthwhile effort, I would think every commercial dental labora­tory in the State of Virginia would support their dentists and contribute to this profession's generous outreach."

Carla Taylor, Dental Assistant; and Dr. Cameron Heydari our new full time dentist

:\JI1U )\".1\( J)Cllf.ll :\:,-,>",'l.lfll>rI

~'\\'\\.;Idl (11',[_'.

- The Virginia Dental Health Foundation,

v which works through(. HealthyS...,ileS)

the Virginia Dental ZOIO ­

Cnest Association to help

National Children's increase oral healthcare Dental Access Day

access across the state, February 6, 2004 recently received more

'lhunk-; 10 111//" tricnds (/1/c/'IIPI'O!"lCJ'\" \\-}/O 11<'/Iwd 10 1)/(11,(' if hapPcl/' that $8,500 worth of

free dental supplies from Henry Schein, Inc. (NASDAQ: HSIC), the largest provider of health­care products and services to office­based practitioners in the combined

North American and European mar­kets, to help the Foundation further its mission of improving dental health for the state's underserved. This was the third shipment of donated supplies to the Foundation's MOM Project.

The donations, which recognize the importance of the Foundation's work, come from Henry Schein Cares, the

global corporate citizenship program of Henry Schein. Through Henry Sschein Cares, equipment and sup­plies are donated to organizations working toward improving healthcare education, access and delivery in the

United States and abroad. Last year the Foundation also received more

that $20,000 worth of free supplies through Henry Schein Cares.

"Henry Schein Cares continues to

playa vital role in helping our Poun­

Working Together with the Healthcare Community•.•

~f:~Y''U1 Henry Schein Cares \,.' ,l..<, '"~ (.,

The Virginia Dental Health Foundation Part­ners With Henry Schein To Improve Oral Health­care Access To The State's Underserved

The Foundation will receive free dental and medical supplies from Henry Schein Cares, the global corporate citizenship program of Henry Schein, to help increase oral healthcare access and delivery across Virginia.

dation further vital- but often over­looked - oral healthcare delivery to

Virginia's poor and underserved," said Terry Dickinson, D.D.S., Executive Director of the Virginia Dental Health

Foundation. "These supplies will help the estimated 4,600 dentists better support the more that 7 million people that live in Virginia, and allow us to

mobilize resources, from a financial

and human perspective, to help make a difference in people's lives.

Henry Schein Cares currently sup­

pOrts dozens of nonprofit organiza­tions across the United States and abroad. Its mission is to help narrow the disparity of healthcare delivery, ser­vices and information in underserved communities. Henry Schein Cares provides the programs of community­based health professionals and their

oranizations.

"Henry Schein Cares is committed to

helping narrow the gap in the delivery of healthcare services and improv­ing access to care in underserved communities," said Stanly Berhman, Chairman, Chief Executive Officer and President of Henry Schein. "A

partnership between the public and private sector is one of the best ways to achieve this mission. The Virginia Dental Health Foundation is an excel­

lent example of a community-based

organization helping residents access critical dental care."

Crest Healthy Smiles 2010

The VDA has been pleased to team up with Crest Healthy Smiles 2010. Through this partnership, the VDA has

been able to provide education, sup­plies, and access to oral health care for even more of the undeserving children in Virginia.

CREST HEALTHY SMILES 2010 (CHS2010) is designed to address the

alarrnins disparirv in the oral healthb .

of America's low-income children and

their families. CREST HEALTHY

SMILES 2010 provides education, oral care tools and increased access to

dental professionals to reach 50 mil­lion children across the country within

the next 10 years.

Prompted by the Surgeon General's

200 report addressing the disparity of oral heal rh in America, CBS 2010 combines the passionate vision of Crest with national and local non­profit partners and leading dental professionals to help provide healthy smiles to children nationwide.

Crest 2010

ve: Healthy SK1iJeS) WL

2010

Crest

Virginia Dental Journal 41

Survey Results Reveal Oral Hygiene Habits of Men Lag Behind Women

Text Via Press Release From American Dental Association

Men will have to brush up on caring for their teeth and gums to equal the oral hygiene efforts of women, according to survey find­ings from the American Dental Association (ADA).

In the ADA's 2003 Public Opinion Survey: Oral Health of the U.S. Population, women say they take better care of their teeth than men. According to the survey, women were more likely than men to brush their teeth after every meal (28.7 percent to 20.5 percent) or twice a day (56.8 percent to 49 percent). The survey also re­vealed women were more likely to have a dentist than men (89.2 percent to 74.6 percent).

Overall, American adults recorded a slight increase among those brushing twice a day or after each meal to 78 percent in 2003 com­pared with 1997's 75.4 percent. But the most dramatic jump is brushing frequency occurred in the number of respondents say­ing they brushed after every meal, reaching 24.8 percent in 2003 compared with 11.5 percent in the 1997 survey.

The daily use of dental floss or an interdental cleaner rose slightly to 50.5 percent in 2003 compared with 1997's 48.2 percent.

"Being thorough in your daily oral hygiene lays the groundwork for a healthy smile," explains Dr. Kimberly Harms, ADA con­sumer advisor. "A daily routine of

Virginia Dental Journal

brushing and flossing, in addition to regular dental checkups, can be enough in most cases to help prevent tooth decay and gum disease."

The ADA recommends the fol­lowing:

• Brush your teeth twice a day with fluoride toothpaste.

• Clean between teeth daily with floss or an interdental cleaner. Decay-causing bacteria still lin­gers between teeth where tooth­brush bristles can't reach. Floss­ing removes plaque and food particles from between the teeth and under the gum line.

• Eat a balanced diet and limit between-meal snacks.

• Visit your dentist regularly for professional cleanings and oral exams.

The survey, by Zogby Internation­al in December 2003, consisted of telephone interviews with a nationally representative sample of 1,014 adults aged 18 years and older who identified themselves as the head of household.

The not-for-profit ADA is the nation's largest dental association, representing more than 149,000 members. The premier source of oral health information, the ADA has advocated for the public's health and promoted the art and science of dentistry since 1859. The ADA's state-of-the-art re­search facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient ex­perience more positive. The ADA Seal of Acceptance long has been a valuable and respected auide to consumer and professional prod­ucts. For more information about the ADA, visit the Association's Web site at www.ada.org.

Will Your Retirement Dollars Weather The Coming Storm?

Submitted By: Richard Howard

Alan Greenspan, testifying before Congress' Joint Economic Commit­tee Wednesday, April 21st, stated flatly, "Interest rates are going to rise and the increase will be sooner than later."

That may be good news for CD investors who have been living on a fixed income and have watched the amount of money they live on go down as interest rates have dropped to a forty five year low in past years. When you consider that the inflation rate was recently reported at 5.1%

end of the see-saw goes down - this includes mutual funds which are made up of stocks and bonds. When the rates are at a forty five year low, as they are currently, and the Chairman of the Federal Reserve announces that "Interest rates must rise at some point to prevent pressure on price inflation from eventually emerging" it is a market storm that is brewing that will affect all stock and bond investors. When he states that the rise in rates will "Be sooner than later" this should mean something to investors.

to retire because of a drop in asset value? Note: Some investors lost 30% to 50% of their retirement ac­count value in the 2000, 2001 and 2002 bad market.

2) If I am invested in bonds, how far will the value of these bonds drop with rising rates?

3) If I sustain losses in the market, do I have enough time left to see the market recover and to recover my lost principal and any appreciation I may have gotten in past years?

and CD income is tax­able at ordinary income tax rates, this means that the majority

4) As re­demptions increase at mutual funds be­cause of a falling mar­ket and investors

of these investors have no where to go.

Enough about CD investors, the an­nounced pending rise in interest rates is not relevant to most astute inves­tors because they have chosen to buy mutual funds and be fully invested in the stock market, right? Let's look at what Chairman Greenspan's com­ments mean for these investors.

If you imagine a huge see-saw (remember the long board that two elementary school children played on at the play ground that went up and down) where on one end is inter­est rates and on the other is stock and bond prices. When interest rates are low. as they are currently, the stock and bond prices are historically high. The Dow Jones Industrial Average was at 10.317 as ofthis writing. When interest rates go up. the other

What does all this mean to some­one who is considering retirement or someone who is already retired? Simply put: RISING INTEREST RATES MEAN FALLING STOCK AND BOND PRICES. If you are invested in the market, you will be affected! Will Rogers once said, "Even if you are on the right track, you will get run over if you don't move." With this fact in mind, what questions or considerations should the retiree or soon to be retired den­tist take into account?

Here are several: I) If there is a substantial drop in the stock market. will this affect my retirement monies and conse­quently my plans and time table for retirement? Will I have to continue working past the date I have planned

pulling money out, am I prepared to pay the long term capital gains tax bill I get at the end of the year from the mu­tual fund, even though I didn't sell any shares myself?

5) Can I get these assets out of my estate tax-free even if! don't lose money in a down market?

6) Do I have a large stock position that I don't want to sell because I don't want to pay the long term capi­tal gains taxes that would be due on the sale but can I afford the market risk to this stock position since it is a major part of my total assets?

7) Do I have a Charitable Remain­der Trust that was designed to pay lifetime income and will a falling

Cominued On Page 44

Virginia Dental Journal 43

WashEd

& StrEtchEs likE LatEX.

"" Elasticity for a PErfEct Fit

market mean that the income I have been getting will be reduced or completely eliminated but the annual fees for the administration continue? 8) Will I be able to maintain my lifestyle in retirement as I liquidate assets from my retirement plans to take the required minimum distribu­tion (RMD) when the value of the assets is falling with a declining market?

9) Am I paying a money manager or an advisor fees annually to give me less than average results (only 6% of all mutual funds beat the Dow on a consistent basis) and has my advisor or money manager cautioned me about the effect of rising rates-or have they insisted I remain invested in the market for the "long term"?

These are just some of the questions that can be answered in a beneficial way for retiring or retired dentists when they compare their current

financial situation and plans to the benefits of using of the Virginia Dental Health Foundation's Tax Smart AnnuitylY in their financial and estate planning.

By using the Tax Smart Annuity'>' in your financial and estate plan­ning, the dentist gets a current year tax deduction which saves immedi­ate tax dollars and eliminates market and interest rate risk. In addition, the dentist gets lifetime income at a high rate for two people, the dentist and the spouse. In the process. the participant can move this money out of their estate to their heirs tax-free and save approximately one-half of the asset value in estate and inheri­tance taxes that would otherwise have to be paid by liquidating assets.

Mr. Howard is a Certified Senior Advisor, a member of the Financial Planning Association and the Soci­ety of Senior Market Professionals.

He is featured in the May issue of Senior Market Advisor magazine where he discusses several of these tax saving strategies. Before form­ing his company in 1989, he was a Registered Representative, Vice President of Investments and Branch Manager for Shearson, Lehman Securities. He speaks nationally to industry groups, and conducts con­tinuing education classes for CPAs, attorneys and financial planners.

Student News Gerald C. Canaan, II, Esquire spoke to

the dental students March 22, 2004, for the last Dinner and Learn of the 2004 Academic year. Mr. Canaan had a wonderful presentation prepared on Dentistry and Law in Virginia. Mr. Canaan represents only medi­cal professionals in Virginia. Dental malpractice, standard of care, informed consent, documentation, billing, risk management and several examples of

44 Virginia Dental Journal

cases were presented. It was a very educational evening! In reviewing some of the trial cases, the audience was most surprised on the reasons and monetary amount the jury would award the plaintiff. Thank you Gerald Canaan!

Gerald Canaan, Esquire with students afrer rhe Dinner and Learn

Dr. McMunn ar rhe February Dinner and Learn

I Dr. DeGinder Provides Keynore Address At Dental School Awards Ceremony

COMPONENT NEWS

Component I Tidewater ,

•Dr. Barn Einhorn, Editor

A « warm" hello from Tidewater. We are in the throes of what is supposed to be spring, but it feels very much like summer.

This has been an active year for our component. We had a large contingent

of volunteers for our fall MOM project and as usual it was a rousing success. What is most amazing about this effort is the fact that those who participate seem to enjoy it so much and we have folks who repeat each time we make

the trip across the bay.

We held a very successful "Give Kids a Smile Day" in conjunction with

the School of Dental Hygiene of Old Dominion University. According to

chairman, Anthony Peluso, 40 chil­dren were seen and besides exams and bitewings, 152 sealants were placed on indicated teeth.

We have two significant functions planned for the summer. The first is The Alabama Implant Study group on August 5-8 at the Virginia Beach Re­sort and Conference Center. Speakers will be; Dr. Charles English who will talk about Implant Prosthetics and Mr. Dan Root whose topic will be Implant Complications and Their Cosmetic Results.

The second event is our annual meet­ing which will be held on Wednesday, August 18, 2004 at the Holiday Inn­Greenbrier at 6:00 PM. For Information about either of these events please call Ginnie Donne at

757-491-4626.

We are proud of our retired colleague Jack Atkins who at age 80 undertook a cross country bike tour to raise money for Lee's Friends a local charity which

provides services to cancer patients. We mourn the loss of two of our out­standing colleagues. Van K. Heely and Jerry Weinstein. Do come and visit us. the water is get­

ting warm and the skies are remarkably blue.

Component II

Peninsula

Dr. Elizabeth A. Bernhard, Editor

No News To Report, Please Contact Your Component Secretary.

Component III Southside

.. Dr. Mike Hanley, Editor

Greetings from Southside

Not much good news from South

of the James. Nothing really on the agenda until our annual golf and swim business meeting in late August.

Lost a good friend in May when Dr. Eduardo Ortiz passed away after a prolonged illness. I met Eddie in 1986 while I was looking for a practice to purchase. We hit it off instantly and worked together for two very reward­

ing years. Eddie always had stories to tell; about his patients, about his family, and about his life. His patients loved him- talk about a tough act to follow! He always tried to give a painless injection ... and succeeded.

He decided a long time earlier that he wouldn't extract any more teeth: his job was to save them. Up until his passing, his old patients would

ask how he was doing. Many, many patients told me that Dr Ortiz took away their fear of dentistry. I'm still running explorers over the smooth margins crafted thirty year prior. Nice job, Eddie.

I'll see everyone at the VDA in Norfolk. The last meeting there was great. Later in the month it's down to

Orlando for the ADA. I hope to play

one round of golf with Goofey .... .1 hope David Ellis is bringing his clubs.

Virginia Dental Journal 45

Talk to you later, Component VIComponent V Mike SouthwestPiedmont

Component IV Richmond

Dr. Kitt Finley-Parker, Editor

We hope our fellow Virginia Com­ponents are having a great summer! Component TV's end of the year Annual Golf Outing, Bike Ride and Family Cookout was a great success. Everyone had a wonderful time. We want to thank Mike Miller for orga­nizing such a fabulous event.

Our new slate of officers for the 2004­2005 year is:

President- Dr. Frank Straus President-Elect- Dr. Kitt Finley-Parker Secretary- Dr. Roger Wood Treasurer- Dr.Ed Griggs

We have some exceptional CE planned for the fall and into 200S! On November 19, 2004 we will have Connie Podesta for an all day course. On February 18,2005 the phenomenal Dr.Gordon Christianson will be in Richmond to give a course that is always filled with so much use­ful information you can take it back to your office on Monday and start implementing it right away. Our last all day CE course will be Dr.Ray Bertolotti. Please mark these dates on your calendars and plan to attend. Enjoy your last few weeks of summer and we will see you in Norfolk for the Annual Meeting in September!

46 Virginia Dental Journal

.. Dr. Lori Snidow, Editor

The Piedmont is pleased to announce that our very own Mark A. Crabtree, DDS from Martinsville is running for VDA President-elect. We wish him lots of luck!

We had a great spring meeting at the Holiday Inn Select in April. Everyone learned a lot and seemed to enjoy the day.

Our fall meeting is fast approaching and we are excited to have Dr. Den­nis Brave with RealWorid Endo be our guest speaker. We will be having a hands on session Saturday with limited space so if you are interested in attend­ing the hands on, please let Ann Huff­man know as soon as possible.

Get your golf clubs ready for our spring 2005 meeting. We will be going back to The Homestead, Hot Springs, VA. The dates are April 8-9, 2005. On Saturday we will be having a golf tour­nament. Registration forms will go in the mail soon! Make sure to mark your calendar today.

We are working to get some exciting speakers for our upcoming meetings. Linda Miles is one of everyone's favor­ite. She will be with us corning soon. This will be a great opportunity for you to bring your staff. Details will follow as they become available.

If additional information is needed please contact OUt executive secretary Ann Huffman at 276-732-3789.

~..'

Dr. Robert G. Schuster, Editor

No News To Report. Please Contact Your Component Secretary

Component VII Shenandoah Valley

Dr. Harry M. Sartelle, III, President

No News To Report. Please Contact Your Component Secretary

Component VIII Northern Virginia

Dr. Scott McQuiston, Editor

Northern Virginia hosted its second M.O.M project in March under the direction of Dr. David Anderson. Overall the event was a success being held at the newly constructed dental hygiene facility at Northern Virginia Community College's Allied Health Center in Lorton, Virginia. Over 900 patients were served. Spe­cial thanks goes to the Northern Vir­ginia Hygiene Association for their help in keeping the hygiene chairs busy. The facility was superb and the staff was excellent. Thanks to Dr. Anderson for his hard work and dedication to this worthy event and to all the volunteers and sponsors for their unwavering commitment to the underserved of Northern Virginia.

Most noteworthy was our annual fund-raising event for the Northern Virginia Dental Clinic. This years Field Day was held at the Virginia Oaks Golf Course in Gainesville , VA. The event generated nearly

$9,000.00 for the clinic. There were many winners that day both dentist members and non-members alike. Rumor has it that all the awards in the female category were eked out by Dr's Brenda Young and Melanic Love. Hummm? Everyone was a winner that day because the weather was beautiful and all had fun. Thanks to Dr. Ron Hauptman and Tom Wil­son (clinic director) for their efforts in planning this event.

We were both informed and amused by the speakers Dr. Ellen Byrne and Dr. John Sivirsky in recent months. Sivirsky is synonymous with comedy and his show is a good one. Dr. By­rne and Dr. Sivirsky are exceptional speakers as well as excellent educa­tors. In related news our Committee for the New Dentist has put together a program titled, "Creating the Ideal Dental Practice", Thanks to Dr. Peter Cocolis' committee for bringing together those entities and businesses that can help the new dentist achieve their goals.

All<:6n;tr(j~e~tf'T~"'S Is.:~u~1nitte~ On A V91urite~BasisB~YourOo1n­ponent~ecretary.·l'oLe~~n'N1Q~e About SpecificEvents, QrTo Find Out More Ab()utUpeom~ng.Events In Your 'Component,Plea~e Contact Your Component Secretary.

-:

Alliance News Shirlev S. Meade, President

Enjoy those lazy days of summer because fall is right behind and that

means annual meetings! 'The Alli­

ance cordially invites you to join us and the VDA in Norfolk, September

9 - 12, and take part in the following

activities designed for your entertain­ment and enjoyment. On Thursday,

September 9, enjoy having lunch and roaming through the Norfolk Botani­

cal Gardens. We will depart from the

\XTaterside Marriott at ] 1am. The

price is Si 1Gper person which includes

your lunch and garden admission with tram tour of the gardens. On Friday,

September 10, the members of the Al­liance Executive Board will meet at the

Waterside Marriott Hotel from l Oarn

until 2pm. All Alliance members and

guests are invited to attend the Alli­ance Annual Membership Meeting on

Saturday, September 11, which will be

held at The Painted Lady restaurant

in the historic Ghent District. We will leave from the Waterside Marriott

at 10:30am. After our meeting and

lunch, we will have time to shop! The

price is $20 per person. To attend any

of these functions, please send a check

made payable to AVDA to Shirley Meade, 13004 Chipstead Road,

Chester, VA 23831. Please make your

reservations by August 10.

From Hampton Roads, it's off to

Florida for a fantastic ADA meeting in

Orlando in October. I'd like to high­

light a few of the Alliance activities that are scheduled to take place there.

Thursday, September 30, we will take

care of business, beginning with our ADPAC Breakfast and Awards, fol­lowed by our first House of Delegates.

Lunch will recognize the winners of the Thelma}. Neff Distinguished Ser­

vice Award. Later that evening all are invited to attend (for free) the AADA

President & President-Elect Recep­

tion, underwritten by MBNA

Friday, October 1 is the date for the ADA/AADA/FDHE "Dish­

ing Up Smiles" Luncheon. This is

a luncheon event planned to release the new AADA dental health cook­book, "Dishing Up "Smiles". This

fun and entertaining book combines

humorous photos, quick, easy & healthy recipes, dental health tips and

etiquette hints from the owners of

Professional Courtesy. Speakers for the event are Karen Hickman and Nancv

Sweet, nationally recognized etiquette consultants. Their focus is empower­

ing professionals, executives and indi­

viduals in Business Dining Etiquette and How to Dine like a Diplomat. Their presentation is for both men

and women. Proceeds from this event

will benefit dental health programs

in America sponsored by the AADA and the Foundation for Dental Health Education. For more information on

this event, see page 10 of the ADA 04

Orlando preview book or your summer edition of KEY.

Also on Friday, AADA will assist the

ADA Foundation with their Health

Screening Program from 2pm to 4pm.

Saturday, October 2 will conclude our

convention with the Member Project

Awards Breakfast, 2nd House of Del­

egates, and the Incoming President's

Reception.

The Rosen Plaza Hotel will be the headquarters for the Alliance meet­ings. It is located near the convention

center. Our schedule will be posted

in the Summer Issue of KEY. If you haven't been part of an annual Alliance

meeting before..,you are just the dental

spouse we are looking for! Everyone

has something to offer to this profes­

sional organization and the Alliance

has something to offer to each of you. You will discover the benefits of

your membership by being with other members from across the United States

and finding out what [he BIG picture

is all about. You will find yourself sur­

rounded by some of the nicest people and possibly life long friends are await­

ing you!

So much to look forward to! I look

forward to seeing all of you - first in Norfolk and then down in Orlando!

VAENews Dr. TimothY J. C;olian, President

No News To Report. Please Contact Your Organization Secretary

Virginia Dental Journal 47

Virginia Association of Orthodontists Penny L. Lampros, 0.0.5, M.S.D.

President, VAG

The Virginia Association of Ortho­

dontists had our annual meeting at the

Cavalier Hotel in Virginia Beach from

June 25-30. Our speakers were Dr.

David Sarver who spoke on the esthet­

ics of orthodontics and Dr. Jerry Clark who discussed strategies to ensure

retiring financially secure. Both speak­

ers were excellent. We also had a great

time seeing old friends and meeting

new colleagues.

The VAO has a long history of proven leadership in Virginia and across the

United States. Many orthodontists

have laid the groundwork for us to

have successful practices by support­ing the VAO The VAO continues to

provide continuing education but more

importantly allows us as orthodontists

to gather to share experiences, net­

work, and understand current happen­ings in local, national and international

health care.

Sincerely,

Penny L. Lampros, D.D.S., M.S.D.

School Of Dentistry

Dr. Betsy A. Hagan Senior Associate Dean for Dentistrv

Meredith Brvk Contributing Editor

Another Exciting Year .

-- Dean Ron Hunt

lt has been an exciting and busy year at the VCU School of Dentistry. In May, we sent classes of excellent dental and dental hygiene graduates into the dental workplace to help meet the oral health needs of the public. An exceptionally strong Class of 2008 has been accepted for the coming year and will begin classes in late July. At year's end, we had dental and dental hygiene students participating in off-campus rotations

48 Virginia Dental Journal

at Free Clinics in Lynchburg in Cen­tral Virginia and Kilmarnnock in the Northern Neck. By fall, students also will be treating patients at the Bradley Free Clinic in Roanoke. Faculty retire­ments have led to the recruitment of new faculty and administrators who are bringing stimulating change to the school's programs. We also began the series of renovations that ultimately will result in creation of the new preclinical simulation laboratories.

From January through early May, we watched the 2004 Session of the Virginia General Assembly with great interest. The session was noteworthy for its unusual length and its contentious budget standoff. In the end, though, the VCU School of Dentistry emerged with major gains.

Private Practice Preceptorships

With the passage of House Bill 1049 unanimously in both houses of the Gen­eral Assembly, the statutes governing dental practice in Virginia were changed to benefit dental and dental hygiene education. We now can begin placing dental and dental hygiene students in off-campus rotations in private practice preceptorships, which will expand the students' education while giving them important exposure to nonmetropolitan areas. We are very excited about the prospect of sending students into the smaller communities of Virginia to serve and to learn. Delegate Phil Hamilton of Newport News parroned this bill for us and was very helpful in steering the bill to passage.

Private practice preceptorships will com­plement the public clinic preceptorships we initiated this year, with a long-range goal of having all fourth-year students complete a one-month rotation in a public clinic and a one-month rotation in a private office. We will emphasize rotations in rural and underserved areas of Virginia.

HB 1049 also leads to some statute

and regulation changes that permit the creation of temporary licenses for dental graduate students. With the issuance of

these licenses, the school is able to avoid problems with Virginia laws regulating prescription writing.

Rural Dental Scholarships

In a related matter, Senator Benjamin Lambert of Richmond secured for us $25,000 for rural dental scholarships and loan repayments. This annual ap­propriation doubles the funds available for students and graduates who agree to practice in rural underserved areas of Virginia. Senator Lambert serves on the School of Dentistry's Board ofAdvi­sors and has been a long time supporter ofVCU and the School of Dentistry.

Dental Simulation Funding

In a very exciting budget victory for the VCU School of Dentistry, the Virginia General Assembly in May approved a $2. I million capital outlay for dental simulation equipment. The funds will be allocated to us over four years, and require the school to match 2: I with private funds. Our match is coming from the Clinical Simulation campaign that has just passed the half way mark toward raising its goal of $4 million.

It took the work of many people to

bring about this exciting funding victory. VCU leaders put the project in VCU's biennial budget request. It subsequently was supported by the Governor and by the Senate. However, the House removed it in forming its anti-tax budget. With the help of many people, especially from the Virginia Dental Association (VDA), our ap­propriation was reinserted in the House budget, and remained a part of the budget that was hammered out by the Budget Conference Committee.

This simulation equipment will al­low the VCU School of Dentistry to introduce state-of-the-art, virtual reality technology into its preclinical cur­riculum. From their first day of dental school, students will be able to work with dental mannequins that closely

simulate the direct patient care envi­ronment that the students will enter later in the curriculum. Using infrared

sensors and computers, tooth prepara­tions can be tracked and evaluated with Dental Simulators. With greater op­portunity for self-study and self-assess­ment, students will more quickly prepare for direct patient care, while being less

reliant on full-time faculty. Dental simulation technology allows us to

provide better and more timely instruc­

tion, while lessening our dependence on full-time faculty. Which, in turn, allows

us to work within the smaller budget we now have.

Thank You to the Virginia Dental As­

sociation and Other Friends

We owe a great debt of gratitude to the leaders of the Virginia Dental Associa­

tion for their lobbying efforts -- especial­ly with the nine members of the Budget

Conference Committee -- in getting the

funding reinstated in the House budget. Within the dental school, Ellen Byrne,

Betsy Hagan, and Jim Revere were in­strumental in contacting budget confer­

ees with whom they had close working

relationships. Many other dentists in the VDA contacted other conferees on our behalf. In the end, the dentists were

heard.

When coupled with the General Assem­bly's adoption of two statute changes for

us - private practice preceptorships and temporary licenses for graduate students

-- this was a great legislative session for

the VCU School of Dentistry. The VDA also was instrumental in gaining those

statute changes, sponsoring the legisla­

tion through Delegate Hamilton, and carrying the lobbying flag for us. Most notable in those efforts were Lobby­

ist Chuck Duvall, Executive Director

Terry Dickinson, and Legislative Liaison

Nicole Pugar of the VDA. The Virginia Board of Dentistry and the Virginia Dental Hygiene Association also helped

draft HB 1049 and supported its passage.

On behalf of the school, I'd like to thank all of these people For their guidance and support. Through the work of many, we were able to continue the remark­able string of legislative successes for the

dental profession and the public it serves in the Commonwealth of Virginia.

United Concordia Contributes to Mis­sion of Mercy

United Concordia Companies, Inc., has

generously donated more than $48,000 to the School of Dentistry for expenses associated with the Mission Of Mercy

(MOM). Through MOM, the school

sends students, residents, faculty, and staff to contribute their skills and time

to provide dental care to Virginians in underserved areas. The dental school

anticipates participating in as many as six MOM projects per year. With a Glen

Allen office in the greater Richmond area, United Concordia was looking for

a unique service project in the Com­monwealth.

United Concordia is a dental insurance company with more than 6.5 mil­

lion members in the United States and

abroad. Headquartered in Harrisburg,

they carry the world's largest dental con­tract on behalf of the U.S. Department

of Defense. We thank United Concordia

for their generous contribution and look forward to a fruitful relationship that will continue to advance the goals of the Mission of Mercy.

Alumni Return for Reunion Weekend

2004, Two Honored at Banquet

On the weekend ofApril 23, 2004,

more than 300 dental and dental hygiene alumni returned to the MCV

Campus for the annual reunion week­end. The festivities began on Friday

evening with a reception hosted by the School of Dentistry and the MCV Alumni Association at the Richmond

Omni Hotel.

During the alumni banquet on Satur­day evening, Dr. Ron Tankersley (DDS

'68 and Oral Surgery '71) was honored with the Harry Lyons Outstanding Alumni Award. A previous longstanding engagement prevented Tankersley from

attending the banquet. However, his son, Dr. Ken Tankersley ('97), accepted the award on behalf of his father, who has

been a tireless advocate for dentistry at

all levels, including his dedication to the School of Dentistry, the Virginia Dental

Association, the American Association of Oral and Maxillofacial Surgery, and

the American Dental Association. This

coming fall will mark his 30th year as a

member of the adjunct faculty.

Dr. Lewis T. Rogers ('51) was awarded the School of Dentistry's first-ever Dr.

James H. Revere, Jr. Outstanding Ser­vice Award. Dr. Rogers was an adjunct faculty member of the school for almost

his entire dental career. This year's award

recognizes his tremendous dedication to

service, and his 47 years of teaching at the dental school.

This annual service award will recognize either an alumnus of the MCV/VCU

School of Dentistry or an honorary alumnus who has shown outstanding

leadership, loyalty, and service to the community, to the School or Univer­

sity, or to professional or community

organizations. This award bears the name

of Dr. James H. Revere, Jr. ('65) whose

immeasurable contributions idealize the principles of this award. The award

will be coordinated through the VCU School of Dentistry's Dean's Office and presented at the Annual MCV Campus Reunion Weekend dentistry dinner.

News Continued On Page52

Virginia Dental Journal 49

Continued From Page 12

future, bleach-lighr combinations may

be found that will allow faster and better tooth lightening than the bleach alone.

We are still waiting.

I HAVE HAD ENOUGH!

The solution-I suggest that editors of

journals and magazines recruit thoroughly informed, honest consultants, who have

had actual clinical experience with the concept being studied, to screen the

advertisements, weeding out the mislead­ing or overtly dishonest ads. Additionally,

dentists need to be wary of advertising from companies known to exaggerate product characteristics or to misrepresent

the advantages of their products in ads. Companies should realize [hat honest

advertising is clearly evident to informed readers, and similarly dishonest ads soon

are soon disproved by clinical results. When clinical research and experience do not confirm the claims in the ads, dentists soon lose confidence in believing any future ads from the company involved.

ARTICLES IN JOURNALS A recent research paper published on the most commonly used esthetic dentistry procedure in a prestigious "peer reviewed" journal, and showing positive characteris­tics for the product evaluated, was funded by the company selling the system. In some situations, this may be legitimate, but in this case, studies from other re­searchers published in the same issue with

the commercially supported paper would certainly have made the results more cred­

ible. Most companies are doing their best to be honest and sincere, but the few who flagrantly try to promote their products by "bought research" soon become identified

by practitioners.

A popular, well accepted technique was

denounced in another research paper in a "peer reviewed" journal. Immediately, den­tist participants in continuing education

courses asked why the clinically success­ful technique, which most of them were using, didn't do better in the research. After reviewing the paper, it was found

that a third-party payment company, with obvious vested interests to reduce the use

of the popular concept, had funded the research.

50 Virginia Dental Journal

You have read many scientific projects that test a group of commercially avail­able products, and find one product to be the best. It should not be a surprise to

find that the product from the company funding the study had the most positive results. Unfortunately, dental education and dental educators have always been un­derfunded. Dental manufacturers provide much of the funding for university-based dental research. Although not impossible, it is difficult for a dental faculty member to remain totally unbiased, when accom­plishing a research project, if all or a major portion of his/her salary comes from the research grant. Additionally, when a com­pany-funded project does not come out to favor a given product, it is well known

that publication of the ill fated project can be delayed or stopped by the fund­ing company. The recent tobacco research fiasco is manifestation of this problem on a larger scale. Such information is lost to the public of practitioners until someone else happens to study the same question.

Peer review of research in dentistry, with a few exceptions, is not a guarantee that a published paper has legitimate conclu­sions. In my opinion, peer review in den­tistry is in need of major revision, bringing in many more practicing clinicians along with their academic counterparts, and using more than a few persons as reviewers on controversial topics.

The solution-dentists-wake up! How many companies can produce an unbiased research project? I know a few, but there are many that are questionable. Editors­publish more than one paper on the same subject when a company- funded project is published in your journals, recruit peer reviewers who have expertise in the specific subjects of the papers, and expand your review teams to include more "real world" practitioners who know clinical dentistry. Companies - just be honest. We practitio­ners soon discover dishonest research by simply observing our clinical results, and you and the patients will be the losers.

EVALUATION OF PRODUCTS Most dental journals/magazines have prod­uct endorsements in them from compa­nies or individuals that have been paid to

evaluate the products they are endorsing. If independent companies want to evalu­ate dental products and report on them,

honesty in the results would be increased if these evaluations were accomplished without fees paid to the evaluating compa­ny by the manufacturer that produced the product. The evaluating companies should obtain their income from publication of their data, or ocher means. The lay group, Consumer Reports, is a prototype for such evaluations. This company does not allow publication of their data for commercial purposes, but it is readily available from the company.

Some dental companies use information from published papers in their product advertisements. With the permission of the author/researcher, and if the informa­tion is used in fairness to other similar products in the study, such inclusions in ads appear to be appropriate. Reference to the published paper should be included. The solution-again, dentists beware! Analyze the source of endorsements carefully. When the endorsement in an advertisement looks questionable, money has probably changed hands. Companies, be honest! Your good products sell by word of mouth about clinical success. Honest, conservative ads are appreciated, and you are respected when practitioners read them.

SPEAKERS ON THE LECTURE CIRCUIT After spending roughly 40,000 hours on the circuit, I can probably comment on this one with some experience. Can you smell a paidoff speaker? If you can't, you are pretty naive. Although for most of the larger meetings, speakers have to sign a statement that they are not being paid by companies producing products contained in their lectures, there are many devious ways to get around that challenge.

How about paying spouses or other rela­tives, funding children in college, donat­ing to favorite charities in the speaker's name (this is okay if the money is donated in the company name and the speaker does not get a tax deduction), using company condos, cabins, or planes, paid vacations, and many other manufacturer perks? It is relatively easy to observe when a speaker favors one company or another

in lectures. It is obvious when the speaker

is selling his or her own dental product to the exclusion of other products in the

course. Continued On Page52

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Virginia Dental Journal 51

Continued From Page50 Your Personal Asset Allocation The solution-do not attend lectures of

Submitted By: Douglas L Hartz, Branch Manager speakers who appear to be on the "take". These speakers soon expose their financial commitments by their overt favor of products, companies, or commercial tech­niques. I have seen hundreds of speakers come on the circuit and burn our within a couple of years. Suggest reliable speak­ers to your colleagues, especially younger dentisrs.

SUMMARY I apologize for making some of you nervous, and perhaps even resentful, bur I HAVE HAD ENOUGHl I do not like rhe new unethical face of my profession, where incessant seeking of more money has replaced service to the public, honesty, and selfrespect,

Numerous areas of major ethical concern in dentistry are identified in this article. The ongoing, if not accelerating, degenera­tion of professional ethics in dentistry is clearly evident to even casual observers. Improvements in professional ethics are necessary to regain our self-respect and the respect of the people we serve. All of us need to improve, including practitioners,

speakers, dental schools accomplish­ing research, manufacrurers.editors, and evaluaring groups. It is time to rerum to honesty and to dealing with our fellow men and women in the way we would want to be treated ourselves. I do not rhink it is too late.

BIO Dr. Gordon Christensen, a prosthodontist in Provo, UT, is Co-founder and Senior Research Consultant of Clinical Research Associares (CRA). Dr. Christensen is also the Director of Practical Clinical Courses, a continuing education career development program for the dental profession at Bring­hamYoung University and the University of Utah.

You can contact Dr. Christensen at: Practi­cal Clinical Courses, 3707 North Canyon Rd., Suite 3D, Provo, UT, 84604-4587. FAX (801) 266-8637. Visit his website at gordonchristensen-pcc.com.

Acknowledgment This article, appearing in the September 2003 issue has been reprinted with permis­sion of Denral'Iown Magazine.

52 Virginia Dental Journal

C&F Investment Services Raymond James Financial

Too many individual investors blur the distinction between "saving" and "invest­ing". "Saving" is setting money aside in a secure location for a certain need or desire. "Investing" entails putting money to work toward achieving a financial foal with the possibility of generating return. As an investor, it is of utmost importance to be able to answer certain fundamental questions. Will your current investment portfolio be able to meet both short- and long-term investment objectives? Is your current portfolio correctly geared to your individual level of tolerance for risk?

One sound way to answer these ques­tions is by utilizing asset allocation - a disciplined, objecrive investment game plan that will help you meet your financial goals.

Many financial professionals believe the asset allocation decision is the most impor­tant step in the investment process. To be most effective, a personal asset allocation model should be tailored to your particular goals and needs.

A simple asset allocarion model for an individual investor generally requires a portfolio of assets divided into three ca~­egories -stocks, bonds and cash. Each IS.

assigned a fixed percentage. Based on this strategy, a conservative portfolio would generally contain more bonds and cash than stock. Since diversification of assets is generally recognized as a reliable way to reduce and manage risk in a portfolio, the mix of assets in your current spending requirements, tax implications and infla­tion-adjusted return may also be addressed through the asset allocarion process.

Asset allocation is flexible and revolves around personal needs. However, profes­sional financial advisors have generally found that investors at various age levels tend to be best served by adopting alloca­tion models that address the needs of their "life-cycle phase". In most cases, the longer your investment time horizon, the more

aggressive your investment strategy might be.

For example, investors in the 30s and 40s

tend to have several needs and concerns in common (e.g., children, new home, college education, retirement planning). To address these concerns, an asset alloca­tion plan that emphasizes stocks is often recommended because they historically have provided superior returns over time. At the other end of the spectrum are in­vestors who are close to or who maintain a lifestyle, or growth of their capital to ensure that they do not outlive their as­sets. For these investors an above-average holding in bonds may be recommended.

Obviously, these are guidelines. When implemenring as asset allocation strat­egy, the various percentages allocated to stocks, bonds and cash should be assessed on a personal basis and reassessed annu­ally. Be sure to check with your financial advisor regularly on your asset allocation strategy.

Virginia Department of Health News

Continued From Page 49 Surveys by the Division of Dental Health (DOH) have shown that an average of 60% of Virginia children have decay in their primary teeth with increased risk of disease in permanent dentition and high treatment costs. This past year DOH used one year limited grant funds from the Maternal and Child Health Bureau to develop training materials for parental and provider an­ticipatory guidance for the prevention of early childhood decay as well as informa­tion on fluoride varnish application. Dr. Frank Farrington and JoAnn Wells worked on this project and have begun training for dental and non-dental professionals as well as pilot projects in some Head Start Centers. DOH will now be submitting a proposal for a State Oral Health Collabora­tive Systems Grant to build on this year's accomplishments and expand educational information to high risk maternity patients. Data will also be collected on targeted groups of patients that will be participating in the program. As this grant cycle is for three years it is anticipated that if funded, there will be measurable results from the fluoride varnish intervention.

Dr. Karen C. Day

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Virginia Dental Journal 53

2004 Board of Directors Membership Survey Results

The latest VDA survey says:

l.Top three critical issues:

•Hygienist shortage 23% •Insurance company issues 21.8% •Licensure by credentials 12.6%

2.Favor licensure by credentials for all dentists:

Yes: 66%

3.Model of licensure exa • Continue the clini rently is done bX • Eliminate live dentiforms or si

• Completion of a ate general dentistr SRTA exam required

VDA Candidates No: 33%

Mark A. Crabtree

4. Model most favored giene practice:

1.Continue the c model 64%

2. Allow hygienists to prac tice also in alternative

No: 53%

7. If question 6 was answered yes, under what level of supervision should that duty be allowed:

Direct: 37% General: 9%

Surveys returned: 819

Board responses to survey responses regarding hygiene shortage:

to create a volunteer license for retired dentist or dental hygienist during the

VDAHouseof Delegates

The Opening Session of the VDA An­nual Meeting and the First Session of the House of Delegates will take place at 8: 15am, Thursday, September 9, 2004 at the Norfolk Waterside Mar­riott Hotel. Issues will be discussed at the reference committee hearings following the House of Delegates. All VDA members are invited to attend to hear discussion of the issues that go before the House of Delegates Sunday, September 12th.

' avid C. Anderson, Charles L. Cur-

Ginder, Gus C. Weisberg

A Alterna e e ega e - Mark A. Crabtree, Alonzo M. Bell, R~Ph L.

Virgrnia"')aEiitftl~iftssOiiiti;n Direct: 8% General: 26%

5. Dental hygiene education model most favored: • Continue with current dental hygiene education models 21 % • Create an expanded function dental assistant (EFDA) to use as a scaling tech­nician 13% • Increase the number of 2-year dental hygiene programs 41% • Create a model based on the Alabama plan 14%

6. Favor an appropriately trained dental hygienist being allowed to administer local anesthesia:

hygiene program at Thomas Nelson

Community College, Williamsburg Campus. (3) The Legislative Commit­tee will study, plan and recommend financing for development of a school of dental hygiene in the Shenandoah Valley and other areas of identified need for dental hygiene programs.

We WANT To Hear What You Think!

You have probably noticed that regular surveys appear in the Journal every quarter. These cards are an invaluable resource that the VDA staff uses to

better serve your interests. Please take the time to fill out the surveys in

your Journal and let us know what you think!

Yes: 47%

56 Virginia Dental Journal

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