Virginia Dental Journal

Volume 76 Number 2 .:. April May June, 1999

HIGH QUALITY

HEALTH BENEFITS ARE HARD To FIND...

...UNLESS You FIND A COMBINATION SUCH AS THE VDSC INSURANCE SERVICE CENTER

AND TRIGON BLUE CROSS BLUE SHIELD.

The Virginia Dental Association (VDA) and the Virginia Dental Services Corporation (VDSC) are proud to announce a new association sponsored healthcare program through Trigon Blue Cross Blue Shield. This new program is available for all dentists interested in setting up a benefit program for themselves or their practice.

Call our toll-free number between 8:30 am VDA's HEALTH INSURANCE PROGRAM INCLUDES: and 5:30 pm. Monday through Friday. Choice of Products - Indemnity, PPO, POS, Simply dial 1-800-832-7001 for quick HMO, and MSAs.

Trigon's extensive networks of participating and efficient service. It's that easy. The hospitals and doctors. VDSC Insurance Service Center aIso has

Special Trigon "Value Added" and "Membership" a toll free fax line, 1-800-886-4913. benefits available to you because of your

association membership.

association is working to assist members in this important area.

Num:ber 2

4 Editorial 5 Letters to the Editor 6 Message From the President 7 From the Executive Director 8 Bill Zepp Resigns 9 Abstracts

11 National New Dentist Conference 12 Dental Erosion: A Review & New Concerns for Practitioners in Virginia 16 Great Question- Glad You Asked That... 18 1999 VDANSOMS Annual Meeting Preview 22 Candidate Information 31 Fourth National Grassroots Conference 32 Virginia General Assembly Overview 34 PAN.DA of Virginia 37 Executive Council Actions in Brief 42 Ethics Perspective 43 VDSC 44 Membership Benefit Highlight 45 Y2K 47 Upcoming Continuing Education 48 Donated Dental Services Volunteers 53 VDA News 55 Component News & Specialty News 62 Classified Advertising

COVER: 130'hAnnual Meeting of the Virginia Dental Association PUBLICATION TEMPLATE: C:\Change

THE VIRGINIA DENTAL JOURNAL (ISSN 0049 6472) is published quarterly (January-March, April-June, July-September, October-December) by the Virginia Dental Association, 5006 Monument Avenue, PO Box 6906, Richmond, Virginia 23230-0906, Telephone (804)358-4927 SUBSCRIPTION RATES: Annual: Members, $6.00. Others $12.00 in U.S., $24.00 Outside US. Single copy: $6.00. Second class postage paid at Richmond, Virginia. Copyright Virginia Dental Association 1996 POSTMASTER: Send address changes to: Virginia Dental Journal, PO Box 6906, Richmond, VA 23230-0906 MANUSCRIPT AND COMMUNICATION for publications: Editor, PO Box 6906, Richmond, VA 23230-0906 ADVERTISING COpy, insertion orders, contracts and related information: Business Manager, PO Box 6906, Richmond, VA 23230-0906

VIRGINIA VDA COMMl7TEE CHAIRMENJOURNAL EDITORIAL

BOARD

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

Annual Meeting Bruce R. Hutchison

Auxiliary Education & Relations T. AndrewThompson

Budget & Financial Investments Raymond L. Meade

Cancer & Hospital Dental Service Michael E. Miller

Caring Dentists Harry D. Simpson, Jr.

Communication & Information Technology Corydon B. Butler, Jr.

Constitution & Bylaws Wallace L. Huff

Dental Benefits Programs Fred A. Coots, Jr.

Dental Continuing Education B. Ellen Byrne

Dental Delivery for the Special Needs Patient Al J. Stenger

Dental Health & Public Information Al J. Rizkalla

Dental Practice Regulation Albert L. Payne

Dental Trade & Laboratory Relations Jeffrey L. Hudgins

Direct Reimbursement David Swett

FOUNDATIONS Relief Foundation Scott H. Francis

1999 ADA DELEGATION Delegates: 14(}h ADA Session, October9-1s, 1999, Honolull!, HI William H. Allison ( I 999) DavidC.Anderson(2001 ) M. Joan Gillespie (2000) Wallace L. Huff (2001 ) RonaldL.Tankersley ( 1999) Leslie S. Webb, Jr. (2000)

Alternate Delegates: Anne C. Adams (2000) Richard D. Barnes (2000) BruceR.DeGinder (2000) Lindsay M. Hum, Jr. (1999) RodneyJ. Klima (2000) Edward K. Weisberg (2000)

Ethics & JUdicial Affairs M. Joan Gillespie

Fellows Selection Donald L. Martin

History & Necrology French H. Moore JJJ

Infection Control & Environmental Safety Paul F. Supan

Institutional Affairs Elizabeth A. Bernhard

Journal Staff Leslie S. Webb, Jr.

Legislative T. Wayne Mostiler

Membership H. Reed Boyd JJJ

New Dentist Carolyn C. Herring

Nominating Wallace L. Huff

Peer Review & Patient Relations Neil J. Small

Planning William H. A/Jison

Search Committee for VA Board of Demisit Wallace L. Huff

VADPAC Rodney J. Klima

VDA Foundation William H. Allison

Charles L. Cuttino HI (2001 ) Emanuel W.Michaels (1999) RichardD. Wilson (1999)

Thomas S. Cooke III ( 1999) Bruce R.Hutchison (1999) Andrew J. Zimmer ( 1999)

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

OFFICERS President: Charles L. Cuttino III, Richmond President Elect: Andrew J. Zimmer, Norfolk Immediate Past President: Wallace L. Huff, Sr., Blacksburg Secretary- Treasurer: Thomas S. Cooke III, Sandston Executive Director: William E. Zepp, CAE

P.O. Box 6906, Richmond, 23230-0906

EXECUTIVE COUNCIL COUNCILORS . Includes officers and councilors listed and: I Edward J. Weisberg, Norfolk David C. Anderson, Alexandria - Chairman II Bruce R. DeGinder, Williamsburg Gus C. Vlahos, Dublin - Vice Chairman III Harold J. Neal, ,Jr., Emporia Richard H. Wood, Richmond IV James R. Lance, Richmond William J. Viglione, Charlottesville V Edward M.O'Keefe, Roanoke

VI Ronnie L. Brown, Abingdon Ex Officio Members: VII James C. Gordon, Jr., Winchester Parliamentarian: Emory R. Thomas, Richmond VIII Rodney J. Klima,Burke Editor: Leslie S. Webb, Jr., Richmond Speaker of the House: D. Christopher Hamlin, Norfolk Dean, School of Dentistry: Ronald J. Hunt, Richmond

SOCIETY PRESIDENT SECRETARY PATIENT RELATIONS

Tidewater, I Stanley P. Tompkins Harvey H. Shiflet III W. Walter Cox 5830 Trucker Street 3145 Virginia Beach Blvd., 104 5717 Churchland Blvd. Portsmouth, VA 23708 Virginia Beach, VA 23452 Portsmouth, VA 23703

Peninsula, II Corydon B. Butler, Jr. Wayne E. "A.J." Booker Lawrence A. Warren 1319 Jamestown Rd., #103 6632 Geo Wa Mern Hwy . 106 Yorktown Road Williamsburg, VA 23185 Grafton, VA 23692 Tabb, VA 23693

Southside, III Richard F. Roadcap Richard W. Bates ;Richard F. Roadcap 3501 Boulevard 3505 Boulevard 3501 Boulevard Colonial Heights, VA 23834 Colonial Heights, VA 23834 Colonial Heights, VA 23834

Richmond, IV John S. Kittrell HA "Jack" Dunlevy . William J. Redwine 2600 Grove Avenue 11601 Robious Rd, Ste 130 :6808 Stoneman Road Richmond, VA 23220 Midlothian, VA 23113 Richmond, VA 23236

~i1

Dentistry: Health Care That Works

Six years ago when President Clinton began the accelerated national discussion on health care reform, organized dentistry made a decision which had a major impact on dentistry and the dental marketplace. Rather than be swept along with the fragmented medical community, which accounts for 95% of the health care expenditure, dentistry would stand on its own because it is different. Many scoffed at this stance. How could dentistry,which accounts for such a small percentage of health care spending, afford to take such a bold stance? How could it succeed?

Over the last six years, the delineation that dentistry is clearly different in its delivery system, its overhead costs, and its insurance payment mechanisms has

made it clear that dentistry must be treated on its own merits. Dentistry is preventative based, cost efficient and patient focused. Dentistry's provider base is composed of 80% general practitioners and only 20% specialists. Dentistry supports its patients' freedom to choose their dental providers of care, freedom to hear all their treatment alternatives and make their own treatment choices, freedom to assign their insurance benefits, and freedom to have decisions about what constitutes dentally necessary care made by dentists based on accepted standards of dental practice.

Dentistry has consistently taken a stand for its patients. We should take pride in our choice to adopt the slogan "Dentistry: Health Care That Works" and to support our unique niche in the health care system. It was the right decision.

of.tJfUJS. W-U,Jr.., DD.S. Editor

4 Virginia Dental Journal

Dear Editor:

The 1999 Session of the Virginia General Assembly has now closed. The members of the Virginia Dental Association should be extremely proud of the passage of HB 871 and SB 1235 (Managed Care Ombudsman Bills) both of which contained Assignment of Benefits language written by the VDA for dentists. This is a remarkable accomplishment when you consider that the VDA stood alone, opposed at every turn by two of the largest dental insurance companies in Virginia. We were able to effect this stunning outcome because 1) Chuck Duvall demonstrated incredible lobbying wizardry during the General Assembly Session while Lisa Finnerty further enhanced Chuck's efforts with relentless follow-ups and alerts to the members of our legislative phone trees; 2) Many of our members and their patients made phone calls, sent letters, email and faxes to legislators and ultimately the Governor himself; and 3) We were justly fighting for our patient's right of choice.

The Virginia Dental Association has led the way on Assignment of Benefits by adopting our own policy, introducing the policy to the 1997 ADA House of Delegates and now establishing this important right as Virginia law in 1999. Our victory in the state legislature demonstrates two important concepts: If we work together, dentists and their patients do not have to be victims of unilateral policy decisions on the part of third party payers, and we can make a difference for our patients and for the practice of dentistry.

Those who participated in this marvelous legislative effort deserve our sincere thanks. To those who were not involved in this year's campaign we hope you will be with us the next time it is necessary to go to the state legislature to obtain fair consideration for our patients and our practices.

Although we have now remedied the Assignment of Benefits issue in Virginia, we must be vigilant and pro active to maintain freedom of choice for our patients and control of our practices. There is a growing concern that third party payers may now resort to some alternative method to dominate patients and providers-once again attempting to penalize dentists and subscribers for exercising their freedom of choice. We must prepare to address this eventuality by communicating with our patients and colleagues to preserve freedom of choice and the profession we love. Be ready to work hard and work together.

If we stand united as an Association and a profession we can make a difference!

Sincerely, Andrew J. (Bud) Zimmer, D.D.S. President-Elect

March 3, 1999

Dear Dr. Webb,

I would like to congratulate you on the latest VDA Journal, January/March 1999. The Association and our Staff have a lot of talent that we continually need to utilize. The selection for the cover of a photograph by Linda Gilliam, VDA Director of Finance, was outstanding.

I think it would be appropriate for a call to go out to all of our members to submit their own photographs for possible use as a cover. The criteria should be a scene from anywhere in Virginia. Another possibility, would be a show at the Annual Meeting exhibiting works of art by our members. This could be paintings, photography or sculpture.

Sincerely, Charles L. Cuttino, D.D.S. President

April 6, 1999

Dear Officers, Members & Staff:

I am deeply honored that you have chosen to name the Virginia Dental Association annual MCVNCU School of Dentistry scholarship donation the David A. Whiston Scholarship.

You enhance the great honor by contributing to the education of those who seek to be a part of our wonderful profession.

I look forward to participating in the Graduation ceremonies at the Cathedral of the Sacred Heart in Richmond on Saturday, May 15 with VDA President Dr. Charlie Cuttino.

Sincerely, David A. Whiston, DD.S. ADA Immediate Past President

Virginia Dental Journal 5

Spring has arrived and we are feeling rejuvenated from the winter with summer not far behind. With spring comes new growth and replacement of the old. This is an important growth time for the VDA and our committee meetings in June are an example. This is a time and place where you the members have the opportunity to communicate your ideas and thoughts about the direction of the Association.

The Association only progresses with your ideas and your work to get those ideas in place. The leadership cannot come up with all the issues and solutions by ourselves. Hopefully, we are here to inform and stimulate you to provide us with the ideas to move this organization forward. You can start the process.

An issue that has dentistry concerned, is the recent Pew Health Professions Commission report (Strengthening Consumer protection: Priorities for Health Care Workforce Regulation). This report calls for periodic evaluation of the practicing dentist by written examination and office evaluations. The purpose is to have the dentist maintain a level of competency in the

art and science of dentistry that will protect the consumer patient.

The State Board of Dentistry will have to be the agency that will formulate the process, implement the system and monitor the outcome. Dentistry has to have a say in how this is done. Do not think that the government can not direct how and what you practice.

The Medical Profession is already struggling with Evaluation and Management (E&M) documentation guidelines as well as the American Medical Accreditation Program (AMAP).1

The E&M Guidelines were established by HCFA because of perceived fraud and abuse by the practitioner and set standards for what is included in charting and the filing of insurance claims. We see this somewhat in dentistry today.

AMAP is an individual physician accreditation process that has national standards and criteria. At the present time it is voluntary but with acceptance by the physicians has the potential to become mandatory.

In dentistry there exists presently recertification of board certification. The American Association of Oral and Maxillofacial Surgeons and the Academy Board of Pediatric Dentistry have recertification examinations to measure the continued competency of their fellows. The Fellowship program of the Academy of General Dentistry could also be considered a competency examination. On the state level, Cali

fornia and Utah have quality improvement programs in place. 2

Dentistry has to be involved in the process and have a say in what is the outcome of any competence mechanism. The VDA Committee on Dental Practice Regulations has begun looking at this situation. If we do not address this issue someone else will do it for us.

I feel that what is developed must maintain a level of knowledge, allow for differences of treatment modalities, allow for professional judgement, provide a minimal intrusion into the way we practice as well as protect the patient.

I feel that this may well be the next major challenge to the practice of dentistry. It is time for you to become involved and have a say in the way we are regulated and the future of dentistry.

For four and a half years the Association had the privilege of being associated with Mr. William Zepp as our Executive Director. Bill has brought us into the 90's in association management and growth. We have benefited in many ways such as the organization of the central office, the staff development, the growth in the annual meeting, and our legislative presence. Bill is leaving to take the Executive Director position in Oregon. We all wish him well. Thanks Bill.

Cfuu.f.tl of. Culiino III, D.D.S. President

1 American Medical Association House of Delegates, Annual Meeting, Chicago, IL, June, 1998. 2 Meskin, L. H., JADA, Vol. 130, January 1999, p 12.


Ave atque vale,

In this column in January, I reflected on the difficulty in selecting topics and composing thoughts that mayor may not be of interest by the time the members read them. This time the selection of topic got much easier.

On March 26, 1999, I accepted the offer of the Oregon Dental Association to serve as their Executive Director. Their current Exec, my good friend Barry Rice, resigned to accept a position with ODA's for-profit subsidiary. I will begin my duties in Oregon in July.

This was not an easy decision and the timing was not to my liking. The Oregon and Virginia columns were both filled with positive considerations. The VDA is currently making some great strides forward in any number of areas and I would enjoy seeing them come to fruition. I suppose that's always the case in an active organization, but the timing is difficult nonetheless.

Our strongest pull was that of family and friends. Pat is from Portland and her parents and several brothers and sisters and families are there. We both attended the University of Portland and have many friends in the area. Most importantly, Taylor Christine Still (age 2 1/2) and Zachary Clayton Still (age 1/2) reside with their parents (our daughter and son-in-law) in Seattle. But even the family portion of the column became complicated: our son, a tennis pro in Charleston, announced his engagement at Easter. I'm sure we're destined to be a bi-coastal family on a permanent basis.

I am tempted to launch into a "thanks to the Academy, mom, my agenL" litany, but won't. The list of members would be way too long and I would forget and leave Bruce DeGinder off and he'd be upset. On Pat's behalf, I'll make a special mention of Gladys Tankersley - not a member but such a wonderful friend.

The Virginia Dental Association is blessed with a strong and talented staff. The next Exec will be indeed fortunate. The Virginia Dental Association is blessed with many, many volunteer leaders and leaders-to-be. I know that I belong to a number of associations and I do not give the time that so many of you do to this volullteer endeavor. It's why organized dentistry is in better shape than other associations and professional groups.

Learn from your collective experience, trust your colleagues, encourage your young leaders, celebrate and promote your diversity, participate selflessly, and embrace change - it's the only certain thing (besides the two other certain things, but hey ... ).

Thanks and regards. Wl/-uun G. Zpp, CAE


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BILL ZEPP RESIGNS AS VDA EXECUTIVE DIRECTOR " "

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Leslie S. Webb, Jr., D.D.S., Editor Bill Zepp submitted his resignation as Executive Director of the Virginia Dental Association effective June 26, 1999. He has accepted the position of Executive Director of the Oregon Dental Association. In his resignation letter Bill stated "My relationship with the VDA over the past four and one-half years has been very positive, and I would like to maintain that spirit throughout this transition period and in the future." He thanked the membership for their support and friendship. During his four-plus year tenure the VDA office has greatly expanded its operation. Bill has overseen the development of the Virginia Dental Service Corporation and the VDA Foundation.

The VDA Executive Committee met via conference call and established a timeline for the process of selecting a new VDA Executive Director. Announcements of the vacancy were mailed to all ADA Constituent Societies, the ADA and selected others. Applications for the position must be received by April 23, 1999.

The Search Committee will consist of the VDA Executive Committee and Doctors Ron Tankersley and Les Webb. Every effort will be made to have a new Executive Director in place by midsummer.

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II


ABSTRACTS

The following abstracts were provided by the Department of Pediatric Dentistry at VCU/MCV School of Dentistry. We appreciate the consideration that these individuals have made to the Journal.

Prolonged Demand BreastFeeding and Nursing Caries. Weerheijm,K.L., UyttendaeleSpeybrouch,B.F.M., Euwe,H.C., Groen,H.J. c.ariesResearch;32:46.50.1998.

The purpose of the study was to evaluate the characteristics and to study the risk factors within a group of Dutch children breast-fed on demand over a prolonged period of time, and whose mothers attended the meetings of La Leche League. This organization encourages an unrestricted breast-feeding habit as comfort for the children during a prolonged period of time. A total of ninety-six children, between the ages of 14 and 42 months, were examined. The population consisted of 55 boys and 41 girls (mean age 28.8 months, SO 8.8). The study included a questionnaire inquiring about the duration and time of the breast-feeding, age of eruption of the first primary teeth, feeding habits, and parenteral educationallevel and employment. Along with the questionnaire, the study included a dietary sheet, combined with the caries status of the child.

The children were breast-fed 21.5 months (SO 9.8) on average. Parents started brushing the child's teeth at a mean age of 1 1.7 months (SO 5. 1). The children were divided into three categories according to their caries pattern: 1 caries free; 2 caries; 3 nursing caries. 70% of the children used a fluoridated toothpaste (250 ppm fluoride). The

children of the nursing-caries group (group 3) used fluoridated toothpaste less often than the children in groups 1 and 2. In addition, most of the children in group 2 and 3 received less supplemental fluoride from other sources. In the Netherlands, drinking water is not fluoridated. The mean DMFS of all examined children was 1.2 (SO 4.8). Dentin caries were found in 14 (14.5%) of the children, of which 9 (9.8%) met the criteria of nursing caries. Children still being breastfed during the investigation slept in the parent's bed more frequently.

The results of the study demonstrate that prolonged demand breast-feeding does not lead to higher caries prevalence. However, comparison between the three categories shows that frequent breast-feeding and lack of supplemental fluoride should be considered as contributing factors to the nursing caries process.

Dr. Matthew Abdoney is a first year advanced education student in Pediatric Dentistry at the Medical College of VirginiaNirginia Commonwealth University, School of Dentistry. He received his D.MD. degree from the University of Florida College of Dentistry in 1998.

S. Hatibovic-Kofman, GZ Wright, Ian Braverman, Microleakeage of Sealants After Conventional, Bur, and Air-abrasion Preparation of Pits and Fissures. Jou~ nal.of.the American Academ~ f.ediatric Dentistry. 20 (3): 173176,1998.

Microleakage or marginal leakage is defined as the ingress of oral fluids into the space between the tooth and the restorative material. Microleakage can cause caries to

develop below a sealant. Marginal leakage of sealants placed by conventional acid etch techniques has shown varying results. Boj et al found no statistical difference in the microleakage of sealants placed conventionally compared to bur preparation of the pits and fissures. Eakle et al. found less microleakage in sealants placed conventionally compared to those prepared by air abrasion. The purpose of this study was to compare microleakage of unfilled and filled pit and fissure sealants after conventional, bur, and air-abrasion preparations of the tooth.

Seventy-two extracted molars were randomly assigned to three groups. Group 1 had 24 teeth that were prepared by pumicing and acid etching with 37% phosphoric acid. Group 2 had 24 teeth that were prepared with a 1/4 round bur in a lowspeed hand piece and then acid etched. Group 3 had 24 teeth that were prepared without acid etch by high-speed (160PSI) microabrasion using 50 Ilq. alumina particles in a KCP 2000 machine. In each group 12 teeth were sealed with a filled sealant (Prismashield) and 12 teeth with an unfilled opaque sealant (Delton). The teeth were soaked in artificial saliva for 7 days and thermocycled for 2000 cycles. The teeth were sealed apically, coated with nail varnish 1 mm from the margins, and soaked in 1 % methylene blue stain for 24 hours. Each tooth was sectioned in three locations and examined for microleakage.

A total of 216 tooth sections were analyzed for microleakage. When considering the entire sample 66% of the sealants had no leakage. The bur-prepared sealants showed significantly less microleakage (P

conventionally and KCP-prepared sealants was found not to be significant (P>O.05). Also the unfilled sealants showed significantly less microleakage (P>O.05) than the filled sealants independent of the method of tooth preparation. When both variables were considered the air-abrasion preparation with the filled sealant yielded the worst result.

The major finding of this study was that the bur preparation followed by acid etching produced sealants with less microleakage than conventional or air-abrasion techniques. There are several possible explanations for this finding. Since the bur will open a pit or fissure, better sealant adaptation and penetration can be accomplished. Deep pits and fissures may not facilitate good acid conditioning or may cause air to be trapped between the tooth and sealant. Greater leakage after pumicing may be due to the fact that debris cannot be completely removed from the pits and fissures. This prevents total tooth conditioning and eventually reduces resin penetration into the enamel. Airabrasion produces a roughened surface but lacks the seal obtained with acid etching.

This study also found that unfilled sealants displayed less microleakage than the filled sealants. This finding is consistent with previous studies and is attributed to the difference in viscosity between the two types of sealants. This reviewer feels that acid etching along with air-abrasion would produce different results. Further study in this area is warranted.

Dr. Jeffrey D. Kearns is a first year resident in Pediatric Dentistry at MCVNCU School of Dentistry. He received his DDS degree from the University of Maryland Dental School in Baltimore in 1998.


~....

Warren. JJ, Kanellis, MJ, and Levy, S. Ms; Fluorosis of the Primary Dentition: What Does it Mean for Permanent Teeth? JADA,130:347-356,1999

There is a lack of information pertaining to fluorosis in the primary dentition. Fluorosis in the primary dentition is often overlooked or thought to be of lesser consequence. This article reviews articles pertaining to fluorosis in the primary dentition and evaluates primary-tooth fluorosis clinically. Also correlation's are made as to the predictive value primary dental fluorosis may have on fluorosis occurring in the permanent dentition. Fluorosis in the permanent dentition in the United States and Canada has increased in the last few decades, however, there is little reported on fluorosis in the primary dentition.

The article reviews various studies on primary dental fluorosis, most of these articles describe similar findings in the clinical presentation of fluorosis in the primary dentition. The primary teeth most commonly affected are the primary first and second molars, with primary incisors least affected. Also the most common factor related to the prevalence of fluorosis is water fluoride levels. The authors describe several characteristics of primary-tooth fluorosis including its description of being less severe than that seen in the permanent dentition often limited to the molars and is directly related to water fluoride levels. Detail description of the clinical appearance of primary-tooth fluorosis is provided supplemented with clinical photos.

A brief description of the development of the primary dentition is provided in order to facilitate a possible correlation to the time frame inwhich

fluorosis may develop. The author indicates that further studies are needed to evaluate primary-tooth fluorosis as a predictive marker of permanent-tooth fluorosis. At the very least the clinician detecting primary-tooth fluorosis should be prompted to investigate fluoride levels of that child as well as evaluate younger siblings for sirnilar"findings.

Dr. Alex Olea is a second year advanced education student in Pediatric Dentistry at MCVIVCU School of Dentistry. He received his DDS degree from the University of Texas Health Science Center at San Antonio in 1994. Dr. Olea practiced General Dentistry in San Diego, CA from 1995-1997 where he plans to return to practice Pediatric Dentistry.

Lopez, L., Berowitz, R., Zlotnik H., Moss, M., Weinstein, P. Topical antimicrobial therapy in the prevention of early childhood caries." Journal of the American Academy of ~e.diatric Dentistry; (21)1. 1999.

Early childhood caries (ECC) is a disease of infants, toddlers and young preschool children that may devastate or destroy the primary dentition. Microbiologic studies show the etiology of ECC to be heavy infections of Streptococci Mutans on dental surfaces. Therefore, it is reasonable to assume that suppression of these bacteria would decrease the risk of ECC. A randomized double blind, placebo controlled pilot study was performed to test this hypthoseis.

A study population of thirty one subjects, ages 12 to 19 months, who were clients of a Women, Infants and Children (WIC) clinic were selected to participate in the study.

The inclusion criteria were: unremarkable medical history, presence of 4 primary maxillary incisors with no visible defects, clinically caries free, use of nursing bottle at naptime and or bedtime which contained a cariogenic substrate and two consecutive positive streptococcus mutans cultures (separated by an 8 week interval) taken from pooled plaque.

The subjects were randomized into two groups, 15 subjects in the experimental group and 16 subjects in the control group. The subjects were evaluated at two week intervals for the duration of the study period. At each evaluation the experimental group had a 10% povi

done iodine applied to their dentition, via a cotton tip applicator. The control group received a placebo of commercial instant tea, without sweetener or lemon, via a cotton tip applicator. Treatment failure was defined as the appearance of white spot lesions on the primary maxillary incisors.

There were no statistically significant differences in the age or gender distribution of the subjects in the two study groups. The mean duration of treatment was 155 days. Five of the sixteen control subjects and 0 of the 16 experimental subjects experienced treatment failure (Fisher's exact test: P=0.04). These results and observations from the

clinical trial suggest that reduction in the number of Streptococcus Mutans reduce the risk for early childhood caries in high risk individuals. In this study, topical antimicrobial therapy signifcantly reduced the incidence of ECC in highrisk children.

Matthew R. Cooke. D.D.S. is a second year advanced education student in the Department of Pediatric Dentistry and a graduate student in the Department of Preventive Medicine and Communtiy Health. Dr. Cooke received his DD.S. from MCVNCU, School of Dentistry in May of 1997.

THIRTEENTH NATIONAL CONFERENCE ON THE NEW DENTIST

New dentists will converge for peer networking and continuing education at the is"National Conference on the New Dentist, to be held July 29-31, 1999, at the Opryland Hotel in Nashville, Tennessee. The theme for the Conference is "Networking in Nashville ... Dentistry For a New Century." ChesebroughPond's USA Co. has been the sole corporate sponsor since the first conference was held in 1987.

The conference program includes outstanding continuing education opportunities directed towards the new dentist. Kicking off the conference, keynote speaker Emory Austin will speak to dealing with change and building loyalty utilizing her own personal philosophy, "An Ounce of Different."

Some of the educational courses include technology, clinical issues, practice management, professional

issues, and, the "New Dentist Committee Network Idea Exchange and Open Forum," a perennial favorite among conference attendees who "step up to the mike" to discuss hot issues and share ideas.

The Opryland Hotel is one of the premier hotel properties in the U.S., boasting over 2,000 guest rooms, 30 specialty shops and 25 restaurants, all built under a series of beautiful 15 story atriums. The hotel is

The early registration fee for memberdentists is $195.00 and for predoctoral and graduate student members it is $55; register by June 26, 1999. Special rates apply for spouses, guests, dental office staff and nonmembers. For more information about the conference, contact the ADA Committee on the New Dentist on the ADA toll-free number, ext. 2779.

situated with --.,,,,....- ~_... -"-~"~'---~ easy access to ..I1/dW~ tA- ..I1/advd&- .. downtown Nashville and nearby historic sites and

13thNatlOna'activities, includConferenc:e ontnE;ing the Grand Ne'h Dentist

Ole Opry.

FOR M(jPt !NFDRMtJIOi( C4~L THE AMtRI,C,~N DENTAL ~,SSOCiATIO'" ~ .. 80HII809', EXTENSIDN


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DENTAL EROSION: A REVIEW AND NEW CONCERNS FOR DENTAL PRACTITIONERS IN VIRGINIA

Francis J. Robertello, D.M.D., M.S., M.Ed., and Mathew R. Cooke, D.D.S.

Dental erosion is the clinical term used to describe the pathologic, chronic, localized, chemical dissolution of dental hard tissue, in a process that does not include bacteria.' This chemical dissolution is caused by acidic solutions which come into contact with the teeth. The acids responsible for erosion of teeth are not products of the intraoral flora, but come from either intrinsic (endogenous), extrinsic (exogenous), or idiopathic (unknown) oriqin.' Several investigators- believe the term "erosion", as currently used in dentistry, is misleading. They proposed the term "corrosion", as defined by metallurgists, as a more scientifically precise term to describe the process. However, "erosion" remains the commonly accepted term used by dentists to describe the gradual dissolution of tooth surfaces by acid. Any acid solution that can lower the pH below the critical 5.5 forenamel, can cause erosion particularly if the exposure is of long duration and repeated over time.

Intrinsic factors: Dental erosion related to intrinsic factors is the result of gastric acids bathing the teeth regularly over a period of

several years. This usually occurs due to the habitual regurgitation of gastric acids associated with organic or psychosomatic vomiting,or gastroesophogeal reflux dlsease.?" Eating disorders of psychosomatic origin such as anorexia nervosa or bulimia are also causes of chronic regurgitation or vomiting which leads to gastric acids with a pH of 1-1.5, well below the critical pH for enamel dissolution, coming into frequent contact with tooth structure. 7,9, 10

Extrinsic factors: Zero 11 has categorized the extrinsic factors involved in dental erosion under four headings: (1) medications, (2) lifestyle, (3) environmental, and (4) diet.

(1) Medicati~ The acidity of the preparations as well as frequency and method of administration are important. Chewable Vitamin C (L-ascorbic acid) tablets, 12,13 chewable aspirin tablets for children." salivary substitutes, flow stimulants, anti calculus mouth rinses,15,16 and acidic lozenges 17 have been identified as some of the preparations contributing to tooth erosion.

(2) Lifestyle: Today's "modem" lifestyle focuses on healthy diets, fitness regimens, and appearance enhancing procedures and products. While diets considered healthy today include more fruits and vegetables, the consumption of these more acidic foods has been associated with a higher prevalence of dental erosion .18 Fitness programs and rigorous exercise may lead to increased consumption of acidic sports drinks, fruit juices, and other low pH beverages. 2,1920 Vigorous exercise may increase the effect of acidic beverages by the loss of fluids, decreased salivary flow, and an increased possibility of gastroesophogeal reflux."

(3) Environmental: Factory workers exposed to acid fumes and aerosols in battery, fertilizer, chemical, and metal etching and galvanizing plants, experience a high incidence of acid erosion of their teeth,22-25 Although OSHA regulations have significantly reduced this problem in the US, factory conditions in some countries still present cause for concern. Of particular interest in Virginia, which is experiencing a rapidly expanding winemaking industry, is the tooth erosion associated with winemaking and tasting.26-27The pH of wine may range from 3.0 to 3.6 and present a potential risk for acid erosion in full time wine-tasters and wine connoisseurs, Also swimmers, especially competitive swimmers who swim often in large gas chlorinated pools, may experience dental erosion from low pool pH. The low pH results from the formation of hydrochloric acid during the gas chlorination process, and requires that pools be frequently


monitored and buffered to maintain the recommended pH range of 7.28.0.28,29

(4) Diet: Most foods and drinks with a pH less than 4.5 have the potential to cause dental erosion. Citrus fruit and citrus fruit based foods and beverages, as well as natural fruit juices have long been implicated in dental erosion 18,30-33 Also important is the pattern and frequency of the dietary acid challenge as well as the chelating properties of the dietary substances and oral hygiene habits.

Differential diagnosis between erosion, abrasion, attrition, and abfraction (a theory relating cervical lesions to occlusal stresses and tooth flexure) is difficult and often confusing. Also, patients are unreliable when discussing their dietary preferences and habits. Clinically, depending on area involved, erosion may present as broad, shallow, smooth, highly polished depressions in enamel, dentin, and cernentum.>' Depressions or cupping on cusps of posterior teeth, margins of amalgam or composite raised above the level of the adjacent tooth surface, and a grooved appearance on the incisal edges of mandibular anterior teeth are also clinical signs of erosion. Erosion defects may be made worse by physical abrasion and the clinical differentiation may be impossible to make. However, in most instances, the cause of the presenting clinical condition is likely to be multifactorial.

Recently, investigators have identified an association between dental erosion seen in school age children in Southwest Texas, with consumption of low pH citric acid and salt confections imported from Mexicc."" These acid snacks, popular in the Hispanic population,

are available either in granular form packaged in small cylindrical cardboard containers, or as a semi-liquid fruit paste packed in plastic sleeves or other flexible plastic containers (Figure 1.). The ingredients are usually citric acid, salt, silicon dioxide, and occasionally sugar and chili powder. The granular form of the product is referred to as "sal y limon" (salt and lemon), while the fruit paste product is commonly referred to as "chemoy". Depending on the buffering capacity of saliva, the pH of these products is low and may range from 1.8 to 2. 1. These products are intended for use in seasoning vegetables, but are also used in the socially fashionable technique of garnishing the rim of cocktail glasses or beer bottles. Children like to sprinkle the granular form on the back or side of their hands or wrists, and lick the tangy powder. The tangy citrus fruit flavors are said to be thirst quenching, and young teenagers have also used these products for diet control. The loss of tooth structure associated with their use frequently results in sensitivity to temperature changes and chewing pressures.

Rapidly changing demographics has seen the introduction of these products in many states, and the use of these acid snack products is becoming a national rather than just a regional concern. A recent article in the Richmond TimesDispatch cited US Census Bureau statistics that indicate Virginia's Hispanic population is up 40 percent since 1990,37 Loudon County, a fast growing suburb of Washington DC, has the fourth fastest growing Hispanic population in the South. Based on information from investigators in Southwest Texas, and the rapidly changing state demographics, The Division of Dental Health, Virginia Department of Health, has supported an investigation into the

availability and use of these low pH snack products and the associated prevalence of acid erosion in teeth of Virginia school children. These products were found to be readily available in Richmond, Northern Virginia, and the Tidewater area, and are most commonly found in super-markets and convenience stores in or near Hispanic neighborhoods.

The examination of Virginia school children is on going, and a future report will present data on the use of these products and the prevalence of acid erosion in Virginia school children. However, early evidence indicates that these products are popular among Hispanic children in Virginia. A significant number of the Hispanic children examined to date have acknowledged through a snack questionnaire, use of these products, and have experienced acid erosion on one or more teeth. The erosion patterns most frequently observed were primarily on the facial surfaces of anterior teeth, and presented as a loss of facial enamel leaving a smooth glazed appearance. In some cases, the facial surfaces also demonstrated slight pitting. Erosion patterns were also seen, although to a far lesser extent, on the occlusal surfaces of mandibular posterior teeth and lingual surfaces of maxillary anterior teeth. This preliminary information is presented to encourage Virginia dentists to include the use of these acid snack products in their differential diagnosis for Hispanic patients who present with erosion patterns on their teeth. The consumption of low pH foods, beverages, candies, snacks, and exposure to acidic environmental factors should also be considered in the evaluation of any patient who presents with unexplained erosive loss of tooth structure.


Francis J. Robertello, D.M.D., M.S., M.Ed., Assistant Professor, Department of General Practice,Virginia Commonwealth University School of Dentistry.

Mathew R. Cooke, D.D.S., Advanced Education student in Pediatric Dentistry and Preventive Medicine & Community Health, Virginia Commonwealth University School of Dentistry.

Acknowledgements The authors would like to thank Dr. Peggy P. Gragg, Department of Dental Diagnostic Sciences, University of Texas Health Science Center at San Antonio; Dr. Karen C. Day, Director, Division of Dental Health, Virginia Dept of Health, Richmond; and Dr. Bonnie D. Foster, Practitioner in General Dentistry, Manassas, for their support and contributions to the acid erosion study in Virginia.

References

1. Pindborg JJ. Pathology of the dental 15. Smith BGN. Toothwear: aetiology and 27. Gray A, Ferguson MM, WAIIJG. hard tissues. Copenhagen, diagnosis. Dent Update 1989; 16:204 Winetasting and dental erosion. Munksgaard 1970, 294-325. 212. Casereport. Aust DentJ 1998;

2. Imfeld T. Dental erosion. Definition, 16. Rytbmaa 1, Meurman JH, Franssila S, 43(1):32-34. classification, and links. Eur J Oral Sci, Torkko H. Oral hygiene products may 28. SavadEN. Enamel erosions-multiple 1996;104: 151-155. cause dental erosion. Proc Finn Dent cases with a common cause(?).

3. Grippo JO, Simring M. Dental erosion Soc 1989; 85: 161-166. JNJDent Assoc 1982; 53:32-37,60. revisited. J Amer Dent Assoc 1995; 17. Lussi A, Portmann P, Burhop B. Ero 29. CenterwallBS, ArmstrongCW, 126: 619-628. sion on abraded dental hard tissues FunkhouserGS, ElzayRP. Erosion of

4. Smith BGN, Knight JK. A comparison by acid lozenges: an in situ study. Clin dental enamel among competitive of patterns of tooth wear with Orallnvestig 1997; 1(4): 191-194. swimmers at a gas-chlorinated swimaetiological factors. Br Dent J 1984; 18. Linkosalo E, Markkanen H. Dental ero ming pool. Am J Epidemiol1986; 123: 157: 16-19. sions in relation to lactovegetarian diet. 641-647.

5. Jiirvinen V, Rytbmaa 1, Meurman JH. Scand J Dent Res 1985; 93: 436-441. 30. Fuller JL, Johnson Ww. Citric acid Localization of dental erosion in a re 19. AI-Hiyasat AS, Sanders WP, Sharkey consumption and the human dentition. ferred population. Caries Res 1992; SW, Smith GMCR. The effect of a J Am Dent Assoc 1977; 95: 80-84. 26: 391-396. carbonated beverage on the wear of 31. Asher C, Read MJF. Early enamel

6. Scheutzel P. Etiology of dental ero human enamel and dental ceramics. erosion in children associated with the sions - intrinsic factors. Eur J Oral Sci J Prosthodont 1998; 7: 2-12. excessive consumption of citric acid. 1996; 104: 178-190. 20. BirkhedD.Sugar content,acidity and ef Br Dent J 1987; 162: 384-387.

7. Andrews FFH. Dental erosion due to fect on plaque pH of fruit juices, 32. Grobler SR, Senekal PJ, Kotze TJ. anorexia nervosa with bulimia. Br Dent fruitdrinks, carbonated beverages and The degree of enamel erosion by five J 1982; 152: 89-90. sport drinks. CaliesRes 1984; 18:120 different kinds of fruit. Chn Prev Dent

8. Gregory-Head B, Curtis DA. Erosion 127. 1989; 11: 23-28. caused by gastroesophageal reflux: di 21. Clark CS, Kraus BB, Sinclair J, Castell 33. Smith AJ, Shaw L. Baby fruit juices and agnostic considerations. J DO. Gastroesophogeal reflux induced tooth erosion. Br Dent J 1987; 162: Prosthodont 1987; 6(4): 278-285. by exercise in healthy volunteers. J 65-67.

9. Knewitz JL, Drisko CL. Anorexia Am Med Assoc 1989; 261: 3599-3601. 34. Richmond NL. Update on erosion. An nervosa and bulimia: A review. Comp 22. ten Bruggen Cate HJ. Dental erosion operative dentistry problem. J Indiana Contin Educ Dent 1988; 9: 244-247. in industry. Br J Industr Med 1968; 25: Dent Assoc 1983; 62(2): 23-24.

10. Robb ND, Smith BGN, Geidrys-Leeper 249-266. 35. Dodds MNJ, Gragg PP, Rodriquez D. E. The distribution of erosions in the 23. Tuominen M, Tuominen R. Dental ero The effect of some Mexican citric acid dentitions of patients with eating dis sion and associated factors among snacks on in vitro tooth enamel eroorders. Br Dent J 1995; 178: 171-175. factory workers exposed to inorganic sion. Pediatr Dent 1997; 19(5): 339

11. Zero DT. Etiology of dental erosion acid fumes. Proc Finn Dent Soc 1991; 340. extrinsic factors, Eur J Oral Sci 1996; 87: 359-364. 36. Gragg PP, HUdepohl NC, Baker BR, 104: 162-177. 24. Peterson PE, Gormsen C. Oral condi Marshall MV. Dental erosion associ

12. Meurman .IH, Murtomaa H. Effect of tions among Gen-nan battery factory ated with the use of imported low-pH effervescent vitamin C preparations on workers. Community Dent Oral snacks. Texas Dent J 1998; 115(3): bovine teeth and on some clinical and Epidemiol 1991; 19:104-106. 7-13. salivary parameters in man. Scand J 25. GotoH, KosakaM, UedaT, YoshidaM, 37. Shapiro JE. Hispanics, Asians mak

Dent Res 1986; 94: 491-499. Haral.Association between dental ero ing mark on South. Richmond Times

13. Giunta JL. Dental erosion resultinq sion and exposure to acid sina chemi Dispatch, 1998 Sunday, Sept 27, K-2. from chewable vitamin C tablets. Amer cal factory. Sangyo-Eiseigaku Zasshi Dent Assoc J 1983; 107: 253-256. 1996; 38(4): 165-171.

14. Sullivan RE, Kramer WS. Iatrogenic 26. Wiktorsson AM, Zimmertnan M, erosion of teeth. J Dent Child 1983; Angmar-ManssonB. Erosive tooth 50: 192-196. wear: prevalence and severity in

Swedish wine-tasters. EurJOralSci 1997;105(6):544-550.


GREAT QUESTION GLAD YOU ASKED THAT... J B. Ellen Byrne, R.Ph., D.D.S., Ph.D.

What Are The New Drugs On The Market? specific inThe FDA cleared more than 30 new Many of you may recognize Thalihibitors.molecular entities (one with two domide (Thalomid) on the list and You canstrengths*) in 1998. They also ap remember that it was the drug that think ofproved 13 new dosage forms of was taken off the market in Europe them as imexisting drugs and withdrew 3 many years ago when it caused proved nondrugs due to toxicities. It is inter phocomelia ... the absence of the steroidalesting to note that 3 of the newly proximal segment of the limbs in anti-inflamreleased dosage forms are used in newborns if the mother had taken matoryperiodontal therapy (Periochip, this drug while pregnant. One dose agents.Atridox and Periostat). Versed in early pregnancy can cause this They reSyrup is indicated for sedation, severe birth defect. The FDA will duce painanxiolysis and amnesia prior to di be controlling distribution to prevent and inflammation but with less risk agnostic, therapeutic, or endo its use by pregnant women. It was of 81 ulcers and bleeding. Look for scopic procedures or before induc never marketed in the U.S. The

tion of anesthesia in pediatric pa FDA has approved it for leprosy but more drugs to come out in this class tients. Versed Syrup must be you will also see it used for wast in the near future. Vioxx

(rofecoxib) will probably be the next given only to patients if they will be ing syndrome in some AIDS and drug in this class that you will see. monitored by direct visual observa cancer patients, and recurrent aph

tion by a health care professional. thous ulcers in HIV patients. It is a Versed (midazolam), a short act powerful immune suppressant. It Pharmacist Letter Supplement Vol.

15, No.2ing benzodiazepine in the same is also being tested for lupus, rheufamily of drugs as Valium, matoid arthritis, multiple sclerosis Pharmacist Letter Vol. 14, No.8, Xanax, Ativan, is now available and several forms of cancer. pg.48 in an oral dosage form. It has been available for several years in an in Cebebrex (celecoxib) is in a new jectable dosage form. class of pain relievers call COX-2

NEW DRUGS APPROVED BY THE FDA IN 1998 BRAND GENERIC DESCRIPTION Actonel risedronate Bisphosphonate for the treatment of Paget's disease of the bone Acutect technetium apcitide Imaging agent for diagnosing acute venous thrombosis Aggrastat tirofiban Glycoprotein lib/lila blocker for acute coronary syndrome Alrex' loteprednol etabonate 0.2% Ophthalmic steroid for allergic conjunctivitis Amerge naratriptan hydrochloride Serotonin agonist for migraines Arava leflunomide Immune modulator for rheumatoid arthritis Atacand candesartan cilexetil Angiotensin II receptor blocker for hypertension Celebrex celecoxib First COX-2 inhibitor for rheumatoid and osteoarthritis Celexa citalopram Selective serotonin reuptake inhibitor for depression Detrol tolterodine tartrate Muscarinic receptor antagonist for overactive bladder Intergrilin eptifibatide Glycoprotein lib/Ilia blocker for acute coronary syndrome Lotemax* loteprednol etabonate 0.5% Ophthalmic steroid for ocular inflammation Maxalt rizatriptan benzoate Serotonin agonist for migraines Micardis telmisartan Angiotensin II receptor blocker for hypertension

NEW DRUGS APPROVED BY THE FDA IN 1998 BRAND GENERIC DESCRIPTION Priftin rifapentine Antituberculosis agent Provigil modafinil Non-amphetamine for narcolepsy Refludan lepirduin Thrombin inhibitor anticoagulant Renagel sevelamer Phosphate binding polymer for renal failure Singulair montelukast sodium Leukotriene receptor antagonist for asthma 16 Virginia Dental Journal

Sucraid Sustiva Tasmar Thalomid Thyrogen Valstar Viagra Vitravene Xeloda Zemplar Ziagen

BRAND Actiq Activelle Atridox Cipro HC Ditropan XL Perio Chip Periostat Prometrium Rebetron Roca Hrol Sandostatin LAR Versed Viramune

BRAND Duract Posicor Seldane

sacrosidase efavirenz tolcapone thalidomide thyrotropin alpha valrubiun sildenafil citrate fomivirsen sodium capecitabi ne paricalcitol abacavir

GENERIC fentanyl citrate estradiol/norethindrone acetate doxycycline hyclate gel ciprofloxacin/hydrocortisone oxybutynin chlorhexidine doxycycline hyclate progesterone ribavirin/interferon alfa 2b calcitriol octreotide midazolam nevirapine

GENERIC bromfenac mibefradil terfenadine

Oral replacement therapy for sucrase deficiency Non-nucleoside reverse transcriptase inhibitor for HIV COMT inhibitor for Parkinson's disease Immune suppressant for leprosy complications Recombinant TSH for use in thyroid cancer Doxorubican analog for intraversical therapy in bladder cancer Oral phosphodiesterase inhibitor for erectile dysfunction Intravitreal injection for CMV retinitis Oral pro-drug of 5-fluorouracil for breast cancer I.V. Vitamin D analog for secondary Nucleoside reverse transcriptase inhibitor for HIV

NEW DOSAGE FORMS DESCRIPTION Transmucosal sucker for break through cancer pain Combination tablet for hormone replacement therapy Doxycycline topical gel for periodontal disease Otic antibiotic/steroid suspension for otitis externa Extended release form Periodontal disease adjunct Low dose anti-collagenase agent for periodontal disease Oral micronized progesterone Combination treatment for chronic hepatitis C Oral solution Depot injectable form Oral Syrup Oral suspension

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WEDNESDAY, SEPTMEBER 15, 1999 SATURDAY, SEPTEMBER 18, 1999 8:00am Executive Committee Meeting 6:30am Fun Run/Walk 11 :OOam Golf Exhibition 7:00am Registration and Ticket Sales 1:OOpm Golf Tournament - Lansdowne Resort 7:00am VSOMS Membership Meeting 1:OOpm Registration and Ticket Sales 7:30am International College of Dentists Breakfast

8:30am Johnson Course - Consults Patients 5:30pm Golf Reception Can't Refuse

9:00am Alliance Business Meeting THURSDAY, SEPTEMBER 16, 1999 10:00am Exhibit Hall Opens 7:30am VSOMS Board Meeting 11 :30am Pierre Fauchard Academy Luncheon 8:00am Registration and Ticket Sales 12:00pm CDHS Luncheon and Annual Meeting 8:00am Board of Dentistry Meeting 1:30pm Endodontist Meeting 8:00am Executive Council Meeting 6:30pm VDNMCV Reception10:00am Credentials Committee 7:30pm President's Banquet & Dance 10:30am VDA House of Delegates 12:00pm VDA Fellows Luncheon SUNDAY, SEPTEMBER 19, 1999 1:30pm VDA Reference Committees

7:30am VADPAC Breakfast 5:00pm 130lh Annual Meeting Opening Session 8:00am Registration6:15pm Exhibition Hall Opens/Members Reception 9:00am VDA Annual Business Meeting 7:30pm ACD Dinner & Dance 10:00am VDA House of Delegates 1:OOpm VDA Executive Council FRIDAY, SEPTEMBER 17,1999

7:00am Registration and Ticket Sales 7:00am VSOMS Membership Meeting 7:30am VAGD Breakfast 8:00am Board of Dentistry Meeting 8:00am Risk Management Course 8:30am Sullivan Course - Acheiving Esthetic Fixed

Implant Restorations 9:30am Alliance Meeting 10:00am Exhibition Hall Opens 11 :30am Luncheon for Learning 11 :30am ADA 16th District Delegation Meeting

Sullivan Course - Acheiving Esthetic Fixed 11:30pm Implant Restorations

11:30pm VAO Board Meeting f.: 30pm Constitution & Bylaws Committee Meeting

~:30pm VAGD Board Meeting 5:00pm Reception with Exhibitors

*Thisisa preliminary schedule; some events may not be included.


Hyatt Regency Reston

Dan Sullivan, D.D.S. Acheiving Esthetic Fixed Implant Restorations

September 17,1999 8:30am-11 :30am & 1:30pm-4:30pm

Daniel Y. Sullivan is a Diplomate of the American Board of Prosthodontics and an internationally recognized authority on dental implants. In 1982, he restored the first osseointegrated implants placed in the U.S. by Dr. P. I. Branemark. Recognizing the future restorative potential of dental implants, Dr. Sullivan co-founded Osseointe

gration Seminars, training and educating over 10,000 dentists in two-day seminars.

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Achieving Esthetic Fixed Implant Restorations: The interrelationship between bone, soft tissue, implant and prosthetic components influence the final esthetic result. The roles of the surgeon and restorative dentist will be reviewed in achieving outstanding esthetic implant restorations.

"G.L." Johnson Consults Patients Can't Refuse

September 18, 1999 8:30am-11 :30am & 1:30pm-4:30pm

Twenty-one years serving dentistry has taught "G.L." Johnson that national, state, and local dental associations are interested in speakers who deliver valuable information, motivation, and enjoyable staff participation.

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Consults Patients Can't Refuse: 10 Key Questions - Cold Feet Solution - Expectations -The Double Edged Sword - Financial Arrangements That Accelerate Acceptance - Success Formula Secret to "One Minute Phone Consults"


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Date: Wednesday, September 16 Time: 1:OOpm Attire: Collared Shirts

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The 1996 Virginia Dental Association House of Delegates adopted Constitution and Bylaws changes stating that candidates for VDA elective office have the opportunity to submit a statement and CV to be published in the April-May-June Virginia Dental Journal. Candidates for President-Elect and Secretary Treasurer can have a 500 word statement. All other candidates can have a 250 word statement. This will give members of the Virginia Dental Association an opportunity to meet candidates for elected offices.

Dave C. Anderson, D.D.S. Candidate for Office of: President-Elect

I have had the privilege to serve the VDA on the executive council since 1991 and the executive committee since 1994. During that

time concerted effort was made to contribute to the new transparent, member driven VDA. My views should be well known.

Now that the opportunity has presented itself I would consider the office of President-Elect, a great challenge and an even deeper honour. My pledge is to make the VDA the best possible organization it can become. Fortunately the organization has been given a whole host of gifted leaders to carry this forth.

My pledge is that my time and effort will always be available to you. This is a joint effort and to this end I ask your support.

Name: Dave C. Anderson Address: 5288 Dawes Avenue City & Zip: Alexandria, 22311 Phone: (703) 671-6060 Component: 8

CV and Biographical Information

Education: A.B., Seton Hall Uni

versity, 1970; D.D.S., MCV, 1974; Cert Perio, Fairleigh Dickinson Uni

versity, 1976. Memberships: ADA, MP, VDA & NVDS. Honors: Fellow: VDA, 1986; Pierre Fauchard, 1990; ACD, 1993; & lCD, 1994; ICD Journalism Award, 1988; & ADA Presidential Citation, 1998. Leadership Activities: AD-fLand VDA: Councilor-at-Large, 1994

1999; Vice Chair Executive Coun

cil, 1994-1998; Chairman Executive Council, 1999; ADA Alternate Del

egate, 1996-1998; ADA Delegate, 1999. CQmponentSociet}l: Coun

cilor, 1991-1994; President, 1989

1990. Community: Fairfax County Task Force on AIDS, 1988-1990; Medi

cal Care for Children's Project, 1991- present; Friends of the Chair in Local Government, George Ma

son University, 1993- present.

Thomas S. Cooke III, D.D.S. Candidate for Office of: SecretarylTreasurer

I am pleased to announce my candidacy for the position of Secretary/Treasurer of the VDA. Having held this position for the last two

years, I've helped contribute to the growth, effectiveness and efficiency of our organization. The VDA is continuing to evolve to accommodate changes that affect our profession. In the past two years, our accounting system has been refined and simplified so as to be better understood by the membership. In addition, we have increased information dissemination by use of computers. VDSC is off and running and our involvement in the political process through VADPAC is on the upswing. We need to continue focusing our efforts in membership retention and recruitment of new members. It is important that these members become leaders because they are our future.

As Secretary/Treasurer I had the responsibility of seeing that the Association runs smoothly and efficiently. The many hours I've spent at the Central Office these past two years have resulted in a complementary working relationship with the staff. I am committed to working to improve organized dentistry and look forward to applying my skills and enthusiasm to the challenges facing the Virginia Dental Association.


A Virginia Name: Thomas S. Cooke III Address: 39 W. Williamsburg Rd. City &Zip: Sandston, 23150 Phone: (804) 737-7402 Component: 4


Education: Virginia Military Institute, 1970, B.S., Biology; Medical College of Virginia School of Dentistry, 1974, D.D.S. Memberships: RDS,VDA,ADA, Academy of General Dentistry. Honors: Fellow VDA, Fellow Pierre Fauchard Academy, Fellow International College of Dentistry, Fellow American College of Dentistry, Paul Harris Fellow. Leadership Activities: ADA and VDA: American Dental Association, Positions held: Alternate-Delegate, Mediation Workshop, ADPAC. Virginia Dental Association, Positions held: Secretary/Treasurer, Executive Council, Delegate, Reference Committee Chair, Peer Review/ Patient Relations Chair, Fellows Committee, Annual Meeting Committee, Presidents Club, Commonwealth Club. Component Society: Richmond Dental Society Positions held: President, Secretary, Board of Directors, Delegation Chair, Peer Review/ Patient Relations Chair, Arrangements Chair, Long-Range Planning Chair, Bylaws Chair, Budget Chair, Harry Lyons Chair, Nominating Chair, Military Committee. Community: Trinity Methodist Church, Greater Richmond Area Health Education Center Executive Committee Program Chair, Byrd International Airport, Rotary Club Past-President, Class Agent VMI 1970, Blue Cross Blue Shield Advisory Committee.

D. Christopher Hamlin, D.D.S. Candidate for Office of: Councilor-at-Large

My appreciation for the strength of a well informed, unified association grew immeasurably during my tenure as Speaker of the House of

Delegates. Our success comes when we work together for the benefit of all. Fostering the development of communication technology within the VDA has minimized our geographic distances and permitted our organization to respond quickly to challenges. My goal is to facilitate communication and the dissemination of information statewide. The energy of the leadership of our organization has been infectious and it is my desire to continue to be a part of the exciting process of evolution in the Virginia Dental Association.

Name: D. Christopher Hamlin Address: 1806 Hampton Blvd. City & Zip: Norfolk, 23517 Phone: (757) 627-7550 Component: 1

Education: Indiana University, B.A., Biology, 1973; Indiana University School of Dentistry, D.D.S., 1976; James Whitcomb Riley Hospital for Children, residency, 19761978; Certificate in Pediatric dentistry, Board Certified, American Board of Pediatric Dentistry, 1986. Memberships: ADA, VDA, Tidewater Dental Association, American Academy of Pediatric Dentistry, American Academy of

Pediatrics, Southeastern Society of Pediatric Dentistry, American Board of Pediatric Dentistry, Virginia Pediatric Dental Society, Indiana University Pediatric Dentistry Alumni Association. Honors: American College of Dentistry Fellow; VDA Fellow; American Academy of Pediatric Dentistry Fellow; Pierre Fauchard Academy. Leaderships Activities: ADA and VDA: ADA: Alternate Delegate, 1996-1998; Council on Ethics, Bylaws and Judicial Affairs, 19992002. VDA: Speaker of the House, 1994-1999; Executive Council, 1994-1999; Reference Committee, Chair; President's Address and Administrative Matters; Alternate VDA Delegate; VDA Delegate; Annual Meeting Committee; Dental Health and Public Information Committee, Chair. Component Society: President, President-Elect, Treasurer, Executive Committee, Membership Committee, Children's Dental Health Month CommitteeChair, Legislative Committee, Tidewater Dental Association Foundation President; TDA United Way Fund Chair. Community: Junior League Norfolk-Virginia Beach; Pride and Parenting Facilitator; National Ski patrol; Children's Hospital of the King's Daughters-Surgical Authorities Committee; Adjunctive Professor- Otolaryngology Eastern Virginia School of Medicine; Adjunctive Professor- Dental Hygiene and Dental Assisting- Old Dominion School of Dental Hygiene.


Rodney J. Klima, D.D.S. Candidate for Office of: Councilor-at-Large

The Virginia Dental Association is the voice of dentists in Virginia. I have always desired to be active in the affairs of our great profes

sion. The past four years I have served on the Executive Council as Component 8 Councilor. I would now like to continue serving as Councilor-at-Large of the VDA.

We are facing new challenges every year, some are threats, some are opportunities. I believe the future of dentistry is bright as long as our members remain informed and involved.

Name: Rodney J. Klima Address: 5204B Lyngate Ct. City and Zip: Burke, 22015 Phone: (703) 425-5125 Component: 8


Education: College of William and Mary, B.S., Chemistry, 1970; Medical College of Virginia, School of Dentistry, D.D.S., 1974; Orthodontic Residency, Medical College of Virginia, School of Dentistry, 1976. Memberships: American Dental Association; American Association of Orthodontists; Virginia Dental Association; Northern Virginia Dental Society; Southern Society of Orthodontists; Virginia Association of Orthodontists; Fairfax County Dental Society; Alexandria Dental Society; College of Diplomates American Board of Orthodontics. Honors: Omicron Kappa Upsilon; A.D. Williams Award; Diplomate of


the American Board of Orthodontics; Fellow of the Virginia Dental Association; American College of Dentists; International College of Dentists; Pierre Fauchard Academy. Leadership Activities: ADA and VDA: Alternate Delegate to ADA, Grassroots Co-chair, VDA Executive Council, VADPAC,VDA Budget and Financial Affairs Committee, 1994-1997. C~rnpoo~nLSQcleJ~ President NVDS, 1994-1995; NVDS Executive Committee, 1987present; Councilor, 1995-present; Delegate to VDA, 1984-present; Editor NOVA News, Newsletter of the Northern Virginia Dental Society, 1987-1992. Community: Consultant Cleft Palate Team Walter Reed Army Medical Center, 1981-1995; Youth soccer and basketball coach; Swim team representative.

Gus C. Vlahos, D.D.S. Candidate for Office of: Councilor-at-Large

I am running for the Executive Council as an at-large member. I currently hold this position and also serve as vice-chair

man of the Executive Council. As Vice-Chairman I serve on the Executive Committee. The Virginia Dental Association has faced many challenges in the past and has reacted very well to these issues. The last two years the Virginia Dental Association has taken a pro-active stance to increase Medicaid Reimbursement rates and on the assignment of benefit issues, and have been successful in both cases.

The major issues facing the Virginia Dental Association in the future will always be legislative action that can affect us and our ability to practice dentistry. The Virginia Dental Association must work hard to retain its current membership and to increase membership in the future.

The major financial issue is the current need for a new Virginia Dental Association Central Office. The Leadership and the House of Delegates must decide on how to finance the new building without putting the Virginia Dental Association into financial difficulties. It must also find a way to retain its membership because of the dues increase that will be needed for the new central office. I will continue to serve with the same professional standard I have worked with in the past and would like to serve in this position to deal with the issues that will be forthcoming that I have discussed.

Name: Gus C. Vlahos Address: P.O. Box 1379 City & Zip: Dublin, 24084 Phone: (703) 674-4396 Component: 6


Education: B.S., Chemistry, Virginia Tech, 1976; D.D.S., Medical College of Virginia, 1981. Memberships: New River Study Club; Southwest Virginia Dental Society; Virginia Dental Association; American Dental Association. Honors: Fellow of the Virginia Dental Association; Member Pierre Fauchard Academy. Leadership Activities: ADA and V_DA: Alternate Delegate, 1997 and 1998; Delegate from Southwest Virginia Dental Society to the Virginia Dental Association House of Delegates 1987-1993; Chairman of the Presidential Address and Reference Committee, 1991;

Member of the Young Dentist Committee 1991-1993; Member of the VDA Nominating Committee 1991 and 1992; Member of the VDA Search Committee for Virginia Board of Dentistry Committee 1992 and 1996; Member of Ad Hoc Committee on Component Borders 1995; Member of Executive Council 1993-present; Member of the VDA Auxiliary Aid and Education Committee 1996 and 1997; Liaison from the Virginia Dental Association to the Virginia Dental Assisting Association; Advisory Committee Member at Wytheville Community College Dental Assisting Program; Member of Annual Meeting Committee 1994-97; ViceChairman of Executive Council; Member of Executive Committee. Component Society:Southwest Virginia Dental Society ViceP resid ent; Pres id ent-E Iect; President. Community: Member of Holy Trinity Greek Orthodox Church, Roanoke, Virginia; Little League Basketball Coach, Dublin, Virginia.

Bruce Hutcison, D.D.S. Candidate for Office of: ADA Delegate

I am running for the position of Delegate to the ADA. This position demands a person who is able to listen both to the members

"back home" and to the information and ideas that are presented during the House of Delegates. The delegate then should seek out further information and synthesize a position. He must look ahead to the possible ramifications of action (and inaction) and make a decision that will improve and advance our

profession. An effective delegate should be able to communicate ideas with the purpose of finding the best solutions. I am currently serving my third year as an alternate delegate and feel that I have the ability to serve the members of the VDA well. I have been involved in the decision making process, have spoken before the House of Delegates when I nominated our own Dr. Dave Whiston for the position of ADA president, have interacted with other delegates and alternates in reference committees, on the house floor, in the hallways, and by fax and phone. I believe that my experience, my demeanor, and my love of the profession of dentistry qualify me for this position and I ask that you give me the honor of representing you.

Name: Bruce R. Hutchison Address: 14260-A Centreville Sq. City & Zip: Centreville, 20121 Phone: (703) 830-9110

CV & Biographical Information

Education: B.S., Electrical Engineering, University of Rochester, 1976; MS, Electrical Engineering, University of Rochester, 1977; D.D.S., Georgetown University School of Dentistry, 1981. Memberships: ADA, VDA, NVDS, AGD, Delta Sigma Delta, Implant Society of Northern Virginia, SEAP. Honors: Fellow: VDA, ACD, lCD, ADI, Fellowship and Mastership AGD. Leadership Activities: ADA and VDA: ADA Alternate Delegate, 1996-1999; Chairman, Annual Meeting Committee, 1995,19971999; Chairman, Young Dentist Committee, 1990-1992; CPR Instructor; Delegate to VDA Annual Session, 1988-1999; House of Delegates, Chairman Credentials Committee, 1991; VADPAC Committee, 1998-2001. Component

SQcifrty~ Northern Virginia Dental Society: President, 1996-1997; Chairman, Executive Committee, 1997-1998; Chairman, Program Committee, 1991-1992; Chairman, Membership Committee, 19931994; Chairman, Young Dentist Committee, 1988-1989. Community: Centreville Presbyterian Church; United States Jaycees, Centreville Chapter Charter Member, Past President; Northern Virginia Dental Clinic; Fairfax Family Services; Spent 10 days as volunteer dentist on the Northern Cheyenne Indian Reservation in Lame Deer, Montana; Provide dental care for the Mattaponi Indian Tribe in Virginia.

Ron Tankersley, D.D.S. Candidate for Office of: ADA Delegate

The governance and policies of the ADA help determine the destiny of our profession. Historically,the ADA has played a

major role in initiatives ranging from the fluoridation of the nation's water supply to determining the quality of dental education. Currently. the ADA is dealing aggressively with managed care, OSHA, and healthcare reform. During the 1998 House of Delegates, we took positive steps to address the hygienist-shortage problem, enhance communications within the ADA, and assure that we remain a"membership-driven" organization.

I was a member of an ADA Reference Committee last year and have


served as Chairman of the Council on Dental Benefits Programs. I am currently the Chairman of the 16th District Caucus, which represents Virginia, North Carolina and South Carolina. In a volunteer professional organization like the ADA, these "duties" are also "privileges". While they require preparedness, attentiveness, and energy, they are also educational, stimulating, and gratifying.

I enjoy serving you at the ADA level and try to fulfill my responsibilities with integrity and your interests in mind. As a recent Past-President of the VDA, I understand your concerns and objectives. I hope that you will allow me to continue representing you as an ADA Delegate.

Name: Ronald L. Tankersely Address: 716 C-1 Denbigh Blvd City & Zip: Newport News, 23608 Phone: (757) 874-6501 Component: 2


Education: VPI, William & Mary; Medical College of Virginia, D.D.S., 1968; Medical College of Virginia, Certificate in OMS, 1971; American Board of Oral & Maxillofacial Surgery; Certification, 1973; Examiner, 1990-1995; Associate Clinical Professor, Medical College of Virginia, 1974- present. Memberships: PDA; VDA; ADA; VSOMS; MOMS; SSOMS; American Dental Society of Anesthesia; Academy of Osseointegration; Mary Immaculate, Williamsburg Community, Riverside & Medical College of Virginia Hospital Staffs. Honors: Sigma Zeta Honorary Science Fraternity, 1967; A.D. Williams Scholarship Award, 1967 & 1968; Omicron Kappa Upsilon Honorary Dental Society, 1968: Fellow, Virginia Dental Association, 1981; Pierre Fauchard Academy, 1985; Fellow, American College of Den26 Virginia Dental Journal

tists, 1987; Fellow, International College of Dentists, 1989. Leadership Activities: PDS, President; VDA, President; ADA House of Delegates, Delegate & Caucus Chairman; ADA Council on Dental Practice Parameters Committee; ADA Dental Indicators Consensus Panel; ADA Reference Committee on Dental Benefits, Practice and Health; American College of Dentists, Chairman, Virginia Section; Donated Dental Service Board; VSOMS, President; AAOMS House of Delegates, Delegate & Caucus Chairman; MOMS Reference Committee on Health Care Programs, Government and Hospital Affairs; MOMS Reference Committee on Membership and Administrative Matters, Chairman; AAOMS Committee on Membership, Chairman; MCV School of Dentistry Board of Advisors, Chairman.

Richard D. Wilson, D.D.S. Candidate for the Office of: ADA Delegate

The role of a delegate to the American Dental Association House of Delegates includes being conversant with the issues,

appropriately representing both the dentists of Virginia and their patients and beingdiligentand innovative prior to and during the deliberationsof the House. If re-elected, I shall continue to be as responsive as possible to my colleagues in Virginia in fulfilling the serious responsibilities inherent in the position of AmericanDental AssociationDelegate.

Name: Richard D. Wilson Address: 3800 Patterson Avenue City &Zip: Richmond,23221 Phone: (804) 358-7582 Component: 4


Education: Villanova University, B.S.; Temple University, D.D.S. Memberships: OKU, American Academy of Restorative Dentistry, RDS; VDA; ADA; American Academy of Periodontology, Board of Trustees; American Academy of Fixed Prosthodontics, Immediate Past President; Academy of Operative Dentistry. Honors: Fellow, Virginia Dental Association; Fellow, American College of Dentists; Fellow, American Academy of Periodontology. Leadership Activities: ADA Council on Dental Education, 19921996, Member/Chairman; ADA House of Delegates; Commission on Dental Accreditation, 19921996; Virginia Dental Journal, Editor, 1988-1994. Community: Virginia Health Council; Civic Association, President; Virginia Board of Health Professions; Virginia Board of Dentistry.

Andrew J. "Bud" Zimmer, D.D.S. Candidate for office of: ADA Delegate

Serving as a member of Virginia's ADA Delegation is a great privilege because you have the opportunity to participate in policy deci

sions that are direct benefits to members. The 1998 ADA House of Delegates passed several resolutions having budgetary impact as

well as benefits for members:

1. Support for accredited alternative training programs and outcome based evaluation for dental hygiene education.

2. Continuation of the DMSO Task Force to accumulate information on this dental management entity and support for legislation to mandate public disclosure of dental practices not owned by a dentist.

3. Establishment of a specific Association Reserve policy at 30% of the annual operating budget.

For the past four years, I have served as a member of the ADA Budget Reference Committee Observer Team and am currently designated as the 16th District representative to the Special Committee to Study the Office of ADA Treasurer. I am committed to assuring that the ADA Budget is presented in a concise and understandable format and that our dues dollars are expended in a responsible and universally beneficial manner.

I would also continue to encourage the development of greater outside income activities ultimately utilizing two non-dues dollar for every dues dollar spent. Fiscal policy of this type would certainly enhance the perceived value of our dues dollars.

It has been an honor to serve on the Virginia Dental Association ADA Delegation and I respectfully ask your support for Delegate in 1999.

Name: Andrew J. Zimmer Address: 1 Southern Shopping Center #208 City & Zip: Norfolk, VA 23505 Phone: (757) 588-8566 Component: 1


Education: Georgetown University, Washington, DC, B.S., Biology 1966; Georgetown University School of Dentistry, Washington, DC, D.D.S. ,1970. Memberships: ADA; VDA; Tidewater Dental Association, 1970present; DePaul Hospital Staff, 1970-1989; Past President of two Tidewater area Study Clubs; Psi Omega. Honors: Fellow Virginia Dental Association, 1992; Fellow Pierre Fauchard Academy, 1993; Fellow American College of Dentists, 1994; Fellow International College of Dentists, 1996. Leadership Activities: ADA and VDA: ADA Alternate Delegate, 1995-1999; Special Committee to Study the office of ADA Treasurer, 1999; Whiston '96 Campaign Committee; VDA President-Elect, 19981999; VDA Councilor-at-Large, 1993-1998; VDA Annual Meeting Chairman, 1994 & 1996; Past Chairman of two VDA Committees; Fellows Selection Committee, 1995-1997; Secretary, 1997. Component Society~ Tidewater Dental Association President, 1990-1991; Nominating Committee Chairman, 1992-1998; Past Chairman of Budget Program and Dental Health Month Committees; Delegate to VDA, 1986-1993, Chairman, 1991; Simmons Award Recipient, 1998. Community: Norfolk Jaycees; Wards Corner Lions Club; Cub Scout Pack 490; Norfolk Catholic High School Board; Virginia Beach Respite Care Expansion Program; Elder Fair; Holy Family Church Debt Committee.

Thomas 5. Cooke, D.D.S. Candidate for Office of: ADA Alternate Delegate

I am pleased to announce my candidacy for the office of ADA Alternate-Delegate. I have served the Virginia Dental Association as ADA

Alternate-Delegate (1995, 1998, 1999) and was Delegation Secretary in 1998. To represent the VDA to the national organization is a privilege requiring research, preparation and commitment. I am knowledgeable of the issues affecting dentistry and willing to give the time and effort necessary to confront these issues and find solutions. I would appreciate your vote and look to further serving the membership.

Name: Thomas S. Cooke III Address: 39 W. Williamsburg Rd. City & Zip: Sandston, 23150 Phone: (804) 737-7402 Component: 4


Education: Virginia Military Institute, 1970, B.S., Biology; Medical College of Virginia School of Dentistry, 1974, DD.S. Memberships: RDS, VDA, ADA, Academy of General Dentistry. Honors: Fellow VDA, Fellow Pierre Fauchard Academy, Fellow International College of Dentistry, Fellow American College of Dentistry, Paul Harris Fellow. Leadership Activities: ADA and VDA: American Dental Association, Positions held: Alternate-Delegate, Mediation Workshop, ADPAC. Virginia Dental Association, Positions held: Secretary/Treasurer, Executive Council, Delegate, Reference


Committee Chair, Peer Review/ Patient Relations Chair, Fellows Committee, Annual Meeting Committee, Presidents Club, Commonwealth Club. CQmP-O-~enLSQCletc Richmond Dental Society, Positions held: President, Secretary, Board of Directors, Delegation Chair, Peer Review/ Patient Relations Chair, Arrangements Chair, Long-Range Planning Chair, Bylaws Chair, Budget Chair, Harry Lyons Chair, Nominating Chair, Military Committee. Community: Trinity Methodist Church, Greater Richmond Area Health Education Center Executive Committee Program Chair, Byrd International Airport, Rotary Club Past-President, Class Agent VMI '70, Blue Cross Blue Shield Advisory Committee.

Ronald J. Hunt, D.D.S. Candidate for Office of: ADA Alternate Delegate

The academic and practicing dental communities are closely intertwined and share common ideals, goals, and challenges.

In Virginia, the VCU School of Dentistry and the Virginia Dental Association enjoy a mutually beneficial relationship. As dean of the School of Dentistry and member of the VDA Executive Council, I strive to strengthen even more the bond between these two great institutions. In addition to keeping the VDA leadership apprised of dental school activities, my role on the Executive Council is to provide counsel in matters involving public health dentistry and Medicaid. If elected to serve as an alternate delegate to the ADA House, I will strive to pro


vide fellow delegates informed counsel regarding dental education, accreditation, and public health issues to come before the House.

Name: Ronald J. Hunt Address: MCVIVCU School of Dentistry, PO Box 980566 City & Zip: Richmond,23298 Phone: (804) 829-9184 Component: 4


Education: University of Iowa, DDS; M.S. in Dental Public Health. Memberships: ADA, VDA (North Carolina and Iowa state associations previously), American Association of Dental Schools, American Association of Public Health Dentistry, International Association for Dental Research. Honors: Diplomate of the American Board of Dental Public Health; Omicron Kappa Upsilon Honor Dental Society; Visiting Fellowship to University of Adelaide, Australia; Gies Fellowship to the American Association of Dental Schools; National Academy of Practice in Dentistry. Leadership Activities: V

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