14-124 NAGD Summer 2014 Newsletter - …nebraskaagd.org/wp-content/uploads/2014/08/July-2014...July 2014 | N ebraska Academy of General Dentistry 5 N T he Affordable Care Act mandated

July2014|NebraskaAcademyofGeneralDentistry 1

NebraskaAcademy of General Dentistry

J u l y 2 0 1 4

Quarterly Publication of the NAGD

inside THis issue Page

President’s Message . . . . . .1Editor’s Message . . . . . . . . .2NAGD Board of Directors . . .2Future NAGD CE/Mastertrack Dates . . . . . . . .3June 2014 Mastertrack Recap . . . . . . .4Medicaid RAC Audits Update . . . . . . . . . . . . . . . .52014 Fall NAGD Mastertack . . . . . . . . . . 6 & 7Region 10 RD Report . . . . .8Open Enrollment for NAGD Mastertrack . . . . . . .9National Hemophilia Foundation Survey . . . . . . .9AGD Fellowship Review Course & Exam . . . . . . . . .102014 AGD Meeting in Detroit . . . . . . . . . . . . . . . .112014 Student Award Winners . . . . . . . . . . . . . . .122014 UNMC Transition Seminar . . . . . . . . . . . . . . .13Proposed Changes in Sedation . . . . . . . 14 & 15Thank you to Corporate Sponsors . . . . .15

For more information visitwww.NebraskaAGD.org

•Like us on Facebook: Nebraska Academy of

General Dentistry•

Follow us on Twitter @NebraskaAGD

(O/F) 402.438.2321 [email protected]

6331 Tanglewood LaneLincoln, NE 68516

•

R.BurkeNoel,DDS,MAGD

SUMMER 2014

President’s Message

NI would like to start off

introducing myself as your newly elected President. I was born and raised in Texas and have been practicing in Omaha area for last fourteen years. I can truly say my time in Nebraska has been wonderful and mostly due to my membership with the NAGD. As an advocate for the general dentist and dentistry as a profession, the AGD has been the driving force for quality and pertinent continuing education. I am humbled

to be able to carry this torch forward and, with the cooperation and teamwork with the board and general members, validate that we can be considered the best organization for dentists.

Ok introductions aside, I would like to thank Dr. Antholz, the Board, and especially Julie Berger-Moore for their tiring efforts to bring us where we are today. The amount of work involved in planning and executing the various events, including the Master track program, can be daunting. I am hoping for those of you that attended Dr. Massad a couple weeks ago, you found his information use-ful for your practice. I would like to jump a little forward and get everyone thinking of our next course with Dr. Karl Koerner in October. Dr. Bob Margeas will be presenting in June 2015, and Dr. Jim Gerner for the fall of 2015. It is a mission of the NAGD to be able to provide top notch presenters without having to travel great distances. The Master track program now

has an Open Enrollment which allows one to jump into the program at any time, even if you are still work-ing on your Fellowship. A special note should be made acknowledging the NAGD for winning multiple awards again this year from National, including but not limited to: the Membership Award, the ACE (Newsletter) Award, the Continuing Education Award, the PIO (Public Information) Award and also Constituent of the Year.

In closing I would like to remind everyone to have a great summer and spend as much time as you can away from the offi ce, your families will appreciate it. If anyone has a question or sugges-tion for me please feel free to email me at [email protected].

Sincerely,R. Burke Noel, DDS, MAGDNebraska AGD President

N

N2 NebraskaAcademyofGeneralDentistry|July2014

NAGD Board of Directors President/Continuing Education Chair Burke Noel, DDS, [email protected]

President-Elect/Co-Student Membership Chair Tom St. Germain, [email protected]

Immediate Past President Travis Antholz, [email protected]

Region 10 Regional DirectorKevin Low, [email protected]

TreasurerDavid Swanson, [email protected]

Membership Chair/PACE Steve Wegner, DDS, MAGD, [email protected]

Legislative Chair Bob Roesch DDS, MAGD, [email protected]

Co-MasterTrack Program ChairWilliam Kathrein, DDS, MAGD, [email protected]

Co-Public Information Offi cerWilliam Printz, DDS, [email protected]

Co-Public Information Offi cerPhil Strevey DDS, [email protected]

Region 10 TrusteeMark Malterud, DDS, [email protected]

Co-Mastertrack Program ChairCassandra Pietrok, MAGD402.330.2243cass@pacifi chillsdental.com

Fellow Track Program Coordinator/Co-Student Membership ChairSarah Donner, DDS, [email protected]

Co-Editor/Co-Student Membership ChairNatalie Fendrick, [email protected]

Co-Editor Brian Penly, [email protected]

Member at LargePatrick Wachter, [email protected]

Executive DirectorJulie Berger-Moore6331 Tanglewood LaneLincoln, Ne 68516Offi ce/Fax: 402.438.2321Cell: [email protected]

N

SUMMER 2014

Co-Editor’s Message

Wow, life has been very busy for me.

Since the last newsletter I have purchased the practice I was working in, got married, and moved. I have hardly had time to catch my breath. As I was preparing to write this issues editor's message I didn't even know where to begin. There is so much involved in a practice transition from loans to forming an LLC. All I can say is I have been very thankful to have fellow AGD colleagues that I could turn to with

questions and look to for guidance. With the variety of continuing education the AGD has to offer I felt somewhat prepared for this opportunity. Nothing can always quite prepare you for everything coming your way. I’m excited for my journey, and a little nervous for the road ahead as a business owner. I would be lying if I said I wasn't.

With all of the stresses and challenges of running a practice, I’m glad we have an organization that provides us with

opportunities to get away for the weekend and learn about what’s new in the world of dentistry. Broadening our knowledge and improving our skills truly helps us provide better care for our patients and it helps us to become better dentists. Not to mention the NAGD has proven to be an award winning organization year after year by providing such top notch meetings. Don’t miss an opportunity to hear Dr. Karl Koerner in October in Lincoln!

Dr.NatalieFendrickN


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october 17-19, 2014Dr.KarlKoerner

OralSurgeryLincoln(see article on page 6)

december 5, 6 & 7, 2014FellowshipReviewCourse&Exam

Omaha(see article on page 10)

october 2015Dr.JimGerner

Occlusion

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Future NAGD CE/Mastertrack Dates

Mark your Calendars now for these great speakers!

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4 NebraskaAcademyofGeneralDentistry|July2014

2014 June Mastertrack with Dr. Joseph Massad

By Dr. Natalie Fendrick & Dr. Travis Antholz

NAGD hosted Dr. Joseph Massad for the weekend annual session course. The course consisted of a Friday lecture titled ‘Current

Concepts in Implant Prosthodontics,’ followed by a hands on portion titled ‘Impressions to record making to delivery

of the complete and implant-retained restorations’ at UNMC Friday evening, Saturday, and Sunday.

The lecture portion was very interesting. Dr. Massad discussed a wide variety of trials and tribulations he experienced that led

to his predictable protocol when it comes to treating the edentulous patient. He covered everything from impression methods using his trays to records appointments to delivery. Conventional dentures and implant retained dentures were covered in detail. Dr. Massad shared video of him with his own patients and the approaches he uses in different scenarios. Overall, Dr. Joseph Massad’s lecture on Friday was top notch.

Our Mastertrack weekend was filled with great knowledge in treating the edentulous and partially edentulous arch, as presented by Dr. Joseph Massad. Our hands

on portion started with perfecting the Massad Impression technique using trays he designed to eliminate custom trays and obtain more accurate impression of the edentulous and partially edentulous arch. In addition, our class also learned a simpler and more

effective method for Gothic Arch Tracing, and how to teach your laboratory technician to incorporate it into the treatment procedure. That was followed up with learning about methods to better locate the Neutral Zone for proper tooth placement, and finally how to impress during wax try-in to obtain proper lip, face, and cheek support.

Dr Massad was an excellent teacher, always patient and willing to spend as much time as possible to ensure everyone in class had completely perfected the afore mentioned techniques. It was a very educational CE course, full of many ideas ready to take back to our respective practices!

Dr. Massad with Drs. Nicole Stevens, Amy Fournier and Robin Hildebrand

Creighton Dental Students

Drs. Scott Osborne and Allen Reavis at the hands on

Dr. Joe Massad, Ken Waldo, CDT and Dr. Richard June

Exhibitors at 2014 NAGD Annual Meeting

Shad Chandler & Clay Madden with Almena State Bank talk to the Senior dental students from Creighton


NT he Affordable Care

Act mandated that Medicaid Recovery

Audit Contractor (RAC) audits be performed. Nebraska was one of the fi rst ten states to receive these RAC audits. Nebraska Medicaid contracted with Health Management Systems, Inc. (HMS) to complete these audits.

In April about 300 Nebraska dentists received a letter stating that HMS had identifi ed

them as owing money back to the state. HMS apparently did not read Nebraska’s Medicaid manual. The Nebraska Department of Health and Human Services(HHS) had stated in the manual that prophys were “covered at the frequency determined appropriate by the treating dentist.” The Nebraska Dental Association and Senator Campbell asked for clarifi cation from HHS. Nebraska dentists were encouraged to document

why they disagreed with the fi nding from HMS, and many did.

The NAGD has supported the NDA during this process. Please thank Senator Campbell for her support and talk to your state senator about this apparent overreach by HHS.

Dr.RobertRoesch,NAGD

LegislativeChair

NDr.RobertRoesch,

NAGDLegislativeChair

Medicaid RAC Audits


4. Prevent and/or manage bleeding problems that can occur during oral surgery.

5. Better understand patient selection and risks of third molar surgery.

6. Perform oral surgery according to current standards of care.

Hands on Trainingdr. Karl Koerner Friday evening, october 17 and saturday, october 18This workshop builds on the Friday lecture. It applies the surgical principles covered already — to use on life-like dentoform models.The following procedures will be done on the models: full-thickness mucoperiosteal

flaps (envelope and triangular),

suturing (interrupted/surgeon’s knot, cross-suture, continuous-lock),

surgical extractions (multiple root-tip removals with several different methods),

alveoplasty, socket grafting (bone graft

and barrier membrane) moderate third molar

impaction (mesioangular), excisional biopsy incision and drainage, mini-implant placement

Topics covered today that were not discussed in lecture include:• anxiety control for

apprehensive surgery patients,• basics of using mini-implants

for more economical denture stabilization,

• I&D in general practice, discussion of antibiotic usage

• incisional/excisional biopsies, • bisphosphonates, • other discussions as time

permits.

Course objectivesIn addition to the course objectives on Friday, the dentist will also be able to:1. Control patient anxiety

related to oral surgery.

2. Understand principles of mini-implant placement — along with advantages and disadvantages of this modality.

3. Correctly perform I&Ds on the less-invasive abscesses.

4. Do easier third molar impactions.

5. Perform oral surgery according to current standards of care.

LeCTuredr. John engel & dr. steve Coffeysunday, october 19all-on-4The All-on-4 procedure is gaining in popularity with both the dental community and the general public. This lecture will discuss all aspects of the All-on-4 concept including: pre-op evaluation and planning, patient selection, surgical procedure and prosthetics. The role of the restorative dentist, surgeon and lab technician will be discussed. Upon completion of the course, clinicians should have a basic understanding of the All-on-4 process and be able to discuss the concept comfortably with their patients.

Cone Beam Technology & guided implant surgeryCone beam technology is becoming more prevalent in many aspects of dentistry. Dental specialists such as oral surgeons and periodontists have been using cone beam technology for some time and now many general practitioners are installing cone beam technology in their own offices or sending patients to outside facilities to obtain cone beam images. Cone beam computerized tomography (CBCT) scans can be useful for a variety of diagnostic situations from pathology, to implant planning and supernumerary teeth. This lecture will discuss the basics of CBCT technology as well as its indications and applications. Guided implant surgery utilizing CBCT will also be discussed.

KarlR.KoernerSpeaker

LeCTureFriday, october 17 (8 hours CE/AGD Oral Surgery Lecture Credit)

“oral surgery for the general dentist: easier and More Predictable” — Dr. Karl Koerner

Many extractions look easy but can soon become difficult, time consuming, and lead to complications. This course reviews the best techniques and instruments to remove “surgical” extractions easily and quickly while conserving bone. From that primary emphasis, Dr. Koerner branches to other related surgery subjects that use many of the same instruments and principles.These include: • The most common suturing

techniques and materials, • avoiding sinus problems,

• predictable socket grafting techniques (without company hype),

• ridge preparation for immediate dentures,

• bleeding management during surgery,

• a review of moderate third molar impaction essentials (anatomy and step-by-step guidelines).

Course objectivesAs a result of attending this course, the dentist will be able to:

1. More easily do “surgical” or difficult extractions that frequently occur in general practice.

2. Be more proficient at ridge preparation for immediate dentures.

3. Select appropriate socket grafting cases and have the knowledge to do them successfully.

D r. Koerner has presented many didactic and participation oral

surgery courses at international, national, and regional meetings and at the state level for many dental associations and AGD groups. He is currently Director of Oral Surgery for Intermountain Dental Associates in Utah. In 2008-2009, he was Director of the Oral Surgery Department at the Scottsdale Center for Dental

Education. Dr. Koerner is not an oral surgeon but learned oral surgery in the U.S. Army where he completed a general practice residency. For the last 15 years, his Utah practice has been limited to oral surgery.

He is the author of many articles on oral surgery for the general dentist and has authored or co-authored four books in addition to making several DVDs on surgery with Dr. Gordon Christensen. Dr. Koerner is on Clinicians’ Report (formerly CRA) Board of Directors and editorial boards for the Academy of General Dentistry Journal, Dentistry Today’s peer reviewed articles, and Premium Practical Dentistry (PPD) in the UK. He is past president of the Utah Dental Association and Utah Academy of General Dentistry. In 2010 he received the National AGD’s Weclew award.


The AGD-Nebraska is designated as an Approved PACE Program Provider by the Academy of General Dentistry. The formal continuing education programs of this program provider are accepted by AGD for Fellowship, Mastership and membership maintenance credit. Approval does not imply acceptance by a state or provincial board of dentistry. The current term of approval extends from 1/1/2014 to 12/31/2017. Provider ID# 219313

PACEFAGD/MAGD Approved1/1/2014 to 12/31/2017

Dr. John Engel has been practicing oral

surgery in Omaha for 18 years. He received his DDS from the University of Nebraska College of Dentistry in Lincoln and received his Medical Degree from UNMC before completing his residency in Oral and Maxillofacial Surgery at University of Nebraska Medical Center. Dr Engel is a Diplomate of the American Board of Oral and Maxillofacial Surgery and participates in many professional organizations. He is President of the Metro Omaha Implant Study Club.

Dr. Steve Coffey was raised in Omaha and

attended Creighton Prep High School follow by Creighton University. He completed his DDS at Creighton University School of Dentistry. He then continued his education at the University of Tennessee Health Science Center where he completed his Oral Maxillofacial Surgery Residency. Dr. Coffey is a member of many dental groups including the American College of Oral and Maxillofacial Surgery, American Association of Oral and Maxillofacial Surgeons, American Dental Association and the Omaha District Dental Society.

GeneralInformationFriday, oCToBer 17, 2014Lecture will be held at the Hilton garden inn 801 r street, Lincoln, 402.475.9000

7:30 am . . . . . . . . . . . . . . . . . Registration8 am . . . . . . . . . . . . . . . . . . . . Course Begins12 noon - 1 pm . . . . . . . . . . . Lunch hour 1 pm . . . . . . . . . . . . . . . . . . . Course resumes5 pm . . . . . . . . . . . . . . . . . . . Course adjourns* Coffee breaks and lunch will be provided

Hands-on Course — Limited Space Available Held at unMC College of dentistry, Lincoln, neFriday, october 17, 2014 • 6:30 pm – 8:30 pm saturday, october 18, 2014 • 8 am – 5 pm

LeCTure — Limited Space AvailableHeld at unMC College of dentistry, Lincoln, nesunday, october 19, 2014 • 8 am – 1 pm

RegistrationFormPlease mail registration form and payment to: NAGD, 6331 Tanglewood Lane, Lincoln, NE 68516. Or you can fax your registration with credit card to 402.438.2321. Registration can be taken over the phone with a credit card.

Name

Staff

Address City State Zip

Phone Fax

Email (required)

AGD# Non-member Yes

PayMenT MeTHodCheck (made payable to the NAGD) Amount: Credit card: Credit card type:

Credit card # exp. Date code on back

Credit Card Address (If different from above)

Credit Card City, State & Zip (If different from above)

Phone (If different from above)

Signature Date

PLease noTe: A$25processingfeewillbeappliedtoallpersonsrequestingarefund.NorefundswillbeissuedafterSeptember30th.Youwillreceiveanemailconfirmationwhenyourregistrationisprocessed.Questions?ContacttheNAGDOfficeat402.438.2321orinfo@nebraskaagd.org

Don’tforgettotakeadvantageofHUGEmemberonlydiscountsifyouregisterbyJuly18th!Alatefeeof$45willbeaddedifyouregisterafterSeptember30th.

AblockofsleepingroomshavebeenreservedattheHiltonGardenInnfor$109untilSeptember17,2014.Askforthe“NebraskaAGD”rate.Tomakereservations,call1.402.475.9000.

IfyouattendtheentireweekendANDareanAGDmember,youwillreceive24hoursofParticipationCreditinOralSurgery.24additionalhoursofparticipationcreditmaybeearnedbypresentingaclinicalhomeworkassignmentafterthecourseandpresentinginJuneof2015.Thereisanadditionalfee.

Course FeesAGD Dentists: Friday Lecture Only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 350 (Register by 7-18-14 and receive a $75 member only discount: $275)

Non-AGD Dentists: Friday Lecture Only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 600AGD Dentists: Entire 3 day Event . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$1,850(Register by 7-18-14 and receive a $200 member only discount: $1,650) includes materials, meals and handouts. Lodging not included

Non-AGD Dentist: Entire 3 day Event . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$2,500includes materials, meals and handouts. Lodging not included

Staff Member/Assistants/Hygienists (Friday only lecture) . . . . . . . . . . . . . . . . . . . . .$ 75Dental Students (Friday only lecture) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 35Lab Techs (Friday only lecture) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 125

N8 NebraskaAcademyofGeneralDentistry|July2014

KevinC.Low,DDSKevinC.Low,DDS

SUMMER 2014

RegionalDirector Report

The AGD Annual Session in Detroit: Four Days in the Windy CityYeah, I know...when we speak of the Windy City, we

are usually referring to Chicago, not Detroit. However, the AGD House of Delegates convened in Detroit

last month, and it got rather breezy inside during the regional caucuses, the reference committees, and on the fl oor of the HOD.

There were two main governance issues debated this year. First, there was a proposal to offer AGD membership to dentists from

around the world. International members would be required to pay full dues, and would not be eligible for FAGD or MAGD awards for at least three years. In spite of considerable opposition to the proposal, the issue was voted up, and international membership will be offered around the world yet this year.

The other proposal heavily debated this year was no stranger to the HOD. There has been literally years of discussion regarding separation of the CE portion of the annual meeting from the governance portion.

However, this year, the HOD ultimately decided that there was very little downside to separation, and voted up on the issue. This policy will take effect in 3 years.

Professional associations and organizations that hold annual meetings have discovered over the

last several years that making a profi t on conventions can be a challenge. I was a fairly vocal opponent of the decision to hold a meeting in Detroit, for obvious reasons. Many of my colleagues felt I was being unreasonable. My response was always the same...if one of the goals of the AGD is to generate non-dues revenue, then it is imperative that we build a better meeting at a family-friendly venue. In my opinion, there is simply NO excuse for fi nancial losses in the hundreds of thousands of dollars regarding AGD annual sessions.

As always, if you have any concerns or questions regarding the AGD, please don’t hesitate to contact me.

Sincerely,Kevin Low, DDSRegion 10 Regional Director

Dr. Kristen Hermansen-Ryan before the convocation

Julie Berger-Moore, Executive Director and Dr. Luke Matranga, NAGD member and Past AGD President

Dr. Mark Malterud, Region 10 Trustee and Dr. Kevin Low, Region 10 Regional Director

NAGD members, Drs. Sue Christensen, Phil Strevey and Kristen Hermansen-Ryan. Drs. Christensen & Hermansen-Ryan received their Fellowships. Dr. Strevey received his Mastership

Region 10 Masters and Fellows


Contact us at Dental Designs in Omaha at 402-496-1400, or Lincoln at 402-476-1331. Or, visit us on our website at www.dentaldesignsinc.com

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• Lunch & Learns with CE credits

Nebraska AGD Mastertrack — Begin Your

Journey At Anytime!By Julie Berger-Moore, Executive Director

How many times have you caught yourself saying “I really want to start working towards my Mastership” but don’t know

where or when to start? Or “The NAGD had already started a new Mastertrack class, do I have to wait to join?” I receive questions like these regularly and I am happy to answer that last question with a resounding “NO! You can begin YOUR Mastership journey at any time!” This is just a reminder that the NAGD now offers an “Open Enrollment” for our Mastertrack, which means you can join our Mastertrack at any time!! For more information, see the flyer inserted into this month’s newsletter or contact the NAGD Office at 402.438.2321.

National Hemophilia Foundation Survey

D r. Jennifer Baumert, DDS, and the medical director of the National Hemophilia Foundation, Neil Frick, designed a

National Dental Care Provider Survey as part of a national dental health initiative for the NHF. The goals of the survey are: to establish a national database of dental providers that those with rare inherited blood disorders can access; to assist dentists in connecting with state and regional networks of fellow health care providers including hematologists, for professional and educational purposes; and to help the NHF provide up-to-date educational materials to interested dentists through established channels. You recently received an email blast with the link to the survey. We encourage you to help the cause by completing it. The Link is: https://www.surveymonkey.com/s/HRDVT29


“AGD Fellowship Review Course”December5&6,2014•8a.m.to5p.m.

The class is limited to 35 doctors! Register today!

“AGD Fellowship Exam”December7,2014•8a.m.tonoon

(The exam will only be administered if we have a minimum of 30 participants register. See details on back.)

Nebraska&Iowa Academy of General Dentistry

Course LocationPattersonDental

(Conference Room)

12008PortalRoad#102LaVista,Nebraska

For more information or to register, contact the NAGD Office at 402-438-2321 or [email protected].

Questions? If you have any additional questions about your award or recognition, please contact the educational awards administrator at 888.AGD.DENT (888.243.3368), ext. 4096

Course OutlineAttend the two-day Fellowship Review Course on Friday, December 5 & Saturday, December 6, 2014 from 8 a.m. to 5 p.m.

The Fellowship Review Course is a review of currently accepted knowledge, techniques, and practices in general dentistry.

Members may sit for this course as part of their preparation for the Fellowship Exam; however, taking this course does not guarantee that a member will pass the exam.

Information on the content of the Fellowship Exam is held in strictest confidence, and as such, information

regarding the overall content of the exam will not be released during the review course or to the course speakers.

Candidates may refresh their knowledge of basic clinical information in the 19 areas of general dentistry covered in the exam by attending the review course.

Candidates are expected to draw on their own practical experiences as they take the Fellowship Exam. The Exam will be offered on Sunday, December 7, 2014 only if we have 30 registered by October 17th. If we do not have the minimum required by national, participants are encouraged to register with a SMT Testing Center near their home following the course.

adg Fellowship review CourseTuition — for the 2 day course only (exam fee is additional)

AGD Member: $550

Non-AGD Member: $850

agd Fellowship examIt is our intent to offer the exam on Sunday, December 7th from 8 a.m. to 12 noon. In order for national to proctor the test, they require a minimum of 30 people to sit for the exam. We do have the option to cancel the exam (Sunday only) if we don’t have enough to sit for the exam. A decision will be made by October 17th on whether or not we will hold the exam. In order to determine whether we will have enough, you must also register for the exam. If we do not have the minimum required, we will notify you by October 17th and encourage you to register with the SMT Testing Center near you following the course. To find a testing site visit www.isoqualitytesting.com. if the exam portion is cancelled, you can request a refund from national or have that fee applied to a take the test at a testing center near you.

Exam fee: $600

To register for the exam see additional registration form from national.

Handouts for the AGD Fellowship Review courses are provided in electronic format only; paper copies will not be available at the course. Attendees will be sent a link to access the course materials. It is recommended that attendees either print the handouts or download them to a laptop before attending the course. We will provide power strips and internet at the course so laptops can be electronically utilized.

The AGD-Nebraska is designated as an Approved PACE Program Provider by the Academy of General Dentistry. The formal continuing education programs of this program provider are accepted

by AGD for Fellowship, Mastership and membership maintenance credit. Approval does not imply acceptance by a state or provincial board of dentistry. The current term of approval extends from 1/1/2014 to 12/31/2017. Provider ID# 219313

PACEFAGD/MAGD Approved1/1/2014 to 12/31/2017

Plan to be a part of the class of 2015!AGD 2015 Annual Meeting & Exhibits

June 18 to June 21, 2015, San Francisco


2014 AGD Meeting in DetroitCongratulations to NAGD members Drs. Susan Christensen

and Kristen Hermansen-Ryan on receiving their Fellowship and to Dr. Phil Strevey on receiving his Mastership at the 2014 AGD Meeting in Detroit. The Nebraska AGD won numerous awards again this year. They are: the Membership Award, the ACE (Newsletter) Award, the Continuing Education Award of Excellence, the Public Information Award and the Constituent of the Year Award. Congratulations to all!

Region 10 Delegation

Dr. Linda Edgar, AGD President addresses the House of Delegates

Reference Committee

Region 10 Caucus

Dr. Kristen Hermansen-Ryan and her husband Nick

Dr. Sue Christensen before the convocation

Dr. Phil Strevey before the convocation

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Student Award WinnersBy Julie Berger-Moore

Julie Berger-Moore presents certificate to Student Award Winner, Dustin Cameron.

T he NAGD is pleased to announce that Sara Kluver of UNMC and

Dustin Cameron of Creighton were this year’s winners of the 2014 AGD Student Award for Nebraska.

Sara Kluver grew up in Fairfield, Nebraska, which is a small town south of Hastings. She is married to Jeff Klug who is going to start his residency at UNMC in July. They have a 13 month old son Matthew. She received her undergrad degree in Biology from Hastings College.

She always liked science and gravitated towards dentistry due to the influence of her uncle who is an Endodontist in California. She also spent time with a dentist in Hastings and she was hooked.

Sara said several times during our talk that her classmates were wonderful! Her favorite part of dental school was being able to discuss cases with her

classmates; what worked, what didn’t. Being able to share their successes and problems, knowing that they could count on each other. She will miss the camaraderie of her fellow classmates on a daily basis.

She is excited to begin her dental career in Omaha!! She will be practicing with Dr. Jill Hild beginning in July. She chose general dentistry so that she would be able to offer her patients a variety of dental treatments. And being able to treat the entire family; providing care to the youngest child to parents to grandparents. Growing, learning and earning the trust of the entire family is important to Sara and being able to come to one office for their treatment is what matters to her.

She enjoys working with children as well as doing restorative and crown/bridge procedures. She loves being able to make a HUGE difference in the lives of her patients. She said there is nothing like seeing a patient smile!!!

Dustin Cameron grew up in Pleasantview, Utah. He is the youngest of 5 and has 3 brothers and 1 sister. He is married to Monica and they have 2 children: Hannah is 4 and Logan is 18 months. They also are expecting their 3rd child in November. Congratulations! Dustin received his undergraduate degree in Zoology from Weaver State University in Ogden.

Growing up Dustin wanted to be a doctor, leaning towards pediatrics because he loved kids. But growing up in a small town, he realized that he also wanted to be able to spend more time with his family. He shadowed a dentist who was a family friend and was also a Creighton grad and had the influence of another dentist. After that, he knew that dentistry was the path he wanted to take!

Dustin said that his favorite part of dental school was the patient interaction, earning the patient’s trust, getting to know them and having that professional relationship. He chose general dentistry so he could maintain and develop that relationship with the entire family. Being able to create a treatment plan that would contribute to their physical and overall health is another reason he chose general dentistry.

He enjoys doing crown & bridge and esthetic procedures. Being able to change someone’s smile is something he really looks forward to doing more of.

Dustin has returned to practice in North Ogden and expressed to me several times about his strong belief in God, and being excited about beginning his dental career. His hope is to get involved in the community in which he lives, wanting to raise his family there, to serve, love and grow!

The Nebraska AGD sends their best wishes to Sara and Dustin as you both begin your dental careers! Congratulations to you both on being the NAGD’s Student Award Winners for 2014!

Sara Kluver


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T he University of Nebraska Medical Center College of Dentistry would like to invite you to attend the 2014 tri-annual Transition Seminar & annual Dental Opportunities

Fair on Friday, October 24, 2014. The program will be held at the College of Dentistry in Dixon Lecture Hall. Dr. C. Steven Wolff, DDS., who comes highly recommended by college faculty in the practice management section, will be the featured speaker. This day-long program will focus on — fair market value, analysis of hard assets, patient statistics, financial records, including intangibles — all of which will make “your practice” attractive to active buyers.

The Opportunities Fair will be held in conjunction with the seminar. Attendees will be provided with a table and two chairs. Some tables can be provided with electricity (no internet connections). You can plan to attend one or both programs. These programs will give you an opportunity to meet students and discuss dental practice opportunities open to them after graduation. Registration is required: Seminar $100 per person; Fair $50, e.g., dentist attends seminar plus two staff at Opp Fair table, cost $150; or dentist, spouse and business manager for seminar and two staff at the Opp Fair table, cost $350. When: Friday, October 24, 2014Where: University of Nebraska Medical Center

College of Dentistry 40th & Holdrege Streets Lincoln NE 68583-0740 Lower Level Area & Dixon Lecture Hall

Seminar begins at 9 a.m. – 4:30 p.m., registration 8:30 a.m.Opportunity Fair 10 a.m. – 2 p.m.; set up begins at 9:00 a.m. Lunch will be provided. Parking will be available in the east lot of the college.

The registration deadline is Friday, October 10, 2014. Late registration fee of $125 for seminar and $60 for fair. Clip and Mail Registration:

___ Seminar $100 per person ___ Opportunity Fair $50 (for two) ($10 for each additional person)

___ Electricity ___ # in your party (provide names of attendees)

Name _________________________ Street _______________________

City ____________________________ State ______ Zip ____________

Email ______________________________________________________ (registration confirmed via email).

Please indicate if you have special dietary needs (__________________________________________________________).

Mail with check payable to the UNMC College of Dentistry to:Veronica McManamonc/o UNMC College of Dentistry40th & Holdrege StreetsLincoln NE 68583-0740 [email protected]; 402-472-3285

Sponsored by the University of Nebraska Medical Center College of Dentistry in cooperation with Health and Human Services Office of Rural Health, the Nebraska Dental Association & the Nebraska Academy of General Dentistry.


Proposed Sedation Changes in Nebraska

N

O n April 18th, 2013, the Nebraska Board of Dentistry

(BOD) submitted an application to the Nebraska Department of Health and Human Services Credentialing Review (407) Program. At the heart of the initial proposal are changes with regards to how sedation is practiced and regulated in the State of Nebraska. The intent is to make changes that are necessary to bring NE into line with the current ADA and other national standards.

So what exactly does this mean for the general dentist practicing in the State of Nebraska?

In Nebraska, the defi nition of sedation is separated into three groups: general, parenteral, and inhalation. In the ADA guidelines, sedation is delineated to levels of sedation rather than method of sedation. In the ADA defi nition, we see the terminology minimal sedation, moderate sedation, and deep sedation/general anesthesia.

In the State of Nebraska, sedating dentists has been required to have one of two permits. The General Anesthesia permit allows a dentist to administer parenteral (IV or other) and inhalation analgesia and the Inhalation permit allows a dentist to administer nitrous oxide (N2O).

With the rise of “conscious sedation dentistry”, a gap has been identifi ed in the Nebraska sedation defi nition. Under the new proposal, a dentist will need appropriate permits in place prior to engaging in any form of sedation other than inhalation analgesia . The new permits would be Minimal Sedation, Moderate Enteral or Parenteral Sedation, and General Anesthesia/Deep Sedation. The administration of N2O would become a basic tenet of your dental license and would not require additional permitting.

Minimal sedation is most equivalent to an “anxiolysis” protocol. Under proposed changes, a patient could receive no more than 1.0 times the maximum recommended dose (MRD) of an appropriate sedative that can be prescribed for home use. A single, additional dose may be given, provided that administration follows the expiration of the clinical half-life of the initial dose and that no more than 1.5x the MRD is given on

the date of treatment. N2O may be paired for adults, but is classifi ed as a “moderate sedation” in children. Each minimal sedation permit holder must have BLS (or pediatric advanced life support (PALS) for children under 12) and must take at least six hours of CE every two years. Monitoring protocols are basic, with oxygenation and chest excursions being continually monitored, and BP/HR taken pre, intra, and post operatively or as tolerated by the patient.

The Dental Organization for Conscious Sedaton (DOCS) provided testimony with regards to minimal sedation. Legal counsel, John Bitting, testifi ed that the defi nition of “minimal sedation” should not be based on the MRD (which he defi nes as Manufacturer’s Recommended Dose vs. Maximum Recommended Dose), but rather as patient responsiveness on a sedation scale. He stated that DOCS goal is to achieve and maintain minimal sedation even if it means exceeding the MRD. If a higher level of sedation is achieved, then the practitioner should stop all procedures to monitor the patient until minimal sedation is regained. Mr. Bitting suggested following the style of regulations seen in the State of Colorado. In Colorado, minimal sedation dentists must take 16 hours of

appropriate courses (DOCS education is 25 hrs). The obvious intent is that this would allow for incremental dosing under the minimal sedation regulation. The amended proposal does not appear to have accepted this recommendation, rather the writing appears to mimic regulations seen in South Dakota rather than Colorado.

The intent of the “Moderate Sedation” permit is to defi ne a separate, deeper level of sedation; however the written defi nition is very similar to that of minimal sedation and one could argue that they are almost indistinguishable. The moderate level of sedation is where the BOD plans to place an incremental oral sedation protocol.

In moderate sedation (enteral or parenteral), standards for care are elevated. The dentist needs to have ACLS or equivalent training, records must be more descriptive, and equipment/operatory requirements are more stringent. Most importantly, the dentist will need to have “completed an advanced education program accredited by the ADA Commission on Dental Accreditation that affords comprehensive and appropriate training necessary to administer and manage moderate sedation.” or “be a

Continued on page 15

BrianB.Penly,DDSCo-Editor


fellow of the American Dental Society of Anesthesiology.” To acquire the appropriate training, a dentist will need to commit to an IV sedation course that is 60+ hours in length (most reach 100+ hours of class/hands-on time). Such courses do not focus on oral sedation protocols and having acquired IV training, it is diffi cult to envision that incremental oral sedation will be a method of choice for sedating dentists.

I have not reviewed the Deep/General Anesthesia changes in this article. It should be noted that the new proposal encourages many changes from the previous regulations.

My goal is to direct AGD members to review the existing proposal and make comments to the Credentialing Review during the review period. If your practice utilizes sedation in any manner, you certainly need to understand the changes in education and facility requirements. Any previously “grandfathered-in” sedation dentists will need to understand where they stand as well.

At the end of the day, the goal of everyone is patient safety. As healthcare providers, we owe it to our patients to understand the proposed regulations, provide solid input to the Credentialing Review, and work toward a well-defi ned sedation regulation.

Please note that all documents used in writing this Op-Ed are available at:

http://dhhs.ne.gov/pages/CredReviewDentalAnesthesia.aspx

Continued from page 14

NThank you to those companies who donated

items for prize drawings or goody bags!

Special thanks to Danter Dental Lab for donating the bags

Kiess Kraft Dental Lab

Proctor & Gamble

Benco Dental Supply

Lincoln Visitors Bureau

Special Thanks todenTsPLy

Patterson dental

Prodenco

almena state Bank

for their generous fi nancial assistance and donations of the supplies for the hands on portion this weekend.

Please make sure to thank them!!!

Danter Dental LabPatterson Dental

DENTSPLYProdenco

Almena State BankKiess Kraft Dental Lab

3M ESPEHarold Diers & Company

UltradentBenco Dental Supply

GC AmericaBiomet 3i

Thank You Exhibitors!

dentsplyPatterson dental

Prodencoalmena state Bankdanter dental Lab

Henry schein

NThankyou

CorporateSponsors!

Nebraska AGD6331 Tanglewood Lane

Lincoln, NE 68516

Documents

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