The Journal of the Philadelphia County Dental Society, Volume 80 Issue 4

The Journalof the Philadelphia County Dental Society

October/November/December 2014

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THE JOURNAL of the Philadelphia County Dental Society ________________________________________________________________________________ First District of the Pennsylvania Dental Association October/November/December 2014 Vol. 80 No. 4 ______________________________________________________________________________________________

CONTENTS SBOD Mandated CE Program on Child Abuse Recognition ............ 2Nominations ........................................................................................ 2President’s Message ........................................................................... 3Pennsylvania’s Dental Law: Are You in Compliance ....................... 5Cyber-Attacks: A Clear and Present Danger ......................................... 6Necrology ............................................................................................ 6Newsbriefs .......................................................................................... 7Report of the Bylaws Committee ..................................................... 13Health Watch .....................................................................................14Dental Dates ..................................................................................... 17Workplace Tips .................................................................................. 21Classified Ads ................................................................................... 232015 Liberty Continuing Education Dates ..........................................25

The JOURNAL is published by the Philadelphia County Dental Society, One Independence Place, 241 South 6th Street, Unit #C3101, Philadelphia, PA 19106-3797.

The opinions expressed herein are those of the author under whose name they appear and are not to be regarded as representing the views of the Philadelphia County Dental Society unless so indicated.

All advertising materials and correspondence, including classified advertisements and replies should be sent to: JOURNAL of the Philadelphia County Dental Society, One Independence Place, 241 South 6th Street, Unit #C3101, Philadelphia, PA 19106-3797.

The Philadelphia County Dental Society does not approve or disapprove any products or services ad-vertised in the JOURNAL.

Articles for publication may be sent directly to the Editor electronically via e-mail to [email protected] Articles and classified advertisements should be submitted as Word documents; all other advertising should be submitted in .pdf format (Adobe 6.0 or higher). Contact the Society via telephone or e-mail if you require additional information. Deadline for copy is the first of the month PRECEDING the month of issue.

Subscription is included in the annual dues. The JOURNAL is published electronically 4 times a year, January through December. Single printed copies: $4.00. Standard postage paid at Philadelphia, Pennsylvania. Copyright 2014. The Philadelphia County Dental Society.

Saul N. Miller, D.D.S., '14 Editor Stanley B. Toplan, D.D.S. Associate Editor Teresa F. RavertExecutive Director

OFFICERS Kevin J. Klatte, D.M.D.President Andrew J. Mramor, D.D.S.President-Elect Judith A McFadden, D.M.D. Secretary A J. Chialastri, D.D.S. Secretary Emeritus Rochelle B. Lindemeyer, D.M.D. Treasurer Stanley B. Toplan, D.D.S. Historian

GOVERNORS Peter J. Carroll, D.D.S., '14 Susan M. Chialastri, D.M.D., '15Renee Fennell Dempsey, D.M.D., '14T.J. Filip, D.M.D., '16Jay M. Goldberg, D.D.S., '14Chinchai Hsaio, D.M.D., '15Michael A. Koumaras, D.M.D., '16Stanley W. Markiewicz, D.M.D., '14Thomas P. Nordone, D.M.D, '16Mary M. “Toni” Rust., D.D.S., '15

• • •Anand V. Rao, D.M.D., '17PDA Trustee

• • •EXECUTIVE OFFICES: One Independence Place 241 South 6th Street, Unit #C3101 Philadelphia, PA 19106-3797215-925-6050 FAX: 215-925-6998 E-mail: [email protected]: www.philcodent.org

Member Publication

THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY2

IMPORTANT INFORMATION:

Child Abuse Recognition and Reporting Requirements for Mandated Reporters* Continuing Education Program

*(Mandated Reporters include: dentists, dental hygienists & EFDAs) In response to the requirements of Act 31 (which were announced by the Pennsylvania State Board of Dentistry on September 17, 2014), PDA will offer a CE course in multiple locations across the state for both members and non-members and their professional dental staff. PDA’s program, Child Abuse Recognition and Reporting for Dental Professionals, is custom designed for members of the dental profession. The CE presentation provides training on: your legal responsibilities as a mandated reporter under the Child Protective Services Law; recognizing child abuse indicators, including clinical and oral pathologies of abuse; the reporting process: when, where and how to report suspected abuse; legal protections for reporters and penalties for failure to report. PDA’s program will fulfill the 2 hour training requirement for relicensure in March 2015. The program will be offered in 12 different locations in Pennsylvania. Dates, locations and registration information will be made available on or about October 13, 2014 on the PDA website at www.padental.org Act 31 applies to all health-related licensees, regardless of whether they are subject to the continuing education requirements of the applicable state board.

Nominations As mandated by the Bylaws, the Board of Governors met as a Nominating Committee and presents the following report of nominations for 2015:

President-Elect: Renee Fennell-Dempsey, D.M.D.

Secretary: Judith A. McFadden, D.M.D.

Treasurer: Rochelle G. Lindemeyer, D.M.D.

Historian: Stanley B. Toplan, D.D.S.

Editor: Saul N. Miller, D.D.S.

Board of Governors: Peter J. Carroll, D.D.S. Jay M. Goldberg, D.D.S. Jonathan Siegel, D.M.D.

Elections will take place during the Annual Business Meeting at 7:00 p.m., on Tuesday, November 18, 2014, at the Society’s Executive Offices (all Society members are welcome to attend). The Bylaws provide: 12.1.4 Additional nominations may be made by written petition signed by at least twenty (20) Active, Life or Retired Members in good standing. Such petitions must be submitted to the Secretary at least fifteen (15) days prior to the date of the Annual Business Meeting. The Secretary shall make a prompt determination as to the eligibility of nominees and willingness to serve if elected. 12.1.5 No additional nominations shall be made from the floor at the Annual Business Meeting.

THE JOURNAL OF THE PHILADELPHIA COUNTY DENTAL SOCIETY 3

President’s MessageKevin J. Klatte, D.M.D.

It’s hard to believe that two years have flown by, and I am now writing to you for the last time as President of the Phila-delphia County Dental Society. As they say, life goes on; we con-tinue moving forward while adapting to all that life offers us – personally and professionally.

I am pleased to tell you that your Philadelphia County Dental Society has again risen to the challenge in working on members’ behalf in 2014. We monitored Philadelphia City Council activities that affected us as business persons: an issue that dealt with new zoning regulations in some parts of the city morphed into a bill that addressed Nuisance Health Establishments; and the Mayor ap-pointed a task force to investigate mandatory paid sick leave. These issues were tracked by your Board of Governors. The Society was an active player on each issue; and, through our Legislative Alerts, many of you jumped on board to let your voices be heard, too, and we thank you for that. At the end of June 2014, Mayor Nutter named some new administration officials. Among those are James Buehler, M.D., Drexel University School of Public Health Professor in the Department of Health Management and Policy, as the new Health Com-missioner. Dr. Buehler has more than thirty years of public health experience having served as a Com-missioned Officer in the U.S. Public Health Service, senior scientist at the U.S. Centers for Disease Control and Prevention (CDC) and public health pro-fessor at Drexel University and Emory University’s Rollins School of Public Health. Ms. Susan Kretsge, a graduate of Temple University with nearly forty years of experience working in City government, is the new Deputy Mayor for Health and Opportunity. Pre-viously, she worked in the Fire Department, Health Department, Office of Human Resources and the Managing Director’s Office. Since 2008, she has served as the Chief of Staff for the Office of Health and Opportunity and worked closely with the City’s health and social services departments, managing programs and legislative, budgetary and analytical projects. In welcoming Ms. Kretsge and Dr. Buehler to their new posts, I offered to meet with them to discuss items relevant to the dental health of the citizens of Philadelphia, and that meeting was scheduled for mid-September – too late to provide a report for this issue of The Journal.

Again this year, as a membership service, we provided meaningful continuing education programs

to help members meet their legal and ethical responsibilities.

We scheduled two Workshops for New Dentists, one was held in March and the second will be on October 18, 2014 to help our new colleagues understand ways in which they can repay college loans, live a comfortable lifestyle and begin saving for their future, i.e., educating their children and preparing for retirement. Both of these Workshops were made possible by a generous grant from the American Dental Association. The feedback from the March session, as well as the one held in September 2013, told us that our young colleagues are eager to hear about commonsense approaches to handling their finances, and they overwhelmingly agreed that the Workshop provided them with ideas and methods that could make that aspect of their lives less stress-ful.

The 2014 MOM-n-PA, which was held in Allentown on September 12 and 13, was a great follow-up to last year’s initial event that was held here in Philadelphia. The generosity and kindness of the members of this profession may not always reach media headlines, but they do reach the hearts of all of those who participated – as a volunteer, a donor or as a patient.

By now, you probably know that the PDA has begun a new governance operation due to Bylaws changes that were adopted in April 2014. We are all hopeful that the new model will fulfill the hopes that many of us shared for a stronger and more adaptable association that will represent its members on a timelier basis. The loss of the House of Delegates puts a larger burden on the Board of Trustees. I have great confidence that our First District Trustee, Dr. Anand V. Rao, is up to this challenge, and I am certain he will continue to share PDA’s activities and decisions with us in Philadelphia to keep us apprised on an “up-to-the-minute” basis.

At the beginning of September, your PCDS leaders participated in the PDA’s annual Welcome Reception for dental students. This was a lively and thoroughly enjoyable evening at Ladder 15. We networked with many soon-to-be new dentists, and, I hope, forged friendships with them that will translate into their future active participation in our dental associations. Speaking of dental students, our Mentoring Committee continues to receive numerous requests from current dental and pre-dental students to shadow dentists in Philadelphia. The pre-dental stu-dents are hoping to enter dental school in 2015 or (continued on page 4)


President’s Message (cont’d.)2016. All of the students who contacted us have ex-pressed a strong sense of commitment to the pro-fession and are eager to observe the daily routine of a dental office. Please consider volunteering some of your time to welcome one of these young people into your practice for a day and, perhaps, begin a collegial relationship that may last into the future. Contact me at [email protected] or call Ms. Ravert at 215-925-6050, and we will add your name to our mentor list. This is a tremendous opportunity for each of us to share a one-on-one educational experience — for both the students and the dentists. PDA will host a reception for New Dentists (dentists who have completed their graduate and/or postgraduate programs within the last ten years) on October 2. Several PCDS officers and board members are planning to network with our new colleagues at that event, to encourage them as they encounter the everyday ups and downs of dental practice and to suggest that they become involved in our dental associations and aspire to roles of leadership in PCDS, PDA and ADA. Membership in PCDS, PDA and ADA remains our biggest mission. Here is an excerpt, I think worth repeating, from my first President’s Message in January/February/March 2013: “We need our established members to recruit new, young dentists to become members of the tripartite system. Today’s economics — especially with young dentists having to repay large student loans, finance new practices and staff, and establish a comfortable personal life — are seen as first priorities, as they rightly should be. But, we need to impress on the new dentists the impor-tance of a united profession that will be there for them (and their successors) in the next ten, twenty and thirty years. . . I ask each member of the Society to reach out to young dentists — perhaps your neighbor, your associate, or your own child — and encourage them to become active in our tripartite membership associations. One by one, each new member CAN and WILL make a difference. ” Likewise, we are constantly seeking members to become involved in leadership roles. If you are interested in taking a more active role, I encourage you to contact me at [email protected] As you read this issue, our ADA delegates will be preparing to attend the ADA House of Delegates (HOD) in San Antonio (Thursday, October 9, to Tuesday, October 14). All of the reports and resolu-tions to be considered by the HOD are available online to ADA members at www.ada.org (in the search box type: 2014 HOD resolutions) — member login is required. Feel free to share your comments about any item of House business with the PCDS members who will be serving as part of the PDA delegation: Doctors

Anand Rao ([email protected]) and Thomas W. Gamba ([email protected]) In addition, if you are planning to attend the ADA Session in San Antonio, remember that a Mission of Mercy (MOM) event to provide free dental care to underserved citizens of San Antonio will be sponsored on Sunday, October 12. To register as a volunteer for this event, visit ada.org/goto/session/ Based on the excellence of the MOM-n-PA events over the last two years, I know you will find this to be a worthwhile and rewarding experience. Someone once said that volunteers do a little and get a lot. From my own experiences as a member of the Board, as Treasurer, as your President and as a member and chair of the PDA Membership Com-mittee, I can guarantee you that this is true. The time spent working with and on behalf of our members has been enriching to me in so many ways — not only in learning much more about the state of the profession today and its impact on the community at large — but for the friendships made and the appreciation shown for “being there” for our member dentists. I appreciate the support of all of our members. I thank all of the governors, past presidents, council and committee chairs for their counsel and encouragement; and I appreciate the fine support of our staff, Teresa Ravert and Betsy Sonnenberg. I look forward to continuing to work with all of you on behalf of the Philadelphia County Dental Society. As we wind down the year and prepare for a new president, I want to express my admiration for and best wishes to our incoming president, Dr. Anrew J. Mramor. Andrew is intelligent, thoughtful and deeply committed to our professional associations, and I pledge him my support and goodwill. Now, it is time for change. In this issue you will see a list of the nominees for offices for 2015. I ask your support of these members as they embark upon their terms of service on behalf of our members and our profession.


Pennsylvania’s Dental Law: Are You in Compliance? You are aware that part of the mission of the PA State Board of Dentistry (SBOD) is to insure that individuals are qualified to practice dentistry. Some of the Board’s duties include determining license or certificate suspension and/or revocation if an indi-vidual is found not to be compliant with State re-quirements and/or standards of professional conduct. Here are reminders of some of your obligations:

Dental offices are responsible for weekly biological monitoring of sterilizing equipment. The following is excerpted from the Rules and Regula-tions of the Pennsylvania State Board of Dentistry: §33.211. Unprofessional conduct.

“(a) Dentists. Unprofessional conduct, as defined in section 4.1(a) (8) of the act (63 P. S. § 123.1(a) (8)), includes the following conduct by a dentist:

(7) Failing to follow current infection control recommendations issued by the Federal Centers for Disease Control or to ensure that auxiliary personnel and other supervisees follow these Federal guide-lines.” Learn about the CDC’s recommendation for ster-ilization online at http://www.cdc.gov/oralhealth/infectioncontrol/faq/sterilization_monitoring.htm#a2 Following is an excerpt from that site: “How often should I perform biological monitoring (BI) (spore testing)? Correct functioning of sterili-zation cycles should be verified for each sterilizer by the periodic (at least weekly) use of BIs. Users should follow the manufacturer's directions concerning the appropriate placement of the BI in the sterilizer. A control BI (not processed through the sterilizer) from the same lot as the test indicator should be incubated with the test BI. The control BI should yield positive results for bacterial growth. In addition to conducting routine biological monitoring, equipment users should perform biological monitoring.

Whenever a new type of packaging material or tray is used. After training new sterilization personnel. After a sterilizer has been repaired. After any change in the sterilizer loading procedures.”

Licensed dentists in Pennsylvania are obli-gated to verify that all employees/associates who are required by law to hold active licenses in the Commonwealth (dentists, dental hygienists, and EFDAs) possess current, active licenses, and display those licenses openly in the office. Licensure can be verified electronically at www.licensepa.state.pa.us

Licensed dentists must complete 30 hours of continuing education prior to each licensure renewal (§ 33.401. Credit-hour requirements) through atten-dance at programs presented by SBOD approved

sponsors. At least 50 percent of CE must be taken in lecture or clinical presentations. Dental hygienists must complete 20 CE hours, and EFDAs, 10 hours. In addition, all license holders must be current in CPR. Remember, too, that while not a CE requirement of the SBOD, licensed dentists and their staff members who are involved with X-ray procedures must include radiology safety, biological effects of radiation, quality assurance and quality control as part of their CE curriculum. The Pennsylvania Department of Environmental Protection recom-mends that individuals obtain two contact hours, or four hours of continuing education every four years. “Contact hours” are defined by DEP as those obtained in a traditional classroom setting. Each office must maintain a record of their Radiation Safety CE. When DEP inspectors come to the office to inspect your X-ray machines, they may ask to see these records. Any person who chooses not to be compliant with the radiology continuing education requirements may be subject to civil and criminal penalties.

In addition to your dental license, you must possess a current permit prior to administering con-scious sedation and nitrous oxide/oxygen analgesia. The following is excerpted from the Rules and Regulations of the Pennsylvania State Board of Dentistry: “§ 33.332. Requirement of permit to administer general anesthesia, deep sedation, conscious sedation or nitrous oxide/oxygen analgesia.

(a) Permit required for administration of anesthetic modality in dental office. A dentist shall possess a current permit issued by the Board under this subchapter before administering, or supervising the administration of, general anesthesia, deep sedation, conscious sedation or nitrous oxide/oxygen analgesia in a dental office.”

The SBOD has issued verdicts from temporary to indefinite license suspensions, remedial continuing education, financial penalties and/or fines and entered into Consent Agreements with some who were judged to have been in violation of the Regulations. Be aware that you can face charges from a variety of sources – i.e., a formal complaint filed by a disgruntled patient, a DUI arrest or conviction, failure to provide requested proof of CE attendance and actions taken against you by dental boards in other states, to name just a few. It is important to remain vigilant in both your professional and private life in order to maintain your PA license as well as your good name.


Cyber-Attacks: A Clear and Present Danger Kurt E. Taylor I read an interesting article in The New York Times recently regarding “cyber-warfare” and “cyber-weaponry”.1 The article explains the different levels of authority within our governmental agencies and military and how cyber-weaponry is being used to protect our country. I know that “cyber-anything” seems to be the craze, yet I was shocked at the comparisons they were making to the potential devastation from cyber-weapons and nuclear weapons and the potential harm they pose when in the wrong hands. In fact, the United States government plans to increase our cyber-defense budget, in spite of current financial hardships, to protect our nation from these detrimental attacks. I couldn’t help but relate this back to my back-ground in insurance. Every insurance company calls it something different: Corporate Identity Protection, Netprotect, or Privacy Liability; it’s all intended to cover the same thing: cyber-attacks and/or data breeches. Cyber Liability Insurance is a growing seg-ment of the insurance industry and rightfully so. You can’t check many news outlets these days without the cyber world headlining. It seems like every day they are reporting on a new hacking of sensitive information, which is quickly becoming the crime of choice for the new age criminal. It happens to schools, retailers, and, yes, even dentists. Cyber-criminals target information, and while they are prepared and able to go to extreme lengths to obtain this information, they prefer to attack where they feel they can easily obtain what they want. Why go through the trouble of breaking through a complex firewall at a prestigious financial institute when you can get your hands on the same information from the dental office down the street and at a fraction of the effort? For this reason, dentists and other medical professionals have become among the most targeted businesses from which to steal confidential informa-tion that patients trust will remain under lock and key. Therefore, without Cyber Liability insurance, the risk of financial loss due to a cyber-attack is rapidly growing. It is worth noting that the medical community ranks second only to colleges and universities when it comes to being the target of a cyber-attack. The days

of thinking this type crime will never happen to you are over, so let’s talk about how to protect yourself from the devastating cost of such a breach or hack. While exploring your options, I think you will find that insurance is the obvious answer. Whether you add this coverage to an already existing policy or purchase the coverage as a standalone policy, most are surprised at how inexpensive the coverage is to add. And in my world, it’s nice when a little money can actually buy some piece of mind. Cyber-attacks are clearly a threat to our physical and financial safety. As stated in The New York Times article, “Broad Powers Seen for Obama in Cyberstrikes,” “. . . officials quickly determined that the cyber weapons were so powerful that — like nuclear weapons — they should be unleashed only on the direct orders of the commander in chief.” 1 It goes to show how the things that bring risk to us are constantly changing and, in order to protect yourself, you need to stay educated and open to the changing world in which we live. The exposures you planned for and protected against need to be revisited from time to time to be sure that you have the coverage for the claims or incidents most likely to affect attorneys and law firms. You built it — now you need to protect it. PCDS members should know that, as a courtesy, Willis of Delaware has been adding coverage to all Dentist’s Advantage policies with a limit of $10,000 (which can be increased up to $100,000 at your request). Others who may be interested may contact me, and I’d be happy to talk with you about how you might add this type of protection to your current insurance. __________Kurt Taylor is a property and casualty Account Executive at Willis of Delaware, the endorsed vendor for the Philadelphia County Dental Society, special-izing in professional and commercial coverages for dentists. He may be reached at 302-397-0332 or [email protected] Sanger, David E. and Shanker, Thom. “Broad Powers Seen for Obama in Cyberstrikes.” The New York Times, February 3, 2013, accessed February 19, 2014. http://www.nytimes.com/2013/02/04/us/broad-powers-seen-for-obama-in-cyberstrikes.html

NECROLOGYWe are saddened to report the loss of the following members:

Dr. Folgorite Giorgio – February 2014Dr. Abraham W. Mamlin – July 2014 Dr. Charlene Hirsch – August 2014


NewsbriefsMembers in the News

PCDS past president, Dr. Jay M. Goldberg, is being honored as a member of the Temple University 2014 Gallery of Success Award. This marks the seventeenth year that the General Alumni Association of Temple University is honoring dis-tinguished alumni from each of the University schools and colleges. As a member of the Gallery of Success, each honoree’s photo and a one-page biography will be on display at the University for one year. A recognition luncheon is scheduled for October 2014.

Congratulations to the following Active Members who have been elected to ADA LIFE

MEMBERSHIP for 2015, having fulfilled the require-ment of at least 30 years of continuous membership at the local, state and national levels: Doctors Augustine C. Au; Norman C. Clark, Sr.; Arnold L. Freedman; Jesse Friedlander; Oscar L. Goren; Earl P. Pearson; and Frank M. Torrisi. Thank you for your many years of support and par-ticipation in your local, state and national dental associations.

If You Treat Medicare Patients . . . As reported in an article in ADA News, June 16, 2014 by Kelley Soderlund, any dentist who treats Medicare beneficiaries must either enroll in the program or opt out in order to prescribe medication to their qualifying patients with Part D drug plans, according to the federal government. Either way, dentists who fit this requirement must take action — either to opt in or opt out — by June 1, 2015. The Centers for Medicare and Medicaid Services (CMS) published a final rule in May 2014 that requires all physicians and eligible professionals — including dentists — who prescribe Part D covered drugs to be enrolled in Medicare or opt out for those prescriptions to be covered under Part D. By signing an affidavit opting out of the program, and entering into private contracts with patients as appropriate, dentists are out of Medicare for two years and cannot receive any direct or indirect Medicare payment for services provided to Medicare patients. ADA does not agree with this change. In March 2014 ADA President Charles Norman and Executive Director Kathleen O’Loughlin sent a letter to CMS asking that dentists be excluded from the require-ment because it “places an unnecessary burden on dentists and their Medicare eligible patients,” and it will not address the underlying rationale for a portion of the law, which is to stop fraud and abuse in the Medicare program.

In 2010, only an estimated 3-4 percent of the 186,000 practicing dentists were enrolled as Medicare providers. Despite the ADA’s expressed concerns, CMS moved forward with the enrollment or opt-out requirement. “Dentists who do not take action won’t see an impact until next year but it will be when their local pharmacy or patient starts to complain that they are not being reimbursed for the prescriptions the den-tist writes,” said Dr. Andrew Vorrasi, chair of the Council on Dental Benefit Programs. “We’re not sure how the pharmacies will handle this. Will they refuse to accept the prescription? Will they accept the prescription but force the patient to pay and tell them it’s because Medicare won’t reimburse the pharmacy or patient because their dentist didn’t comply with the law? How will the patients react if they file their own claim for reimbursement that is denied? While the ADA opposed this action, it is one of those situations where the decision was beyond our control. Complying with this law will save practitioners much time and aggravation come June 15, 2015.” To read the ADA’s Frequently Asked Questions on Medicare Enrollment, visit ADA.org and click on the Member Center, then Member Benefits, then Legal Resources, Publications & Articles, Reimbursement, Medicare Enrollment Decision Tool: Introduction Medicare Enrollment, then Medicare Enrollment FAQ. The Reimbursement section can also take you to a Medicare enrollment decision tree and informa-tion on how to opt out of the Medicare program. ADA also offered a Q & A primer on opting in or out. To read the ADA News articles, visit http://www.ada.org/en/publications/ada-news/2014-archive/june/dentists-must-choose-to-opt-in-or-out-of-medicare-enrollment and https://www.ada.org/en/publications/ada-news/2014-archive/august-2014/ada-offers-qa-primer-on-opting-in-or-out-of-medicare?nav=news

PDA Webinar – October 23 PDA will offer a complimentary one hour webinar on Practice Management from Noon to 1:00 p.m. on October 23. The session will offer tips on how to manage staff, debt collection and other financial aspects of day-to-day operations in a dental practice and will be presented by Thomas J. Weber, Esq. and PDA Chief Executive Officer, Camille Kostelac-Cherry, Esq. Visit padental.org to register or contact Ms. Michelle Rozman at [email protected] (continued on page 8)


Newsbriefs (cont’d.)More HIPAA Violations Two health care entities paid settlements to the federal government after possibly violating the Health Insurance Portability and Accountability Act (HIPAA) when unencrypted laptops were stolen, according to an article by ADA News staffer Kelly Soderlund published on June 2, 2014. An unencrypted laptop was stolen from one of Concentra Health Services’ facilities, the Springfield Missouri Physical Therapy Center, resulting in a $1,725,220 fine. QCA Health Plan Inc., of Arkansas, reported that an unencrypted laptop was stolen from a workforce member’s car. The company agreed to a $250,000 settlement. “These major enforcement actions underscore the significant risk to the security of patient information posed by unencrypted laptop computers and other mobile devices,” according to a U.S. Department of Health and Human Services Office for Civil Rights (OCR) news release. OCR’s investigation into Concentra revealed the health care provider had recognized in previous risk analyses that a lack of encryption on its laptops, desktop computers, medical equipment, tablets and other devices containing electronic protected health information was a critical risk and that Concentra’s efforts to correct the problems were incomplete and inconsistent. The investigation also found that Concentra had insufficient security management processes in place to safeguard patient information. In addition to the settlement, Concentra agreed to adopt a corrective action plan. In Arkansas, the stolen unencrypted laptop from a workforce member’s car contained the electronic protected health information of 148 people. QCA encrypted their devices following the breach but OCR’s investigation found that the company failed to comply with multiple requirements of the HIPAA Privacy and Security Rules. Along with the monetary settlement, QCA is required to provide HHS with an updated risk anal-ysis and corresponding risk management plan that includes specific security measures to reduce the risks to and vulnerabilities of its electronic protected health information. The health plan must also retrain its workforce and document its ongoing compliance efforts. OCR has six educational programs on compliance with various aspects of the HIPAA Privacy and Security Rules for health care providers. They are each available with free continuing education credits for health care professionals, with one module focusing specifically on mobile device security, at hhs.gov/ocr/privacy/hipaa/understanding/training

The ADA Complete HIPAA Compliance Kit (J598) has tools to help dentists design and implement a comprehensive HIPAA compliance program. The kit includes two products: The ADA Practical Guide to HIPAA Compliance: Privacy and Security Manual and The ADA Practical Guide to HIPAA Training CD-ROM. It is available to members for $300 and $450 retail. Visit adacatalog.org to purchase.

Serving Your Patients (and Your Practice) Better

The April 29, 2014 Newsletter of Shechtman, Marks Devor PC, certified public accountants, notes that businesses cannot afford to underestimate the influence that customer service has on their bottom line. One nearly certain way to lose customers is to make them wait too long. Polls have shown that more than eighty percent of customers have left a business because of long waits. The amount of time a customer has to wait is a primary driver of customer satisfaction and should be at the top of the list when assessing how to better serve consumers. One survey also showed that bad customer ex-periences tend to have a ripple effect. That’s because customers who perceive negative service not only won’t spend money at a business again, they are likely to tell others about their experience. At a time when people are engaged online and through social networking to share and collect ideas, the article stated, businesses risk losing potential customers before they ever set foot in their stores or offices. The article offers examples of good customer service: such as, make customers and clients believe they are your only concern. Let your clientele think you have all the time in the world — even when you don’t. Also, a relaxed tone of voice and patience go a long way toward keeping customers satisfied, even if they don’t get what they want. If problems or questions arise, try to resolve them rather than saying that “there’s nothing we can do.” The article offers a final thought: always say “thank you.” A good rule of thumb is to end every interaction with words of appreciation. Certainly, these observations and suggestions do not speak to what a wonderful dentist you are and the excellent care you provide for your patients, but they do point to what today’s consumers feel are important measurements to receiving outstanding customer service. (continued on page 9)


Newsbriefs (cont’d.)U.S. Budget Office Reviews EPA Separator Proposal

On June 6, 2014, ADA News staffer, Craig Palmer, reported that the Environmental Protection Agency submitted a draft proposed rule to the White House Office of Management and Budget (OMB) for review of pretreatment standards for existing and new dental practices that discharge dental amalgam to publicly owned treatment works. The draft rule, titled Effluent Guidelines and Standards for the Dental Point Source Category, is under review by the OMB. The OMB notice at reginfo.gov, EPA/WATER RIN: 2040-AF26 Publication ID: Spring 2014 said the affected sectors include dental laboratories and offices of dentists. The ADA supports a national separator mandate in accordance with common sense principles estab-lished by Association policy and patterned on ADA best management practices. All dentists are advised to comply with these guidelines (visit online at (www.ada.org/en/member-center/oral-health-topics/ amalgam-separators). The language of the draft regulation, though, is not a matter of public record, and the Association was unable to review it as the OMB review process began. The OMB abstract of the draft proposal said, “EPA is developing pretreatment standards for pollutant discharges from dental offices. When dentists place or remove amalgam fillings, mercury and other contaminants are flushed into the sewer. Dental amalgam contains mercury and other metals that have the potential to pass through or interfere with municipal wastewater treatment at publicly owned treatment works (POTWs). EPA’s technology assessment will focus on best management practices, such as use of amalgam separators, as a regulatory requirement.”

Fines for AwDA Violations Increased As reported by ADA News staffer, Craig Palmer, the Department of Justice (DOJ) has issued a final rule increasing civil penalties for violations of the Americans with Disabilities Act (AwDA), which covers “professional offices of health care providers” including dental offices. The rule became effective April 27, 2014, but applies only to violations occurring on or after April 28, 2014. The final rule “adjusts for inflation” civil monetary penalties assessed or enforced by the Justice Department’s Civil Rights Division. “For the Americans with Disabilities Act, this adjustment increases the maximum civil penalty for a first violation under Title III from $55,000 to $75,000; for

a subsequent violation the new maximum is $150, 000,” the DOJ said. Title III of the AwDA covers 12 types of public accommodations, a category that includes as covered service establishments “professional offices of health care providers” and “hospitals.” A professional office of a health care provider is a location where a state-regulated professional provides physical or mental health services to the public, according to the DOJ Title III technical assistance manual, which is available online at http://www.ada.gov/taman3.html Title III imposes a number of requirements on public accommodations, such as taking certain steps to make their facilities accessible, making reasonable modifications in policies, practices and procedures that would deny equal access to individuals with disabilities, and furnishing auxiliary aids when necessary to ensure effective communication.

ADA Offers PatientSmart – Patient Education through Your Website A shortcut to patient education materials is available for practices through PatientSmart, the ADA’s library of concise ADA patient education information that is accessible from the home page of subscribing dentists’ websites. Patients can watch videos or read pages from ADA’s best-selling brochures covering 26 different topics related to dental health and treatment directly from their dentist’s home page. Each page of PatientSmart (X100) has the sub-scribing dentist’s contact information at the top. Subscribers may e-mail PatientSmart content to patients before or after an office visit or to reinforce chairside messages. New content is now available, including new topics and Spanish pages. A subscription to PatientSmart is available for a one-time set up fee of $99 and $29.95 a month, which may be canceled at any time. All Toothflix customers get free start-up. To see a demo video, sample pages and other PatientSmart information, visit ADA.org/patientsmart (continued on page 11)

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Newsbriefs (cont’d.)ACA-Related Health Insurance Rate Hikes Expected Health insurers say consumers in the individual insurance market should expect premiums to double over the coming year in some parts of the country as a result of delays and changes in the rollout of the Affordable Care Act (ACA), as reported in the March 20, 2014 issue of ASAE Inroads, publication of the American Society of Association Executives. The rate hikes are expected to vary substantially by region, state and insurance carrier, with areas of the country with older, sicker or smaller populations to be hit hardest. The Obama Administration has downplayed talk of rising premiums, although former Health and Human Services (HHS) Secretary Kathleen Sebelius testified before the House Ways and Means Commit-tee in March that health insurance premiums are likely to increase in the coming year, but that new premium tax credits and rules ensuring fair pre-mium rates will make private coverage more afford-able for consumers in the long run. “The increases are far less significant than what they were prior to the Affordable Care Act,” Sebelius said in her testimony. To get information about health insurance or to compare costs of various plans, visit online at www.healthcare.gov In addition, the Society’s preferred insurance provider, Willis of Delaware, can provide information. Visit online at www.willisinsurancemarketplace.com or call 1-855-484-6275 to speak with Kent Evans.

New ADA E-Mail Resource to Help Practices with HIPAA Compliance On August 14, 2014, the ADA announced a new resource on e-mailing patient information in compli-ance with Health Insurance Portability and Account-ability Act (HIPAA) requirements. This was a joint effort with the New Jersey Dental Association. ADA members may access E-mailing Patient Information: A Resource for Dental Practices through the Member Center on ADA.org The resource includes sample forms and ad-dresses HIPAA-related e-mail topics such as e-mailing patients, e-mailing radiographs to a spec-ialist, encryption and breach notification. Sample forms include:

HIPAA Security risk assessment for e-mailing patient information;

Policies and procedures that state safeguards to use when e-mailing patient information;

An authorization form for a patient to use to consent to unencrypted e-mail (must be a stand-alone document);

A Notice of Privacy Practices with a section on e-mail. Specific HIPAA regulations address the use of electronic means to communicate patient informa-tion. Member dentists with questions about e-mailing patient information, including HIPAA requirements related to e-mail, can turn to the new resource for a discussion of some pertinent legal issues and options. Every dental practice must determine how best to meet patient needs in compliance with applicable regulations concerning the use of e-mail. Covered dental practices must develop their own policies and procedures on transmitting patient information based on their individual risk assessments. Access to the resource requires member login at ADA.org Search for Emailing Patient Information: A Resource for Dental Practices.

Supreme Court to Hear NC Board Appeal Oral arguments are set for early October 2014 before the U.S. Supreme Court in the case of the North Carolina Board of Dental Examiners v. Federal Trade Commission (FTC), a case in which the U.S. Court of Appeals for the Fourth Circuit upheld an FTC ruling that the board violated federal antitrust law in attempting to preclude non-dentist providers from engaging in the sale of teeth whitening services. The dental board contends that its actions are not subject to challenge because the federal antitrust laws are not applicable to acts by a state or its agencies. The case is significant because of its po-tential impact on professional boards as argued by the ADA, various associations and state attorneys gen-eral. Following the appeals court decision, the ADA led an effort to file briefs with the Supreme Court in support of the board's petition for review and its position on the merits of the case. The Association's efforts garnered support from professional organi-zations including the American Medical Association, American Osteopathic Association, American Associ-ation of Dental Boards and Federation of State Medi-cal Boards and also resulted in the filing of a sepa-rate brief by the attorneys general of 21 states. Oral arguments give an attorney from each side an opportunity to make a presentation to the Court and answer questions posed by the justices. A decision will be rendered during the 2014-2015 term, probably in the first few months of next year. (continued on page12)


Newsbriefs (cont’d.)International Classification of Diseases (ICD) Implementation Set for 2015 The International Classification of Diseases (ICD) codes have been used in medicine for more than a century. They were originally used for re-porting mortality statistics, and physicians, medical examiners, and coroners have used ICD codes since the early 1900s. More recently, they have been adopted for the reporting of diagnoses on claims for medical services in the United States. ICD Clinical Modification, Release 9 (ICD-9-CM) codes have been the standard for reporting diagnoses on HIPAA electronic transactions since the US first adopted electronic transactions standards in the early 2000s. The U.S. Department of Health and Human Services (HHS) has set a compliance date of October 1, 2015 for implementation of ICD-10-CM as the HIPAA standard code set for diagnoses. ICD-10-CM contains about 68,000 terms compared to ICD-9-CM's 13,000. It also contains more dental concepts, although not as many as found in SNODENT®.

(Systematized Nomenclature of Dentistry, an official subset of SNOMED CT, is a vocabulary designed for use in the electronic environment — for electronic health and dental records. To learn more about SNODENT®, visit www.ada.org and type in the search box SNODENT.) Those who are covered entities will be required to use ICD-10-CM as of October 1, 2015, but they must continue to use ICD-9-CM through September 30, 2015. ADA advises that the current electronic dental claim standard and the ©2012 ADA paper claim form can both support the use of either ICD-9-CM or ICD-10-CM codes, but inclusion of an ICD code is not required unless a patient's dental plan requires a diagnostic code for adjudication purposes. Typically, a plan only requires a diagnostic code for a service or services connected to the patient's systemic health. For example, a patient with diabetes may have a benefit for a third cleaning within a given calendar year. In order to obtain reimbursement for the additional cleaning from the dental plan, the dentist would have to report an ICD code for diabetes on the claim. Inclusion of ICD codes in general practice dental claims is uncommon, and reporting a diagnosis is not likely to be required most of the time. ADA notes, however, that this may change, and both dentists and dental billing staff are encouraged to acquaint themselves with ICD codes and the details of patient benefits for services connected to patients' systemic conditions. Some dental plans may require inclusion of diag-nostic codes on claims as part of their rules for claim

preparation and submission by participating pro-viders. If your practice is a participating provider with one or more dental plans, ADA advises you to check with those plans regarding their intentions for ICD diagnostic code implementation. For more information, visit the Centers for Dis-ease Control and Prevention ICD Home at http://www.cdc.gov/nchs/icd.htm or the World Health Organization ICD Home at http://www.who.int/classifications/icd/en/

Help Keep Your Patients Healthy In August of 2014, the Food and Drug Admin-istration (FDA) issued a warning to tattoo parlors, their customers and those buying at-home tattoo kits that not all tattoo ink is safe. In the light of a recall of in-home tattoo kits in California, the FDA said there are concerns about skin infections with all methods of tattooing. Remind your patients that Hepatitis, staph infections and even the superbug known as MRSA have been tied to tattoos. Dirty needles and unsani-tary environments are often to blame; but people can get infections in the skin even in the cleanest con-ditions. The ink can carry bacteria that can cause sepsis; and less severe infections may involve bumps on the skin, discharge, redness, swelling, blisters or excessive pain at the site. The FDA also noted that it has received reports of bad reactions to tattoo inks years later as well as right after tattooing.

More Seniors Documenting End-of-Life Wishes The percentage of senior citizens with living wills was 72 percent in 2010, a record number and a substantial increase from 47 percent in 2000. The figures come from a study published in the Journal of the American Geriatrics Society, examining data from the Health and Retirement Study conducted by the University of Michigan Institute for Social Research on behalf of the U.S. National Institute on Aging. Preparing end-of-life documentation, as well as a health care power of attorney, is a wise idea. It can help alleviate many difficulties for loved one who may have to make decisions on your behalf. It conveys a clear message of your desires regarding health care and estate decisions. (continued on page13)


Newsbriefs (cont’d.)Curt Schilling Reveals Smokeless Tobacco as Cancer Source Former Philadelphia Phillies pitcher Curt Schil-ling revealed that it was his use of smokeless tobacco for thirty years that caused oral cancer that required both radiation and chemotherapy. “I do believe without a doubt, unquestionably, that chewing is what gave me cancer,” Schilling said. Schilling first revealed the nature of his cancer during an interview on a Boston radio station in August of 2014. “It's a dangerously addictive habit that I wish I had never done,” Schilling said. He said he had been unable to kick the habit even though he suffered pain and bleeding during the years he used smokeless tobacco. “I am in remission,” Schilling said, adding that he lost 75 pounds during his illness. I don't have any salivary glands. I can't taste anything and I can't smell anything.” Earlier in the year, Schilling announced he was being treated for cancer and had undergone surgery, but never revealed the nature of the disease. Schilling pitched in the majors for 20 seasons for the Baltimore Orioles, Houston Astros, Philadelphia Phillies, Arizona Diamondbacks and Boston Red Sox. The six-time All-Star finished with a record of 216-146 and a 3.46 ERA. His 3,116 strikeouts rank 15th all time. ADA has long been an advocate for overcoming the use of smokeless tobacco. ADA.org has numerous articles and intervention tips to help your patients quit this dangerous habit. In the Search Box type: smokeless tobacco.

Australian Study: Acidic Drinks Can Damage Kids’ Teeth Permanently As posted online August 11, 2014 at IntelliHealth ([email protected]), a study by an Austra-lian researcher in the Journal of Dentistry says that, “Our research has shown that permanent damage to the tooth enamel will occur within the first thirty seconds of high acidity coming into contact with the teeth. This is an important finding and it suggests that such drinks are best avoided,” Dr. Sarbin Ranjitkar, of the Craniofacial Biology Research Group at the University of Adelaide in Australia, said. “If high acidity drinks are consumed, it is not simply a matter of having a child clean their teeth an hour or thirty minutes later and hoping they’ll be OK — the damage is already done.” Dr. Ranjitkar said there’s a balance between acids and protective mechanisms in a healthy mouth. But, “once that balance is shifted in favor of the acids, regardless of the type of acid, teeth become damaged . . . Often, children and adolescents grind their teeth at night, and they can have undiagnosed regurgitation or reflux, which brings with it acidity from the stomach. Combined with drinks high in acidity, this creates a triple threat to young people’s teeth which can cause long-term damage,” he said. ADA advises everyone to avoid sugary and starchy snacks. Consumption of sugary foods, soda, juice or energy drinks, puts everyone, especially kids and teens, at risk for tooth decay and periodontal disease. Dentists may order “Soda and Your Teeth” postcards for marketing and appointment recalls at http://ebusiness.ada.org/productcatalog/product.aspx?ID=570

Report of the Bylaws Committee Thomas W. Gamba, D.D.S., Chair On September 23, 2014, the Board of Governors approved revisions to the Society’s Bylaws. The changes were necessary to keep the Society in conformity with the governance of the Pennsylvania Dental Association. As you will recall, PDA no longer has a House of Delegates, thus it was necessary to remove those sections of the PCDS document referring to election and duties of PDA Delegates and Alternate Delegates.

A copy of the revised Bylaws, as approved by the Board of Governors, will be published on the Society’s web site by October 8. We will notify members when the document is available for inspection. The revisions will be on the agenda for a final vote by members attending the Annual Business Meeting, Tuesday, November 18, at 7:00 p.m. at the Society’s Executive Office. The proposed revisions require a 2/3 majority of those voting.


Health WatchBe Careful Purchasing Meds Online

Illegal online pharmacies that sell unapproved and potentially danger-ous prescription drugs to Americans were targeted in May of 2014 in a worldwide operation. More than 19,600 packages contain-

ing medicines supposedly from Australia, Canada, New Zealand and Great Britain were seized in the action, which involved authorities from 111 countries, the Federal Drug Administration (FDA) said in a news release. The packages contained unapproved or sus-pected fake drugs from countries such as China, India, Laos, Malaysia, Mexico, Singapore and Taiwan, as well as Australia, New Zealand and Great Britain. In the United States, officials inspected shipments at international mail facilities in Los Angeles, Chicago and New York City and seized or detained 583 packages. Many of the packages contained illegal prescription medicines that had been ordered online. These drugs ordered by U.S. consumers included drugs such as insulin, glaucoma eye drops, the pain reliever tramadol and medications for erectile dysfunction – tadalafil and sildenafil citrate. Hor-mone medications including estrogen and human chorionic gonadotropin were also seized.

“When consumers buy prescription drugs from outside the legitimate supply chain, they cannot know if the medicines they receive are counterfeit or even if they contain the right active ingredient in the proper dosages,” Douglas Stearn, director of the FDA’s Office of Enforcement and Import Operations, said in an agency news release. Some countries have less stringent drug manufacturing standards or regula-tions than the United States, according to the FDA. “Consumers have little or no legal recourse if they experience a reaction to the unregulated medication or if they receive no therapeutic benefit at all,” Stearn said. “In addition to health risks, these pharmacies pose other risks to consumers, including credit card fraud, identity theft or computer viruses.” Philip Walsky, acting director of the FDA’s Office of Criminal Investigations, said many illegal online pharmacies use slick website templates and empty guarantees to convince U.S. consumers that the inexpensive drugs they sell are the exact same prescription drugs that are dispensed in the United States. The FDA has more about buying medicines online at http://www.fda.gov/Drugs in the search box type: Be SafeRX Know Your Online Pharmacy.

(continued on page15)

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Health Watch (cont’d.)Exercise Affects Men and WomenDifferently

The formula physicians use to evaluate treadmill stress tests, and thereby assess heart health, doesn’t account for important dif-ferences between men and wo-men, a new study contends. A

revised formula would better determine peak exer-cise rate, or the maximum number of heart beats per minute, for each sex, the researchers said. The findings were presented recently at the an-nual meeting of the American College of Cardiology in Washington, DC. “Exercise physiology has been known to differ for men and women of different ages,” said Dr. Gregg Fonarow, associate chief of cardiology at the Uni-versity of California, Los Angeles, and spokesman for the American Heart Association. The proposal for a sex-specific maximal heart rate warrants further research, he said. “This may represent a valuable

improvement for guiding exercise stress testing,” added Dr. Fonarow, who was not involved in the study. Physicians currently use the formula “220 minus age” to determine how hard patients should work out during exercise stress tests. Many people also use this formula to set their target heart rate during work outs. A team led by Dr. Thomas Allison, director of stress testing at the Mayo Clinic in Rochester, MN, reviewed 25,000 stress-test results. They saw signif-icant differences between men and women. The team found that although peak heart rate declines with age for both sexes, the rate declines more gradually in women. This difference results in an overestimated peak heart rate in younger women and under-estimated peak heart rate in older women, the researchers said. According to the revised formula, the maximum heart rate for women aged 40 to 89 should be 200 minus 67 percent of their age. For men, the preferred formula is 216 minus 93 percent of their age, the researchers said.

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Dental DatesThe JOURNAL welcomes news concerning activities of your dental study club or other bona fide dental associations. Send information (as formatted below) to the Philadelphia County Dental Society via e-mail: [email protected] or fax: 215-925-6998. Deadline for publication is the first of the month prior to publication (December1 for January/February/March issue), and information will be published on a space-available basis.

OCTOBER1 NE DENTAL IMPLANT/PERIODONTAL PROSTHESIS STUDY CLUB – 6:00 p.m., Dinner meeting at

the Buck Hotel, Feasterville featuring William C. Scarfe, B.D.S., F.R.A.C.D.S., M.S., “Cone Beam Computer-ized Tomography for Site Assessment.” For information, contact Paula Chernoff at 215-677-8686 or e-mail [email protected]

8 EASTERN DENTAL SOCIETY – Fall Dine Around at Smith & Wollensky, Philadelphia, featuring Kip Lynch, “HIPAA Compliance – What Does That Mean for My Office?” For information, contact Dr. Michael Salin at [email protected] or visit online at www.Eastern-Dental.org or call 215-322-7810.

9-14 AMERICAN DENTAL ASSOCIATION – 155th Annual Session, San Antonio, TX. For information, visit the web site at www.ada.org/goto/session

14 CONTINUING EDUCATION FOR DENTAL EXCELLENCE – Joint program in Northeast – 6:30 p.m., Dinner meeting, Gallo’s Restaurant, featuring Dr. Michael Sonick, “Topic to be announced. Sponsored in

cooperation with 3i-Biomet. For information, contact Vickie Fisher at 215-732-4450 or visit www.PhilaPerioImplants.com

NOVEMBER5 NE DENTAL IMPLANT/PERIODONTAL PROSTHESIS STUDY CLUB – 6:00 p.m., Dinner meeting at

the Buck Hotel, Feasterville, featuring Study Club Members’ Lectures, the “All-on-4™” Experience, Robert A. Levine, D.D.S., F.C.P.P., Zola Makrauer, D.M.D., Gary Nack, D.D.S., F.A.G.D., Harry Randel, D.M.D., Robert Sattler, D.M.D., M.A.G.D. and Drew Shulman, D.M.D., M.A.G.D. For information, contact Paula Chernoff at 215-677-8686 or e-mail [email protected]

6-8 THREE RIVERS DENTAL CONFERENCE – Nemacolin Woodlands Resort & Spa. For information, visit online at www.dswp.org or e-mail [email protected] or call 412-321-5810.

7 PHILADELPHIA COUNTY DENTAL SOCIETY – Continuing Education Program at the Philadelphia Hilton Hotel, City Avenue, featuring Sam Halabo, D.M.D., San Diego, CA, “Achieving Superb Results: Cementation, Bonding and Bulk Fill Composites.” Register online at www.philcodent.org

11 CENTER CITY STUDY CLUB – 6:00 p.m., Dinner meeting at Estia Restaurant, featuring Dr. Jay B. Laudenbach, “Immediate Loading of Dental Implants.” For information, contact Amanda Cerini at [email protected] or 215-985-4337 or visit the website at www.laudenbach.com

12 CONTINUING EDUCATION FOR DENTAL EXCELLENCE – Joint program in Northeast – 3:00 p.m., Dinner meeting, Gallo’s Restaurant, featuring Dr. Clark Stanford, “Evolution of Dental Implant Therapy – Combining the Best of Procedures, Devices and Patient Care.” Sponsored in cooperation with Dentsply. For information, contact: Vickie Fisher at 215-732-4450 or visit www.PhilaPerioImplants.com

18 PHILADELPHIA COUNTY DENTAL SOCIETY – Annual Business Meeting and Election of Officers, 7:00 p.m. at the Executive Office.

28 – Dec. 3 GREATER NEW YORK DENTAL MEETING – Jacob Javits Convention Center, New York. Meeting: November 28 to December 3; Exhibits: November 30 to December 3. For information, visit www.gnym.com or call 212-398-6922.

DECEMBER2 CONTINUING EDUCATION FOR DENTAL EXCELLENCE – Center City – 6:30 p.m., Dinner meeting, Doubletree Hotel, featuring Dr. Pat McGovern, “Ancient Viticulture and Its Therapeutic Effects.” For information, contact: Vickie Fisher at 215-732-4450 or visit www.PhilaPerioImplants.com

3 CONTINUING EDUCATION FOR DENTAL EXCELLENCE – Northeast – 6:30 p.m., Dinner meeting, Gallo’s Restaurant, featuring Dr. Pat McGovern, “Ancient Viticulture and Its Therapeutic Effects.” For information, contact: Vickie Fisher at 215-732-4450 or visit www.PhilaPerioImplants.com

(continued on page 19)


THE DENTAL SOCIETY OF CHESTER COUNTYAND DELAWARE COUNTY, PAproudly presentsDKU ContinuingDental Education

DENTISTS KEEPING UP

All meetings will be held at the Springfield Country Club on Route 320, Springfield, Delaware County, PA, except for the Bonus Courses.Registration for all courses 8:15 AM. Lecture 9:00 AM – 4:15 PM. Continental breakfast and lunch included for all DKU courses.

Delco and Chesco Society Members - Entire Series plus both bonus Courses - $695, Individual Courses - $195, 3 Courses - $530, 4 Courses - $615Other ADA Members - Entire Series plus both bonus Courses - $745 Individual Courses - $210, 3 Courses - $570, 4 Courses - $665Non-ADA Members - Entire Series plus both bonus Courses - $815, Individual Courses - $225, 3 Courses - $605, 4 Courses - $715Staff members accompanied by a doctor will be $95 per course per person with reservation at least one week in advance, $110 per course per person at door.Cancellations and Refund Policy - No refunds will be made without notice of at least one week prior to course date. (A $25 administrative fee will be deducted.)For information please contact: DKU • c/o Barry Cohen, DMD • 4750 Township Line Rd • Drexel Hill, PA 19026 • 610-449-7002 • [email protected]

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Fri., October 24, 2014

Friday, November 7, 2014Harold Crossley, DDS, MS, PhD – Cambridge MD – Avoid Liability; Know Your Patients’ Medications and Their Impact on DentalTreatment! Your patients are living longer thanks to their medications but many of the physician-prescribed medications used by your patients have dental implications and side effects affecting yourtreatment plan. Some of these medications are the drugs of choice of “doctor shoppers”. And one of these medications is the most prescribed medication abused by adolescents. This presentation includesthe indications, contraindications, and side effects of the most commonly prescribed medications. Many of these medications were not approved when you took your pharmacology course in dental school.At the conclusion of this course, the attendees will know: Medications that could adversely interact with dental drugs; Why your patient is taking their medications; What oral side effects may be caused bythese medications; Maximum doses for commonly prescribed pain medications; When not to prescribe NSAIDs; How to manage patients taking some of the newer anticoagulant medications; How to com-bine analgesics to maximize their effects; Indications and contraindications for opiate analgesics; and Current recommendations for SBE and orthopedic prost hesis prophylaxis. Harold L. Crossley is ProfessorEmeritus at the University of Maryland Dental School where he was awarded his D.D.S. degree. The liaison between the classroom and his part-time dental practice produced a practical approach to under-standing the pharmacology of drugs used in the dental office. Bring your hygienist to this important Pharmacology update! This course is supported by educational grants from Dodd Dental Lab, Dentsply,Hayes Handpiece Repair, and PDAIS.

Wednesday, December 3, 2014Jeffrey P. Okeson, DMD – Lexington KY – “What every dentist needs to know about Temporomandibular Disorders” The management of temporo-mandibular disorders is a complex problem in dentistry. This complexity arises from the many different disorders that can be present as orofacial pain in the masticatory structures. In order to effectively man-age TM disorders the clinician must first be able to differentiate these disorders from other orofacial pain conditions. Emphasis will be placed on diagnosis so that correct therapy will be selected for eachpatient. The role of occlusion and joint stability in TMD will be discussed. Appropriate use and fabrication of occlusal appliances will be presented. This course will benefit all practitioners. You will learn: Toidentify those pain disorders that will likely respond to your therapy from those that will not; The relationship between occlusion, bruxism and temporomandibular disorders; The most favorable condylar posi-tion for restorative dentistry and why there is so much controversy; and The appropriate use of occlusal appliance therapy. Dr. Okeson is a graduate of the University of Kentucky College of Dentistry wherepresently he is Professor and Chair of the Department of Oral Health Science and Director of the College's Orofacial Pain Center, which he established. This course is supported by educational grants fromDodd Dental Lab, Dentsply, and PNC.

Wednesday, January 14, 2015Brian Nový, DDS, – Loma Linda, CA – “Offensive Dentistry” Let’s face it, sitting through a lecture about dental caries doesn’t sound appealing (in fact it sounds downrightboring). However, the science of clinical cariology is beginning to have an impact on restorative techniques and technology. Handpieces and burs will remove compromised tooth structure, but compre-hensive patient care involves addressing the chronic disease that leads to cavitation. Combining the medical management of disease along with bioactive restorative materials can take the practice of den-tistry to new heights – and give Streptococcus mutans more to fear than stronger fluoride. At the end of this course, participants should be able to: Describe the systemic theory of dental caries; Providebasic salivary analysis to identify “hidden” risk factors; Control patient caries risk with focused therapeutics; Design restorations to minimize recurrent decay; and Identify restorative materials that cre-ate ionic bonds. Dr. Nový is the Director of Practice Improvement at the DentaQuest Institute, and an Assistant Professor of Restorative Dentistry at Loma Linda University. He served on the ADA Councilof Scientific Affairs 2014 and acts as the chairman of the CAMBRA coalition. This course is designed for the entire clinical team. This course is co-sponsored by a major educational grant from GC Americaalong with grants from Air Techniques, Dodd Dental Lab, Dentsply, Hayes Handpiece Repair and Shofu.

Friday, April 10, 2015David Hornbrook, DDS – San Diego, CA – “Functional Aesthetic Dentistry” For the past decade, the search for invisible, beautiful dentistry has been the goal of boththe clinician and the manufacturers. Coupled with the public’s quest for ideal aesthetics and a youthful, white smile, as the journey continues, it has also become more difficult. More difficult because ourpatients are more demanding for perfection today than ever before and more confusing because of the vast array of new materials and options available to provide this care. Join Dr. David Hornbrook ashe explores our options for aesthetic, metal free dentistry for our patients in applications including smile design, posterior restorative, bridge applications, and full mouth rehabilitation. Discussion willinclude: updates of dentinal adhesion; ideal cementation of the new materials using the new resin cements; and addressing the role function plays in our decision making. Objectives and subjects cov-ered will include: Understanding the advantages of the new ceramics ideal for smile designs; The use of lasers to enhance the aesthetic result; Reviewing and evaluating the diagnostic wax up; Learninghow to predictably choose the correct cements for different materials that enhance aesthetics and long term success; and Understanding how we can truly be metal free, even with posterior bridges. Thisis a great course for the entire clinical team. Dr. Hornbrook serves on the faculty of many postgraduate university programs in aesthetic or cosmetic dentistry, including those at Baylor University, TuftsUniversity, SUNY at the University at Buffalo, and UCLA. This course is supported by educational grants from Bisco, Dodd Dental Lab, Dentsply, PNC and PDAIS.

Friday, May 8, 2015Uche Odiatu, DMD, – Toronto, Canada – “The Wellness Advantage: the Value Added Practice!” Want to add incredible value to your patient experience? There'san avalanche of evidence demonstrating the link between your patients’ mouth with their lifestyle habits: lack of sleep, shift work, poorly managed stress, overeating & sedentary living. Patients appreci-ate the dental professional who sees the bigger picture & understands the relationship between the body, mind & mouth. You will gain new appreciation into the miraculous nature of the human bodyand to the way every part is connected. • Recognize the destructive inflammatory cascade in your patients. • Discover how visceral fat behaves like an active organ causing havoc throughout the body &mouth. • Identify 7 key foods & lifestyle habits that contribute to inflammation • Discover new lifestyle questions to add to your new patient exam. We'll go into advanced strategies to create change inyour patients’ daily health practices & maybe yours? Across the board, your patients’ lifestyle cannot be ignored as you work at getting them to optimal health. From sedentary living (Is Sitting the NewSmoking?) to mismanaged stress, you will discover a new way of looking at how chronic inflammation and disease is supported by your well-intentioned patients. Understand why certain patients do notrespond well to your hygiene programs. Spot how stress & disrupted sleep shows up in your patients’ mouth. Implement a new dimension to your overall treatment planning. Develop team building strate-gies to get your entire office on board focusing on whole body health. Create a circle of influence & develop relationships with allied health professionals & get loads of referrals. Dr. Odiatu is an inter-nationally recognized wellness & performance expert. This practicing dentist from Toronto is also an NSCA certified personal trainer, a holistic lifestyle coach, and a professional member of the AmericanCollege of Sports Medicine. Invite the whole dental team for this day of health. This course is supported by educational grants from Dodd Dental Lab, Dentsply, Hayes Handpiece Repair and PNC.

2014/2015DKU is an ADA CERP Recognized Provider. ADA CERPis a service of the American Dental Association toassist dental professionals in identifying qualityproviders of continuing dental education. ADA CERPdoes not approve or endorse individual courses orinstructors, nor does it imply acceptance of credithours by boards of dentistry. DKU designates thisactivity for 30 continuing education credits. Concernsor complaints about a CE provider may be directed tothe provider or to ADA CERP at www.ada.org/cerp.

Registeron -line atDKUdental.com

Approved PACE Program ProviderFAGD/MAGD credit. Approval does notimply acceptance by a state or provin-cial board of dentistry or AGD endorse-ment. The current term of approvalextends from 3/1/2013 to 2/28/2017.Provider ID #217995


Dental Dates (cont’d.)JANUARY20 CENTER CITY STUDY CLUB – 6:00 p.m., Dinner meeting at Estia Restaurant, featuring Dr. Pamela Doray, “Successful Restoration of the Anterior Single Tooth Implant.” For information, contact Amanda Cerini at [email protected] or 215-985-4337 or visit the website at www.laudenbach.com

MARCH18 PHILADELPHIA COUNTY DENTAL SOCIETY – Continuing Education Program at the Philadelphia

Hilton Hotel, City Avenue, speaker to be announced. Register online at www.philcodent.org after January 1.

18 EASTERN DENTAL SOCIETY – Spring Dine Around at Davio’s, Philadelphia, featuring Harriet Levin, M.S.P.T., “Dentistry Induced Repetitive Stress Injuries.” For information, contact Dr. Michael Salin at [email protected] or visit online at www.Eastern-Dental.org or call 215-322-7810.

APRIL21 CENTER CITY STUDY CLUB – 6:00 p.m., Dinner meeting at Estia Restaurant, featuring Dr. Amy James, “Orthodontics Redefined.” For information, contact Amanda Cerini at [email protected] or

215-985-4337 or visit the website at www.laudenbach.com

MAY13 PHILADELPHIA COUNTY DENTAL SOCIETY – Continuing Education Program at the Philadelphia

Hilton Hotel, City Avenue, speaker to be announced. Register online at www.philcodent.org after January 1.

15 EASTERN DENTAL SOCIETY – All Day Program at the Buck Hotel, Feasterville, featuring Timothy Bigza, D.D.S.; Theresa Groody, M.Ed., E.F.D.A., C.D.A., Marriane Drywer, R.D.H., M.Ed.; and Amy Kirsch, “Dentistry 360.” For information, contact Dr. Michael Salin at [email protected] or visit online

at www.Eastern-Dental.org or call 215-322-7810.

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Fall All Day Program: Friday, September 12, 2014The Buck Hotel, Feasterville, PA

“The Dental Practice Pro�tability Program” &“From “Hello” to “How Much”??? Improving Financial and Insurance Related Patient Care Discussions”

Lorraine Guth and Ben Tuinei presents 2 programs in 1! This program is intended for solo and group dentists to help maintain and increase practice reimbursements for the future. Whether you participate in PPO’s, Delta Premier, or are solely a fee for service practice, this program will

provide you with the critical information you need to be able to make decisions for the future of your practice.

Fall Dine Around: Wednesday, October 8th, 2014 Smith & Wollensky, Philadelphia, PA

HIPAA Compliance – What Does That Mean For My O�ce Kip Lynchis the owner and operator of CMIT Solutions in Bucks County that focuses on increasing client’s productivity and pro�tability by

keeping their computers running e�ciently and implementing data security procedures. The goal of his presentation is to provide the most recent updates in electronic security regulations, implementation within your practices, and help you develop a security action plan.

Spring Dine Around: Wednesday, March 18, 2015Davio’s, Philadelphia, PA

“Dentistry Induced Repetitive Stress Injuries” Harriet Levin MSPT: Harriet Levin, MSPT, has more than 16 years of experience as a practicing physical therapist in the Philadelphia area.She created the Practitioner Wellness Program that is designed for the prevention and treatment of repetitive stress injuries (RSI) commonly

experienced among health care practitioners, especially dentists and oral hygiene professionals. In this program Harriet will review the myofascial pain cycle, recognize the clinical pattern of dentistry induced repetitive stress injuries, di�erentiate between modi�able and �xed risk

factors to injury, and review preventive and corrective treatment measures for the working dentist

Spring All Day Program: Friday, May 15th, 2015The Buck Hotel, Feasterville, PA

“Dentistry 360” In this “Total O�ce Training”, Timothy Bigza, D.D.S., Theresa Groody, M.Ed, EFDA, CDA, Marriane Drywer, RDH, M.Ed, and practice

management consultant Amy Kirsch come together for one day at the Buck Hotel together to present and train you and your sta� in the latest techniques and technologies that are driving advancements in dental care and practice development. We invite you, your assistants, hygienists, and your front desk team to experience this one of a kind course. Each group in your team will experience their own lecture from these experts in

their �eld. As the doctor, Tim Bigza, D.D.S. will educate you on the clinical and practice management advancements in dentistry. And at the end... your entire team comes back together to tie everything together. This course format is changing the way study clubs

and dental societies engage their dental teams and advance their practice.

Annual Golf Outing: June, 2015Philmont Country Club

We continue our 107th year of camaraderie and education asone of the oldest dental societies in the region!

07th year of camaraderie and education as


Workplace Tips Ragan Communications, publisher of corporate communications, public relations and leadership development newsletters, offers the following workplace tips through several of its online publications. Although targeted to corporate environment, these can be adapted for your practice and your personal life.

Stay on the Boss’ Good Side A good relationship with the boss is critical to your professional success, wherever you work and whatever your duties are. Here’s how to stay on the boss’ good side through thick and thin:

Build confidence. The boss wants to trust that you’ll accomplish whatever he/she asks. Tackle every assignment with a sense of urgency: not “I’ll try,” but “I’ll do it.” If you make a mistake, take responsibility for fixing it: “This is what happened, and I’ll get to work on a solution right away.”

Respect the boss’ time. Don’t interrupt the boss for something inconsequential. Don’t keep him/her waiting. Get to the point when you have something to say, and make every effort to complete your assignments on time – or ahead of schedule.

Support your boss. You don’t have to become a yes-person, but refrain from talking about bosses behind their backs. If you must disagree, do it in private. No boss will trust or respect an employee who cuts him or her down to others.

Stay Up to Date: Neutralize Information Overload You can’t accomplish ambitious goals without the right kind of information – and the right amount of it. To become a conscientious consumer of news and information, follow this advice:

You simply can’t absorb everything that’s out there. Concentrate on prioritizing data, handing it off to someone who can decide whether you need to digest it, and discarding what’s not useful.

Identify sources of information that are es-sential and trustworthy. Weed out any publication, website, or professional association whose informa-tion isn’t of the highest quality.

When you open a publication or look at a website, skim before diving in. Focus only on articles or reports that you need to read, not what’s just mildly interesting to you. Stick to what’s important.

As you read a book or magazine, highlight or underline key messages. Save online articles in a special folder, and check it once in a while. If you haven’t gone back to any saved material, discard it.

Be an example. If you don’t want to get bogged down by long e-mails or voice messages, keep your own short. Let others know that they should keep their information as concise as possible – and remind them when they don’t.

Two Key Questions for Job InterviewsHiring employees is an important responsibility.

The questions you ask during an employment inter-view are crucial to discovering whether you and a candidate can work together. In an interview with The New York Times, Hannah Paramore, presi-dent of a Nashville-based advertising agency, shared the two most important interview questions she knows:

“How old were you when you had your first job?” The answer to this communicates much about a person’s work ethic, ambition, and sense of entitle-ment. Part-time work in high school or college, for example, demonstrates a commitment to earning one’s way in the world.

“Why did you leave your last job?” There’s no right or wrong answer to this one. You’re looking for evidence of honesty. If a candidate tries to evade the question or makes a weak excuse, you won’t be able to trust him or her. If the candidate tells the truth about wanting a better job, or even making a mistake that he or she has learned from, you can have more confidence in his or her integrity.

Ask These Questions WhenEmployees Fail When an employee makes a mistake, your first step is to assess the employee’s responsibility – not to assign blame, but to find the lesson in the error. Here are some general questions to keep in mind:

Was the employee prepared? Was the employee sufficiently trained or experienced? Was he/she given clear, accurate instructions and proper tools, materials, and information? Negative answers may shift some of the responsibility, but don’t neglect one other important question: Did the employee recognize and report that he/she was unprepared? Emphasize the importance of anticipating problems ahead of time.

Did the employee receive sufficient support? If the employee missed a report deadline, did he or she receive all the information needed on time? Were co-workers and other managers helpful? “No” answers here mean that you may need to widen the responsibility.

How did the employee deal with the error? Did he/she try to correct the problem as quickly as possible? If the error occurred because the employee wasn’t on top of the process, you need to emphasize his/her responsibility to follow through.



Classified AdsClassified Advertisement Policy. The Society reserves the right to accept, decline or withdraw classified advertisements at its discretion. The Society believes the advertisements that appear in these columns are from reputable sources; the Society neither investigates the offers being made nor assumes any responsibilities concerning them. Every precaution is taken to avoid mistakes, but responsibility cannot be accepted for clerical or printer’s errors. Requests to run advertisements “until further notice” cannot be accepted; the advertiser is responsible for renewals. Names of box number advertisers cannot be revealed. The JOURNAL reserves the right to edit copy of classified advertisements. Classified ads will not be taken over the telephone. DOCTOR, ARE YOU SEEKING EMPLOYMENT? Call the Philadelphia County Dental Society at 215-925-6050 or Fax 215-925-6998 to have your name listed on our employment referral list. Monday thru Thurs-day, 10 a.m. to 4 p.m.

DOCTOR, ARE YOU LOOKING FOR AN ASSO-CIATE or for a dentist to work in your practice? Call the Philadelphia County Dental Society at 215-925-6050 or Fax 215-925-6998 for the list of dentists seeking employment. Monday thru Thursday, 10 a.m. to 4 p.m.

HOMEBOUND PATIENTS NEED CARE — If you have time in your schedule, why not consider providing care to homebound patients? Many patients need dental care, and most pay for the services. For more information, call Dr. Glenn Goodhart at 215-635-0200.

PRACTICE TRANSITIONS — We specialize in Practice Sales, Appraisals and Partnership Arrangements. Ask about our free guides for Sellers and Buyers. For information on services and listings, contact Philip Cooper, D.M.D., M.B.A., American Practice Consultants, toll free 1-800-400-8550, or www.ameriprac.com

FOR SALE — Practices in zip codes 19116 or 18960. Includes equipment, inventory, four operatories. Transition available. Established practice that owner would like to sell to reduce workload. Fax: 215-643-0333 or e-mail: [email protected] OPPORTUNITY AVAILABLE — Established Bala Cynwyd practice seeks an associate who is motivated, skilled and able to work independently. Could lead to transition/purchase potential. Call Steven @ 610-960-8905.

OPPORTUNITY AVAILABLE — Doctor needed for unique opportunities. This is not your ordinary practice. Excellent earning and ownership potential. Must possess energy and drive for servicing a high demand population. For information, please fax @ 610-667-4374 or call Steven @ 610-960-8905.

OPPORTUNITY AVAILABLE — Hygienist — Take charge of your schedule and earning potential. Operations in 5 counties. Call for further information at 610-664-7795.

FOR SALE — General dental practice in Northeast Philadelphia. Established at same location for 61 years. Presently two operatories, but has room for expansion. Excellent opportunity for an energetic business-minded doctor to build a close-knit neighborhood practice. Please call 1-609-280-2768.

MARYLAND/D.C./NORTHERN VIRGINIA DEN- TAL PRACTICES FOR SALE — No buyer’s fees. COLLEGE PARK: 3 ops grossing $500K. SOUTH-ERN MARYLAND: 3 ops P/T grossing $550K, near Bay. CARROLL COUNTY: 4 ops grossing $400K, high net. Call 800-544-1297 or check our web site at www.polcariassociates.com

SPACE AVAILABLE — Main Line Location — 4-chair office. One-to-three days possible in our fully equipped state-of-the-art facility. Fax for further information at 610-667-4374.

FOR SALE — Office & building; Dr. retired. Accumulate EQUITY while you work, not rent receipts. Located in Pennsauken, NJ, 7 minutes from Philadelphia. Well-known location. 4+ ops, equipment good. 1,000 sf. Call 856-665-6404.

SEEKING POSITION — NOW IS THE TIME!! Endodontist available to perform High Quality, Com-passionate Root Canal Treatments on Your Patients in Your Office. Increase Your Productivity. PA or NJ. Email: [email protected] or call 267-560-7425.

REMEMBER: One more CE program for 2014 Friday, November 7 — 8:30 to 3:30 Achieving Superb Results: Cementation, Bonding & Bulk Fill Composites with Dr. Sam Halabo Register online at www.philcodent/org/members/programs.aspx or call 215-925-6050 for reservation form


American Practice Consultants, a full service Dental Practice Broker

& Appraiser, was founded in 1985 by Philip A. Cooper, D.M.D.,

M.B.A. to provide a range of transition services to dentists who are

selling or buying a practice.

Let Us ExpertlyGuide You Through:• VALUATION • MARKETING

• NEGOTIATION • CONTRACT REVIEW

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Philip A. Cooper, D.M.D., M.B.A.

Ask About Our

FREE GUIDESFor Sellers & Buyers!

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704 East Main Street, Suite D • Moorestown, New Jersey 08057856-234-3536 • 800-400-8550 • [email protected]

Am Pract Philad Cty 10/2/12 12:03 AM Page 1

PCDS Liberty Continuing Education Dates for 2015Mark your calendar for the following dates and watch your mail in January for the reservation form

(or register online after January 9 at www.philcodent.org)

Wednesday, March 18 – speaker/topic to be announced (Plus CPR recertification at 4:00 p.m.)

Wednesday, May 13 – speaker/topic to be announced

Friday, October 9 – speaker/topic to be announced

Friday, November 13 – speaker/topic to be announced

Mark Your Calendar Now & Plan to AttendPCDS Continuing Education

Convenient Relevant AffordableHelping you meet your legal and ethical responsibilities.

Documents

The Journal of the Philadelphia County Dental Society, Volume 80 Issue 4