MARCH 2010 VOLUME 11, ISSUE 3 AVAILABLE ONLINE AT TDA.ORG

Inside

TDA Member Receives Prestigious National AwardDr. Xochitl Anderton of Lubbock named Geiger Gibson Emerging Leader TDA Member Visits HaitiDr. Manuel Carrasco of Odessa shares experience TDA Member Inducted Into Honor Society TDA Smiles FoundationFluoride Fest LampasasCapital Area Dental Foundation partnership TDA Perks Program TEXAS Meeting Preview Evidence-based Tip of the Month TSBDE Rule Update Medicaid Update

April Journal News

Special Prosthodontics IssueRemovable Partial Dentures — Treatment Now and for the Future

Functional Impressions for Complete Denture Fabrication

Edentulism and Comorbid Factors

Around the State

April 10Fluoride Fest, Goliad April 15 – 17Star of the South Dental Meeting, Houston April 16ADA 15th District Delegation Caucus Meeting, Austin

Click & Connect

Join us on Facebookwww.groups.to/texasdental Follow us on Twittertwitter.com/theTDA Get LinkedINlinkedin.com, search “Texas Dental Association” March TDJtda.org/tdapublications

JUNE, 2008 VOLUME 9, ISSUE 6 AVAILABLE ONLINE AT TDA.ORG

InsideMedicaid in My Office?Yes, I Think So!Richard M. Smith, DDS

TDA Smiles FoundationTMOM gains ardent advocate

Ask the PresidentIncoming President’s messageHilton Israelson, DDS

Let’s TalkOutgoing President’s messageA. David May, Jr., DDS

2008-2009 TDA Board of Directors

Meet Your TDA StaffTDA’s new Finance Director Dee Dee Delagarza

Congratulations to TDA Component Societies

Streamline Your Insurance ClaimsSpeeding up confirmation of benefits and eligibility

TSBDE Rule UpdateRequirements for dental office radiograph machines

In the NewsTDA members in the news

July Journal NewsTooth Whitening: A Clinical Review

TDA Historical PerspectivesDentists, dental hygienists, and the dental team

The 2007 C.T. Rowland AwardOrthodontic case report

The El Paso Dental Conference

Around the StateAugust 14:TDA Board MeetingAustin, Texas

October 15-19:ADA Annual SessionSan Antonio, Texas

Click & ConnectUpdate Profile tda.org – Membership Info Ask a Colleague tda.org – Features TEXAS Meeting Photostexasmeeting.com/estore

Volunteer for ‘08 ADAtda.org/volunteerada08

Every Member MattersRise’ Lyman, DDS, TDA Future Focus Committee

Membership growth is vital to any thriving organization. The Texas Dental Association (TDA) Board is strongly committed to the Membership goal within the “TDA 2009” strategic plan, which addresses continued growth. I am proud to report that, as evidence of that commitment and for the second year in a row, the TDA received the following ADA awards in 2008:• Greatest Percentage Membership Net Gain: Texas had a net gain of 198 members in the year 2007.• Top Constituent Dental Society with Greatest Percentage of Non-Members to Membership: Represents a conversion of 4.7 percent of non-members into membership at end of year 2007.• Top Constituent Dental Society to Improve Retention Rate Percentage in 2007: Represents a 97 percent Association retention rate, which is an increase of 7 percent from the previous year.• Greatest Percentage of New Dentist Members: Represents a gain of 111 new dentist members (those dentists who are 1-9 years out of school).

Another example of the commitment to the growth of our Association is the TDA Externship Program, which builds student awareness of organized dentistry. This innovative program, created in 2007, offers students the opportunity to gain insight into the different components of organized dentistry including legislative and regulatory affairs, membership, governance, continuing education, and charitable dentistry and to gain a better understanding of their role as future leaders of the dental team. The program is open to dental students from each of the three dental schools in Texas. This year the externship program will take place June 20 – June 27 in Austin at the TDA central office. As an ongoing effort to enhance the value and benefits of the Association, the TDA Council on Membership developed a survey that was sent to all members in 2006. The results clearly showed that members have a high satisfaction rating with benefits such as the TEXAS Meeting, TDA publications, and the ability to participate philanthropically in the TDA Smiles Foundation. A great number of the discounted programs offered to members through the TDA Perks Program also received a high satisfaction rating. In accordance with the strategic plan, the Council on Membership, will survey members again in 2009. Participation from all members and a collaborative effort between the ADA, TDA, and local component societies are the keys to successful membership recruitment and retention. We encourage every member to get involved whether it is by attending local meetings, taking part in Give Kids a Smile! Day activities, volunteering at a Texas Mission of Mercy, or participating in TDA Legislative Day activities in Austin. Each member matters and is essential to the continued growth of our Association and of organized dentistry. This is the seventh and final in a series of articles focused on the TDA’s accomplishments guided by the strategic plan. To view the entire plan, log in at www.tda.org and click on “TDA 2009” under “Current Issues” on the member homepage. For more information, please contact Lyda Creus Molanphy, staff liaison to the Future Focus Committee, at the TDA central office, (512) 443-3675.

MembershipDentists will value membership and participation in the TDA.

Objectives1. Improve perceived value and benefits of membership in TDA. a. Increase members’ knowledge about the impact and benefits of TDA membership. b. Ensure that components are an integral aspect of the membership process. c. Create greater awareness of the availability of the Peer Review, Ethics & Judicial, and Risk Management benefits. d. Actively promote adherence to the Code of Ethics. e. Enhance communication with members and non-members. f. Build student awareness of and interest in organized dentistry and membership in TDA. g. Ensure ongoing contact with students throughout dental school. h. Work closely with dental school faculty. i. Evaluate number of nonmember dentists who attend and participate in TDA activities (TEXAS Meeting, TDA Smiles Foundation programs, etc.).Metrics1. Seventy percent of active licensed dentists in TX will be members of TDA by 2009 (baseline of 68.5% in January 2007); increase

membership retention rate to 97 percent by April 2007 (baseline 96% in 2006). a-d. Increase the number of dentists serving on component peer review and ethics and judicial affairs committees to attain a

participation rate of 2-5 percent relative to the total number of component society members by August 2009.2. Ninety percent of TX dental school graduates actively licensed in TX will be members of TDA five years after graduation (89%

dental student conversion from the graduating class of 2005 in Texas).3. Increase the number of member dentists actively participating in TDA by 1 percent a year (as measured by a variety of means

– participation at TX Meeting, TMOM, TXDDS, FSI programs, DENPAC participations, TDA legislative day) with annual report to TDA Board by the Council on Membership.

4. Establish baseline of nonmember participation at TDA activities (CAS, TDA Smiles Foundation, Membership) 5. Established baseline of members’ understanding of and satisfaction with the benefits of their TDA membership through Member

Benefits and Services Survey (completed Nov 2006), re-evaluate % increase at that time for 2009.6. Sixty-five percent of all full-time faculty will be TDA members by 2009 (2006 baseline = 63%).

Mission: To be The Voice of DenTisTry in Texas

Manpower Advocacy OrganizationalExcellence

Public Image

Development Membership

The TDA will update it’s strategic plan with another statewide retreat in August of 2008.

In 2003, Texas Dental Association members from across the state develop TDA’s first strategic plan, TDA 2009.

The Public Image of the Texas Dental Association is … Howdidyoucompletethatsentence?OurpublicimageisoneofthemostimportantissuesfacingtheTDAtoday.Thefactisthatcreatingapositivepublicimageissomethingweallstriveforeverydayinourpersonallives,ourpracticelives,andinourdentalprofessionasawhole. Thepublic’sperceptionofourprofessionconsistentlyranksatthetopofourmember’sconcernsintherecentsurveysthatwehaveconducted.Asaresult,itisoneofthesevengoals(PublicImage)ofthestrategicplan,TDA2014.TherearefiveobjectivesofthepublicimagegoalinTDA2014,andtheycanbefoundintheirentiretyontheTDAwebsite.Byattainingtheseobjectives,theTDAhopesto:1)promotethedentistastheauthorityonoralhealth;2)educatethepublicabouttheimportanceoforalhealth;3)increaseawarenessaboutTDAcharitableservices;4)promotetheTDAmemberasavaluablememberofthecommunityand5)promotethecollaborativeeffortsoftheTDAwithotherhealthorganizations. Youcanimaginethedepthandcomplexityofthisissue,sotocontinuetheroadtraveledbyearlierleadersoftheTDA,yourFutureFocusCommittee(thecommitteechargedwithoverseeingtheimplementationoftheTDA2014)recentlyaskedoneoftheprinciplesofthePulsePointGroup(anAustin-basedcommunicationsmanagementconsultingfirm)toaddresstheTDABoardregardingthe“publicimage”oftheTDA. Whatwelearnedisthatnotonlyaretheremanynewwaysforustoreachouttoourmembers,ourpatientsandthepublicatlarge,butthatthebestwaytocommunicatewithsomeoneisstillpeertopeer.Howthatpeer-to-peercommunicationtakesplaceiswhathaschangedsodramatically.Theratherlivelydiscussionfocusedonthedramaticchangebroughtaboutbysocialmedia.“Socialmedia”istheumbrelladefinitionforFacebook,Twitter,MySpace,YouTube,etc.Haven’theardofthosewebsites?Alotofushavenotusedorevenheardofthis“socialmedia”phenomenon.However,ofthosewebsitesjustmentioned,Facebookalonehas400,000,000users.SocialmediaaretotheXandYgenerationswhatnewspaper,radio,andTVweretopreviousgenerations. HowdoesallofthisaffectthepublicimageoftheTDA?Whyshouldwebeinterestedinsocialmedia?ThedisseminationoftheinformationgatheredbytheTDAmightbemoreaccessibletoouryoungermembersthroughsocialmedia.WilltheTDAabandonthetraditionalmediumweusetocommunicatewithoneanother?No,wewillstillhavethoseavenues,butifwedon’tlookintoenhancingourpresenceinthesocialmediaarena,wemaylosedentistswhootherwisewouldbeproductivemembers.Astheoldsayinggoes,“Ifyouaren’ttheleaddog,theviewneverchanges”.

TDA Presents Award to Rep. Chuck Hopson Attheconclusionofeachlegislativesession,theTDABoardofDirectorsapproves“ExcellenceinPatientAdvocacyAwards”toselectlawmakerswhowereinstrumentalinassistingTDAwithitslegislativeagenda.TheTDAproudlyawardedTexasHouseRepresentativeChuckHopson(R-Jacksonville)anawardonFebruary22inJacksonville.Localdentists,electedofficials,andtheSpeakeroftheTexasHouseJoeStraus(R-SanAntonio)attendedtheevent. InadditiontosuccessfullycarryingTDA’sdentalassistantlegislationthroughthe81stLegislativeSession,Rep.Hopsonwassupportiveofnumerousbillsrelatedtooralhealthandmedicine.AsapharmacistinJacksonville,Rep.Hopsonknowsfirst-handthemanyissuesthathealthcareprovidersfaceonadailybasis. Theeventcameatapivotaltimeintheelectionprocess,just1weekbeforetheprimary.Rep.Hopsonfacedoppositionfromtwochallengersandtheawardceremonyproducedlocaltelevisionandnewspapercoverage.Rep.Hopsonwonhisprimaryracewithmorethan60percentofthevoteandwillreturnforasixthtermtotheTexasHouseofRepresentatives.

(L-R) Pictured are Speaker of the Texas House Joe Straus, Texas Rep. Chuck Hopson, recipient of the TDA “Excellence in Patient Advocacy Award,” and TDA president Dr. Matthew B. Roberts. Photo courtesy of the JacksonvilleDailyProgress.

TDA will promote a positive image of the profession of dentistryObjectives:1. Promote the dentist as the definitive

authority on all oral health issues to the public and the medical community.

2. Educate the public regarding the critical importance of good oral health.

3. Promote awareness of TDA-sponsored charitable services and increase public recognition of people who participate.

4. Promote the image of the TDA dentist as a valuable member of the community.5. Promote TDA’s collaborative efforts/

partnerships with other oral health organizations.

TDA 2014: An UpdateDr. R. Lee Clitheroe, TDA Future Focus Committee

TheTexasDentalAssociationhostedaStateStrategyConferenceMarch5-6,2010,attheOmniHotelindowntownAustin.Thisinitialconferencebroughttogether34representativesfrom14constituentassociationsto

exchangeapproachesandideasregardinglegislative,public,andinstitutionalstrategiesdesignedtopreservethedentist’sroleasheadofthedentalteamandprotectthefutureofdentistry. Allparticipantsagreedthatnow,morethanever,organizeddentistrymustpresentaunified,coordinatedapproachtoaccesstocarethatincludeseducatinglegislatorsandthepublicastowhyalternativeunsupervisedpracticemodelsarenotthesolutionforresolvingaccessissues. TheagendaincludedanexcitingpresentationbyDr.JamesCrall,AmericanAcademyofPediatricDentistryChildAdvocate—NationalOralHealthPolicyCenterUCLA2008.Headvisedtherepresentativestoacknowledgethesignificantdisparitiesinoralhealthstatusamongthepopulationanddevelopplansaimedataddressingthosedisparities.Healsosuggestedpromotingoralhealthservicesasessential,notoptional,healthservices. Overall,thisfirstofhopefullymanymeetingswasaresoundingsuccessandparticipantsleftknowingtheyhadanetworkofvaluableresourcesandopportunitiestoshapeoralhealthpolicyaboutthenationalandstatelevels.Theattendeesagreedthatorganizeddentistrymustleveragecollectiveresourcestostrengthenthepracticeenvironmentfortheprofessionandensurethebestpossibledentalcareforthepatient.

(L-R) Kansas Dental Association president-elect Dr. David Hamel, Georgia Dental Association Patient Protection Task Force chair Dr. Ty Ivey, and Illinois State Dental Society president-elect Dr. Darryll Beard.

(L-R) Georgia Dental Association president Dr. Kent Percy, Indiana Dental Association president Dr. J. Mark Thomas, and TDA past president Dr. Hilton Israelson.

(L-R) Mississippi Dental Association ADA delegate Dr. James Russell Dumas, Louisiana Dental Association president-elect Dr. Eddie Hebert, and Louisiana Dental Association governmental affairs chair Dr. Bill Hall.

TDA Hosts a Successful State Strategy Conference

(L-R) Delaware State Dental Society (DSDS) president Dr. Sharon W lsh, DSDS past president Dr. Charles Calhoon, and Alabama Dental Association president-elect Dr. Deborah Bishop.

TDA 2014 Public Image Goal

e

Fluoride Fest Lampasas Yields Flying Colors and Big Smiles All AroundHundredsofchildrenfromtheLampasasIndependentSchoolDistrictattendedtheTDASmilesFoundation’s(TDASF)FluorideFestinLampasaslastmonth.

Th eevent’sgoalwastoeducatethecommunity’syoungestmembersonthecorrelationofgoodoralhealthandoverallsystemichealthandtocommunicatethebenefitsofpublicwaterfluoridationtocommunityleaders.

Th eLampasaskindergartenersthroughsecondgradersmadetheirwaythroughFluorideFest’sfivestations,whichincludedsomecomponentsoftheUnitedWaysofTexasCavityFreeCorralcurriculum:

1. SaddlebagSnacks:Healthysnacksandfluoridatedbottledwaterwereavailable;2. PlaqueRound-Up:Squirtinganimalpuppetswithhumanmouthsanddentalhygienepuppeteerstaught

properbrushingandflossingtechniques;3. PrairieTattleteeth:Handmirrorsandcoloringsheetshelpedchildrenidentifytheirprimarydentition;4. FitnessRodeo:Physicalfitnessdisguisedasactiveplaytaughtthelessonsofmaintaininghealthybodies;5. FluorideandExams:Drs.BeverlyB.ZinserofGeorgetown,BarryJ.CurreyandW.KurtLoveless,bothof

Lubbock,VincentIpofAustin,andJayElderofLampasasexaminedparticipants,orderedtopicalfluorideandsealanttreatments,andsenthomenotessuggestinghygieneandrestorativecarethatcouldbeprovidedthefollowingdayattheSmilesonWheelsevent.

WantaFluorideFestinyourcommunity?Ifyourcommunity’swaterisnotactivelyfluoridatedandhasaless-than-idealnaturallyoccurringfluoridationlevel,contacttheTDASFattdasf.org.

March 2010 / TDA Today / 2

Happy, Healthy Smiles …

That’s Our Mission!TDASF Partners with the Capital Area Dental FoundationAsanobjectivetothePublicImagegoalontheTDA2014StrategicPlan,theTDASFischargedwiththepromotionofcollaborativeeffortsandpartnershipswithotheroralhealthorganizations.

Th us,TDASFformedapartnershipwiththeCapitalAreaDentalFoundation(CADF).Th roughgrantfundingfromtheRGKFoundationofAustin,CADFlaunchedaninitiativetoservetheelderlyandpermanentlydisabledpatientbaseintheirarea.Asaresult,MissyQuintana,aCADFpart-timeemployee,willmanagetheTDASF’sTexasDonatedDentalServicescasesforWilliamson,Travis,Hays,BurnetandBastropCounties.

Th egoalsfortheCADFprogramaretorecruitdentistsforprogramparticipationandeliminatethewaitlistforthearea.Th eprogramalsoaidsthefoundationgreatlyasfivecountieshavenowbeenremovedfromthe254countiesstatewidethatasingleTDASFcaseworkermanages.

Missy’sbackgroundincludesextensivecaseworkexperienceinElPasoandMaryland.SheandherhusbandJay,alongwithherdaughtersSydneyandTyler,relocatedtoAustinforJay’scareerwithCornerstoneHospital.

Access to Care UpdateAtlastmonth’sSmilesonWheelsLampasas,TDASF’smostrecentmissionevent,dentistvolunteerssaw150patientsandprovidedmorethan$94,000incharitabledentistry.

TDASF’snextstopisTylerforthesixthTexasMissionofMercy(TMOM)forthatarea—andthelandmark20thsincetheprogram’sinception!

TMOMTylerwillbeexecutedinthe“distributedstyle,”utilizingalargegroupofvolunteerdentists’officestobeusedinplaceoftheTDASF’sportabledentalequipment.AsmallportableclinicwillbeerectedinthestyleofaSmilesonWheelsevent.

Pleasejoinwithusattdasf.org.

Alliance to the ADA Provides Dental Health Books to San Antonio LibrariesMs. Cindy Bates, District 8 Trustee, Alliance to the ADA

Th eAlliancetotheAmericanDentalAssociation(AADA)District8TrusteeMs.CindyBatesofSanAntoniodonated20copiesof“Ready,Set,Brush”fordistributionthroughouttheSanAntonioPublicLibrarysystemtopromotegoodoralhygiene.

“Ready,Set,Brush”isapre-schoollevel,SesameStreet-themedbookthatillustratestheelementsofgoodoralhygiene.BysubmittingagrantrequesttotheAADA,Ms.Batesreceivedthebooksfordistributioninpublicandschoollibrariesaspartoftheorganization’snationaldentalhealthoutreachprograms.

Inadditiontodonatingthebooks,Ms.BatesandmembersoftheAlliancetotheSanAntonioDistrictDentalAssociationperformedaSesameStreet-themedpuppetshowanddistributedchildren’stoothbrushes.

Pictured are San Antonio Central Library children’s services coordinator Ms. Viki Ash, her grandchildren Carlos and Iris Bernal, and (right) AADA District 8 Trustee Ms. Cindy Bates.

Missy Quintana, Capital Area Dental Foundation

April 15 – 17Please join the TDASF at the Star of the South’s “Reaching New Heights” 24-foot climbing wall in the exhibit hall!

Dr. Barry J. Currey, a Lubbock pedodontist, clowns around with a child at Fluoride Fest in exchange for a thorough oral exam.

Dr. Vincent Ip of Austin

participated in Fluoride Fest as a

fi rst-time volunteer.

TDA Member Visits HaitiDr. Manny Carrasco Helps Earthquake VictimsNicole Scott, Managing Editor

Periostealelevator.Orthopedicrongeur.Hemostats.

Th osearetheonlydentalinstrumentsDr.Manuel“Manny”C.CarrascoofOdessacouldgathertoperformdentalextractionsinHaitilastmonth.

Hewasn’tsurewhattoexpect,buthewascertainthathecouldprovidehelptoHaiti’searthquakesurvivors.

Dr.Carrasco,alongwitharegisterednurse,acertifiedregisterednurseanesthetist,andhispastorformedamedicalteamofvolunteersfromtheMid-CitiesCommunityChurchinOdessa,equippedwithonlytheirskillsandasmallamountofsupplies.

“Wehadtwomissions,”saysDr.Carrasco.“Donoharm.Takecareoftheirimmediateneeds.”

Th reeweeksafterJanuary’s7.0magnitudequake,thevolunteersflewtoHaitionasmallprivateairplanepilotedbyaTampa,Florida,businessmanwhogotwindoftheirmission.Th eycircledthePort-au-Princeairportfivetimestoallowforincomingandoutgoingmilitaryflights.Oncetheylandedthesceneonthegroundwasdevastating.

“Itlookedlikewar-timeattheairport,”saysDr.Carrasco.“Yougothroughcustomsandseeallthesepeoplewithsignssaying,‘Food,’‘Water,’‘Money.’Itwasjustchaos.”

Peoplegrabbedatthem.“Th eywereinsurvivalmode,”hesays.Th egroupheadedtotheirhostchurch,GeraldBatailleMinistries,whichalsohadtheonlywaterfilteringsystemforthatlocal,batteredcommunity.

Fromthere,theywenttowhatwasleftofthePort-au-PrinceGeneralHospital,thegroundsofwhichservedasastagingareaforemergencyrelief.

Afterwalkingthroughthegatesofthehospitalgrounds,theamountofpeoplewaitingforemergencyhelpstunnedhim.“Iwasshocked.Icouldn’tgraspthat.”

Internationalmedicalandemergencyvolunteerswereusingpartsofthehospitalnotdestroyedinthequake.“Intheoperatingrooms,surgeonswereusingjustheadlights.Triagetentsweresetupoutsidebecausetheydidn’tknowhowstablethebuildingwas.”

Dr.Carrascowalkedintooneofthenumberedtriagetentsandsaid,“Who’sincharge?”Operatingonafirst-namebasis,Dr.GenefromRussiahelpedhimsetupshop.Dr.Carrascowasnow“Dr.Manny.”

For5days,anestimated900peoplecamethroughhismedicalrelieftent.Itwasa“conveyerbeltofpatients,”Dr.Mannysays.And,theinjuredkeptcoming.Cuts,scrapes,amputations,crushinginjuries.“You’dlookout(atthecrowd)andjuststartworking.”

Heperformedonlyahandfulofdentalprocedures—aboutfiveextractionsandremovalofalargemass.Withoutmodernconveniencesofpanographsorsuction,theproceduresweremadeevenmoredifficultwiththelanguagebarrier.TranslatorshelpeddeciphertheHaitianFrench-Creolelanguage.

To see more pictures and read the rest of the story about Dr. Carrasco’s experience in Haiti, please visit the Current Issues section on tda.org.

Dr. Manny Carrasco of Odessa performs a tooth extraction on a patient in Haiti.

A man carries a coffi n down the street in Port-au-Prince, Haiti.

Dr. Manny hugs a 5-year-old patient whose resilience and strength was an inspiration, he says.

TDA Member Inducted Into Health Clinic’s Honor Society

Dr.DavidF.NicholsofTylerwasinductedintoBethesdaHealthClinic’sDoctorLukeSocietyinTylerlastmonth.

Dr.Nicholsisthefirstdentisttobeinductedintotheprestigioussociety,formedtohonormedicalprofessionalswhodemonstrateacaringspiritandreachouttothosewhocannotaffordadequatemedicalcare.

Th eBethesdaHealthClinichastreatedmorethan12,000peopleandhadmorethan18,000volunteerhourslastyear.

Inductionsresultfromasponsorshipdonationof$25,000tothesociety.Sponsorsincludefriendsandfamilymembers,aswellaslocalhospitals,clinics,foundations,andbusinesses.

Dr. Nichols

March 2010 / TDA Today / 3

Th eMarchprimaryelectionsareinthebooks.Asyouknowbynow,GovernorRickPerrywonwithoutarunoffandwillfaceBillWhiteintheNovembergeneralelection.Weunfortunatelylosttheonlydentistinthelegislature,Dr.YbarraRios,whowasunabletowinagainstherprimaryopponentandwillnotreturntoAustinforhersecondtermnextJanuary.

Latelastmonthyourleadership,alongwithourdirectoroflegislativeaffairsandoutsidelobbyists,presentedTexasRepresentativeChuckHopsonhis“ExcellenceinPatientAdvocacyAward”inJacksonville.District3PresidentMikeHatchettdidagreatjoborganizingmemberattendanceattheluncheonhonoringRep.Hopson.SpeakeroftheTexasHouseJoeStrausalsoattendedandcommentedontheturnoutandsupportforRep.Hopsoninhisre-electionbid.Rep.Hopsonhasbeenagreatfriendofdentistry,andwelookforwardtoworkingwithhimagaininthecomingsession.

YourTexasDentalAssociationhostedthefirstStatesStrategyConferencethethefirstweekendinMarch.Pleasereadtheaccompanyingsummaryofthemeetingforfurtherinformationonwhattookplace.Myhopeisthat,fromthisbeginning,amultitudeofideasandstrategiescanbedevelopedandimplementedtothwartanyoutsideinterferencestowhatweinTexasbelieveisthebestwaytosolvetheaccesstocareissuesweface.

Asmyyearwindsdown,Ihopethatthecommunicationseffortsandtheabilitytodisseminateinformationhavebeenacceptable.Websites,Facebook,Twitter,theTexas Dental Journal,andthispublicationhaveallbeenutilizedinanefforttoreachasmanypeopleaspossible,withthelatestinformation,inastimelyamannerascanbeaccomplished.Th isisnotastaticfieldinwhichwelive,andcontinualimprovementswillbeexaminedinanefforttocommunicatequickly.So,untilnextmonth,enjoythearticlesandstay“IntheLoop”.

In The Loop

Matthew B. Roberts, DDS, TDA President 2009-2010

It’s Almost Here … Make Plans Now for the 2010 TEXAS Meeting Th eTDACouncilonAnnualSessionencouragesTDAmemberstomakearrangementsnowtoattendTh eTEXASMeeting,140thAnnualSessionoftheTexasDentalAssociation,scheduledMay6-9,2010,attheHenryB.GonzalezConventionCenterinSanAntonio.

REGISTERTODAY—AvoidadditionalonsitefeesandreceiveyourmaterialsinadvancebyregisteringbeforeApril6,2010.Registeronlineattexasmeeting.com.

HOTELRESERVATIONS—Don’tdelaybookingyourhotelroom,theApril6,2010,deadlineisquicklyapproaching.Takeadvantageofthesespecialhotelrates.MakeHotelReservationsonlineattexasmeeting.com.

CEVERIFICATION—Th eTEXASMeetingwillmeetallofyourcontinuingeducationneeds.Attendeescanearnupto18hoursofcontinuingeducationwithin3days.VerificationCertificatesareavailableonsiteorelectronicallyfollowingthemeeting.ONE-STOPSHOPPING—Th e2010ExhibitHallpromisestobethebiggestandbestever.Takeadvantageofspecialpricingonthelatestsuppliesandservicestoenhanceyourpractice.

WelookforwardtoseeingyouinSanAntonio!

For additional information, please visit texasmeeting.com or call the TDA Annual Session staff at (512) 443-3675.

ComplicationsofTonguePiercing

IamstilltakenabackwhenIseemetaljewelryinthetongue.Maybethisisanattractiveadornmenttosome,butitconcernsmetothinkaboutthepotentialpostplacementandlong-termcomplications.

PublishedarticlesonthesubjectreinforcemyconcernsandIhavelistedafewstatementsfromthescientificliterature.Fortheinterestedreader,PubMedIDentificationnumbers(PMID)areprovidedforeacharticletofacilitatesearchingpubmed.gov.Aftercallinguppubmed.gov,enterthePMIDnumberinthesearchboxandyouwillbetakendirectlytotheabstract(ifavailable)ofthearticle.

Th efollowingareexcerptsfromtheliterature:

“Th eprevalenceoforalpiercingrangedfrom3.4percentto20.3percent.Immediatepost-operativecomplicationsreportedwereswellingand/orinfections(24%-98%)painortenderness(14%-41%)(PMID17993034)(1).”

“ApatientwithLudwig’sangina,secondarytotonguepiercingispresented”(PMID9062002)(2).”

“Intraoralpiercingandtonguejewelryplaceathletesatgreaterrisk(ofinjury)whencompetingwithmouthguardsinplace.Allbodyjewelryshouldberemovedinsportingevents(PMID12004711)(3).”

“Wedescribeapreviouslyhealthyadultwhohadasolitarycerebellarbrainabscess…diagnosed4weeksafterthetonguepiercingprocedure(PMID12522766)(4).”

“Wepresentthecaseofa27-year-oldmanwitharecenttonguepiercingandinfectiveendocarditisoftheaorticvalve.Hewastreatedwitha6-weekcourseofintravenousantibioticbuteventuallyrequiredaRossprocedureforprogressiveaorticinsufficiency(PMID15961010)(5).”

“…sideeffects(oftonguepiercing)areassociatedwithintraoralpiercing,includingpain,swelling,infection,gingivaltrauma,chippedorfracturedteeth,increasedsalivaryflow,calculusbuildup,andinterferencewithspeechandswallowing.Wepresentacasereportofperiodontaltreatmentoftraumatizedgingivaltreatmentcausedbyatonguestud(PMID16300253)(6).”

AlsotakealookatPMID19822789andPMID17517312.Icouldonlyfindthetitles:“Multiplebrainabscessesassociatedwithtonguepiercing”and“Th rombophlebitisofthesigmoidsinusaftertonguepiercing:acasereport”(7,8).

So,althoughrare,seriousmedicalcomplicationscanoccurassociatedwithtonguepiercing,andwecouldinformourpatientsaccordingly.

References1. LevinL,ZacikY.Oralpiercing:complicationsandsideeffects.AmJDent2007Oct(5):340-4.2. PerkinsCS,MeisnerJ,HarrisonJM.Acomplicationoftonguepiercing.BrDentJ1997Feb22;182(4):147-8.3. McGearySP,Studen-PAvlocichD,RanalliDN.Oralpiercinginathletes:implicationsforgeneraldentists.GenDent2002Mar-Apr;50(2);168-72.4. MartinelloRA,CooneyEL.Cerebellarbrainabscessassociatedwithtonguepiercing.ClinInfectDis2003Jan15;36(2):e32-4.Epub2003Jan3.5. LickDS,EdozieSN,WoodsideKJ,ContiVR.Streptococcusviridensendocarditisfromtonguepiercing.JEmergMed2005Jul;29(1):57-9.6. ChoeJ,AlmasK,SchoorR.Tonguepiercingasariskfactortoperiodontalhealth.NYStateDentJ2005Aug-Sep;71(5):40-3.7. HerskovitzMY,GoldsherDetal.Multiplebrainabscessesassociatedwithtonguepiercing.ArchNeurol2009Oct;66(10):1292.8. NicolasJ,SoubeyrandEetal.Th rombophlebitisofthesigmoidsinusaftertonguepiercing:acasereport.JOralMaxillofacSurg2007Jun;65(6):1232-4.

Evidence-Based Practice Tip of the Month

Stephen R. Matteson, DDS, Editor

New Money-Saving Perks Programs Th eTDAFinancialServices,Inc.Boardapprovedfournewmoney-savingprogramsforTDAmembersatitsFebruary19meetinginAustin.JLTEnergyConsultantswillqualifyTDAmemberdentalofficeslocatedinderegulatedareasforlowerelectricitypricetiers.LifeGas(replacingtheAirGasprogram)nowoffersTDAmembersdiscountedratesonmedicalgases.LifeGas’excellentdeliveryserviceisavailabletomostTDAmembers.LOGIXCommunicationsnowoffersTDAmembers$500offthe$1,000installationfeeonitsDirect-TSolutions(T-1)bundledproduct,whichincludes:localandlong-distancephoneservices;Internet,e-mailandwebhosting;voicemail,fax-to-e-mailservicesandmore.Th eReynoldsCompanyspecializesinestablishingnewdentaloffices,andwillassistTDAmembersfreeofchargewithallphasesofrealestateconsulting.FormoreinformationontheseandmanyothervaluablePerksprograms,ortoreceivePerks’e-newsletters,visittdaperks.com,orcall(512)443-3675.

TDA Welcomes New Staff

KristenPonderjoinstheTDASmilesFoundationteamastheTexasDonatedDentalServiceprogramassociate.SheiscurrentlyattendingAustinCommunityCollegetopursueadegreeinaccounting.She

currentlylivesinSouthAustinwithherhusbandJoseRamos,Jr.,andtheirsonXavier.

Dr. Xochitl Anderton Named Geiger Gibson Emerging LeaderLubbock dentist is fi rst in profession to receive national award

Th eGeigerGibsonPrograminCommunityHealthPolicyatTh eGeorgeWashingtonUniversitySchoolofPublicHealthandHealthServicesnamedDr.XochitlAndertonofLubbockarecipientofitsEmergingLeaderAwardinWashington,D.C.lastmonth.

Dr.Anderton,thedentaldirectorattheCommunityHealthCentersinLubbock,receivedtheawardforextraordinaryserviceandleadershipinclinicalmanagement.

Sheisthefirstdentisttoreceivethisdistinguishedaward,whichwaspresentedatthe6thannualsymposiumattheNationalAssociationofCommunityHealthCentersPolicyandIssuesForum.

Establishedin2007,theEmergingLeaderawardhighlightsanewgenerationofhealthcenterleaders.Oneormorerecipientsareselectedannually.

For only $10 per employee/year, your staff can become TDA Team Members. TEAM membership gives your staff access to many of the benefi ts you enjoy as TDA members through the Perks Program. Download the TEAM-membership application form from the “Valuable Resources” page at tdaperks.com. Questions? Contact TDA Perks Program at (512) 443-3675. Going to the TEXAS Meeting in May? Stop by the TDA Pavilion and register your staff. While you’re there, don’t forget to register to win a Dell laptop. Your staff can enter to win, as well!

InsuranceAnsw

ers

Your Sta� CanHave Perks, too. MARCH 2010 VOLUME 11, ISSUE 3 AVAILABLE ONLINE AT TDA.ORG

EDITORIAL STAFFDr. Stephen R. Matteson, D.D.S., Editor

Nicole Scott, Managing EditorBarbara S. Donovan, Art DirectorPaul H. Schlesinger, Consultant

BOARD OF DIRECTORS

Matthew B. Roberts, D.D.S., PresidentRonald L. Rhea, D.D.S., President-Elect

Hilton Israelson, D.D.S., Immediate Past President Vice Presidents

Craig S. Armstrong, D.D.S., SoutheastJohnny G. Cailleteau, D.D.S., Southwest J. Brad Loeffelholz, D.D.S., Northwest Arlet R. Dunsworth, D.D.S., Northeast

Senior DirectorsR. Lee Clitheroe, D.D.S., Southeast

John W. Baucum III, D.D.S., Southwest Kathleen Nichols, D.D.S., Northwest Donna G. Miller, D.D.S., Northeast

DirectorsKaren E. Frazer, D.D.S., SoutheastLisa B. Masters, D.D.S., Southwest

Robert E. Wiggins, D.D.S., Northwest Larry D. Herwig, D.D.S., Northeast

J. Preston Coleman, D.D.S., Secretary-TreasurerGlen D. Hall, D.D.S., Speaker of the HouseMichael L. Stuart, D.D.S., Parliamentarian

Stephen R. Matteson, D.D.S., EditorMary Kay Linn, Executive DirectorWilliam H. Bingham, Legal Counsel

TDA Today (USPS 022-007) is published monthly except for December by the Texas Dental Association, 1946 S. IH-35, Ste 400, Austin, Texas 78704-3698, (512) 443-3675. Periodicals Postage Paid at Austin, Texas and at additional mailing offices.POSTMASTER: Send address changes to TDA TODAY, 1946 S. IH-35, Ste 400, Austin, TX 78704-3698.Annual subscriptions: Texas Dental Association (TDA) members, $5. In-state American Dental Association (ADA) affiliated, $15 + tax. Out-of-state ADA affiliated, $15. In-state non-ADA affiliated, $30 + tax. Out-of-state non-ADA affiliated, $30.Single issue price: TDA members $1. In-state ADA affiliated, $3 + tax. Out-of-state ADA affili-ated, $3. In-state non-ADA affiliated, $6 + tax. Out-of-state non-ADA affiliated, $6.Contributions: Manuscripts and news items of interest to the membership of the Associa-tion are solicited. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. Please refer to Instructions for Contributors in the annual September Directory of the Texas Dental Journal for more information. The Information for Contributors is available at tda.org. Every effort will be made to return unused manuscripts if a request is made but no responsibility can be accepted for failure to do so. Anonymous communi-cations will receive no consideration whatsoever. All statements of opinion and of supposed facts are published on authority of the writer under whose name they appear and are not to be regarded as the views of the Texas Dental Association, unless such statements have been adopted by the Associa-tion. Articles are accepted with the understanding that they have not been published previously.

aade

TSBDE Rule UpdateThis recurring section is designed to help TDA members keep up with important Texas State Board of Dental Examiners (TSBDE) rules, other regulations, and state law affecting their practices.

Question:DoIneedtotakeapatient’sbloodpressureorpulsemeasurementeverytime thepatienthasanappointmentatmydentaloffice?

Answer:TSBDERule108.7(2)(B)statesthattheinitiallimitedphysicalexaminationshouldinclude,butshallnotnecessarilybelimitedto,bloodpressure,andpulse/heartrateasmaybeindicatedforeachpatient.TheTSBDEhasdeterminedthattheminimumstandardofcarerequirestherecordingofatleastaninitialbaselinebloodpressure/pulsereadingduringtheinitiallimitedphysicalexaminationofadentalpatient.ThedentalpractitionershouldalsorecordbloodpressureandpulseheartrateasindicatedforinvasiveproceduresandasrequiredbyBoardrulesregardingproceduresinvolvingsedationandanesthesia.

Ifthedentalpractitionerisunabletoobtainapatient’svitalsigns,thedentalpractitionermustdocumentinthepatient’srecordanacceptablereasonwhytheattempttoobtainvitalsignswasunsuccessful.Also,pleasenotethatbloodpressureandpulsemeasurementneednotbetakenonapatientthatis12yearsofageoryoungerunlessthereisaspecificmedicalneed.

FormoreinformationcontactTDApolicymanagerDianeRhodesat(512)443-3675ordiane@tda.org.

Medicaid UpdateAsaTexasMedicaidprovider,theHealthandHumanServicesCommission(HHSC)isinterestedinanyideas,issues,concerns,orsuggestionsyoumayhaveaboutTexasMedicaid.Tothatend,HHSCisexcitedtointroduceyoutotheIMPROVE(InteractiveMedicaidProviderVoice)system.ItwasdevelopedtoutilizetheknowledgeandexperiencesofMedicaidproviderstoimproveMedicaidandaccesstocareforMedicaidpatients.

TheIMPROVEsystemallowsproviderstopinpointsystemicissueswithintheMedicaidprogramandoffersuggestedresolutions.

SomeoftheadvantagestoaccessingIMPROVEinclude:• OpportunitytoincorporatefreshproviderideasandinnovationintoMedicaid.• IncreasesaccesstocareforyourpatientsthroughimprovedMedicaidproceduresandpolicies.• PotentialforincreasedproviderparticipationandsatisfactionwithMedicaid.• AbilitytointeractdirectlywithMedicaidandreceiveanswersfromMedicaidpersonnelwell-versedintheareaofyour concern.• AllowsHHSCtoaddressyourissuesandconcerns.

UsingtheIMPROVEsystemiseasy.Youwillsimplyneedyournationalprovideridentifier(NPI)number.Togetstartedgotohttp://www.hhsc.state.tx.us/medicaid/improve.html.