VOL. 86 NO. 1 WINTER 2007 TerraFirma, your HR Department that feels like it’s down the hall!...

VOL. 86 NO. 1 www.cdaonline.org WINTER 2007

CDA Editorial Board

Editor-in-ChiefJoseph C. Tomlinson, D.M.D.Director of Communications,

Managing EditorMolly M. Osberg

CDA EXECUTIVE COMMITTEEDr. Rhett Murray

PresidentDr. Jeanne Salcetti

President-ElectDr. Jeffery Hurst

Vice PresidentDr. Pasco Scarpella

TreasurerDr. Dave Lurye

SecretaryDr. John Hanck

Immediate Past PresidentDr. Kevin Sessa

Speaker of the HouseGary CumminsExecutive Director

BOARD OF TRUSTEESDr. Robert Morrow Arkansas Valley

719/324-5251, fax 719/324-5621

Dr. Gerald Savory Boulder/Broomfield County

303/530-4145, fax 303/530-9620Dr. Cal Utke Colorado Springs

719/593-8701, fax 719/593-9258

Dr. Rob Yardumian Intermountain719/687-9011, fax 719/687-3919

Dr. Tom Pixley Larimer County970/221-5115, fax 970/221-5136

Dr. Ken Peters MDDS303/791-2570, fax 303/683-4198

Dr. J. Scott Hadley Northeastern970/521-7267, fax 970/521-7203

Dr. Brian West San Juan Basin970/259-5600, fax 970/247-2820

Dr. Stephen Schiffer San Luis Valley719/589-4946, fax 719/589-4949

Dr. R.J. Schultz Southeastern719/542-0036, fax 719/544-6777

Dr. Robert Benke Weld County970/356-2120, fax 970/356-1013

Dr. David Nock Western970/242-4433, fax 970/256-7671

Cynthia Packard, RDH ADT Liason719/324-5251, fax 719/324-5621

USPS 661730 ISSN 0010-1559Journal of the Colorado Dental Association (ISSN 0010-1559) ispublished quarterly by the Colorado Dental Association, 3690 S.Yosemite St., Ste. 100, Denver, CO 80237-1808. Annual subscriptionrates: CDA members included in dues; Non-members US – $35;Other countries–$45. Periodical postage paid at Denver, Colorado,and additional offices. Single copy is $10 in the USA.POSTMASTER: Send address changes to: Journal of the ColoradoDental Association, 3690 S. Yosemite St., Ste. 100, Denver, CO80237-1808.Articles for publication, correspondence, and advertising should beaddressed to: Managing Editor, Journal of the Colorado DentalAssociation, 3690 S. Yosemite St., Ste. 100, Denver CO 80237-1808. 303/740-6900 or 800/343-3010.The Journal reserves the right to reject any advertising and, as amatter of policy, does not accept advertising of any product classifiedby the American Dental Association Council on Dental Therapeuticsas unacceptable.Advertisements: For advertising rates and specifications call303/740-6900 or 800/343-3010.Contributions: Neither the Editors nor the Colorado Dental Associationare in any way responsible for the articles or views of contributorspublished on these pages.The Journal of the Colorado Dental Association is a peer-reviewedpublication.

©2006 Colorado Dental Association. All Rights Reserved.

VOL. 86, NO. 1 Journal of the Colorado Dental Association 5 ■

6 A New Captain of the Ship for CDAPublicationsBy Joseph Tomlinson, D.M.D.

8 Ascent BenefitsCompanyBy Rhett L. Murray, D.D.S.

9 Ascent Board ofDirectors

10 Ascent Providers Chart

11 Ascent ProvidersDirectory

18 New EmployeeVerification ProcessRequirement By Stacy Jensen

19 February: NationalChildren’s Dental HealthMonth

21 2007 Annual Poster andColoring Contest

23 New Advertising RulesAdopted by State BoardBy Edward F. Rosenfeld, D.M.D.,M.S., CDA Ethics CommitteeChair

24 Monitoring How YourPractice is Really DoingBy Janet and Lawrence Steward

26 Bisphosphonate RelatedOsteonecrosis of theJaws: Report of TwoCasesBy Gregory R. McGee, D.M.D.and Richard D. Zallen, D.D.S.,M.D.

32 Classifieds

JournalC O N T E N T S

Vol. 86, No. 1 www.cdaonline.org Winter 2007

OF THE COLORADO DENTAL ASSOCIATION

PRINTED ON RECYCLED PAPER

About Our Cover:

Join Colorado’s newest

dental benefits company—

50% owned by CDA

Enterprises, Inc.

303/996-2848 or

800/343-3010 x108.

Publication Member of the AmericanAssociation of Dental Editors

6 ■ Journal of the Colorado Dental Association WINTER 2007

E D I T O R I N C H I E F

By the time youread this, it

will be the start of anew year and almosttime for the 2007MDDS RockyMountain DentalConvention. I can’tthink of a better timefor my openingcolumn as your newCDA editor. It is withgreat pleasure that I

begin my duties as editor and workingwith our experienced Managing EditorMolly Osberg. I have come to know her asa well-organized and cheerful person towork alongside.

To begin, I commend my predecessor,Dr. Pasco Scarpella, for the approach hehas taken to discuss and present a morepersonal side of dentists and dentistry. Inmy opinion, he has written a number ofexcellent columns over the past severalyears, and I hope to write my columnsevery bit as interesting. I intend to

continue along a similar thread as Dr.Scarpella, sharing the positive effortsdentists make to improve the field ofdentistry, their personal and family lives,and the lives and health of their patientsand staffs.

While there seems to always be manychallenging issues facing the dentalprofession that create negative energy inour lives, I intend to draw attention to thepositive energy and actions that dentistsbring to confront these issues in an effortto achieve solutions and resolution of theissues we face. By focusing on thepositive efforts dentists make to resolveissues, and by drawing some attention tothe positives of the issues themselves –we can find the silver lining in anotherwise “dark cloud.”

I encourage each of you to submit yourideas and views on various issues ofinterest to you to the Journal. After all, thisis your Journal, and we welcome inputfrom all of our members. One group Iespecially encourage comments from is thedentists under 39 years of age who are lessthan five to 10 years out of dental school.

As the father of a dentist in that category, Iam interested in hearing what dentists inthat age group have to say about dentistryand its future. Your comments arewelcomed, regardless of how new you areto the profession, or how experienced.Write now, and write often.

Another suggestion I have for those inthe early years of practice —volunteer toserve as a delegate to represent yourcomponent society at the annual CDAmeeting in June. The meeting is moreabout camaraderie and friendship than itis about politics. You will meet many finedentists from around the state and buildsome excellent ties to one another. Youwill hear interesting speakers, and enjoygreat food and entertainment. The lodgingis affordable and located in some greatvacation destinations. The professionneeds a continual infusion of new energyand enthusiasm, and new ideas to shareand discuss, so don’t be shy aboutvolunteering to become a delegate. If allthe slots are taken, there is always a needfor alternate delegates.

I volunteered to be a delegate in my firstor second year of practice and was giventhe opportunity to fill a slot right away. Ididn’t have enough confidence to speak onthe floor about any issues at the time, butless than a dozen delegates ever do standup and speak on an issue. The otherdelegates serve to listen, digest, weigh thecomments pro and con, and vote. No realstress, but a big confidence builder.

I served as a delegate for a few yearsuntil family sports activities (mostlyswimming and diving meets) began to

A New Captain of the Ship for CDA Publications

By Joseph Tomlinson, D.M.D.

Dr. JoeTomlinson is ageneralpractitioner inFort Collins,Colo.

Practice dentistry – not Human Resources!Hire TerraFirma, your HR Department that feels like it’s down the hall!

TerraFirma is a Professional Employer Organization (PEO). We administer all of yourHR functions including payroll and worker’s compensation, keeping you in complianceand enabling you to focus on your dental practice. When employers partner with Terra

Firma they are provided with services including:

The plans we offer are those only Fortune 500 companies can obtain. Let Terra Firma’s staff of HRprofessionals handle your employee administration so that you can focus on your dental practice.Call Monica Denler at 720.974.7823 to learn more about our customized plan available exclusivelyfor CDA members. Visit us at: www.hrvp.com.

• Human Resources Counsel• Payroll Processing and Tax Administration• Risk Management and Safety Training• Legal and Regulatory Compliance


conflict and became our main priority.However, in more recent years, whenthose activities were no longer a part ofour daily life, I returned to serving as adelegate, once again.

Encourage your spouse or significantother to be involved in CDA meetings, aswell. Dot, my wife of 39 years, hasenthusiastically attended all of the CDAannual meetings that I have attended. Wewill be celebrating our 40th anniversaryless than a week before the CDA meetingin June. In fact, her interest and enthusi-asm in attending has usually exceeded myown. She has always encouraged me tocontinue as a delegate, even when I wasless interested in doing so. The reason forher level of interest is that she was alwaysan active participant. In the early years,she was active in a dental spouses group,and was asked to become an officer. Sheaccepted that task. Before long, she wasthe vice-president for this organizationand was slated to become president-elect

when we made the decision to give ourpriority to our children and their activities.

Now when we attend meetings, it isagain a family affair with my daughter, Dr.Kathy Tomlinson, often attending for atleast a part of the meeting. She is usuallythere to attend the alumni parties for theCU Dental School alums, to swap storieswith classmates and other dentist friends,and to take in a little recreation anddining at popular restaurants. Mydaughter, Patty Johnson, and her husbandDennis also attended the last meetingheld in Vail. We all had a great timetogether at that Annual Session.

One theme Dr. Scarpella wrote about inhis final editorial was “closing the circles.”Becoming your new editor closes a bit ofa circle for me, or at least continues anarc of a circle that began many years agoin high school. My first involvement as awriter was for my high school newspaperin Eden Prairie, Minn. My older sister,Sue, had been a writer and editor of thepaper for three years and encouraged me

to follow her path by writing articles forthe sports section of the paper. It was aneasy assignment since I was activelyinvolved in most of the sports our schooloffered, so I knew what was happeningfrom a participant’s viewpoint. My senioryear, I served as editor and columnist forthe sports section, and was honored andrecognized for my work with the Out-standing Journalism Award.

In my next column, I’ll share a fewcomments about issues and topics behindmy more recent writings, and what led meto become your editor. It is those issuesand my published opinions about them,particularly about the fluoridation issue,that have led my friends, colleagues andfamily members to encourage me to stepforward to replace Dr. Scarpella as editor.I hope you enjoy what I have to say inupcoming columns. In the meantime, besure and participate in, and enjoy, theupcoming Rocky Mountain DentalConvention! ■


I N S U R A N C E

After almost twoyears of hard,

tenacious work, it’sfinally a reality. AscentBenefits Company, Inc.is alive and in themarketplace, working

on behalf of patients, employers anddentists in Colorado. On Dec. 15, 2006,Ascent Benefits Company received theapproval of its license application fromthe Division of Insurance. Ascent BenefitsCompany began selling dental plans toemployers on Jan. 1, 2007.

The Colorado Dental Association,through its subsidiary, Colorado DentalAssociation Enterprises, Inc. (CDAE),partnered with Southwest BenefitsAdministrators, LLC to form AscentBenefits Company. This new company willcompete in the Colorado dental insurancemarket providing the following services:Direct Reimbursement, AdministrativeServices Only (for self-funded plans that

employers want a third party to adminis-ter) and a fully insured dental plan.

The CDA is very excited and proud tointroduce Ascent Benefits Company. Thekey goals of our new company are toprovide employers with high end dentalinsurance plans for their employees (wewill not be offering deeply discountedplans), provide patients with the highestlevel of dental care and the freedom tochoose their dentists, and provide dentistswith fair reimbursement rates andprotection from interference in the doctor-patient relationship.

The CDA understands that this newbusiness venture will present newchallenges, just as the CDA faced in the1980s when it addressed the malpracticeinsurance crisis and created the DentistsProfessional Liability Trust of Colorado.Just as we have seen the DPLTC succeed,we believe that in the years to come,Ascent Benefits Company will be lookedback on as a milestone decision thatbenefited employers, patients and dentiststhroughout Colorado.

One of the keys to Ascent BenefitsCompany’s success will be the strength ofits provider network. In only five months ofnetwork recruitment, we have nearly 1,000dentists signed on as network providers.

I hope you will join us in celebratingAscent Benefits Company. I also hopeyou will join this company’s providernetwork. By doing so, you will make apositive difference in the way oral healthcare is delivered in Colorado.

Thank you for your continued supportof the Colorado Dental Association andcongratulations to all CDA members asyou are now the proud owners of a newdental insurance company! ■

Ascent Benefits Company, Inc.By Rhett L. Murray, D.D.S., CDA President

THANK YOU for joining Ascent Benefits Company as a provider!Ascent has nearly 1,000 network providers and, because of your support, Ascent has one of the

larger networks in Colorado.

The Ascent dental insurance product is being sold to employers now.

Please help us recruit even more employers by placing Ascentbrochures in your office for your patients to take to their company’s

insurance consultants or human resource departments.

Simply contact the Colorado Dental Association, and we will mail thebrochures to your office for display.

The CDA can be reached at 303-996-2848, 800-343-3010 x108;

fax 303-740-7989; E-mail [email protected].


I N S U R A N C E

Bernard Glossy is thepresident of the largestdental insurance companyin Arizona and its wholly-owned subsidiaries,Southwest BenefitAdministrators and

Canyon Insurance Services. He possessesmore than 29 years of experience in thehealth care industry. He serves as an ex-officio member of the Ascent Board ofDirectors.

Gary Cummins is theexecutive director of theColorado Dental Associa-tion. He serves as thechief executive officer ofthe association and isresponsible for the overall

operation of the association, andbusiness and staff administration. Heserves as an ex-officio member of theAscent Board of Directors.

Marcia Benshoof is thechief business officer atPinnacol Assurance inDenver, Colo. Pinnacol isColorado’s largest worker’scompensation carrier. Inher role, she develops and

leads the enterprises business andinsurance operations, as well as directsales for Pinnacol Assurance.

Dr. Roy Daniels is apracticing general dentistin Sedona, Ariz. He hasbeen a Board of Directorsmember for a majordental insurance com-pany in Arizona since

2001. He is a past president of theArizona State Dental Association.

Leroy Gaintner is aC.P.A. for Gaintner,Bandler, Reed, & PetersPLC. With his threedecades of experience, hepossesses expertise instrategic planning,

analysis and problem solving forcommercial entities across industrylines. He currently serves on the Boardof Directors for a major dental insurancecompany in Arizona.

Dr. Robert Griego hasbeen a general dentist for33 years in Arizona. He isa past president of theArizona Dental Associa-tion and the chairman ofa major dental insurance

company in Arizona.

Dr. Wesley Harper is ageneral practitioner inPhoenix, Ariz. He is thevice chairman for a majordental insurance companyin Arizona and serves aschair of the board’s Audit

and Finance Committee. He has beenpracticing dentistry since 1981.

William Kirven III is anattorney and a formercommissioner of insur-ance for the ColoradoDivision of Insurance. Heserved as a consultant tothe National Insurance

Producer Registry, and now is a consultingexpert and witness for private law firms.

Oksana Komarnyckyj isan attorney. She is thepresident of the CareerAdvancement InstituteBoard of Directors inPhoenix, Ariz. She is also

a board member of a major dentalinsurance company in Arizona andserves on the board’s Planning Commit-tee, and Finance and Audit Committee.

John Kurath is vicepresident of the Coloradomarket for Warner PacificInsurance Services, oneof the nation’s largestgeneral agencies. He is apast president of the

Colorado Group Insurance Association.

Dr. David Lurye is ageneral practitioner inWinter Park, Colo. He isthe secretary of theColorado Dental Associa-tion. He has beenpracticing dentistry since

1985 and is a clinical associate professorat the University of Colorado School ofDentistry.

Dr. Rhett Murray is thecurrent president of theColorado Dental Associa-tion and a generalpractitioner in Aurora,Colo. He has been inpractice since 1977. Dr.

Murray is the former chair of the ColoradoDental Association Ethics Committee.

Dr. Kenneth Versman isa periodontist in Aurora,Colo. He will be amember of the AmericanDental Association Boardof Trustees in 2007 and isa past president of the

Colorado Dental Association. Dr.Versman has served on the ColoradoState Board of Dental Examiners and theColorado Dentist’s Liability Trust Board ofDirectors. ■

The Ascent Board of DirectorsA majority of dentists comprise the Ascent Board of Directors in addition to several other well-qualified professionals.The board has 11 members – five selected by the Colorado Dental Association, five selected by Southwest Benefit

Administrators and one selected by both parties.

I N S U R A N C E

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Arkansas Valley Dental Society 4 11 0.4% 0.4% 36.4%Boulder/Broomfield County Dental Society 66 223 6.8% 8.6% 29.6%Colorado Springs Dental Society 168 347 17.3% 13.4% 48.4%Intermountain Dental Society 7 26 0.7% 1.0% 26.9%Larimer County Dental Society 64 172 6.6% 6.7% 37.2%Metropolitan Denver Dental Society 551 1,367 57.0% 53.1% 40.3%Northeastern Colorado Dental Society 10 21 1.0% 0.8% 47.6%San Juan Basin Dental Society 8 45 0.8% 1.7% 17.8%San Luis Valley Dental Society 10 14 1.0% 0.5% 71.4%Southeastern Colorado Dental Society 35 92 3.6% 3.6% 38.0%Weld County Dental Society 17 67 1.8% 2.6% 25.4%Western Colorado Dental Society 29 195 3.0% 7.6% 14.9%

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Ascent Providers


*Represents CDA active members as well as non-members who are Ascent providers.

Ascent Providers by Specialty (as of Dec. 15, 2006)

Ascent Providers by Component (as of Dec. 15, 2006)

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Dental Public Health 1 11 0.1% 0.4% 9.1%Endodontics 39 77 4.0% 3.0% 50.6%General Practice 762 2,011 78.6% 77.9% 37.9%Oral/Maxillofacial Surgery & Pathology 56 108 5.8% 4.2% 51.9%Orthodontics 61 182 6.3% 7.1% 33.5%Pediatrics 18 78 1.9% 3.0% 23.1%Periodontics 27 80 2.8% 3.1% 33.8%Prosthodontics 5 33 0.5% 1.3% 15.2%

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Abbey, Paul FLongmontAbrames, AricaFort CollinsAbrams, John NDenverAdams, Timothy WDenverPediatricsAdler, EricDenverAlbert, David MLittletonOrthodonticsAlford, Annette MGreenwood VillageAllen, Kenneth BFort CollinsAllen, William RColorado SpringsDental Public HealthAlmeida, Adam DLone TreeAlmeida, Donald FLone TreeAmes, William GCentennialAmundson, Peter BCentennialAndersen, DavidGreeleyAnderson, Erick TColorado SpringsAnderson, Jackson LColorado SpringsAnderson, Robert RDenverAnderson, Roger VCentennialAnderson, Timothy WFort CollinsAndow, Kenneth LCentennialAndreatta, Paul ATrinidadAndrus, Paul WLakewoodAntiel, Robert DAlamosaArango, Jose MColorado SpringsOrthodontics

Arbuckle, Richard WColorado CityArcher, Raymond EDenverArmbruster, James ISterlingArmstrong, J CDenverArmstrong, Raymond EColorado SpringsArnold, Julia AColorado SpringsAugustine, Lisa MAuroraAutobee, Thomas VPuebloAvant, Daniel AColorado SpringsOrthodonticsAverbach, Robert EDenverEndodonticsAyers, William ABroomfieldBabin, Brian PLittletonBagley, Steven EGreeleyBahr, Carl AThorntonBahr, Craig ADenverOrthodonticsBahr, Shayna NArvadaBaker, James HEnglewoodBallard, Stephen WLovelandBandrowsky, TimothyColorado SpringsOral/Maxillofacial SurgeryBarker, Stephen DLittletonBarnes, Bruce WColorado SpringsBarnes, Mark JBoulderBaros, Bernard BColorado SpringsBarr, Elizabeth SWestminsterPediatrics

Barr, Nelle VWestminsterPediatricsBarrett, Edward JCentennialOrthodonticsBarth, Gary RGreeleyOrthodonticsBartlett, James RAuroraBarton, Stephen LLittletonBasit, SaadiaLouisvilleBassett, John WDenverBauman, John TLongmontBaumgardner, Thomas RColorado SpringsBaumgart, Steven GLakewoodBausch, Wayne ELakewoodBeard, ByronPueblo WestBeasley, Michael WColorado SpringsBecvar, Frank GLongmontBeer, Paul RDenverBeilby, George FHighlands RanchBelfiglio, E JColorado SpringsBelford, Mark LLafayetteBellamy, Marcus CMonumentBellon, Michael DDenverOrthodonticsBenak, Susan GGrand JunctionBender, William CLa SalleBenke, Robert JGreeleyBennell, Robert LFort Collins

Benning, Allen NColorado SpringsOrthodonticsBenning, Brian DColorado SpringsBenson, Gary PDenverOrthodonticsBergles, James APuebloBerman, David NGreenwood VillageOral/Maxillofacial SurgeryBerman, Mark DGreenwood VillageOral/Maxillofacial SurgeryBerndt, ShawnaFort LuptonBerry, Eric LPuebloBerry, Kary LGreenwood VillageBerry, Kevin SDenverBethers, JohnDenverBevans, DaveLittletonBevans, Gregory RDenverBiel, Timothy SAuroraBielecki, PawelDenverBiety, Christopher MBroomfieldOrthodonticsBiles, Jill MLongmontBillingsley, Michael LColorado SpringsOral/Maxillofacial SurgeryBird, Philip TColorado SpringsBirnbaum, Anne WBoulderBlackley, David WColorado SpringsBley, Justin CColorado SpringsOral/Maxillofacial SurgeryBlumenschein, Gary LLakewood

Bobier, GeneGreeleyBodoni, ElenaGreenwood VillageBoeyink, Timothy RCentennialBonbright, Thomas ADenverBoraz, Robert AParkerPediatricsBorg, Timothy DWestminsterBottenbley, Cecil JDenverBottoms, BrandiBroomfieldBoudreaux, Gary LGreenwood VillageBowden, Clyde AAuroraBowers, Soledad CLittletonBowling, Franklin LBroomfieldBowling, Nina RBroomfieldBoyd, Dana MLittletonBrantes, Liliane ACentennialBravo, LuisCentennialBrewick, TerryDenverBridgeman, Harold EColorado SpringsBrockman, John RLone TreeBrody, L ScottCastle RockBrones, Collin GColorado SpringsBrown, Jennie CAuroraBrown, Julie ABoulderBrown, Richard LDenverBrown, Ronald NDenver

Ascent Benefits Company, Inc.Provider Directory

Ascent proudly introduces its rapidly growing network of providers. 969 providers are listed below (this listing reflects those whosigned up by Dec. 15, 2006). The following dentists are general practitioners unless otherwise noted. This listing does not reflect

multiple office addresses. If your name is not listed below, we welcome you to join Ascent as a network provider.Please call 303/996-2848 or 800/343-3010 x108.

I N S U R A N C E

ASCENT continued on page 12


Bruhin, Michael JWindsorBuck, RonaldWheat RidgeBuist, John AEnglewoodBull, John WGrand JunctionBumgarner, Roger LCastle RockOrthodonticsBunch, Robert LDenverBurchfield, John MGoldenBurchfield, John RGoldenBurkart, John DAuroraBurns, Kendall RBroomfieldBurns, William RLittletonBurquest, James WCentennialEndodonticsBurton, Matthew JColorado SpringsButkevich, EkaterinaDenverButler, BenjaminLakewoodButler, Brian CDenverProsthodonticsButler, MaryanneAuroraPeriodonticsCaldwell, Michelle LDenverCaletti, Gary BEnglewoodCall, Richard LThorntonCallender, David DLakewoodOrthodonticsCallender, Galen LArvadaOrthodonticsCallender, Galen TLittletonOrthodonticsCampbell, MonteColorado SpringsCardon, Paul NMonumentCarlson, Kendal NDenverCarlson, Steven WColorado SpringsCarnes, Perri LCentennialEndodonticsCarpenter, John AArvadaCarter, Colleen SDenver

Carter, Richard LColorado SpringsCarver, Douglas DLittletonOral/Maxillofacial SurgeryCasement, Kelley ADenverCasement, Russell LDenverCasson, Anne FLittletonCastillo, Steven AColorado SpringsCatalano, Joseph MAuroraOral/Maxillofacial SurgeryCea, Richard AColorado SpringsChalian, G GAuroraEndodonticsChambers, Alvin DPuebloChang, Michael WAuroraChapman, Kevin CWheat RidgeOrthodonticsChapman, Thomas JHighlands RanchPeriodonticsChernoff, Kenneth LDenverChildress, KennethPuebloChoi, Seong-HeeAuroraCholfin, Stuart NAuroraChristiansen, Bart GCentennialChristiansen, Harold RAuroraChua, Mark NWinter ParkCimino, Michael AColorado SpringsCiner, SheldonDenverClement, Charles EDenverClouatre, Jean ALakewoodCockrell, Ronald DColorado SpringsCollett, Miles BDenverColletti, Laurence JLouisvilleOrthodonticsCollins, Larry CDenverColt, RobertArvadaCombes, Craig AMonte VistaConcialdi, Ronald APueblo

Connor, Donald PDenverCope, George ABrightonCorcoran, Paul GVailCosby, Michael PDenverOral/Maxillofacial SurgeryCountryman, Joey DLittletonCourtad, Charles LGoldenOrthodonticsCowen, Neil REnglewoodCrawford, Stanley DArvadaOrthodonticsCreal, Stephen MFort CollinsCrichton, David DColorado SpringsOral/Maxillofacial SurgeryCrisler, SteveColorado SpringsCrockett, Olen CLakewoodCurry, James THighlands RanchOral/Maxillofacial SurgeryDahler, Bryan MWheat RidgeD'Amico, Nicholas MAuroraDaniel, Thomas EAuroraDanna, Charles SLittletonDarling, AmandaHighlands RanchDaugherty, David DLittletonDavis, William HBroomfieldDawson, Kevin ZLittletonDay, Gregory NPuebloOral/Maxillofacial SurgeryDe Cino, Donald ALakewoodOral/Maxillofacial SurgeryDe Long, Gary JArvadaDeal, Brock FCentennialEndodonticsDean, Mark DArvadaDelo, Richard IArvadaOral/Maxillofacial SurgeryDemaray, Robert FWestminsterDembitsky, Stephen ZGrand JunctionDeschene, JimBerthoud

Dial, Richard DLakewoodDigiorgio, Robert MParkerDilley, SteveFort CollinsDinsmore, David MDenverDiorio, Michael KEnglewoodDisse-Pfeifer, ScarletCentennialDistelhorst, DorothyVailDobbin, Monica LColorado SpringsDobbin, Richard DColorado SpringsDodgion, EarlSouth ForkDoi, Bradley HDenverDoida, Stanley YDenverDombrowski, JeffreyColorado SpringsOral/Maxillofacial SurgeryDorsey, Ronald AEnglewoodDost, James EGreenwood VillageDougherty, Michael DAuroraDouglas, G BBoulderEndodonticsDowns, James CDenverDrake, Thomas PLongmontDraper, Mathew HLongmontDraper, Scott AColorado SpringsProsthodonticsDroel, RodgerLakewoodDumke, Paul RWheat RidgeDunbar, Andrew JCastle RockOrthodonticsDunkleberger, Elizabeth AHighlands RanchDunn, Bruce RDenverDunn, Christopher NThorntonDunn, David SAuroraDunn, Jack HLongmontDuran, Jack EEnglewoodOrthodonticsDuran, Tomas LPuebloDurbin, Charles LColorado Springs

Echols, Steven RLittletonEckles, Terry AGreeleyPeriodonticsEgert, Terry WDenverElliott, BrianLittletonElliott, Robert CWoodland ParkEnea, SteveColorado SpringsEngel, Neal HAuroraEngelhardt, Geoffrey RFort CollinsErmolaeva, InnaDenverEvans, David LBoulderEvans, Douglas BColorado SpringsProsthodonticsEvans, Raymond WAuroraEyer, Robert MArvadaFacy, RebeccaColorado SpringsOral/Maxillofacial SurgeryFager, Frank KDenverEndodonticsFahmy, SharonAuroraFarley, LynnLittletonFeghali, Carl AGrand JunctionFeichtinger, DaleLovelandFermelia, Catherine ALakewoodFischer, James AFort CollinsFleischmann, DavidBroomfieldFlood, PatrickLakewoodFlower, Brett PArvadaFogarty, Todd MColorado SpringsFord, Michael JAuroraForman, Roger JBoulderPeriodonticsForti, Thomas AGreenwood VillageFoster, Cory EFort CollinsFoutz, NicoleParkerFowler, Jeffrey DCentennialPeriodontics

ASCENT continued from page 11


Franz, WayneLouisvilleFrey, Ron DDenverFriedl, MicheleGreenwood VillageFriedman, MitchellArvadaFriedman, Stephen MDenverFrisbie, KentColorado SpringsFrisch, Michael KAuroraFujita, Dana KSteamboat SpringsFulton, DoyleParkerFulton, Laurel CDenverFurgason, Brian ALakewoodGanz, Neil ISteamboat SpringsGarehime, William JLittletonOral/Maxillofacial SurgeryGasper, Kenneth OColorado SpringsGates, PamelaEnglewoodGeck, David CLittletonGeller, Jeffrey BPuebloOrthodonticsGeorge, Mark DColorado SpringsOrthodonticsGeorge, Theodore MColorado SpringsPediatricsGerathy, Albert JMonumentGerken, Louis RLovelandPediatricsGeving, Anna MParkerGiannetto, Steven JPuebloGilbert, Michael EColorado SpringsGill, Nancy EGoldenGillespie, Terri AParkerGillespie, Wayne RDenverGinther, Stefan WAuroraGirardi, Anthony FFort CollinsEndodonticsGlenn, Falona HAuroraGlenn, Gerald LAurora

Glick, Paul LAuroraPeriodonticsGold, David ECentennialOrthodonticsGold, Frank JLakewoodGolinvaux, Michael JDenverGomez, Jose AGreeleyGomez, Luis ADenverGorsky, Michael MColorado SpringsGrabiak, Guy FLakewoodGraves, Gary BPuebloGreen, Leon CFort CollinsGreene, Craig SLittletonGreene, Jerome YCentennialGreenhalgh, ScottLakewoodGreenstein, Bruce IDenverGreenstein, Peri MDenverGregston, Mark DDenverOrthodonticsGrossman, Gregory BDenverGrout, Jeffrey BLittletonGrout, Ronald WLittletonGryzick, David VAuroraGurinsky, Brian SDenverPeriodonticsGurman, Alan HDenverHaberstroh, JulieAuroraHadley, J ScottSterlingHahn, Christopher SDenverEndodonticsHakala, Catherine HDenverHakala, Joseph MDenverHale, Michael GParkerHall, Andrew DColorado SpringsHall, Jason PCastle RockHaltom, George WGlenwood SpringsOral/Maxillofacial Surgery

Haman, Michelle LColorado SpringsPediatricsHamblin, RobertBoulderHamersky, Paul ACastle RockOrthodonticsHanck, John JFort CollinsHansen, Dan LLakewoodHansen, Jason LColorado SpringsHansen, Matthew CColorado SpringsHarman, BeckieGreenwood VillageHarman, Greg SParkerHarris, HeatherDenverHarris, Michael PColorado SpringsHarrison, Robert TFort CollinsHartgerink, Dayle VColorado SpringsOrthodonticsHartman, David RDenverHarvey, Fred RLakewoodHashemi, Amir ADenverHastings, Paul FColorado SpringsHatch, Randy CGreeleyHatzidakis, Melissa MDenverHavener, Darrell LLittletonOrthodonticsHayes, Paul MEnglewoodHeikes, Lloyd CGreeleyHeil, Brian CWestminsterHekkert, ErikHighlands RanchHeller, Douglas AAuroraPeriodonticsHening, John CDurangoHerremans, Tamara JLakewoodHildebrandt, John RColorado SpringsOral/Maxillofacial SurgeryHill, DoxiadesFountainHill, Jonathan WFountainHilty, Jack BGlenwood SpringsOrthodontics

Hinton, MischelleGreeleyPediatricsHoch, Donald HDenverHoeft, Paul MLittletonHoffman, Gary SDenverProsthodonticsHoffman, Geoffrey LThorntonHohert, ChandraDenverHolloman, Irene MFort LuptonHolmes, Caron GLakewoodHolmes, Daniel AFort CollinsHolmes, Nicole ZFort CollinsHoltzmann, David JAuroraEndodonticsHood, StevenLovelandHoriuchi, Paul YAuroraHorner, Craig WLittletonOrthodonticsHowell, Bruce EHighlands RanchHubble, Greg SLittletonHubble, Timothy SCentennialEndodonticsHudson, Dale WDenverHumphrey, Stephen RThorntonHumphreys, RogerColorado SpringsHunter, CraigPuebloOrthodonticsHurst, Jeffery MLakewoodHutchinson, LarryDenverIgo, Robert MColorado SpringsOral/Maxillofacial SurgeryIngalls, Gregory KArvadaOral/Maxillofacial SurgeryIshley, David JColorado SpringsEndodonticsIversen, William WFort CollinsOrthodonticsJabour, Dorienne RArvadaJackson, DarrellAlamosaJacobson, DavidGrand Junction

Jakubanis, Terrence JDurangoJames, Kevin KBoulderJanda, Matthew CSterlingJankowski, Mark AEnglewoodPeriodonticsJensen, Douglas MLongmontJensen, Ole TDenverOral/Maxillofacial SurgeryJenson, ColleenColorado SpringsJeranko, StanleyWestminsterJimison, Lori MLovelandJoesaar, Harald MArvadaJohnsen, Curtis DLakewoodJohnson, Charles ELittletonJohnson, CollisDenverJohnson, Dana JBoulderJohnson, David CFort CollinsPeriodonticsJohnson, David MColorado SpringsJohnson, Glenn EGrand JunctionJohnson, JollyLongmontJohnson, Roy DLakewoodJohnson, Scott AColorado SpringsEndodonticsJohnson, Scott SLittletonJohnson, Stephen LGrand JunctionJohnson, Vaughn ADurangoOrthodonticsJohnston, Jeff DDenverJolly, AnkurDenverJolstad, Mark ADenverJones, David JMonumentJones, David MFort CollinsEndodonticsJones, Kelly BFort CollinsEndodonticsJoo, Nelson SAuroraJordeth, WilliamColorado Springs



Jostes, James LDenverJultak, Jed SDenverEndodonticsKaines, Joel RFort CollinsKammer, Robert JBoulderKammer, ThomasLongmontKanchanlal, VikashPuebloKantor, Michael EDenverPeriodonticsKarden, Steven CAuroraKawano, Richard NDenverKearney, James WColorado SpringsKearney, John MCanon CityKeller, Brian JColorado SpringsKeller, Tracie EColorado SpringsKelley, Charles DLamarKelliher, Joseph RLongmontKellogg, Michael JLongmontKelly, Brian RThorntonKempton, CindyLittletonKennedy, Wade AColorado SpringsEndodonticsKeogh, Barry SAuroraOral/Maxillofacial SurgeryKessler, Mark EFederal HeightsKillebrew, James EColorado SpringsOrthodonticsKillingsworth, Yvette LParkerKilroy, Thomas JDenverKinder, Bruce BLittletonKirchner, Thomas JDenverKish, Michael JArvadaKissinger, MaryHighlands RanchKissinger, ScottLittletonKleier, Donald JAuroraEndodonticsKlein, Joel TColorado Springs

Klein, Mark ELakewoodKlekamp, David HDenverKnecht, Alexander GFort CollinsKnecht, Nathaniel FFort CollinsKnowlton, AnthonyPuebloKochevar, Casey LLongmontKochevar, Mark LFort CollinsEndodonticsKoehler, Steven JFort CollinsKoff, Robert AColorado SpringsKonegni, John SLakewoodOrthodonticsKramer, Steven WFort CollinsKreider, Beth FDenverKrieger, George WElizabethKuljis, Lawrence MGreenwood VillageLa Fonte, Bret EDenverLadd, Stanley ALongmontLamb, Daniel DColorado SpringsLampert, JodiCentennialLangenfeld, Brian WDenverLangley, Donald CAuroraLanzisera, Paul MColorado SpringsLarsen, David WGrand JunctionLarson, Craig GColorado SpringsLarson, Michael JEvergreenLatta, James ELittletonOral/Maxillofacial SurgeryLaw, Steven JDenverLawler, Michael SLone TreeLe, Nickie KDenverLee, Charles ECentennialLee, Christina JDenverLee, Darin CCentennialEndodonticsLee, Kye WDenverLee, Thomas HAurora

Lehrer, L EFort MorganLeone, EdwardThorntonLesnick, Julie AArvadaOral/Maxillofacial SurgeryLevasseur, Dennis JColorado SpringsLevin, Stanley IBoulderPediatricsLevine, Mark EDenverEndodonticsLewis, J CFort CollinsLewis, Jonathan MWestminsterLewis, Lucinda AAuroraPediatricsLey, John CColorado SpringsLindeberg, Richard WFort CollinsPeriodonticsLink, Michael JDenverLinkow, Ronald GDenverLinn, Brandon JLittletonOrthodonticsLinn, Stephen KConiferLipe, Carl FDenverLodes, Eugene AColorado SpringsLodl, Jeffrey TArvadaLoe, Kimbal WAuroraLong, LanceLakewoodLongo, Norma MColorado SpringsLook, Harley KAuroraLook, Kim MColorado SpringsLopez, SergioDenverLorenz, Roy MAuroraOrthodonticsLosacco, ThomasGeorgetownLovato, Matthew AColorado SpringsLovato, Michael AColorado SpringsLucero, Orlando JColorado SpringsLundy, Brooke HBroomfieldLurye, David CWinter Park

Lyford, RobertPuebloPeriodonticsLynch, Thomas JColorado SpringsPeriodonticsLyons, Juliann CDenverMack, Eric LLittletonMackie, William RBroomfieldMacPherson, JeffColorado SpringsMadden, Robert DLittletonMadison, Mark DGrand JunctionMaier, Thomas RBroomfieldMaines, Jason EFort CollinsEndodonticsMalivuk, Michael MColorado SpringsMaloney, Scott MDenverEndodonticsMaloy, Shawn PLittletonMameda, Herbert KRocky FordManske, Jennifer LCentennialMarron, Bruce OFort MorganMarshall, Daniel WFort CollinsMartin, Donovan TBoulderMartin, Timothy EParkerMartinich, Robert LHighlands RanchMasterson, Timothy PCentennialMateron, Juan CArvadaMathews, Michele MColorado SpringsOrthodonticsMatthes, JonColorado SpringsMatthews, W JColorado SpringsMatthews, W JohnColorado SpringsMaurer, Amber MGrand JunctionMaurer, Casper DGrand JunctionMc Artor, Shivaun JFort CollinsMc Artor, Steven RLovelandMc Auliffe, Kevin FDenverMc Cartney, James GColorado SpringsProsthodontics

Mc Clain, Pamela KAuroraPeriodonticsMc Culloch, Edward JColorado SpringsMc Lain, Richard LHighlands RanchOral/Maxillofacial SurgeryMc Manaman, Richard LLongmontOrthodonticsMc Munn, WilliamLittletonOral/Maxillofacial SurgeryMc Murtrey, Lonnie LDenverMc Neely, W DLakewoodMcDill, MichaelFort CollinsMedaugh, Peter CArvadaMeister, Robert CBreckenridgeMessingham, Jason AArvadaOrthodonticsMetcalfe, Richard WDenverPeriodonticsMeyer, M WLittletonMeyer, Robert DColorado SpringsMeyers, John PColorado SpringsEndodonticsMiller, Andrew SDenverMiller, Bill JDenverOrthodonticsMiller, Charles TLakewoodMiller, Michael JLittletonMiller, RodgerAuroraMilushev, Metodi ADenverMiner, Mason ODurangoMinnich, Scott GColorado SpringsEndodonticsMinnis, Robert ECentennialMitz, Richard BDenverOral/Maxillofacial SurgeryMiyamoto, Paul KAuroraMjos, David PColorado SpringsMock, Gregory DColorado SpringsMollner, Mark DColorado SpringsMoore, Gregory BColorado Springs



Morehead, JonathanArvadaMorehouse, John HFort CollinsMorrissey, Donald JColorado SpringsMorrow, Robert LWalshMoss, Jack CArvadaMoss,Stewart ANorthglennMucci, Michael JFort CollinsMueller, Ryan ABuena VistaMullins, Rob CCentennialMunholland, Thomas LAuroraOrthodonticsMurdoch, Richard ADenverMurphy, F RBoulderMurray, Rhett LAuroraMurray, Stephen CDenverMusella, Anthony EWheat RidgeOral/Maxillofacial SurgeryMutchler, Richard EColorado SpringsNaiman, Ivan SGreenwood VillageNajjar, Ellias MLittletonNale, Thomas WBroomfieldNassimbene, Bradley LDenverNassimbene, Leo LColorado SpringsOral/Maxillofacial SurgeryNassimbene, Ray REnglewoodNassimbene, Robert DDenverNelson, Bryan PArvadaOrthodonticsNelson, Donald AColorado SpringsNelson, James DColorado SpringsNelson, Jeff SDurangoNelson, Richard MDenverOral/Maxillofacial SurgeryNelson, Steven RDenverOral/Maxillofacial SurgeryNelson, William RDenverNewman, Richard AArvadaOral/Maxillofacial Surgery

Nguyen, Andrew TAuroraNguyen, Huy TAuroraNicholas, Kenton CGreeleyOral/Maxillofacial SurgeryNielsen, KurtCentennialNieters, G JKeystoneNoble, Glenn AFountainNock, David LGrand JunctionOral/Maxillofacial SurgeryNordstrom, David WLovelandNordstrom, W BDenverNorrie, Daniel BCentennialNorris, Garth JEnglewoodNorthen, Roger LFort CollinsNovak, Scott AAuroraNovelen, Mark REnglewoodNovembre, KajsaFountainNoyes, Michael RCentennialNyvold, Thomas ELakewoodO'Berry, ShawnArvadaO'Brien, Robert TLongmontO'Day, Richard TArvadaOral/Maxillofacial SurgeryOhmart, Scott WLittletonOrthodonticsOja, Eugene EEstes ParkO'Leary, Joseph PLone TreeOlivier, Jonathan LThorntonOlsen, Lonnie EColorado SpringsOlsen, Steven CLittletonOlson, Richlund DCentennialOlson, Robert DArvadaOmi, Sheldon RWheat RidgeO'Neal, Kelly DColorado SpringsOnstad, Michael SColorado SpringsOral/Maxillofacial SurgeryOntiveros, MichaelLakewood

Orban, James EColorado SpringsPeriodonticsOrdahl, John NColorado SpringsOrthodonticsOrr, Mark FFort CollinsOral/Maxillofacial SurgeryOuellette, Thomas EDenverOwens, Timothy MFort CollinsPaini, WilliamDenverPaison, Thomas ASterlingPalmer, RonaldColorado SpringsPangborn, CameronDenverEndodonticsPareja, Claude AWestminsterParish, Dural LWestminsterPark, MichaelLongmontPark, TimAuroraParlet, Craig RColorado SpringsParsons, Joseph RBoulderEndodonticsPatel, Sanjay NHighlands RanchEndodonticsPatterson, Kevin MDenverOral/Maxillofacial SurgeryPayne, Wayne FPuebloOral/Maxillofacial SurgeryPeak, Douglas LColorado SpringsPeebles-Turner, MaryBroomfieldPeede, Louis FAuroraOral/Maxillofacial SurgeryPeppler, ScottLittletonPerino, Kenneth EGrand JunctionOral/Maxillofacial SurgeryPerrett, W. BradleyColorado SpringsPerry, Stephen MArvadaPeters, Kenneth SHighlands RanchPetersen, Michael DParkerPeterson, Glen FArvadaPeterson, ShonNorthglennOrthodontics

Petracek, Justin SBroomfieldPettine, Eric AFort CollinsPfeifer, William ACentennialPfister, CandaceFountainPierson, Dianne RBroomfieldPinkner, Jay CLongmontPixley, Thomas RFort CollinsPizer, Scott BDenverPlamondon, Thomas JColorado SpringsPlous, Michael BLakewoodPodratz, AdamColorado SpringsPontarelli, William JLakewoodPosnick, Richard BBoulderPoulos, Michael NDenverPeriodonticsPowers, RobertArvadaPrendergast, Patrick TCentennialPreston, James MLittletonProbst, Travis JColorado SpringsProvorse, Robert CBuena VistaPruett, Nicolas RColorado SpringsPuchalski, John EThorntonRaab, Richard WFort CollinsRagulsky, Ronald JPuebloRahimpour, FaranakColorado SpringsRahimpour, NavidColorado SpringsRaizen, MichaelDenverRandolph, David RDenverRanta, George VFountainRanta, Jeffrey AFountainRay, Veronica DFort CollinsReady, Thomas WPuebloReardon, WilliamWindsorReck, Steven MPuebloOral/Maxillofacial Surgery

Reed, Thomas CEnglewoodReich, Gregory MColorado SpringsPeriodonticsReid, Douglas GColorado SpringsReposa, RyanFountainRevoir, Jeffrey HDenverRieker, Bryan JNorthglennRingdahl, Mark JFrederickRipplinger, David LCortezRoach, Maureen KDenverRobbins, Arthur HDenverRobbins, Kristin FDenverRoberts, Tony LPuebloRobinson, David BPuebloRobinson, Harold ELakewoodRoby, Todd MLongmontRocke, Paul ALittletonOrthodonticsRodgers, James WCommerce CityRogers, William TColorado SpringsRold, Trent MLakewoodRolfson, Matthew RCastle RockRollert, Michael KDenverOral/Maxillofacial SurgeryRollow, John A IVColorado SpringsRones, Jonathan LAuroraRosenfeld, Edward FGreenwood VillageEndodonticsRosenzweig, ToddAuroraPeriodonticsRothbard, David MLongmontRowe, Merril FAuroraRoyal, John RColorado SpringsRubenstrunk, John MDenverPediatricsRudman, Robert TDenverOrthodontics



Runnings, Steven PDenverRush, Steven MLittletonRysner, Eric THighlands RanchSachs, EllenDenverEndodonticsSafer, Donald SDenverEndodonticsSajbel, Joseph LPuebloSalcetti, Jeanne MColorado SpringsPeriodonticsSalehrabi, RobertAuroraEndodonticsSalvo, Joseph AColorado SpringsOral/Maxillofacial SurgerySanders, Cary WFort CollinsSanders, Nelson CWestminsterSanders, Wm RAuroraSandoval, Dean ECanon CitySanti, Richard DMonte VistaSauza, JuanLongmontSayre, Jeremy MGlenwood SpringsOrthodonticsScarpella, Pasco WBrightonScavuzzo, Frank PHighlands RanchSchaefer, Stephen RFort CollinsSchafer, Natalie JWheat RidgeOral/Maxillofacial SurgeryScheidt, Michael JNorthglennPeriodonticsScherber, Joseph PWheat RidgeSchiffer, Stephen JAlamosaSchindler, Joy MCentennialSchlagel, GregDenverOral/Maxillofacial SurgerySchneider, Walter EEnglewoodScholes, Landis CCentennialSchonberger, Charles LBrushSchreiber, William LLoveland

Schroeder, David HColorado SpringsOrthodonticsSchroeder, Timothy MLakewoodSchuler, Darrell FAuroraSchultz, R JPuebloSchulz, Kyle SPuebloSchwab, Tommy RMonumentSchwartz, Marc EDenverSchwartz, Timothy ADenverSchwerdt, Janne MDenverScriven, Clark LSterlingSekiya, Floyd TWheat RidgeSelner, Daniel JDenverSelting, Wayne JColorado SpringsSessa, Kevin DBoulderSessions, Bruce LLongmontSeymour, BrittanyDenverShaddock, James MGreeleyShaner, William GColorado SpringsOrthodonticsShaver, TheresaAuroraOrthodonticsSheldon, Lisa ABoulderSherick, Paul MFort CollinsOrthodonticsShields, Michael WColorado SpringsShipley, Samantha RColorado SpringsShort, Howard BColorado SpringsSica, PaulBoulderSiegmund, John DFort CollinsSiegrist, G BDenverSimpson, Thomas MBoulderSinn, Alice VesselColorado SpringsSites, Brent PSalidaSkromme, Allan GBoulderSkulski, Carl CBoulderEndodontics

Slack, Thomas DColorado SpringsSlavsky, Aaron ELakewoodSmart, Janis PCentennialSmith, Bradley RDenverPediatricsSmith, H VCentennialSmith, Larry EAuroraSmith, Mark PThorntonSmith, Paul AColorado SpringsSmith, Richard LLakewoodSmith, Scott DDenverPediatricsSnider, Larry LLakewoodOral/Maxillofacial SurgerySoden, Ryan IDenverEndodonticsSomers, AnnDenverPeriodonticsSommer, Craig KColorado SpringsSonger, Debra MBroomfieldSousa, AprilBoulderSpeer, JenniferDenverSpeirs, Aaron MLakewoodSpencer, JaclynnBrightonSperle, Andrew RColorado SpringsSpicciati, Louis VColorado SpringsStacey, Robert LLovelandStacey, Timothy FColorado SpringsStamm, Heather LDenverStang, JeffreyWestminsterSteeghs, BrigitteGreenwood VilliageSteen, Dale NLakewoodStegelmeier, Krehl WFruitaStein, Arlene RParkerEndodonticsStein, Stephen MHighlands RanchOral/Maxillofacial SurgeryStiles, Michael JWestminster

Stoor, Michael JColorado SpringsStranahan, Patrick FDenverStricca, Duilio APuebloSwanbom, Jon EFort CollinsSwanson, DavidLakewoodSwanson-Culbertson, PeggyDenverSwartzwelter, Jay EBoulderSweeney, Patrick CWheat RidgeSwing, Sandra LColorado SpringsSyrpes, Demetrios CAuroraEndodonticsTabberson, BruceColorado SpringsTakaki, Alan MPuebloTakaki, Duane MPuebloTalavera, Sylvia ILakewoodTaloumis, Louis JColorado SpringsOrthodonticsTaylor, Amy JDenverTaylor, Stephen HArvadaTheisen, J KFort MorganTheroux, Kevin LGreenwood VillageOrthodonticsThoman, Robert DColorado SpringsPediatricsThomas, AbrahamColorado SpringsThompson, Glenn DColorado SpringsThompson, Harold RPagosa SpringsThompson, Larry WLakewoodThomson, Patrick BWoodland ParkThorne, Donald JGreeleyThurgood, David BFort CollinsOral/Maxillofacial SurgeryThurman, Lon SColorado SpringsTidwell, Scott ALittletonTilliss, Steven AGreenwood VillagePeriodonticsTillotson, Evan CColorado Springs

Tomasetti, Boyd JLittletonOral/Maxillofacial SurgeryTomasetti, David RLittletonTomlinson, KathyArvadaTomlinson, JosephFort CollinsTopelson, IanDenverToriggino, Dominic JAuroraTrammell, GeraldLakewoodOral/Maxillofacial SurgeryTraul, John MGlenwood SpringsOrthodonticsTrembath, Lori MDenverTritsch, Thomas RColorado SpringsTroop, MichaelCentennialTroxell, James BFort CollinsOral/Maxillofacial SurgeryTrujillo, David NLa JuntaTsumura, Kurt KDenverTurnquist, KerryBroomfieldUchida, BruceLakewoodUchida, Thomas KLittletonUnser, Michael EDenverUnterseher, Ronald EWestminsterOrthodonticsUremovich, Mark AArvadaUremovich, MilanArvadaUtke, Calvin DColorado SpringsValuck, Paul EDenverVan Acker, AlexanderPenroseVan Ness, Marc RColorado SpringsVan Wagenen, Jason RWestminsterVan Zytveld, Eric WDenverVanicek, Peter ACentennialVean, Allen HDenverPediatricsVersman, Kenneth JAuroraPeriodonticsVessel, Allen AColorado Springs



Villalon, Elmer APuebloVilner, LeonidDenverVogl, WaltAuroraWachuta, Timothy JDenverWadsworth, Kenneth VLakewoodWagenaar, PaulCentennialWaggoner, Clyde EDenverOral/Maxillofacial SurgeryWahl, Michael EColorado SpringsWalker, John SBoulderOrthodonticsWallace, Gerald FDenverWalter, Philip CAuroraPediatricsWard, Larry DArvadaWarlick, Philip OWalsenburgWarrington, Carl TAlamosaWasinger, Jack LLakewood

Waters, GregoryArvadaWaters, Jennifer UGoldenWeddle, Larry TWestminsterOrthodonticsWeenig, Val DColorado SpringsWeimer, Allan DSteamboat SpringsOrthodonticsWeinbach, Jonathan RWestminsterOrthodonticsWeisenfeld, Andrew BCentennialPediatricsWelch, Chad ADenverWelch, Christopher STrinidadWelch, Frank AAlamosaWelden, David JBoulderWellman, Robert DCentennialWells, Gordon WFort CollinsWennogle, Charles FCentennialOral/Maxillofacial SurgeryWerner, Sarah JDenver

West, Brian LDurangoPeriodonticsWest, Walter HEnglewoodWetmore, Bruce CBroomfieldOral/Maxillofacial SurgeryWeyman, Paul SEnglewoodWhalen, Dann FLakewoodWhalen, Sean RWestminsterPediatricsWheeler, Mark ABroomfieldPeriodonticsWherley, Daniel JDenverWhite, Dawn MDenverWhite, Jeffery MAuroraOral/Maxillofacial SurgeryWhitney, Scott ILone TreeEndodonticsWiggins, Cassady BParkerOrthodonticsWilken, Keith ISalidaWilkman, Stephen WBoulder

Williams, Richard DAlamosaWilson, Robert LColorado SpringsWilsted, Neal KCentennialWinber, Ralph BWheat RidgeWinquist, Heidi EBoulderWise, Randall SLakewoodWittenberg, Edd BColorado SpringsWohlgemuth, Barry LAuroraWolcott, James FColorado SpringsEndodonticsWolcott, SusanColorado SpringsEndodonticsWolf, Steven HColorado SpringsWolff, Tracy LDenverWolfson, GaryCentennialWorkman, John TLongmontWorley, Richard FDenverWostrel, Terry LLittleton

Wright, PeggyAkronWuerker, Richard SFort CollinsWursten, JeffreyArvadaWurtzebach, Robert JLakewoodWyatt, John AWheat RidgeYahnian, Lawrence DDenverYancey, Marianne MGreenwood VillageYardumian, Robert PWoodland ParkYaros, Ronald MAuroraYi, Woon HAuroraYork, Kimberly KCentennialYost, Lyle LDeltaYoungquist, Adam JFort CollinsZelazek, Paul LWestminsterZelenka, Rodney JDenverZeppelin, DanielAuroraZimmer, Donald JEnglewood


M A N A G E M E N T

QUESTION: I was told that there is anew law that requires employers tosign a form attesting that they havenot knowingly hired an unauthorizedworker. Who does this law affect andhow do I comply?

ANSWER: Colorado Governor BillOwens approved House Bill 1017 on July31, 2006, which will require all Coloradoemployers to verify the immigration statusof all new employees. House Bill 1017will apply to all employees hired onor after Jan. 1, 2007 (current employ-ees are not subject to the bill).

This new law requires all employers inColorado, as well as any out of statebusinesses that have employees engagedin business in Colorado, to sign anadditional affirmation within 20 days of thenew hire date. The affirmation must state:

1. That the employer has examined thelegal work status of the newly hiredemployee, and has retained file copiesof the documents required by 8 U.S.C.,Section 1324a.

2. That the employer has not altered orfalsified the verification or identificationdocuments provided by the newly-hiredemployee.

3. That the employer has not knowinglyhired an unauthorized alien.

This affirmation is required in additionto the existing I-9 Form. The ColoradoDivision of Labor indicates that it willdevelop a form for the required affirma-tion and make it available to employersbefore Jan. 1, 2007.

Federal law requires that employersretain the I-9 Form for the later of threeyears after the date of hire or one yearafter employment is terminated. The newColorado law requires maintaining theaffirmation and documentation for theduration of employment.

The Colorado Division of Labor mayaudit compliance with this new law, andemployers who recklessly fail to maintainthe required documentation or submitfalse documentation may be fined up to$5,000 for the first offense and up to$25,000 for any subsequent offense.

What does the new house billmean for employers and their newlyhired employees? Basically, as of Jan. 1,2007, an affirmation form and copies ofthe identity documents should be attachedto each employee’s I-9 Form. As always,employees must fully and properlycomplete section one of the I-9 at the timeemployment begins and employers should

continue to complete section two.Employers should be prepared to demon-strate that they have reviewed therequired I-9 documents to ensure thatthey appear genuine and belong to theperson who presented them.

In addition, any Colorado employerwho has a contract with the State ofColorado or any political subdivision ofthe state is required by law to participatein the Department of Homeland SecurityBasic Pilot Program. If you have agovernment contract, please ensure thatyou are participating in the program. ■

Stacy Jensen is a CommunicationStrategist for Terra Firma, a locally ownedand operated Professional EmployerOrganization (PEO) in Denver, Colo. TerraFirma is a CDA Medallion Plan Partnerand provides small to mid-sized employ-ers with a full scope of human resourcesservices, safety and risk management,employee benefits administration, andregulatory compliance consulting. [email protected] for information.

Do you have a human resourcesquestion to be answered in thisquarterly column? Submit your ques-tions to [email protected] or 3690 S.Yosemite St., #100, Denver, CO 80237.

New Employee Verification ProcessRequirement

Effective Jan. 1, 2007By Stacy Jensen

Helpful Web Links:For general information on HouseBill 1017 relating to the Jan. 1, 2007verification requirements, go to:www.coworkforce.com

Download an I-9 Form at:www.uscis.gov/files/form/i-9.pdf

To view the new Colorado Mini-mum Wage ($6.85 per hour) FactSheet, go to: www.coworkforce.com/lab/MinimumWageFactSheet.pdf


V O L U N T E E R I S M

The Colorado Dental Association isbusy at work preparing for

National Children’s Dental Health Month inFebruary. As in past years, two eventsfocused on the oral health of Colorado kidsdominate February: Give Kids a Smile Dayand the Healthy Smiles Coloring Contest.

Give Kids a Smile Day: Friday,Feb. 2, 2007

Thank you to thedental offices andindividuals who haveregistered to partici-pate in Give Kids aSmile Day, a nationalaccess-to-care day forchildren. Dentistsacross Colorado, andthe nation, will beproviding free

treatment to children, and visiting schoolsand community centers to teach childrenabout the importance of good oral health.For the first time, continuing education(CE) credit will be available to dentistsparticipating in Give Kids a Smile events.CE forms will be sent to participatingoffices in the coming weeks.

If you have registered for Give Kids aSmile Day, you should have received aconfirmation letter regarding yourparticipation in December from the CDA.If you did not receive this letter or haveany additional questions, please call theCDA at 303/740-6900 or 800/343-3010.

Give Kids a Smile Day is on Friday, Feb.2. The CDA has learned that activities forthis year’s event will range from puppetshows in schools to full orthodontictreatment at no charge. We applaud youin advance for your generosity anddedication to this program. Typically, GiveKids a Smile Day events fall into one ofthree categories: private treatment, offsitetreatment and educational/schoolpresentations. Please note the importantinformation below.

• Private Treatment: Thank you forvolunteering to treat children in yourprivate dental office. Your office is eitherrecruiting patients for the day OR hascontacted the CDA to help with patientrecruitment (if you are unsure of yourpatient source, please contact MollyOsberg at the CDA). If you requestedpatients through the CDA, local schoolnurses or nearby health centers will be

providing you with patients to schedulein the next couple weeks. Events of thisnature tend to have an increasednumber of no-show patients due totransportation and other issues on theactual day. To maximize your valuabletime on Feb. 2, you might considerdouble booking a few extra patients. Tominimize the no-show rate, the MetroDenver Dental Society has establishedsome proven successful guidelines thatwe will be mailing to your office. If youhave not received the guideline pages,please call the CDA – we would behappy to fax them to you.

• Offsite Treatment: Thank you forvolunteering to treat patients in anearby clinic, non-profit health centeror the CU School of Dentistry. Thefacility will have patients and aschedule waiting for you on Feb. 2. Youwill be receiving more information bymid-January regarding hours ofoperation and directions to the facility.Please contact the CDA if you have anyquestions regarding your Give Kids aSmile arrangements.

February: National Children’s Dental Health Month

FEBRUARY continued on page 20

• Educational/School Presentations:Thank you for volunteering to providemuch needed education in schools,community centers, etc. If you requestedadditional activity sheets, lesson plansor materials, they will be mailed to youby mid-January. If you would like to doa presentation but need a school to goto, please contact the CDA for a list ofinterested classrooms.

As you prepare for your Give Kids aSmile event, less than a month away,please know that the CDA is here to helpmake your day a success. If you have anyquestions or need additional assistance,please call the CDA at 303/740-6900 or800/343-3010.

Thank you for being a part of an eventthat truly will give kids a smile!

Healthy Smiles Coloring ContestEach February, the CDA conducts

outreach programs in Colorado schools,encouraging and promoting oral healtheducation. The annual Healthy SmilesColoring Contest is available to elementaryschool students, kindergarten throughsixth grade. The CDA encourages teachersand school nurses to not only participatein the program, but to also incorporate alesson on oral health, nutrition and/orhygiene. Lesson plans and additionalactivity sheets are available to schools atthe teacher’s request.

This year’s grand prize winner will receive$100 cash for his/her school to be used atthe school’s discretion, a gift card to Barnesand Noble, art supplies, and his/her winningcoloring sheet featured in the Journal of theColorado Dental Association. Winners willalso be selected from each componentsociety area across the state, and awardedart supplies and other prizes. Each winner’s

classroom will receive toothbrushes,toothpaste and dental health month posters.

In addition to mailing information aboutthis contest to every elementary school inColorado, we hope that you will encour-age your pediatric patients to participateas well.

Please photocopy both sides of the 2007coloring sheet (see next page) and givecopies of the sheet to your patients tocolor in your waiting room or at home.They must fill out the appropriateinformation on the back of the coloringsheet. The picture can be colored withcrayons, markers, paint, pencils, etc.Contestants must color their own entrywithout assistance from others.

The deadline to submit entries is Feb. 28,2007. Entries can be mailed to: HealthySmiles Contest, 3690 S. Yosemite St., #100,Denver, CO 80237. Please call 303/740-6900 or 800/343-3010 for more information.Thank you for your participation! ■

FEBRUARY continued from page 19


2007 Healthy Smiles Coloring Contest Registration

First Name______________________________________________________________________________________

Last Name ______________________________________________________________________________________

Address_________________________________________________________________________________________

City, State, Zip__________________________________________________________________________________

Phone Number _________________________________________________________________________________

School __________________________________________________________________________________________

Teacher’s Name ________________________________________________________________________________

Grade_______________________________________________Age________________________________________

Eligibility:Children in kindergarten through sixthgrade are eligible to participate.

Guidelines:1. Contestants must color their own entry,

without the assistance from others.

2. The picture can be colored withcrayons, markers, paint, pencils, etc.

3. Entries must be submitted by February28, 2007.

4. No purchase is necessary in order toenter.

Prizes:The grand prize winner will receive$100 for his/her school, a gift card toBarnes & Noble, art supplies andhis/her winning art sheet featured inthe Journal of the Colorado DentalAssociation. Up to 11 additional winnerswill be selected and awarded artsupplies, posters and toothbrushes fortheir entire class.

How to Enter:Mail the completed coloring sheet to:

Healthy Smiles Contest3690 S. Yosemite St., Suite 100Denver, CO 80237

Don’t forget to include your name,address, phone number and gradeabove.

Artwork becomes the property of the Healthy SmilesColoring Contest and will not be returned unlessprevious arrangements have been made

Coloring Contest Rules


E T H I C S

As a result of a rulemaking hearingin October 2006, the Colorado State

Board of Dental Examiners has adoptednew regulations to govern all types ofadvertising by dentists and dental hygienistsin Colorado, effective Jan. 1, 2007. Theserules are posted on the board’s Web site:http://www.dora.state.co.us/dental/rules.pdf(scroll down to Rule XXVI-Advertising).

The revised rule applies to all types ofmedia, including but not limited to, print,radio, television and the Internet. Many ofthese changes were made based on theAmerican Dental Association’s Principles ofEthics and Code of Professional Conduct.

The board’s goal is to protect the publicby eliminating misleading, deceptive orfalse advertising such as implying superiorabilities over other licensees, implyingspecialty status or listing an unearneddegree. Unearned degrees are defined asany degree other than that issued by anaccredited educational institutionrecognized by the Commission on DentalAccreditation, http://www.ada.org/prof/ed/accred/commission/index.asp. Somecommonly recognized earned degrees

include D.D.S., D.M.D., M.S. (in a dentalfield), M.P.H. or M.D. Any degree issuedby a non-recognized entity such as theLas Vegas Institute (LVI), or any honorarydegree such as FICD (Fellow InternationalCollege of Dentistry) or FACD (FellowAmerican College of Dentistry) would beconsidered an unearned degree.

The use of unsubstantiated testimonialsattesting to the technical quality orsuperiority of treatment offered by alicensee is also in violation of these rules.Patient testimonials may be allowed ifthey fulfill the specific requirements underparagraph six of the rules. In addition, alicensed dentist or dental hygienist isresponsible for and must approve anyadvertisement made by a corporate dentalor dental hygiene practice to which he orshe is associated.

General practitioners cannot imply aspecialty practice by advertising in anymedium, such as the phonebook or anInternet directory, under a specialtyheading or section, or by using the terms“specialist in,” “diplomat in,” or “practicelimited to.” According to these rules,“Dental specialties are recognized as only

those defined by the American DentalAssociation, and dental specialists arethose dentists who have successfullycompleted a Commission on DentalAccreditation specialty program”(http://www.ada.org/prof/ed/specialties/definitions.asp#recognized).

Furthermore, “practitioners whoadvertise dentistry or dental hygiene shallnot make any claim to a patient or to thegeneral public in any advertisement,business card, letterhead or envelope, anyrecognition, accomplishments, levels ofattainment, diplomat status, fellowshipstatus, teaching credentials, or any otherform of recognition from an unaccreditedschool or organization or continuingeducation program.”

Licensees who violate any of these newrules could be subject to disciplinaryaction by the Colorado State Board ofDental Examiners. According to theattorney general’s office, it is the responsi-bility of every Colorado licensed dentistand dental hygienist to be familiar withthe board rules and regulations, and toperiodically visit the board’s Web site forany changes and updates. ■

New Advertising Rules Adopted by State Board

By Edward F. Rosenfeld, D.M.D., M.S., CDA Ethics Committee Chair


P R A C T I C E

QUESTION: Sometimes I feel I’m reallyin the dark when it comes to knowinghow well my practice is actually doing.My office manager and accountantgive me lots of different figures andnumbers, but the information isusually like trying to drink from a firehydrant. How can I know what’sgoing on without having to pour overtons of statistics?

ANSWER: Your question is one thatnearly every dentist has or will ask atsome point in his or her career. At thevery heart of the issue is the critical

difference between the mindset of thedentist as a clinician and the attitudeneeded to succeed in business.

Success on the clinical side requiresprecision and strict attention to detail.Success for business owners, particularlyin established dental practices, however,lies in the ability to focus on the bigpicture and to avoid getting caught up inmost details. Tons of numbers aren’treally a help – they overwhelm but theydon’t inform. By grasping the biggerpicture, you can gain more control overyour practice, and achieve greater

efficiency andprofitability.

In your question, youcorrectly identified thefact that there aredifferences betweenthe numbers providedby your accountant, theinformation providedby your office manager,and the data youwould find meaningful.Dental practice ownersneed specifics that tellthem exactly what theywant to know, whichallows them to detectproblem areas andthen determineappropriate courses ofaction.

In an establishedpractice, dentistsshould be focusing ondoing what they dobest – dentistry – anddelegating the

authority and responsibility for the rest.The watchword is delegation, notabdication. The practice owner mustmaintain absolute control over thebusiness aspects of his or her practice toavoid the risks of embezzlement or othermalfeasance.

The solution lies in learning to use acomprehensive strategic monitor thatmeasures 12 vital statistics. Thesestatistics in the aggregate provide a clearsnapshot of where the practice is andwhat, if anything, needs attention.Following are the 12 vital statistics andtheir desired performance ranges andpercentages:

1. New Patients: A practice should haveat least 25 new patients each month ifemergencies are not counted (40 newpatients if emergencies are included.)

2. Appointments: 97 percent of patientsshould be reappointed before theyleave the office, as it’s much easier toreappoint than reactivate. (Whileteam members often estimate a 97percent reappointment, actual trackingoften reveals a considerably lesseramount.)

3. Reactivation: While reactivationshould be unnecessary, if required, theideal is to schedule 75 percent or morepatients who can be contacted bytelephone.

4. Broken Appointments: Brokenappointments should be less than 5percent of monthly production.

5. Provider Production Goals andResults: Each provider should beassigned production goals. Thesegoals, versus results, should be

Monitoring How Your Practice isReally Doing

By Janet and Lawrence Steward


provided to the entire team eachmonth.

6. Advanced Schedule to Goal: At thebeginning of each month, schedulesshould be at 90 percent or more ofproduction goals.

7. Collections: Ideally, this should benearly 100 percent of production.

8. Accounts Receivable (A/R): A/Rshould be less than the average of onemonth’s production. Accounts 90 daysor over should not exceed 5 percent ofthe total A/R.

9. Adjustments: This statistic should beless than 2.5 percent of total production.

10.Over-the-Counter Collections: Whilethis varies considerably depending oninsurance plans, the ideal over-the-counter collection is 40 percent orgreater.

11.Cash Flow: The available cash fromall sources must exceed payment

obligations. Our national research,including Colorado practice owners,shows more than 20 percent ofpractice owners frequently struggle topay bills and meet payroll.

12.Overhead as a Percentage of TotalCollections: The goal is to have a totaloverhead of 60 percent or less of totalcollections. Here’s a general guidelineby subcategories: dental supplies (5 to7 percent); lab expenses (8 to 11percent, although a higher percentageis a good thing if it is reflective of morecrown and bridge work); marketingexpenditures (2 to 3 percent); staffsalaries (22 to 24 percent); payrolltaxes (1 to 3 percent); staff benefits (2to 6 percent); and administrativeexpenses (2 to 6 percent).

These vital statistics are importantbecause, as every practice owner knows,the dentist only gets paid what’s left aftereveryone else gets their checks. With the

proper data monitors in hand, the practiceowner has the tools to keep his or herpractice on the path toward even greaterbusiness success.

Additional details regarding strategicmonitors are available atwww.theManageDentPros.com. ■

Janet and Larry Steward are speakers,consultants and authors. Their recentlypublished book, “What Do Dentists ReallyWant?” is available from www.theManageDentPros.com. JanetSteward is the president of StewardQuantum Leap Dental Practice Consultingand can be reached at 970/207-0776.

Do you have a practice managementquestion to be answered in thisquarterly column? Submit your ques-tions to [email protected] or 3690 S.Yosemite St., #100, Denver, CO 80237.

Supporting Colorado’s Fee-For-Service Dentisits

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Call: 303-320-4580

Legal Counsel to the Colorado Dental Association Since 1978501 S. CHERRY ST., SUITE 610, DENVER, CO 80246


F E A T U R E

I. OverviewBisphosphonates are powerful drugs

used to treat a number of diseasesincluding metastatic cancer and osteo-porosis. They are either given in tabletsor by intravenous infusion. The intra-venous formulation is more powerful thanthe tablets, but regardless of the route ofadministration, severe side effects mayoccur. This medication is of interest tothe practicing dental professional since adental procedure, usually an extraction ofa tooth, is associated with the develop-ment of osteonecrosis of the jaws.According to Ruggiero,17,19 a dentalprocedure has been associated with theonset of bisphosphanate relatedosteonecrosis of the jaws (ONJ) 80% of thetime. There is debate over whether or notthe dental procedure incited the diseaseor whether the disease motivated thepatient to seek treatment. There aremany oral complications noted in patientsreceiving treatment for malignancies,28 butthere were no reports linking chemother-apy and osteonecrosis until 1982 whenSchwartz1 reported ONJ in patientsreceiving chemotherapy. Recently, analarming increase in this disease has beenassociated with the advent and use ofbisphosphonates.

II. PharmacologyBisphosphonates were initially designed

for use as a water softener in the 1950s.They were banned by the EnvironmentalProtection Agency in 1964 because oftheir long half-life and poor biodegrad-ability. In 1966, bisphosphonates were

given to animals and were found toprimarily inhibit bone resorption throughosteoclastic inhibition and secondarilyinhibited new bone formation. This isdone through the cholesterol biosynthesispathway. In 1984, an interest in osteo-porosis and Skeletal Related Events (SRE)began, and drug companies began studiesto determine if a therapeutic effect couldbe derived from bisphosphonates. SREsuch as hip, femur and vertebral fracturesare associated with significant complica-tions – with 12 month mortality ratesranging from 12% to 35% with hipfractures.20 By 1995, Fosamax (alen-dronate) tablets were approved for thetreatment of osteoporosis. A 53%reduction of hip fractures was noted inpatients taking Fosamax.21 Bisphospho-nates can significantly decrease SRE andbone pain in patients with malignanciesas well. They are also used to treathypercalcemia of malignancy. Thesefindings have been welcomed in themedical community and have led to thewidespread use of these drugs.

There are currently two intravenousand three oral formulations of bisphos-phonates. Zometa (zoledronate) andAredia (pamidronate) are typically givenby intravenous infusion for cancerpatients with metastatic bone disease orto treat hypercalcemia of malignancy.Fosamax (alendronate), Actonel (rise-dronate), and Boniva (ibandronate) aregiven in tablet form for the treatment ofosteoporosis. There is poor intestinalabsorption and the oral versions can

cause severe esophageal irritation as wellas food interactions. Once administered,bisphosphonates are nearly undetectablein the bloodstream after 30 minutes.About 50% to 60% of the absorbed oraldose or administered intravenous dose issequestered in the skeleton in 15 to 30minutes; the remainder is eliminated bythe kidneys. The skeletal effects ofbisphosphonates persist long afterdiscontinuation, with a half-life estimatedto be 10 to 11 years.19

ONJ develops due to disruption of thenormal bone turnover cycle. Osteoclastsare inhibited and there is a subsequentloss of bone turnover. A study7 showedthat Aredia decreased bone blood flow inrats secondary to a decrease in insulin-like growth factor and growth hormone.Bisphosphonates have antiangiogenicproperties including a decrease invascular endothelial growth factor, adecrease in vessel sprouting, a decreasein capillary tube formation, and anincrease apoptosis or cellular death.7,10,12,22

Despite its antiangiogenic properties, it isfelt that the primary reason for thedevelopment of ONJ is due to decreasedbone resorption from osteoclast inhibition.19

III. Bone Pathophysiology/MetastaticBone Disease

Approximately 350,000 people die eachyear with metastatic bone disease.19

Patients with bone metastases may livefor many years and suffer from SRE(pathologic fractures, spinal cord traumaand nerve root compression) as well asbone pain and hypercalcemia of malig-

Bisphosphonate RelatedOsteonecrosis of the Jaws:

Report of Two CasesBy Gregory R. McGee, D.M.D. and Richard D. Zallen, D.D.S., M.D.


nancy. Of patients with metastatic bonedisease, 40% to 50% will require medicaltreatment or surgery.

IV. Incidence of BisphosphonateRelated Osteonecrosis of the Jaws(BRON)

About three million people have beentreated with the intravenous bisphospho-nate formulations, and six million with theoral formulations of bisphosphonates.19

Several studies have noted the incidenceof BRON to range from 0.05% to 12.5%.The drug manufacturer, Novartis (Aredia)stated the incidence to be 6/4,056 (0.15%),while an online survey of a multiplemyeloma group reported 75 cases out of1,203 respondents (6.2%).5 Durie states theincidence to be about 12% after a reviewof patients at the MD Anderson CancerCenter in Houston, TX.19 In a letter to theeditor, Durie et. al. estimated the incidenceof ONJ in patients taking zoledronate(Zometa) to be 10%, and 4% for thosetaking pamidronate (Aredia).27 The

average time of onset after bisphospho-nate administration to development ofBRON was three years, but has been asshort as five months.16 A definite riskfactor was a history of “dental problems”reported by the patient.5

V. Principles of Dental/Oral SurgicalTreatment

Treatment goals for patients with BRONare aimed at decreasing pain, controllingsoft tissue infection and preventingadditional exposure of bone.

Treatment of patients taking bisphos-phonates can be divided into four broadcategories:

1. Dental treatment prior tointravenous bisphosphonate therapy

Prior to administering bisphosphonates,all patients should receive a comprehen-sive dental examination, removal ofnon-restorable teeth and teeth with a poorprognosis, restorative dental procedures,dental cleanings, oral hygiene instruction,disease awareness,13, 24, 25 and evaluation ofdentures for mucosal irritation.

2. Symptomatic patients taking oralbisphosphonate therapy

These patients appear to be a muchlower risk compared to patients taking IVbisphosphonates. OMSNIC (OMS NationalInsurance Company) provides its sub-scribers with a designated consent form touse for patients taking bisphosphonates.23

Surgery is not contraindicated, but the

patient should be fully informed of thepossibility of developing ONJ. Discontinu-ing oral bisphosphonate therapy iscontroversial, Ruggiero advocated stoppingfor two months before an invasiveprocedure and restarting after full bonyhealing. At Denver Health, bisphosphonatetherapy is not interrupted because of itslong half-life. Endodontic therapy insteadof extractions should be done whenpossible.26 Patients should be educated andmade aware of the disease process.13, 24, 25

3. Asymptomatic patients receivingintravenous bisphosphonate therapy

Treatment of this group primarilyinvolves avoidance of invasive procedures(i.e. extractions), routine cleanings,aggressive management of dentalinfections, endodontic therapy instead ofextractions whenever possible (howeverthere are case reports where endodontictherapy has initiated ONJ26), diseaseawareness13, 24, 25 and examining denturesfor mucosal irritation.

4. Patients with established ONJ(Stages I- III)

Patients with ONJ should be informed oftheir condition and there should be opencommunication between the dentist, oralmaxillofacial surgeon, and oncologist.Superficial debridement of sharp,symptomatic edges may be done todecrease pain. No biopsy is needed

Risk factors for development ofbisphosphonate inducedosteonecrosis of the jaws are:

1. Zometa > Aredia >> Orals

2. Duration of bisphosphonatetherapy

3. Dental surgery

4. Poor dental healthOSTEONECROSIS continued on page 28


unless there is a strong suspicion ofmetastatic disease. It has been ourexperience, as well as Ruggiero’s, thatbiopsies of this type have not proven to bemetastatic disease and have onlyintensified the severity of ONJ. Bisphos-phonate therapy is continued as thebenefits outweigh the risks, and discontin-uing bisphosphonate therapy may notmake a difference. Hyperbaric oxygen hasnot shown any benefit.2, 4, 16

VI. Staging Bisphosphonate RelatedOsteonecrosis of the Jaws (BRON)

At the American Association of Oraland Maxillofacial Surgeons nationalmeeting in September 2005, Ruggieroproposed a three-stage clinical stagingsystem for patients with BisphosphonateRelated Osteonecrosis of the Jaws (BRON):

I. Asymptomatic exposed bonewithout signs of infection.

II. Exposed bone with pain andinfection.

III. Pathologic fracture, large areasof exposed bone not manageablewith antibiotics and conservativetreatment.

Treatment of ONJ is determined bystage and should be performed by an oralmaxillofacial surgeon or other healthcareprofessional familiar with this disease andits implications.

Stage I Treatment:• Chlorhexidine mouthrinse is used twice

a day empirically, there is no evidenceto document its effectiveness inmanaging ONJ.

• Avoidance of surgical procedures (i.e.placement of dental implants, extractions).

• Endodontic therapy instead of extrac-tions when possible.26

• Follow-up three months or sooner ifcomplications arise.

Stage II Treatment:• Pain control.

• Culture directed antibiotic therapy for

several months.

• Chlorhexidine mouth rinses twice a day.

• Avoidance of surgical procedures.

• Endodontic therapy instead of extrac-tions when possible.26

• Follow-up three months or sooner ifcomplications arise.

Stage III Treatment:• Pain Control.

• Culture directed antibiotic therapy forseveral months, consider inpatienthospital admission or outpatientintravenous therapy.

• Chlorhexidine mouth rinses three timesa day.

• Surgical debridement and resection todecrease load of necrotic bone. Mayneed to be aggressive.

About 85% of the time, stage III patientsstabilize, according to Ruggiero, whentreated according to this protocol.19

Case ReportsCase #1

A 70-year-old Hispanic female pre-sented to the Denver Health MedicalCenter Department of Oral and Maxillofa-cial Surgery on Feb. 24, 2005 with a chiefcomplaint of pain in her upper rightquadrant. The pain began in November2004 and the patient’s general dentistextracted several teeth. Her medicalhistory was remarkable for being diag-nosed with breast cancer in 2000 forwhich she was treated with a modifiedmastectomy and chemotherapy withAdriamycin and Cytoxan in 2000. Herinitial presentation was that of a largebreast lump with metastatic bone diseasein the spine, pelvis and long bones. Hercurrent medications included lisinopriland monthly Zometa infusions for 23months. Initially an area of about 1.5 cmby 2 cm was exposed on the rightposterior maxilla (Figure 1).

The patient was started on penicillin,chlorhexidine mouth rinses and scheduledfor a biopsy to rule out metastatic disease.The biopsy was performed and was

negative for malignancy. The diseaseseemed to stabilize, but the patientexperienced intermittent episodes of painand swelling. On Sept. 6, 2005, the patientpresented with a complaint of a stuffynose and pain. Her primary care physicianprescribed Sudafed and the patient wasadvised to follow-up with the Departmentof Oral and Maxillofacial Surgery. She wasseen on Sept. 12, 2005 with significantprogression of ONJ as well as obliterationof the right nares (Figure 2).

A total maxillectomy was performed onOct. 21, 2005 by the Department of ENTand Oral and Maxillofacial Surgery. Thepatient’s disease had stabilized, but sherequired subsequent procedures to help

Figure 1. Case #1 at presentation on Feb.24, 2005.

Figure 2. Case #1 – note purulence andincreased bone exposure. Photo taken onOct. 21, 2005 prior to her maxillectomy.

OSTEONECROSIS continued from page 27


with speech and swallowing. She passedaway in February 2006.

Case #2A 68-year-old male was referred to

Denver Health Medical Center’s Depart-ment of Oral and Maxillofacial Surgery byhis oncologist with a chief complaint ofpain on the lower left for four to five days.No recent history of dental treatment wasreported by the patient. His medicalhistory was remarkable for multiplemyeloma and obstructive sleep apnea.The patient also reported a rhinoplastyand pathologic fractures of the femoralneck necessitating a hip replacement andan open reduction of the ulna. Hismultiple myeloma was treated with

vincristine, adriamycin and dexametha-sone (VAD) for six months. Pamidronatewas started in February 2003 and givenmonthly along with VAD for six months,until Zometa was started in August 2003.Zometa was given for a total of fourmonths until ONJ was noted on Dec. 28,2004; the Zometa was then stopped.Figures 3 and 4 document the patient’spresentation.

The patient was started on chlorhexi-dine rinses and was maintained for aboutone month. On Jan. 31, 2005, a purulentexudate was noted from the patient’s leftmandible and he was started on clin-damycin. The exudate improved and thepatient continued to follow-up. He waslast examined on Oct. 10, 2005 and notedto have a slightly larger area of exposedbone, but was asymptomatic (Figure 5).He expired in January 2006 due tocomplications of chemotherapy.

ConclusionDue to the possibility of a dental

procedure initiating the process ofosteonecrosis, the dental practitionermust be aware of bisphosphanates andtheir implications for treatment. Athorough preoperative medical history andpatient education will minimize anycomplications associated with this diseaseentity. Any patient with a history ofcancer or osteoporosis should prompt aninquiry into the use of bisphosphonates.A consultation with an oral maxillofacial

surgeon and the patient’s oncologist orprimary care physician is appropriate.Treating this disease is difficult and mostlesions do not respond well to therapy. ■

Gregory R. McGee, D.M.D., is the formerchief resident of oral and maxillofacialsurgery at Denver Health Medical Center.He is now practicing in Albuquerque, NM.

Richard D. Zallen, D.D.S., M.D., is thedirector of dentistry and oral and maxillo-facial surgery at Denver Health MedicalCenter.

Bibliography1. Schwartz, HC, Osteonecrosis of the Jaws: A

Complication of Cancer Chemotherapy. Head &Neck Surgery, Jan./Feb. 1982; 4:251-253.

2. Gonzales-Moles MA, Bagan-Sebastian JV.Alendronate related oral mucosal ulcerations. JOral Pathol Med. 2000; 29:14-518.

3. Berenson J, Hillner B, Kyle R, et al. AmericanSociety of Clinical Oncology Clinical PracticeGuidelines: The Role of Bisphosphonates inMultiple Myeloma. J of Clin Oncology 20(17): 3719-3736, 2002.

4. Marx RE, Stern D. Oral and Maxillofacial Pathology: arationale for diagnosis and treatment. 1st ed, chapter2. Carol Stream, IL: Quintessence 2003; 36-38.

5. Durie B, Katz M, McCoy J, et. al. Osteonecrosis ofthe Jaws in Myeloma: Time Dependent Correlationwith Aredia and Zometa use. InternationalMyeloma Foundation 2004. Dec. 7, 2004 at theAmerican Society of Hematology Annual Meeting.

6. Durie B. Aredia/Zometa and osteonecrosis of thejaws. A New Update. http://www.myeloma.org/main.jsp?type-article&tab_id=1%menu_id=0&id=1259,2004.

7. Kapitola J, Zak J, Lacinova Z, et al. Effect of growthhormone and pamidronate on bone blood flow,bone mineral and IGF-I levels in the rat. Physiol Res49: S101, 2000 (suppl 1).

8. American College of Oral and MaxillofacialSurgeons. Bisphosphonate Treatment.

9. Kapitola J, Zak J: Effect of pamidronate on boneblood flow in oophorectomized rats. Physiol Res47:237, 1998.

10. Fournier P, Boissier S, FilleurS, et al. Bisphospho-nates inhibit angiogenesis in vivo andtestosterone-stimulated vascular re-growth in theventral prostate in castrated rats. Cancer Res 62:6538, 2002.

11. Greenspan S, Harris S, Bone H, et al. Bisphospho-nates: Safety and Efficacy in the Treatment andPrevention of Osteoporosis. American Academy ofFamily Physicians. http://www.aafp.org/afp/20000501/2731.html, Jan. 5, 2000.

L ink found between bisphosphonates and a seriousbone disease called osteonecrosis of the jaw.http://www.new-medical.net/print_article.asp?id=6844, Dec. 13, 2004.

12. Martin J, Grill V. Bisphosphonates - mechanismsof action Aust Prescr 23:130-2, 2000.

13. International Myeloma Foundation, patientbrochure for Dental Health and Osteonecrosis ofthe Jaw, available from: http://www.myeloma.org/pdfs/PatientDentalBrochure.pdf.

Figure 3. Case #2 at presentation on Dec.28, 2004.

Figure 4. Case #2 panoramic radiographat presentation on Dec. 28, 2004. Thearrow points to a lesion of multiplemyeloma, not biopsied.

Figure 5. Case #2 with increased area ofexposed bone, taken Oct. 10, 2005.

OSTEONECROSIS continued on page 30


14. Marx RE. Pamidromate (Aredia) and Zoledronate(Zometa) induced avascular necrosis of the jaws: agrowing epidemic. J. Oral Maxillofac Surg. 61:1115-1118; 2003.

15. Novis B. International Myeloma Foundation -Understanding Bisphosphonate Therapy.

16. Migliorati CA, Schubert MM, Peterson DE, SenedaLM. Bisphosphonate-Associated Osteonecrosis ofMandibular and Maxillary Bone, Cancer, July 1,2005, 104:1; 83-93.

17. Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL.Osteonecrosis of the jaws associated with the useof bisphosphonates: a review of 63 cases. J OralMaxillofac Surg. 62: 527-534; 2004.

18. University Health Care System. Bisphosphonate -Side Effects.http://www.univeristyhealth.org/116795.cfm, Jan. 9,2005.

19. Boston Meeting, AAOMS 87th Annual meeting,Symposium on bisphosphonate induced bonenecrosis.

20. Center JR, Nguyen TV, Scheider D, et al. Mortalityafter all major types of osteoporotic fracture in menand women: an observational study. Lancet.Volume 353, March 13, 1999. pp. 878-882.

21. Hochberg MC, Thompson DE, Black DM, QuandtSA, et al. Effect of alendronate on the age-specificincidence of symptomatic osteoporotic fractures. JBone Miner Res. June 2005; 20 (6):971-976.

22. Wood J, Bonjean K, Ruetz S, et al. Novelantiangiogenic effects of the bisphosphonatecompound zoledronic acid. J Pharmacol Exp Ther2002; 302:1055-61.

23. OMSNIC, Consent for Treatment for patients takingbisphosphonates, https://www.dds4dds.com/por-tal/server.pt/gateway/PTARGS_0_15737_628_0_0_18/Consent%20for%20Treatment%20for%20Patients%20Taking%20Bisphosphonates.doc.

24. For the dental patient: oral care for cancerpatients. Am Dent Assoc. 2002; 133:7; 1014.

25. National Cancer Institute. Oral complications ofchemotherapy and head/neck radiation (PDQ)2004.

26. Sarathy AP, Bourgeois SL, Goodell GG. Bisphos-phonate-Associated Osteonecrosis of the Jaws andEndodontic Treatment: Two Case Reports. Journalof Endodontics, 31: 759-763, October 2005.

27. Durie BGM, Katz M, Crowley J. Letter to the editor.N Eng J Med 2005; 353:99-100.

28. Sonis ST, Sonis AL, Lieberman A, Oral Complica-tions in patients receiving treatment formalignancies other than of the head and neck.JADA 1978; 97:468-472.

OSTEONECROSIS continued from page 29

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www.mendelandcompany.com1165 S. Pennsylvania St.

Suite 204 • Denver303-698-5628

P O S I T I O N S A V A I L A B L EOpportunity: Dental partnership available inemergency dental clinic in Denver. Limitednumber of partners accepted. You do not need towork there. The value of partner doctors’expertise and management skills advantageous.LLC with benefits of partnership without the risks.All inquiries confidential, [email protected],402/740-9235.Associate/Partner: Colorado Springs, Colo.This beautifully designed, well-established fee-for-service general dental practice is an excellentopportunity for a general dentist seeking anassociate/partnership opportunity in a uniquepatient-centered practice. This premier practicehas an excellent reputation in providingcomprehensive quality dentistry with anemphasis on cosmetic, laser and implantdentistry. Wonderful patients and growthopportunity with an exceptional dental team thatwill welcome you to the community. Please replyin confidence with your objectives, CurriculumVitae, and written goals to: The Sletten Group,Inc., c/o Terri Ness, 7882 S. Argonne St.,Centennial, CO 80016. Contact 303/699-0990, fax303/699-4863 or e-mail [email protected]. Associate/Partner Buy-In: Colorado Springs,Colo. Exceptional opportunity for right personwith advanced skills. Busy progressive,profitable group with great partners andsupportive staff. In-house lab, fee-for-service.Fax CV to 719/579-0155. Associate/Partner: High-quality grouppractice in Aurora is seeking a FTassociate/partner. Must have a minimum oftwo years dental experience. Potential forpartnership within 12 months. Please e-mailyour resume to [email protected]: Broomfield fee-for-service practiceneeds a part-time associate interested in afuture partnership and buy-in. Must haveexceptional people skills and a GPR or morethan two years experience. Will be required toprovide dental hygiene as an introduction topatients. Call 303/466-4784 and fax CV to303/466-5107.Associate: Positions leading to buy-in. CO:Boulder, Parker, Littleton, Denver (Spanishspeaking). Temporary Dentist Available: 20+years experienced practitioner will workanywhere in Colorado. WY: Casper, state-of-the-art facility, $1.2M collections, buy-in. OralSurgery Assoc.: Denver. Precise Consultants:Peter Mirabito, D.D.S., Jed Esposito, M.B.A.,www.dentalsales.com, 303/759-8425.Associate: Topeka, Kan. Established dentistseeks associate/partner to share a full-timeequity position in the practice. Great upscalelocation, excellent growth history withcontinued potential, unique educationalopportunities and a caring motivated staff!Please contact Susan at 303/973-2147 [email protected].

Associate Buy-In: Cheyenne, Wyo. Threeoperatory practice grossing $820,000, with 45percent overhead. Call Larry Chatterley303/795-8800.Associate: Associate needed for our estab-lished practice located Wheat Ridge/Denver,Colo. Great money for a production-orienteddentist. This is a full-time position. We seeadults and children. Please call Todd at303/940-9755.Dentists: Denver, Colo. Perfect Teeth isseeking senior dentists in Colorado with acompensation range of $90,000 to $200,000+.Successful private or group experiencerequired. Benefit package. Also seekingassociate dentists (compensation range $75,000to $95,000). Specialist opportunities alsoavailable for part- and full-time ortho, endo,oral surgery, pedo and perio with exceptionalcompensation. Call Dr. Mark Birner at 303/691-0680, e-mail at [email protected] orvisit www.bdms-perfectteeth.com.Dentist: Smiles 4 Kids is seeking an energeticself-starter, committed dentist to join our team.We serve children, ages 0-21, in our upbeatnew office. Competitive compensation packageand four-day work week. Colorado licenserequired. If you enjoy the outdoors, Montrose,Colo. is the place for your rewarding dentalcareer. Please submit resume/references to:[email protected]: Montrose, Colo. Established non-profitdental clinic has part-time (three days/wk) staffposition open for a Colorado licensed dentist.Duties will include direct service provision andclinical oversight/quality assurance. Ourcommunity based state-of-the art clinic servesthe dentally underserved (Medicaid, underin-sured and uninsured children/adults) on theWestern Slope. Desirable, beautiful locationnear the Black Canyon, Telluride and Ouray –great biking, hiking, skiing, hunting, fishing,camping and golf. Competent, experienced bi-lingual staff; competitive salary and benefits;possible dental loan repayment program. If youwant to change lives and work with great staffin a professional environment, contact Bill Sale,executive director, at 970/252-8896 [email protected]: Progressive group practice in theDenver metro area seeks general dentists,endodontists and oral surgeons to fuel ourcontinued growth in 2007. Full-/part-time. Pleasee-mail CV/resume to [email protected]. Endodontist: Progressive group practice ingreater Denver metro area seeks endodontist tosupport our very significant GP referral base.Part-/full-time. Pick your hours, pick your days,pick your locations – we will work hard withyou to make it work. Please e-mail CV/resumeto [email protected].

Classified Ads:Journal of the Colorado Dental Association,Vol. 86, No. 1, Winter 2007 issue.

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P R A C T I C E S / O F F I C E S P A C E F O R S A L E / L E A S E

Practice: North/central Boulder generalpractice with six chairs. Very modern. Averageage of dental equipment is two years. Canaccommodate two dentists. Gross income$950,000. Call 303/499-7133 or 303/579-9729.Practice: West Aurora, Colo. Sold: Denver(south City Park), Louisville, Colorado Springs,and Longmont! Call for new listings in metro-Denver, Lakewood and Western Slope! SusanSpear, Practice Transition Specialist/LicensedBroker, Medical Practice Brokers, Inc., 303/973-2147 or [email protected]: Must see! Located near Kennedy GolfCourse. Growing residential community underre-development. Priced to sell and so muchbetter than a start-up! Susan Spear, 303/973-2147, [email protected]: South central Colorado. Generaldentistry practice for sale. Three treatmentrooms with Dexis digital x-rays in each.Average age of dental equipment is five yearsnew! Practice has been in its present locationfor 40 years. Don't miss out on this excellentopportunity! Call Deanna Wright at 800/730-8883 or e-mail to [email protected]: Westminster, Aurora, HighlandsRanch, Colorado Springs and Denver. Call foradditional listings: Professional Marketing andAppraisal, 800/632-7155.Practice: Pueblo, Colo. Well-run family practicein a professional building. Four plumbed ops.1,566 sq. ft. Normal operative, surgical, implantequipment. No capitation or PPO insurance.Looking to transition ownership over to the

new dentist. Visit www.TransDent.com or callMercer Transitions at 800/588-0098.Practice: Southern Colorado pediatric dentalpractice for sale or looking for associate/ buy-in. Excellent opportunity with competitivesalary. Southern Colorado has numerousoutdoor activities. Very busy practice withdentistry limited to children and young adults.Hospital based dentistry is also practiced.General dentistry with an emphasis in treatingchildren also considered. We are seekingcaring, motivated individuals with excellentskills including sensitivity of the diversesocioeconomic and ethnic backgrounds of ourpatients. Please fax or e-mail resume [email protected] or 719/253-7761.Practice: Westcliffe, Colo. Beautiful small towncommunity, 75 miles south of Colorado Springs.Three operatories, $115,000 in collections for2006, two and a half days per month. ContactDr. Jonathan W. Hill, 719/392-1506. Practice: Southeast Denver, Colo. Grossing$980,000+, netting $400,000+, four days/week,four ops., 1970 sq. ft. with space to expand.5,100 patients, excellent lease + option,outstanding staff, great location near I-25 andlight rail. E-mail [email protected] formore information.Practice: Boulder, Colo. Practice at the foot ofthe Rockies in the beautiful, exciting city ofBoulder – where recreational, educational andlifestyle opportunities abound. Well-established,highly successful, high-income oral surgeryoffice offering a partnership leading to aprogressive buy-out and complete ownership.Owner will assist in the transition. Modern,highly computerized, no managed care.

Emphasis on dentoalveolar, implants, bonegrafting, pathology, some orthognathics andtrauma with full scope opportunities. Idealcandidate will be honest, caring, and haveexcellent people and surgical skills. Please sendobjectives and CV to: The Sletten Group, Inc.,7882 S. Argonne St., Centennial, CO, 80016.Contact 303/699-0990, fax 303/699-4863 or e-mail [email protected]. Practice: Durango, Colo. Unbelievable buy-inopportunity! Earn $125,000 first yr., guaranteedincrease, full ownership, sweat equity.Established GP, three ops., practice collected$1.2+ million. Buyer will receive majority ofprofit from growth. Practice mgt. and sellerassist. Prof. Practice Advisors, 800/863-9373,www.practiceadvisors.com.Practice: SE Aurora, Colo. Grossing $488,000with six operatories. Please call Larry Chatterleyat 303/795-8800.Practice: Longmont, Colo. Grossing $240,000.Overhead is under 50 percent with three newoperatories. Call Larry Chatterley at 303/795-8800.Practice: Grand Junction, Colo. Grossing$567,000 with four ops. Call Larry Chatterley at303/795-8800.Practice: Small town southern Colorado.Grossing $343,000, 51 percent overhead, busypractice, facility and equipment look great. CallLarry Chatterley at 303/795-8800.Practice: Delta, Colo. Acquire the building andthe practice for under $200,000. Call LarryChatterley at 303/795-8800.

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Practice: Pueblo, Colo. Call Larry Chatterley at303/795-8800.Seller/Buyer Services: If you would likemore information on how to buy, sell orassociate in a practice, please check our Website, www.ctc-associates.com or call CTCAssociates at 303/795-8800.Practices: CO: Aurora, Boulder, ColoradoSprings, Denver, Cherry Creek, DowntownDenver, Dillon, Fort Collins, Denver TechCenter, Glenwood Springs, Eagle, HighlandsRanch, Durango, Lakewood, Loveland, CentralCO, Southern CO, Steamboat Springs, Pueblo,Rifle, Southwest CO, Edwards, Winter Park. AZ:Arrowhead, Bullhead City, Prescott, Phoenix,Flagstaff, Yuma. NE: Scottsbluff. SD: Black Hills.WY: Casper (state-of-the-art facility, $1.2Mcollections, buy-in), Buffalo. Specialties: DenverMetro: oral surgery. Colorado Springs: pediatric.Precise Consultants: Peter Mirabito, D.D.S., JedEsposito, M.B.A., www.dentalsales.com,303/759-8425.Office Space: Ken Caryl: Three plus op. dentaloffice for lease. Littleton: 1,550 sq. ft. CastleRock: Five op. dental office for lease. PreciseConsultants: Peter Mirabito, D.D.S., JedEsposito, M.B.A., www.dentalsales.com,303/759-8425.Space Sharing: Denver, Colo. Share expenses –why pay for everything yourself? Seeking generaldentist/specialist wanting to share practice costswithout the burden of going solo on expenses.Office totally re-equipped three years ago. Fouroperatories, each with computer, intra-oralcamera, DVD, CD, satellite radio and TV. Digitalx-ray, Pan-X, Caesy, Luma bleaching, portableDiagnodent, Harvey, Statim, & Hydrim washer.Software schedules, bills, processes insurancefor multiple providers. Private office, consultroom, and reception room with large flat screeneducational program. Contact Dr. Pavlik,719/592-0878 or [email protected] Sharing: Office space to share inConifer, Colo. Share costs. Fully finished. Threeops. Ortho using part-time. Available threedays/wk. Perfect space for pedo or GP. Growingarea. Call 303/816-0148.Office Space: Fort Collins commercial land.Very desirable Harmony corridor location;highly visible across from mall. Initial work-up,layout, architecture approved for dental office.4,400 sq. ft. building plans w/eight operatoryoffice can also be included. Private financingpossible. [email protected] Space: Loveland, Colo. New construc-tion class “A” space; L.E.E.D. Certified:1,500-8,000 sq. ft. Available May 2007, Call Dr.Ted Mioduski, 960/663-1000.Office Space: Build/Relocate/Remodel: Callus or visit www.fcbidenver.com for free officelocator assistance. Foothills CommercialBuilders, the future is now! 303/755-5711 x306.Office Space: DTC/Highlands Ranch. Moderndental building in a new business park. Perfectfor a GP or specialist. 1,500 sq. ft. Centralvacuum and air compressor. Available immedi-ately. Contact Ken Andow at 303/799-1525.

Office Space: Castle Rock, Colo. Dental spaceavailable to build out, perfect for pediatrics,approximately 1,700 sq. ft. Call 720/733-1222for info.Office Space Partnership: Join our multi-specialty group private practice in Englewood,Colo. New state-of-the-art facility with qualityfinish and décor, and major arterial visibility.We offer a positive work environment,efficiently managed business systems and acollegial partnership. General dentist orendodontist preferred. Please call DaveWeymouth at 303/320-0999, or [email protected]. Confidentialityassured.Office Space: SW Colorado Springs, Colo.Open concept with dental chairs, Panorex andcabinets that can be purchased. Beautiful viewof mountains. Professionally designed,previously occupied by an orthodontist. 2,500sq. ft. Call Dr. Gary Stiehl, 719/636-3015.Office Space: Fountain, Colo. Close toColorado Springs. One of the fastest growingareas in Colorado. 25-year dental officelocation, available April 1. Dr. Stephen Seiler,719/576-4247.Office Spaces: Plug and Play #1: Finisheddental suite, south DTC. Three-to-five ops., twooffices, lab, reception, admin. #2: Finisheddental or oral surgery space, County Line Roadand south Holly Street. Four ops., office,reception, two restrooms, recovery room, twolabs. Great location, excellent value. ContactBob, 303/713-1588.Office Space: First floor office with fiveoperatory suites located in central Greeley. Allplumbing, nitrous lines, computer lines andcabinetry are in place, along with sterilizationroom and lab space. Call 970/356-5151.Office Space: Dental office condo for sale nearUniversity and County Line in Centennial. 2,028sq. ft. Leaseholds in place. Great location!303/881-1263. Office Space: Lakewood, Colo. Dental officespace for lease at 2290 Kipling St. Building haseight other dental practices. 1,000 sq. ft., threeops. plus office, lab and x-ray. Owner will assistwith cost of tenant finish. Call Jack Maxfield,303/919-0813.Office Space: Aurora, Colo. Professional dentaloffice space with up to 2,672 sq. ft. (which couldbe divided into two smaller suites) will beavailable July 1, 2007 for lease in a wonderfullocation and beautiful building. Office iscurrently partitioned, plumbed and wired with apossibility of four or more dental operatories.Great visibility with easy access near highresidential area. Ideal location for a generaldentist, orthodontist, pedodontist, prosthodon-tist or periodontist. Call 303/688-3838.

SERVICES/ANNOUNCEMENTS/MISC.

For Sale: Three Pelton-Crane Chairman chairs,one A-dec chair, several matched and mis-matched stools – good condition. NewImageintraoral (older style) camera/printer/monitor/mobile cabinet, Mada Jet XL injector, Visicominter-office wireless 8 station visual communica-tion system, Dr./asst. carts, NEW Kodak DX7590digital photo system, Buffalo vibrator, Toritcasting arm, lathe, vacuum former, Alginator,Ney shading light, hot water bath, case pans andmore. Needs? [email protected],970-988-6655.For Sale: Belt driven triple arm with hand-piece, mobile stand, foot controller; five feettall, excellent condition. Use for hygienehandpiece back-up, lab, jewelry, garage, back-to-the-’50s conversation [email protected], 970/988-6655.For Sale: Retiring-active dentist has twooperatory office with all equipment required fora general practice. Equipment available aftermid-December. Appointment preferred forviewing. Contact 303/296-2059.For Sale: New Solara High-Speed TitaniumHandpiece from Star Dental. Fiber-optic. lubefree ceramic turbine. Very lightweight andpowerful. Retails for $800. Asking $599. Callwith questions, 720/252-5407.Practice Management Software: PerfectByte:Comprehensive/user friendly/affordable, $695-$1,295. Billing, scheduling, recall module,charting, image storage, customizabledocuments and more. Free trial! www.perfect-byte.net, 877/767-7007.Temporary Coverage: We have more jobsthan we have dentists! Just name your flat dailyfee. Paid weekly. Bread and butter proceduresonly. Maternity, disability, personal leaves. Fee-for-service practices, not mills. We can’t callyou until you first call us. No strings orobligation. So say hello. Doctors per Diem, Inc.,800/600-0963. Temporary placement (locums)since 1997. Ask us the secret to working out ofstate occasionally or on demand, in state. E-mail: [email protected] or visithttp://www.doctorsperdiem.com.On-Call Services: I need occasional callcoverage two-to-three times per year. Do you?General dentist in south Denver area wishes toshare occasional on-call with other areadentists. Please call 303/733-8885.Looking To Hire A Trained Dental Assistant?We have dental assistants graduating every threemonths in the Denver/Boulder, Colorado Springsand Grand Junction areas. To hire or to host a32-hour externship, please call the ColoradoSchool of Dental Assisting at 866/880-3030.Service: Concerned Colorado Dentists (CCD) isa subcommittee of the Colorado DentalAssociation. We are in existence to helpcolleagues, staff and/or families who think theymay have a problem with substance abuse. Ifyou think you or someone you know may havea problem, please call Dr. Brett Kessler at720/989-7960 (day or night). All inquiries arekept confidential.

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VOL. 86 NO. 1 WINTER 2007 TerraFirma, your HR Department that feels like it’s down the hall!...

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Transcript of VOL. 86 NO. 1 WINTER 2007 TerraFirma, your HR Department that feels like it’s down the hall!...