gp - nysagd.org · ira levine, dds, fagd – (914)997-2775 region x – nassau joel goldenberg,...

FALL 2011GP Class of 2011 Masters and Fellows .................................................................................6-7Infection Control for Air-Borne Harzards-Masks and Respirators for Health Care Providers ....8A Commentary, ‘Mind the Gap’....................................................................................9-10Corner Consult ................................................................................................................11Raving Fans......................................................................................................................13Favorite Clinical Techniques from the Board of Trustees ...................................................14Installation Dinner Photos ...........................................................................................16-18

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www.nysagd.org | Fall 2011 | GP 3

GP – Journal of the New York State Academy of General Dentistry is published twice a year by the NewYork State Academy of General Dentistry. The issues are mailed out in March and September to all themembers of the New York State Academy of General Dentistry and are available on-line at www.nysagd.org.All correspondence should be addressed to the Editor at 222 Mamaroneck Ave, Suite PH, White Plains, NY10605 or [email protected].

The views, opinions and recommendations expressed in this publication are those of the respectiveauthors and are not necessarily endorsed by the Academy of General Dentistry. Placement of anadvertisement in GP – Journal of the New York State Academy of General Dentistry does not indicate anendorsement of its products or services by the Academy of General Dentistry.

The Journal of the New York State Academy of

General Dentistry

222 Mamaroneck Avenue, Suite PH, White Plains, NY 10605

Tel: 914-683-1139 Fax: 914-683-1345www.agd.org www.nysagd.org

Joseph DiDonato III, DDS, MBA, FAGD – EditorMichael Steinberg, DDS – Associate Editor

Paula Bostick - Interim Executive Administrator

2011-2012 Executive Council

President – Muhammed Kasem, DDS, MAGD479 Bay Ridge Parkway, Brooklyn, NY 11209

President-Elect – Louis Bartimmo, DMD535 Plandome Rd., Manhasset, NY 11030-1961

Vice President – Seung-Hee Rhee, DDS, FAGD

Treasurer – Berry Stahl, DDS4424 Third Avenue, Bronx, NY 10457

Secretary – Joel Goldenberg, DDS, FAGD131 Main St., Ste 10, East Rockaway, NY 11518

Editor – Joseph DiDonato III, DDS, MBA, FAGD608 South Ave, Rochester, NY, 14620

National Trustee – John C. Comisi, DDS, FACD, MAGD2333 N. Triphammer Rd., Suite 304, Ithaca, NY 14850

Regional Director – Abe Dyzenhaus, DDS, FAGD84-09 35 Avenue, Jackson Heights, NY 11372

Immediate Past President – Ira Levine, DDS, FAGD111 North Central Park Avenue, Suite 280, Hartsdale, NY 10538

Area Vice Presidents

Region I – ManhattanBenjamin Godder, DMD – (212)750-3478Tony D. Wu, DDS, FAGD – (212)682-0888

Region II – Brooklyn/ Staten IslandHenry Amen, DDS - (718)836-7612Michael Steinberg, DDS – (718)743-6680

Region III – Albany/Monticello/Kingston Edmise Forestal, DDS – (347)563-0146

Region IV – Schenectady/Northern TierMarshall Price, DDS – (518)356-0077

Region V – Syracuse/UticaJanice Pliszczak, DDS, MS, MBA, MAGD – (315) 469-3229

Region VI – Binghamton/ElmiraJoseph Jaen, DDS, FAGD – (607)723-9391

Region VII – RochesterTeresa Skalyo, DDS, FAGD – (585) 797-4579

Region VIII – Buffalo/Niagara/JamestownNicholas Rodo, DDS, MAGD – (716)675-2900

Region IX –Westchester/Rockland/Orange/Putnam/Dutchess Ira Levine, DDS, FAGD – (914)997-2775

Region X – NassauJoel Goldenberg, DDS, FAGD – (516)561-0957B.K. Verma, DDS, FICOI, FAGD – (718)699-8268

Region XI – QueensJames Keenan, DDS, MAGD – (718)474-4075Arthur Volker, DDS, FAGD – (718) 937-6750

Region XII – Suffolk Sheri Glazer, DDS – (631)361-3666Jay Orlikoff, DDS, FAGD – (631)751-8222

Region XIII - BronxStephen Lowy, DDS – (845)354-5699

The 2011 AGDmeeting in San

Diego proved to besomething for every-one. To be sure, theAGD leadershipworked hard to create ameeting worthy of ourtime and money. I

attended my first annual meeting in 1986 inSeattle and my impression has always beenthat this is the best time for me to collectCE and create a new plan for the year.For years the leadership has heard den-

tists- they want more practical, businessand finance courses. Well, Kevin Andersonand John Porter were just two of many thatconducted sessions on retirement planningand advanced investment. This was timelybecause according to Anderson, 35% of thelate baby boomers (born 1955 to 64) won’tbe able to maintain their same standard ofliving in retirement. A serious statistic.Furthermore, many practitioners will be

depending on the sale of their practice tofund their retirement, or worse yet the valueof their home. In both cases these itemsmay not translate into predictable cash.Here are some common mistakes:

Top 5 retirement mistakes• Ignoring the early working years- notsaving from age 25-35.

• Cashing out savings for a large purchase.(Home)

• Failing to structure portfolio for growth:stay in stocks (110 - age = % in stocks).

• Retiring too early.• In retirement, lacking a spend downstrategy or the discipline to execute it.

Retirement investment is difficultbecause, according to Anderson, we shouldprepare for contingencies. He asked,“Does anyone think the stock market isgoing to have a 15% downturn?”(Remember this is in July.)One lone hand raised from the back of

the room. After the drama in August thislone investor appears prophetic. Anderson gave us his strategy, “When

the market turns I have cash to buy fundsthat have fallen in price.” How? “A por-tion of new money always goes into cash tobe ready on the sidelines.”There is a lesson here in being prepared.

We know that we live in a time of tumul-tuous markets, 100 year storms and terror-ist actions. Do we need to be prepared?Now more than ever. In “Mind the Gap”we look at reasons to prepare for emergen-cies both within your practice and in thecommunity. The case is made to do yourhomework and consider additional trainingin disaster preparedness. When was the last time you were eager

to get back to your practice to install newcapabilities? This is what you get on theplane trip home from the annual meeting.A chance to sit and think about the newpotentials from what you’ve learned. Inthis trip alone I came home with additionsto social networking, retirement/investmentplanning, implant restoration and staffdevelopment ideas. I was thrilled to see that J. Craig Venter

was the keynote speaker. He is a pioneer inDNA research and the scientist whomapped the human genome. He has adream job- his research requires him to flyto tropical locales where his sailboat awaitsand to collect DNA in oceans never beforesampled. How’s that for a life? Venter described in some detail the lat-

est thinking on creating artificial life forms-cells with genetic material that has beenentirely created by his team. Look up aUtube video of Dan Gibson to see more onhis work in genetic engineering. And finally has this ever happened?

Recently a patient called while vacationingin the Bruce Peninsula, Canada, she had adry socket. Well not much I can do for her.Of course she could see a local dentist- butthat’s a half day activity and some bit ofresearch. Instead, and here is another greatbenefit of the AGD, I placed a call to a col-league in Canada- Dr Tony Mancuso,Welland Dental, a quick exchange of someinformation and my patient soon had a pre-scription to tide her over. Thank you Tonyand thank you AGD.

Editorialby Joseph DiDonato III DDS MBA FAGD

by Louis Bartimmo, DMD

BUILDING A BETTER ACADEMYNOT JUST A LARGER ONE

Once again the membership committeehas been charged with the task of

maintaining existing members and recruit-ing new members. For anyone who hasbeen a part of organized dentistry it seemslike this is a right of passage that eachmembership committee is charged withbringing in more new members. Well, we

are not just interested in members but providing an enduring andvaluable service to our members. We are sincerely interested inbuilding a community in the Academy that gives to members anessential element that can not be attained anywhere else.

One of our primary goals is to aid our members in fulfilling thecontinuing education requirements for licensure in New YorkState and for membership in the academy. We all believe that itis essential as professionals to stay current in new techniques andmaterials. Our purpose as Academy leaders is to provide accessto the kind of CE that will help our members improve diagnosticand treatment skills and thus, the delivery of care to all ourpatients. But even with that there is something more the Academyoffers.

Recently, Mrs. Paula Bostick, our education manager, recalledhearing AGD members characterized as “C.E. Junkies.” That isquite a compliment. On the other hand, Dr. David Halpern, AGD

past president, referred to us as “Cubicle Dentists.” That’s aninteresting observation. Whether it’s a cubicle in dental school orin our operatories, it’s true, we are isolated. Removed, consumedand sometimes overwhelmed by our practices, this is the reality ofdentistry today. But, in a larger sense these are all artificial walls.I have observed many of my colleagues at our C.E. courses whosat silently for hours, and even during lunch, with very little per-sonal interaction. This is not the purpose of education- sitting forseven hours listening to someone talk, nor the purpose of ourAcademy.

It is not the number, variety or the cost of CE courses nor the dis-count rates for car rental that are important in determining youraffiliation or membership in any professional organization. Forme the most important benefit to being a member of the Academyof General Dentistry is because I can share so much in commonwith my colleagues. I think we have to help others to see thevalue in this because otherwise we lose out on the greatest bene-fit and educational opportunity that can be found anywhere. It hastaken years to accumulate, it is priceless. It is invaluable. Thegreatest benefit? It is the members themselves, with their years ofexperience, training, wisdom, mentoring and friendship. And it’sa wonder that we don’t afford ourselves the opportunity interactwith our colleagues more often. To me, this is the element thatrings the bell.

In the final analysis, it is the members that make the Academy andbring distinction to it. As I prepare this year to take on thePresidency in 2012, “Let’s knock down some walls in 2011-2012.”

From the President-Elect

by Muhammed Kasem, DDS, MAGD

It is a great honor and privilege for me tobe sworn in as the president of the NewYork State AGD. I would like to thank thenominating committee, the Board, and themembers of the New York State AGD whogave me the opportunity to serve as theirpresident in this great state. About 39 yearsago, my older brother and my fatherencouraged me to be a dentist. Theyinspired me and gave me all of the supportI needed. The first full denture I made was

for my father. Whether or not it worked well, I will not say, but,it was the first one I ever did, so you can probably understand.Those memories of my brother and father supporting me bring mehere today. I respect them deeply and offer my sincerest gratitudeto them for their help and support.

I am fortunate to be a dentist . Dentists are leaders in our com-munities and we make a contribution to the community healthevery day we work and every day our patients follow our direc-tions. This is a remarkable place to be and with it comes the

responsibility to create a safe and happy work environment for ourcolleagues and employees. Life is not easy. Life can be blatantlytough. NYSAGD is going through tough challenges. Wise leadersof the BOT took that challenges. In our practices we sometimesface painful situations and complex problems. Victory over adver-sity starts when you accept the facts and face the challenges. Therewards go to those who meet difficulty face to face, and overcome it. Every noble work appears at first to be impossible. Ourgoal at the AGD, as in our practices, is high, our mission concrete,we believe in, both the individual and in the group to promotepublic oral health and foster the increased proficiency of generaldentists. We are committed to the advancement of the dental pro-fessional and we join, with pride, to work diligently toward theAGD mission.

"...that which ordinary men are fit for, I am qualified in; and thebest of me is diligence."

-William Shakespeare (King Lear)

n


From the President


by Abe Dyzenhaus, DDS, FAGD

Iam writing this article a few weeksafter the AGD national meeting washeld in San Diego. It was a great meetingwith a lot of discussion in the House ofDelegates and two highly contested elec-tions. In addition, the AGD offereddozens of courses with many worldrenowned speakers. And, it was in SanDiego, the place with the best weather inthe US, especially since the weather inNY at the time was in the midst of a heat

wave that saw the heat index hit between 110-115 degrees F.

Congratulations to Linda Edgar, from Washington State, who waselected AGD vice-president and Manuel Cordero, from NewJersey, who was elected AGD secretary.

In New York, we also have new officers: Mohammed Kasem isthe new president, Lou Bartimmo is the new president-elect andSue Rhee is the new vice-president. Good luck to all the new offi-cers.

Recently, the topic of conversation in my office and around theworld has been the economy. First, we saw Congress discussingraising the debt ceiling but it seems to take forever and when itwas finally resolved the US Government’s rating was loweredfrom AAA to AA+. This new lower rating has sent the world mar-kets into a decline wiping out the gains of the past few days. Thiseconomy will affect our profession, as well as many other profes-sions, as patients wait to see how the economy is going to affectthem and their wallets. But, our profession is resilient and I expectour patients to return to our offices for their treatment, it just maytake a little time.

As the summer season draws to a close and we look forward tothe fall season, the NYSAGD is resuming its continuing educa-tion courses. We invite you to come down and enjoy the coursesbut come to meet your fellow AGD members and the NYSAGDboard members. Maybe it’s time to think about getting that FAGDor the MAGD, check your transcript, you may be closer than you think.

See you at the courses.

From the Regional Director

by John C. Comisi, DDS, FACD, MAGD

Autumn is upon us!

How quickly the time seems to pass. As Ienter into my 5th year as AGD Trustee, Ihave seen many changes in organized den-tistry.

The new working relationship between theNYSAGD and the NYSDA is a great thingto be a part of. We were honored to have

ADA President Elect, Bill Calnon, ADA Trustee Steve GounardesNYSDA Executive Director, Mark Feldman, NYSDA PresidentChad Gehani and President-Elect Deborah Weisfuse, along withAGD President Fares Elias at the NYSAGD Installation Dinnerthis past spring.

Having all these leaders of organized dentistry in the same roomwith the NYSAGD leadership was a wonderful sight, and the net-working that occurred there leads me to conclude that if we allwork together, we can accomplish great things for our professionand our patients.

The evening went on to honor our new Fellows and Masters, apart of the event that impressed the NYSDA leadership. Theycommented on how wonderful it was to recognize those dentists

who were making such a commitment to greater learning and totheir patients and their practices.

This is an example of the new working cooperation between thesetwo organizations and the understanding that we must worktogether in this very hostile environment we are in today. Withoutside agencies attempting to redefine how we practice, it isimportant to speak with one voice.

The AGD has become that one voice, and its voice is being rec-ognized by other organizations in dentistry as being on the righttrack. Our White Paper on Work Force Issues is the basis of thisvoice and has been echoed in the ADA’s Breaking Down theBarriers to Oral Health for All Americans. This would have neverhappened a few years ago. What changed? Understanding. Theunderstanding that the AGD as the Voice for General Dentistryhas a good handle on how the work force issues need to beaddressed and dealt with. The understanding that there are morefundamental methods that can help us reach more of those in needthen is being suggested by the Pew and Kellogg Foundations.Understanding that using Expanded Function Dental Assistantssuch as our NY State Registered Dental Assistants in the dentaloffice, and dental hygienists directly supervised by the dentistwill enable us to care for and treat more patients effectively andsafely.

Now more then ever, it is so important to be a member of theAGD!

From the National Trustee


Congratulations to our new Fellows and Masters. The following doctor’sreceived their designations on July 30, 2011 at the AGD Annual Meeting

Convocation in San Diego, California.

Class of 2011 Masters

Binod K. Verma, DDS, MAGDNew York University School of

Dentistry, 1980Bachelor of Dental Surgery, Dental school India, 1970

John C. Comisi, DDS, MAGDNorthwestern University Dental School,

1983

Marc E. Lazare, DDS, MAGDNew York University College of

Dentistry, 1996

Awards at the Annual Meeting 2011San Diego

2011 Fellows and Masters

front row: Stewart Gordon DDSMAGD, Katte Anilesh DDS MAGD,Indu Anilesh DDS MAGD, Binod Verma DDS MAGD. Back row: Benjamin SchwartzDDS FAGD, John Lynch DDSFAGD, Peter Mehr DDS FAGD

Stewart Gordon, DDS, MAGD

Indu Anilesh DDS MAGDNew York University College of

Dentistry DDS

Katte Anilesh DDSBangalore University India. BDS


Class of 2011 Fellows

Andrew D. Frangella, DDS, FAGDNYU College of Dentistry, 2005

Michael Katzap, DDS, FAGDNew York University College of

Dentistry, 1995

Grecy R. Martinez, DDS, FAGDUniversidad Nacional Pedro HenriquezUrena (UNPHU), 1988 Doctor in

Dentistry (CUM LAUDE)New York University ( NYU), 1993,

Doctor in Dental Surgery

Benjamin E. Schwartz, DDS, FAGDNew York University, 2006

Not pictured: Edward Yi-Guey Huang, DDS, FAGD, David S. Stewart, DDS, FAGD

John W. Lepore DDS, FAGDSUNY Stony Brook

School of Dental Medicine in 1992

John T. Lynch, DMD, FAGD University of Pennsylvania, 1980

Emanuel LaylievNew York University

College of Dentistry, 2001

Peter J. Mehr, DDS, FAGDGeorgetown University, 1985


Infection Control for Air-borne Hazards-Masksand Respirators for Health Care Providers

(Penugonda Bapanaiah, BDS, MS, Patel Vikaskumar, BDS, MBA, Patel Anuja, BDS, MBA, Silver, Joel, BS, MS, DDS, Congiusta, Marie, DDS)

Various types of airborne pathogens con-taminate the health care setting environ-ment. These contaminants range fromparticles as small as viruses, fungi, andbacteria to larger particles that are envi-ronmental by-products. Health careproviders (HCP) should use personalprotective equipment (PPE) to minimizethe damage from hazardous agents. Inrecent years facemask technology hasresulted in new designs with greater effi-ciency which afford greater levels ofprotection. The respirator mask, in par-ticular, has improved in design and com-fort and has become a significant contri-bution in respiratory infection control.Both surgical and respirator masks havedifferent protective properties and know-ing these differences can be a valuablesource of information for HCP’s in ahigh-risk environments.

Surgical MasksSurgical facemasks were first used in theearly 1900’s. The purpose at that timewas to offer barrier protection from con-tact with open wounds. Since then, sig-nificant changes have lead to the devel-opment and improvement in design andfunction. Used by healthcare providersas well as members of the general popu-lation, facemasks have served todecrease the incidence of infection andillness from cross contamination andminimize the spread of disease. In 1991,OSHA issued the Blood BornePathogens Standard which recommendsthe use of surgical masks as part of theuniversal precautions that all HCWshould implement. The use of surgicalmasks has now been commonly adoptedand remains a standard in PPE for HCP. The fact that surgical masks act as aphysical barrier and not as a vapor barri-er is an important caveat. There is a mis-conception that all facemasks offer adegree of protection against biohazardswhen, in fact, they may not. While theprincipal function of the facemask is tofilter air before inhalation, the capacityto filter differs among types of masks.

Of concern to dental workers is the factthat the average surgical mask cannot fil-ter particles as small as viruses and bac-teria. This means, for example, that theuse of a surgical mask is useless in pro-tection against the H1N1 virus. Theviruses are small enough to pass throughthe mask and thus the mask offers noprotection against infection. This consid-eration has sparked a new interest in theuse of respirator masks for infection con-trol in highly contagious environmentsand during peak infection seasons.

RespiratorsOriginally developed in the 1900’s, respi-rators offered protection to soldiers fight-ing chemical warfare and later, for fire-fighters exposed to smoke and carbonmonoxide. It was not until the 1990’s thatrespirators found their way into the health-care field to aid in the prevention of drugresistant Tuberculosis. In the early 2000’san increase in HCW deaths from SevereAcute Respiratory Syndrome (SARS) andthe pandemic outbreak of influenza in2006, lead to further interest in the use ofrespirator masks. Respirators prove to bemuch more effective in protecting individ-

uals from contracting respiratory infec-tions caused by smaller microbes like theinfluenza virus. In view of this it raises thequestion of using respirators during fluseason and in the presence of high riskaerosols. Recommendations for the infec-tion control measures for H1N1 Influenzacan be found at http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm. Respirators are certified by the NationalInstitute for Occupational Safety andHealth (NIOSH) which publishes a list ofcertified respirators. (http://www.cdc.gov/niosh/topics/respirators/)To be certified a respirator must filter apercentage of airborne particles and havean oil resistance rating. Letters areassigned to signify the level of oil resis-tance. The three categories of resistanceto oil are labeled N (Not resistant to oil),R (Resistant to oil), and P (oil Proof).Similarly, numbers are assigned to indi-cate the capacity to filter, thus a respira-tor that filters 95% of airborne particleshas a rating of 95. Ratings are from 95-100.HCP’s should wear a N95 rated respira-tor or better during aerosol-generatingprocedures. When respiratory protectionis required in an occupational setting,respirators must be used in the context ofa comprehensive respiratory protectionprogram that includes fit-testing andtraining as can be found under OSHA’sRespiratory Protection Standard.Many respirators contain an antimicro-bial-coated layer. For example, Iodine isadded to increase filtration capacity.These respirators can be highly effectivefor healthcare providers who work inhigh-risk environments that may containviruses like influenza. Respirator masksare more effective compared to the sur-gical facemask during the flu season orduring outbreaks of severe infectiousdiseases. Respirator masks offer the bestprotection to people who must workwithin 6 feet of contaminated sites orpeople infected with the influenza virus.

Respirator Mask


Abstract:

Anyone who has traveled to London, andhas taken its Underground system fortransportation, has heard the announce-ment to “mind the gap” when a train isapproaching a station. At some pointsthere is a considerable separation betweenthe metro car and the station when thetrain comes to a stop. The phrase is soassociated with the Underground thatTransport for London sells T-shirts withthis phrase on a London Transport symbol.

The particular “gap” that the authors arealluding to in the following commentary isthe considerable lack of emergency plan-ning in most office- based healthcare pro-fessional practices, and thus the inabilityto be ready and able to respond to a widespread emergency, or disaster situation.The fact is most of these offices have nocontingency plans in place, and their staffsare probably not trained to react effective-ly. How soon would these offices recoverfrom an event, and could they offer assis-tance to an overall public healthresponse?

Introduction:

Since September 11th, large and moderatesized businesses and other private sectororganizations have increasingly acknowl-edged the need to have organization-wideemergency management and business con-tinuity programs in place. In the UnitedStates alone, this need has been provenreal by recent events including devastatinghurricanes in America’s southeast, theblackout of the Northeast, tornadoesthroughout the Midwest, wildfires in theWest, and the recent nationwide threat ofan H1N1 pandemic.

Corporate preparedness can mitigate theimpact of emergencies on both people andproperty. The degree of preparedness orthe lack of it, can determine the ongoingviability and continuity of a company or aninstitution.

In 2007, the President signed into lawstatutes concerning “Private Sector

Preparedness”. As a result FEMA is nowthe lead federal agency for creating publicstandards of resiliency and certifying busi-ness compliance. This was followed bytwo publications from the U.S.Department of Homeland Security (DHS)to organize national efforts: the NationalPreparedness Guidelines, which estab-lished a goal for national preparedness;and the Target Capabilities List (TCL),which describes national capabilities toprevent, protect against, respond to andrecover from terrorist attacks, major disas-ters and other emergencies.

To be prepared to face the threat ofunplanned business interruption corpora-tions introduced the position and processof business continuity management. Itsaim is to safeguard information technolo-gy, identify critical activities, developalternate operations, and exercise recoveryplans.

Discussion:

Until recently however, little informationon preparedness was available for the den-tal practitioner who wished to protect theiroffice, their staff and their patients, and atthe same time show a commitment to theircommunity. For this practitioner emer-gency planning might consist of four phas-es; mitigation, preparedness, response andrecovery, the latter the longest and mostdifficult period.

Reports vary, but 40 per cent of small busi-nesses do not reopen after a major disastersuch as a flood, tornado or earthquake.However, appropriate and quick action andbasic planning can help minimize theimpact of any emergency on people andthe physical infrastructure. Those in a dan-ger zone must consider the resources avail-able and must establish priorities forresuming operations when a danger haspassed. These responses must be plannedand drills must be conducted. Disasters aredifferent from daily emergencies, whichare part of a community’s routine, and theycan present many unique problems. Thedifference is more than just the magnitudeof casualties and physical damage; roads

may be blocked or jammed, telephonesmay be overloaded or nonfunctional,emergency responders and the publichealth system may be overwhelmed, elec-tricity may be out and major facilities maybe damaged.

A toolkit, prepared by the AmericanMedical Association (AMA) andColumbia University School of NursingCenter for Health Policy, “What To DoBefore, During, and After An Emergencyor Disaster: A Preparedness Toolkit forOffice-based Health Care Practices” isavailable through the AMA ($35). TheAmerican Dental Association (ADA) hasalso fully endorsed the toolkit for dentist’soffices.

The toolkit includes:* assessing vulnerability;* business continuity planning;* training staff to implement the plan;* evaluating staff readiness by drills andexercises.

Emphasis is also on helping the practiceconnect with local emergency prepared-ness partners to become a resource. Sincehealth professionals will have a role toplay in any possible (all-hazards) scenariotheir effectiveness will depend on theirpreparation to assist.

The first step is to define the possible haz-ards in their area. Over and above terror-ism or a pandemic, are they likely to expe-rience an earthquake, a hurricane, or possi-bly a tornado.

One key decision to make is how they seethemselves responding to the emergency.Will they stay open if possible, seeing justtheir patients, or all patients, or will theyserve elsewhere as additional manpower.In addition, all staff members should havea family emergency plan in place, knowtheir probable reaction roles and when andwhere to report.

As a further update, and to address theconcerns generated by the recent H1N1pandemic crisis, the US Occupational

A C om m entary, ‘ Mind the G ap’ David L. Glotzer, DDSBenjamin Godder, DMD

continued on next page

Save the Date:First Annual Region I/Region II AGD Meeting

A Dental Implant And Socket Preservation Update: For The Cutting Edge General Dentist. From Surgical

Placement To Restoration. Check the NYSAGD website for more details in the near future.

Speaker: Dr. John Minichetti

March 30 and 31, 2012

Mystic Hotel and Spa in Groton, Connecticut


Safety and Health Administration (OSHA) has issued a directive entitled “PandemicInfluenza Preparedness and Response Guidance for Healthcare Workers and HealthcareEmployers.”

Both the Preparedness Toolkit and the Pandemic Influenza Guidance can be found athttp://www.nycepce.org.resources.htm.

What became clear after 9/11 and hurricane Katrina was that for the most part the tradi-tional healthcare workforce needed to be better trained to respond to wide spread disas-ters. It became clear that specific knowledge of chemical, biological, radiological,nuclear and explosive agents (CBRNE) are additional competencies for those choosingto be prepared.

One of the major reasons a possible ‘gap’ exists is in the fact that although there has beeninitiatives to train existing health care workers, courses on public health response are stillnot yet a standard part of the average health professional’s school curriculum.

At the New York University College of Dentistry’s an effort to build a preparedness cur-riculum for its students began shortly after 9/11. It was developed around four questions:1. Why should dentists be concerned and involved? 2. How can dentists respond to a cat-astrophe as part of the organized public health effort? 3. What additional practical train-ing is useful for dentists? 4. How can the average general dentist prepare to protect them-selves if a disaster occurs when they are in their offices?

We believe it is essential for all health care professionals to become equipped to react toa disaster or public health emergency. Furthermore, there must be a shared uniform pol-icy of preparedness activities between the public health sector and all of the health pro-fessions, and their governing agencies.

A C om m entary, ‘ Mind the G ap’ … continued from previous page

CourseSchedule

OctoberOctober 2, 2011NYSAGD Stated Meeting3 Speakers/3 Topics (8:30am - 3:00pm)A ‘triple play’ series of lectureson various topics. Category: LectureLocation: East Elmhurst, NYSpeakers: Drs. RichardGoldman, Analia Veitz-Keenan,M A Kasem6 CE Lecture Credit Hours

NovemberNovember 4 & 5, 2011 Empire State Masters Programon Oral Surgery with Dr. Karl Koerner (8:30am - 4:30pm)Oral surgery including socketbone grafting, moderate thirdmolar impactions, repair ofsinus perforations, alveoplasty,and the management of pain,swelling, and bleeding. Category: ParticipationLocation: Glen Cove, NYSpeaker: Dr. Karl Koerner14 CE Participation CreditHoursNovember 11, 2011 Dr. Michael Goldfogel (8:30am - 4:30pm)This hands-on seminar willdemonstrate proper placementand contour of anterior andposterior composite restorationsCategory: ParticipationCheck the website for moredetails


Can you improve this case? Often col-leagues will discuss a case over lunch,sometimes with the benefit of models,radiographs and photos. While nothingsurpasses an actual patient exam here aresome photos of a case your colleague isworking on. Before the final impressionsare taken what would you suggest wouldimprove the outcome?

A 46 year old male presents with a failingveneer proximal caries on #8 and a MLfracture on #9. He is dissatisfied with theuneven gum line of his two front teeth andthe broken restorations. To address theimmediate esthetic dilemma #9 wasrestored with a composite and the patientwas asked to return for a treatment planpresentation.

Figure 1 Pre-op

Figure 2 Pre-op guidelines

Discussion

JoeD- This can be a tricky case. Thepatient says that they have only this oneexpectation but a lot can go wrong whenwe try an do ‘just a little improvement onan anterior problem.”

Artie- I agree this can be a challenge espe-cially because from what I understand inthis case patient preferences were part ofthe constraints.

JoeD- Okay, so creating an esthetic resultin this case requires a multi-disciplinaryapproach. There are multiple challenges;poor dental hygiene, limited tooth size andthe well known difficulty of restoring oneor two anterior teeth.

Artie- Yes, and this patient was a filmmaker who traveled to South Americawhere he filmed indigenous people. I wastold that the opportunities for good oralhygiene were limited and that’s why hecouldn’t make regular dental visits.

JoeD- Okay, so what about the gingivaldiscrepancy? The golden proportion?

Artie- Yes, that’s the first thing I see. Buthe question is how much do you correctand where?

JoeD-The height of #9 should be severalmillimeters larger and its tempting to justdo a gingivectomy on #9. However, thereneeds to be an analysis of the bone levelsbefore proceeding. This means access toradiographs and complete probing to deter-mine the sulcus and bonecontour. Generally I like to see the gingi-val margin of the centrals approximate thecuspids, but in this case that might be tooextreme.

Artie- Here is where the patient prefer-ences again made the case more diffi-cult. The patient declined crown lengthen-ing. He wanted just a minor improvementof the gingival height on # 9. Because ofthat it was decided to do a laser gingivec-tomy to acquire just enough gingivalheight to bring the two centrals to the samelevel.

JoeD- What if he would have said yes toperio surgery, what would you have done?

Artie- If the patient did elect to have theperio surgery, a great way to handle thereferral would be to send a prescription andthe final gingival position desired markedon either a cast or a photo.

JoeD- So, is this a case that can be doneinstead with a laser?

Artie- In this case #9 probed three mil-limeters on the facial. That would easilyallow two millimeters of gingival removalwithout encroaching the biologic width.The likelihood of compromising the bio-logic width increases as we remove tissue

apically. We also have to contend with thefrenum attachment which is about sevenmillimeters away from the free gingivalmargin. So if the free gingival margin isreduced two millimeters do you risk amuccogingival involvement with thefrenum that low? I think the treating den-tist has just enough room.

JoeD- I can see where crown lengtheningsurgery would give a predictable result, butis this the kind of case that judicious use ofthe laser can accomplish the job?

Artie- I would agree with that.

JoeD- Okay, so that’s the apical determi-nate of tooth length, if he is going to havenew crowns what about the position of theincisal edge?

Artie- Well the clinical crown length isdefined by the gingival free margin and theincisal edge. I find it helpful to look at theincisal edge of the laterals in relation to thedesired position of the central. Certainlythe placement of the incisal edges will begoverned by the incisal guidance and thepatient preference, but I like to look at theso-called “lip at rest” view, and see howmuch tooth is showing. For youngerpatients I might let a little more tooth show.In other words, what can the occlusionsupport in protrusion and what length doesthe patient desire the front teeth.

JoeD- I agree, also getting patient accep-tance to tooth length and incisal position isparamount. Creating temporaries that areperhaps slightly too long and then adjust-ing them in the mouth is one way to assurepatient acceptance of the final result. Andfor the final result I will sometimes send analginate study model of the temps to thelab as a guide.

Discussion by Arthur Volker DDS MSEdFAGD and Joseph DiDonato III DDSMBA FAGD

(Do you have a case you would like to sub-mit or discuss? Contact the Editor atNYSAGDeditor at gmail.com)

Corner Consult


NYSAGD BYLAWS Suggested Changes approved by the BOT on April 14, 2011

Dr Robert Margolin, Chair, Bylaws Committee

ITEM 1 -Under the duties of the Treasurer in Chapter V111, Section 4, Subheading E. Duties of the Treasurer, item #9 states: “Toemploy, with the approval of the Executive Council, a Certified Public Accountant to make an audit of the books prior to his/herreport at the Annual Spring meeting of the NYSAGD.” As per the Treasurer, since we do not and have not employed an accountant, if we do not change this we have been and will continueto be in violation of our By-Laws. If we proceed with this every year, the financial implication will be between $5,000 and $10,000yearly. The following resolution is presented:

Resolution 1 Resolved that Chapter VIII, Section 4, Subheading E. Duties of the Treasurer, item #9 be deleted and replaced with the following “Toemploy a Certified Public Accountant, with the approval of the EC, to conduct an audit of the books prior to his/her report at theAnnual Spring meeting of the NYSAGD no fewer than once every five years effective January 2012.”

ITEM 2- Chapter IX, Section B, item 5 states that “Budget and Finance shall present an audited financial statement annually to the Board of Trustees prior to the Spring Meeting”. As per the Treasurer, this is currently not being done. As for the audited statement annually, he suggests that we are looking at signifi-cant costs involved. An audited statement by our CPA or any other CPA will cost an additional $4000 per year. The treasurer suggeststo delete this clause.

Resolution 2 Resolved that NYSAGD Bylaws Chapter IX, Section B, Item 5 be deleted

ITEM 3- Currently, Bylaws Chapter VIII, Section 1, item F states that the Executive Committee “shall establish salary of all NYSAGDemployees”. This current section of the Bylaws is in conflict with Chapter IX Section 1B-4, which tasks the Budget and FinanceCommittee to present the budget tothe BOT for approval or amend-ment, as well as Chapter VII Section3C, quoted earlier, which tasks theBOT: “To approve a budget for thecoming year.” The following resolution wouldallow the EC to recommend—notestablish- salaries with the finalapproval given to Budget andFinance Committee and then to theBoard of Trustees.

Resolution 3 Resolved that Bylaws Chapter VIII,Section 1, item F be amended as fol-lows- F. It shall recommend the salary ofall NYSAGD employees.

SIZE SCREEN W IO # NOTES

Practice Made Perfect


The book is written as a parable, a newmanager is told to improve the customerservice department and fortune smilesupon him when his fairy godfather pro-vides him with insights on how to createraving fans.

The premise is that we live in a societywith eroding customer service and thatwe have come to accept it as the norm.As owners of a business if we careabout success we must care aboutexcellent customer service.

The worst thing you can do is meet expecta-tions sometimes, fall short another and exceed every now

and then.

You need to be focused beyond your vision. Only an up to theminute vision can create raving fans.

The perfect vision is constantly changing because the wants andthe needs of the patients are changing.

Step 1: Decide what you want.• The starting point- a detailed vision based upon your

idealism and understanding of the service model youwish to create. Think of ways you can creativelyexpand your menu of options. Will you try to wowpatients with hi-tech, a ‘family’ oriented delivery styleor perhaps a calm, soothing spa setting? Write out thevision in detail.

Step 2: Discover what the customer wants.• Second, what do your patients want? What do they

think about your practice? This is the central idea of thebook. In some circles it is called the ‘voice of the cus-tomer’. Consumers have grown numb from inadequateperformance. Many say nothing when they are dissat-isfied. Therefore, you must listen to what your patientsare telling you, and you must also be attentive to whatthey are not saying. Many patients will avoid con-frontation and simply leave. Poor service has createdapathetic consumers who feel complaining may not doanything but waste their time. So, ask your clients whatthey want, what you are doing well, and what could bebetter.

• Then be prepared to alter your vision in response toyour patient’s feedback. Are you prepared to acceptthat you cannot be all things to all people? Are youprepared to accept that your perception of servicedelivery might not be hitting the mark with yourpatients?

Step 3: Deliver, plus one percent• To create a raving fan you need to exceed on delivery

of your service promise each and every time the cus-tomer deals with you, the customer needs to believe

that they can count on you again and again.Consistency creates credibility. Start by making smallchanges to your current customer service model andgradually build on these changes, this way you will beable to achieve consistency of service. To achieve this level of consistency you will need sys-tems, training, alignment between your vision andpay/promotion, these systems are required to buildyour vision in to the soul of the company. Customer expectations don’t remain static so be pre-pared to continually enhance your vision.

Flexibility—What is delivered.Consistency— How it is delivered.

The Rule of One percent-move ahead beyond the visionMonitor the patient needs. Do some patients require differentlevels of service?

Take the vision and turn it into an action plan.

Raving Fansby Ken Blanchard and Sheldon Bowle

Summary by Linda Edgar DDS MEd MAGD

Practice Exclusive to

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Ultrasonics in Endo and SealantsI use ultrasonics for many clinical conditions. Three of myfavorites are to create and improve endodontic access. This isespecially handy when I have a potential MB2 canal in an upperfirst molar. I also like to use it to refine the access so that myinstruments have a smooth path of insertion. This allows me tocreate a straight path from the cavosurface right to the orifice ofthe canal. I also like ultrasonics for the placement of sealants.Occasionally I may find the grooves of a tooth are deep and vari-ously stained or superficially carious. Using the ultrasonic tipallows me to lightly excavate the grooves. This is nice because itis atraumatic for children and often gives me enough excavation toimprove the sealant success. And lastly when I have a post toremove this is my instrument of choice. I can use it to lightlyexcavate the cement around the post and leave the tooth structureintact.

(Cemented post removal with an ultrasonic device. Before and after.)Dr James Keenan

Impression Technique for InvisalignThe Invisalign technique demands an accurate impression so thatevery anatomical aspect of the tooth is portrayed in the finalmodel. To arrive at a great impression I use a putty and a washtechnique. My first step is a solid putty which will give me a goodfoundation. Then I use a hydrophilic wash for great detail.

-Dr Art Volker

Inoffice Splints Minor Tooth MovementIn cases where I need to achieve some minor tooth movement butit doesn’t justify full blown orthodontic treatment I will sometimeselect to make a hard acrylic stent and use block out material in the

direction I want the tooth to move. I then lightly relieve the modelin the area of the tooth where I want the stent to apply force. Overa short time this usually affords me enough movement to gain theadded space or improve the case esthetics.

Dr. Ira Levine

Dycal for Temp CementI like it because it holds well, cleans up nicely, sets very quicklyand the price is right.

Dr. Janice Pliszczak

Full Arch Rubber DamDuring full mouth rehab it is so convienent to have fully retractedfield. I find that punching two holes in a rubber dam and then cut-ting a short “U” will allow me to isolate the entire arch.

Full Arch Rubber DamDr. Joseph DiDonato III

The Dental Button for Constructing TemporariesThe Button is a thermoplastic product. It comes in two differentshapes, round and oblong. It is used to make a plastic mold of thetreatment area to aid in the making of temporary crowns and orbridges.

Heat the button in hot water. When soft, place the button over thetreated area. Extend the button to establish occlusal stops. Thenrinse with cold water until it is opaque, then remove. After thefinal preparation is complete inject the temporary material into theform and set it back over the teeth until the temporary material hashardened. Remove the button from mouth with the newly formedtemporary.

Dr. Louis Bartimmo

Favorite Clinical Techniques from the Board of Trustees


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Installation 20011 Meritorious Service Award Dr. Robert Margolin (l.) with Dr. Abe Dyzenhaus


Dinner

From left, Seung-Hee Rhee, Joseph DiDonato, JoelGoldenberg, Muhammed Kasem, Louis Bartimmo

Installed new members to our 2011-2012 Executive CouncilMuhammed Kasem, DDS, MAGD – President*Louis Bartimmo, DMD – President-Elect*Seung-Hee Rhee, DDS, FAGD – Vice President*Berry Stahl, DDS – SecretaryJoel Goldenberg, DDS, FAGD – Treasurer*Joseph DiDonato III, DDS, MBA, FAGD – Editor*John Comisi, DDS, MAGD, FACD – National TrusteeAbe Dyzenhaus, DDS, FAGD – Regional DirectorIra Levine, DDS, FAGD – Immediate Past President*

*Newly installed


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Big Apple

2012

Dental Meeting

Sponsored byThe Bronx County Dental Society

WEDNESDAY, MARCH 28, 2012 THURSDAY, MARCH 29, 2012

THE SHERATON MAHWAH. MAHWAH, NEW JERSEY Two full days of education Morning, afternoon and evening seminars Commercial Exhibits Rebate Coupons for Exhibitors Free Parking: Indoors and Outdoors Free Breakfast and Free Buffet Lunch

For Paid Seminars EXHIBIT HOURS: 9:30 a.m. to 7:00 p.m.

CONTINUING EDUCATION CREDITS WILL BE GIV-EN TO ALL ATTENDEES. THESE CREDITS WILL BE APPLICABLE FOR DENTIST AND DENTAL HYGIENIST RE-QUIREMENTS AS ALLOWED BY STATE LAW.

SPECIAL BONUS FOR ATTENDING OUR SEMINARS

A $25 exhibitor’s coupon will be given to each dentist for attend-ing a full-day seminar and a $10 coupon to each dentist attending a half-day or evening seminar. When presenting your $25 or $10 coupon for full day, half day and evening paid seminars — any purchase made at the exhibitor’s booth will be discounted at the $25 or $10 rate. You will receive a coupon for every paid course that you attend and no minimum purchase is required!

26th AnnualBIG APPLEDENTAL MEETINGSponsored byThe Bronx County Dental Society

2012 Partial List of Speakers

For further information, contact: The Bronx County Dental Society

718-733-2031 718-733-0186 (fax)email: [email protected]: www.bigappledentalmeeting.us

Secure online registration on our website.

The New York StateAcademy of General Dentistry222 Mamaroneck Ave.White Plains, N.Y. 10605

PRSRT STDUS POSTAGE

PAIDWHITE PLAINS NYPERMIT #4304

2011 Section 2 Delegation to the AGD National MeetingHouse of Delegates.Left to right: Drs MuhammedKasem, Brian Ciporin, Seung-Hee Rhee, Berry Stahl, Louis Bartimmo, NathanHershkowitz, Artie Volker

Delegates to the Annual meeting atthe conclusion of the House of

Delegates-from left to right, Drs. Joe DiDonato, Ira Levine, Janice Plisczak, Jim Keenan,

Brian Ciporan, Abe Dyzenhaus,(obscured, Binod Verma),

Lou Bartimmo, Muhammed Kasem,Artie Volker, Steve Akseizer,

John Comisi, Seung-Hee Rhee,Nathan Hershkowitz.

gp - nysagd.org · ira levine, dds, fagd – (914)997-2775 region x – nassau joel goldenberg,...

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