Summer 2009

SPRING 2010, VOLUME 36, ISSUE 2

Team TAGD, Ser ving YouInside this issue: TAGD Advocacy Fund

2010 Lone Star Dental Conference Preview

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY2

1-866-300-9426 • www.unitedconcordia.com

Let us be your dental health partner . . .And help grow your practice to include patients from the largest dental customer in the world—the TRICARE Dental Plan—which has over 167,000 enrollees in Texas.* Plus, you’ll join over 66,500 dentists nationwide and over 4,000 dentists in Texas* who enjoy network benefits, including: •Competitiveandtimelycompensationandreimbursement •Claimssubmissionsthroughourfreeonlineprocessingsystem •Onlineaccesstopatients’benefitsandclaims

information through My Patients’ Benefits •Programupdatesandcorporateandindustry

news in the quarterly Connection newsletter

TXAGD-0608 • Texas dental products are offered by the following operating subsidaries of United Concordia Companies, Inc. —United Concordia Insurance Company for Fee-for-Service products and United Concordia Dental Plans of Texas, Inc. for DHMO products. *Based on United Concordia internal research & reports, 04/08.

How Close Are You?TAGD wants to help you on the road to Fellowship & MastershipIf you received your Fellowship before 2003 hours might be lost from your transcript. Contact the TAGD office and we will help you recover those hours. You may be closer to Mastership than you think!

September 9 - 12, 2010Austin, TX

AT&T Executive Education & Conference Center

Operative Dentistry • Presented by Dr. Gordon Christensen

Implants • Presented by Dr. Frank Higginbottom

For more information visit www.tagd.org or call the TAGD office at 512-244-0577

TAGD has worked to make the

MasterTrack seminars a true

benefit for TAGD members. Each

session is $895 for 48 hours of

participation credit - That’s only

$18 for each hour!

3Spring 2010

PresidentDan McCauley, DDS, FAGDMount Pleasant

President-ElectJoey Cazares, DDS, FAGDMcAllen

Immediate Past-PresidentRon Theiss, DDS, MAGDNacogdoches

Secretary/TreasurerMark Peppard, DDS, MAGDAustin

EditorJeff Roy, DDS, FAGDIrving

Director (2010)Craig Armstrong, DDS, MAGDHouston

Director (2010)Dean Armstrong, DDS, MAGDAmarillo

Director (2011)Jamie Bone, DDS, FAGDKerrville

Director (2011)Gary Jennings, DDS, MAGDHouston

Director (2012)Carlos Garcia, DMDWeslaco

Director (2012)Andrew Lazaris, DDS, FAGDPlano

AGD Regional DirectorDouglas Bogan, DDS, FAGDHouston

AGD National TrusteeRalph Cooley, DDS, FAGDConroe

Executive DirectorConnie Sonnier, CAERound Rock

2009/2010 OFFICERS

TAGD StaffSandy Frizzell • Programs Director

Margaret Hulse • JTC Foundation Director

Amy Knitt • Membership & Communications Director

Administrative Assistants:Kimberly Blair Lauren OakleyNick Prelosky

Disclaimer: The TAGD does not necessarily endorse opinions or statements contained in articles or editorials published in the TexasGP. The publication of advertisements in the TexasGP does not indicate endorsement for products and services.

Texas GP is published quarterly by the Texas Academy of General Dentistry, 409 West Main Street, Round Rock, TX 78664. Address changes should be sent to the TAGD. TexasGP is provided as a member service to members of the TAGD. Nonmember subscription rates are $25.00 individual and $40.00 institutional. Canadian orders add $5.00; outside the U.S. or Canada, add $10.00. Single copy rates are $3.00 to individuals and $4.50 to institutions (orders outside the U.S. add $1.00 postage). All orders must be prepaid in U.S. dollars.

Printed in U.S.A. Copyright 2010, Texas Academy of General Dentistry, Round Rock, TX.

No portion of TexasGP may be reproduced in any form without prior written permission from the TAGD. The opinions expressed by TexasGP are not necessarily endorsed by the TAGD. The publication of an advertisement in TexasGP does not indicate endorsement for products and services. TAGD/AGD approval for continuing education courses or course sponsors will be clearly stated.

TAGD 512-244-0577 Toll-free 877-464-8243 Fax 512-244-0476 www.tagd.org

AGD 888-243-3368 www.agd.org

ADA 800-621-8099 www.ada.org

TDA 800-832-1145 www.tda.org

TSBDE 512-463-6400 www.tsbde.state.tx.us

Important Contacts

Information change request:Send your new address, phone, fax and e-mail to Amy@TAGD.org

NEXT ISSUE:

TEXAS DENTIST OF THE YEAR™ NOMINEES

J O U R N A L O F T H E T E X A S A C A D E M Y O F G E N E R A L D E N T I S T R Y

Dental Fillin’s .....................................................................................4President’s Message ..........................................................................5Pearls of Wisdom ...............................................................................6Drill Bits ............................................................................................9TAGD Advocacy for the GP ...............................................................10Motivational Minute ........................................................................11TAGD Event & CE Schedule ...............................................................15Welcome New Members .................................................................15

S P R I N G 2 0 1 0

6Emergency Preparedness

7

8 & 92010 Lone Star Dental Conference Preview

T A B L E O F C O N T E N T S

AGD Foundation Outreach Program in New Orleans

14

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY4

DENTAL FILLINS • Can I Get Real For a Moment?Grab a seat, witness the transparency of

a personal train wreck, and vow to re-spect me still in the morning. I'm writing this following two prior work days of near hell in my practice. My business partner was out chasing CE for a couple of days and the world came down hard upon me. We have a practice with 14 operatories and five hygienists. When two Docs are there, life is copacetic. On Thursdays, I am always the only doc in house. It's a little frantic, but hey, I only have to push it for one day. The team is motivated by knowing it's the last treatment day of the week, and Sonic Happy Hour gives us something to look forward to. Not this week.

As things can, "stuff" happened. Bog-ging down in NP exams with unusually complex medical histories and tons of questions, the hall line waiting for Dr. Bottleneck was growing. With a restorative patient down the hall wondering how long the anesthesia "needs to soak," my shoul-ders began to slump, palms sweating. I was on the outside looking in and didn't like what I saw. Quite frankly, I was appalled by the product.

Everything I believe in relation to my philosophy of practice, vision, and high demands for almost obsessive quality and customer service was under attack. For the first time in 14 years, I felt the walls coming in on me and worse, couldn't see a quick way out. Calgon take me away! This went on for an afternoon it seemed.

At 5:00 p.m. I debriefed and brainstormed with my office manager and an assistant, formulating ways to NEVER let this happen again. I felt disappointed, em-barrassed, and worst of all, responsible. I was already fearing the results of the daily electronic survey responses that would be deserved. I fell way below the bar set for my team, self, and most importantly my patients. Patients deserve better and on this afternoon, it was not delivered. Their time was not respected, their dollar was not valued. Even with a 20-30 minute commute home, which is usually perfect for being 100 percent fresh by the time the

door swings open into a drastically differ-ent world, the cloud was still above me. I felt guilty. The team, surely a few patients, and the boss weren't happy. Epic failure...horrible afternoon!

I spent the evening reading motivational blogs, consulting my creator for guid-ance and encouragement, and replaying the patient apologies I'd given that af-ternoon. The gauntlet was thrown! I de-clared war, vowing to have a scheduling plan by Monday morning to prevent this from ever happening again. Our patients are smart; they are aware of the practice environment good or bad, and they have choices about where they spend their mon-ey. Unlike many medical offices, where in my opinion the bar is often rather low for customer service, the practice of dentistry is consumer-focused and driven; patients know it.

The gauntlet has been thrown here at TAGD, also. We are becoming educated as board members in ways like never before. The commitment to be the presiding of-ficer, a board or committee member, trust-ee, or regional director is more challenging than ever, yet exponentially rewarding. The stakes are higher and we are moving in new ways to be The Voice of the General Dentist. We know that the membership is smart and aware of the organizational en-vironment good or bad. You, the customer, have choices about where you spend your dues dollars. Some members are excited about this new direction, some unaware; some want us to stick to CE.

I wage that we must "soldier on" in the are-na of advocacy for the Texas general den-tist. There is no other voice that can speak solely for the GP's needs, in honor of our core beliefs. This profession is a treasured, respected occupation. It's under attack in ways that most could not imagine: mid-level providers, challenges against anesthe-sia portability, and lack of Botox privileges to name a few. Outside forces are working to define what we can do with our training, or even be trained in. We are learning how to better communicate with lawmakers

and the importance of open, synergistic lines of commu-nications with the TSBDE, TDA, the three Texas dental schools, and a mul-titude of other peer organizations. We had our inaugural Advocacy Training in January led by our TAGD Lobbyist, in conjunction with the Dallas SWDC. It was a landmark event that will shape our future.

I want to thank dentists serving on vari-ous committees and leaders in all branches and tiers of organizational dentistry. I'm amazed at what goes on behind the scenes and how hard some work to protect all, at the sacrifice of their families and pocket books. Please support the new TAGD Ad-vocacy Fund without missing a step with DENPAC, ADPAC and the AGD Advo-cacy Fund. Yes, it's like insurance. Let the workers work for you! Send the letters and e-mails to legislators when ADA or AGD asks.

I'd be lying if I said it didn't cost money to protect us, but it's cheaper than los-ing your freedoms to practice as a general practitioner. Don't wait for others to do it. I'm sitting in the rooms, watching it work; trust me when I say it's effective, respon-sible, and protecting you. If you question it, contact the TAGD office for a list of up-coming events and go watch your dues and advocacy dollars hard at work.

The value of your dues dollars is increasing in unimaginable ways. For years, despite being the largest collective group of den-tists as general practitioners, we've been unorganized, politically. Let us be perfect-ly clear, the goal is not division from ADA forces fighting for all dentists, it's simply added protection for our unique practices when GP advocacy is needed. This board, under Dr. McCauley's leadership, is both preparing for the rainy day and proactively trying to prevent it.

Continued on page 6

Jeff Roy, DDS, FAGD

5Spring 2010

I am honored to serve you as the President of the TAGD. The challenges that we face

today as a profession are enormous and very serious. You have a board of directors that are very proactive, informed, and involved in every aspect of dentistry and the future of our profession.

Health care is in a complete paradigm shift. The profession of dentistry, as we know it today, will vastly change in only a few years. New practice models, insurance fee control, insurance limitations and even government employment of dentists are a real probabil-ity. Quite easily, our government may man-date how you practice, your fee structure, and who you will have to treat.

Foundations are funding studies to address the access to dental care issues in the United States. Models of mid-level providers that include advanced dental hygiene practitio-ners, independent dental hygiene practitio-ners, dental provider models, dental health aid providers, denturists and advanced as-sistant programs all are being developed or are allowed in other states.

As an Academy, we still promote the den-tist’s control of the patient care in a dental home. Most of these other models do not value the education or experience necessary to provide what we consider the best dental care in the world. Many of the models being created see dentistry and access to care as a manpower issue, which can be remedied by supply and demand. This attempt to solve access to care may actually increase costs to the patients. It certainly compromises the quality of care offered to patients who need quality care or options for quality care.

Presently, in my opinion, the ADA appears to be allowing these mid-level pro-vider models to be developed. I can assure you that many other states do not think like we do in Texas. They also do not enjoy a practice act that allows us to practice inde-pendently, as the owner of the practice and head of our dental team, and with minimal governmental intervention or regulation.

On a state level, our Academy continues to

offer quality continuing education courses that allow you, the practitioner, to com-petently treat your patients with evidence-based care. I recommend that each of you consider the MasterTrack program; con-sume continuing education and be the best professional you can be.

In Texas, we have not allowed international accreditation as an answer to access to care, which exists in four states, including Ar-kansas. We do have border issues and ille-gal dentistry in Texas. We are seeing mall bleaching and dentists from Mexico coming into Texas to avoid the border drug wars. Presently, the TSBDE has neither authority to police nor fine people who do not have a license to practice in Texas.

To specifically address and support the practice needs of general dentistry this year, your TAGD board created an advocacy fund program and council, as well as a commit-tee. We also hired a full-time lobbyist. All are positioned to monitor and financially support legislative and legal issues that af-fect general dentists. In our initial week, the fund accumulated over $40,000. I ask that you financially support your profession and the TAGD efforts to protect our practices. This is a very important and tangible way that you can be involved in supporting our profession.

We also have created a state board commit-tee that monitors all state board activities and is present at all meetings. Current issues that are serious to general dentistry include the ability of the state board to deal with illegal dentistry in Texas, issues of Botox us-age which under state law is only allowed by oral surgeons regardless of training, and anesthesia portability issues which can be restrictive if you use sedation in your office as a general dentist.

To address state crisis management, we have created a state emergency prepared-ness committee. They are working with state and national organizations to be ready to provide dental care following an emer-gency situation in Texas. You will all have an opportunity to be part of this necessary

organization. We have also formed a finance and in-vestment commit-tee to monitor our investments, our budget, and to de-cide both long and short range invest-ment needs. Presently, we are financially stable with proper reserves and have both investments and advocacy funds to protect the future of the TAGD.

Nationally, we are monitoring the McCa-rran-Ferguson bill regarding insurance com-panies’ abilities (for 41 years) to be exempt from anti-trust lawsuits, thus stifling the ability to have free market competition in insurance benefits. International accredi-tation issues, and certainly the mid-level provider models, are also being monitored. Hopefully, through legislation, we can limit the dental health aid therapists to Alaska.

Our board now has a long range planning committee that considers vision positioning for our state Academy. We also have a new missions committee that is creating state and international opportunities for service.

In 2011, the state legislature will meet to consider new bills for Texas. This session will be largely focused on education, trans-portation, and health care. With a projected $15 billion deficit, we must be prepared to defend our position against taxing both dental and medical health care. Also, we must collectively push for legislation that will help and protect dentistry in Texas. Our legislative committee and lobbyist are working daily on your behalf, to see that we are at the table when dental issues are pre-sented.

I ask that you stay informed, and stay in-volved in organized dentistry. This is your profession and your future. Your board is giving you 100 percent daily. We have a lot at risk and much to protect. Rest assured that we are collectively speaking as one uni-fied voice for dentistry in Texas, advocating for health care that works.

MESSAGE FROM THE PRESIDENT

Dan McCauley, DDS, FAGD

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY6

The oral cancer screening exam is one area of our profession where we can ef-

fectively help save a patient’s life, so why is it often disregarded?

One of the techniques taught is the pro-tracting, or pulling of the tongue with a gauze, a method that feels both intimi-dating and unnatural. For every action, there is an equal and opposite reaction and when the tongue is pulled, it is just natural for it to pull back. This is uncom-fortable for both the clinician and the pa-tient. Over time, I developed a technique which allows me to do a thorough oral cancer screening with a gentle touch. This method is quick, thorough, and comfort-able to the patient and clinician.

First, warm your mirror under running warm water to prevent fogging. Give the

patient an initial feel of comfort then re-tract each cheek, one at a time. View gin-gival tissues of the mandible and the bilat-eral buccal mucosa with direct vision and a mirror. Follow through with the index fingers and thumb only, to palpate the lips and cheeks; this leaves the rest of the fin-gers dry. Next, place the mirror above the tongue and view the entire hard palate us-ing your mirror as a scanning tool. Check both the tuberosity areas and the distal aspect of the lower second molars. Take your mirror and slide it between the lat-eral border of the tongue and gently tease the tongue medially, just enough to view the lingual side of the mandible. This al-lows vision behind the third molar region, the area most likely to reveal metastasis from other areas of the body.

Then, take your mirror and hold it above the base of the tongue, where the hard and soft palates meet. Say to the patient, “take a deep breath through your mouth,” and at the same time place gentle pressure at the base of the tongue. Watch as the en-tire soft palate and oro-pharynx open up to you.

I have found that very few patients will gag with this technique and you couldn’t ask for a better view. Ask the patient to place their tongue all the way over on their left cheek; you will see all the way back to the base of the tongue including the viliform papilla. Take the time to view it for a second or two and then gently glide your index finger down the lateral border to feel for any unusual bumps or irregu-larities. Do the same for the right side of the tongue, then have them place their tongue to their palate and finally say to them, “stick your tongue all the way out and open wide.” Hold your mirror above the tongue, at the center of the palate, to view the base of the tongue.

Then take your index finger only and gen-tly palpate the floor of the mouth. This completes the intra-oral portion of the exam. Use your middle and ring finger to palpate the external structures of the neck and face to complete the screening. Try this, and you will be amazed how much easier your exam will go for both you and the patient, and more importantly, you might save your patient’s life.

PEARLS OF WISDOM

Oral Cancer Screenings with a

Gentle Touch

By Michael Hodapp,

DDS, MAGD

Dental Fillins continuedTell your friends and recruit new mem-bers. We are so much more than Fellow-ship and Mastership CE these days, two of our shining stars. As I said in an article a few years ago, "this is not your father's AGD" because this is a new and politically challenged practice environment. We must adapt.

We may survey you in the coming year. If we survey, please take the time to tell us what information you want to read

and how you want us to advocate on your behalf. We need to know where you, the customer, stand. We want to educate you on the risks to general practice and insure that everything you believe in is protected, when under attack.

This publication's contents are important and we acknowledge our responsibility to both inform and educate. Follow the Gatekeeper e-mails for more current feeds of advocacy information. Please com-mit to educating yourselves on mid-level

provider concerns and other emerging is-sues. It's all that we ask. Well, we always want you to recruit new members in the spirit of assembling sweeping, large quan-tities of advocating voices. Thank you for your commitment to TAGD!

Please enjoy the reprinted article Customer Introduction; it relates to each of us and is now framed in my office break room.

United we stand, Jeff

7Spring 2010

Save the DateJack T. Clark Foundation Golf Classic

Forest Creek Golf ClubJune 18, 2010 • Austin, TX

Training and experience has taught us how to manage emergencies in our

dental practices. On a micro-scale, we are all emergency coordinators. We have medi-cal training, treat patients and manage staff.

By our nature, we also care about our com-munities and giving back. The networks of dentists that volunteer and do mission work, or serve in mobile dental clinics in under-served areas, attest to this. Our ex-pertise has also had crossover into other fields. Dentists already work with the FBI and coroner’s offices for body identifica-tion.

On the macro-scale, this will not always be enough. As evidenced by recent events in Haiti and Chile, large-scale emergencies do happen. Whether it is an earthquake, hurricane, or terrorist act, our profession can play an important role in crisis man-agement. Dental representation is lacking in current emergency services provided by non-military, government agencies.

To explore areas that dentistry can be more involved in emergency preparedness, the TAGD has created an Emergency Pre-paredness committee. The goal of the com-mittee is to open communication channels between dentists, and other health care providers or government agencies, to co-ordinate resources in the event of natural or man-made emergencies. Currently, there are no lines of communication between dental organizations and government agen-cies.

Over the next year, organizational and communication efforts will increase and there will be opportunities to train and participate in emergency preparedness. A census will be taken to identify dentists and support staff available to assist in fu-ture emergencies. A list will also be com-piled of available physical assets (i.e. dental equipment, office space, mobile dental clin-ics, etc.).

Interested parties are invited to participate. Please contact TAGD for more info.

EMERGENCY PREPAREDNESS Andrew Lazaris, DDS, FAGD

May 6 - 9, 2010 San Antonio • Texas

TAGD Sponsored Speaker Dr. Jeff Brucia

Friday, May 7 • 8:30 a.m. - 11:30 a.m.3 Lecture CE Hours • Fee: $65

Adhesive And Restorative Materials Update

This course provides detailed insight into the total spectrum of adhesive dental treatment. The numerous choices in restorative materials has confused the clinician as to what is best indicated in a given situation. Dr. Brucia will guide you through the step-by-step clinical technique.

Friday, May 7 • 1:30 p.m. - 4:30 p.m.3 Hands-on CE Hours • Fee: $225

Direct Aesthetic Posterior Restorations; An Adventure In Excellence

Direct aesthetic restorations are the most re-quested and performed procedures in any dental practice today. This in-depth workshop provides details to perfect the posterior Class II composite restoration. You should leave with a high level of predicable success when applying these techniques clinically.

Saturday, May 8 • 9:00 a.m. - 12:00 p.m.3 Lecture CE Hours • Fee: $45

Diagnosis And Treatment For Predictable Advanced Restorative Dentistry

Advanced diagnosis and treatment planning for comprehensive restorative dentistry is ab-solutely necessary to ensure the best possible chance for successful treatment. Learn when occlusal factors may play a role in restorative failure and TMD and how to restore patients us-ing the latest materials coupled with the time-tested approach of occlusion.

To register for these courses visit www.tda.org

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY8

2010 Lone Star Dental ConferenceSeptember 9 - 11 • Austin, TexasAT & T E x e c u t i v e E d u c a t i o n & C o n f e r e n c e C e n t e r

Dr. Gordon Christensen will present his brand new lecture:New Aspects of Dentistry 2010 7 hours lecture credit

This full day program includes many of the new concepts in restorative dentistry compared to the long proven products and techniques. The morning session is a comparison of porcelain-fused-to metal restorations and the several competing types of all-ceramic crowns and fixed prostheses. The afternoon session is a fast paced, multi-topic discussion and comparison of the many techniques and materials used in fixed prosthodontics.

Friday Course • Open to the entire dental team • 8:00am - 4:00pm

Gordon J. Christensen DDS, MSD, PhD

S aturday Seminars

Dr. Gordon J. Christensen is Founder and Director of Practical Clinical Courses (PCC) in Utah, and Senior Academic Advisor of the Scottsdale Center for Dentistry (SCD) in Arizona. Both groups are international continuing education organizations providing courses and videos for all dental professionals. Dr. Christensen has presented over 45,000 hours of CE throughout the world and has published many articles and books. Gordon’s degrees include: DDS, University of Southern California; MSD, University of Washington; PhD, University of Denver; an Honorary Doctor of Science from Utah State University, and an honorary Doctor of Dental Education and Research from Utah Valley University.

Criteria for crowns vs. direct restorations in view of new superior • direct restorative materialsRidge preservation for optimum pontic anatomy• Building-up teeth rapidly and well• The best posts and cores compared• Are pins still necessary• New tooth preparations•

Air vs. electric hand pieces for fixed prosthodontics• A brief clinical comparison of PFM and all-ceramic crowns• Conventional and digital impressions. Which is best?• Interocclusal records• The best cements for specific situations• Repair of ceramic restorations• Many everyday dilemmas and solutions •

Your Future

Photo Workshop8:00 am - 12:00 pm • 4 hrs hands-on

Presented by Dr. Mike MaloneSponsored Kodak Dental Systems

Stain & Glaze Made Easy8:00 am- 12:00 pm • 4 hrs hands-on

Presented by Dr. Todd Ehrlich Sponsored Ivoclar Vivadent

The Abused Mouth8:00 am - 12:00 pm • 4 hrs hands-on

Presented by Dr. Jerry BouquotSponsored by the

Jack T. Clark Foundation

Topics include:

9Spring 2010

4.

2.

What is the first step I should take to look for an employer upon graduation?The first step is not to wait until gradua-tion. Students should be looking for jobs and making contacts beginning in their third year of dental school.

What are some helpful tips to find an associateship?Direct mail/“cold calls” helped one new graduate land interviews with several den-tists. He sent letters to prospective offices located in the area he wanted to work in and was able to land interviews with those he contacted.

Job postings through dental schools and organized dentistry web sites (such as the AGD career center) are also helpful.

Another useful method is to attend your local dental CE meetings and social events. By establishing and growing your network of colleagues you’ll be able to find out about new job openings and get infor-mation about a potential employer.

What are important qualities to look for in an employer?One of the most important elements is to see if you and your potential employer share the same belief system and profes-sional values when it comes to practicing dentistry. For example, if new technology and learning new techniques are impor-tant to you, then ask the practice owner

how much CE he/she attends.

Getting a good read of their personality will also be very important. Understand-ably, this will be hard to do in the short time of an interview so talk to the office staff to get a little more insight.

What are important things to know or questions to ask when entering an associateship?

What the owner is expecting by •hiring an associate How new patients will be assigned•How many days and what hours the •associate will workHow will the associate be compen-•sated (percentage, hourly, etc.)What types of procedures does the •owner performWill there be special compensation •for procedures the associate can do that the owner doesn’t doIs there a restrictive covenant•Get an idea of the offices’ books, •mainly in regards to the collection ratio of the practiceKnow the employee turnover rate•

What are important elements to have in the contract with your new employer?A Proximity Clause – there should be something in there about soliciting pa-tients to your new office after you have left the practice.

Benefits – what type of health insurance you’ll have (or if that’s even included) and if there’s a retirement plan. Younger den-tists don’t always think about retirement but it should be in the back of your mind.

Long term plans – this is important to discuss but don’t have to be outlined in the contract. An example is if the owner would extend to you the option to buy in to the practice.

Can two dentists work together if their treatment planning differs?The key is to be able to discuss things openly. One dentist said she makes time to sit down with her associate once or twice a month. Even though you practice together work can get really busy and there’s not always time to just talk and have real con-versations. Go somewhere away from the office where things are more relaxed when talking about work issues.

Best advice about working in this setting? Communication is key! Plan those off-site lunches.

You have to remember that this practice is the owner’s baby. They’ve worked hard for many years to build this practice to his/her liking

Don’t expect to come in as an associate and get rich. It takes time to build your patient load and establish yourself within the office.

Thursday, September 9 • TAGD Leadership ReceptionAll LSDC attendees are invited to the Leadership Reception on Thursday night where we celebrate the achievements of our lo-cal components as well as leaders who have demonstrated their commitment to dental excellence through education. TAGD will also announce our New Dentist of the Year award recipient at this event.

Friday, September 10 • 2010 Texas Dentist of the Year Gala™The 2010 Texas Dentist of the Year Gala™ celebrates dentists throughout the state who exhibit a commitment to continuing dental education, service to the community and activism in the dental profession. Nominees are selected by their colleagues from dental societies and local components around the state.

2010 LSDC Events

This year’s conference will once again be held at the AT&T Executive Education and Conference Center, located on the UT campus in Austin. The conference center also houses a four-star hotel where attendees can stay for the special rate of $170 per night. If you would like to reserve a room call 512-404-1900 and ask for the Lone Star Dental Conference room block. If you book your room on-line just enter our promotional code: LONEST0910. This rate is offered until August 17. *Be sure to book your room early, the UT Longhorns have a game vs. Wyoming on Saturday, September 11; the room block is limited.

AT&T Executive Education and Conference Center

For more information visit w w w.tagd.org • Online registration is now available

DRILL BITS • ASSOCIATESHIPS

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY10

Being a General Dentist requires a unique skill set unlike that of any other specialty. By virtue of this, legislative and regulatory issues more often directly affect the practice of General Dentistry than other specialty groups.

As the “Voice of General Dentistry,” Texas AGD wants to help.

Protecting the mission of Texas AGD, “Advancing Excellence in Dentistry” becomes more difficult every year as other states struggle with increasing regulations and the addition of mid-level providers such as the advanced dental hygiene practitioner and DHATs. Texas dentists have maintained a strong commitment to patient care, and Texas AGD intends to supply the support necessary to continue.

In order to accomplish our goals of advocacy for our members we have created an advocacy fund.

The Texas Advocacy Fund provides Texas AGD with resources needed to protect the rights and privileges of the General Dentist before the legislature and regulatory bodies.

With the fund, Texas AGD will continue to:Monitor regulatory and legislative issues that affect the GP•Provide grass roots training and communications so TAGD can •make an impact on policies that can affect how you practice den-tistryMaintain advocacy staff, a lobbyist, and volunteer support•

The Texas Advocacy Fund is not a political action committee and cannot be used to support candidates or ballot initiatives. Texas AGD recommends you continue to support the TDA’s DenPAC and to individually support candidates running for office as we must continue to have legislative sponsorship of bills that provide quality dental care for the patients of Texas.

To create and sustain this fund, TAGD is calling on members to make a meaningful contribution at one of the following suggested giving levels:

Founder Advocate $5000Master Advocate $1500Fellow Advocate $500General Advocate $250

The TAGD has long heard that its members want us to advocate for them legislatively, now is the chance to have your voice heard by making a contribution to the Texas Advocacy Fund.

To make a contribution or if you have questions about the fund, contact Fund Chairman Dr. Craig Armstrong at carmst@aol.com or Sandy Frizzell at 512-244-0577.

TEXAS ACADEMY OF GENERAL DENTISTRY ADVOCACY

Texas Advocacy FundTexas Academy of General Dentistry

Advocacy Fund Committee

Craig Armstrong, DDS, MAGD • Chairman

Roberto Diaz, DDS, MAGD

Dave Roberts, DDS

Mike Stuart, DDS, FAGD

Jacquelyn Vo, DDS

11Spring 2010

Allow me to introduce myself. I am a cus-tomer.

I am the person that makes the economic engine turn. I am the reason you take home a paycheck. I am the reason you are able to feed your family, pay your mortgage, go on vacation, buy a car, and contribute to your church or synagogue. Because of me, gigan-tic corporations and small businesses alike have risen and flourished. Because of my absence, they have faded from existence.

The roads you drive on, the police and fireman that protect your community, the teachers that teach your children all exist

because of me. Politicians and postal work-ers, sanitation workers and soldiers all owe their jobs to me. Without me, no taxes would be paid and any and all societal ad-vances would come to a halt.

The wise come to know, respect, and love me. The foolish disregard my importance and suffer accordingly.

By the way, you’ll notice that I didn’t in-troduce myself as your customer. That’s be-cause I don’t belong to you. Even if I make a purchase from you, that doesn’t mean that I will do it again in the future. You are al-ways on trial and I am always evaluating, measuring, and testing your product and service.

So pay attention to me. Get to know me. Learn my habits. My likes. My dislikes. My desires. My dreams. My values. Learn my language. Learn to recognize my moods.Above all, treat me with respect. I will not be ill-treated, and why should I be? There are too many businesses vying for my atten-tion. Every time you turn on the television, open a newspaper, or listen to the radio, you see and hear multitudes of companies competing for my attention. There are too many people who are willing to treat me right in exchange for my business.

And know this, I am not easily fooled. Businesses treat me right or suffer the con-sequences. Sooner or later I always discover dishonesty, disrespect, or disinterest. Most of the time, I don’t announce my displea-sure. I simply take my business elsewhere.

Occasionally, we will have disagreements. I don’t like mistakes but I understand that you sometimes make them. The manner in which you handle my complaint deter-mines any future interaction I have with you. And, in my mind, it also determines the character of your business. I rarely ever give you a second chance to make the same mistake twice.

So, watch for me in your business commu-nity. If you’re fortunate enough to see me, do everything in your power to woo me and make me your own, because I hold the key to your financial success. It is no exaggera-tion to say that when you interact with me, your future hangs in the balance. Learn me. Know me. I am a customer.

© 2010 Charles Marshall. Charles Marshall is a nationally known humorous motivation-al speaker and author. Visit his Web site at www.charlesmarshall.net or contact him via e-mail at charles@charlesmarshall.net.

MOTIVATIONAL MINUTE Customer Introduction

One of the most common errors involves claims that are lacking documentation regarding medical necessity. For exam-ple, a provider submitting a claim for a new stainless steel crown that had been previously chewed through by the patient must include those essential, descrip-tive remarks. Too often, providers are not providing the specific documentation. Thus, the claim is reviewed and initially declined, requiring an appeal by the provider due to missing information. The provider will then need to resubmit the claim in its entirety, not just the missing information.

The second most common error involves tooth and surface ID issues. Providers

must identify all teeth and surfaces on their claims and without this, even sealants will be declined. A reminder was given that red or yellow ink on appeals does not show up on resubmitted claims, because they are scanned in black and white in the com-puter system.

At a recent meeting, Dr. Linda Alten-hoff, Medicaid State Dental Director, dis-cussed the above and other common issues associated with providers using clearing-houses for claim submission. She remind-ed us that when there are internal issues within the clearinghouse, such as not submitting claims to TMHP within the 90 day deadline, the claim will be denied. The actual date that the provider sub-mitted to the clearinghouse is irrelevant. Sometimes, clearinghouses will drop in-formation needed by TMHP, leading to a claim denial. She reminded all that such contracts are between providers and clear-

inghouses; TMHP is just a third party.

When a clearinghouse is being utilized, she recommended finding one that is an enrolled provider with TMHP. This way, TMHP can recoup monies from the clear-inghouse (not the provider) if they change codes or make a mistake on claims.

Dr. Altenhoff stated that it is critical for providers to keep track of all claims in re-lation to their respective submission dead-lines, and encouraged all providers to take an active part in their practice which in-cludes the front office, billing, and submis-sion of dental claims.

All claims are submitted under the provid-er’s license and they are ultimately liable for what is being submitted. She encouraged providers to stay abreast of code changes; they are posted in the quarterly Medicaid bulletin.

COMMON MEDICAID REPORTING ERRORS Marko Alanis, DDS

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY12

Membership Dues Renewal

THE HEAD START DENTAL HOME INITIATIVE (DHI) Partnering to Provide Dental Homes for Head Start Children in Texas

The AGD has now sent out an e-invoice, their dues renewal notices for 2010.

Renewal is simple, either visit www.agd.org and renew online or contact Amy at the TAGD office at 512-244-0577 to

renew over the phone.

If you need to make a change to your contact information please e-mail Amy@tagd.org to

update your address, e-mail, or phone number.

As many read-ers already know, TDA has been working with the American Acade-

my of Pediatric Dentistry (AAPD) along with the Texas Academy of Pediatric Dentistry, the Texas Academy of General Dentistry, the Texas Department of State Health Services – Oral Health Branch (OHB), and the Texas Dental Hygienists’ Association to establish dental homes for Texas children enrolled in Head Start – the DHI. Dr. Paul Kennedy, Jr., heads the DHI Steering Com-mittee with Dr. Tommy Harrison serving as TDA’s liaison to the Steering Committee.

Work is well underway to place every Head Start child into a den-tal home before the 2011 legisla-tive session and to create an ex-

tensive network of dentists willing to provide needed dental care to Head Start enrollees. In Decem-ber 2009, representatives from or-ganized dentistry, Head Start, and the OHB met to finalize the first stage of dentist recruitment.

By February 2010, invitations will be mailed asking dentists to participate in the DHI. This is an excellent opportunity for participating dentists to build their practice while helping Head Start children and their families engage in good oral health habits that will follow them for a life-time.

Please consider becoming involved in this very worthwhile project! For more information, contact Dr. Paul Kennedy at (361) 992-9500 or Diane Rhodes at TDA, (512) 443-3675. or diane@tda.org

13Spring 2010

The Jack T. Clark Foundation needs donations for its Silent Auction Fund-

raiser, which will be held during the TAGD’s Lone Star Dental Conference on September 9- 11 in Austin, Texas. Proceeds from the auction will fund programs that make public education of oral cancer available throughout Texas. Individuals, constituents, regions and exhibitors are welcome and encouraged to donate and bid on items.

Auction items, such as continuing education courses, dental equipment and instruments, vacation and spa getaways, jewelry, artwork, tickets to sporting events, autographed items, luxury gift

baskets and gift certificates are especially needed.

To make a donation, complete the form below and mail or fax it to: Jack T. Clark Foundation 409 W. Main Street Round Rock, TX

Fax: 512-244-0476

For questions please contact Meg Hulse at Meg@tagd.org or call 512-244-0577l

Donations will be acknowledged on the Jack T. Clark Foundation web page, at the Lone Star Dental Conference on-site auc-tion and in post-meeting materials

Donations are needed by August 13, 2010. Please mail the items to the Jack T. Clark office (at the address above) or let us know if you will be bringing the items with you to the Lone Star Dental Conference

For best exposure and to raise as much money as possible, please include a product brochure or more informa-tion. Also, while all dona-tions are appreciated, items that are easily shipped will bring more return for your donation.

Thank you.

The JTCF is a 501(c)(3) charity; gifts to the JTCF are fully deductible for United States federal income tax purposes, subject to the limi-tations placed on charitable gifts by the Internal Revenue Service. Be sure to check with your tax professional or at-torney for specific, allowable deductions in your state.

Jack T. clark FoundaTion

Silent Auction DonationsAustin • September 9 & 10, 2010

Individual/Company Name: __________________ Contact Name:___________________________

Street Address:_______________________________________________________________

City:___________________________________ State:____________ Zip:_______________

Phone:______-______-__________ E-mail:_______________________________________

Web site address, if applicable:____________________________________________________

(Web site address will be included with your item description)

Dollar value of item(s) that you are donating (please list each item separately):

$________________________________ $________________________________

$________________________________ $________________________________

Description and value of item(s) (please be as detailed as possible and include applicable expiration dates or

restrictions):_______________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

It’s That TimePlease donate to the Jack T. Clark Foundation’s 2010 Silent Auction

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY14

AGD/ AGD Foundation Outreach Program

Restoring more than smilesSince 1972, the Academy of General Den-tistry (AGD) Foundation has been actively funding educational, scientific, and chari-table initiatives that provide oral health re-sources for the public and continuing edu-cation (CE) opportunities for dentists.

This year, the AGD Foundation, in collab-oration with the AGD, introduces its first-ever AGD/AGD Foundation Outreach Program. This ambitious new program was conceived to increase the AGD and

AGD Foundation’s ability to address the oral health needs of un-served and under-served populations.

The first-annual AGD/AGD Foundation Outreach Program will be held Thursday, July 8, at the Louisiana State University Dental Clinic, during the AGD Annual Meeting & Exhibits, July 8 to 11, 2010, and will continually strive to serve resi-dents of each AGD Annual Meeting & Exhibits host city.

The AGD/AGD Foundation Outreach Program is in need of volunteer dentists and dental teams to provide free oral health and dental care to residents of New

Orleans, La. The State of Louisiana will provide a free temporary license for U.S. licensed dentists to practice in that state.

Volunteers are needed by May 1, 2010. To learn more about the AGD/AGD Foundation Outreach Program or to vol-unteer your services, please contact Mari-lyn Mays, manager, AGD Foundation, at 888.243.3368, ext. 4329 or marilyn.mays@agd.org.

The AGD Foundation is a 501(c)(3) char-ity; gifts to the AGD Foundation are fully deductible for United States federal income tax purposes, subject to the limitations placed on charitable gifts by the IRS.

SAVOR THE

Terry T. Tanaka, DDS, MAGD David S. Hornbrook, DDS, FAACDChoose from choice continuing education*• A Dedicated Implant Track• Live-Patient Training• Education Hosted at the Louisiana State University School of Dentistry• Government Relations Training*Courses and speakers subject to change.

AGD 2010 Annual Meeting & Exhibits July 6 to 8, 2010: AGD House of DelegatesJuly 8 to 11, 2010: AGD Annual Meeting & ExhibitsVisit the AGD Web site for more information at www.agd.org/neworleans.

Discover the industry’s best opportunity for learning—the AGD’s Annual Meeting & Exhibits. It is the premiere dental event of the year, offering general dentists and their team access to top-notch quality CE, new products, exciting social events, and an unforgettable

convocation ceremony. Jeffrey Taylor, founder of Monster.com, will address the AGD’s Annual Meeting registrants this summer. Partici-pants will hear from the globally recognized career giant, innovator, entrepreneur, and author about social networking, the power of the consumer, and many other exciting topics through his presentation, You Are the CEO of Your Own Life.

After indulging in the AGD’s daily educational offerings, treat yourself to exciting attractions at night, beginning with the people, culture, and cuisine of New Orleans. Best known for its spicy Cajun and Creole dishes, New Orleans’ fanciful fares also blends French, Italian, Spanish, African, and Indian influences into its recipes.

15Spring 2010

WELCOME NEW TAGD MEMBERS!

TAGD CONTINUING EDUCATION & EVENT SCHEDULE

April 21Fort Worth AGD

Using the Internet to Promote Your Practice & Cut Your Overhead

w/ Dr. David M. MikulencakFort Worth, TX

May 7TAGD Sponsored Speaker

TDA TEXAS MeetingAdhesive & Restorative

Materials Update & Direct Aesthetic Posterior

Restorations w/ Dr. Jeff Brucia

May 8TAGD Sponsored Speaker Diagnosis & Treatment For

Predicable Advanced Restorative Dentistry

w/ Dr. Jeff Brucia

May 14Jack T. Clark FoundationDifferential Diagnosis of Common Oral Lesions

w/ Dr. Jacqueline PlemonsRichardson, TX

May 14Houston AGDDone In A Day!

OSHA Annual Update & CPR Certification

Houston, TX

May 14Dallas AGDE4D Preview

Richardson, TX

May 28Fort Worth AGDPorcelain Veneers

w/Dr. Jose Luis RuizFort Worth, TX

June 18Fort Worth AGD

Perfecting and Understanding Occlusion

w/ Robert B. KersteinFort Worth, TX

August 6CenTex AGD

Practice Makes Perfect! Part 2w/ Dr. Roger Levin

AUSTIN, TEXAS

September 9-11Lone Star

Dental Conferencew/ Dr. Gordon Christensen

Austin, TX

October 1Houston AGD

Reality Lecture: A Guide to Selecting Products

w/ Dr. Michael B. MillerHouston, TX

November 12East Texas AGD

Periodontal Inflammation and the Impact

on Systemic Healthw/ Dr. David Paquette

Tyler, TX

June

FAGD/MAGD credit#219328 • 1/1/06-12/31/10

April

May

Dr. Walid Abdel Fatah, HoustonDr. Elias Abou Khalil, BaytownDr. Dwight Bailey, El PasoMr. Justin Baker, HoustonMs. Allyson Bauch, HoustonDr. Matthew Bayne, Garden RidgeDr. Ioan Bec, El PasoDr. Matthew Bentley, MabankMs. Elizabeth Botello, HoustonDr. Jerry Bouquot, HoustonDr. Jason Burkett, McAllenMs. Levely Castelo, HoustonDr. Edariz Castilla, AustinDr. Karen Chandler, El PasoDr. Eileen Chen, San AntonioDr. Crystiane Couto, EulessDr. Marlin Cox, DallasDr. Jonathan Dehart, HoustonDr. Eunjung Edwards, CordovaDr. Daniel Edwards, FriscoMr. Daniel Esobedo, DallasDr. Scott Essig, SpicewoodDr. Philip Estes, FriscoDr. Theodore Fortier, McKinneyDr. David Gary, HoustonMr. Senaido Garza, Houston

Dr. Taylor Gehring, DallasDr. Matthew Gillham, Fort WorthDr. Paul Graf, HoustonDr. Chet Gray, MidlandDr. Wesley Gray, MidlandDr. Joshua Haden, WacoMr. RJ Harris, HoustonDr. Asra Hashmi, ClevelandDr. Mohammad Hashmi, ClevelandDr. Theresa Heaton, AllenDr. Vincent Ip, AustinDr. Trever Keele, SpringMr. Kevin Keys, HoustonDr. Sayaka Kondo, HoustonDr. Dallas Krommenhoek, Round RockDr. Agee Kunjumon, PearlandMs. Jini Kuruvilla, Sugar LandMs. Christina Ky, RowlettDr. Brian Le, SpringMs. Katelynn Le, HoustonDr. Mark Littlestar, San AntonioDr. Pau Long, HoustonMr. Sergio Lopez, HoustonDr. Sasha Mahabir, League City

Dr. Kay Malone, Spring BranceDr. Yahya Mansour, DallasDr. Brian Martin, GrapevineMr. Juan Carlos Martinez, HoustonDr. Michael Melanson, LubbockDr. Angela Moore, BedfordMr. Tyler Myser, HoustonMr. Kevin Nail, HoustonMs. Anh Quynh Nguyen, DallasDr. Hannah Nguyen, HoustonDr. Jennifer Nguyen, KatyMs. Quyen Nguyen, HoustonDr. James Nielsen, ProsperDr. Ricardo Ochinang, San AngeloMr Brian Oribello, HoustonDr. W. Osborne, FriscoDr. Samera Owhadian, AustinDr. AnnaLynn Pappas, RichardsonDr. Minesh Patel, San AntonioDr. Mary Peters, AustinDr. Shelli Peters, HoustonMs. Hoa Phan, HoustonDr. Kevin Phan, HoustonDr. John Potter, Irving

Dr. Royanna Puen, San AntonioDr. Nicholas Quach, McAllenDr. Gayatri Raina, IrvingMs. Victoria Ramirez, HoustonDr. Anissa Reagor, BryanDr. Cecelia Reid, RichmondDr. Donald Reynolds, San AntonioMr. Justin Rich, San AntonioMr. Jared Roberts, San AntonioDr. Tim Robinson, DallasDr. Ivan Rodriguez, HarlingenDr. Victor Rodriguez, HoustonDr. Rachana Sangani, GrapevineMs. Naomi Sever, San AntonioMs. Katya Sherchenko, HoustonDr. Chad Silvertooth, KilgoreMr. Rory Smith, DallasDr. Lauren Standefer, DallasMr. Brian Stanworth, HoustonDr. Natalie Stimpson, Cedar HillDr. Ashley Strickland, BudaDr. Kevin Sturdy, BurlesonMr. Austin Teitelbaum, HoustonMs. Dania Turcios, HoustonDr. Christa Walker, RoanokeDr. Michael Witkowwski, Houston

For more information on these courses contact the TAGD office at 512-244-0577 or toll-free 877-464-8243

August

October

September

November

Texas Academy of General Dentistry409 West Main StreetRound Rock, TX 78664

ADDRESS SERVICE REQUESTED

1. Choose your interestsCheck any areas of interest that you would like to know more

about or participate in:

Educational Programs

Fellowship/Mastership Award

Jack T. Clark Foundation/Volunteering

Advocacy

Other:________________________________

2. Tell us about youName______________________________________

Address_____________________________________

City, State, Zip_______________________________

Phone_____-_____-______ Fax_____-_____-_____

E-mail______________________________________

Date of Birth ______/_____/______ M F

License #____________ Year of Graduation*______

Dental School___________________ New Dentist?*

*If you graduated less than five years ago your dues are less (see

special rates on the right)

Type of Practice - Check all that apply Solo Associateship Group

Federal Services (specify)____________________

Specialist (specify)_________________________

Sponsor Name (optional)______________________

3. Send in your application and dues

2010 Academy Dues - State & National $504 Student Dues $16

Or New Dentist Special Dues Rates - State & National 2006 Graduate $435 2007 Graduate $332 2008 Graduate $2272009/2010 Graduate or Resident $131

Local Component Dues $_________Dues vary by component area, see chart

Total Amount Due $___________Payment Information Check Enclosed (Payable to Texas AGD)

Discover Master Card Visa

Card #_________-__________-_________-_________

Card Expiration Date______/_______

Signature_____________________________________

Brazos Valley $25 Panhandle $0 Central Texas $35 Rio Grande Valley $40 Dallas $45 River District $15 East Texas $20 San Antonio $50 El Paso $10 Southeast Texas $10 Fort Worth $40 Houston $50 Heart of Texas $15 2009 Grad $25 Lubbock $35 2008 Grad $35 2007 Grad $45

Texas AGD Membership Application

Mail or fax your completed form to: Texas Academy of General Dentistry • 409 West Main Street • Round Rock, TX 78664 • Fax 512-244-0476