Delta-Sierra Dental DigestDelta-Sierra Dental Digest

In this issue ...

President’s Message

Maria Stefan, DDS

President

For older generations of dentists like

me that went through dental school

without using magnification, starting to

use it can be very challenging. As you

increase magnification, the learning curve

becomes steeper, and the field of view

(how much of the working site you can

see through the loops) decreases. At first,

I found myself flipping them out of the

way to be able to have a better picture of

Take Your Loops Off!the entire clinical field. It is like having

“tunnel vision.”

Several months ago, I was sitting

down by my mother’s bed having a

conversation. These moments were

special and rare since she was mostly

under the influence of opioids, fighting

terminal cancer. I was telling her how

awful I felt the whole day doing menial

jobs (cleaning, cooking, mopping, ironing,

etc.) during my day off. She looked at me

with loving eyes and told me in a soft

voice, “Oh, my sweet child, I cannot

describe to you, in words, how much I

miss all these chores!”

Our parents never stop teaching us

lessons!

In an instant, I felt selfish and

ungrateful. I was “wearing loops” again.

Instead of seeing the bigger picture and

my blessings (my family, my good health,

all the people that love me, etc.), I was

focusing on a single, tiring day, blowing it

out of proportion.

I learned that day that once in a

while it helps to “take my loops off” and

look at life from a different perspective.

In the memory of my mother who

passed away at the end of May.

Save the Date and Sign Up to Volunteer

CDA Cares Stockton will take

place Oct. 15-16, 2016 at the

San Joaquin County Fairgrounds

(Read more on page 13 and register)

Page 2

Staff AppreciationNight

EntertainmentTable Clinics

DinnerSocializing

Raffle Prizes andMuch More ...

Mark your calendar andstart planning now for youroffice raffle prize donation.

General Membership MeetingThursday, September 22, 2016

Integrated Therapy - “A RighteousDinosaur Fighting Extinction in

Dentistry’s Modern Era”

4:00 PM - 9:00 PM(NOTE START TIME)4 CE (Core)

Manteca Transit Center220 Moffat Blvd.

Manteca

Dr. Craig S. Wada

Dr. Sean P. Avera

Cathy J. Avera, RDH Dr. Paul Bianchi

ProgramTechnology is changing modern Dentistry at a faster clip than

most practitioners can keep up with. Specifically, digital tech-

nology (x-rays, impressions, restoration design, restoration

fabrication) delivered with space age futuristic equipment is

transforming the Dental Profession before our very eyes.

Less radiation, no messy goop in your mouth, increased preci-

sion, increased accuracy and fit of restorations and decreased

chair time - all make perfect sense right? Absolutely, but

there’s one area in dentistry that can’t be abbreviated and still

requires “hands on, roll up your sleeves,” effort - the exami-

nation, diagnosis and treatment planning process. There is

no substitute or abbreviated option for a comprehensive ex-

amination. Complete extra oral head and neck, TMJ, oral

cancer screening, occlusion, periodontal and restorative

evaluations are taught in all dental schools but rarely per-

formed in private practice. Why? Is it because the experi-

enced dentist is vastly superior to the protocol taught in

school? Maybe it’s because the experienced dentist is clair-

voyant and can diagnose problems without examining the pa-

tient. Sadly, in most cases, the “time equals money” busi-

General Membership MeetingThursday, October 27, 2016

5:30 PM - 9:00 PM

Brookside Country Club3603 St. Andrews Drive

Stockton, CA

-- Continued - Page 6

2016 ProgramsMark Your

Calendar

Page 3

General Membership MeetingThursday, November 17, 2016

4:00 PM - 9:00 PM(NOTE START TIME)

Stockton Golf & Country Club

3800 W. Country Club Blvd.

Stockton, CA

“California DentalPractice Act &

Infection Control”

SpeakerLeslie Canham, CDA, RDA

*Tentatively: This program will be teleconferenced for

regional members and their staff.

Page 4

2016 Board of Directors

OFFICERS

Dr. Maria Stefan ........................ President

Dr. Pankaj Patel ............... President-Elect

Dr. John Reed ........................... Treasurer

Dr. Cameron Wheeler ................ Secretary

Dr. Rommel Bal ............... Immediate Past

President

BOARD OF DIRECTORS

CDA Trustee:Dr. John Hall

Dr. Mircea Mitu

Dr. David Neal

Dr. Lita Rodriquez

Dr. Mickey Samra

Dr. Bruce Toy

Deadline to Submit Articlesfor the Next Issue - 9/16/16

EDITORIAL BOARD -

SJDS Board of Directors

EDITORIAL STAFF

Lyndon Low, DDS, EditorKathy White, Managing Editor

Colleen Lee, Executive Director

Laura Lomba, Secretary

Delta-Sierra

Dental Digest

Published by theSan Joaquin Dental Society

7849 N. Pershing Ave.

Stockton, CA 95207

Phone (209) 951-1311

FAX (209) 951-1321

Website: www.sjds.orge-mail: sjds-exec@sbcglobal.net

Dr. Tony Arredondo

Dr. Jim Grabow

Dr. Jennifer Low

Dr. Lyndon Low

Dr. Michael Moreno

A Warm Welcometo Our New SJDS

Members

Ivan Chicchon, DDSProsthodontics

2013 Graduate, UOP

2016 Graduate, Univ of Michigan

2363 W. March Lane

Stockton, CA 95207

209-952-3951

Robert Rasco, DDSGeneral

Transferring from Tri-County

Dental Society

2016 Graduate, Loma Linda

University

19969 Greenley Rd., Stes. C & D

Sonora, CA 95370

253-797-0801

Matthew Winkle, DDSGeneral Dentistry

Transferring from Humboldt

Del Norte

2005 Graduate, UOP

5100 Obyrnes Ferry Rd.

Jamestown, CA 95327

707-923-4313

Revised CPR

Schedule

CPR classes are only offered on a

limited schedule for the rest of 2016

instead of on a monthly basis due to

low enrollment. There are only two

classes being offered:

Wednesday, October 5

Tuesday, November 15

All classes are the American Heart

Association Program with two year

certification and 3.5 hours of continu-

ing education. Call the dental society

office to register or go online to

www.sjds.org for a registration form.

New Dentist SocialThurs., September 15, 2016

Casa Flores Marina3210 W. Benjamin Holt Dr.

Stockton

6:00PM to 8:00PMDinner, Drinks and Football!

Our SJDS Mission ...

The mission of the San

Joaquin Dental Society, an or-

ganization of local dental pro-

fessionals, is to provide pro-

fessional development and ad-

vancement for its members.

The Society is committed to

improving the community’s oral

health through information,

education and service while

maintaining the highest stan-

dards of ethics.

Page 5

Editorial Book Review

Lyndon S. Low, DDS, MS

Let me first say that I am not a big

Tony Robbins fan. I have never

read any of his motivational books nor

have I ever attended any of his seminars.

I, for sure, have not walked over hot

coals. Having been an observer of the

highly successful and popular self-help

guru, I was intrigued recently when some-

one I respected suggested I read his third

best-selling book on money and financial

freedom. This is the first book that Mr.

Robbins has published in more than

twenty years and after its release in late

2014 (paperback 2016), it went to the top

of the New York Times business best

seller list.

Mr. Robbins bases his seven steps af-

ter extensive research and interviews with

50 of the world’s most brilliant financial

minds. Many of the lessons he lays out

come from an impressive list of the mas-

ters of money he spent time with in pre-

MONEY - Master the Game:

7 Simple Steps to Financial Freedom

By Tony Robbins

paring for this book: Warren Buffet, Carl

Icahn, John Bogle, Charles Schwab, and

Ray Dalio just to name a few.

As in many of his other publications

and seminars, there is a lot of fluff and

filler in between some very helpful infor-

mation. Whether you are a beginning, in-

termediate, or advanced financial inves-

tor, this book will offer insights and strat-

egies that will pay dividends when prop-

erly studied and applied.

Step 1 of his strategy is by far the

most important step in your financial fu-

ture. It is making the decision to become

an investor and not just a consumer.

Without automatically committing a por-

tion of one’s income to savings and in-

vesting, one can never be financially free.

This coincides with some sage advice

given to me by another dental colleague

many years ago:

It’s not the money you’ll

make from dentistry that

will dictate if you can

retire or have the finan-

cial freedom you desire,

it’s what you do with

that money that will ulti-

mately determine your

future.

Knowing the rules of the game is

important and what you don’t know can -

and likely will – hurt you. Investors have

long been marketing a set of myths that

are supposed to guide their decision mak-

ing. Being aware of sound principles and

fighting financial ignorance is key to de-

bunking the constant barrage of misinfor-

mation. Fortunately, I discovered many

years ago the magnificent power of com-

pound investing and the importance of

time, when it comes to helping achieve

one’s financial goals. It’s easy to make

more money, but you can never make

more time.

Mr. Robbins makes a great case for

investing in index funds to take advantage

of diversification, tax efficiency, and the

difficulty in picking the “right” stocks or

mutual funds. When 96% of all actively

managed funds and a near identical num-

ber of hedge fund managers fail to beat the

S&P 500, how cool is it to know that by

investing in an index fund that mirrors the

extended market, you are doing better than

nearly all of the world’s so-called experts!

One of the better parts of this book I

found to be interesting was the notion of

asymmetric risk vs. reward. This concept

involves minimizing your downside risk

while garnering a greater upside potential.

While there was no specific strategy or

tips to achieve this, it is something that an

intelligent investor should be looking to

incorporate in the myriad of decisions of

sound financial planning and especially in

asset allocation.

Overall, the book is long (700

pages) but an interesting read. There is a

lot of name dropping and inconsistencies

that makes one question his motives and

self-promotion. There is a lot of fluff that

the reader has to get through to make it to

the final steps, but I still found the book to

be entertaining and a reassurance of my

desire to be a better investor.

Page 6

ness philosophy has significantly altered

how dentists evaluate their patients. To

date, no computer program or robot is

equipped to palpate the head and neck

lymph nodes for disease; palpate and lis-

ten to the TMJ’s for TMD; visually inspect

and palpate the oral cavity for cancer;

analyze static and functional occlusion

for signs of malocclusion or trauma;

probe for attachment loss, furcation in-

volvement and mucogingival problems

and assess the serviceability of existing

restorations.

The predictability and longevity of

the Treatment Plan is dependent on the

accuracy of the diagnosis and only as

good as the education, experience and

technical skill of the clinician(s) executing

it. Integrated Therapy is best performed

by clinicians through a collaborative pro-

cess involving a two way dialogue and

exchange of information and ideas. Al-

though technology can make the interac-

tive process more convenient (Go to

Meeting conference calls, Skype, etc.), it

is by no means a substitute or replace-

ment.

As we do what’s best for the financial

bottom line in our practices, let’s not for-

get about what’s best for the patient. “Do

what’s best for the patient” means com-

prehensive examination and planning

BEFORE initiating treatment. In the

midst of cutting corners, scrutinizing

overhead and lab costs, procedure times

and jumping onto the latest technological

bandwagon, it’s very easy to lose sight of

our bottom line responsibility to the pa-

tient. This moral awakening is personified

in a scene from the 1957 movie, “The

Bridge on the River Kwai.” In the film’s

most climatic moment, British POW Colo-

nel Nicholson (Alec Guinness) realizes

the fruits of his men’s lives, labor and

suffering, although monumental in build-

ing a bridge over the river (complete with

train tracks) isn’t worth defending from

imminent destruction because its mere

existence DIRECTLY BENEFITED THE

ENEMY. . .

This presentation explores Inte-

grated Therapy and the importance of the

Team Conference prior to treating the pa-

tient. Valuable insights into both the risks

and benefits of performing treatment with

and without a complete examination, ac-

2016 General Membership Meetings -- Continued from Page 2

“Integrated Therapy - “A Righteous Dinosaur Fighting Extinction in Dentistry’s Modern Era”

Thursday, September 22, 2016

curate diagnosis and treatment plan will

be provided. The unique presentation for-

mat will include all members of the treat-

ing team including Implant Coordinator,

Periodontist/Surgeon, Endodontist, Pros-

thodontist and Hygienist. Clinical cases

will be used to illustrate the importance of

“look before you leap” planning, treatment

and maintenance. Perspectives from

the Periodontal, Endodontic, Prostho-

dontic and Hygiene disciplines will be pre-

sented. Emphasis on the second half of

the lecture will be devoted to the plan-

ning, treatment and maintenance of con-

ventional, implant and combination cases

including all-on-4 and precision attach-

ment overdenture cases.

Continued - Page 11

Page 7

In Memory of

Leland A. Rosenau, DDS

August 8, 1931 - May 26, 2016

In Memory of

Daniel F. Talbot, DDS

April 22, 1936 - May 31, 2016

Page 8

Annual Leadership Development

Committee Report

2017 Nominations for Officers and Board of Directors

Rommel Bal, DDS, Chair, Leadership Development Committee

Use this QR Code to open the SJDS

website with your smart phone. Don’t

have a QR Code app? They are free

from your app store!

Page 9

SJDS Member Profile

Thao Le, DDS, MS

Interviewed by Lyndon S. Low, DDS, MS

Where did you go to college andwhere did you have your profes-sional training?

I went to college at UC Berkeley

and pursued my dental degree at Colum-

bia University. I subsequently completed

a one-year General Practice Residency at

West Los Angeles VA hospital and then

attended Harvard School of Dental Medi-

cine for my specialty training in endodon-

tics.

What differences have you notedbetween East Coast dentistry andWest Coast dentistry?

Clinically, I haven’t noticed any dif-

ferences. However, I have noticed that on

the West coast, there are a greater number

of corporate chain dental practices, more

so than on the East Coast.

Your implant fellowship traininggives you a unique skill set. How doyou integrate that with the practiceof endodontics?

I was blessed to have the opportu-

nity to pursue a two-year implant fellow-

ship at Harvard after completing my endo-

dontic residency. By attaining dual train-

ing in endodontics and implantology, I

have a better understanding of either treat-

ment option.

During my time teaching pre-doc-

toral students at Harvard School of Dental

Medicine, there were many instances

where extraction versus saving a tooth be-

came a heated topic of discussion amongst

faculty and students during our

multidisciplinary discussions. At times, I

found that our decisions are biased, for

they are based on our own clinical exper-

tise and knowledge. My basic understand-

ing of implant therapy became an impetus

to pursue further training as an endodontic

resident. The advantage of being trained in

both disciplines allows me to have a dis-

cussion with colleagues and patients of

both options, either implant replacement

or root canal therapy, without a biased

opinion.

If given the choice, most dentists

would choose the natural tooth if the tooth

is deemed restorable. There was a period

when the im-

plant pendulum

was swinging

too far in one di-

rection and natu-

ral teeth that

could be saved

were extracted.

Within the

last couple of

years, I am see-

ing the endodon-

tic implant pen-

dulum resorting

back to saving

natural teeth as

we now have

more reliable

clinical data. I

recommend reading a recent article from

the Journal of Dental Research which is a

retrospective clinical study looking at the

“Effectiveness of Implant Therapy Ana-

lyzed in a Swedish

Population: Preva-

lence of Peri-

implantitis, by Derks

et al.”

Dr. Dennis

Tarnow provided his

perspective in regards

to the paper and

noted the alarming

prevalence of peri-

implantitis. He rec-

ommends we should

inform our patients

after implant place-

ment that “your im-

plant may have to be

revisited,” similar to how orthopedic sur-

geons would often say to their patients

when their prosthetic may last 15 years

and needs to be revisited.

The most challenging cases any im-

plant dentist would face are anterior high

smile line cases. I make every effort to try

to save an anterior tooth for a patient with

a high smile line. I often cringe when I see

a restorable anterior tooth removed, as

trying to regain the natural hard and soft

Dr. Thao Le (right) and his wife, Tram Nguyen

Continued - Page 10

L-R: Tram Nguyen (wife), Dr. Le’s mom and dad, Dr. Thao Le.

Page 10

tissue architecture of the tooth becomes a

monumental task.

Would you please share with us abit about your family?

My family roots are traced through

my parents back to the late 1970s when

hundreds of thousands of Vietnamese

refugees were fleeing South Vietnam from

the communist take-over of the country.

My parents were fortunate enough to es-

cape by boat. After spending nearly a

week at sea with hundreds of others on

board in search of political freedom, they

were rescued by personnel on an oil rig in

the South China Sea. From

there, they ended up in a refugee

camp in the Philippines for a

year in 1978.

Subsequently, they

gained refugee status and immi-

grated to the United States in

1979. I grew up not too far from

Atwater in Livingston, CA.

I often reflect on my

parents’ journey to the United

States and what they had to face

in order for us to have the life

that we have today. I have a

strong sense of gratitude for ev-

erything they sacrificed for my

brothers and myself. They are

the reason for my motivation to seek

higher education, as they never had the

opportunity to do so.

What are your favorite foods tocook, prepare and eat?

I’ve always been open to try and eat

foods from all different cultures. By go-

ing to school in the Bay Area, Los Ange-

les, Boston and New York City, I have

been fortunate to try and appreciate the di-

verse ethnic foods that were available.

However, nothing beats a home cooked

meal by my mom. Even though I try to

copy her recipes, it is never the same.

L-R: Dr. Thao Le and nephew, Logan

- Continued from Page 9

SJDS Member Profile

Thao Le, DDS, MS

SJDS once again celebrated a

Stockton Ports Night on July

16th. The members, staff, family

and friends who attended en-

joyed a fun night of entertain-

ment and camaraderie. Although

the Ports had a tough time play-

ing against the Modesto Nuts

that night, they and their staff

throughout the ballpark strived as

always to treat us all very well

and also recognized SJDS on

the scoreboard inbetween in-

nings. As a finale to the evening,

a fireworks show highlighted the

night.

SJDS Nightat the

Stockton Portsby Doug Fong, DDS

Dr. Doug and Marcella Fong and

family

Dr. David and Beth Neal

Page 11

The Dental PPA ...

A Better Way

The Mission of the Dental PPA is to provide quality dental care for a reasonable

reimbursement, to provide our patients with the freedom to choose their own prac-

titioner, and to accomplish these objectives at a cost savings to the employer

whenever possible.

www.projectsandsolutions.com

2016 General MembershipMeetings -- Continued from Page 6

Thursday, Sept, 22, 2016

We of The Dental PPA are very

pleased to announce the selection of

Daugherty Insurance Services as our

exclusive representative of the PPA’s

self-funded dental plan for employers

throughout California. Daugherty In-

surance Services, located in Stockton,

CA and part of the international insur-

ance brokerage firm of Integro USA,

Inc. has an insurance presence dating

back to 1860. Scott and Jeff Daugherty

have made a commitment to grow the

customer base of The Dental PPA and

are pleased to have been selected to

represent our organization. We of The

Dental PPA are committed to main-

taining the private practice of den-

tistry, with quality care, at a fair and

reasonable reimbursement.

Jeff commented, “We are excited

to represent The Dental PPA and look

forward to successfully meeting the

growth objectives of such a progressive

organization and build upon its 15 year

track record that has already saved em-

ployers nearly $1,000,000.”

We are confident that The Dental

PPA, and all our member dentists, will

benefit greatly through this relation-

ship. We will be updating our website

with new content and it will reflect this

arrangement with Daugherty Insurance

Services. In the meantime, please

feel free to contact Jeff Daugherty

by phone: (209) 475-4455 or a t

jdaugherty@rsdins.com for any ques-

tions or to refer a prospective employer.

Remember, The Dental PPA’s

growth is beneficial to our private prac-

tice success while serving local em-

ployers and their employees. “The

Dental PPA – A Better Way.” Visit the

website at www.thedentalppa.org

Page 12

Can you be-

lieve it’s been al-

most eight years

since I stepped

into the position

of the Executive

Director? Over

that period of

time, there have

b e e n m a n y

changes that have

occurred in the

dental society. Thanks to our members

who donated, we’ve gone through an of-

fice purchase/expansion and remodel.

Each year, a new President takes over the

helm of the dental society, new Board

members begin their term, new members

join, members retire and members transfer

to other dental societies. These and other

changes take place throughout the year.

Even with all these changes occur-

ring, there is one main constant: your

dental society. Your dental society has

been here for over 100 years, serving the

needs of its members and providing valu-

able resources. The dental society pro-

vides a cohesive and organized method of

referring patients, providing continuing

education units, providing CPR classes,

providing a dental auxiliary job referral

service, and providing information that

you, as a member of the dental society

seek. If we don’t have the answer, we’ll

direct you to where you can get an answer

to your question.

Did you know there is a fun side to

the dental society? There is always an op-

portunity to have fun at our annual leader-

ship conference, our CE meetings, our

shred/e-waste/fire extinguisher check

event, our night at the Stockton Ports

game, our annual golf tournament, our

new dentist meetings and our Staff Appre-

ciation night.

Speaking of fun, come join us for

our annual golf tournament. This year’s

tournament will benefit CDA Cares Stock-

ton on October 15-16 and will be held at

the Brookside Country Club in Stockton

on August 26. Play in the tournament and

sign up to volunteer to provide dental ser-

vices at CDA Cares Stockton. You’ll have

a lot of fun and contribute to a great

cause! We’re counting on you, our mem-

ber, to get involved!

Your dental society is here to stay

and to help provide you, our member, with

the resources and information you need

and provide fun too!

Colleen’s Commentary

by SJDS Executive Director, Colleen Lee

Page 13

After a successful event in Ventura

in April, CDA Cares returns to the Central

Valley in October.

CDA Cares Stockton will take

place Oct. 15-16 at the San Joaquin

County Fairgrounds and provide for a

population in dire need of oral health

care.

“The population is primarily an ag-

riculture community so you have a high

number of migrant and seasonal workers.

And since the recession, Stockton has

been a slow recovery area of high unem-

ployment,” said Bruce Toy, DDS, CDA

Cares Stockton co-chair. “Being that it is

an agriculture-based community, there

aren’t technical jobs so farming is the

main employer. There is a high poverty

rate and high unemployment.”

Toy knows the community well as

he has practiced in Stockton for 35 years.

He also has chaired the local Give Kids a

Smile events and established a free local

dental clinic of his own. In between that,

he has made time to volunteer at seven of

the CDA Cares events across the state. His

fellow Stockton CDA Cares co-chair,

Brad Louie, DDS, has volunteered at

about the same number of CDA Cares

events and has practiced in the area for 32

years himself. He shared Toy’s sentiments

about the population.

“It’s great that CDA Cares is com-

ing to Stockton because the needs in the

Central Valley are generally higher than

other parts of the state,” Louie said. “All

but emergency services in the adult Denti-

Cal program were eliminated in 2009 and

that hit this area hard. We don’t have a lot

of industry in the Stockton area other than

farming, so we have a lot of people who

CDA Cares Returns to Central Valley - Oct. 15-16, 2016Reprinted with permission from California Dental Association

don’t have resources for dental care. Es-

sentially, the population of those in need

here gets larger and larger.”

Louie, who currently serves on a

local task force to increase access to care

in the Stockton area, said “CDA Cares is

one of the most important things CDA

does.”

CDA Cares is a volunteer dental

program hosted by the CDA Foundation

that provides dental services at no charge

to Californians who experience barriers to

care. CDA Cares also educates the public

and policymakers about the importance of

good oral health and the need for an ad-

equately funded dental safety net, which

includes a well-functioning Denti-Cal pro-

gram. Dental volunteers help relieve pain

and infection by offering extractions, fill-

ings, cleanings, root canals, oral health

education and a limited number of den-

tures and temporary partial dentures.

At CDA Cares Ventura in April,

volunteers delivered $1.5 million in chari-

table dental services to 1,884 people. To

date, CDA Cares has provided $14.6 mil-

lion in dental services to 17,965 people

thanks to 14,312 volunteers.

“I always get more back

than I give at CDA

Cares,” said Louie, who

has volunteered in the

oral surgery, restorative

and pediatric dentistry

areas of CDA Cares

events.

“You get to participate in such a positive

event and there are so many volunteers

who are there for the same purpose. You

relieve pain and infection, but you also re-

store dignity and hope for people. The pa-

tients feel like they have hope after getting

treatment and can go out and get a job,

make friends and restore relationships.”

To ensure these life-changing trans-

formations happen at CDA Cares Stock-

ton, Toy and Louie are working to raise

funds in the community from large em-

ployer groups and corporate sponsors, and

looking for in-kind donations such as

food, water, compressors, forklifts and

more.

“We are currently talking to the city

and county government. The business

community response has been positive.

All the local Rotaries have donated and

the local hospitals and insurance compa-

nies are considering support,” Louie said.

The event, of course, also needs

dentists to volunteer.

“I’m sure dentists are aware of how

many poor and underserved people are in

this community and if they could volun-

teer half a day or a day that would be

great,” Toy said. “Providing the care is

awesome, we’re doing extractions, we’re

relieving infection and pain, and patients

are grateful and thankful they can receive

these services at no charge. The denture

patients who haven’t had teeth in a while

are so happy to receive new teeth. They

look at themselves in the mirror and they

are so emotional and crying from being so

happy.”

To help provide oral health care

services to the large number of expected

patients in Stockton, the CDA Foundation

is currently seeking additional sponsors,

as well as volunteer dental and health pro-

fessionals to sign up for an entire day,

rather than a shorter shift. Additionally,

community volunteers are needed to assist

with registration, clinic setup, data entry,

escorting patients, interpreting and much

more.

“CDA Cares would not be possible

without the support of many volunteers,

organizations and businesses from

throughout the community and state that

donate their time, talents, funds, food and

supplies to help the many patients who

cannot help themselves. We give a heart-

felt thank you,” Toy said.

Local SJDS Committee Chairs

L-R: Drs. Brad Louie and Bruce Toy

Page 14

Scholarships were awarded to three de-

serving students from the local dental as-

sisting and hygiene schools. Beginning

last year, the SJDS Board of Directors

names the dental assisting scholarship

after a past SJDS member. This year,

the scholarship was named the SJDS

Memorial Scholarship in Honor of Dr.

Kenneth Yi. The following students

were this year’s recipients:

SJDS Memorial Scholarship in Honor

of Dr. Kenneth Yi

Maria Gomez - UEI College

Allee Popp - UEI College

SJDS Dental Hygiene Scholarship

Bailey Penix - UOP

The presentation took place at the Board

of Directors meeting on June 9, 2016.

2016 Scholarship Awards

Also attending were Gina Macias,

Campus Department Chair, DA, UEI

College; Deborah Horlak, Dental Hy-

giene School Director, UOP; and the

recipients’ families.

The awards were presented by Dr.

Bruce Toy, SJDS Long Term Del-

egate and Past President.

Dr. Bruce Toy and 1. Allee Popp, 2. Maria Gomez amd 3. Bailey Penix

CDA Cares Coming to Stockton this year!Saturday & Sunday, October 15-16, 2016

3

1 2

Page 15

San Joaquin County’s Homeless Vet-

eran Stand Down—a biannual “benefit

faire” for homeless veterans—was last

held on September 26, 2014. The military

term “Stand Down” stands for a grass-

roots, community-based intervention pro-

gram designed to help homeless veterans

“combat” life on the streets. Like the first

four events before it, the last Stand Down

was a one-day event held in Stockton. The

sixth, however, will be a three-day event

beginning September 16, 2016 and ending

September 18, 2016, at

Mather Air Force Base in

Sacramento. Transporta-

tion of local veterans will

be arranged by Veteran

Stand Down San Joaquin,

Inc., which governs local

stand down events.

A growing popu-

lation of men and women

who have served their

country are returning

from combat with Post

Traumatic Stress Disor-

der and other psychologi-

cal ills. Media has re-

ported that forty-five per-

cent of the 1.6 million veterans from the

wars in Iraq and Afghanistan are seeking

compensation due to service-related af-

flictions. Many of these veterans do not

seek the professional help they need, but

turn instead to “self-medication,” fre-

quently resulting in the development of

substance-abuse problems. Veterans may

ultimately lose their families, jobs, and

motivation to these illnesses, casting them

into a downward spiral and leading in

some cases to homelessness.

September 2014 marked the first

year that a homeless veteran mother at-

tended the Stand Down with her children,

and volunteers observed the high percent-

age of younger veterans in attendance this

time, especially ones that had suffered ob-

vious traumatic injuries.

San Joaquin County Homeless Veteran Resource Faire:

2016 “Stand Down”

September 16-18, 2016

Mather Air Force Base, Sacramento

The Stand Down committee of vol-

unteers came together with a common be-

lief that there is just something fundamen-

tally wrong with the concept of “homeless

veterans.” The committee wanted to give

back, even if just a tiny bit of honor and

appreciation, to let America’s veterans

know that we care and we still remember

that they served our country to keep us all

safe, secure, and free. We wanted to ex-

press our thanks and gratitude for all that

our veterans have done for us.

Past Stand Down events were held at

San Joaquin County WorkNet in Stockton,

with a number of services being offered

nearby at the Stockton Shelter for the

Homeless property and the adjoining St.

Mary’s Interfaith Community Services.

Booths were set up at the two locations for

the thirty-plus service providers.

The events culminated in a 3:00

p.m.-5:00 p.m. standing-room only session

of the Homeless Court. At the last Stand

Down, we saw between 80-85 veterans

during the court session, who cleared ap-

proximately 125 old court cases. The 2014

Stand Down yielded over 200 volunteers,

including San Joaquin County S.T.A.R.S.

(Sheriff’s Team of Active Retired Seniors)

and Stockton Police V.I.P.S. (Volunteers in

Police Service) who provided transporta-

tion. University of the Pacific volunteers

including both students and faculty served

in a variety of capacities at the events, in-

cluding many community members and

volunteers representing numerous organi-

zations.

Over 200 homeless veterans at-

tended the last Stand Down and were of-

fered full medical, dental, and eye exams;

showers; and a clothes closet. Legal ser-

vices, employment referrals, housing as-

sistance, health services, mental health

services, substance abuse

counseling, Veterans Af-

fairs benefits counseling,

Department of Motor Ve-

hicles services, hot

meals, and more were

also offered. As a final

stop, each veteran re-

ceived the ever-popular

large backpack stuffed

with all sorts of useful

items as a parting gift.

Legal services for

each of the five prior

Stand Downs were coor-

dinated by Charles

“Chuck” Keen, a local

attorney, and legal advice was provided in

all areas of the law. In past years, in addi-

tion to Child Support and Homeless Court

clients, additional legal services were pro-

vided to approximately 50 veterans.

Members of our local Bar have gener-

ously volunteered their time and talent

over the years to provide free legal advice

at each of the Stand Downs.

A major goal of the Stand Downs

has been to provide services to the home-

less veterans that will connect them with

continuing services beyond the single

event that will assist in breaking the cycle

of homelessness. We aim to encourage re-

integration of the veterans into main-

stream society with volunteer organiza-

- Continued - Page 16

Page 16

Friday, August 26, 2016SJDS Golf Tournament

Saturday, October 15 andSunday, October 16, 2016

CDA Cares Stockton

www.sjds.org

tions continuing to offer follow-up ser-

vices to this population as necessary.

It is hard to tell who gets the most

out of the Stand Down events: the Home-

less veterans or the multitude of commu-

nity volunteers and participating agencies.

The veterans are always so very apprecia-

tive of all our efforts, services and dona-

tions. The volunteers and participating

agencies experience the feeling of making

a difference in the lives of this deserving

group. It is an honor and a rewarding ex-

perience to serve our homeless veterans at

these Stand Downs.

This year, the local committee will

be providing legal support services in co-

ordination with the Sacramento Stand

Down’s legal group. We anticipate that

that we will be on-site for all three days. If

you can spare a morning or afternoon and

would like to help on-site or, if unable to

be there in person, could be available for

telephone consultation in your area of ex-

pertise, please contact Chuck Keen at

(209) 948-0434 or email: cek@bgrn.com.

We will get back to you as soon as pos-

sible to confirm your participation once

the final details have been ironed out.

To volunteer as a general volunteer

for the Stand Down (not providing legal

services), please contact Jason LeBeouf at

Jason.lebeouf@usi.biz or (209) 954-3920.

There are plenty of tasks to assist with, es-

pecially since the combined Stand Down

will now last for three days.

- Continued from Page 15

San Joaquin County Home-

less Veteran Resource Faire:

2016 “Stand Down”

Moscone SouthSan Francisco

Thurs.-Sat.Sept. 8-10, 2016

www.cdapresents.com

Page 17

Risk Management

Data breach news is ongoing and

2015 closed with no shortage of informa-

tion about medical and dental record

breaches.

The U.S. Department of Health and

Human Services’ (HHS) online listing of

protected health information breaches,

known as the “wall of shame,” includes

nearly 1,400 incidents of major data

breaches (affecting 500 or more people)

since 2009 when the HIPAA

Breach Notification Rule be-

gan. One incident alone last

year exposed the dental

records of more than 151,000

patients to unauthorized users

when an internal database was

hacked at an Oregon-based

dental services provider.

The Dentists Insurance

Company receives numerous

calls to its Risk Management

Advice Line regarding data se-

curity, and analysts say den-

tists may not be aware of data

security risks and the extent of

notification required if a data

breach occurs.

“Dentists can be un-

aware of their obligation to protect patient

data and are astonished at how easily pa-

tient information can fall into the hands of

unauthorized parties,” said Sheila Davis,

TDIC assistant vice president of claims

and risk management.

A data breach is generally defined as

an impermissible use or disclosure under

the HIPAA Privacy Rule that compromises

the security or privacy of patients’ pro-

tected health information (PHI).

“The term data breach is often asso-

ciated with someone hacking into your

computers or website, but a data breach is

when protected health information is in the

possession of an unauthorized person or

entity,” Davis said.

The HIPAA Privacy Rule defines

PHI as individually identifiable health in-

formation that is transmitted or maintained

Top Seven Data Breach ConsiderationsBy TDIC Risk Management Staff

in electronic, oral or paper form. State

laws address PHI and may vary from state

to state. Examples of protected informa-

tion include medical and dental records,

defined as “any information regarding an

individual’s medical history, mental or

physical condition, or medical treatment

or diagnosis by a health care profes-

sional.”

Also protected is personal informa-

tion such as a person’s first name or first

initial and last name in combination with

identifiers such as a Social Security num-

ber, driver’s license number, account

number, credit or debit card number, in

combination with any required security

code, access code or password that would

allow access to the person’s financial ac-

count. A username or email address, in

combination with a password or security

question and answer that would permit

access to an online account, is also pro-

tected.

In the constantly changing digital

environment, TDIC reminds dentists of

the following data security consider-

ations:

Electronic theft:Theft of computers, hard drives,

portable devices and back-up drives is the

leading cause of data breach. The HHS

Office for Civil Rights data breach portal

indicates the type of breach and location

of compromised information, and theft is

by far the most common type of breach

listed. Back-up drives and portable de-

vices are especially vulnerable to theft.

“Data breach occurs

when there is a theft of

unencrypted patient data,

either in the office or of

portable equipment stolen

in transit,” Davis said.

“There can be several

thousand records in-

volved.”

TDIC can assist with

breach claims for policy-

holders who purchase

data compromise cover-

age as an addition to their

commercial property

policy. In one recently

closed case, TDIC cov-

ered the five-figure cost

of determining the extent

of patient data on a stolen mobile device,

as well as the required patient notification

and credit monitoring services.

Notification:Both federal and state laws require

patient notification in the event of a data

security breach. Regulations vary from

state to state regarding data security

breaches, but most states require notifica-

tion of affected individuals. State attor-

neys general offices have state-specific in-

formation. For instance, in California,

businesses are required to send consumers

a letter if an unauthorized user has ac-

quired their data. If letters are sent to

more than 500 individuals, businesses

must notify the attorney general’s office.

Continued - Page 18

Page 18

“Dentists can be caught off guard re-

garding the extent of patient notification

required when they become aware of a

data breach,” Davis said. “They may also

believe that unless someone has attempted

to access or use the information, they do

not need to notify their patients.”

“The problem is that once someone

has attempted to access the information,

then it’s too late to try and take preventa-

tive measures,” Davis added. “What could

be viewed as careless security of patients’

data compounded by a failure to notify the

affected parties may have longstanding

reputational damage for the practice.”

Notification expenses:The cost of data breach notification

is estimated at $200 per individual, ac-

cording to the Ponemon Institute, a re-

search center focusing on data protection.

This expense includes the cost of fines,

mailings, published notification and credit

monitoring services.

Increasing regulation:At least 32 states in 2015 introduced

or considered security breach notification

bills or resolutions, according to the Na-

tional Conference of State Legislatures.

This is in addition to laws that impose

monetary penalties upon individuals and

institutions that fail to protect the privacy

of patient medical records. With varying

degrees of success, many of the newer

bills sought to amend existing security

breach laws to require entities to report

breaches to attorneys general or another

central state agency or expand the defini-

tion of “personal information” to include

medical, insurance or biometric data in

the event of a security breach.

California’s data breach notification

law was amended to require changes, ef-

fective this month, to breach notification

notices. New requirements include format-

ting, such as specified headers and text no

smaller than 10-point type, of the notice to

call attention to the significance of the

content.

Also in California, additional legis-

lation defined “encryption” as “rendered

unusable, unreadable or indecipherable to

an unauthorized person through a security

technology or methodology generally ac-

cepted in the field of information technol-

ogy.”

Hawaii looked to expand the defini-

tion of “personal information,” establish a

timeline in which a business must notify

individuals affected by a security breach

and prohibit use of email as a means of se-

curity breach notification if login creden-

tials for email were compromised.

In Illinois, proposed legislation

aimed to amend the Personal Protection

Act, expand the scope of protected infor-

mation to include medical, health insur-

ance, biometric, consumer marketing and

geolocation information and require no-

tice of security breaches to be provided to

the attorney general.

Staff training:Malware infection of office comput-

ers can cause data breach, and the entire

dental team must use caution in accessing

unfamiliar email, using the Internet and

handling protected health information.

Email security:Given that many breaches occur

when data travels outside the walls of

your practice, it’s important to ensure that

data can’t be compromised when travel-

ling from point A to point B. HIPAA/

HITECH regulations mandate that medi-

cal patient data being sent over the net-

work must be encrypted.

If you send unsecured email with pa-

tient information, make sure to have the

patient’s signed consent on file. TDIC has

a patient release form on its website at

thedentists.com for this purpose.

Encryption:Analysts say encryption is the most

effective way to minimize the damage that

can occur from a breach of protected

health information. Password protection

of computers alone is not secure. If you

are not sure if your office computers,

back-up drives and portable devices are

encrypted, chances are they are not. An

experienced IT professional can help pro-

tect your data. Encrypting protected health

information provides safe harbor under

HIPAA’s data breach notification rule.

Call TDIC’s Risk Management

Advice Line at 800.733.0634.

Top Seven Data Breach Considerations - Continued from Page 17

Volunteers Needed!

A Hearty Thanksto Our

St. Raphael’sDental ClinicVolunteers

Our thanks to the following mem-

ber volunteers who gave of their

time and talents in June-July 2016

at St. Raphael’s Dental Clinic:

You can’t change the world in four

hours, but volunteering 4 hours

per month or every other month at

St. Raphael’s Dental Clinic is a

start. Call Mary Ann at the clinic

to sign up (467-0703). For ques-

tions call Dr. Lester Low (474-

3333).

Volunteer Form atwww.sjds.org

click on Dental Health St.

Raphael’s Volunteer

Page 19

why a suggestion to boost productivity

with time off might sound counter-

intuitive. Studies have shown that paid

time off ranks high on the wish-list of

potential job candidates, especially young

parents. Without a paid time off policy,

you may be at a disadvantage when

competing with larger firms for

employees.

When it comes to fraud, the old

adage about a small amount of prevention

being worth a large amount of cure is spot

on. Investing in fraud prevention methods

can be more cost-effective than spending

time and money on clean-up after a fraud

has been detected.

PayrollIf your company uses payroll

software, set up the internal control

features to keep master hourly rates, hours

worked, and bank direct deposit

information secure. Depending on the

Brett L. Tholborn, CPA

No business wants to be hit by fraud.

The following are several simple

ways which could help you protect

yourself and your business. The goal is to

make sure that your business cannot easily

be taken advantage of by employees and

others.

Paid Time OffPaid time off can be a critical

component of your employee benefits

package. Besides the obvious perk to

workers, as a business owner, you stand to

gain from offering paid time off as well.

One reason is that paid time off is tax

deductible, just like regular wages. Other

reasons include health and customer

service benefits. When combined with a

sick leave policy, paid time off can help

persuade employees with contagious

illnesses to stay home. What’s more, if

your workers have a high level of contact

with the public, paid time off can be a

marketing tool to help assure your

customer base that your company takes

safety and health issues seriously.

Paid time off can also help you

attract higher quality workers. A good

employee is a valuable company asset,

and no doubt you want your employees to

be as productive as possible – which is

size of your business, you might want to

consider pulling timecards periodically to

verify that payroll checks are being issued

to actual employees, not “ghosts.” (Ghost

employees are workers who do not

actually work for your company, such as

former employees who continue to receive

paychecks.) Monitor your expense

accounts and financial statements.

Higher-than-budgeted payroll costs are a

potential tip-off to payroll fraud.

Accounts PayableEstablish a very clear segregation of

duties between the employees who receive

goods or authorize services, and the

employees who process the payments for

those goods and services. Having more

than one person complete a task makes

fraud more difficult. Take time to get to

know your vendors. You want to be sure

the companies you are paying are real, not

fictitious entities. Monitoring the number

of invoices you receive from individual

vendors, as well as the average payment

amounts for specific vendors, can alert

you to suspicious payments.

One More TipCommunication about what is and is

not acceptable behavior is also a

prevention method. Emphasize to your

employees, your vendors, and your clients

that unethical behavior and practices are

not acceptable, and clearly state the

consequences.

Whatever the size of your business, fraud

can impact your bottom line. Employee

downtime is not wasted time if it is part of

a thoughtful plan. If you have questions

about implementing fraud prevention

strategies, contact your Certified Public

Accountant. Request suggestions and tips

that can help keep your business assets

safe.

Brett L. Tholborn, CPA

Brett L. Tholborn is a managing partner at

Tholborn, Ostrowski & Crane, LLP. These

Accountants and Consultants are located at

4525 Quail Lakes Drive, Suite B, Stockton,

CA 95207. If you have any questions or com-

ments, please call Brett at 209-474-3375 or e-

mail him at Brett@TOCaccounting.com.

Business Fraud Prevention

Page 20

Page 21

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