gda action

ACTIONTHE JOURNAL OF THE GEORGIA DENTAL ASSOCIATION APRIL 2010


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index of advertisers

GDA ACTION (ISSN 0273-5989) The official publication ofthe Georgia Dental Association (GDA) is published monthly.POSTMASTER: Send address changes to GDA Action at7000 Peachtree Dunwoody Road N.E., Suite 200,Building 17, Atlanta, GA 30328. Phone numbers in state are(404) 636-7553 and (800) 432-4357. www.gadental.org.

Closing date for copy: first of the month preceding publicationmonth. Subscriptions: $17 of membership dues is for thenewsletter; all others, $75 per year. Periodicals postage paidat Atlanta, GA.

Dr. Jonathan Dubin Delaine HallGDA Editor GDA Managing Editor2970 Clairmont Rd 7000 Peachtree Dunwoody Rd NESuite 195 Suite 200, Building 17Atlanta, GA 30329 Atlanta, GA 30328

2009-2010 Georgia Dental Association Officers Kent H. Percy, DDS, PresidentJohn F. Harrington Jr., DDS, President ElectMichael O. Vernon, DMD, Vice PresidentJames B. Hall III, DDS, MS, Secretary/TreasurerJonathan S. Dubin, DMD, Editor

GDA/GDIS/PDRS Executive Office Staff Members

Martha S. Phillips, Executive DirectorCarrie Carter, Administrative Assistant

Nelda H. Greene, MBA, Associate Executive Director

Delaine Hall, Director of Communications

Skip Jones, Director of Operations (PDRS)

Courtney Layfield, Director of Member Services

Victoria LeMaire, Medical Accounts Manager

Melana Kopman McClatchey, General Counsel

Denis Mucha, Director of Operations (GDIS)

Phyllis Willich, Administrative Assistant

Pamela K. Yungk, Director of Membership & Finance

GDA Action seeks to be an issues-driven journal focusing on current mattersaffecting Georgia dentists, patients, and their treatment, accomplished throughdisseminating information and providing a forum for member commentary.

© Copyright 2010 by the Georgia Dental Association. All rights reserved. No partof this publication may be reproduced without written permission. Publicationof any article or advertisement should not be deemed an endorsement of theopinions expressed or products advertised. The Association expressly reservesthe right to refuse publication of any article, photograph, or advertisement.

10 State Legislative Update on Tobacco Tax, Dental CMOs

12 The Do’s and Don’ts of Dental Patient Records

14 Health Care Reform Roundup: The Impact on Dentistry

25 GDA Reaches Out on Give Kids ASmile Day with District Programs

28 Got Children? Working With and Passing Your Practice On to the Next Generation

4 Parting Shots

5 Editorial

6 Member Commentary

8 News and Views

24 Annual Meeting Room Form

31 Minutes

35 Event Calendar

36 Classifieds

38 Breaking the Mold

Registration is open for the 143rd GDAAnnual Meeting in Amelia Island, Florida,from July 22 to 25, 2010. Join your fellowGDA members at the extremely popularRitz-Carlton Amelia Island and “Let theGood Times Roll!” Turn to page 17 to readabout the meeting events in store. Use theform in the center of this issue to registerfor the meeting and buy your event tickets,or register at www.gadental.org. Allprices will rise July 1, and many toursand sporting events must meet certainregistration minimums by early July aswell, so register soon!



other features sections

on the cover

Member Publication American Association of Dental Editors

ACTION

V O L U M E 3 0 , N U M B E R 4 • A P R I L 2 0 1 0

Note: Publication of an advertisement is not to be construed as anendorsement or approval by the GDA or any of its subsidiaries,committees, or task forces of the product or service offered in the

advertisement unless the advertisement specifically includes anauthorized statement that such approval or endorsement hasbeen granted.

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4 GDA ACTIONAPRIL 2010

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There is something different about him. Youcan sense it. It might be the sweet smile on hisface that exudes innocence or it might bethe gait of his walk. He is one of many in anoften-forgotten demographic. The worddemographic, although often used, might bethe wrong word here, however, as it seems todehumanize people. He is one of the manythousands upon thousands of children andadults with intellectual disabilities. Whileaccess to care seems to be the most talkedabout issue these days, Georgia dentists areincreasing access for this segment of ourpopulation. How?

For more than 12 years, the GeorgiaDental Association has worked closely withthe Special Olympics to increase access todental care for Special Olympic athletes andto increase the number of dentists who willserve these athletes in their practices.Individuals with intellectual disabilities havehistorically had difficulty accessing healthcare. This is compounded by the fact thatthese individuals are at a 40 percent greaterrisk for certain health issues than the generalpopulation. The Special Smiles program wasfirst implemented in Massachusetts in 1993. Afew years later Healthy Athletes was started toinclude health screenings, podiatry, vision,and overall health promotion.

The late Dr. John McNamara of Atlantaled the GDA’s Special Smiles effort for itsinaugural 10 years. He arranged protocol andvolunteers and implemented the SpecialSmiles program at the Georgia Summer Games.During the Games, typically 60 dentists,dental students, dental hygienists, and dentalhygiene students gather to volunteer theirtime and skills to provide a non-invasive dentalscreening, oral hygiene education, sportsmouth guards (made for the athletes on site),and nutritional counseling. This year, volunteerswill also provide the athletes with sealants andfluoride varnish as additional benefits.

After the athlete finishes their time withthe dental volunteers, they walk away with anoral health report card along with a goody bag

of oral health aids. Volunteers also provideathletes who need further dental attentionwith referrals to GDA dentists who treatindividuals with intellectual disabilities aswell as with information about the DDDFoundation of Atlanta. This clinic, owned byDr. Deidra Rondeno, treats only severelyintellectually disabled children and adults.

The Special Smiles program is importantfor several reasons, but primarily because itincreases awareness of oral health for theathletes and their guardians, parents, and / orcaregivers. It also allows dentists to enjoyincreased awareness of the oral health needsof these individuals, and realize the differencethat dental care can make in their lives. Theprogram helps to break down the barriers toworking with the disabled and to increasethe number of health care professionalswho will serve them. As a profession, we canhave a greater appreciation for what theseindividuals and their caregivers face.

Last year, nationwide, over 22,000individuals received screenings and hygieneinstruction during Special Smiles. The programis not the end-all to solving access to caredilemmas for the disabled, but the programsees continued growth each year. This year,the GDA Special Smiles program will beheld on May 22 on the campus of EmoryUniversity in Atlanta. Also this year, we areadding a Special Smiles program in conjunctionwith the Special Olympics Masters Bowlingtournament in August to be held in WarnerRobins. Won’t you consider volunteering a fewhours of your time to help these individuals?It will open your eyes and hearts. They are notonly special athletes, but also special people.

5GDA ACTIONAPRIL 2010

There is Something Different About Him

Jonathan S. Dubin, DMD

editorialperspective

The GDA Special Smiles

screening and education

program takes place

May 22 at the Emory

University campus in

Atlanta. To volunteer,

email [email protected].

Help continue to increase

access for individuals with

developmental disabilities.

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A few weeks ago LaGrange, Georgia, lost apillar of the community. Sometime in thenight or the wee hours of the morning my friend,Doc, went quietly on to the next journey.

You know, I’ll never forget the first time Iactually met Doc. I was a 23-year-old seniordental student in Augusta, home for a weekend,and uncertain about my future. I had been toDr. Cliff Rainey’s office having my annual eyeexam. If you know Cliff he’s quite a talker.Somewhere in our conversation he gatheredthat I could use a little direction and suggestedthat I call Doc. He thought he had an openingin his office and might be willing to talk to me.

We hit it off right away. I can’t say we hada lot in common. We came from completelydifferent backgrounds. He grew up in an affluentfamily—his father was a prominent physicianin Lakeland, Florida. He had attended Yale andEmory University before fighting in WorldWar II. I was an ambitious redneck kid fromthe Hillside Mill Village who went to Auburnand the Medical College of Georgia. But weboth loved dentistry and a good story.

I’ll miss his stories. We had an uncommon arrangement.

Both of us being stubborn, we could not agreeon the terms of a contract. On a leap of faith,he said, “Aw, Hell, just come on and we’ll workit out later.” We never settled on a contract.We had a handshake. I laugh and say we had acommon law partnership. He did what he saidhe would do and I did what I said I would doand it just worked. He was a man of honor andhis word was golden. That’s the way I wasraised as well. We did have that in common.

I’ll miss his friendship.I’m living with the regrettable ‘shouldas’

and ‘couldas.’ I loved my friend like a fatherbecause he was that and so much more to meas a young dentist. I’ve got a few stories of myown. After all, we spent every day together.We ate lunch together every day. Most ofthose lunches were at Golden Corral whenHarvey Schwartz owned it on CommerceAvenue. There were plenty of stories told overa Number One steak and potato.

He loved to talk about golf and the stockmarket. He gave me plenty of advice abouthow to manage money. He enjoyed driving anice car and even let me drive his Alfa Romeoone weekend when I coerced him into lettingme take it home to clean it up for him. He toldstories of flying a bi-plane as a young man andcrashing a couple of times, once leaving therunning gear at the bottom of a sea wall as hemisjudged a landing. He told me stories ofworking on German soldiers who were prisonersof war at Fort Leavenworth during the war.His life had been an adventure long before Iever met him.

Doc would grin that sly grin of his andlaugh when he’d tell the story of how he and afew other dentists in LaGrange got the waterfluoridated before anybody had a chance tocomplain about it. Back then, apparently, thebureaucracy wasn’t quite as difficult to workthrough. What they did would never happentoday, but they were successful in getting thewater system fluoridated which may be one ofthe most significant events to ever happen inLaGrange to prevent the ravages of toothdecay for thousands of children. By the timethose who would complain (and you knowwho “they” are) did complain about theirnotion of the dangers of fluoride, warningeveryone to not allow fluoridation, Doc andhis forward-thinking dental friends couldproudly point to the fact that the water hadbeen fluoridated for years with no apparentnegative effects. They pointed to the fact thatthe decay rate of children in LaGrange hadbeen significantly reduced for YEARS. Hewas proud of that and I’m proud I knew him.

Before LaGrange had oral surgeons likeBill Hines and Don Neal, Doc would becalled to the emergency room to handle a lotof the cases for broken jaws. His experience inthe service was invaluable. I can’t imagine alocal general practitioner wiring broken jawstoday, but it was common for him. He still hada lot of the instruments in his office when Icame to practice with him. Yes, he had storiesabout that too.

The Value of a Mentor

John W. Vollenweider, DMD

membercommentary

I have to honestly say

I didn’t realize at the

time how lucky I was

to start my career …

with Dr. William T. “Bill”

Richards—Doc.

I’ll be forever grateful

for his generosity, his

wisdom he shared so

freely, his guidance, and

mostly his friendship.

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There is so much more to tell, but I doubt the paper* couldallow the space. I do want to say that I am glad that I got to tell Docwhat he meant to me. I’m glad I don’t live with that regret. This

past Christmas, as was our cus-tom, Doc came to our office partyas a guest. After the eating and thepassing out of gifts, white ele-phant gifts, and Christmas“bonuses” to the staff I had achance to tell him how much Iappreciated him giving me achance and taking a leap of faithwith me. He didn’t really know mewhen he allowed me to join him inhis practice over 30 years ago, buthe extended his hand of friend-ship and experience to me. I haveto honestly say I didn’t realize atthe time how lucky I was to startmy career as a dentist with Dr.William T. “Bill” Richards—Doc.

I’ll be forever grateful for his generosity, his wisdom he shared sofreely, his guidance, and mostly his friendship.

I’ll miss you, Doc, like so many will and as long as I can, I’llshare you and your stories with the next generations of dentists.

*This commentary was originally printed as a Letter to the Editorin the February 5, 2010, LaGrange Daily News.

Dr. Bill Richards—friendand mentor.

The Georgia Dental Association encourages dentists to

submit commentaries of 1,000 words or less to GDA Action

for publication consideration. The GDA will not publish

unsigned commentaries submitted to GDA Action, or

commentaries submitted under a name the GDA office

cannot verify. The GDA Editor reserves the right to

edit all commentaries for clarity and length. Unpublished

commentaries will not be returned. Opinions presented in

letters and commentaries are the authors’ opinions, and do

not necessarily reflect GDA adopted policies. Questions

and submissions may be directed to the GDA office by

email to [email protected].

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State OrthodonticAssociation ElectsOfficersThe Georgia Association of Orthodontists(GAO) elected officers at their recentannual meeting. Kudos to President Dr.Michael Williams of Woodstock; PresidentElect Dr. Steven Ricci of Johns Creek;Vice President Dr. James Paschal ofMadison; and Secretary-Treasurer Dr.William Newell of Jefferson. Kudos as wellto Past President Dr. Dallas Margeson ofAlbany for his term of service. Also takingoffice were GAO Directors Dr. AnnaVeilands, Albany; Dr. Joe Vargo, Rome; Dr.Mark Dusek, Savannah; and Dr. DonSpillers, Warner Robins. To learn moreabout the GAO, visit www.gaortho.org.

MilledgevilleOrthodontist DonatesBraces for FundraiserDr. Anne Sanchez and her orthodonticemployees are hard at work raising fundsfor an American Cancer Society Relay forLife initiative in their middle Georgiacommunity. Besides earning money through

more traditional channels like cookie sales,Dr. Sanchez and her team implementedtwo dental-themed fundraisers. First,patients deemed as “good brushers” cansign a specially constructed 6-foot-tallbirthday cake on display in Dr. Sanchez’swaiting room. The cake is meant to tie intothe Cancer Society’s tagline of “less cancer,more birthdays.” The practice will donate$1 for each signature on the cake by April30. Second, the office is holding a raffle fora free set of braces. Each raffle ticket isbeing sold for $5. As of early March, theoffice had sold 200 tickets.

Budget Woes ThreatenState Hygiene ProgramsEarly March brought disturbing news toArmstrong Atlantic State University dentalhygiene faculty and staff. Administratorsstated that the school was looking at closingthe 42-year-old Savannah dental hygieneprogram due to budget cuts. The proposedprogram closure followed warnings fromstate legislators that the University Systemof Georgia prepare to cut $300 millionfrom its Fiscal Year 2011 budget. This

would be in addition to a $256 millionreduction already recommended byGov. Sonny Perdue for 2011. TheAASU portion of the $300 millionreduction is $5.3 million, which is inaddition to a reduction of $3.9 millionalready in place.

Despite initial fears that first yeardental hygiene students would notbe allowed to graduate, the schoolis now planning to field a skeletonfaculty to give current students thechance to graduate in 2011. Theschool is also not planning to close thedental hygiene clinic that providescare to the public and schoolemployees. This 18-month transitionperiod before the 2011 graduationcould potentially give anotherorganization the time to obtainaccreditation and to take over theprogram.

Upon hearing of the proposedprogram closure, the GDA developed

a position paper and talking pointssupporting keeping the dental hygieneprogram viable. That information wasdistributed in March to the dentists of theSoutheastern District to use in contactingtheir elected officials.

Meanwhile, officials at GeorgiaHighlands College in Rome had alsoconsidered shuttering the dental hygieneprogram at that school due to budgetpressures. After much discussion andconsideration, however, the school hasinformed the program’s faculty that theprogram will remain intact and in factwill be allowed to accept an incoming classfor this fall.

There were also rumors earlier duringthe legislative session that the dentalhygiene program at the Medical College ofGeorgia could be in jeopardy. However,that program also remains funded and fullysupported by the school.

National DentistryMuseum HoldsFacebook.com ContestThe Samuel D. Harris National Museumof Dentistry has announced a two-month-long Facebook.com challenge to raiseawareness of the museum and its missionto improve oral health nationwide. Helpthe museum reach 5,000 Facebook fansand you could win a tooth-rific dream tour.Just become a “fan” of the museum’sprofile on the Facebook.com social mediasite by June 1 (current fans are eligible aswell) to be automatically entered for aprize package that features a curator-ledtour of the museum for six people, includinga rare chance to get up close and personalwith George Washington’s choppers; apeek into the museum vault, where someof the most curious dental treasures arestored; swag from the Museum Shop;and smile kits including toothbrushes,toothpaste, and floss. (One winner will beselected from a random drawing of fans onJune 4, 2010. The tour package must beredeemed by December 31, 2010.)


generalnews

Visit www.ada.org and enjoy a bright,updated look and easier to navigate layout.Members are encouraged to submit a photofor the new ADA.org find a dentist feature.

ADA.org Debuts New Look

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The middle of March saw movement inseveral key areas:

Dental Single AdministratorLegislation IntroducedA “dental single administrator” bill wasintroduced March 16 by Rep. Carl Rogers.HB1407 would require the state to utilizea single administrator for Medicaid dentalbenefits. Reps. Rogers and MickeyChannell spoke to the House Health andHuman Services Committee on behalf ofthe bill. While they both praised Doral(now DentaQuest, the company that han-dles administration of the dental Medicaidplans for the Care ManagementOrganizations Peach State, WellCare, andAmerigroup), the legislators made it clearthat it does not make fiscal sense to con-tinue paying two layers of administrativefees (one to the CMOs and another toDoral / DentaQuest). The legislators advo-cated in favor of cutting out the middleman and paying a single entity to adminis-ter dental benefits.

GDA Associate Executive DirectorNelda Greene testified in favor of the billin March and informed the Committee ofthe CMOs’ administrative costs as well asthe potential cost savings a single adminis-trator would bring to Georgia. After hear-ing this information and the comments ofRep. Rogers and Channell, the bill wasunanimously voted out of Committee.

Silent PPO Bill Silenced—Hopefully, TemporarilyAmended SB50, the Silent PPO bill(which would require companies that use a“rented network” of providers to complywith the original terms of the contract asnegotiated with the provider and the net-work) was heard before the House Lifeand Health Insurance Subcommittee onSt. Patrick’s Day. Unfortunately, the luck ofthe Irish was not with the GDA on this bill.

Before the Senate passed the bill,Sen. Seth Harp was successful in addinglanguage which would make the penaltiesfor violations of the legislation more strin-gent. To help move the bill through the

House, those amendments were laterstricken. Additionally, providers in con-junction with the American Association ofPreferred Provider Organizations amend-ed the bill with the hope that all of thechanges and partnerships would ensuresuccess in the House. The Georgia DentalAssociation testified in favor of the billalong with the Medical Association ofGeorgia, the Optometric and ChiropracticAssociations, and other providers. TheHouse Committee cut short testimonyand delayed a vote on the matter until alater date (not yet set).

Tobacco Tax Likely Flames OutOn another sour note, the tobacco tax billappears to have been defeated. Rep. RonStephens has publically stated that he hasbeen unable to get enough votes to get thelegislation passed. He stated that “[w]e’vegot 81 commitments … we need 91 to passit. The chances of that bill passing are very,very slim and none,” he told WABE’sDenis O’Hayer in March.

If Rep. Stephens’ bill did succeed, theGeorgia Budget and Policy Institute esti-mates that Georgia would gain at least$335 million in revenue.

This may be the end for the proposed$1 per pack tax legislation (which the GDAsupported), but Rep. Stephens is now try-ing to pass a constitutional amendmentwhich would allow voters to decide forthemselves whether the tobacco tax shouldbe imposed. Getting a constitutional meas-ure through both the House and theSenate could prove to be even more chal-lenging than passing a bill. Doing so wouldrequire two-thirds votes in the House andthe Senate. To put it in perspective, Rep.Stephens would need 120 votes for a con-stitutional amendment rather than the 91House votes he needed for his bill.

Budget News Continues to Draw InterestThe GDA previously reported thatGovernor Sonny Perdue was warning thatMedicaid providers should expect a 10.25

percent decrease in reimbursements, andthreatening elimination of the sales taxexemption on purchases by non-profit hos-pitals. That threat led to a meetingbetween the Governor and hospitaladministrators in mid-March, at which theGovernor turned down requests to consid-er funding the state’s Medicaid gap with adollar-a-pack increase in the tobacco tax.

Since that meeting, the CEOs of themajor hospitals, the board members of theGeorgia Hospital Association (GHA), theGeorgia Alliance of Community Hospitals,and Hometown Health worked together toapprove a hospital provider paymentagreement with the state which includes a1.45% “bed tax.” While the proposal is farfrom perfect, it reaches a compromise thatthe hospitals have said is “far more palat-able than the removal of the sales taxexemption for not-for-profit hospitals anda 10.25 percent Medicaid rate cut.”

State to Sue over Health Care Reform?Gov. Perdue said on March 25 that he willappoint a “special attorney general” tochallenge federal health care legislationsigned into law by President Obama. Gov.Perdue made the announcement a dayafter state Attorney General ThurbertBaker, a Democrat running for governor,told Perdue, a Republican, he would notpursue a lawsuit. Perdue wanted Baker toeither sue on his own or join 14 otherattorneys general in the U.S. in their jointlawsuit. Baker said in a letter to Perduethat the lawsuit is almost surely to fail andwould be costly in a time of plunging staterevenues.

The governor said the state constitu-tion gives him the leeway to appoint a spe-cial attorney general if the elected attorneygeneral fails to carry out the wishes of thegovernor, and that the state will probablygo it alone on the suit to avoid any costs.

Asked in March about talk in the leg-islature that Baker should be impeached,the governor said impeachment is a leg-islative prerogative and declined furthercomment.

State Legislative Update on Tobacco Tax, Dental CMOs

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Gov. Perdue’s spokesman BertBrantley told the Atlanta JournalConstitution that “… given that many,many attorneys have offered to take up thiscase pro bono, which means free of chargefor any Democrats who are reading this,we do not expect any state resources to bespent in this effort.”

Hawkins Resigns from Senate to PursueCongressional SeatU.S. Rep. Nathan Deal resigned his seat asGeorgia’s 9th District congressman onMarch 21 after remaining in Congress forthe vote on health care reform. On March22, GDA Past President Dr. Lee Hawkinsre-affirmed his intention to run for that 9thDistrict seat, and resigned his State Senateseat to concentrate on the campaign. Hisclosest competitor, Rep. Tom Graves, alsoresigned his state seat.

Dr. Hawkins said in an email to sup-porters, “My experience in the StateSenate—notably my work on the commit-tees on Health and Human Services andNatural Resources, and as Chairman ofState and Local Government, andSecretary of Agriculture—will serve mewell in Washington. The need for conser-vative leadership in Washington is clear,and I am confident that I can provide it.The challenges we face were dramatized… in passage of a radical health carereform opposed by most Americans. Thebill amounts to a job-killing machine. Noone will work harder than me in the nextCongress to overturn this disastrous plan.”

A special election to fill Rep. Deal’sunexpired term in Congress will take placeon May 11. Dr. Hawkins is seeking finan-cial and community support in advance ofthis election. For more information on Dr.Hawkins’ campaign, visit www.leehawkins-forcongress.com.

Dentists Support LAW Day ProgramDespite the legislature adjourningperiodically and making other, unexpectedchanges to its schedule, Georgia dentistscontinue to make a great showing at theGDA Legislative Awareness programsscheduled each Wednesday during thesession. The GDA appreciates all dentistswho have made time in their schedules totravel to Atlanta. There have certainlybeen a large number of issues dentistshave been asked to address with theirlegislators. Every voice counts!

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Properly maintained dental records are amust. Not only does state law require it,but appropriate dental records ensure thebest possible care for all patients. Dentalrecords serve essentially two purposes:communicating necessary data among thehealth care team, and providing a perma-nent written record of treatment and thefacts and reasoning behind the chosentreatment. To help GDA member dentistswith creating, maintaining, and destroyingtheir records, here are some best practicesthat should be considered.

What Must Georgia DentalRecords Contain?In Georgia, the Board of Dentistry broadlydefines dental records to include treatmentnotes, evaluations, diagnoses, prognoses,x-rays, photographs, diagnostic models,laboratory reports, laboratory prescriptions(slips), drug prescriptions, insurance claimforms, billing records, and other technicalinformation used in assessing a patient’scondition. Should a dentist have emails,texts, phone messages, or other writtencorrespondences related to the patient,those documents may also need to beincluded to ensure a complete dental record.

How Long Should DentistsMaintain a Dental Record?In 2002, the Georgia Health Records Actwas amended and requires that dentalrecords be maintained for a period of atleast 10 years from the date of the lastpatient visit. While the general rule is thesame for minors, dentists are encouragedto keep the minor patient records inaccordance with their malpractice carrier’srecommendation. Often malpracticecarriers will ask that their insured dentistskeep minor patient records for longer than10 years. The reason for this is that minorsunder some circumstances may have alonger period of time to file a lawsuitthan adults and doing so allows thepatient to have their records transferredto a provider of their choice when theyturn 18.

How to Correct Mistakes in a Dental RecordEveryone makes mistakes so there willcome a time when documentation errorsoccur or clarification is necessary in a patient’srecord. When this happens it is imperativethat any corrections or clarifications aredone without compromising the integrityof the dental record and without unneces-sarily exposing the dentist to an indefensiblemalpractice case.

So what do you do if you need tocorrect the dental record? Generally, adentist should never delete, erase, markout, or “white out” entries. These actionsmay be construed as evidence of improperalteration. A better practice is to draw athin pen line through the error but stillensure the inaccurate informationremains readable. The correction shouldbe initialed or signed and dated so thatanyone viewing the record at a later timecan identify when and who modified therecord. Accurate or corrected informationshould then be inserted above or to theside of the struck-through entry. Significantevents such as a cancelled appointmentalong with the reason for the appointmentand the cancellation may also be documented.

It is never a good idea to makecorrections after a lawsuit has been filedor to justify the occurrence of an adversetreatment event.

That brings us to another point aboutcorrecting mistakes—proofreading allentries in the record helps to identify thosemistakes. Dentists should try and reviewtheir patient records periodically. This willensure that all entries are accurate andreflect the intent of the dentist.

Making Late Entries in a Dental RecordIt happens to the best of dentists.Information that belongs in a patient’srecord was not documented in a timelymanner. What is a good way to documentlate entries into the dental record? Onegood way would be to label the addition asan “addendum” and reference the originalentry should there be one. Enter the

current date and time. While there is nohard and fast rule about how quickly anaddendum must be documented, dentistsshould keep in mind that the more timethat passes the less credible and reliablethe entry becomes. That brings up anotherimportant detail: dentists should avoidmaking it appear as though the late entrywas made at the time of the original entry.This could be used in court to discreditthe dentist. When in doubt, call theGDA or your malpractice carrier’s riskmanagement department.

Should a Dentist Document aPatient’s Refusal?The dentist’s role is normally to assess,diagnose, and recommend the besttreatment options for the patient. Whiledentists always hope that the patientagrees to receive necessary care, a patientdoes have the right to refuse treatment.What do you do if the patient refusesnecessary care? One important “do” a den-tist should consider in such a circumstanceis to document this refusal in the patient’srecord. Dentists could record in thepatient’s dental record the details of anydiscussion about the potential benefits andrisks of the treatment recommended andthe risks associated with the patient refusingthe suggested treatment. The reasons thepatient gives for refusing the treatmentwould also be appropriate information toput in the record. Another consideration ismaking a note in the record to show thepatient was competent to refuse treatment.

One other alternative could be to havethe patient sign a document with theseimportant elements. Should the risksdiscussed occur down the road, the dentistthen has documentation establishing thatindeed there was communication withthe patient educating them about thesepotential dangers.

Maintaining Objectivity in a Dental RecordAnother important fact to keep in mind isthat the dental record will be the startingpoint for evidence in a malpractice lawsuit.

The Do’s and Don’ts of Dental Patient RecordsMelana Kopman McClatcheyGeneral Counsel

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Think before you write or type! Dentistsmust be cautious about keeping all entriesobjective and clinical in nature. Limit anycomments to necessary information aboutthe patient’s treatment. Avoid making crit-ical or derogatory entries about the patientin the dental record. Maintaining onlyobjective notes will help to avert the needfor uncomfortable explanations in thefuture or liability. Just imagine a plaintiff’sattorney reading the dental record to ajury. If you would be uncomfortable hav-ing your subjective comments read incourt, then those statements probably donot belong in the dental record.

Procedures to Follow WhenDestroying Dental RecordsWhen discarding records containingpatient dental/medical data, account balanceinformation, or records that can beassociated with a particular patient, dentalpractices must follow specific steps.Information which could be associated witha particular patient includes photographs,Social Security numbers, disability information,driver’s identification number, date of birth,

and under certain circumstances addressesand telephone numbers.

HIPAA requires covered entities (anyhealth care provider who transmits anyhealth information in electronic form) toapply appropriate administrative, technical,and physical safeguards to protect theprivacy of medical records and otherprotected health information for whateverperiod that such information is maintainedby a covered entity, including throughdisposal. Dental practices may utilize oneof several options to destroy dentalrecords. Many dental offices choose tooutsource the destruction of records topaper shredding companies. There arenumerous paper shredding companieswhich specialize in destroying medical anddental records. To find such a service,check in the Yellow Pages or use anInternet search. Keep in mind that it may benecessary to have the shredding companysign a confidentiality agreement also referredto as a HIPAA “Business Associate Agreement.”

Another option would be to obliteratethe personal information to make itunreadable or to take action the dentalpractice reasonably believes would ensure

that no unauthorized person will have accessto the patient’s information in the record.

Another practice a dental office shouldconsider is keeping a log of destruction. Thelog should contain a list of what record wasdestroyed, the date of destruction, themeans by which it was destroyed, thename and signature of the person or thecompany destroying the records, and a wayto identify to which patient each entry inthe log belongs. Should a dentist outsourcethe destruction, most of these businessesissue a Certificate of Destruction or thecompany may allow the dentist or staffmember to witness the destruction. Keepthe Certificate of Destruction with thelog and memorialize which employeewitnessed the destruction along with theother information in the log. You may wishto check with personal legal counsel beforedestroying records.

Please be aware that this article is forinformational purposes only and is notintended to provide legal advice. Dentistsmust consult with their private attorneysfor such advice.

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The health care reform bill that passedthrough Congress in March and wassigned by President Obama contains anumber of significant provisions thatwould affect the dental profession. Detailson some of these provisions as prepared bythe American Dental Association (ADA)are provided below.

The ADA has a health care reformQ&A and in-depth analysis of the recentreform legislation (The Senate’s PatientProtection and Affordable Care Actpassed in December 2009 and theHealth Care and Education AffordabilityReconciliation Act of 2010 that passed inMarch 2010) available at www.ada.org. Tosummarize, however, the ADA’s primaryconcerns with the health care reform billare 1) A failure to properly fund dentalMedicaid; 2) The extension of Medicaideligibility without also providing a basicadult dental benefit for existing or newMedicaid enrollees; 3) A failure to includemeasures that would remove administrativebarriers or establish data-gatheringinitiatives to help policymakers improveoral health care delivery in Medicaid;4) No provision to prevent non-dentistsfrom performing surgical dental pro-cedures within workforce pilot programs;5) Restrictions on Flexible SpendingAccounts; 6) No patient protections forgroup health plans offering dental benefits(including free-standing dental plans),such as prohibiting plans from limitingpayments on services not covered by theplan; 7) The lack of antitrust provisions,specifically regarding the repeal of theMcCarran-Ferguson exemption for insur-ance companies; and 8) No inclusion ofmeaningful medical liability reform. So,while the ADA believes the reform legisla-tion does contain worthy provisions,including increased funding for publichealth infrastructure, prevention educa-tion, school-based health center facilitiesand Federally Qualified Health Centers;Title VII grant program opportunities forgeneral, pediatric or public health dentists;and National Health Services Corps loanrepayment programs, the ADA overall isdisappointed with the outcome.

Significant Dental and SmallBusiness Provisions in Health Care Reform Legislation

• Beginning in 2014, Medicaid is expand-ed to all individuals with incomes up to133 percent of the FPL. There is norequirement for comprehensive adultdental services, although the benchmarkcoverage that must be provided to adultsmight offer some dental services. TheADA lobbied unsuccessfully for anamendment to increase Medicaid dentalfunding and to ensure comprehensivedental services are available to the adultMedicaid population.

• Stand-alone dental plans are permittedto operate in a state run AmericanHealth Benefit Exchange (Exchange)either separately or in conjunction with amedical plan if the dental plan providesthe required children’s oral health cover-age required of all qualified health plans.

• Unless a state opts out, the federalgovernment can offer “CommunityHealth Insurance Options” through stateExchanges to compete with other plans.The government would negotiate ratesfor reimbursement of health careproviders under this option, which can-not be higher in aggregate than the aver-age reimbursement rates paid by healthinsurance issuers offering plans in anExchange. Unless required (and paidfor) by a state, this option would providecoverage only for essential health bene-fits.* Providers could potentially acceptout-of-pocket payments for other servic-es. Providers would not be required toparticipate in this option, or be penalizedfor not participating.

• In the original Senate bill, small busi-nesses (fewer than 25 employees andaverage annual wages of less than$50,000) would be eligible for a tax cred-it on a sliding scale. The full credit (50percent of the premium cost) is availableto employers with 10 or fewer employees

and average wages of $20,000 or less(multiplied by a cost-of-living adjust-ment for years after 2013). The reconcil-iation measure passed by the House isthe same as the Senate bill, except thecredit will apply to businesses with aver-age annual wages of less than $40,000.

• There is enhanced federal funding forthe CHIP program (Georgia’s CHIPprogram is called PeachCare) andMedicaid / CHIP enrollment simplifica-tion. In addition, the Medicaid andCHIP Payment and Access Commission(MACPAC) will assess policies affectingMedicaid beneficiaries, including pay-ments to providers.

• The reform package authorizes appro-priations for fiscal years 2010-2014 for“oral health infrastructure.” This woulddirect the Centers for Disease Controland Prevention to enter into cooperativeagreements with the states, territories,and tribes to establish “oral healthleadership” and program guidance, datacollection, and a multi-dimensionaldelivery system, and to implementscience-based programs such as sealantsand community water fluoridation.

• Payments under the National HealthService Corps loan repayment programand state loan repayment programsintended to provide for the increasedavailability of health care services inunderserved or health professionalshortage areas (as determined by a state)would not be taxed. In addition, fundingwould increase for National HealthService Corps loan repayments. TheADA believes that eliminating the taxa-tion of NHSC and state loan repaymentsand expanding NHSC funding are verysignificant steps toward addressing theaccess to care problem.

• The reform authorizes grants to plan,develop, and operate training programs inthe field of general, pediatric, or publichealth dentistry for dental students,residents, practicing dentists, dental

Provisions From the Health CareReform Bill That Affect Dentistry

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hygienists, or other approved primarycare dental trainees, which emphasizetraining for general, pediatric, or publichealth dentistry. The grants would providefinancial assistance to dental students,residents, practicing dentists, and dentalhygiene students who are in suchprograms and who plan to work in thepractice of general, pediatric, or publichealth dentistry or dental hygiene.The grants would also help train thosewho would teach and provide loan repay-ment programs for dental faculty.

• A reform provision that seeks to increaseteaching capacity authorizes the governmentto award grants to teaching health centersfor new primary care residency programs.The ADA is mentioned as an accreditingentity.

• Grants would be available to establishschool-based health center facilities thatprovide comprehensive primary care,including oral health services. Thepurpose of the centers is to serve schoolswith a large population of Medicaid andCHIP-eligible children. The clinic mustmake every reasonable effort to establishand maintain collaborative relationshipswith health care providers in theircatchment area.

• Individuals who work at free clinics areextended medical liability protection.

• The bill establishes a National Prevention,Health Promotion and Public Health Councilto coordinate a national preventionprogram, as well as a Preventive ServicesTask Force to review scientific evidenceregarding the effectiveness of variousservices and to make recommendations.The task force will also coordinate withthe Community Preventive Services TaskForce run by the Centers for DiseaseControl and Prevention and the AdvisoryCommittee on Immunization Practices.At this time, there is not a requirementthat dentistry must be represented onthe preventive services task force.

• The reform bill would direct the CDC,in consultation with professional oralhealth organizations, to establish a 5-yearnational, public education campaignfocused on oral health care preventionand education. The science-based strate-

gies would include community waterfluoridation and school-based dentalsealants, and grants to demonstrate theeffectiveness of research-based dentalcaries management.

• The reform bill would establish aNational Health Care WorkforceCommission to make recommendationsregarding workforce, such as determin-ing if the demand for health care work-ers is being met (including supply anddistribution), evaluating training andeducation activities, and revising nationalloan repayment programs. One of thecommission’s priorities is the educationand training capacity, projecteddemands, and integration with the healthcare delivery system of the oral healthcare workforce capacity. There is also

a grant program to enable states tocomplete similar strategies. A NationalCenter for Health Care WorkforceAnalysis would be established to workwith professional and educationalorganizations and state and regionalcenters for health workforce analysis forthe purpose of data collection, analysis,and reporting.

• The bill establishes an Alternative DentalHealth Care Providers DemonstrationProject. Under this project, 15 entities willreceive grants to establish demonstrationprograms to train “alternative dental

Thoughts on the Further Impact of Health Care Reform

• A Bank of America / Merrill Lynch analysis states that reform could increase dentist

traffic by 10%. Starting in 2014, state insurance exchanges would ultimately cover 16

million individuals, while 16 million more gain access to Medicaid benefits. If 10 mil-

lion buy dental, consistent with commercial plan penetration rates, enrollment

would increase by nearly 10%. Massachusetts health care reform in 2006 immedi-

ately triggered higher demand for medical services, including dental. Similar to the

Senate bill, Massachusetts required everybody to buy insurance (“individual man-

date”) with subsidies. In 2008, 76% of adults in Massachusetts visited the dentist at

least once, up from 68% before reform.

• The Wall Street Journal notes that the reform bill signed in March 2010 would boost

funding by $10 billion over five years for Federally Qualified Health Centers. An

additional $2.5 billion was included in a package of changes to that bill which passed

Congress. The clinics offer care such as basic blood and dental work to 20 million

patients in hundreds of locations across the U.S. In 2006, roughly 43% of patients at

the clinics were uninsured, with another 30% on Medicaid. The reform law includes

the biggest expansion of Medicaid since its founding. Because many doctors in pri-

vate practice do not accept Medicaid, it is likely many new enrollees will end up at

the clinics.

HEALTH CARE REFORMContinued on page 16

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health providers,” including communitydental health coordinators, advancepractice dental hygienists, independentdental hygienists, supervised dentalhygienists, primary care physicians, den-tal therapists, and dental health aides.Entities eligible to receive grants includeinstitutions of higher education, commu-nity colleges, Federally Qualified HealthCenters, Indian Health Service facilities,state or county public health clinics,public-private partnerships, or publichospitals or health systems. The programmust be accredited by the Commissionon Dental Accreditation or within a dentaleducation program in an accreditedinstitution. Dental health aide trainingprograms approved by the IHS areeligible for grants.

• The reform bill does not providemeaningful tort reform and does notaddress limits on non-economic damagesor reasonable limits on attorneys’ fees.The bill authorizes grants to states forthe development of alternatives tocurrent tort litigation.

• Reform places a $2,500 annual limiton the amount of salary reductioncontributions to flexible spendingarrangements (FSAs). The penalty fornonqualified distributions from healthsavings accounts and Archer MSAs (suchas distributions that are not used to payfor health care expenses) will beincreased from 10 percent to 20 percent.Over-the-counter medicine would nolonger be eligible for reimbursementunder HSAs, FSAs, or HRAs.

* Essential health benefits include atleast the following categories and the

items and services covered within thecategories: Ambulatory patient services,emergency services, hospitalization,maternity and newborn care, mentalhealth and substance use disorder servic-es including behavioral health treatment,prescription drugs, rehabilitative andhabilitative services and devices, labora-tory services, preventive and wellnessservices and chronic disease manage-ment, and pediatric services, includ-ing oral and vision care. The govern-ment would survey employer-sponsoredcoverage to determine the benefits typi-cally covered by employers, includingmultiemployer plans, to ensure that thescope of the essential health benefits isequal to the scope of benefits providedunder a typical employer plan.

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Georgia Dental Association (GDA) volunteers were out in force onFriday, February 5, providing free dental care to Georgia’s lessfortunate children on the eighth annual Give Kids A SmileDay. The American Dental Association reports that some 50,000dental professionals provided care to more than 320,000 childrenat 2,000 program sites nationwide on this day. The GDACouncil on Dental Health sponsored programs in all seven GDAdistricts with the Northern District providing care at twolocations in partnership with the Fulton and Dekalb countypublic health departments.

“We were pleased to have programs throughout Georgiathis year so that member dentists could volunteer in their owncommunities,” said Dr. Byron Colley, Chairman of the GDACouncil on Dental Health. “Each member of the committeedid an excellent job of organizing their district event andrecruiting volunteers. We hope to springboard into an even biggerevent next year.”

Kudos to the following Council on Dental Health membersfor coordinating district programs that allowed volunteersto supply care for 704 children in eight locations around thestate and provide dental services valued at approximately$139,000. Details about the care provided in each district’sprogram appear below the list of names.

• Dr. Byron Colley (Chair / Southeastern District)

• Dr. Shirley Fisher (Central District)

• Dr. Jennifer Wells (Eastern District)

• Dr. Heather Perry McGee (Northern District)

• Dr. Casey Hart (Northwestern District)

• Dr. Stephanie Skinner (Southeastern District)

• Dr. James Knighton (Southwestern District)

• Dr. Al Lugo (Western District)

The GDA thanks national sponsors Colgate and Henry Scheinand state sponsors Mr. Jacob Sigman (Atlanta Dental Supply) andMr. Foye Rocket (Patterson Dental Supply) for donating suppliesfor the state-wide event.

Central DistrictDr. Shirley Fisher, Warner Robins, worked with Dr. Mark Shurett’sHelp A Child Smile mobile van team and other GDA volunteers tocare for 24 children in Warner Robins. They provided preventiveand restorative services valued at $19,264. The volunteersincluded Dr. Shirley Fisher, Dr. Joe Dufresne, Dr. JasonYoung, Dr. Grant Loo, Dr. Wendy Mitchell, Dr. Myra Shivers,Dr. Tom McDonald, Dr. David Fagundes, Dr. DrewFerguson, Dr. Mark Shurett, MCG dental student Brian Esco,van driver Mac Hale, dental hygienist Amanda Poole, and dentalassistant Mitzi O’Hearn.

GDA Reaches Out on Give Kids A Smile Day with District Programs

GIVE KIDS A SMILE DAYContinued on page 26

Dr. Heather Perry McGee, Dr. Julia Bruno, Jaimie Phillips,Louisa Alejos, Cleaira Anderson, and Dr. Megan Shinglerprovided care at Ison Springs Elementary School in SandySprings.

Dr. Dwayne Turner headed up a spirited group of public healthand private dental volunteers at Carey Reynolds ElementarySchool in Atlanta.

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Eastern DistrictDrs. Jennifer and Erik Wells opened their dental practice inAthens for an Eastern District program. Volunteers totaling 24dental professionals saw 53 children. All the children received acleaning and fluoride treatment. The dentist volunteers also pro-vided restorative treatment (composites, amalgams, and pulpo-tomies) and preventive services (sealants and fluoride). Treatmentservices were valued at $14,000. Dentist volunteers were Dr.Rhonda Chambers, Dr. Phil Durden, Dr. Tom Henson, Dr. BobMcGuinn, Dr. Brandi Owensby, Dr. Terry Parkman, Dr. RossRussell, Dr. Chuck Smith, Dr. Whitney Swann, Dr. Erik Wells, andDr. Jennifer Wells. Dental hygienist volunteers were Leigh Craig,Kathy Kennon, Karen Patton, Molly Smith, Jackie Vaughn, andBrenda Zareie. Dental assistant volunteers were Tabitha Adams,Leigh Bagwell, Christine Brooks, Nikki Dodd, Melissa Eberhart,Marilyn Edwards, Sheryl Folse, Melinda Gillespie, CrystalHudson, Alan Mobley, Kerry Rode, Jenny Trammel, and LeisaWeaver. Front office volunteers were Sherry Arrowood andTammy Burt. Pre-dental student couriers were Sarah Fuqua,Matthew Lewis, Alyssa Martini, and Karan Thachil.

Northern DistrictThe Northern District partnered with DeKalb and Fulton countiesto provide school-based prevention services and education pro-grams in two elementary schools. The GDA applauds the district’scollaboration with the dental public health programs that reachedapproximately 1,000 students.

In DeKalb County Dr. Dwayne Turner and Ms. SherryWiggins organized an extensive program at Carey ReynoldsElementary School. Alliance members and puppeteers Rose MarieDougherty and Nancy Ferguson performed the WandaWondersmile puppet show for three groups of children grades pre-K through third grade. Dental hygiene students from GeorgiaPerimeter College provided age-appropriate oral health educationto fourth and fifth graders. Approximately 850 children werereached with these two education efforts. Each student in theschool also received a goody bag with a toothbrush, toothpaste, andimportant educational materials. Dentists and dental hygienistsprovided preventive services (prophys, fluoride, and sealants) to216 children valued at $22,260.

Dentist volunteers were Dr. Faith Drennon, Dr. Janice Lee,Dr. Elizabeth Lense, Dr. Frank Mathews, and Dr. Dwayne Turner.Dental hygienist volunteers were Jeanette Clarida, Jackie Holley,Ashley Kennedy, Jael King, and Sherry Wiggins. Dental assistantvolunteers were Kimberly Burke, Tasha Cook, Christy Hutchins,Lola Rosser, Tina Williams, and Sharon Wilson. Our Alliance pup-peteers were Rose Marie Dougherty and Nancy Ferguson.Georgia Perimeter College student volunteers were Ana Castino,Jenny E-Chong, Fiona Morgan, Danielle Roberts, MiriamSamaniego, and Carlos Silva. GDA Associate Executive DirectorNelda Greene also volunteered.

Dr. Kimberly Lewis, Dental Services Program Manager fromthe Fulton County Department of Health and Wellness, provided

two mobile vans and staff to provide prevention services and edu-cation at Ison Springs Elementary School in Sandy Springs.Approximately 140 children received services which includedscreenings, fluoride varnish, and sealants valued at $2,100.

Dentist volunteers at Ison Springs were Dr. LaToya Barbee,Dr. Julia Bruno, Dr. Elizabeth Caughey, Dr. Nalini Kataria, Dr.Kimberly Lewis, Dr. Heather Perry McGee, Dr. Harold Rish, Dr.Megan Shingler, and Dr. Kamili Willis. Dental hygiene volunteerswere Lisa Cooper and Stephanye Ware. Dental assistant volun-teers were Cleaira Anderson, Sandra Lawhorn, Jaimie Phillips, andLouisa Alejos. MCG dental student Erin Sitz also volunteered, asdid GDA staff members Delaine Hall and Melana KopmanMcClatchey.

Northwestern DistrictDr. Casey Hart joined forces with several public health depart-ments to coordinate a successful event in Woodstock. Volunteersfrom the North Georgia Dental Public Health mobile van were onlocation to assist in providing dental services to 44 children.Children received preventive services (prophys, fluoride varnish,sealants) and restorative care (restorations and pulpotomies) val-ued at $14,655.

Dental professionals also provided education and oral hygieneinstructions to 38 kids. Alliance member Molly Bickford assistedby providing goody bags (toothbrush and toothpaste) and oralhealth education.

Dentist volunteers were Dr. Mireddy Benet, Dr. JanineBethea-Freihaut, Dr. Jack Bickford, Dr. Elisha Buckley, Dr. CaseyHart, Dr. Chris Shim, Dr. Neely Thornton, and Dr. NancyWilliams (public health). Other public health volunteers wereDenise Bowman and Delores Benfold. Dental hygienist volunteerswere Amanda Alligood, Cassie Armstrong, Michele Day, JulieDeason, Sarah Rickman, and Tonya Roach. Dental assistant volun-teers were Christy Hubbard, Sandi Pringle, and Lisa Wisdom.

GIVE KIDS A SMILE DAYContinued from page 25

(L to r) Dr. LaToya Barbee, Stephanye Ware, Sandra Lawhorn,and Dr. Kamili Willis participated in Give Kids a Smile Day atIson Springs Elementary School in Sandy Springs.

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Administrative volunteers were Cindy Moran, April Qualman, andBridget McAdams. MCG School of Dentistry dental student vol-unteers were Brian Bragassa and David Quintero. Medix Schoolstudent volunteers were Rachel Gaton, Patricia Garcia, JanineGentry, Hilary Harris, Shandra Moore, and Sharon Warren.Translators from First Baptist Church of Woodstock were YvoneeBianchi, LaToya Boyer, Martha Pena, and Annette Prem.

Southeastern DistrictThe Southeastern District partnered with the Armstrong AtlanticState University Dental Hygiene Program to provide preventiveand restorative care to 183 children with a value of $51,405.Approximately 100 people were waiting in line for care by 7:30a.m. due to extensive publicity from area news media—Drs. ByronColley and Felix Maher were featured on two local televisionshows discussing the event, and the district purchased newspaperads and distributed posters.

Volunteer dentists were Dr. Dan Breitberg, Dr. RussClemmons, Dr. Byron Colley, Dr. Ben Duval, Dr. Chuck Fana, Dr.Jacqueline Gilkey, Dr. Eric Gladden, Dr. Kamiti Harden, Dr.Laura Hissam, Dr. Felix Maher, Dr. Matt Rosenthal, Dr. Larry

Schmitz, and Dr. Stephanie Skinner. Armstrong Atlantic StateUniversity dental hygiene faculty and students volunteers wereRenata Berni, Rose Brown, Sara Harrison, Jessica Deloach, SarahCrouse, Wendy Dickens, Rachel Ege, Lauren Grassi, MeaginGardner, Donnisha Humphries, Andrea Lee, Gina Merlo, CortneyMorris, Jennifer O’Dell, Corrine O’Donnell, Emily Peterson,Stacy Simmons, Amanda Sunken, Ashlyn Thomas, Teresa Tyler,Dr. Suzanne Edenfield, Kimberly Coulton, Julie Harvey, DonnaDelSardo, Laurie Bryant, and Jan Mengle.

Southwestern DistrictDr. James Knighton organized an event in Valdosta and partneredwith the dental hygiene program at Valdosta Technical College toprovide outreach. This was primarily a prevention program, butdentists did perform some extractions. The volunteers treated 44

GIVE KIDS A SMILE DAYContinued on page 30

Students from the Valdosta Technical College dental hygiene and dental assisting classes of 2010 and 2011 joined SouthwesternDistrict dentists as volunteers on Give Kids A Smile Day.

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How many business owners dream ofhaving their children take over the familybusiness? The answer is quite a few. It’scalled leaving a legacy. Dentists are nodifferent. They build a practice over theyears, putting their blood, sweat, and tearsinto the business, nurturing the relationshipswith patients. Not only is it gratifying tothink that work will live on but it’s aresponsibility to continue the patient care.

How many children of businessowners dream of taking over the familybusiness or dental practice? Not asmany—let’s face it, not every dentalpractice lives on, but enough to makeintergenerational practices a fairly commonoccurrence. At dental meetings across thecountry, I meet dentists in practice withtheir parents. And while many considerhaving a practice to come into and continuea blessing, for others it can become a curse.

How to Avoid the Pitfalls ofPassing on Your PracticeWhat are the pitfalls of passing a practiceon to the next generation and how to avoidthem? There are several main areas thatcan be challenges for the family dentalpractice as one generation comes in andone generation goes out. Roles, goals, andboundaries are complicated by familyrelationships and history. Add to thatpatient and staff relationships and financialconsiderations and the situation can becomplicated.

Communicating about the roles thateach dentist will play in the practice iscrucial to heading off problems withpatients, staff, and each other. How do thedifferent dentists see their roles in thepractice? Are their expectations compatible?Do they see their roles as equals, mentorand protégé, or parent and child? How willtheir family roles, patterns of interaction,and history of behavior affect their officeroles? Many dentists coming into a practicesee themselves immediately assuming anequal role and are frustrated when thereseems to be a training period imposed.

Many dentists, after years of building apractice, may feel that training period isnecessary to build patient and staff rela-tionships and build the new dentist’s skills.

A transition plan may need to bediscussed and then put in place. Manyolder business owners bring in a youngperson to groom for the takeover of thebusiness. That plan is then communicatedto staff and clients or patients. With theright preparation, the business owner ordentist can ensure that the transition issuccessful. The staff will be watching as wellas listening. Communication is physicaland verbal. If you say one thing but youractions contradict your words, the staff andpatients will tend to believe your actions.They will take their lead from their leader.

Patients may need some extra com-munication from both dentists and staff.Some may accept the new dentist withoutquestion, but many will balk at “changing”from one dentist to another. They chose tocome to their original dentist and deservethe right to stay with that dentist. Don’tassume they will be comfortable right awaywith a new dentist.

When the Owner Stays Longer Than ExpectedWith the transition plan in place, the dentistowner then can move from mentor toequal partner and then to a retired oremeritus status. But what happens if thebusiness owner decides to delay transitioningout of the business or practice? For manyof us, what we do becomes who we areand the loss of identity is scary anduncomfortable. The idea of retiring andnot having an office to come to every daybecomes less attractive. Combine thatwith all of us living longer and more active,productive lives and the transition maylast longer than anyone anticipated.Unfortunately, the unintended messagefor the incoming dentist may comeacross as, “I don’t have confidence in yourabilities and don’t want to lose control ofthe business.”

The transition may at this pointbecome more about making room for a newdentist in the practice instead of the newdentist taking over. This longer transitionperiod can be accommodated with differentroles—for example, one dentist being theCEO and the other being the CFO. Somepractices set up separate practices in thesame building or satellite offices.

While talking about these issues maybe uncomfortable for the dentists withboth parties not wanting to hurt or worrythe other, other family members, especiallyspouses, may feel free to add their thoughtsand feelings. After all, a mother or father isconcerned for both their spouse and theirchild’s success and happiness. There are amyriad of solutions to transition issues. Themost important issue is the well being ofthe family relationships. Seeking objectiveadvice from a mediator, family therapist,business consultant, trusted attorney,accountant, or pastor is always a good idea.

Setting Compatible Practice GoalsCompatible expectations for the goals ofthe practice are another area that cancause conflict. Each dentist has an idea orexpectation of how the practice shouldoperate and what should be the goals ofthe practice. The younger generationbrings with them their new knowledge,technology, and enthusiasm. The oldergeneration sometimes views this as criticism:“The way I’ve been doing it all these yearshas served me well!” Fear of the unknown(or known!) can also be behind theresistance. The older generation may thinkthat all the sacrifice and passion over theyears is not being appreciated by theyounger generation. The younger generation’sview, of course, is influenced by growingup in the business.

All family businesses that transitionfrom generation to generation have tonegotiate the changing goals of the business.Should we keep the restaurant, constructioncompany, engineering firm, or dentalpractice the same or should we change it,

Got Children? Working With and Passing Your Practice On to the Next GenerationWendy Cassidy

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grow it? Each generation naturally wantsto create their own future and write theirown story. The process of how to do thatand still honor the past can benefit fromthe perspective of a trusted outsider.

Outsiders can provide a helpfulperspective because insiders, i.e. spouses,children, and siblings, will be more thanhelpful with their own comments andactions. The last thing any family needs iseveryone taking sides in a business conflict.Let’s be honest—there are financialmotives for everyone involved. Whether toenlarge or split the financial pie causes moreconflict than just about any other issue.

Taking Financial Issues Into AccountFinancial issues can be uncomfortable, butmust be addressed if the transition fromone generation to the next is to be successful.Too many times assumptions are made,conflicts arise, feelings are hurt, andrelationships are damaged. My father-in-lawalways said, “make your decisions whileyou’re still friends.” My father always said,“the best way to avoid a misunderstandingis to have an understanding.” Both aregood pieces of advice.

The question of buying the practicealmost always comes up. My next questionusually is what are you buying? Are youbuying the building that houses thepractice, the equipment, the patientrecords, the debt? Many consultants willgladly help you value a practice, but familybusinesses are influenced by the fact that afamily member is buying or selling thebusiness. Real estate appraisers will tellyou that a real estate transaction betweenfamily members is not “at arms’ length”and “not qualified.” The same holds truefor business transactions. There are differentmotivations in a sale between familymembers than between strangers.

Many dentists count on selling theirpractices for retirement income or in thecase of disability or death. My experiencewith family business transitions is that401(k)s and insurance do a better job ofprotecting you and your family and yourfuture. Again, as many folks have realizedlately with real estate, anyone can put anyprice on something they want to sell,but the fair price is one that a ready andwilling seller will take from a ready andwilling buyer. If you are trying to sell yourpractice because you become disabled or

your spouse is trying to sell the practicebecause of your death, you may be a readyand willing seller but are under duress andmay not find a ready and willing buyerright away. Within 6 to 12 months, many ofyour patients will have moved on to otherpractices and the value of your practicewill have diminished–not a pleasantthought, but a fact of life.

Just as uncomfortable can be settinga price for a practice that will provideretirement income for you and that yourson or daughter is willing to pay. A child isnot a stranger and may feel obligated toprovide you with income they cannotafford to pay. But, you say, I should getsomething for all my hard work andsacrifice all these years. That may be true;however, you did derive income from thepractice all those years! Just be realisticabout a fair price between ready andwilling buyers and sellers. Hard assets suchas buildings and equipment have a largerpool of ready and willing buyers and areeasier to value than patients who haveminds of their own and can choose to leavethe practice at any time.

ConclusionThe bottom line is family relationships areworth more than any practice. Care forthose relationships by communicatingand not assuming. Reach out to all theimportant players, including spouses.And don’t hesitate to seek advice froma mediator, family therapist, businessconsultant or trusted attorney, accountant,or pastor when transitioning a dentalpractice to the next generation.

Wendy Cassidy is the spouse of GDAmember dentist Dr. Jimmy Cassidy ofMacon. She is a family therapist anddomestic mediator registered with theGeorgia Office of Dispute Resolution andthe Third Judicial District. She receivedher mediation training from the SettlementInstitute and Atlanta Divorce Mediators,Inc. and is a member of the Academy ofFamily Mediators. Since earning a Mastersin Family Studies from Mercer University,Ms. Cassidy has been in private practiceworking primarily with individuals andfamilies struggling with divorce.

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children and the value of these dental services was $15,210.Children came from 11 cities and seven counties, some as far awayas 90 miles, to take advantage of the care. Local businesses alsodonated food and supplies.

Dentist volunteers were Dr. Brad Adams, Dr. Tim Grantham,Dr. James Knighton, Dr. Ashley Moorman, Dr. Randal Smith, andDr. Carly Thomas. Dental hygienist volunteers were Judy Arden,Hope Arnold, Gail Blitch, Margaret Frailey, Heather Dumas,Jennifer Johnson, Lisa Noyes, Lisa Searcy, Emily Tillman, PatriciaShell, and Sandi Woodward. Volunteers from the Valdosta Techdental hygiene and assisting classes of 2010 and 2011, as well asAshley Knighton, Kacey Myers, Brenda Johnson, Wendy Davis,Stacy Griffin, Lauren Singletary, Sara Knighton, and Chase Blitchalso pitched in. Business sponsors were Dr. Joe Kirbo, Dr. MichaelMcCartney, Dr. Kit Robinson, Dr. Jeff Newbern, and Dr. SharonPatrick.

Western DistrictExtremely inclement weather negatively impacted the WesternDistrict’s efforts for their Give Kids A Smile event. Volunteerswere ready and waiting but children who were scheduled to attenddid not show. Dr. Al Lugo gave kudos to Columbus TechnicalCollege’s dental assisting students for their willingness toparticipate and “can do” attitude.

Private Practice ProgramsThe GDA knows that many private practices also conducted GiveKids A Smile Day activities. For instance, we have seen newspaper

articles on activities in the offices of Dr. Brian Carpenter, Dr.Melissa Durand, Dr. Cindy Hall, Dr. Michael McCartney, Dr.Michael Palmer, Dr. Ron Reid, and Dr. Jimmy Talbot just to namea few. Please remember to report activities you conducted in yourcommunity and practice to Nelda Greene at [email protected].

Dr. Cindy Hall, Dr. Ron Reid, Dr. George Talbot, and Dr. Jimmy Talbot of NorthwesternDistrict, along with dental hygienists Linda Talbot, Heather Thurman, Lori Brown,Brenda Hall, and Amanda McFarland as well as Tammie Talbot, Jo Lynn Long, MandyDarby, Beverly Abernathy, Susan Makant, Trish Dyer, Nickey Newton, Carla Weaver,Brook White, and Maria Guzman donated care worth $11,747 to 35 children on GiveKids a Smile Day. The event held at the Talbot dental office received significantsupport from Tony Zylstra with Henry Schein.


GIVE KIDS A SMILE DAYContinued from page 27

GDA Alliance dental spouses Rose Marie Dougherty (left) andNancy Ferguson performed the Wanda Wondersmile puppetshow for students at Carey Reynolds Elementary School inAtlanta.

Dr. Janice Lee examining a child atCarey Reynolds Elementary School inAtlanta.

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hodminutes

President Kent Percy called the House ofDelegates to order on January 10, 2010, at 9a.m. Dr. Mark Dusek gave the invocation andled the Pledge of Allegiance to the flag.

Recognition of GuestsDr. Percy recognized the following guests: Dr.Carole Hanes, Emile T. Fisher Foundation forDental Education Board member; Dr. MarieSchweinebraten, past ADA Fifth DistrictTrustee; ASDA students: Chris DeLeon,William Bennett, Jorge Griswold, AmandaKossick, James Maina, Destiny Murray, IvanStojanov, Ann Downer, Rebecca Paquin, JayneKelly, Kristen Shaw, Erika Lentini, EvanGrodin, Paul Hinchey, Francesca Seta, PatrickArnett, Amanda Davis, Jose Navarro, JohnHaycock, Brian Bragassa.

Roll CallSecretary / Treasurer Jim Hall called the roll fordelegates and alternate delegates and declareda quorum. The following persons were present:Central (delegates) Drs. Paul Fraysure,Lindsay Holliday (for Roy Lehrman), KendrickMathews, Craig McCroba, Alfred Peters; (alter-nates) Drs. Shirley Fisher, Amy Loden, MikeLoden, Deena Holliman Smith; Eastern (dele-gates) Drs. Lee Andrews, David Brown, CeliaDunn, Brian Hall, Carole Hanes, Grant Loo,David Perry, Annette Rainge; (alternates) Drs.John Blalock, Rhoda Sword, Barbara Utermark,Erik Wells; Northern (delegates) Drs. ChrisAdkins, Hank Goble (for Daren Becker), RandyDaniel (for Brian Carpenter), Chris Childs,Max Ferguson, Tom Field, Jim Granade Jr.,Brad Greenway, Troy Schulman (for KathyHuber), Tom Jagor, Ben Jernigan Jr., DonaldBrown (for Don Johnson), Jeff Kendrick, PaulKudyba, Roy McDonald, Bob O’Donnell,David Pumphrey, David Remaley, Richard A.Smith, Doug Torbush, Richard Weinman,Marvin Winter, Carol Wolff; (alternates) Drs.Evis Babo, Jim Dougherty, Jonathan Dubin,Vivian Hudson, Joe Looper, Greg Marks, MattMazzawi, Grady Parrish, Heather Perry, Randy

Phillips, Zack Powell, Sidney Tourial, VictorVan Greunigen, Rebecca Weinman;Northwestern (delegates) Drs. Bruce Camp,Celeste Coggin, Nelson Conger, David Drew,Stan Halpern, Jim Hutson, Todd Mullikin (forHoward Jones), Ben Knaak, Terry O’Shea,Jason Oyler, Robin Reich, Wilkie Stadeker;(alternates) Drs. Jack Bickford, Jimmy Talbot,Elizabeth Lewis, Stuart Loos, Dave Mason,Wendy Mitchell, Jim Roos, Peter Shatz, KarynStockwell, Jason Young; Southeastern (dele-gates) Dr. Mark Dusek, Jay McCaslin VI (forJennifer Hall), Julie Routhier (for Sam Norris),Donald Nelson (for Matt Rosenthal), LarrySchmitz; Southwestern (delegates) Drs. BrentDepta (for Keith Crummey), Chris Hasty,Amanda Merritt, Steve Sample, Jeff Singleton;(alternates) Drs. Mike McCartney and JayPhillips; Western (delegates) Drs. RobertCarpenter (for George Childress), DavidFagundes, Mark Lawrence; (alternates) Drs.Jay Harris and Matt Adams; AmericanStudent Dental Association (delegate) Mr.Chris DeLeon; (alternate) Dr. William Bennett.

Resolution 2010-01 Minutes (Passed)Passed by general consent: Resolved that theminutes of the July 30, 2009 House ofDelegates meeting be approved.

Resolution 2010-02 Members Emeritus (Passed)Passed on motion by general consent: Resolvedthat the following persons be designatedMembers Emeritus of the GDA without dues:Eastern: Isaac F. Holton, Jr.; Northern: Paul A.Smith; Northwestern: Ted Aspes, Joanne M.Miller, Paul E. Smith, Ronald E. Wilson andSoutheastern: James A. High and Lee A. Bell.

Resolution 2010-03 Position PapersBy general consent the House divided the ques-tion in Resolution 2010-03 to discuss the posi-tion paper “Administration of Local Anesthesiaby Dental Hygienists” apart from the otherposition papers.

Resolution 2010-03A Position Papers(Passed): Passed on motion by Dr. Kent Percy:

Resolved that the House of Delegates approvesthe position papers (with the exception of the“Administration of Local Anesthesia by DentalHygienists”) as presented and approved by theHouse of Delegates.

Resolution 2010-03B (Passed as Amended):Dr. Jimmy Talbot moved to change verbiage inparagraph two and the summary paragraph andDr. Donna Thomas Moses moved to amend Dr.Talbot’s motion to place the words “cardiacarrest” in bullet four. The amended motionpassed the House. Following is the verbiage tobe included in the “Administration of LocalAnesthesia by Dental Hygienists” positionpaper, which passed the House:

• The following paragraph will replaceparagraph two: “Many patients may be treatedcomfortably by dental hygienists, includingscaling and / or root planing procedures withthe use of topical (needle free) anesthetics.These topical anesthetics may include Oraqix orsimilar products. For patients requiring moreprofound anesthesia, the patient must beanesthetized by a licensed dentist.”

• Bullet four: add the words “cardiac arrest” tothe last sentence so that it reads, “Medicalcomplications, such as paresthesia (numbnessor loss of feeling), cardiac arrest, and a hostof other complications, can occur with theadministration of local anesthesia.”

• Summary (last paragraph): add the word“profound” before local anesthesia and theword “topical” before needle-free so that itreads, “Therefore, dentists should be adminis-tering profound local anesthesia, not dentalhygienists. Dental hygienists currently have amechanism for delivering topical (needle-free)anesthetics for those patients requiringlocalized anesthesia prior to scaling and / orroot planing.

Unofficial Minutes from the January 10, 2010,House of Delegates MeetingEditor’s Note: Only the persons present and resolutions produced are printed here. Full minutes are available at www.gadental.org inthe member’s only section, and can be provided upon request to those members without access to the Internet. Call (800) 432-4357 or(404) 636-7553.

MINUTESContinued on page 32

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Board of TrusteesBy general consent the House divided the ques-tion in Resolution 2010-04 to discuss BOTmotions [09-8.02] and [09-11.06] related to theproposals from the Fanning Institute.Resolution 2010-04A (Passed): Passed onmotion by Dr. Kent Percy: Resolved that theactions of the GDA Board of Trustees as report-ed in the minutes of the August 22 andNovember 7, 2009 meetings (with the exceptionof motions 09-8.02 and 09-11.06) are ratified bythe House of Delegates. Resolution 2010-04B:Dr. Ben Jernigan moved for the House todecline ratification of BOT motions [09-8.02]and [09-11.06] concerning the proposal fromthe Fanning Institute to perform an associationaudit. (Motion seconded.) Dr. Paul Kudybamoved to amend to postpone this issue until theJanuary 2011 House of Delegates meeting sothat additional information could be gathered(motion seconded). Dr. Lindsay Hollidaymoved to amend Dr. Kudyba’s motion to post-pone until the July 2010 House of Delegatesmeeting and the two amendments failed. Dr.Jernigan’s original motion passed.

Resolution 2010-15 (Ratification of Actionsfrom the January 9, 2010 BOT meeting): By

general consent the House divided the questionin Resolution 2010-15 to discuss BOT motion10-1.02 separately from the other motions.Resolution 2010-15A: Dr. Richard Smithmoved to amend BOT motion [10-1.02] con-cerning the creation of a GDA Facebook pageto include the following: “Be it further resolvedthat the GDA Facebook Page will be used forinternal and external public relations and socialinformation only. The page will not contain anyproprietary information or any other informa-tion that may reflect negatively on theAssociation.” The amendment passed. TheHouse voted to approve BOT motion [10-1.02]as amended, which is printed below: [10-1.02 asamended] Dr. Eric Wells moved for the GDA toinstitute a GDA Facebook Page with the stipu-lations that the page be closed (limited infor-mation to the public) and that the page utilizean appropriate disclaimer. The GDA FacebookPage will be used for internal and external pub-lic relations and social information only. Thepage will not contain any proprietary informa-tion or any other information that may reflectnegatively on the Association. The ITCommittee shall provide a status report to theBoard of Trustees in six months.

Ratification of motions from January BOTmeeting: Resolution 2010-15B Ratification ofother actions from the January BOT meeting(passed).

Passed on motion by Dr. Kent Percy:Resolved that the following motions from theJanuary 9, 2010, Board of Trustees are ratifiedby the House of Delegates: [10-1.01] Dr. JayHarrington moved to approve the Teledentistryposition paper as edited. The motion passedunanimously. [10-1.03] Dr. Steve Samplemoved to rescind Board of Trustees motion 09-8.03 [regarding the ADA Delegation]. Themotion passed 11 yeas and 9 nays. Following ismotion 09-8.08 as postponed from the AugustBOT meeting and passed at the NovemberBOT meeting: Dr. Mike Vernon moved the fol-lowing resolution from the ADA Delegation:Resolved that the ADA Delegation PolicyManual be changed to reflect that the GDAVice President and Secretary/Treasurer as exofficio members will be ADA Delegation mem-bers with no voting privileges.

Finance Committee[10-1.04] Dr. Jim Hall moved for the BOT toaccept the Finance Committee’s recommenda-tion to approve the audit. The motion passedunanimously.

[10-1.05] Dr. Jim Hall moved for the BOT toaccept the Finance Committee’s recommenda-tion to approve the co-endorsement with theADA of Whirlpool Corporation. The motionpassed unanimously.

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[10-1.06] Dr. Jim Hall moved to approve theFinance Committee’s recommendation torescind the endorsement of Pitney Bowes. Themotion passed.

Mid-level Provider Related[10-1.07] Dr. Robin Reich moved the followingresolution which passed unanimously: Resolvedthat the President of the GDA appoint a specialtask force to explore avenues to protect thepatients of Georgia from the undereducatedproviders who might seek to perform acts cur-rently restricted to dentists as defined in thecurrent Dental Practice Act for the State ofGeorgia. The composition of this task forceshall be limited to eight people and shallinclude at least one member from each districtwho will be chosen by the GDA President withthe approval of the district presidents. Thechairman of the task force shall be elected bythe members of the committee. The chairmanof the Governmental Affairs Committee shallserve as ex-officio. This task force will providethe Board of Trustees and House of Delegateswith the task force’s first report by February 12,2010, by email, fax or Facebook.

[10-1.08] Dr. Robert Carpenter moved the fol-lowing resolution which passed unanimously:Resolved that the Georgia Dental Associationapprove up to five members to be chosen from

the BOT and/or past and present members ofthe ADA Delegation to attend a meeting to beheld in Texas of states concerned with estab-lishing a clear ADA course of action for stateswho are concerned with the proliferation ofproviders who lack appropriate education andcredentials.

[10-1.09] Dr. Byron Colley moved the followingresolution which passed unanimously: Resolvedthat the Board of Trustees direct the Presidentof the Georgia Dental Association to write andsend a letter of censure to the officers andBoard of Trustees of the American DentalAssociation for failing to develop a clear plan forstate associations to protect the patients thattheir members serve from under-educated enti-ties who would encroach on existing DentalPractice Acts. (Dr. Colley stated that the timingof the letter could follow the Texas meeting ifdeemed appropriate.)

Constitution and BylawsThe following motion failed: Resolved that theGDA Bylaws, Article I (Membership), Section 1(Classification) be amended to add a new categoryof membership called a “Non-Practicing DentistMember” as reported to the Board of Trustees.

Resolution 2010-06 (relates to Resolution2010-05): Moot since Resolution 2010-05 didnot pass.

Resolution 2010-07 Establish a standingcommittee (passed): Passed on motion by Dr.Celia Dunn: Resolved that the GDA Bylaws,Article VI (Committees), Section 1 (StandingCommittees), Part H be amended by adding“15. Committee on Oral Health in InstitutionalSettings” to the list of Standing Committees.

Resolution 2010-08 Policy manual changesfor new standing committee (passed): Passed onmotion by Dr. Celia Dunn: Resolved that theGDA Policy Manual be amended as reported tothe Board of Trustees. [The policy manual forthe new Committee on Oral Health inInstitutional Settings is available for viewing atwww.gadental.org in the Committees section.]

Resolution 2010-09 ADA DelegationPolicy Manual (failed): The following resolutionfailed: Resolved that the ADA DelegationPolicy Manual (as found in the GDA PolicyManual) be amended as reported to the Boardof Trustees. (Note: this Policy Manual changedealt with the removal of ADA Delegation vot-ing privileges for the GDA Vice-president andSecretary/Treasurer).

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NominatingDr. Kent Percy reported that the NominatingCommittee submitted for information only thefollowing candidate: Dr. Sidney Tourial forGDA vice president. Voting will occur at theJuly 23, 2010, GDA Business Meeting at theAnnual Meeting.

The Nominating Committee received thenomination and accompanying CV from the fol-lowing candidate, who is in good standing, forelection by the House of Delegates: At-largeAlternate Delegate position (term expires 1/14):Dr. Pete Trager. The House of Delegates elect-ed Dr. Pete Trager for the ADA At-largeAlternate Delegate position (term expires 1/14).

Resolution 2010-12 Board of Trustees(passed): Passed on motion by Dr. Kent Percy:Resolved that the following candidates beapproved for a three-year term of office on theGDA Board of Trustees effective July 25, 2010:Dr. Robin Reich, Northwestern District (termexpires 7/13); Dr. Robert Carpenter, WesternDistrict (term expires 7/13).

Resolution 2010-13 ADA Delegation(passed): Passed on motion by Dr. Kent Percy:

Resolved that the following candidates be elect-ed to the ADA Delegation: Dr. RobertCarpenter (Western District Delegate, termexpires 1/14 first term); Dr. Carol Wolff(Northern District Delegate, term expires 1/14second term); Dr. Richard Weinman (NorthernDistrict Delegate, term expires 1/14 secondterm); Dr. Mark Ritz (Southwestern DistrictDelegate, term expires 1/14 first term); Dr. JimReynierson (Eastern District Delegate, termexpires 1/11 third term); Dr. Marshall Mann(Northwestern District Alternate Delegate,term expires 1/14 second term); Dr. JonathanDubin (Northern District Alternate Delegate,term expires 1/11 first term); Dr. AnnetteRainge (Eastern District Alternate Delegate,term expires 1/11 first term).

Resolution 2010-14 Georgia Board ofDentistry (passed): Passed on motion by Dr.Kent Percy: Resolved that the following candi-dates be approved for submission to the gover-nor for consideration as members of theGeorgia Board of Dentistry: Western DistrictDrs. Leo C. Berard, James I. Lopez, William D.Campbell, Gerald A. Adams.

Awards CommitteeResolution 2010-10 Honorable Fellows(passed): Passed on motion by Dr. MarvinWinter: Resolved that the following dentists be

awarded GDA Honorable Fellowship in 2010:Daren J. Becker, DMD (Northern), Mark A.Lawrence, DDS (Western), Jason B. Oyler,DMD (Northwestern), Michael W. Yarbrough,DMD (Northern).

Resolution 2010-11 Community Service Awards(passed): Passed on motion by Dr. MarvinWinter: Resolved that the following dentists beawarded GDA Community Service Awards in2010: Jonathan S. Dubin, DMD, and Isaac F.Holton Jr., DMD.

AdjournmentBeing no further business, the House ofDelegates adjourned at 3:30 p.m. The nextmeeting is scheduled for Thursday, July 22,2010, 9 a.m. at the Ritz Carlton Amelia Island,Florida.

MINUTESContinued from page 33

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classified ads

DENTISTS AVAILABLEFOR LOCUM TENENS

Dentist Available Daily (DAD): Dentistavailable during vacations, emergenciesand CE courses. Leave your practice inwell-trained hands. I am licensed, insuredand have a DEA registration number so Ican write prescriptions. Call Dr. RichardPatrick at (770) 993-8838.

Dentist will fill in for illness, vacation,or continuing education. Licensed,insured, DEA #. Call (404) 786-0229 oremail [email protected].

Dentist available during emergencies,vacation, CDE courses. I have a currentlicense, DEA certificate, and insurance.Contact me at (706) 291-2254 or cell (706)802-7760. I hope I can be of service to you.Patrick A. Parrino, DDS, MAGD.

DENTAL RELATEDSERVICES

X-RAY SAFETY CERTIFICATION fordental assistants. Complies 100% withGeorgia law. This six-hour course has cer-tified over a thousand x-ray machine oper-ators. Send $149.99 per registrant withname(s) to: Dr. Rick Waters, 385Pinewood Circle, Athens, GA 30606. Visitwww.gaxray.com for credit card paymentor the NEW! on-line version. Call (706)255-4499 for more information.

POSITIONS AVAILABLE

An associate is invited to work /become a partner / buy into two verybusy practices—Conyers / Covington, GA.Great traffic, Visible locations, Digitalequipment, Well maintained, Teamenvironment, Dedicated staff, Flexiblehours, Lab-on-site. A huge patient base,thousands of patients by referrals,unbelievable walk-in patients. Fax:(770) 760-9810 Call: (770) 393-9111Email: [email protected].

PRACTICES / SPACE /LOTS FOR SALE / LEASE SHARE

For sale: Well-established PediatricDental Practice in suburban area south-west of Atlanta, GA. For details contact(770) 823-3850.

Well established practice for sale inNorthlake Tucker area. Strictly fee forservice, no managed care plans. 2300 sq.ft. at $10 / sq. ft. Motivated seller due todisability. Send inquiries and resume [email protected] or call (770) 641-1666.

Duluth, GA. Modern Pediatric DentalOffice Space—2620 sq ft and lots of stor-age. With Lease Hold Improvements,Equipment, Furnishings. Easy start upwith min. costs. High traffic area nearGwinnett Place Mall. Available August2010. Tammy or Fran at (770) 497-9111.

Duluth, GA. Upscale Dental OfficeSpace Available—1730 sq.ft. 6 ops: WithLease-Hold Improvements, Equipment,Furnishings. Great opportunity to startpractice with min. start-up costs. Highexposure near Gwinnett Place Mall.Available For Practice May / June 2010.Tammy at Dr. Finkel’s office (770) 497-9111.

Atlanta Galleria-Cobb County—Dentaloffice available immediately. 2,242 squarefeet with 5 plumbed treatment rooms inGalleria 100. Class A office building withFree Parking at the crossroads of I-75 andI-285. Visit our web site for more detailswww.AtlantaGalleria.com or call ConnieEngel with Childress Klein Properties at(770) 859-1203 for a tour of our property.

Space available: 2500-3500 s.f. Class Afinished dental space available in a highvisibility center in Hiram. Already has aG.P., Periodontist / Endodontist. Suitablefor another G.P. or a specialist. Landlordwilling to modify space to suit needs of thetenant. Also, dental space available off I-85/ Clairmont Road in Atlanta. 2,000 s.f. alsoavailable in Cartersville. (678) 640-5466.

How GDA members canplace classified ads

AD FORM: Submit all ads on a GDA ClassifiedAdvertisement Form. To obtain aform, call Courtney Layfield at (800)432-4357 or (404) 636-7553, or [email protected]. (Note: The GDAmay accept or reject any ad for any reasonand in its sole discretion.)

AD DEADLINE: Ads and ad check payments are due by thefirst of the month before the publicationmonth (i.e., Dec. 1 for January).

AD RATES: ADA member dentists pay $75.00 per60-word ad per month. There is a 25 centsper-word charge for each word over 60.Non-dentist-owned companies (real estatefirms, etc.) pay $195 per 60-word ad permonth (additional word charges as above).Non-member dentists may notplace ads.

LATE FEE:Ads for which full prepayment is notreceived by the first day of the ad’spublication month (i.e.; Nov. 1 for aNovember ad) will incur a $25 late fee inaddition to the ad rate.

FORMS OF PAYMENT: Submit a check or money order with the adform. (Make checks payable to GDA.)Credit cards are not accepted as payment.

WEB SITE PLACEMENT: Prepaid ads will appear on the GDA Website www.gadental.org for the month thead appears in print. Non-prepaid ads willNOT be placed online.

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Kennesaw/Cobb County: Beautiful den-tal suite available immediately. 3 operato-ries plumbed. Suite is available for sale /lease / rent to any dental specialist. Sale ispreferable. Contact Dr Kay Kalantari at(404) 452-0786.

SPECIALISTS: North Georgia Mountains.Space available for rent in growing area.Five equipped operatories, business officeand reception furniture in place, wired foryour computer system, ready to move rightin. Eye-catching two story glass building inhigh-traffic area. One general dentist and agovernment agency already in building.Great for satellite office, solo or shared, orfull-time. (706) 745-6848.

Available: ATLANTA: Partnership. $2.4million FFS practice. 9 operatories. EASTCOBB: Grossing $854,000. FFS, 6 opera-tories. GWINNETT: Grossing $823,000, 8operatories. JOHNS CREEK: Gorgeous, 4operatories grossing $289,000. JOHNS

CREEK: Merger opportunity. FFS grossing$900,000. NORCROSS: Grossing $580,000,4 operatories. SNELLVILLE: Grossing$569,000, FFS, 5 operatories. ContactRichane Swedenburg, New South DentalTransitions: (770) 630-0436, Check web sitefor all listings: www.newsouthdental.comor email [email protected].

Practices for Sale: ATLANTA #6276Gross collections $240,015; 4 days; 3 oper-atories; 926 sq. ft. office space. ATLANTA#6723 Gross collections $1.22 Million; 5days; 8 operatories; 2,898 sq. ft. officespace. ATLANTA #8575 Gross collections$456,922; 4 days; 5 operatories; 1,838 sq.ft. office space; additional plumbed butunequipped operatory. ATLANTA #8548Great opportunity! At $197,000 it is lessthan 1/2 the price of a start-up! 6 operato-ries; 1,900 sq. ft. office space. AUGUSTAAREA-ORTHO #8681 1 operatory / 2chairs; Gross collections $268,032; 3.5days, 960 sq. ft. office space. CARROLL

COUNTY #8428 Gross collections$619,384; 4 days; 4 operatories; 2,000 sq.ft. office space; additional plumbed butunequipped operatory. NW GEORGIA#8193 PRICE REDUCED! Gross collec-tions $1.04 Million; 4 days; 5 operatories;1,800 sq. ft. office space. NW GEORGIA#8562 Gross collections $670,375; 4 days;6 operatories; 2,881 sq. ft. office space;additional plumbed but unequipped oper-atory. SOUTHEASTERN GEORGIA#8172 Gross collections $752,638; 4 days;5 operatories; 1,732 sq. ft. office space. Forinformation, call Dr. Earl Douglas, (770)664-1982 or email [email protected].

Many Great Opportunities NowAvailable: Canton: Gross $400K; Southof Atlanta: Gross $1M; Hiram: Gross$550K; Gainesville: Gross $1M. CallSoutheast Transitions at (678) 482-7305 oremail [email protected] visit www.southeasttransitions.com formore details on these and other opportunities.

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Savannah general practitioner Dr. KevinBryant’s first snorkeling experience was inKey West around 1980 while he was aNavy dentist. “The unbelievable beautyfrom that first look through a dive maskwas what hooked me on getting underwaterto see the reef and its creatures,” he said.

After overcoming a concern that divingwith a tank would be a bit claustrophobic,Dr. Bryant took his first recreational divebeyond snorkeling depth in 1988. “I hadno idea what it was like in the recreationaldive depths,” he said. “It’s like a fantasyland. You can’t describe it. I think that isone reason so many divers try underwaterphotography.”

His first attempt to capture underwaterviews with a “real” underwater camera andstrobe (flash) was with a rental setup on atrip to Bonaire, an island near Venezuela.“The learning curve was steep in that pre-digital era,” said Dr. Bryant. “Boats thenwere routinely set up to develop colorslides for passengers. Even this luxurytypically required a day or two wait todiscover how the shots came out. Thedisappointments were often devastating.Still, having the ability to show your friendsand patients where you had been was worththe trouble, even if only one in 20 shots

turned out.” His patients especially enjoyedthat he printed his better shots anddisplayed them on his operatory ceilings.

Burnout on the hobby hit Dr. Bryantsomewhat “once I figured I had managedto photograph most of the things in thishemisphere that would hold still longenough to be photographed.” But whenhe came back to the hobby, after digitalphotography arrived, his hobby became alot more fun.

“With the large memory cards nowavailable, the battery charges in yourstrobes and camera are the only limitingfactors in how many photos you can takeon a dive,” said Dr. Bryant. “The closer youcan get to your subject, the better thephoto you can take. But, as you approach afish, it’s always a guess as to how close youcan get before his fear overcomes hiscuriosity. If you can snap several shots onthe way, the embarrassment of getting onlya ‘tail shot’ dramatically lessens.”

Dr. Bryant’s most recent dive tripwas to West Palm Beach, Florida, aroundAugust 2009 with a couple of rookie diverfriends. “In spite of all the lugging oftanks on and off the boats and the poten-tial of seasickness, the rookies had such agreat time that I got a kick out of it, too. I

even got a few shots of things I hadn’tseen before.”

One bonus to living in Savannah is thatthe drive from that city to the northernmostreef diving in southeast Florida isn’t muchover six hours. “I wouldn’t have pursuedthe hobby if I lived significantly further away,or had to put up with cold water diving theway folks up north do. Probably two-thirdsof my diving has been in the Caribbeanand Bahamas, and about one-third insouth Florida. Several of the ‘liveaboards,’which are diving boats that one lives aboardas opposed to staying in a hotel, actuallyleave out of Florida, making it unnecessaryto get on an airplane. My all-time favoriteliveaboards, the Nekton boats, leave out ofFort Lauderdale. That’s good, consideringall the fragile, heavy, expensive gear that canget lost or broken on the way if you fly.”

Dr. Bryant uses a Canon Rebel XTicamera, Ikelite housing with Ikelite strobes,a Sigma 50mm lens, and occasionally aTokina 10-17mm lens when he dives.“Color is gradually lost as one dives deeper,”said Dr. Bryant. “Red is pretty well gone by30 feet. By 60 or so feet, almost everythingappears to be some shade of blue. The strobesallow all the real color to be captured, althoughthe strobe flash must be within about sixfeet of the subject for it to do any good.”

Interestingly, however, Dr. Bryant hasfound that much of that missing color, if adiver hasn’t gone too deep, can be re-foundwith the use of Photoshop-type software.“There is a lot of learning to do with thisaspect of the hobby, but photo manipulationhas also made it a completely differenttype of hobby,” he said. “I have wasted alot of time playing with my photos onceI’ve gotten home from the trips. It seemsto help make the trip last longer.”

Visit www.gadental.org to view more ofDr. Kevin Bryant’s amazing underseaimages. And email Delaine Hall [email protected] to submit informationfor a future “Breaking the Mold.”

breaking the mold

Snaring Superb Undersea Scenes a Labor of Lovefor Savannah’s Dr. Kevin Bryant

Dr. Kevin Bryant deploys his camera and pair of Ikelite strobes to document a sharkencounter (photo by Captain Jim Abernethy).

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Suite 200, Building 17, 7000 Peachtree Dunwoody RoadAtlanta, Georgia 30328-1655

www.gadental.org

ACTIONInside This Issue

• State Legislative Update

• Health Care Reform: The Impact on Dentistry

DATED MATERIALPLEASE DELIVER AS SOON AS POSSIBLE

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gda action

Documents

dental cmos12

dental care alliance

dentistry25 gda

actionthe journal

executive directordelaine

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peachtree dunwoody rd

issuesdriven journal